OBJECTIVES: Estimation of the anterior lower uterine segment (LUS) thickness difference who underwent prior cesarean delivery measured with transvaginal sonography at or after 36 gestational weeks (sonographic thickness) and a ruler during elective cesarean section (operation thickness) Methods: One hundred sixty women who underwent prior cesarean delivery had the thickness of their LUS measured with transvaginal sonography at or after 36 gestational weeks. The LUS thickness was measured with a ruler during elective cesarean section. We compared group I whose LUS was fairly well visualized 4 cm or more from the uterine cervix to group II which had less than 4 cm. RESULTS: The mean sonographic thickness of LUS was 1.7 0.8 mm and that of operation thickness was 1.9 0.5 mm. The mean difference of the two (thickness difference) was 0.5 0.5 mm. In 31.3% the sonographic thickness was same as the operation thickness and in 70.7% of the total with 0.5 mm or less difference, the sonographic thickness could be regarded as accurate. The thickness difference with the sonographic thickness with 2 mm or more was smaller than those with 1 mm or less (0.4 0.5; 0.6 0.6) and that of group I was smaller than that of group II (0.4 0.4; 0.9 0.6) (p< .05). CONCLUSION: The thickness difference was 0.5 0.5 mm and it was smaller when the LUS thickness is 2 mm or over, clearly visible 4 cm or over from the cervix.
Cervix Uteri ; Cesarean Section ; Cicatrix* ; Female ; Humans ; Pregnancy ; Ultrasonography*

Most renal carcinomas are thought to originate from the epithelial cells of proximal convoluted tubules in the renal cortex. Collecting duct carcinoma is a recently recognized histological variety of renal cell carcinoma considered to arise from the epithelium of the collecting ducts. It is important to distinguish the collecting duct carcinoma from ordinary renal cell carcinoma, because which has an aggressive clinical course with early metastasis and death. But in patients, the natural course of the disease and its response to treatment have not been clearly established. Herein we report a case of collecting duct carcinoma of kidney in 38-year-old woman who had generalized edema and left flank dull pain. The preoperative diagnosis was left renal cell carcinoma on physical examination and radiologic finding, and left radical nephrectomy was done.
Adult ; Carcinoma, Renal Cell* ; Diagnosis ; Edema ; Epithelial Cells ; Epithelium ; Female ; Humans ; Kidney* ; Neoplasm Metastasis ; Nephrectomy ; Physical Examination

Juvenile xanthogranuloma is a congenital or perinatal tumor, 1 to 2 cm in diameter, usually located on the head. The extracutaneous lesions can occur on the eye, the lung, the epicardium, the oral cavity or the testicles. Subcutaneous form of juvenile xanthogranuloma has been reported very rarely in the literature. We report a unique case of a subcutaneous juvenile xanthogranuloma that showed 4 × 4 cm sized plaque and located on the extremity of 9-year-old girl.
Child ; Extremities ; Female ; Head ; Humans ; Lung ; Mouth ; Pericardium ; Testis ; Xanthogranuloma, Juvenile*

PURPOSE: The purpose of this study was to measure home health resource utilization using a Case-Mix Adjustor Model developed in the U.S. METHOD: The subjects of this study were 484 patients who had received home health care more than 4 visits during a 60-day episode at 31 home health care institutions. Data on the 484 patients had to be merged onto a 60-day payment segment. Based on the results, the researcher classified home health resource groups (HHRG). RESULT: The subjects were classified into 34 HHRGs in Korea. Home health resource utilization according to clinical severity was in order of Minimum (C0) < 'Low (C1) < 'Moderate (C2) < 'High (C3), according to dependency in daily activities was in order of Minimum (F0) < 'High (F3) < 'Medium (F2) < 'Low (F1) < 'Maximum (F4). Resource utilization by HHRGs was the highest 564,735 won in group C0F0S2 (clinical severity minimum, dependency in daily activity minimum, service utilization moderate), and the lowest 97,000 won in group C2F3S1, so the former was 5.82 times higher than the latter. CONCLUSION: Resource utilization in home health care has become an issue of concern due to rising costs for home health care. The results suggest the need for more analytical attention on the utilization and expenditures for home care using a Case-Mix Adjustor Model.
Risk Adjustment ; Middle Aged ; Male ; Korea ; Humans ; Home Care Services/*utilization ; Health Resources/*utilization ; Female ; Aged, 80 and over ; Aged ; Adult

BACKGROUND: The psychosocial factors to the musculoskeletal disease has been studied recently as well as environmental factors. Type A behavior pattern which is an independent risk factor for coronary heart disease may have relation to musculoskeletal disease, and the authors studied the relations for these variables. METHODS: The studied subjects were 511 housewives sampled without intention at Taejon city and we excluded 76 persons who had experiences of trauma at neck, shoulder or back region during recent one year on the data analysis. The musculoskeletal symptoms and type A behavior pattern were quantified as the score and the Spearmans correlation coefficient was used to reveal the statistical significance for the relations. RESULTS: Type A behavior pattern had the relation to the symptoms of neck, sboulder, and back region. For the sociodemographic variables, the relations were significant for the group of younger age, lower socioeconomic level, and the group having full time job, lower body mass index. CONCLUSIONS: We concluded that type A behavior pattern was the possible risk factor for musculoskeletal disease, but more studies will be necessary to confirm the influence of behavior pattern to musculoskeletal disease.
Body Mass Index ; Coronary Disease ; Daejeon ; Humans ; Intention ; Musculoskeletal Diseases ; Neck ; Psychology ; Risk Factors ; Shoulder ; Statistics as Topic

Contusions ; Facial Bones ; Facial Nerve ; Facial Nerve Injuries ; Facial Paralysis ; Humans ; Incidence ; Lacerations ; Orbit ; Salivary Glands ; Skin ; Soft Tissue Injuries ; Wounds and Injuries

In order to observe the development of ventricular arrhythmia during regional myocardial ischemia and reperfusion, especially under the presence or absence of ST-T electrical alternans on epicardial EKG. The proximal left descending coronary artery(LAD) was ligated for 20 minutes and then reperfused suddenly in twenty-three cats. Standard lead EKG(Lead??, chest lead EKG and epicardial lead EKG were recorded simultaneously during the occlusion and reperfusion respectively. During the ligation of LAD, STEA was observed in thirteen cats(56.5%). In occlusion period, the incidence of ventricular tachycardia in STEA positive group was significantly higher than in the negative group(p<0.01) and arrhythmic score was significantly higher(p<0.005) also In the reperfusion period the incidence of vefntricular fibrillation in STEA positive group was significantly higher than in the negative group(p<0.025). But there was the tendency to be higher in arrhythmic score of STEA positive group. There were no differences in heart rate, systolic left ventricular pressure, ST elevation and ST width in both groups. Most forms of ST-T of sinus rhythm before and after development of ventricular premature beat was low form(L). It was concluded that at the presence of STEA on EKG, the incidence of ventricular arrhythmia was more prevalent. So, STEA can be available as a marker of ventricular arrhythmia and prognostic factor.
Animals ; Arrhythmias, Cardiac* ; Cardiac Complexes, Premature ; Cats ; Electrocardiography* ; Heart Rate ; Incidence ; Ligation ; Myocardial Ischemia ; Reperfusion ; Tachycardia, Ventricular ; Thorax ; Ventricular Pressure

PURPOSE: To describe an unusual case of rapidly progressive outer retinal necrosis (PORN) with vitreous hemorrhage in a 41-year-old woman with acquired immunodeficiency syndrome (AIDS), who had retinitis developed from what was probably varicellar-zoster virus combined with cytomegalovirus (CMV) and herpes simplex type 1,2, as proven by the polymerase chain reaction restriction fragment length polymorphism method (PCR-RFLP). METHODS: This study is a case report detailing clinical follow-up and an aqueous humor test by PCR-RFLP. RESULTS: The deep, white retinal lesions coalesced and progressively expanded in a circumferential manner, with sparing of the perivascular retina. However, retinal and vitreous hemorrhages, unusual findings for PORN, could be noted around the optic nerve. Varicellar-zoster virus (VZV), cytomegalovirus (CMV), and herpes simplex types 1,2 (HSV-1,2) were detected in the aqueous humor by PCR. CONCLUSIONS: PORN has been described as a variant of necrotizing herpetic retinopathy, occurring particularly in patients with AIDS. Although the etiologic agent has been reported to be VZV, concurrent or combined etiologic agents can include HSV-1, HSV-2, and CMV in AIDS patients. Therefore, combined antiviral therapy with acyclovir and ganciclovir could be more reasonable as an initial therapy.
Vitreous Hemorrhage/*complications ; Retinitis/*complications/pathology/*virology ; Necrosis ; Humans ; *Herpes Zoster ; Female ; Disease Progression ; Adult ; Acquired Immunodeficiency Syndrome/*complications

In order to understand the role of the upstream region of the Mycobacterium leprae 18-kDa gene on the gene regulation, the region was divided into two at the -50 position from the first start codon of the gene and their effect on transcription was examined by using a LacZ transcriptional reporter gene assay. The presence of each of these two regions conferred transcription repression not only on its cognate M. lepraerae 18-kDa gene promoter, but also on a heterologous promoter such as the Mycobacterium bovis BCG hsp65 gene promoter. Moreover, it was found that these regions could confer transcription repression activity in both cases in an orientation-independent manner. Thus, these results indicate that the upstream region of the M. leprae 18-kDa gene harbors transcription repression responsive element(s) acting as an operator and can be further divided into two separately functional regions, suggesting a bipartite structure of the element(s). The identification of transcription repression activity of the upstream region in the M. leprae 18-kDa gene will contribute greatly for the understanding of the 18-kDa gene regulation mechanism, and provide also useful information for the manipulation of mycobacterium gene expression.
Bacterial Proteins/*genetics ; Down-Regulation/*genetics ; *Gene Expression Regulation, Bacterial ; Mycobacterium leprae/*genetics ; Response Elements/*genetics ; Transcription, Genetic

Cleidocranial dysplasia is a rare and autosomal dominent disorder characterized by aplasia or hypoplasia of the clavicles, an open fontanelle, dental abnormalities, and short stature. A 17-year-old female who presented with short stature and subsequent delay in eruption of permanent teeth is described. she showed the abnormal hypermobility of the shoulder, ocular hypertelorism and concave nasal bridge. Radiographs revealed the underdeveloped maxilla, defect of the cranium in the fontanelle region, and aplasia of the clavicles. Characteristically, panoramic view revealed near parallel-sided borders of the ascending ramus and downward curvature of the zygomatic arch with hypoplasia. The prolonged retention of deciduous teeth with delayed eruption of permanent teeth and multiple embedded supernumerary teeth were striking. Radiographic and clinical investigations revealed Cleidocranial dysplasia.
Adolescent ; Clavicle ; Cleidocranial Dysplasia* ; Female ; Humans ; Hypertelorism ; Maxilla ; Radiography, Panoramic ; Shoulder ; Skull ; Strikes, Employee ; Tooth ; Tooth, Deciduous ; Tooth, Supernumerary ; Zygoma