Birth injury is defined as any condition that affects the fetus adversely during the labor or delivery. Clavicle fracture during the delivery can be found in 0.49-0.95% if all living newborns. The objectives of this study were to identify and prevent the contribution facture during delivery. We obtained 98 patients of the clavicle fracture among the 13,698 neonates delivered at P.M.C from March. 1991 to Feb. 1994. We analysed the 98 patients of the clavicle fracture with 857 control group according to neonatal factors, maternal factors and methods of delivery. The results were as follows ; 1. Of all the cases of the clavicle fracture, the site of the fracture was middle 1/3 of the clavicle and majority of the fracture were displaced(82.5%). 2. Birth injuries which were associated with clavicle fracture were increased than those without clavicle fracture in brachial plexus injuries, scalp and intracranial hemorrhage, and skull fracture. 3. Contributing factors which were increased the fracture of the clavicle during the delivery were as follows; i) Maternal age over 37 years and below 24 years. ii) Gestational age over 40 weeks (especially over 42 weeks) iii) Birth weight over 3500kg. 4. The proportion of the vacuum extraction during the delivery was nearly double times in patient group than in control group.
Birth Injuries ; Birth Weight ; Brachial Plexus ; Clavicle ; Fetus ; Gestational Age ; Humans ; Infant, Newborn ; Intracranial Hemorrhages ; Maternal Age ; Scalp ; Skull Fractures ; Vacuum

Chromosomal abnormalities are higher in twin gestations than in the singleton population. Turner's syndrome(gonadal dysgenesis) variety may result from chromosome loss during gametogenesis in either parent or a mitotic error during one of the early cleavage divisions of the fertilized zygote. The vast majority of 45, XO conceptions result in first or second-trimester miscarriage. Fetuses with Tumer's syndrome commonly exhibit posterior nuchal cystic hygromas and generalized edema. Recently we experienced one fetal demise in twin pregnancy. The affected fetus was associated with Turner's syndrome which was diagnosed by amniocentesis and karyotyping. The fetus was associated with cystic hygroma which was antenatally diagnosed by ultrasonogram. The unaffected fetus had normal karyotype and was delivered through cesarean section without any abnormalities. we report this case with brief review of literatures.
Abortion, Spontaneous ; Amniocentesis ; Cesarean Section ; Chromosome Aberrations ; Edema ; Female ; Fertilization ; Fetus ; Gametogenesis ; Humans ; Karyotype ; Karyotyping ; Lymphangioma, Cystic ; Parents ; Pregnancy ; Pregnancy, Twin* ; Turner Syndrome ; Ultrasonography ; Zygote

BACKGROUND: There is a clinical need for a simpler measurement of global cardiac function incorporating elements of both systole and diastole. Doppler time index is theoretically regarded as a sensitive index of global left ventricular perfomance and defined as the sum of isovolumetric contraction time (IVCT) and isovolumetric relaxation time (IVRT) divided by ejection time (ET). This study was designed to determine the clinical usefulness of the Doppler time index in patients with left ventricular diastolic dysfunction as well as systolic dysfunction. METHODS: The study population consisted of 23 patients with hypertension as a diastolic dysfunction group, 16 patients with low ejection fraction as a systolic dysfunction group and 31 subjects with normal LV function. The ejection fraction (EF) was measured using M-mode echocardiography. Doppler profiles such as IVCT, IVRT and ET were obtained from Doppler echocardiography. The Doppler time index [ (IVCT+RT)/ET] was calculated from each Doppler velocity profiles. RESULTS: IVRT, IVRT/ET and (IVCT+VRT)/ET were significantly increased in the diastolic dysfunction group (120.5+/-19.5 msec, 0.45+/-0.1, 0.64+/-0.2, respectively:p<0.001, p<0.001, p<0.001, respectively) compared with normal subjects (66.1+/-17.4 msec, 0.25+/-0.0, 0.41+/-0.1). IVCT and IVRT were significantly increased and ET was significantly shortened in systolic dysfunction group (75.4+/-25.7, 144.0+/-39.5 msec, 242.7+/-46.5 msec respectively:p<0.001, p<0.05, p<0.05, respectively) compared with diastolic dysfunction group (50.4+/-23.0 msec, 120.5+/-19.5 msec, 276.8+/-44.6 msec, respectively). IVCT/ET, IVRT/ET and (IVCT+IVRT)/ET also were increased in patients with systolic dysfunction group (0.32+/-0.1, 0.61+/-0.2, 0.93+/-0.2 respectively:p<0.01, p<0.01, p<0.001, res-pectively) compared with diastolic dysfunction group (0.19+/-0.1, 0.45+/-0.1, 0.64+/-0.2). Ejection fraction calculated by M-mode parameters was significantly correlated with (IVCT+IVRT)/ET (correlation coefficient - 0.605, p<0.001). CONCLUSION: The Doppler time index was significantly difficient from normal subjects in patients with isolated LV diastolic dysfunction as well as in those with systolic dysfunction. Thus, this index can be used as a sensitive indicator of myocardial performance.
Diastole ; Echocardiography ; Echocardiography, Doppler ; Humans ; Hypertension ; Relaxation ; Systole ; Ventricular Dysfunction, Left

The incidence of gonorrhea has increased significantly in recent years in the United States, especially among sexually active twenty-year-olds. Although the incidence of gonorrhea has decreased in Korea since the early 2000s, it is still common among people in their twenties. Nucleic acid amplification test (NAAT) is the most sensitive diagnostic test for detecting gonococcal infection. Gram-staining is a simple and useful laboratory test for diagnosing symptomatic male gonococcal urethritis. Although bacterial culture can be used to detect antimicrobial susceptibility, its sensitivity is lower than that of NAAT. Treatment for uncomplicated gonorrhea infection is a single intramuscular injection of ceftriaxone 500 mg. Doxycycline (100 mg twice daily for 7 days) is added if there is a possibility of co-infection with chlamydia. If ceftriaxone is difficult to use, spectinomycin 2 g can be injected intramuscularly in Korea. Patients with gonorrhea should have repeated examinations within three months at the exposure site because of a high risk of re-infection. A person diagnosed with gonorrhea should discuss the nature of the infection, the importance of informing partners, when sexual activity can resume, and how to reduce the risk of sexually transmitted infections.

PURPOSE: To elucidate host immune responses to intradiscal gene transfer. MATERIALS AND METHODS: Twenty rabbits were utilized. Ad/luciferase (adenovirus construct) were injected into nucleus pulposus of lumbar vertebrae. Group 1 received intradiscal injection of Ad/luciferase only, Group 2 received subcutaneous and intradiscal injection simultaneously, Group 3 received subcutaneous injection then intradiscal injection with 2 weeks interval. Blood samples were obtained serially after injection. Animals were sacrificed at 7 weeks. Antibody to adenovirus in peripheral blood was measured with ELISA and transgene expression was measured with standard luciferase kits. RESULTS: All rabbits in the Group 2 and 3 exhibited increased production of neutralizing antibody. There were clearly two subgroups in Group 1, three rabbits exhibited production of antibody but remaining three rabbits showed little or no production of antibody. All rabbits showed robust increase in transgene expression regardless of titer of neutralizing antibody. CONCLUSION: The intervertebral disc is favorable site for adenovirus-mediated gene transfer escaping from systemic immunity.
Adenoviridae ; Animals ; Antibodies, Neutralizing ; Enzyme-Linked Immunosorbent Assay ; Injections, Subcutaneous ; Intervertebral Disc ; Luciferases ; Lumbar Vertebrae ; Rabbits ; Transgenes ; United Nations

OBJECTIVES: To investigate the prevalence of cognitive impairment and dementia in elderly people, aged 65 or above, residing in Busan Metropolitan City. METHODS: Total of 1, 101 old people, aged 65 or above, living in Busan as of December 31, 2001 were selected using stratified three-stage cluster sampling. Cognitive impairment was determined from the MMSE-K score, and dementia confirmed from five psychometric measures and the Barthel index. The crude prevalence, sex-age adjusted for the Korean population, were obtained. RESULTS: With the cut-off point for cognitive impairment was set at 24 points, or below, on the MMSE-K scale, the crude rate of cognitive impairment was 29.3% (15.7% for men and 37.5% for women), and the sex-age adjusted prevalence was 30.5% (17.5% for men and 37.0% for women). When the cut-off point for cognitive impairment was set at 20 points, or below, on the MMSE-K scale, the crude rate of cognitive impairments were 10.0% (4.1% for men and 13.5% for women), and 10.6% (4.7% for men and 13.1% for women), respectively. The crude dementia, and the sex-age adjusted rates were 7.4% (2.4% for men and 10.5% for women), and 8.0% (2.7% for men and 10.0% for women), respectively. CONCLUSIONS: The prevalence of dementia in this study was somewhat lower than that reported by other domestic and foreign studies. Our results related to the difference in time and space, diagnostic tools, response rates, and distribution of male and female subjects, etc.
Aged* ; Busan* ; Cognition Disorders* ; Dementia* ; Female ; Humans ; Male ; Prevalence* ; Psychometrics

BACKGROUND: Korean Nosocomial Infections Surveillance System (KONIS) operating since July 2006 is the first nationwide monitoring system for nosocomial infections in the in the intensive care unit (lCU) with a standard protocol and web-based prompt response network in Korea. This report describes the characteristics of the KONIS hospitals compared with those of all Korean hospitals with 400 beds and over. METHODS: A survey was conducted for the 44 hospitals participating in KONIS 2006, and the data were rechecked by the KONIS hospitals through KONIS web-network. The survey form included questions about the size of the hospital, infection control personnel, nursing personnel, and the status of microbiologic laboratory. RESULTS: Compared to all Korean hospitals with 400 beds and over, the KONIS hospitals were larger in term of average number of beds (857 vs 654); the number of hospitals with 700 beds and over was over-represented in Seoul (P=0.01) and under-represented in the central/south area (P<0.001) The majority of the KONIS hospitals were major teaching university-affiliated (88,6%) and private (72.7%), but in the central/south area, public hospitals comprised up to 60%. The number of infection control professionals (ICP) averaged 1.6, hospital beds per ICP 531, and infectious disease physicians 1.3. Medical and medical combined ICUs were the major component (67,1%) of the KONIS ICUs, The lCU bed per nurse was 0.63. CONCLUSION: The KONIS 2006 hospitals were over-represented in the overall indicators in Seoul. Because no objective indicators were available regarding the patient quality, KONIS data must be interpreted in consideration of all indicators.
Communicable Diseases ; Cross Infection* ; Hospitals, Public ; Humans ; Infection Control ; Intensive Care Units ; Korea ; Nursing ; Seoul

OBJECTIVE: To estimate the prevalence of osteoarthritis (OA) and rheumatoid arthritis (RA) in Korean. METHODS: Those who participated arthritis/allergy field study in Icheon, Kyunggi Province and Goesan, Chungbuk Province in 2001 were evaluated for the prevalence of arthritis. Diagnosis of OA and RA were made using American College of Rheumatology criteria. RESULTS: Among the 983 participants (mean age+/-SD, 49.9?14.0 years), 498 participants were male (mean age 49.9+/-13.1 years) and 485 participants were female (mean age 49.9+/-15.0 years), and there was no difference of mean age between male and female. There were 153 cases of OA (15.6%, mean age, 61.6+/-9.5), which consisted of 44 male cases (mean age, 58.9+/-10.7) and 109 female cases (mean age, 62.7+/-9.5). Prevalence of OA was significantly higher in female compared to male (22.5% vs 8.8%, p<0.0001). Prevalence of OA in the 4th to the 8th decade was 1.1, 7.5, 19.4, 34, 37.2%, respectively and showed increasing trend in the ascending order of age in decade (p<0.001). Localization of OA was knees (77.1%), knees and hands (17.6%), and hands (5.2%). RA was detected in 14 cases (1.4%, mean age, 58.8+/-14.6, male to female 1:13). Prevalence of RA was significantly higher in female compared to male (2.7% vs 0.2%, p<0.01). CONCLUSION: The prevalence of knee or hand OA and RA were 15.6% and 1.4% in Korean, respectively. The prevalence of OA was significantly higher in female and aged individuals. The prevalence of RA was also significantly higher in female.
Arthritis ; Arthritis, Rheumatoid* ; Chungcheongbuk-do ; Diagnosis ; Female ; Gyeonggi-do ; Hand ; Humans ; Knee ; Korea* ; Male ; Osteoarthritis* ; Prevalence* ; Rheumatology

Objective: The 2019 Korean Emergency Medicine Residents Survey (KEMRS) is the first survey by the Korean Society of Emergency Medicine (KSEM) on the comprehensive satisfaction of their residents. Satisfaction is important not only for the personal well-being of the residents but also for patient safety. Methods: A total of 622 emergency medicine residents were surveyed, using both a paper and email questionnaire from May to August of 2019. Factors related to satisfaction were analyzed. Results: Of the responders, 66% said they would reapply for the emergency specialty and 51% said that they would reselect the same training hospital. The group of residents who said they would choose emergency medicine again felt that their expectations had been met and that they were comfortable with the choice of the specialty. They felt that the factors of satisfaction with their shift schedule and personal health played a more important role in their reselection of the training hospital than the workload. Conclusion The satisfaction levels of the Korean emergency residents were low. Thus, training hospitals should provide a reasonable working environment to increase their satisfaction. Also, it is important to create an environment where residents can feel rewarded and proud of the work they do.

Objective: The 2019 Korean Emergency Medicine Residents Survey (KEMRS) is the first survey by the Korean Society of Emergency Medicine (KSEM) on the comprehensive satisfaction of their residents. Satisfaction is important not only for the personal well-being of the residents but also for patient safety. Methods: A total of 622 emergency medicine residents were surveyed, using both a paper and email questionnaire from May to August of 2019. Factors related to satisfaction were analyzed. Results: Of the responders, 66% said they would reapply for the emergency specialty and 51% said that they would reselect the same training hospital. The group of residents who said they would choose emergency medicine again felt that their expectations had been met and that they were comfortable with the choice of the specialty. They felt that the factors of satisfaction with their shift schedule and personal health played a more important role in their reselection of the training hospital than the workload. Conclusion The satisfaction levels of the Korean emergency residents were low. Thus, training hospitals should provide a reasonable working environment to increase their satisfaction. Also, it is important to create an environment where residents can feel rewarded and proud of the work they do.