No abstract available.
Syphilis, Congenital*

OBJECTIVE: This study was performed to evaluate the effect of cervical cerclage and the clinical characteristics in incompetent internal os of the cervix (IIOC). METHODS: A study was conducted on 170 patients with IIOC, 199 cases of IIOC were admitted and treated with McDonald operation or modified Shirodkar operation at department of Obstetrics and Gynecology Il Sin Christian Hospital from January 1. 1994 to December 31. 1998, of this 14 cases were follow up lost, so 185 cases were analyzed. RESULTS: 1) The incidence of IIOC was 0.43%, 1 in 233 deliveries. 2) The mean age of IIOC patients was 30.54yrs old and the most frequent age group was in 30-34yrs old group (43.78%). 3) The average number of gravida and parity before operation were 4.71 and 1.62. & the success rate of operation was low at high gravida & parity. 4) The predisposing factor was previous history of dilation & curettage (43.75%), Cx. laceration after delivery (6.49%), midtrimester termination (4.32%) etc. 5) The operation methods were McDonald operation (91.35%) and modified Shirodkar operation (8.65%) & the success rate of McDonald operation and modified Shirodkar operation were 85.80% and 87.50%. 6) The successful fetal salvage rate was 85.95% and the highest success rate was 87.50% in 14-16 weeks of gestation group. 7) The more cervix dilate, the more failure occurred. 8) The causes of operation failure were premature rupture of membrane (50.00%), preterm labor (34.62%), FDIU, anomaly, APH etc. 9) The delivery methods after operation were vaginal delivery (65.54%), cesarean delivery (34.46%). CONCLUSION: The 14-16th weeks of gestation group & no cervical dilatation have higher success rate indicating that early diagnosis and appropriate timing of operation is associated with a greater operation success rate.
Causality ; Cerclage, Cervical ; Cervix Uteri* ; Curettage ; Early Diagnosis ; Female ; Follow-Up Studies ; Gynecology ; Humans ; Incidence ; Labor Stage, First ; Lacerations ; Membranes ; Obstetric Labor, Premature ; Obstetrics ; Parity ; Pregnancy ; Pregnancy Trimester, Second ; Rupture

No abstract available.
Ganglioneuroblastoma*

PURPOSE: To investigate the incidence of Terson's syndrome, to find the proper time for its treatment, and to give a prognosis of visual acuity. METHODS: In order to investigate the incidence of Terson's syndrome, 228 patients were taken as the subjects of this study from among the total 275 patients who had been hospitalized in the neurosurgical department for a year. Forty-seven patients were excluded who developed vitreous hemorrhage due to any cause other than intracranial hemorrhage and could not be followed up for three months. In the fundus examination of study subjects, the incidence of Terson's syndrome based on preceding diseases and the patient age, and prognosis of visual acuity with surgical treatment were analyzed according to the Snellen chart, along with nine eyes of seven patients who showed vitreous hemorrhage. RESULTS The average incidence of Terson's syndrome between groups was 3.1%; it was 3.7% for patients with subarachnoid hemorrhage and 2.6% for the other patients (subdural hemorrhage, epidural hemorrhage). The 29% of the subjects were due to binocular involved. Patients in their 40's and 50's accounted for 6.0%, which was higher the percentage of any other age group. The decision as to whether or not to surgically treat Terson's syndrome was made based on the extent of visual acuity improvement during the three months after vitreous hemorrhage development. Thus, we observed comparatively good long-term prognoses for visual acuity and a low frequency of complications occurring. CONCLUSIONS: We expect a relatively good prognosis of visual acuity and a low occurrence of complications. More research similar to this case-control study is needed to confirm the usefulness of such therapy.
Case-Control Studies ; Hemorrhage ; Humans ; Incidence* ; Intracranial Hemorrhages ; Prognosis* ; Subarachnoid Hemorrhage ; Telescopes ; Visual Acuity ; Vitreous Hemorrhage

PURPOSE: To investigate the incidence of Terson's syndrome, to find the proper time for its treatment, and to give a prognosis of visual acuity. METHODS: In order to investigate the incidence of Terson's syndrome, 228 patients were taken as the subjects of this study from among the total 275 patients who had been hospitalized in the neurosurgical department for a year. Forty-seven patients were excluded who developed vitreous hemorrhage due to any cause other than intracranial hemorrhage and could not be followed up for three months. In the fundus examination of study subjects, the incidence of Terson's syndrome based on preceding diseases and the patient age, and prognosis of visual acuity with surgical treatment were analyzed according to the Snellen chart, along with nine eyes of seven patients who showed vitreous hemorrhage. RESULTS The average incidence of Terson's syndrome between groups was 3.1%; it was 3.7% for patients with subarachnoid hemorrhage and 2.6% for the other patients (subdural hemorrhage, epidural hemorrhage). The 29% of the subjects were due to binocular involved. Patients in their 40's and 50's accounted for 6.0%, which was higher the percentage of any other age group. The decision as to whether or not to surgically treat Terson's syndrome was made based on the extent of visual acuity improvement during the three months after vitreous hemorrhage development. Thus, we observed comparatively good long-term prognoses for visual acuity and a low frequency of complications occurring. CONCLUSIONS: We expect a relatively good prognosis of visual acuity and a low occurrence of complications. More research similar to this case-control study is needed to confirm the usefulness of such therapy.
Case-Control Studies ; Hemorrhage ; Humans ; Incidence* ; Intracranial Hemorrhages ; Prognosis* ; Subarachnoid Hemorrhage ; Telescopes ; Visual Acuity ; Vitreous Hemorrhage

OBJECTIVE: Thoracic ossification of the ligamentum flavum (OLF) is a relatively rare disease. Because of ambiguous clinical symptom, it is difficult for early diagnosis of OLF and subsequent treatment can be delayed or missed. Therefore, the purpose of this study is to comprehensively assess the prevalence and distribution of thoracic OLF by magnetic resonance imaging (MRI) and coexisting spinal disease in Korean patients with back pain or leg pain. METHODS: The sample included 2134 Korean patients who underwent MRI evaluation for back pain. The prevalence and distribution of thoracic OLF were assessed using lumbar MRI with whole spine sagittal images. Additionally, we examined the presence of coexisting lumbar and cervical diseases. The presence of thoracic OLF as well as clinical parameters such as age, sex, and surgery were retrospectively reviewed. RESULTS: The prevalence of thoracic OLF in total patients was 16.9% (360/2134). The prevalence tended to increase with aging and was higher in women than in men. The lower thoracic segment of T10-11 was the most frequently affected segment. Of the 360 patients with OLF, 31.9% had coexisting herniated thoracic discs at the same level. Approximately 74% of the patients with OLF had coexisting lumbar and cervical disease. Nine (2.5%) of 360 OLF patients underwent surgery for thoracic lesion. CONCLUSION: The prevalenceof thoracic OLF was relatively higher than those of previous reports. And coexisting lumbar and cervical disease were very frequent. Therefore, we should check coexisting spinal diseases and the exact diagnostic localization of ossification besides lumbar disease.
Aging ; Back Pain ; Early Diagnosis ; Female ; Humans ; Leg* ; Ligamentum Flavum* ; Magnetic Resonance Imaging ; Male ; Prevalence* ; Rare Diseases ; Retrospective Studies ; Spinal Diseases ; Spine

OBJECTIVE: We report an analysis of the clinical outcome of surgical treatment of lumbar facet cyst. METHODS: From March, 1996 to June, 2001, we analyzed the symptom and sign, cyst level, combined disease, treatment method, pathology and surgical result(Prolo's scale) of 11 patients. RESULTS: Mean age of 11 patients was 55.6 years and mean follow up duration was 27 months. Of 11 patients, six cases had low back pain and five cases had radiating leg pain as chief complaint. Five had only facet cyst that compressed the nerve root without other combined diseases. Of six patients who had facet cyst with combined disease, three had intraspinal stenosis and the remaining three had spondylolytic spondylolisthesis. There was one case of bilateral facet cyst. We had totally excised facet cyst and treated combined degenerative disease such as lumbar stenosis, lumbar instability or spondylolytic spondylolithesis. The pathologic result were synovial cyst for eight cases and ganglion for three cases. In all cases, symptoms improved without complication or recurrence. CONCLUSION: Surgical outcome of lumbar facet cyst is good and surgical intervention is recommended in facet cyst with back pain, radiculopathy and combined degenerative diseases.
Back Pain ; Constriction, Pathologic ; Follow-Up Studies ; Ganglion Cysts ; Humans ; Leg ; Low Back Pain ; Pathology ; Radiculopathy ; Recurrence ; Spondylolisthesis ; Synovial Cyst

No abstract available.
Burns* ; Ear*

BACKGROUND: Type 2 diabetes mellitus is an expensive chronic metabolic disorder and its prevalence has been increasing rapidly in South Korea, owing to a westernized lifestyle. We analyzed the annual direct medical costs attributable to type 2 diabetes and its chronic complications in Korea retrospectively. METHODS: We randomly selected 1,051 patients with type 2 diabetes who visited Ajou University Hospital as an outpatient in 2005. Clinical characteristics, duration of diabetes, and microvascular and macrovascular complications were assessed from a medical chart review. The annual direct medical costs included insurance covered and uncovered medical costs. RESULTS: Of the 1,051 patients with type 2 diabetes, 48.2% had at least one microvascular complication, 5.6% had at least one macrovascular complication, and 12.4% of the patients had both microvascular and macrovascular complications. The average annual direct medical cost was found to be 3,348,488won per patient. In patients with microvascular complications, the total cost of management was increased 1.4 times compared to those without complications. Direct medical costs for patients with macrovascular complications were 2.1-fold as high as patients with no complications. Those patients with both microvascular and macrovascular complications, increased costs by 3.1-fold over those without complications. CONCLUSION: Chronic complications have a substantial impact on the direct medical costs of type 2 diabetes. The prevention of chronic diabetic complications will not only influence the mortality and morbidity of patients with type 2 diabetes, but also potentially reduce medical costs.
Diabetes Complications ; Diabetes Mellitus, Type 2 ; Humans ; Insurance ; Korea ; Life Style ; Outpatients ; Prevalence ; Republic of Korea

BACKGROUND: In gastric cancer, lymph-node status is the most important discriminant of patient outcome. In spite of its prognostic importance, lymph-node status is usually examined by a routine histological examination using only one hematoxylin and eosin (H-E) section prepared from a representative cut surface of each lymph node. In order to overcome this drawback, new means based on the polymerase chain reaction (PCR) have recently developed to detect micrometastases in lymph nodes. METHODS: Gastric cancer tissues and lymph nodes were obtained from 9 primary gastric adenocarcinoma patients who underwent gastric resection. A total of 80 lymph nodes and 9 gastric cancer tissues were analyzed by both histologic and molecular examination of keratin 19 mRNA. Regional lymph nodes obtained from patients with benign peptic ulcer perforation were used as normal control lymph nodes. RESULTS: 1) Keratin 19 mRNA was expressed in all patients with gastric cancers, but in none of the 10 normal control lymph nodes. 2) Keratin 19 mRNA was detected in all of the 8 lymph nodes which were histologically metastasis-positive. Of the 72 lymph nodes which were histologically metastasis- negative, 67 were found not to express keratin 19 mRNA, but 5 were found to express keratin 19 mRNA. 3) Especially, of the 3 early gastric cancers which were histologically metastasis-negative, one was found not to express keratin 19 mRNA, but two were found to express keratin 19 mRNA. CONCLUSIONS: Keratin 19 reverse transcripture (RT)-PCR a more sensitive method than histological examination for the detection of gastric micrometastases in lymph nodes and may serve as a useful clinical factor in establishing accurate staging for prognosis and in planning optimum management.
Adenocarcinoma ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans ; Keratin-19* ; Lymph Nodes* ; Neoplasm Micrometastasis* ; Peptic Ulcer Perforation ; Polymerase Chain Reaction ; Prognosis ; RNA, Messenger* ; Stomach Neoplasms*