OBJECTIVE: The aim of this study was to evaluate the role of lower uterine segment thickness in predicting an actual delivery date and to determine the factors affecting the depth of lower uterine segment. METHODS: Sixty patients with singleton gestation were weekly measured for their lower uterine segment (LUS), cervical length, cervical gland thickness and AFI by ultrasonography from 36 weeks. The regression analysis was carried to find out the relevance between LUS and the remaining days to birth and Pearson correlation analysis was performed for relevance between LUS and other factors such as maternal age, parity, cervical length, cervical gland thickness, and AFI. RESULTS: LUS became thin as cervical length decreasing. However, the relevance between LUS and other factors such as age, parity, cervical gland thickness, and AFI was not found. While individual LUS thickness is decreasing as delivery date becomes closer, LUS thickness as a group is found not to be related with the delivery date. CONCLUSION: In term pregnancy, LUS thickness decreases with cervical change but it cannot predict the delivery date.
Female ; Humans ; Maternal Age ; Parity ; Parturition ; Pregnancy* ; Ultrasonography

We report a case of transient abnormal myelopoiesis in a Down syndrome fetus diagnosed at 28(+3) weeks of gestation that rapidly progressed to intrauterine death 10 days later. Fetal hepatosplenomegaly with cerebral ventriculomegaly, although not specific, may be a suggestive finding of Down syndrome with transient abnormal myelopoiesis. Prompt fetal blood sampling for liver function test and chromosomal analysis are mandatory for early detection and management.
Adult ; Down Syndrome/*ultrasonography ; Female ; Fetal Blood/cytology ; Fetal Death ; Fetal Diseases/*diagnosis ; Hepatomegaly/ultrasonography ; Humans ; Leukocytosis/diagnosis ; *Myelopoiesis ; Pregnancy ; *Prenatal Diagnosis ; Splenomegaly/ultrasonography ; Thrombocytopenia/diagnosis

Choriocarcinoma associated with a normal pregnancy is rare. Futhermore, choriocarcinoma coexistent with a viable pregnancy is even rarer and associated with a greater risk of hepatic and cerebral involvement. So timely diagnosis of the disease is important for successful treatment and aggressive diagnostic procedures may therefore warranted. The patient should be treated with primary intensive combination chemotherapy(EMA-CO) and the selective use of irradiation and surgical therapy. We experienced a case of metastatic choriocarcinoma of lung and kidney following preterm delivery at 34th week of pregnancy and so present it with brief review of literature.
Choriocarcinoma* ; Diagnosis ; Female ; Humans ; Kidney ; Lung ; Pregnancy ; Pregnancy*

OBJECTIVE: The objective of this study is to determine whether the club foot of the affected fetus is related to the location, size, and rupture state of the spinal neural tube defect lesion. METHODS: Ultrasound and medical records of 21 fetuses with spinal neural tube defect were reviewed. At the time of diagnosis 7 fetuses had clubfoot and 14 fetuses didn't have. All the fetuses with spinal neural tube defect were divided into two groups, one with clubfoot fetuses, and the others without clubfoot. RESULTS: The mean lesion size of the clubfoot group was significantly larger than normal foot group (4.1+/-1.22 cm vs 2.1+/-1.59 cm). And the level of lesion is significantly higher in club foot group. But the rate of sac rupture is lower in club foot group. CONCLUSION: The fetuses with clubfoot detected at the time of diagnosis had larger size and higher level of lesion.
Clubfoot ; Diagnosis ; Fetus* ; Foot* ; Medical Records ; Neural Tube Defects* ; Neural Tube* ; Rupture ; Ultrasonography ; Ultrasonography, Prenatal*

OBJECTIVE: There are two types of spina bifida aperta: cystic type and flat type. Unruptured cystic sac of spina bifida may interfere free leakage of cerebrospinal fluid into amnionic fluid space. Therefore its presence could influence the appearance of the intracranial signs on prenatal ultrasound. The purpose of this study was to define the ultrasound findings causing the appearance of indirect intracranial signs. METHODS: Twenty-one fetuses with spina bifida were evaluated from Jan/1998 to March/2004. Incidence of indirect cranial signs (changes of ventricular width, morphologic change of cerebellum, obliteration of cisterna magna, decreased biparietal diameter and lemon sign) were evaluated according to gestational age at diagnosis, size, location and morphology of the spinal lesion. RESULTS: Meningeal sac was visible in 10 cases (48%), flat form in 11 cases (52%) on prenatal ultrasound. All of the intracranial signs seemed to appear more frequently on flat spina bifida, but there were no statistical significance. CONCLUSION: It seems like that the presence of the sac in spina bifida aperta did not interfere the appearance of intracranial signs on prenatal ultrasound.
Amnion ; Cerebellum ; Cerebrospinal Fluid ; Cisterna Magna ; Diagnosis ; Fetus* ; Gestational Age ; Incidence ; Neural Tube Defects* ; Neural Tube* ; Spina Bifida Cystica ; Spinal Dysraphism ; Ultrasonography

OBJECTIVE: The aim of this study was to find out the relating factors with the actual delivery day in term singleton pregnancy. METHODS: The 52 patients with singleton gestation were visited weekly and measured for their lower uterine segment (LUS) thickness, cervical length and cervical gland thickness by transvaginal ultrasonography and for amnionic fluid index (AFI) by transabdominal ultrasonography from 36 weeks of gestation until birth. Regression analysis was used to find out the relevance between these factors and remaining days to birth. RESULTS: There was a significant relationship between cervical length and remaining days to birth in term pregnancy, which could be described as a mathematical equation (remaining days for delivery = 6.12 + 0.24 x cervical length (mm) r=0.29, p<0.01). However, no relationship was found between factors such as LUS, AFI, and cervical gland thickness and remaining days to birth. CONCLUSION: Our results suggest that the actual delivery day in term singleton pregnancy might be predicted with cervical length.
Amnion ; Amniotic Fluid ; Female ; Humans ; Parturition ; Pregnancy* ; Ultrasonography

Background and Objectives: Whether beta blockers favorably impact the clinical outcome in patients with acute myocardial infarction (AMI) remains in debate. We investigated the impact of beta blocker on major clinical outcomes during 2 years after percutaneous coronary intervention (PCI) in patients with AMI. Methods: All patients with the first AMI treated with PCI for the period of 2005 to 2014 from the Korean National Health Insurance Service claims database were enrolled. We defined the regular user as medication possession ratio (MPR) ≥80% and non-user as MPR=0%. We compared the occurrence of all cause death, myocardial infarction (MI) and stroke according to adherence of beta-blockers. A 1:1 propensity score-matching was conducted to adjust for between-group differences. Results: We identified a total 81,752 patients with met eligible criteria. At discharge, 63,885 (78%) patients were prescribed beta blockers. For 2 years follow up period, regular users were 53,991 (66%) patients, non-users were 10,991 (13%). In the propensity score matched population, regular use of beta blocker was associated with a 36% reduced risk of composite adverse events (all death, MI or stroke) (hazard ratio [HR], 0.636; 95% confidence interval [CI], 0.555–0.728; p<0.001). Compared to no use of beta blocker, regular use significantly reduced all death (HR, 0.736; 95% CI, 0.668–0.812; p<0.001), MI (HR, 0.729; 95% CI, 0.611–0.803; p<0.001) and stroke (HR, 0.717; 95% CI, 0.650–0.791; p<0.001). Conclusions Prescription of beta blocker in patients with AMI after PCI was sequentially increased. Continuous regular use of beta blocker for 2 years after AMI reduced major adverse events compared to no use of beta blocker.

The prevalence of type 2 diabetes mellitus (T2DM), which is associated with cardiovascular morbidity and mortality, is increasing worldwide. Although there have been advances in diabetes treatments that reduce microvascular complications (nephropathy, neuropathy, retinopathy), many clinical studies have found that conventional oral hypoglycemic agents and glucose control alone failed to reduce cardiovascular disease. Thus, incretin-based therapies including glucagon-like peptide 1 (GLP-1) receptor agonists (RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT-2Is) represent a new area of research, and may serve as novel therapeutics for treating hyperglycemia and modifying other cardiovascular risk factors. Recently, it has been confirmed that several drugs in these classes, including canagliflozin, empagliflozin, semaglutide, and liraglutide, are safe and possess cardioprotective effects. We review the most recent cardiovascular outcome trials on GLP-1RAs and SGLT-2Is, and discuss their implications for treating patients with T2DM in terms of protective effects against cardiovascular disease.
Canagliflozin ; Cardiovascular Diseases ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Glucagon-Like Peptide 1 ; Glucose ; Heart Failure ; Humans ; Hyperglycemia ; Hypoglycemic Agents ; Liraglutide ; Mortality ; Myocardial Ischemia ; Prevalence ; Risk Factors

The small bowel is the least common site for cancer to arise. Only approximately 1% of all gastrointestinal neoplasms arise in the small bowel. Mucinous adenocarcinoma is diagnosed when the amount of extracellular mucin in a tumor is over 50%. Because it is a very rare disease, there is little data available concerning its incidence, most common site of origin, and common sites of metastasis. There are no case reports describing primary mucinous adenocarcinoma of the jejunum in Korea. We report a case of jejunal mucinous adenocarcinoma metastatic to the stomach presenting as a submucosal tumor.
Adenocarcinoma, Mucinous ; Gastrointestinal Neoplasms ; Humans ; Incidence ; Jejunum ; Korea ; Mucins ; Neoplasm Metastasis ; Rare Diseases ; Stomach

Papillary fibroelastomas are the second most common primary cardiac tumor in adults. Over 80% of fibroelastomas occur on the cardiac valves, usually on the left side of the heart, while the remaining lesions are typically scattered throughout the atria and ventricles. Although the optimal timing for surgery is controversial and depends on tumor size and location, prompt surgical resection is warranted in patients at high risk of embolism. A tumor on the cardiac valve can be removed using the slicing excision technique without leaflet injury. Here we present two cases of papillary fibroelastomas occurring on the ventricular surface of the aortic valve and in the right ventricle.