This study was undertaken to make current fetal growth curve throughout later part of pregnancy. 5,110 normal singleton deliveries at Il Shin Christian Hospital were included. The 10th, 25th, 50th, 75th, 90th percentiles of birth weight were calculated from 21 to 42 weeks' gestation and the 10th, 50th, 90th percentiles of birth weight compared by fetal sex, maternal parity and height were graphed to know the potency of factors. There was a linear growth pattern between 28 and 38 weeks' gestation. During last month of prgnancy, three factors have significant effect on median birth weight but no significant differences in 10th percentiles. Maternal height & parity significantly affeect on 90th percentiles. So, these factors must be considered when diagnosing large for date.
Birth Weight* ; Female ; Fetal Development ; Gestational Age* ; Parity ; Parturition* ; Pregnancy

Colposcopic examination and biopsy were performed on 197 patients with abnormal cervical cytology. The patients subsequently underwent electrocoagulation, LLETZ, conization and hysterectomy depending on their diagnosis from January, 1989 to December, 1994. The comparison between the diagnosis of cytology and that of colposcopic biopsy showed fair agreement with only 35% of cases(K=20%). The abnormal lesion was underestimated by cytology in 49.7% of cases. Thirty three cases(16.8%) were threated by LLETZ. Histological comparison between the colposcopic biopsies and LLETZ samples showed fair agreement with 39% of cases (K=25%). 5 cases(15%) of the colposcopic biopsy have been underestimated when compared to the LLETZ histology. Sixty two cases were done conization after colposcopic biopsy. Histological comparison between the colposcopic biopsies and conization samples showed fair agreement with 59% of cases(K=38%). The colposcopic biopsies were underestimated in 24.2% of cases compared to the cone biopsy specimen. The correct diagnosis rates of colposcopic biopsy of dysplasia, carcinoma in situ, and microinvasive carcinoma were 70%, 82%, and 20% respectively. (continue)
Biopsy ; Carcinoma in Situ ; Conization ; Diagnosis ; Electrocoagulation ; Humans ; Hysterectomy

BACKGROUND: Esmolol is a short acting sympathetic beta receptor antagonist, and it was successfully applied to induced hypotension. Esmolol lowers blood pressure by decreasing cardiac output, and does not cause vasodilation. This property of esmolol may help to decrease bleeding during induced hypotension. In this study, we tried to elucidate the effect of esmolol on induced hypotension for total hip arthroplasty. METHOD: Twenty patients receiving total hip arthroplasty were randomly divided to two groups. Esmolol group (10 patients) received esmolol as a hypotensive agent, and sodium nitroprusside (SNP) group (10 patients) received SNP as a hypotensive agent. We measured arterial blood gas analysis, vital sign, amounts of bleeding, amounts of transfusion and administered fluid, and various laboratory findings. RESULTS: Induced hypotension was successfully performed in either esmolol and SNP group. Heart rate increased by SNP, and decreased by esmolol. There were no statistically significant differences between the two groups in amounts of bleeding, amounts of transfusion or administered fluid, and laboratory findings. Arterial oxygen tension was relatively constant in esmolol group, but decreased in SNP group. CONCLUSION: Esmolol can be used as a single hypotensive agent during induced hypotension without significant side effects during total hip arthroplasty.
Arthroplasty, Replacement, Hip* ; Blood Gas Analysis ; Blood Pressure ; Cardiac Output ; Heart Rate ; Hemorrhage ; Humans ; Hypotension* ; Nitroprusside* ; Oxygen ; Sodium* ; Vasodilation ; Vital Signs

PURPOSE:Most but not all intrauterine growth retardation(IUGR) children has catch-up growth postnatally. However, nothing is known about the predictive parameters on the catch-up growth. The aim of this study was to describe serum IGF-I, free IGF-I, IGFBP-1, and IGFBP-3 levels in IUGR children and to correlate these hormone values with auxologic parameters to investigate their value on the postnatal growth pattern. METHODS:Among children with IUGR born at Ewha Womans University from Jan. 1995 to Aug. 1998, 16 children with IUGR at 3 years of age and 12 age-matched normal controls were studied for auxologic and biologic parameters. We measured height, weight, and serum levels of insulin-like growth factor(IGF)-I, free IGF-I, IGF binding protein(BP)-1, IGFBP-3 using immunoradiometric kits. RESULTS: 1)Among 16 children with IUGR at 3 years of age, 13 children had catch-up growth(81.3%), but 3 children remained short stature(18.7%). The height standard deviation score(SDS) in children with IUGR and control were -0.3+/-0.8 and 0.8+/-0.7, respectively(P<0.05) and weight SDS were -0.7+/-0.9 and 1.1+/-1.1, respectively(P>0.05). 2)Serum IGF-I levels in children with IUGR at 3 years of age and normal control were 90.9+/-35.4ng/mL and 68.4+/-24.4ng/mL, respectively(p>0.05) and free IGF-I were 0.9+/-0.5ng/mL and 0.6+/-0.3ng/mL(p>0.05), IGFBP-1 were 50.5+/-30.5ng/ mL and 52.3+/-23.2ng/mL(p>0.05), IGFBP-3 were 4,116.7+/-1,062.2ng/mL and 4,058.4+/-808.5ng/mL(p>0.05), respectively. 3)In children with IUGR at 3 years of age, height SDS in IUGR children with catch-up growth and those without catch-up growth were 0.002+/-0.6 and -1.5+/-0.7, respectively(P<0.001), but there were no differences in weight SDS, body mass index, IGF-I, free IGF-I, IGFBP-1 and IGFBP-3. 4)There were no significant correlations between height gain and any growth factors. CONCLUSION: The results show that there is no difference in the levels of IGF-I, free IGF-I, IGFBP-1 and IGFBP-3 in IUGR children at 3 years of age compared to age-matched normal control, suggesting that other factors rather than IGF-I, free IGF-I, IGFBP-1, IGFBP-3 may cause short stature in IUGR.
Body Mass Index ; Child* ; Female ; Fetal Growth Retardation* ; Humans ; Insulin-Like Growth Factor Binding Protein 1* ; Insulin-Like Growth Factor Binding Protein 3* ; Insulin-Like Growth Factor I* ; Intercellular Signaling Peptides and Proteins

BACKGROUND: The purpose of this study was to discover ways to screen urine culture specimens through Gram stains, urine stick analyses and microscopic examinations for the laboratory cost saving. METHODS: One hundred and fifty-eight urine specimens for culture were included. Fifty uL of urine were inoculated onto one well each of 10-well slide, dried on the hot plate, and Gram-stained. The results combined with routine urinalyses including urine nitrite and leukocyte esterase, and pyuria, were compared with the routine culture results. RESULTS: The screening of bacteriuria by Gram stains, urinalyses and microscopic examinations revealed the high sensitivity (91.9%) and negative predictive value(95.5%) with cost saving of 41.8% of inoculating media. Not considering the Gram stains, the screening revealed 83.8% sensitivity and 92.5% negative predictive value, even if the cost saving of inoculating media were as high as 50.1%. CONCLUSION: It was demonstrated that it was sensitive and economic and produced rapid preliminary results to screen bacteriuria by the Gram stains combined with urinalyses and microscopic examinations.
Bacteriuria ; Coloring Agents ; Cost Savings ; Leukocytes ; Mass Screening* ; Pyuria ; Urinalysis*

Background: Brain MRI may unexpectedly display abnormalities in splenium of the corpus callosum (SCC). However, the clinical implications of this lesion are unclear and are not always consistent with ischemic infarctions. We performed this study to clarify the clinical and radiological implications in patients with SCC lesions. Methods: We retrospectively reviewed consecutive patients with MRIreported SCC changes between 2009 and 2012. We analyzed clinical and radiological findings, etiologies, cognitive impairment, and clinical outcomes. Results: We found 30 patients (16 females; mean 50.5 years) who had SCC lesions on MRI. Confusion was the most common clinical finding in 50% of cases. Cerebral infarction was the most common etiology (50%). The most consistent SCC changes on MRI were low signal in T1WI, high signal on T2WI and FLAIR, and high signal on DWI. We classified SCC lesions into in situ SCC lesions (SCC only) and multiple (SCC plus) lesions for patients with multiple lesions. The clinical symptoms of SCC only lesions were relatively mild. Cognitive functions were evaluated by Mini Mental State Examination (MMSE) and clinical dementia rating (CDR) scale at the time of discharge and patients with SCC only lesions showed less impaired cognition compared with those with SCC plus lesions. Clinical outcomes were evaluated by the modified Rankin scale at 1 month and patients with SCC only lesions revealed good clinical outcomes compared with those with SCC plus lesions. Conclusions: MRI-reported SCC lesions may have heterogeneous etiologies and present with various symptoms. The clinical course and outcome are relatively good, particularly in small isolated and oval shaped SCC lesions.

Background & Objective: Hiccups is a disabling condition of lateral medullary infarction (LMI). Unlike other symptoms of LMI, the anatomical lesions of hiccups are not well known. Few studies have evaluated the relationship between the lesional location of LMI and hiccups. We performed this study to correlate hiccups and magnetic resonance imaging (MRI)-based lesional location in pure LMI. Methods: Between January 1997 and February 2013, we identified 24 patients with pure LMI who presented with hiccups in addition to typical lateral medullary syndrome. Sixty six pure LMI patients without hiccups were included as a control group. Clinical and radiologic findings were compared between the two groups. MRI-identified lesions were classified rostrocaudally as rostral, middle and caudal, and horizontally as typical, ventral, large, lateral and dorsal. Results: The pure LMI patients with hiccups had significantly more frequent aspiration pneumonia (P = 0.001) and longer hospital stay (P = 0.03). The patients with hiccups significantly more often had dorsal rather than ventral lesion at horizontal levels (P = 0.012). But, there were no rostro-caudal differences at vertical levels (P = 0.162). Conclusions: We suggest that pure LMI associated with hiccups often locates in the dorsal medulla at horizontal correlation. This MRI-based comparative study has advanced the understanding of the neural substrate for hiccups in LMI, and indicates that hiccups become predictable when specific lesional locations in the lateral medulla are considered.

A case of carcinoma of the parathyroid gland causing hyperparathyroidism was experienced at the department of orthopaedic surgery, C.A.F.G.H. This patient, a 23 years old male, had complained of a left shoulder pain during the past 3months. And weakness of the lower extremities causing walking disturbance, multiple bone pain, and polyuria had occurred sinoe one month before admission. Physical examination revealed a hard palpable mass in the right anterior region of the neck. Radiologic examination revealed subperiosteal bone resorption in phalanges of the hands and feet, generalized osteoporosis and cystic lesions, and pathologic fracture of the ribs, left humerus, and left femur. Laboratory studies demonstrated hypercalcemia, hypophosphatemia, increased alkaline phosphatase and PTH, hypercalciuria, and hyperphophaturia. Sonogram and C-T scan of the neck revealed a mass in the right inferior portion of the thyroid. Rib biopsy revealed the findings of ostitis fibrosa cystica, and parathyroid gland and regional lymph node biopsy revealed a parathyroid carcinoma with regional lymph node metastasis.
Alkaline Phosphatase ; Biopsy ; Bone Resorption ; Femur ; Foot ; Fractures, Spontaneous ; Hand ; Humans ; Humerus ; Hypercalcemia ; Hypercalciuria ; Hyperparathyroidism ; Hypophosphatemia ; Lower Extremity ; Lymph Nodes ; Male ; Neck ; Neoplasm Metastasis ; Osteoporosis ; Parathyroid Glands ; Parathyroid Neoplasms ; Physical Examination ; Polyuria ; Ribs ; Shoulder Pain ; Thyroid Gland ; Walking

No abstract available.
Adrenoleukodystrophy*

OBJECTIVES: This study was designed to explore body-shape satisfaction and adjustment functions in 410 adolescent school girls. METHODS: After underweight, normal-weight and overweight groups were identified among 410 high school girls according to BMI(body mass index), we compared current weight & height, ideal weight & height, subtracted value of ideal weight from current weight, subtracted value of ideal height from current height, subtracted value of ideal BMI from current BMI, weight dissatisfaction, height dissatisfaction,body-shape dissatisfaction,and EAT-26(Eating attitude Test-26),OSIQ(Offer Self-Image Questionnaire for Adolescents), STAI(State-Trait Anxiety Inventory),BDI(Beck Depression Inventory),BITE(Bulimic Investigatory Test Edinburgh) among the three group. RESULTS: 1) The subjects consisted with overweight group(BMI > 25,N=27,6.6%), normal-weight group(19< or = BMI < or =25,N=278,67.8%),and underweight group(BMI<19, N=105, 25.6%). 2) In comparison to other groups, overweight group was significantly different in subtracted value of ideal weight from current weight and subtracted value of ideal height from current height. These results suggest that overweight group wants greater body-shape change than other groups. Overweight group was significantly shorter in height than underweight group there were no significant differences in ideal height among the groups. 3) Overweight group and normal-weight group showed significantly highter weight dissatisfaction than underweight group. There were no significant differences in height dissatisfaction and body-shape dissatisfaction among the three groups. All groups showed higher weight, height dissatisfaction and body-shape dissatisfaction except higher weight dissatisfaction in underweight group. 4) In comparison of overweignt group with other groups by mean difference of each scale, there was significant difference in superior adjustment subscale of the OSIQ and symptom subscale of the BITE between overweight group and other groups. There was also significant difference in symptom severity subscale of the BITE between overweight and underweight groups. There was no significant difference in EAT-26,STAI,BDI,other subscales of OSIQ among the groups. CONCLUSIONS: 1) The distribution rate of overweight group was lower than in western studies. 2) These results suggest that overweight group wants greater body-shape change than other groups, and overweight group may have binge-eating behavior and poor coping system.
Adolescent* ; Anxiety ; Depression ; Female* ; Humans ; Obesity ; Overweight ; Surveys and Questionnaires ; Thinness