No abstract available.
Social Workers

No abstract available.
Chondrogenesis* ; Ear*

OBJECTIVE: To analyze the indications, clinical features, cytogenetic results and complications of amniocentesis and to determine the efficacy of antenatal genetic amniocentesis. METHODS: We analyzed retrospectively maternal age, gestational age, indications, transplacental puncture, frequency, discoloration of amniotic fluid, karyotype and complications in 325 cases of prenatal genetic amniocentesis performed at Chungnam National University Hospital from January 2000 to December 2002. RESULTS: The most common age group was from 30 to 34 (31.4%) and mean age was 32.7 years old. 85.3% of cases were performed at 16th-20th gestational weeks. Abnormal maternal serum markers were the most common indication of amniocentesis (56.0%) and the second most common indication was maternal age over 35 (33.2%). Abnormal karyotypes were found in 12 cases (3.6%) and normal variants were 21 cases (6.5%). Numerical aberration were 9 cases (2.7%) and structural aberration were 3 cases (0.3%). Among the autosomal aberrations, Down syndromes were 5 cases and Edward syndrome was 1 case. Among the sex chromosomal aberrations, 47,XXX were 2 cases and Turner syndrome was 1 case. As the increasing maternal age, the incidence of abnormal karyotype was increased. Procedure-related complications occurred in 11.7% of cases and fetal loss rate was 7.4%. No significant associations were found between procedure-related complications and maternal age, gestational age, transplacental puncture, frequency, discoloration of amniotic fluid, and antibiotic treatment. CONCLUSION: Amniocentesis is useful for prenatal genetic diagnosis in pregnancies with increasing risk of chromosome aberrations, such as advanced maternal age, abnormal maternal serum markers or abnormal US findings. Further studies are necessary to identify risk factors of complications after invasive procedure.
Abnormal Karyotype ; Amniocentesis* ; Amniotic Fluid ; Biomarkers ; Chromosome Aberrations ; Chungcheongnam-do ; Cytogenetic Analysis* ; Cytogenetics* ; Diagnosis ; Female ; Gestational Age ; Humans ; Incidence ; Karyotype ; Maternal Age ; Pregnancy ; Pregnancy Trimester, Second* ; Punctures ; Retrospective Studies ; Risk Factors ; Turner Syndrome

Mesenteric panniculitis is an extremely rare inflammatory condition of the adipose tissue of unknown etiology. It is characterized by extensive, progressive fibrosis of the mesenteric fat tissue, leading to tumor formation. Clinical manifestations vary according to the process involving the structures. Abdominal pain accompanied by nausea, malaise, pyrexia, and weight loss and a poorly defined mass are common presentations. Major pathologic changes include (1) degeneration of mesenteric fat, (2) an inflammatory reaction, and (3) fibrosis of the adipose tissue. We present four patients with an aggressive form of mesenteric pannicultis with characteristic histopathologic features. We discuss the relationship between the histopathologic features and the surgical intervention in these cases.
Abdominal Pain ; Adipose Tissue ; Fever ; Fibrosis ; Humans ; Nausea ; Panniculitis, Peritoneal* ; Weight Loss

A sarcomatoid carcinoma of the urinary system is a rare malignant tumor, composed of both epithelial and stromal cells, is regarded as a similar disease entity to a carcinosarcoma. In Korea, only 1 case of primary sarcomatoid carcinoma and 4 cases of carcinosarcoma involving the bladder have been reported, but to date, no case of primary sarcomatoid carcinoma involving the renal pelvis has been reported. Recently, we experienced a case of sarcomatoid carcinoma involving the right renal pelvis in a 67-year-old male patient with intermittent gross hematuria. A CT scan demonstrated a 5x4cm sized mass in the right renal pelvis. Under the diagnosis of a right renal pelvic tumor, a right nephroureterectomy, with bladder cuff excision, was performed. The tumor was composed mostly of pleomorphic spindle cells, and in the peripheral part of the tumor and renal pelvis, a high grade transitional cell carcinoma and adenocarcinoma was also found. The tumor was pathologically confirmed as a primary sarcomatoid carcinoma of the renal pelvis.
Adenocarcinoma ; Aged ; Carcinoma, Transitional Cell ; Carcinosarcoma ; Diagnosis ; Hematuria ; Humans ; Kidney Pelvis* ; Korea ; Male ; Pelvis ; Stromal Cells ; Tomography, X-Ray Computed ; Urinary Bladder

OBJECTIVE: This paper describes our experience and implant technique for cranioplasty of a large cranial defects using a porous polyethylene implant(Medpor) and compares the results with polymethylmethacrylate(PMMA). METHODS: Sixteen cranioplasties were performed using Medpor(n=10) and PMMA(n=6) implants between June 2003 and January 2005. The criterion for patient enrollment was a defect larger than 10cm in diameter. This study compared the operation times and complications. RESULTS: The operation times ranged from 105 to 250minutes(Mean 180 degrees +/-44minutes) in Medpor and from 185 to 460minutes (mean 128minutes) in PMMA. The absolute operation times were shorter using the Medpor implant and the differences were statistically significant(P=0.030). Satisfactory cosmetic results were obtained in all cases using the Medpor implant and with no implant-related complications. Bone ingrowth to the medpor implant was presumed to be the result on an increase in Houndsfield units of the implant, particularly at the marginal areas in the serial follow-up brain computed tomography images. CONCLUSION: It is believed that the properties of a Medpor implant make this implant an good alternative to the existing methods of a cranial contour correction. However, a further follow-up study will be needed.
Brain ; Follow-Up Studies ; Humans ; Polyethylene* ; Polymethyl Methacrylate

BACKGROUND: False positive rate of 17-OHP screening test was higher more than other screening tests due to use same cutoff value both term and preterm infants in Korea. The purpose of this study is to set cutoff value of 17-OHP on the basis of birth weight in neonatal screening for congenital adrenal hyperplasia. METHODS: 17-OHP was measured in filter paper blood spots obtained by heel puncture between 3 and 7 days after birth. 17-OHP values were analyzed with respect to birth weight in order to decide the appropriate cutoff values in a neonatal screening for congenital adrenal hyperplasia. RESULTS: The mean concentrations of 17-OHP according to birth weight groups were as follows : 12.6, 7.0, 5.1, 3.7, 3.0, 2.5 ng/mL for birth weight of 1.50 or less, 1.50-1.99, 2.00-2.49, 2.50-2.99, 3.00-3.49, 3.50 kg or more, respectively. The cutoff values for determining the 17-OHP for recall were decided as follows : 55, 35, 18, 11, 8, 8 ng/mL for birth weight of 1.50 or less, 1.50-1.99, 2.00-2.49, 2.50-2.99, 3.00-3.49, 3.50 kg or more, respectively. Application of the new cutoff values according to birth weight dropped the total recall rate from 3.3% to 1.0%. CONCLUSIONS: The cutoff values of 17-OHP on the basis of birth weight should be used in the neonatal screening for congenital adrenal hyperplasia. We believe that the recall rate due to false positive can be reduced using this method in low birth weight infants.
17-alpha-Hydroxyprogesterone ; Adrenal Hyperplasia, Congenital ; Birth Weight ; Heel ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Korea ; Mass Screening ; Neonatal Screening ; Parturition ; Punctures

An ectopic ureter inserts at a point other than the normal trigonal position of the bladder and its association with ectopic renal dysgenesis is extraordinarily rare. We report two cases of ectopic ureter associated with ipsilateral ectopic renal dysgenesis. One was a 44-year-old man whose right ureteral opening was identified at the right seminal vesicle and who was treated successfully by nephroureterectomy and ipsilateral seminal vesiculectomy. The kidney drained by the ectopic ureter was dysplastic. The other was a 32-year-old woman whose right ureter drained into the right anterior vaginal wall and who was also treated successfully by nephroureterectomy. On pathologic examination, there was no renal tissue in the postoperative specimen. From the marked dilatation of the right ureter, this condition was interpreted as an acquired form of renal agenesis, in which renal tissue developed but atrophied during development or during childhood because of an associated ureteral obstruction rather than true renal agenesis which is defined as the complete congenital absence of renal tissue.
Adult ; Dilatation ; Female ; Humans ; Kidney ; Seminal Vesicles ; Ureter* ; Ureteral Obstruction ; Urinary Bladder

The mandibular canal divides into the mental and incisive canals at the premolar region, forms the anterior loop which crosses anterior to the mental foramen, and turns back to reach the mental foramen. The aim of this study was to elucidate the general anatomical structure of the anterior loop of the mandibular canal using morphometry. Twenty-six hemimandibles from 19 cadavers (16 males, 3 females; mean age at death, 54.4 years) were studied by meticulous dissection with the aid of a surgical microscope. The location of the anterior loop, the diameters of the mandibular, mental, and incisive canals, and their distances from bony landmarks were measured using digital calipers. The anterior loop of the mandibular canal was located 3.05+/-1.15 mm (mean+/-SD) anterior to the anterior margin of the mental foramen and 2.72+/-1.41 mm inferior to the superior margin of the mental foramen, and was 4.34+/-1.46 mm long. The diameters of the mandibular, mental, and incisive canals were 2.8+/-0.49, 2.63+/-0.64, and 2.22+/-0.59 mm, respectively. The distances between the inferior border of the mandible and each of these canals were 7.82+/-1.52, 10.11+/-1.27, and 9.08+/-1.66 mm, respectively. The anterior loop of the mandibular canal was located a mean of 3.1 mm anterior and 2.7 mm inferior to the mental foramen, and continued upward and backward into the mental canal, and forward into the incisive canal. These detailed morphological features of the anterior loop of the mandibular canal represent useful practical anatomical knowledge regarding the interforaminal region.
Bicuspid ; Cadaver ; Female ; Humans ; Male ; Mandible

OBJECTIVE: To determine the incidence and types of congenital anomalies and evaluate the efficiency of antenatal ultrasonography for detection of congenital anomalies METHODS: This was a retrospective study, undertaken on 157 cases with congenital anomalies among 5,554 delivered newborns at Chungnam National University Hospital from Jan. 1, 1998 to Dec. 31, 2002. For statistical evaluation, Chi-square test were used. RESULTS: Among the total 5,554 newborns, the overall incidence of congenital anomalies was 2.8%. The incidence of congenital anomalies in birth weights less than 2,500 gm was 9.2% which was 7.5 times higher than that of birth weights more than 2,500 gm. The incidence of congenital anomalies in stillbirth was 19.3% which was 8.2 times higher than that of the live birth. When classified according to the type of congenital anomalies, the incidence of congenital anomalies were 26.5%, 21.0%, 19.8%, 13.0%, 7.4%, 6.2%, 3.7%, and 2.5% respectively in urogenital system, central nervous system, digestive system, cardiopulmonary system, dermatologic system, musculoskeletal system, chromosomal anomaly syndrome, and fetal tumor. Among 157 cases of congenital anomaly babies, anomaly babies were detected antenatally by ultrasonographic examination in 122 cases, and then the rate of antenatal ultrasonographic detection was 77.7%. CONCLUSION: The overall incidence of congenital anomalies was 2.8%. The most common congenital anomalies were urogenital anomalies. The rate of antenatal ultrasonographic detection for congenital anomalies was 77.7%.
Birth Weight ; Central Nervous System ; Chungcheongnam-do ; Diagnosis* ; Digestive System ; Humans ; Incidence* ; Infant, Newborn ; Live Birth ; Musculoskeletal System ; Prenatal Diagnosis ; Retrospective Studies ; Stillbirth ; Ultrasonography* ; Urogenital System