No abstract available.
Amniotic Fluid* ; Corticotropin-Releasing Hormone* ; Female ; Obstetric Labor, Premature* ; Pregnancy

No abstract available.

No abstract available.
Cisterna Magna*

Interrupted aortic arch is a extreme type of coarctation of aorta and mostly associated with other cardiac anomalies. Unless there were no proper management, about 90% of babies would be dead in their neonatal period. A 28-year-old nulliparous woman was refered to our hospital for fetal echocardiography at 23 weeks' gestation with an abnormal prenatal ultrasonographic findings. We found interrupted aortic arch(type A), which was located in distal portion of the left subclavian artery, and ventricular septal defect. After 5 months follow up, the baby was vaginally delivered at 40 weeks' gestation. This baby was delivered at 40 weeks' gestation of a male infant with APGAR scores of 8 and 9 at 1 and 5 minutes, respectively. Neonatal echocardiography and electron beam tomography revealed interrupted aortic arch(type A), ventricular septal defect(subaortic type), patent ductus arteriosus, and atrial septal defect(ostium secondum defect). At the 10th day of birth, the infant was performed the operation of end to end anastomosis of desending aorta, patch repair of atrial septal defect, ligation of patent ductus arteriosus, and direct closure of patent foramen ovale.
Adult ; Aorta ; Aorta, Thoracic* ; Aortic Coarctation ; Ductus Arteriosus, Patent ; Echocardiography* ; Female ; Follow-Up Studies ; Foramen Ovale, Patent ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Infant ; Ligation ; Male ; Parturition ; Pregnancy ; Subclavian Artery ; Tomography, X-Ray Computed

OBJECTIVE: There have been conflicting reports as to whether higher rates of poor perinatal outcome carry over in cases of idiopathic hydramnios. Thus, this study was undertaken to determine whether there is any association between idiopathic hydramnios and adverse perinatal outcome. METHODS: From January 1995 to December 1999, 103 consecutive women with singleton pregnancies complicated by idiopathic hydramnios(amniotic fluid index>or=25cm) who were delivered at the Severance hospital were studied. Measured perinatal outcomes and maternal complications included preterm delivery, small for gestational age, large for gestational age, malpresentation at delivery, primary cesarean section rate, Apgar score at 5 minutes<7, admission to the neonatal intensive care unit, perinatal death, and postpartum hemorrhage. These findings were compared by means of the chi-square test, Fisher exact test, student's t-test, and logistic regression test with those of 320 control subjects with normal amniotic fluid index(5 Amniotic Fluid ; Apgar Score ; Cesarean Section ; Female ; Fetal Development ; Gestational Age ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Logistic Models ; Polyhydramnios* ; Postpartum Hemorrhage ; Pregnancy ; Pregnancy Outcome* ; Pregnancy*

No abstract available.
Amniocentesis* ; Cytogenetics*

This study was conducted to develop job standards for clinical dietitian administering clinical nutrition therapy to diabetic patients in hospitals. Based on DACUM (Developing A Curriculum) analysis of 17 members including clinical dietitians, professors majoring in clinical nutrition and researchers, information on duties, tasks and task elements of clinical dietitians for diabetes care were derived and applied to diabetes mellitus-specific clinical nutrition care in hospitals for evaluation. The final developed job standards for clinical dietitians for diabetes care included four duties, 19 tasks and 56 task elements. The duties consisted of nutrition assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring . evaluation. For application of diabetes mellitus-specific job standards in clinical nutrition care, 108 work activities were developed and classified into 90 basic and 18 recommended types. Performance rates of standardized jobs were 80.2% at nutrition assessment, 99.6% at nutrition diagnosis, 78.5% at nutrition intervention, and 32.9% at nutrition monitoring . evaluation. These results can be applied as guidelines to implement jobs for diabetes mellitus-specific clinical nutrition services in clinical settings. In addition, they would be useful for education standards in educational institutions for education and training of clinical dietitian.
Diabetes Mellitus ; Diagnosis ; Education ; Humans ; Job Description ; Nutrition Assessment ; Nutrition Therapy* ; Nutritionists*

Sirenomelia, characterised by a complete or incomplete fusion of the lower extremities, is a severe form of caudal defect affecting 1.5-4.2 in 100,000 births. Most cases of sirenomelia die within 5days after birth and are associated with abnormalities such as renal agenesis, urinary tract agenesis, single umbilical artery, etc. Third trimester ultrasonographic diagnosis is usually impaired by severe oligohydramnios whereas the amount of amniotic fluid may be sufficient to allow diagnosis in the early second trimester. We report a case of sirenomelius at 12 weeks of gestation using prenatal transvaginal ultrasonography.
Amniotic Fluid ; Diagnosis ; Ectromelia* ; Female ; Humans ; Lower Extremity ; Oligohydramnios ; Parturition ; Pregnancy ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Single Umbilical Artery ; Ultrasonography ; Urinary Tract

The purpose of this study was to elucidate whether the molecular defect of acid-base transporters in renal tubules is related to the functional defect of urinary acidification in distal renal tubular acidosis(RTA). We performed NH4Cl, furosemide, or bicarbonate loading test to evaluate renal acidification function, and immunohistochemistry using antibodies to H+- ATPase, Cl-/HCO3- exchanger(band-3 protein), and Na+/K+-ATPase in kidney tissue in 6 patients with RTA and renal cell carcinoma patients as normal controls. Kidney tissue was obtained either by percutaneous needle biopsy(RTA) or nephrectomy(NC). The results were as follows; 1) In all six RTA patients, proton secretory defect of distal acidification was shown by a failure to lower the urine pH after NH4Cl loading or furosemide test or abnormally low urine-blood pCO2 difference during bicarbonate loading. In two patients with RTA, proximal acidification defect was combined, which was demonstrated by increased fractional excretion of bicarbonate. 2) In normal control, intense H+-ATPase and band-3 protein staining was observed in collecting ducts. 3) In distal RTA patients, H+-ATPase and band- 3 protein staining was not demonstrable or markedly decreased in the intercalated cells of distal nephron. 4) In two patients who had both proximal and distal RTA, H+-ATPase staining was markedly decreased in the brush border of proximal tubules as well as the distal nephron. In conclusion, the defect of acid-base transporters in renal tubule was related with the functional defect of urinary acidification in distal RTA.
Acidosis, Renal Tubular* ; Adenosine Triphosphatases ; Antibodies ; Carcinoma, Renal Cell ; Furosemide ; Humans ; Hydrogen-Ion Concentration ; Immunohistochemistry ; Kidney ; Microvilli ; Needles ; Nephrons ; Protons