OBJECTIVE: To determine if birth weight greater than 4000gm can be predicted by ultrasound measurement of abdominal circumference(AC) and if shoulder dystocia in macrosomic infants can be predicted by ultrasound measurement of the difference between the abdominal diameter(AD) and biparietal diameter(BPD). METHODS: A Retrospective study was performed of births occuring from March, 1998 to August, 1999 at department of Obstetrics and Gynecology, College of Medicine, Chung-Ang University. Among neonates of birth weight greater than 4000 gm, 50 cases in that ultrasound examination was done within 2 weeks before delivery were selected for macrosomic group and 50 cases were selected for control group during the same period, among neonate of birth weight from 3100gm to 3900gm. RESULTS: 1) Normal spontaneous vaginal delivery(NSVD) was 41 cases in control group and 30 cases in macrosomic group. Among NSVD, shoulder dystocia was 1 case in 41 cases of control group and was 7 cases in 30 cases of macrosomic group. 2) On ultrasound measurement, 6 cases had AC greater than 35 cm in control group and 45 cases in macrosomic group. Among 30 cases in NSVD was done in macrosomic group, difference between AD and BPD was 2.9 0.271 cm when shoulder dystocia was existed and was 2.1 0.409 cm when shoulder dystocia was not existed. Between the two groups, statistically significant difference was detected. 3) When AC(cutoff value of 35cm) was used for screening of macrosomia, sensitivity for macrosomia was 88.2% and specificity was 89.8% and when AD-BPD difference(cutoff value of 2.6cm) was used for prediction of shoulder dystocia, sensitivity for shoulder dystocia was 66.6% and specificity was 95.2%. CONCLUSIONS: In prenatal ultrasound measurement, AC measurement at third trimester of pregnancy will be a valuable indicator for macrosomia screening. The AD-BPD difference of shoulder dystocia group was greater than uncomplicated group in macrosomia and the AD-BPD difference cutoff value of 2.6cm was significant value statistically.
Birth Weight ; Dystocia* ; Female ; Gynecology ; Humans ; Infant ; Infant, Newborn ; Mass Screening ; Obstetrics ; Parturition ; Pregnancy ; Pregnancy Trimester, Third ; Retrospective Studies ; Sensitivity and Specificity ; Shoulder* ; Ultrasonography*

OBJECTIVE: To estimate the long-term skeletal responses to hormone replacement therapy(HRT) with or without active vitamin D(VD) by using short-term changes of bone markers in postmenopausal women (PMW). METHODS: Biochemical markers of bone formation(osteocalcin,OC) and (&) resorption(deoxypyridinoline, Dpd ) at 3 months & lumbar bone mineral density(BMD) at 1 year were measured in 64 natural PMW taking HRT(n=41) & HRT with calcitriol 0.25 microgram/day(n=23). The correlation of percent changes of bone markers after 3 months of Tx with those in lumbar BMD after 1 year was evaluated. RESULTS: 1. serum-OC & urine-Dpd showed decrease of 20.9% & 30.1% at 3months respectively & BMD increase of 3.8% after 1 year of Tx. 2. Among 58 PMW with decreased u-Dpd change, 49 (84.5%) revealed increase in BMD, while 40 (81.6%) among 49 PMW with decreased serum-OC change showed increased BMD. 3. Bone gainers showed significant decrease in changes of serum-OC(18.1% vs 9.2% p<0.05) & urine-Dpd(32.6% vs 20.4%, p<0.05) compared with those of bone losers. 4. No correlations of change of serum-OC (r=-0.174 p>0.05) & urine-Dpd (r=-0.091 p>0.05) at 3month with BMD changes at 1year were seen in total PMW, but urine-Dpd changes in HRT without active VD group revealed significantly inverse correlation(r=-0.376 p<0.05). CONCLUSION: Short-term changes of bone markers did not precisely predict the long-term changes of BMD in total PMW except urine- Dpd in HRT without active VD.
Biomarkers ; Bone Density* ; Calcitriol ; Estrogen Replacement Therapy* ; Female ; Humans ; Osteocalcin ; Vitamin D* ; Vitamins*

Pneumonia is one of important complications after allogeneic bone marrow transplantation (BMT). It is essential to disclose the cause of pneumonia because the treatment depends on the cause. The cause of pneumonia which BMT recipients develop can be infectious as well as noninfectious in origin. Acute eosinophilic pneumonia is a very rare cause of noninfectious pneumonia after BMT. We here report a 42-year-old woman with acute myelogenous leukemia (AML, M4) who developed acute eosinophilic pneumonia on 160 days after unrelated BMT. She was diagnosed by bronchoalveolar lavage and was dramatically improved after steroid treatment.
Adult ; Bone Marrow Transplantation* ; Bone Marrow* ; Bronchoalveolar Lavage ; Eosinophils* ; Female ; Humans ; Leukemia, Myeloid, Acute ; Pneumonia ; Pulmonary Eosinophilia*

OBJECTIVES: Our purpose was to evaluate the efficacy of pelviscopic classic intrafascial supracervical hysterectomy (CISH) & compare it with total abdominal hysterectomy (TAH). METHODS: We analyzed retrospectively, the clinical data of 1126 patients admitted from January 1993 to December 1998, at 11 university or general hospitals in Korea, for CISH group and 363 patients admitted from January 1993 to December 1998, at Chung-Ang university hospitals, Seoul, Korea, for TAH group. These patients were operated on with the indication of benign uterine disease without cervical malignant lesion. The patients with malignant cervical lesion were excluded in this study. RESULTS: (1) The average age of CISH group was 42.2 (range 24-63) years old and TAH group was 46 (range 31-54) years old. (2) The mean operative time was 150.7+/-49.9 (mean+/-SD, range 55-395) minutes in CISH group and 133.8+/-35 (mean+/-SD, range 65-350) minutes in TAH group. The mean estimated blood loss was 206+/-183.6 (mean+/-SD, range 20-2000) ml in CISH group and 596+/-452.3 (mean+/-SD, range 100-6500) ml in TAH group. The mean hemoglobin change was 1.52+/-0.98 (mean+/-SD, range 0-7) g/dL in CISH group and 3.03+/-1.47 (mean+/-SD, range 0.2-8.4) g/dL in TAH group. The mean time in hospital was 6.3+/-1.43 (mean+/-SD, range 3-18) days in CISH group and 11.0+/-4.08 (mean+/-SD, range 7-37) days in TAH group. (3) Overall complications occured at 5.3% in CISH group and 9.1% in TAH group. (4) Pathologic findings of cervix were benign in 1121 patients (99.6%) and severe dysplasia or carcinoma in situ in 5 patients (0.4%) among CISH groups. In TAH groups, 351 patients (96.7%) had benign cervical lesion and 12 patients (3.3%) had more than oderate dysplasia or carcinoma in situ. In both groups, no invasive cervical cancer was found and the transformation zone of the cervix was included within the resection margin of the cervix in all cases. CONCLUSION: The pelviscopic CISH group has less operative blood loss, less postoperative hemoglobin change, shorter hospital stay and less operative complication than TAH group. Pelviscopic CISH is truly a minimally invasive and organ-preserving surgery and coring out the cervix with the calibrated uterine resection tool may prevent the development of cervical cancer. Therefore, we believe that pelviscopic CISH is preferred in cases of benign uterine diseases, because it lowers operative complications and it may have several benefits compared with total hysterectomy, especially, in women with no pathologic lesion of the cervix.
Carcinoma in Situ ; Cervix Uteri ; Female ; Hospitals, General ; Hospitals, University ; Humans ; Hysterectomy* ; Korea ; Length of Stay ; Operative Time ; Retrospective Studies ; Seoul ; Uterine Cervical Neoplasms ; Uterine Diseases

OBJECTIVE: To clarify specific serum beta-human chorionic gonadotropin (beta-hCG) levels on 11 days after intrauterine insemination (IUI) and in vitro fertilization-embryo transfer (IVF-ET) that could predict live birth. METHODS: Three hundred ninety-two pregnancies resulting from IUI and IVF-ET procedures between January 1, 1997 and December 31, 2000 were evaluated. Serum quantitative beta-hCG levels were measured 11 days after IUI or ET using standard immunoradiometric assays. Pregnancy outcomes were categorized as spontaneous abortion, biochemical pregnancy, ectopic pregnancy, singleton live birth, or multiple live birth. Statistical analyses were performed by analysis of variances, and Student's t-test. The sensitivity and specificity of serum beta-hCG level for predicting live birth were plotted using receiver-operator-characteristic (ROC) curve. RESULTS: The multiple live birth group has significantly higher serum beta-hCG level among the different pregnancy outcome groups. The beta-hCG level on the eleventh day after IUI and IVF-ET was significantly higher in the live birth group than the non viable pregnancy group. At a threshold level of 65 mIU/ml, the serum beta-hCG level on the eleventh day after IUI had a positive predictive value of 78.9% in predicting live birth with 95% specificity. At a threshold level of 115 mIU/ml, the serum beta human chorionic gonadotropin level on the eleventh day after ET had a positive predictive value of 92.1% with 95% specificity. CONCLUSION: These data suggest that serum beta-hCG level on 11 days after IVF-ET could be a reliable indicator predicting pregnancy outcome.
Abortion, Spontaneous ; Chorionic Gonadotropin* ; Female ; Humans* ; Immunoradiometric Assay ; Insemination* ; Live Birth ; Pregnancy Outcome ; Pregnancy* ; Pregnancy, Ectopic ; Sensitivity and Specificity