we studied the 12 patients, operated only sagittal split ramus osteotomy without genioplasty or maxillary osteotomy in department of oral and maxillofacial surgery, Hanyang university hospital from 1996.1. 1. to 1998. 7. 20. Preoperative and postoperative cephalometric view was measured to know the change of upper lip position and shape after mandibular setback. The result were obtained as follows. 1. The ratio of upper lip change amount to lower incisor horizontal movement was 15.1%. 2. The ratio of lower facial profile between Sn-Stm and Stm-Mes was changed from 1 : 2.352 to 1 : 2.069 after operation. 3. Post-operative upper lip was flattened 72.4% compared with pre-opreative one. 4. The vermilion zone of the upper lip increased 56% horizontally, 5.8% vertically after operation. 5. The vermilion zone ratio of the lower lip to the upper lip was change from 1 : 1.253 to 1 : 1.348. 6. The distance between esthetic line and Ls was changed from -3.958mm to -1.15mm.]]>
Genioplasty ; Humans ; Incisor ; Lip ; Maxillary Osteotomy ; Orthognathic Surgery ; Osteotomy ; Osteotomy, Sagittal Split Ramus ; Prognathism ; Surgery, Oral

OBJECTIVE: To evaluate the early diagnostic key of ovarian pregnancy. METHODS: A Retrospective case study of 31 cases of ovarian pregnancies treated between 1990 and 2007 at Kangnam St. Mary's hospital Catholic University of Korea was performed. The maternal age, obstetric history, clinical symptoms, sonographic findings, preceding factors, diagnostic modalities, and surgical treatment methods were investigated. RESULT: 31 ovarian pregnancies, diagnosed between 1990 and 2007, comprised (31/1176) 2.6% of all ectopic pregnancies. The most common sonographic finding was fluid collection surrounding the ovary and an ipsilateral enlarged ovary (83.9%). Presenting symptoms were similar to those of tubal pregnancies. Before 1997, wedge resection was done mostly by laparotomy (15/16 cases, 93.8 %) and from then on by laparoscopy (8/14 cases, 57.1%). CONCLUSION: Ovarian pregnancy should be suspected in young woman with symptom of lower abdominal pain, history of pelvic adhesion and sonographic finding of fluid collection around ovary or enlarged ovary for an early diagnosis. Early diagnosis and management can preserve fertility and ovarian function.
Abdominal Pain ; Early Diagnosis ; Female ; Fertility ; Humans ; Korea ; Laparoscopy ; Laparotomy ; Maternal Age ; Ovary ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Tubal ; Retrospective Studies

OBJECTIVE: The aim of this study was to compare the clinical characteristics of placental abruption according to the presence or absence of hypertensive disorders in pregnancy. METHODS: The retrospective analysis was performed in total 363 cases of placental abruption among 25,895 deliveries during 5 years from January, 2003 to December, 2007 in 8 hospitals of Catholic university in Korea. Maternal characteristics and neonatal outcomes were compared with parametric test. RESULTS: The incidence of placental abruption was 1.40% during the study period. The proportion of patients complicated with hypertensive disorders was 33.1%. There was no difference in maternal age and the number of previous pregnancy between two groups with or without hypertensive disorders. As expected, mean gestational age at delivery was lower in placental abruption with hypertensive disorders compared to those without the diseases (237.1 days vs 239.1 days). The incidence of abnormal fetal presentation, multiple gestation, PPROM, and polyhydramnios were more common in patients with placental abruption without hypertensive disorders. On the other hand, the incidence of maternal thrombophilia was significantly higher in patients with placental abruption with hypertensive disorders. The patients with placental abruption with hypertensive disorders had higher incidence of abdominal pain, fetal distress, uterine contraction, and uterine hypertonus (p<0.05). In terms of maternal complication, the patients with placental abruption with hypertensive disorders had more severe complications including shock, coagulopathy and renal failure (p<0.05) and had worse perinatal outcome including FDIU (fetal death in uterus) and neonatal death (10.8% vs 10.3%). CONCLUSION: In patients with placental abruption with hypertensive disorders in pregnancy, maternal complications were more common and prenatal outcome was worse compared to patients with placental abruption without hypertensive disorders.
Abdominal Pain ; Abruptio Placentae ; Female ; Fetal Distress ; Gestational Age ; Hand ; Humans ; Incidence ; Korea ; Labor Presentation ; Maternal Age ; Polyhydramnios ; Pre-Eclampsia ; Pregnancy ; Renal Insufficiency ; Retrospective Studies ; Shock ; Thrombophilia ; Uterine Contraction

OBJECTIVE: The aim of this study was to evaluate the clinical course and pregnancy outcome in patients who had ovarian cancer diagnosed during pregnancy. METHODS: Review of medical records of 10 cases of patients who have ovarian cancer diagnosed during pregnancy at three affiliated hospitals in the Catholic Medical Center from January 1991 to December 2007 was done. RESULTS: Among 10 cases diagnosed as ovarian cancer during pregnancy, six cases were in the first trimester, one case in the second trimester, and 3 cases in the third trimester. Six cases did not show any specific symptoms at diagnosis and seven cases showed malignant characteristics on ultrasonography. Pathologic evaluation showed 2 clear cell tumors in stage IIIb and Ia, 1 germ cell tumor in Ic, 1 immature teratoma in Ic, and 2 serous adenocarcinoma in Ic and Ic, 2 borderline serous adenocarcinoma, and 2 borderline mucinous adenocarcinoma. Three cases with epithelial ovarian cancer in stage I did not receive chemotherapy. Two cases in non-epithelial ovarian malignancy and 1 stage IIIb epithelial ovarian cancer received chemotherapy. In one case, chemotherapy was performed during pregnancy and a healthy child was delivered. Five in 10 cases were lost in long term follow-up and 5 cases including stage IIIb case, remain without evidence of recurrent disease. CONCLUSION: If early diagnosis and treatment are performed, ovarian cancer diagnosed during pregnancy has favorable prognosis. So, delay the treatment of ovarian cancer due to pregnancy should not be permitted and proper chemotherapy during pregnancy should be considered if necessary.
Adenocarcinoma ; Adenocarcinoma, Mucinous ; Child ; Early Diagnosis ; Female ; Follow-Up Studies ; Humans ; Medical Records ; Neoplasms, Germ Cell and Embryonal ; Neoplasms, Glandular and Epithelial ; Ovarian Neoplasms ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Prognosis ; Teratoma

OBJECTIVE: The aims of this study were to evaluate the effect of the methotrexate (MTX) method by comparing the change of the serum beta-hCG level between the MTX method and salpingectomy for treating tubal pregnancy, furthermore by analyzing differences between the MTX success group and the failure group, and to provide helps in establishing criteria for choosing the MTX method. METHODS: Medical records of the 118 patients who were diagnosed with tubal pregnancy were reviewed retrospectively for the period of January 2006 to December 2007 at Kangnam St. Marys Hospital. RESULTS: Between the MTX success group and the failure group, no difference was observed in pregnancy duration, but statistically significant differences were observed in the size of hematoma and the quantity of hemoperitoneum at the site of tubal pregnancy in ultrasonography and in the serum beta-hCG level (p<0.05). Compared with salpingectomy, the MTX method showed the patterns of a low decrease rate of serum beta-hCG level after treatment and even its increase during the early period of treatment, but the serum beta-hCG level decreased rapidly from Day 7 after treatment and became equal to that of salpingectomy on Day 28 after treatment. CONCLUSION: The size of hematoma and the quantity of hemoperitoneum at the site of tubal pregnancy and the serum beta-hCG level before treatment are important factors for success in the MTX method. The MTX method may be safe and effective relatively in hemodynamically stable tubal pregnancy patients, who need preserve the salpinx particularly.
Fallopian Tubes ; Female ; Hematoma ; Hemoperitoneum ; Humans ; Medical Records ; Methotrexate ; Pregnancy ; Pregnancy, Tubal ; Retrospective Studies ; Salpingectomy

OBJECTIVE: This exploratory study was undertaken to analyze the anxiety of parents of prenatally diagnosed fetal congenital disease and satisfaction after the multidisciplinary counseling. METHODS: The study included 32 prospective parents of antenatally diagnosed congenital disease fetus who received multidisciplinary counseling at The Catholic Congenital Disease Center (CCDC) for the period from May, 2009 through March, 2010. The Korean version of the Spielberger State-Trait Anxiety Inventory (STAI) was utilized to assess parental anxiety. Categories of satisfaction survey were classified into accessibility, professionalism, empathy, recoverability, satisfaction, and expectation after counseling. RESULTS: The mean time and number of medical professionals for each counseling were 58.0+/-36.9 min and 3.5+/-1.1 persons. Most common congenital diseases were cardiovascular (36.1%) and urogenital diseases (25.0%). STAI scores were significantly decreased after than before counseling (43.5+/-5.9 vs 36.9+/-6.0, P=0.0007). STAI scores after counseling showed significant decrease in prospective mothers who were nulliparous (P=0.0005), less than 35 years old (P=0.0014), had religion (P=0.0014) and counseled more than 40 minutes (P=0.0027). The mean rate of positive satisfactory response about multidisciplinary counseling was 85.6% in satisfaction survey. CONCLUSION: This study provides evidence of the positive impact on the prospective parental anxiety of a multidisciplinary counseling in prenatal management of fetal congenital diseases.
Anxiety ; Counseling ; Empathy ; Fetus ; Humans ; Mothers ; Parents ; Prospective Studies

OBJECTIVE: The present study compared the findings of ultrasonography and MRI in the prenatal diagnosis of congenital central nervous system anomalies and identified the merits of MRI. METHODS: We retrospectively analyzed the medical records of neonates diagnosed with congenital central nervous system anomaly after birth born at the Department of Obstetrics and Gynecology in Kangnam St. Marys Hospital during the period from January 1997 to April 2008, and compared the findings of prenatal ultrasonography and MRI with the results of postnatal diagnosis. RESULTS: There were a total of 13 neonates postnatally diagnosed with congenital central nervous system anomaly, and 6 of them had prenatal MRI. Among them, ventriculomegaly and hydrocephalus were observed in 3 cases, arachnoid cyst in 2 cases, and megacisterna magna in 1 case. Supplementary information was available for all the 6 cases, and diagnosis based on the supplementary information was closer to postnatal diagnosis. CONCLUSION: In fetuses in which congenital central nervous system anomaly is observed in ultrasonography, prenatal MRI can provide supplementary information and enable more accurate diagnosis. This can be helpful in counseling the guardians and deciding treatment modality.
Arachnoid ; Central Nervous System ; Counseling ; Fetus ; Gynecology ; Humans ; Hydrocephalus ; Infant, Newborn ; Medical Records ; Obstetrics ; Parturition ; Prenatal Diagnosis ; Retrospective Studies ; Ultrasonography, Prenatal

PURPOSE: Questionnaire-based diagnostic criteria for atopic dermatitis (AD) have been proposed to detect the major group of AD with flexural dermatitis. We aimed to develop novel, questionnaire-based diagnostic criteria for childhood AD, which can detect more comprehensive AD including non-flexural type. METHODS: The draft version of questionnaire to detect childhood AD was prepared to be used for preliminary hospital- (n=1,756) and community-based (n=1,320) surveys. From analysis, the Reliable Estimation of Atopic dermatitis of ChildHood (REACH) was derived and verified in derivation (n=1,129) and validation (n=1,191) sets by community-based surveys. RESULTS: The REACH consists of 11 questions including 2 major and 9 minor criteria. AD is diagnosed as the major group of 'eczema on the antecubital or popliteal fossa' to fulfill the 2 major criteria (2M), and the minor group of 'eczema on the non-antecubital or popliteal fossa' to fulfill the 1 major plus 4 or more minor criteria (1M+4m). In the validation set, the overall 1-year AD prevalence by the REACH was estimated as 12.3% (95% CI, 10.5%-14.2%), and the REACH showed a sensitivity of 75.2%, a specificity of 96.1%, and an error rate of 6.4%. The REACH demonstrated better diagnostic performance than the ISAAC in terms of the number of misclassification (10.0%). CONCLUSIONS: We propose the REACH as new full, questionnaire-based diagnostic criteria for childhood AD in epidemiological surveys. Further studies are warranted to validate the REACH in different populations or countries in the context of large-scale, epidemiological surveys.
Dermatitis ; Dermatitis, Atopic* ; Prevalence ; Sensitivity and Specificity

BACKGROUND: Psoriasis is an immune-mediated, chronic inflammatory disease affecting multiple aspects of patients' lives. Its epidemiology varies regionally; however, nationwide epidemiologic data on psoriasis depicting profile of Korean patients has not been available to date. OBJECTIVE: To understand nationwide epidemiologic characteristics and clinical features of adult patients with psoriasis visited university hospitals in Korea. METHODS: This multicenter, non-interventional, cross-sectional study recruited 1,278 adult patients with psoriasis across 25 centers in Korea in 2013. Various clinical data including PASI, BSA, DLQI, SF-36 and PASE were collected. RESULTS: A total of 1,260 patients completed the study (male:female=1.47:1). The mean age was 47.0 years with a distribution mostly in the 50s (24.9%). Early onset (<40 years) of psoriasis accounted for 53.9% of patients. The mean disease duration was 109.2 months; mean body mass index was 23.9 kg/m²; and 12.7% of patients had a family history of psoriasis. Plaque and guttate types of psoriasis accounted for 85.8% and 8.4%, respectively. Patients with PASI ≥10 accounted for 24.9%; patients with body surface area ≥10 were 45.9%. Patients with DLQI ≥6 accounted for 78.8%. Between PASI <10 and PASI ≥10 groups, significant difference was noted in age at diagnosis, disease duration, blood pressure, waist circumference of female, and treatment experiences with phototherapy, systemic agents, and biologics. CONCLUSION: This was the first nationwide epidemiologic study of patients with psoriasis in Korea and provides an overview of the epidemiologic characteristics and clinical profiles of this patient population.
Adult ; Biological Products ; Blood Pressure ; Body Mass Index ; Body Surface Area ; Cross-Sectional Studies* ; Diagnosis ; Epidemiologic Studies ; Epidemiology ; Female ; Hospitals, University ; Humans ; Korea* ; Phototherapy ; Psoriasis* ; Waist Circumference