No abstract available.
Birth Certificates* ; Parturition*

OBJECTIVE: We analyzed the clinical features of amniotic fluid embolism confirmed by autopsy or clinical dicision for making a plan of rapid diagnosis and intensive emergency care. STUDY DESIGN: We experienced 2 clincal cases in Ewha Mokdong Hospital and Severance Hospital at 1995, and reviewed the medical record & autopsy report of 15 cases in National Institute of Scientific Investigation from Jan, 1991 to Dec, 1995. RESULTS: The mean maternal age was 31+/-3 years. The mean gestational age was 40+/-1 weeks. The number of delivery were 1.4+/-0.8. The number of abortion history. were 2.6+/-2. The sexuality of fetus were six males (35 %), five females (29%), and unknown six cases (35 %) and the fetal mortality rate was 29 % (5 cases). The initial clinical symptoms and signs were hypotension (12 patients, 71%), vaginal bleeding(ll patients, 65%), cardiac arrest (6 patients, 35 %), dyspnea (5 patients, 29 %), and seizure (2 patients, 12%). In the case of normal spontaneous vaginal delivary (NSVD), the symptoms occurred during induction in 3 (18%), during delivery in 1 (6%), and after delivery in 9 (53%). In the case of Cesarean section, the symptoms occurred during section in 2 (12%), and after section in 1 (6%). There are one case whose symptoms occurred during 3rd gestational period. CONCLUSIONS: We should alert for the amniotic fluid embolism in the clinical findings of acute collapse and vaginal bleeding, respiratory symptoms, and seizure at any peripartum. With eary suspicion of this disease and aggressive intensive care we can reduce amniotic fluid embolism mortality rate and it's legal problem.
Abortion, Induced ; Amniotic Fluid* ; Autopsy ; Cesarean Section ; Diagnosis ; Dyspnea ; Embolism, Amniotic Fluid* ; Emergency Medical Services ; Female ; Fetal Mortality ; Fetus ; Gestational Age ; Heart Arrest ; Humans ; Hypotension ; Critical Care ; Male ; Maternal Age ; Medical Records ; Mortality ; Peripartum Period ; Pregnancy ; Seizures ; Sexuality ; Uterine Hemorrhage

No abstract available.
Neurofibromatosis 1* ; Piebaldism*

Elastofibroma dorsi is a rare, slow-growing, ill defined soft tissue tumor that's typically found between the inferior scapula and chest wall. The characteristic findings on ultrasonography, MRI and CT usually allow the correct diagnosis and so prevent unnecessary surgical procedure. We experienced a case of bilateral elastofibroma dorsi in an 87-year-old man, and we report on this case along with a review of the literature.
Aged, 80 and over ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Scapula ; Thoracic Wall ; Ultrasonography

Recently, three-dimensional (3D) printing technologies have become an attractive manufacturing process, which is called additive manufacturing or rapid prototyping. A 3D printing system can design and fabricate 3D shapes and geometries resulting in custom 3D scaffolds in tissue engineering. In tissue regeneration and replacement, 3D printing systems have been frequently used with various biomaterials such as natural and synthetic polymers. In tissue engineering, soft tissue regeneration is very difficult because soft tissue has the properties of high elasticity, flexibility and viscosity which act as an obstacle when creating a 3D structure by stacking layer after layer of biomaterials compared to hard tissue regeneration. To overcome these limitations, many studies are trying to fabricate constructs with a very similar native micro-environmental property for a complex biofunctional scaffold with suitable biological and mechanical parameters by optimizing the biomaterials, for example, control the concentration and diversification of materials. In this review, we describe the characteristics of printing biomaterials such as hydrogel, synthetic polymer and composite type as well as recent advances in soft tissue regeneration. It is expected that 3D printed constructs will be able to replace as well as regenerate defective tissues or injured functional tissues and organs.
Biocompatible Materials ; Elasticity ; Hydrogel ; Ink* ; Pliability ; Polymers ; Printing, Three-Dimensional* ; Regeneration* ; Tissue Engineering ; Viscosity

OBJECTIVES: The challenge of an increasing elderly population has coupled with everpresent social concerns in Korea. A major problem in health center for the frail older people is that medical, healthcare, and welfare services are often fragmented in terms of providers and settings without appropriate coordination. The purpose of this study was to investigate the need of health center-based integrated healthcare services and its related factors for the elderly. METHODS: A total of 110 elderly people who had visited at a county Health Center were interviewed using a self-administered questionnaire from November to December, 2005. The questionnaire consists of five domains according to the Program of All-inclusive Care for the Elderly. RESULTS: Respondents had high need (total mean score with the 5-point Likert-type sacle: 3.67) of health center-based integrated healthcare services including home visiting service (mean: 4.08), chronic disease care service (mean: 4.06), and transportation service (mean 4.05). According to the results of hierarchical multiple regression analysis, among three regression models the magnititude of the variance of full model that is explained by the need of welfare-domain service was significantly larger than two reduced model. Income was a significant variable in increasing the need of health care and welfare services. CONCLUSIONS: This study suggests that the health center-based integrated healthcare services for the elderly must be continuously developed and provided for the health promotion and improved the quality of life of the elderly who live in rural area in Korea.
Aged* ; Chronic Disease ; Delivery of Health Care* ; Health Promotion ; House Calls ; Humans ; Korea ; Quality of Life ; Surveys and Questionnaires ; Transportation

PURPOSE: Various therapeutic approaches have been suggested for preventing or reducing the adverse effects of topical glucocorticoids, including skin barrier impairment. Previously, we have shown that impairment of skin barrier function by the highest potency topical glucocorticoid, clobetasol 17-propinate (CP), can be partially prevented by co-application of a physiological lipid mixture containing pseudoceramide, free fatty acids, and cholesterol (multi-lamellar emulsion [MLE]). Skin atrophic effects of CP were also partially reduced by MLE. In this study, the preventive effects of MLE on the lowest potency topical glucocorticoid, hydrocortisone (HC), were investigated using animal models. METHODS: Anti-inflammatory activity of topical HC was evaluated using a 12-O-tetradecanoylphobol-13-acetate-induced skin edema model. Topical steroid induced adverse effects were evaluated using hairless mouse. RESULTS: The results showed that the anti-inflammatory activity was not altered by co-application of either MLE or hydrobase. However, co-application of MLE and 1.0% HC showed less impairment in the epidermal permeability barrier function, skin hydration, and skin surface pH compared with hydrobase. Stratum corneum integrity, evaluated by measuring trans-epidermal water loss after repeated tape stripping, showed less damage with MLE co-application. Long-term application of topical HC induced skin atrophy, measured by a reduction in skinfold and epidermal thickness and in the number of epidermal proliferating cell nucleus antigen (PCNA)-positive keratinocytes. Co-application of MLE did not affect the skinfold or epidermal thickness, but the number of PCNA-positive keratinocytes was less decreased with MLE use. CONCLUSIONS: These results suggest that co-application of MLE is effective in reducing the local adverse effects of low-potency topical glucocorticoids and supports the therapeutic efficacy of physiological lipid mixtures on skin barrier function.
Animals ; Atrophy ; Cell Nucleus ; Cholesterol ; Clobetasol ; Edema ; Fatty Acids, Nonesterified ; Glucocorticoids ; Hydrocortisone ; Hydrogen-Ion Concentration ; Keratinocytes ; Permeability ; Skin ; Steroids ; Water Loss, Insensible

BACKGROUND: Non-functioning pituitary adenomas (NFPAs) are characterized by the absence of clinical and biochemical evidence of pituitary hormone hypersecretion, and these tumors constitute approximately one third of all the tumors of the anterior pituitary. Recently, hormonal deficiencies have gradually evolved to become the leading presenting signs and symptoms in patients with NFPAs. We investigated pituitary hormonal insufficiencies according to the magnetic resonance imaging (MRI) findings in patients with NFPA. METHODS: We evaluated the patients who were newly diagnosed with NFPA from 1997 through 2009. Among them, we analyzed 387 patients who were tested for their combined pituitary function and who underwent MRI. The severity of the hypopituitarism was determined by the number of deficient axes of the pituitary hormones. On the MRI study, the maximal diameter of the tumor, Hardy's classification, the thickness of the pituitary gland and the presence of stalk compression were evaluated. RESULTS: The mean age was 46.85 +/- 12.93 years (range: 15-86) and 186 patients (48.1%) were male. As assessed on MRI, the tumor diameter was 27.87 +/- 9.93 mm, the thickness of the normal pituitary gland was 1.42 +/- 2.07 mm and stalk compression was observed in 201 patients (51.9%). Hypopituitarism was observed in 333 patients (86.0%). Deficiency for each pituitary hormone was most severe in the patients with Hardy type IIIA. Hypopituitarism was severe in the older age patients (P = 0.001) and the patients with a bigger tumor size (P < 0.001) and the presence of stalk compression (P < 0.001). However, the patients who had a thicker pituitary gland showed less severe hypopituitarism (P < 0.001). Multivariate analysis showed that age, tumor diameter and the thickness of pituitary gland were important determinants for pituitary deficiency (P = 0.004, P < 0.001, P = 0.022, respectively). CONCLUSION: The results suggest that the hormonal deficiencies in patient with NFPA were correlated with the MRI findings, and especially the tumor diameter and preservation of the pituitary gland.
Humans ; Hypopituitarism ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Male ; Multivariate Analysis ; Pituitary Gland ; Pituitary Hormones ; Pituitary Neoplasms

OBJECTIVE: At present, gold-standard technique of cervical cord decompression is surgical decompression and fusion. But, many complications related cervical fusion have been reported. We adopted an extended anterior cervical foraminotomy (EACF) technique to decompress the anterolateral portion of cervical cord and report clinical results and effectiveness of this procedure. METHODS: Fifty-three patients were operated consecutively using EACF from 2008 to 2013. All of them were operated by a single surgeon via the unilateral approach. Twenty-two patients who exhibited radicular and/or myelopathic symptoms were enrolled in this study. All of them showed cervical cord compression in their preoperative magnetic resonance scan images. RESULTS: In surgical outcomes, 14 patients (64%) were classified as excellent and six (27%), as good. The mean difference of cervical cord anterior-posterior diameter after surgery was 0.92 mm (p<0.01) and transverse area was 9.77 mm2 (p<0.01). The dynamic radiological study showed that the average post-operative translation (retrolisthesis) was 0.36 mm and the disc height loss at the operated level was 0.81 mm. The change in the Cobb angle decreased to 3.46, and showed slight kyphosis. The average vertebral body resection rate was 11.47%. No procedure-related complications occurred. Only one patient who had two-level decompression needed anterior fusion at one level as a secondary surgery due to postoperative instability. CONCLUSIONS: Cervical cord decompression was successfully performed using EACF technique. This procedure will be an alternative surgical option for treating cord compressing lesions. Long-term follow-up and a further study in larger series will be needed.
Decompression* ; Decompression, Surgical ; Follow-Up Studies ; Foraminotomy* ; Humans ; Kyphosis ; Spinal Cord Compression ; Spondylosis

OBJECTIVE: The aim of this study is to review 6 years' experience of peritoneal inclusion cysts at our hospital. METHODS: A retrospective study of 13 cases of peritoneal inclusion cysts between Jan. 1, 1996 and Dec. 31, 2001 was carried out and then clinical feature, radiologic finding, and treatment method were compared with previous reports. RESULTS: Most of patients were premenopausal. Chief complaints were lower abdominal pain or palpable abdominal mass, and so forth. The majority of patients had history of lapalotomy. Peritoneal inclusion cyst was diagnosed by ultrasonogrphy and CT. Most specific finding is that normal ovary is seen in the cysts. In the past, operation was the main treatment method. Recently sclerotherapy was introduced and available. CONCLUSION: Because peritoneal inclusion cyst is benign and uncommon disease, it had not been interesting part. So, preoperative diagnosis rate was low and surgical resection was main treatment method. Preoperative diagnosis rate has been higher after it's clinical feature and specific radiologic findings were reported. Recently, conservative treatment may substitute for operation.
Abdominal Pain ; Diagnosis ; Female ; Humans ; Ovary ; Retrospective Studies ; Sclerotherapy ; Ultrasonography