No abstract available.
Mass Screening* ; Papanicolaou Test* ; Uterine Cervical Neoplasms*

No abstract available.
Mass Screening* ; Papanicolaou Test* ; Uterine Cervical Neoplasms*

We conducted this cohort analytic study to determine whether women with unexplained elevations of maternal serum hCG at 15-18 weeks' gestation are at increased risk for pregnancy complications and adverse perinatal outcomes. The inclusion criteria were a singleton gestation, a confirmed gestational age, and an hCG level greater than 2.0 multiples of the median (MoM). The exclusion criteria were fetal anomalies, an abnormal karyotype, molar pregnancy, and an MSAFP level greater than 2.5 multiples of the median (MoM). A group of randomly selected women with hCG levels under 2.0 MoM served as controls. Patients with elevated levels of hCG had a significantly higher risk for PIH (17.9% versus 4.5%; P <.05) and preterm delivery (17.9% versus 3.5%; P<, 05) than control. But no significant differences were observed in the incidence of intrauterine growth restriction and low birth weight and in the newborn weight. We suggested that pregnancies with unexplained elevated hCG levels should be regarded as high-risk pregnancies. And these patients require careful monitoring with adequate obstetric management.
Abnormal Karyotype ; Chorionic Gonadotropin* ; Cohort Studies ; Female ; Gestational Age ; Humans* ; Hydatidiform Mole ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome* ; Pregnancy* ; Pregnancy, High-Risk

No abstract available.
Diagnosis* ; Heart Defects, Congenital*

BACKGROUND: Trisomy 16 in mice is considered to be an animal model for Down's syndrome in human. We studied the morphologic characteristics of the heart and the edema, and their significance to the teratogenesis in this animal model. METHODS: A total of 30 dams were sacrificed to bear 125 (61.9%) normal fetuses 35 (17.3%) abnormal fetuses and 42 (20.8%) resorptions. Cytogenetic study and morphological examination were performed using microdissection agar-mount sectioning histologic examination and scanning electron microscope. RESULTS: The crown-rump length was significantly shorter in abnormal (trisomic fetuses) than the normal (eusomic) fetuses. Trisomic fetuses showed massive edema at the back from the vertex to the lumbar area. Four-chamber view section of the agar-mount and histologic section showed a common atrioventricular valve bridging the left and the right atrioventricular junction. Scanning electron microscopic examination on atrioventricular valves showed three types of atrioventricular valves:five cases with common atrioventricular orifice, three cases with partitioned atrioventricular orifice and two cases with atresia of the right atrioventricular orifice. CONCLUSION: This study confirmed the presence of massive edema and cardiac anomalies in the mouse with trisomy 16. But there was morphologic diversity of cardiac anomaly in this model.
Animals ; Crown-Rump Length ; Cytogenetics ; Down Syndrome ; Edema* ; Endocardial Cushion Defects ; Fetus* ; Heart ; Humans ; Hydrops Fetalis ; Mice ; Microdissection ; Models, Animal ; Pathology* ; Teratogenesis ; Trisomy*

No abstract available.
Anemia, Hypoplastic, Congenital*

We present a case of pulmonary artery catheter (PAC) placement through the right internal jugular vein, bridging vein and coronary sinus in a patient with previously unrecognized persistent left superior vena cava (LSVC) and diminutive right superior vena cava. A 61-year-old male patient was scheduled for mitral valve repair for regurgitation. Preoperative transthoracic echocardiography revealed dilated coronary sinus, but no further evaluations were performed. During advancement of the PAC, right ventricular and pulmonary arterial pressure tracing was observed at 50 and 60 cm, respectively. Transesophageal echocardiography ruled out intracardiac knotting and revealed the presence of the PAC in the LSVC, entering the right ventricle from the coronary sinus. Diminutive right superior vena cava was observed after sternotomy. The PAC was left in place for 2 days postoperatively without any complications. This case emphasizes that the possibility of LSVC and associated anomalies should always be ruled out in patients with dilated coronary sinus.
Arterial Pressure ; Catheterization, Swan-Ganz* ; Catheters ; Coronary Sinus ; Echocardiography ; Echocardiography, Transesophageal ; Heart Ventricles ; Humans ; Jugular Veins ; Male ; Middle Aged ; Mitral Valve ; Pulmonary Artery ; Sternotomy ; Vascular Malformations ; Veins ; Vena Cava, Superior*

BACKGROUND: The analysis of the papers on the primary care quality assessment in Korea was performed to summarize existing papers, estimate the level of primary care quality, and suggest the directions and areas of the future research. METHODS: Primary care quality-related papers were selected via internet web search engines which were Korean Journal of Family Medicine homepage, KMbase, and KoreaMed. Further papers were added after consultation to primary care quality assessment specialists in Korea. RESULTS: The number of related papers was 29. Data collection was done mostly via mail or telephone questionnaire to suppliers, primary care physicians. Papers on resource capacity area were 11, on services delivery 4, on outcome by service 2, and on clinical performance 12. The total primary care score was low. The themes of clinical performance studies were common diseases in Korea. CONCLUSION: Research volume on primary care quality assessment was poor, especially on outcome area. Data collection methods and quality indicators are needed to diverse. Future researches using OECD health care quality indicators are needed to make international comparison possible, which finally contributes to primary care quality improvement in Korea.
Data Collection ; Humans ; Internet ; Korea ; Physicians, Primary Care ; Postal Service ; Primary Health Care ; Quality Improvement ; Quality Indicators, Health Care ; Quality of Health Care ; Republic of Korea ; Search Engine ; Specialization ; Telephone

PURPOSE: In this retrospective study, we attempted to evaluate the treatment outcome and the prognostic factors of thymoma treated with surgery, radiotherapy and chemotherapy. METHODS AND MATERIALS: Between 1979 and 1998, 55 patients with thymoma were treated at the Seoul National University Hospital. Of these, 11 patients underwent surgery only, 33 patients received postoperative radiotherapy and 11 patients received radiotherapy only. Twenty-three patients had gross total resection and 21 patients subtotal resection. For postoperative radiotherapy, the radiation dose consisted of 41.4-55.8 Gy. The average follow-up was 64 months, and ranged from 2 to 160 months. The sex ratio was 1:1 and the median age was 48 years (15-74 years). Overall survival and disease-free survival were determined via the Kaplan-Meier method, and the log-rank was employed to evaluate for differences in prognostic factor. RESULTS: The five- and 10-year survival rates were 87% and 65% respectively, and the median survival was 103 months. By univariate analysis, only stage ( p=0.0017) turned out to be significant prognostic factors of overall survival. Also, stage ( p=0.0007) was significantly predictive for overall survival in mutivariated analysis. CONCLUSION: This study showed the stage was found to be important prognostic factors, which influenced survival. Especially, as incomplete resection is related with poor results, complete resection is important to cure the invasive thymoma.
Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Humans ; Radiotherapy ; Retrospective Studies ; Seoul ; Sex Ratio ; Survival Rate ; Thymoma* ; Treatment Outcome*

Ganglia of the cruciate ligament are quite rare. About 60 cases were reported previously in the world and 6 cases were reported at two articles in korea. It's symptoms may be similar to those of internal derangement of knee, especially meniscal lesion. We report a case of isolated ganglion of posterior cruciate ligament with brief of literatures.
Ganglia ; Ganglion Cysts* ; Knee ; Korea ; Ligaments ; Posterior Cruciate Ligament*