There are many hypotheses of spinal instability after trauma and the concept had been recently changed from 2-column concept by Holdsworth to 3-column concept by Francis Denis & McAfee and also there are controversies about the operative management of the unstable thoracolumbar spine fractures and fracture-dislocations. So we tried to find some relationship between the spinal instability and the effect of the stabilization operation for the fractures and fracture-dislocations in the thoracolumbar spine in this study. Totally 53 cases that stabilization operation had been performed for the unstable fractures and fracture-dislocations of the thoracolumbar spine at Yonsei University Hospital, including Yongdong hospital, from March, 1973 to October, 1984 and followed up over 6 months, were reviewed. 1. Majority of the patients (84.9%) was in an active age group (20–49 years of his age) and more common in males. 2. The first lumbar vertebra was most commonly involved segment (43.3%) and falling from a height was the most common cause of injuries (50.9%). 3. Injuries to the anterior, middle and posterior column of the spine (58.5%) was the most common mechanism of injury according to the classification by Francis Denis and McAfee. 4. The wedged deformity of the involved segment over 50% was usual (71.7%) and mean wedged deformity was 57% of the height of the vertebral body and most commonly associated fractures besides the body itself was laminae fractures (46.5%). 5. Seventy eight percent of the angular deformity was corrected after Luque rod instrumentation and 76%, after Harrington rod instrumentation, 68%, after posterior wiring, 58%, after anterior decompression and anterior interbody fusion. 6. Forty twa point seven percent of the displacement in anteroposterior plain X-ray film and 58.8% in the lateral film were corrected by Luque rod instrumentation and 39.5% in anteroposterior film and 44.3% in the lateral film were corrected by Harrington rod instrumentation. 7. No significant differences in the recovery of the neurologic signs were found according to the method of surgical treatments. 8. So Luque rod or Harrington rod instrumentation is now recommended for obtaining the spinal stability as a method of surgical treatment in the unstable thoracolumbar spine fractures and fracture-dislocations.
Accidental Falls ; Classification ; Congenital Abnormalities ; Decompression ; Humans ; Male ; Methods ; Neurologic Manifestations ; Spine ; X-Ray Film

OBJECTIVE: This study was designed to evaluate whether maternal serum human chorionic gonadotropin(hCG) level measured during second trimester could be used as a predictor of pregnancy-induced hypertension. METHODS: Between March 1996 and November l997, 505 pregnant women undergoing second trimester(14-22 weeks of amenorrhea) triple marker screening for neural tube defect and Down syndrome who delivered at our institution were reviewed. All samples were assayed in the same laboratory and medical records were reviewed about medical and obstetrical history. RESULTS: Maternal serum human chorionic gonadotropin level(multiples of the median, MoM) was significantly higher in the pregnancy-induced hypertension group than in the control group. With the use of 2. l multiples of the median as a cutoff value, the sensitivity of human chorionic gonadotropin as a screening marker for development of pregnancy-induced hypertension was 38.7%, the specificity was 95.9%, positive predictive value was 38.7% and negative predictive value was 95.9%. Conlusion: We suggest that second trimester maternal serum human chorionic gonadotropin levels can be used clinically as an early predictive marker for pregnancy-induced hypertension.
Chorion ; Chorionic Gonadotropin* ; Down Syndrome ; Female ; Humans ; Humans* ; Hypertension* ; Hypertension, Pregnancy-Induced ; Mass Screening ; Medical Records ; Neural Tube Defects ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy* ; Pregnant Women ; Sensitivity and Specificity

No abstract available.

No abstract available.

OBJECTIVES: The objective of this study is to analyze 1,068 cases of prenatal genetic amniocentesis and to compare the results with reported studies. METHOD: We analyzed 1,068 cases of midtrimester prenatal genetic amniocenteses from September 1994 to February 1999, and investigated the fetal chromosomal abnormality, obstetric outcomes and complications by the indications of genetic amniocentesis and prophylactic antibiotic use at the Department of Obstetrics and Gynecology, Ajou University School of Medicine. RESULTS: Abnormal maternal serum markers were the most common indication of amniocentesis (57.7%) and the most common age distribution was 25-29 years (39.2%). One case of early amniocentesis (14 gestational weeks) was performed. The overall incidence of chromosomal aberration was 5.2% (56/1,068), of which there were 28 cases (50.0%; 28/56) of numerical aberrations and 28 cases (50.0%; 28/56) of structural aberrations. There were 50 cases (4.7%) of autosomal chromosomal aberrations and 6 cases (0.6%) of sex chromosomal aberrations. The pregnancy outcome was full-term delivery in 86.5%, preterm delivery in 7.6%, termination of pregnancy in 4.0%. There were no cases of serious complications including fetal death except for a case of self-limited amniotic fluid leakage(high leakage) in which the pregnancy was maintained. There were no significant differences between prophylactic antibiotics user group and non-user group in obstetric complications and outcomes. CONCLUSION: We could confirm that the trend in the indication of genetic amniocentesis had changed from advanced maternal age(35 year-old) toward abnormal maternal serum marker(triple test), and we recognized the importance of genetic amniocentesis according to the various antenatal screening tests of maternal serum marker, antenatal ultrasound, past history of fetal anomaly or family history of fetal chromosomal anomaly in the younger age groups(< 35 year-old) that are involved in more than half of the chromosomal anomaly. Further study will be needed to elucidate the efficacy of using prophylactic antibiotics in amniocentesis.
Age Distribution ; Amniocentesis* ; Amniotic Fluid ; Anti-Bacterial Agents ; Biomarkers ; Chromosome Aberrations ; Female ; Fetal Death ; Gynecology ; Humans ; Incidence ; Obstetrics ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second ; Prenatal Diagnosis ; Ultrasonography

Twin pregnancy is at increased risk for congenital anomalies. Although twins were relatively infrequent, they accaunted for a disproportionately large portion of adverse pregnancy outcome, primarily as a consequence of preterm delivery, gestational diabetes, and pregnancy induced hypertension. In case of twin pregnancy with a single anomalous fetus, the clinicians are faced with difficult decision-making processes regarding the route of delivery, when to deliver, how aggressively to attempt to prevent delivery. Twin pregnancy discordant for a fetal abnormality can be managed expectantly or by selective fetocide of abnormal twin. Recently we experienced two cases of twin pregnancy with a single anornalous fetus. We reported cases with concerned literatures.
Diabetes, Gestational ; Female ; Fetus* ; Humans ; Hypertension, Pregnancy-Induced ; Pregnancy ; Pregnancy Outcome ; Pregnancy, Twin*

A 38-year-old woman was presented with a dark brown plaque on the abdomen. Clinically, the tumor was simulating the appearance of dysplastic nevus. Microscopically, the cells of the stratum malphighii lay in a disordered pattern. Many cells in the epidermis were atypical and melanin pigment was mainly in the basal layer of the epidermis and the upper dermis. Diagnosis of pigmented Bowen's disease was made. Pigmented Bowen's disease is rarely found at body sites other than the anogenital area.
Abdomen ; Adult ; Bowen's Disease* ; Dermis ; Diagnosis ; Dysplastic Nevus Syndrome ; Epidermis ; Female ; Humans ; Melanins

No abstract available.
Hemangioma, Cavernous*

No abstract available.
Breast* ; Female* ; Humans

PURPOSE: This study was to ascertain whether there are differences in health care utilization and expenditure for Type I Medical Aid Beneficiaries before and after applying Copayment. METHODS: This study was one-group pretest posttest design study using secondary data analysis. Data for pretest group were collected from claims data of the Korea National Health Insurance Corporation and data for posttest group were collected through door to-door interviews using a structured questionnaire. A total of 1,364 subjects were sampled systematically from medical aid beneficiaries who had applied for copayment during the period from December 12, 2007 to September 25, 2008. RESULTS: There was no negative effect of copayment on accessibility to medical services, medication adherence (p=.94), and quality of life (p=.25). Some of the subjects' health behaviors even increased preferably after applying for copayment including flu prevention (p<.001), health care examination (p=.035), and cancer screening (p=.002). However, significant suppressive effects of copayment were found on outpatient hospital visiting days (p<.001) and outpatient medical expenditure (p<.001). CONCLUSION: Copayment does not seem to be a great influencing factor on beneficiaries'accessibility to medical services and their health behavior even though it has suppressive effects on outpatients' use of health care.
Cost Sharing ; Delivery of Health Care ; Early Detection of Cancer ; Health Behavior ; Health Care Costs ; Health Expenditures ; Humans ; Korea ; Medicaid ; Medication Adherence ; National Health Programs ; Outpatients ; Quality of Life ; Statistics as Topic ; Surveys and Questionnaires