OBJECTIVE: Our purpose was to evaluate whether maternal body mass index measured before pregnancy are associated with an increased risk of cesarean delivery. METHODS: Maternal weight and height were prospectively collected on 819 women who delivered between 37 weeks and 42 weeks in the College of Medicine, Catholic University of Taegu-Hyosung. Statistical analysis was done using Chi-square tests, prepregnancy maternal weight and height were used to calculate the body mass index, and its contribution to the risk of cesarean delivery was determined. Women with congenital anomaly and pregestational diabetes were exclude from analysis. RESULTS: The analysis of risk factors for cesarean delivery in the 819 women revealed a decreased risk of cesarean delivery with maternal age < or =20 years and multiparity; increased risk of cesarean delivery was noted with maternal age >30 years. Increase in prepregnancy maternal body mass index and total weight gain were significantly associated with increase in the odds of cesarean delivery. CONCLUSION: The risk of cesarean delivery is associated with incremental changes in maternal weight and body mass index before pregnancy after adjustment for potential confounding factors. Prepregnancy counseling about optimizing maternal weight and monitoring weight gain during pregnancy to decrease the risk of cesarean delivery are supported by this study.
Body Mass Index* ; Counseling ; Female ; Humans ; Maternal Age ; Parity ; Pregnancy ; Prospective Studies ; Risk Factors ; Weight Gain

PURPOSE: Neonatal seizures are mostly symptomatic and have variable atypical clinical features with very different EEG findings from those of post-neonatal period. This study was performed to determine the common types of epileptiform discharges and their relationship with abnormalities in imaging study in neonates with seizures. METHODS: Fourty one neonates under 7 days of age who had been hospitalized at the Hanyang university hospital from June 1993 to May 1997 were studied retrospectively. Their medical records, results of EEG and brain imaging study were reviewed. RESULTS: 1) The types of neonatal seizures were subtle, generalized tonic, multifocal clonic, focal clonic, myoclonic in order of frequency. 2) The most common epileptiform discharge was excessive sharp transients recorded in 28 cases and the rest showed multifocal spikes, sharp waves, repetitive alpha, repetitive theta in order. Epileptiform discharges appeared on the both hemisphere in 24 cases, right hemisphere in 9 cases and left hemisphere in 8 cases. 3) Imaging study showed no abnormal findings in 27 cases and abnormal findings in 14 cases such as brain edema, intracranial hemorrhage, leukomalacia, subarachnoid hemorrhage, cephalhematoma, craniosynostosis. 4) Among 14 cases with radiological abnormalities, 5 cases had localized abnormalities and 3 of them had the abnormal EEG discharges on the same area concomittantly. But in total only 3 cases of 17 cases with localized epileptiform discharges had abnormalities in imaging study on the same site and so significant relationship between two studies was not observed. 5) As for the prognosis of seizures, subsided in 23 cases without any antiepileptic drugs, 13 cases had no seizure after taking medicine for few days and 5 cases needed continuous antiepileptic drug. CONCLUSION: This study showed no meaningful relationship between abnormal EEG findings and localization by imaging study in neonatal seizure but we concluded that brain imaging study was needed to determine degree of encephalopathy in neonatal seizures.
Anticonvulsants ; Brain Edema ; Craniosynostoses ; Electroencephalography ; Humans ; Infant, Newborn* ; Intracranial Hemorrhages ; Medical Records ; Neuroimaging ; Prognosis ; Retrospective Studies ; Seizures* ; Subarachnoid Hemorrhage

No abstract available.
Humans ; Infant* ; Streptococcal Infections*

The purpose of this study is to evaluate the ventricular conduction abnormalities, especially RBBB, observed electrocardiographically after surgical closure of VSD. The present study population consists of 92 patients with VSD who were surgically corrected at the Hanyang University Hospital during 6 years period from Jan. 1985 to Dec. 1990. We reviewed their clinical records including surgical notes and EKG findings before and after operations. The results of the study were as follows: 1) Male to female ratio was 1.1:1 (48:44) 2) Out of a total of 92 cases of VSD, 65cases(70.7%)were perimembranous type and 27 cases (29.3%)were subarterial type. 3) The normal preoperative EKG findings were seen in 22 patients, LVH in 21 patients, BUH in 47patients, and RVH in 3 patiens. 4) A transatrial approach was performed in 55 cases, right ventriculotomy with or without resection of muscles in right ventricle in 13 cases, and pulmonary arteriotomy alone in 24 cases. 5) The right bundle branch block after operation developed in 33 patients out of the 65 patinets with perimembranous defect and 5 patients out of the 27 patients with subarterial defects. Postoperative RBBB developed more frequently in perimembranous defect than in subarterial defect. 6) Postoperative RBBB occured in 31.8% of the patients with normal preoperative EKG findings, 23.8% with preoperative LVH, 52.1% with BVH and 66.7% with RVH. Postoperative RBBB was more frequently observed in the patients group with preoperative BVH or RVH than the patients with normal or LVH. 7) Postoperative RBBB was observed in 84.6% after right wentriculotomy, in 43.6% after right atriotomy and in 12.5% with pulmonary arteriotomy alone.
Bundle-Branch Block* ; Electrocardiography ; Female ; Heart Septal Defects, Ventricular* ; Heart Ventricles ; Humans ; Male ; Muscles

No abstract available.
Epilepsy* ; Video Games*

Tailgut cysts are known to originate from the remnants of the embryonic hindgut. They occur exclusively in the retrorectal and presacral spaces. There have been limited reports of tailgut cysts occurring in the left perirenal space. The present case features a huge tailgut cyst extending from the right perirenal to the perivesical space. We believe that this case report will help to further elucidate the characteristics of perirenal and perivesical tailgut cysts.

In human, Human Papilloma Virus(HPV) is associated with benign squamous tumors in a variety of body sites. But the relationship between HPV infection and malignant epithelial lesions is not clear. Esophageal squamous papilloma is relatively rare tumor but it is reported with increasing frequency recently. We reviewed twenty six patients of esophageal papilloma diagnosed by endoscopic biopsy from 1990 to 1994. The results are as follows; The peak age is fifth decade, men and women ratio is 1: 1.2. Most papillomas located in distal esophagus and have no specific symptoms related to papilloma. All case are sessile form and no malignant change in follow up endoscopy.
Biopsy ; Endoscopy ; Esophagus ; Female ; Follow-Up Studies ; Humans ; Male ; Papilloma*

PURPOSE: Medicolegal problems start when the patient asserts the mistake of doctor and doctor does not accept it. The purpose of this study is to assess the actual condition of medicolegal problems and to provide solutions of medicolegal problems in the pediatric field. METHODS: There is not official statistical data about medicolegal problems in our country. We gathered data of legal insurance program of Korean Medical Association (KMA) and court cases and other fragmentary data. RESULTS: Between 1981 and 1995, of total 2, 338 cases reported to legal problem insurance program of KMA, most common ones were 748 cases of obstetrics and gynecology. Pediatric case was ranked at the 5th, 74 cases (3.1%). According to analysis of 41 medicolegal cases' after 1990, maltreatment of patient had the highest incidence of 14 cases, injection and medication were related to 12 cases, misdiagnosis was 9 cases, patient management were related to 4 cases, and others were 2 cases. The trial result of the medicolegal cases was that 31 cases were compensated, and 8 cases were defeated, and 2 cases were still in the process. CONCLUSION: The aspect of medical legal problem has the tendency of radicalism and systematization. This brings an economic destitution in the patient and gives damage to a doctor. In order to reduce medicolegal problem, doctor should offer a duty of explanation and efforts to his best to satisfy patient and endeavor to make an intimate doctor-patient relationship.
Diagnostic Errors ; Gynecology ; Humans ; Incidence ; Insurance ; Obstetrics

Background: This study purposed to analyze the relationship between extinction risk regions and amenable mortality. Methods: This was a cross-sectional study based on the statistics of 2018 which was extracted from the 228 administrative districts in Korea. Cause of death statistics on each region in 2018 was used to produce the age-adjusted amenable mortality. Regional characteristics were measured by demographic factors, health behavior factors, socioeconomic factors, and medical resources factors. Multiple linear regression model was applied to test their relationship. Results: Results showed that extinction risk regions, crude divorce rates, national cancer screening rates, and independent rate of finance were significantly related to the amenable mortality. Conclusion The study demonstrated differences in health status by the extinction risks of regions. This study suggests that the use of customized community care program can provide integrated services such as housing, health care or the use of information and communications technology which can make early diagnosis.

Spark’s nevus is a compound word composed of Spitz nevus and Clark’s nevus. It is one of the combined melanocytic nevi which is more common in female and usually presents as a sharp circumscribed hyperpigmented macule on the lower extremities. On histopathologic findings, both cytologic features of Spitz nevus characterized as large spindle or epithelioid melanocytes containing large nuclei with abundant cytoplasm, and architecture of Clark’s nevus characterized as elongation of rete ridges, bridging of the nests, concentric and lamellar fibrosis can be seen. A 24-year-old female presented with an asymptomatic, solitary, dark-brown-colored papule surrounded by brownish patch that looked similar to dysplastic nevus or malignant melanoma on the buttock. On dermoscopic examination, it showed brown-to-black globules, diffuse homogenous pigmentation with blue-white structures, and a surrounding brownish reticular pattern that faded away. On histopathologic findings, overall asymmetrical structure, epithelioid large melanocytes containing large nuclei with abundant cytoplasm, and Kamino body were seen in the central portion. Also, lentiginous hyperplasia, bridging of the nests composed of melanocytes containing foamy cytoplasm, concentric and lamellar fibrosis along with the elongation of rete ridge, and perivascular lymphocytic infiltration were seen in the peripheral portion. The diagnosis of Spark’s nevus was made. Following its definition, this combined nevus is diagnosed histopathologically, but the clinicodermoscopic features have not been well described. Herein, we report a case of Spark’s nevus in which dermoscopy was helpful for differentiating it from malignant melanoma.