PURPOSE: Congenital anomalies are known as a major cause of neonatal death with prematurity and birth injuries. We surveyed the incidence of congenital anomalies among livebirths and stillbirths delivered at our hospital, and detected in neonatal and postneonatal period. METHODS: The statistical study was done about congenital anomalies among 9,569 deliveries (9,438 livebirths and 131 stillbirths) at Ulsan University Hospital during the periods of 5 years from Jan 1992 to Dec 1996. We reviewed delivery and newborn record, OPD chart, admission chart retrospectively. We investigated the incidence of congenital anomaly according to each year, period, outcome of delivery, sex, birth weight, gestational age, maternal age, Apgar score, multiple pregnancy, and each system. RESULTS: 1) The overall incidence of congenital anomalies was 5.0% (481 cases) among 9,569 deliveries. The annual incidence was 4.5% in 1992, 5.1% in 1993, 5.2% in 1994, 5.8% in 1995, 4.7% in 1996. 2) The incidence of congenital anomalies detected in neonatal period was 3.5% (333 cases) and 1.5% (148 cases) in postneonatal periods. 3) The incidence of congenital anomalies was 4.9% among live births and 9.2% among stillbirths. 4) The incidence of congenital anomalies was 5.3% in male and 4.7% in female. 5) The incidence of congenital anomalies among the babies, below 2,500g of birth weight was 7.7%, between 2,500g and 3,999g was 4.7%, and over 4,000g was 6.8N. 6) The incidence of congenital anomalies among the babies, below 32 weeks of gestational age was 12.9%, between 32 weeks and 36 weeks was 7.4%, between 37 weeks and 41 weeks was 4.7%, and over 42 weeks was 5.1%. 7) The babies born to mothers younger than 20 years of age have anomalies in 7.1%, mother between 20 years of age and 35 years of age in 5.0%, and older than 35 years of age in 6.5%. 8) The incidence of congenital anomalies according to Apgar score among live births between 0 and 3 was 9.8%, between 4 and 6 was 6.0%, and between 7 and 10 was 5.0%. 9) The incidence of congenital anomalies according to multiple pregnancy was 8.6%. 10)The systems of congenital anomalies in order of incidence were as follows; The digestive system (25.6%), the cardiovascular system (22.1%), the genitourinary system (18.9%), the musculoskeletal system (15.5%), the skin and soft tissue (11.7%), the central nervous system (1.6%), the respiratory system (l%), the others (3.6%). CONCLUSIONS: Regular examination and screening on congenital anomaly is required from newborn period to infant and childhood. In view of these considerations, the incidence of congenital anomaly may be increased more than the past reports because of development of recent diagnostic techniques.
Apgar Score ; Birth Injuries ; Birth Weight ; Cardiovascular System ; Central Nervous System ; Digestive System ; Female ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Newborn ; Live Birth ; Male ; Mass Screening ; Maternal Age ; Mothers ; Musculoskeletal System ; Pregnancy ; Pregnancy, Multiple ; Respiratory System ; Retrospective Studies ; Skin ; Statistics as Topic* ; Stillbirth ; Ulsan ; Urogenital System

No abstract available.
Drinking*

By means of hospital-based data over 8 years we sought to evaluate the clinical indications and incidence of emergency peripartum hysterectomy by demographic characteristic and reproduction history. From the obstetric record of all deliveries at Chung Goo Hospital between Jan. 1, 1990, and Nov. 31, 1997, we identified all women undergoing emergency cesarean hysterectomy, calculated incidence rates, conducted statistical tests of linear trends and heterogenety, and observed the clinical indicatons preceding the onset of this procedure. There were 16731 deliveries during this period, Cesarean hysterectomy was performed in 24 of 5993 cesarean sections(0.40%) and in 10 of 10738 vaginal deleveries(0.09%), so more frequently after cesarean section than vaginal delivery. The age of patients varied from 22 to 40 years old. The higher the age and the parity of patients, the higher incidence of cesarean hysterectomy was noted. The most common indication of cesarean hysterectomy was uterine atony(52.94%) followed by placental disorders(41.18%), uterine myoma with pregnancy(2.9%) and uterine rupture (2.9%). All patients who had hysterectomy received transfusion from 1 pint to 57 pints. The postoperative complications were bladder injury, febrile morbidity, disseminated intravascular coaguolopathy and wound disruption. There were three maternal deaths, the cause was disseminated intravascular coaguolopathy and amniotic embolism. The data identifiy uterine atony as the primary cause for gravid hysterctomy. The data also illustrated how the incidence of emergency peripartum hysterectomy increases significantly with increasing parity, especially when influenced by a current placenta previa or a prior cesarean section. Maternal morbidity remained high.
Adult ; Cesarean Section ; Embolism ; Emergencies ; Female ; Humans ; Hysterectomy* ; Incidence ; Leiomyoma ; Maternal Death ; Parity ; Peripartum Period* ; Placenta Previa ; Postoperative Complications ; Pregnancy ; Reproduction ; Urinary Bladder ; Uterine Inertia ; Uterine Rupture ; Wounds and Injuries

No abstract available.
Blood Transfusion* ; Humans ; Infant, Newborn ; Infant, Premature*

No abstract available.
Abruptio Placentae* ; Female ; Pregnancy

Incidence of human herpesvirus-6 (HHV-6) infection in the neonatal period has been reported in few cases. HHV-6, commonly responsible for roseola, is known to establish infection during infancy and early childhood. A 14-day-old neonate, presented with a fever of 38.3℃, primarily due to an HHV-6 infection, was admitted to our neonatal intensive care unit. A polymerase chain reaction (PCR) of his cerebrospinal fluid was positive for HHV-6. Additionally, serology for HHV-6 PCR was positive. We believe that HHV-6 can cause infection in febrile newborn infants.

BACKGROUND: Parent's alcohol drinking not only influences their health but also their children. This research was designed to assess the family function of children who were affected by parent's alcohol drinking. METHODS: Questionnaire survey was performed on 208 high school students (129 males and 79 females) in Daejeon from March to April, 2005. We defined the students whose CAST (Children of Alcoholics Screening Test) score was 6 or more as children of alcoholics (COA) group. Then, we evaluated the family function by family APGAR score between the COA group and the control group. RESULTS: Among the total, 36 (27.9%) male and 27 (34.1%) female students were in COA group. There was a significant (P<0.01) negative correlation between the CAST score and the family APGAR score in all students. In boys, there was no significant correlation between the CAST score and the family APGAR score, but in girls, there was significant negative correlation (P<0.01). Mean family APGAR score of the COA group was significantly (P<0.05) lower than that of the control group in all students. In boys, there was no significant difference, but in girls, the COA group's family APGAR score was significantly lower than the control group's score (P<0.05). CONCLUSION: The high school students, especially girl students, who were affected by parent's alcohol drinking showed a lower family APGAR score. Therefore, family physicians need to evaluate the family function when encountering students similar to COA group.
Alcohol Drinking ; Alcoholics* ; Apgar Score ; Child* ; Female ; Humans ; Male ; Mass Screening* ; Physicians, Family ; Surveys and Questionnaires

No abstract available.
Lymphangioma*

Vascular complications such as hematoma, pseudoaneurysm and arteriovenous fistula that occur after intracoronary or intracardiac procedures are responsible for considerable morbidity and some mortality. Iatrogenic aneurysms are usually postcatheterization pseudoaneurysms of the femoral artery. Nowadays, it is not uncommon as a consequence of more complex interventional procedures, larger catheters and prolonged anticoagulation treatment. Surgical repair has been mainstay of treatment for pseudoaneurysm. However, recently has it been shown that color Doppler ultrasound-guided direct, noninvasive compression of the pseudoaneurysm stops the blood flow in the communication and lead to pseudoaneurysm clotting and obliteration. We report a case of pseudoaneurysm in femoral artery, which was developed at the right inguinal puncture site in 74 year old male patient with myocardial infarction who had received continuous intravenous infusion of heparin and had undergone primary percutaneous coronary angioplasty and temporary pacemaker insertion treated successfully with color Doppler ultrasound guided direct compression.
Aged ; Aneurysm ; Aneurysm, False* ; Angioplasty ; Arteriovenous Fistula ; Cardiology* ; Catheters ; Femoral Artery* ; Hematoma ; Heparin ; Humans ; Infusions, Intravenous ; Male ; Mortality ; Myocardial Infarction ; Punctures ; Ultrasonography

BACKGROUND: Noninvasive measurements that relate to the extent and severity of coronary atherosclerosis have long been sought for clinical screening of patients with chest pain syndromes and for use in clinical trials. Intima-media thickeness (IMT) of the carotid artery has been suggested to be associated with coronary artery atherosclerosis. In this study, we tried to assess the relation of carotid artery atherosclerosis by B-mode ultrasonography with presence and severity of coronary artery disease. METHOD: We studied 57 patients (36 men, 21 women) with ischemic heart disease, mean age 65+/-8 yrs (48 to 83 yrs), who underwent both coronary angiography and carotid ultrasonography with 10 MHz transducer. The patients who had received revascularization procedure were excluded. We classified the patients into two groups, the control group without significant coronary stenosis (18 patients) and the coronary artery disease (CAD) group (39 patients) with significant luminal stenosis (> or =50%). The CAD group was divided into single vessel disease group (SVD, 19 patients) and multivessel disease group (MVD, 20 patients). IMT was measured in far wall of common carotid artery (CCA) at 10 mm proximal to carotid bulb and abnormal IMT was defined if the measurement was greater than mean IMT+2SD of control group. Serum total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL), triglyceride (TG), Lipoproteinp (a)(Lp(a)) were measured and history of hypertension, diabetes mellitus, and smoking were investigated. RESULTS: A significant difference in IMT of the CCA was found between control and CAD group (0.76+/-0.09 mm vs. 0.97+/-0.20 mm; p<0.0001). Also a significant difference in the number of atherosclerotic plaque was found between the two groups (control; 0.67+/-1.14 vs. CAD; 1.87+/-1.75; p<0.005). In the CAD group, both mean IMT and numbers of athero-sclerotic plaque tended to increase in MVD group compared with SVD group (1.03 mm vs. 0.91 mm; p=NS, 2.65 vs. 1.05; p<0.05). The sensitivity of IMT for prediction of significant CAD was 66.7%, the specificity 83.3%, the positive predictive value 89.7%, and the negative predictive value 53.6%. The sensitivity of plaque presence on the carotid artery for prediction of CAD was 71.8%, the specificity 61.3%, the positive predictive value 80.3% and the negative predictive value 50.5%. Among risk factor, diabetes mellitus and Lp (a) were correlated well with IMT of CCA, Hypertension was correlated with atherosclerotic plaque. History of smoking was correlated with coronary artery disease. CONCLUSION: Increases in IMT and plaque of the carotid artery, as measured noninvasively by ultrasonography, can be used as a predictor of significant coronary artery stenosis.
Atherosclerosis ; Carotid Arteries* ; Carotid Artery, Common ; Chest Pain ; Cholesterol ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis* ; Coronary Vessels* ; Diabetes Mellitus ; Humans ; Hypertension ; Lipoproteins ; Male ; Mass Screening ; Myocardial Ischemia ; Phenobarbital ; Plaque, Atherosclerotic* ; Risk Factors ; Sensitivity and Specificity ; Smoke ; Smoking ; Transducers ; Triglycerides ; Ultrasonography