No abstract available.

No abstract available.
Chorion* ; Chorionic Villi Sampling* ; Chorionic Villi* ; Female ; In Situ Hybridization* ; Pregnancy

The objective is to evaluate the rate and indications of cesarean delivery. All live birth>27weeks at the Dongsan Medical Center, Keimyung University from 1993 to 1997(n=24,227) were respectively analyzed of delivery route, indication of cesarean birth, gestational age, and matemal age. The most common maternal age was between 26-30 years(49.6%). The most common gestational age was over 36 weeks(91.2%). Total cesarean rate was 22.3%(5,396/24,227), and primary rate was 13.6%(3,296/24,227). The annual primary cesarean birth rate and number increased gradually. Abnormal presentation was the most common indication(24.3%, 801/3,296) at primary cesarean deliveries. The second common indication was CPD(18.87%, 622/3,296). We experienced four cases of cesarean hysterectomy due to uterine atony and placenta previa. Further evaluation will be needed about the relationship between cesarean deliveries and long term fetal outcome, and the effort for VBAC will be needed.
Birth Rate ; Gestational Age ; Hysterectomy ; Maternal Age ; Parturition ; Placenta Previa ; Uterine Inertia

OBJECTIVE: The objective of the present study was to evaluate incidence, parirty, gestational age, cause, termination method, and maternal complication of fetal death in utero(IUFD) clinically. METHODS: A retrospective analysis was made of the birth register and hospital records of 384 cases of the fetal death in utero among 23,703 deliveries at Dongsan Medical Center, Keimyung University during 5 years from January 1993 to December, 1997. RESULTS: The incidence of the fetal death in utero was 1.62%. The parity of mother in the fetal death in utero was the most highest in the nulliparous group(26.0%). The most common gestational week when the fetal death in utero was detected was 25-28 weeks gestational period(29.4%). The sex ratio of male vs female fetus was 1.32:1, and the cases of the fetal death in utero weighting less than 2500 gm were 332 cases(86.3%). The mode of the delivery for the fetal death in utero showed that the induction of labor was most common 71.6%, the spontaneous delivery 27.8%, and the laparotomy was 0.2%. The causes of the fetal death in utero showed unexplained causes(34.l%), congenital anomaly(I6.9%), maternal disease(14.3%), pregnancy-induced hypertension(9.6%), abruptio placenta(8.8%), cord complication(5%), and placenta previa(4%). There were 38 cases(9.8%) of maternal complication. CONCLUSION: The cause in about one third of the IUFD could not be determined by this clinical studies, so further studies with autopsy and chromosomal study must be made on stillborn infants, placenta, cord and fetal membranes in cases where the causes is unknown for the purpose of good outcome in next pregnancy.
Autopsy ; Extraembryonic Membranes ; Female ; Fetal Death* ; Fetus ; Gestational Age ; Hospital Records ; Humans ; Incidence ; Infant ; Laparotomy ; Male ; Mothers ; Parity ; Parturition ; Placenta ; Pregnancy ; Retrospective Studies ; Sex Ratio

No abstract available.

PURPOSE: To evaluate the relibility of transrectal ultrasonography (TRUS) to define adult female genital organ and to diagnose and stage the cervical carcinomas. METHODS AND MATERIALS: After analysis of normal ultrasonographic anatomy of female pelvis in ten healthy women, I performed TRUS in thirty patients of uterine cervical carcinomas by rotating the 5 MHz electronic linear array transducer(SL2, Siemens, Erlangen, Germany) along the reference sagittal plane in the middle of uterine cervix & vagina. The results of TRUS were analyzed and compared to FIGO, surgical pathology, CT and MRT, ect. RESULTS: TRUS allowed good visualization of the uterus, uterine cervix, parametrium, vagina, anterior rectal wall, walls of the urinary bladder, and uterine cervical carcinomas. The accuracy of staging with TRUS was 83%, compared with the accuracy of 67% for clinical staging according to the criteria of the International Federation of Gynecotogy and Obstetrics(FIGO). For extent of parametrial involvement, the sensitivity of TRUS was 93%, with the specificity of 86% and the diagnostic accuracy of 89%. The same reliability parameters for clinical evaluation were 71%, 79%, and 75% respectively. CONCLUSION: Above findings suggest that low-cost TRUS could be usefully applied to pretreatment evaluation of patients with uterine cervical carcinoma.
Adult ; Cervix Uteri ; Diagnosis* ; Female ; Genitalia ; Humans ; Pathology, Surgical ; Pelvis ; Sensitivity and Specificity ; Ultrasonography* ; Urinary Bladder ; Uterus ; Vagina

OBJECTIVE: Among various methods developed to quantitatively explore electroencephalograms (EEG), we focused on a wavelet method that was known to yield robust results under nonstationary conditions. The aim of this study was thus to introduce the wavelet method and demonstrate its potential use in clinical sleep studies. METHOD: This study involved artificial EEG specifically designed to validate the wavelet method. The method was performed to obtain time-dependent spectral power and phase angles of the signal. Synchrony of multichannel EEG was analyzed by an order parameter of the instantaneous phase. The standard methods, such as Fourier transformation and coherence, were also performed and compared with the wavelet method. The method was further validated with clinical EEG and ERP samples available as pilot studies at academic sleep centers. RESULT: The time-frequency plot and phase synchrony level obtained by the wavelet method clearly showed dynamic changes in the EEG waveforms artificially fabricated. When applied to clinical samples, the method successfully detected changes in spectral power across the sleep onset period and identified differences between the target and background ERP. CONCLUSION: Our results suggest that the wavelet method could be an alternative and/or complementary tool to the conventional Fourier method in quantifying and identifying EEG and ERP biomarkers robustly, especially when the signals were nonstationary in a short time scale (1-100 seconds).
Biomarkers ; Electroencephalography ; Fourier Analysis ; Pilot Projects

No abstract available.
Prospective Payment System*

With remarkable advances in medicine, the total bill of health care expenditure in Korea continues to rise at an ever increasing rate. Under the health insurance, however, to provide the appropriate medical care in limited resources and finite economy, efficient ways of approach to medical services are needed. One of them is to weigh the justification of sophisticated application of medical practice, taking into consideration both cost and effectiveness. Sice medical services have indispensable relation to health insurance, both sides should try to make good companion in order to accomplish the ultimate goal of health improvement and everythhing about health insurance. Especially the basic principles of medical fees review must be kept in mind.
Delivery of Health Care ; Fees, Medical* ; Friends ; Health Expenditures ; Humans ; Insurance, Health ; Korea

No abstract available.
Clinical Study* ; Female* ; Humans