OBJECTIVE: To evaluate the maternal complications and perinatal outcomes in twin pre-gnancies with one fetal demise PATIENTS: From January 1990 to December 1996, 20 twin pregnancies with single fetal death were observed in Seoul National University Hospital : in 6 cases(group 1) between 20 ~26 weeks and in 14 cases(group 2) after 26 weeks gestation by gestational age of fetal death ; in 7 cases of monochorionic and in 13 cases of dichorionic placentation. RESULTS: The incidence of one fetal death was 5.4% in twin pregnancy. Diagnosis-to- delivery interval of group 1 was longer than group 2(61.0 days : 8.9 days). So it was thou- ght that the gestational age of delivery in group 1 was not always earlier than in group 2. And other parameters(chorionicity, preterm delivery, cesarean section, coagulopathy, IUGR, perinatal mortality, neurologic sequelae, IVH) didn't show the statistical differences between group 1 and group 2. According to chorionicity, it seemed that the perinatal mortality rate of monochorionic group was higher than dichorionic(86% : 62%) and that cesarean section rate was higher in dichorionic group(54% : 14%). But there were no statistical significances between two gruops. All other parameters also didn't show differences statistically. CONCLUSION: We fail to demonstrate that monochorionic placentation is associated with increased risks for the survivor in twin pregnancies of single fetal demise. It may be part- ially explained due to small numbers of cases in this study.
Cesarean Section ; Chorion ; Female ; Fetal Death ; Fetal Growth Retardation ; Gestational Age ; Humans ; Incidence ; Perinatal Mortality ; Placentation ; Pregnancy ; Pregnancy, Twin* ; Seoul ; Survivors

No abstract available.

We observed clinical features of 18 bronchopulmonary dysplasia (BPD) patients who were admitted to the neonatal intensive care unit in the Severance Hospital of Yonsel University College of Medicine from January 1. 1987 to June 30. 1991. Eight patients in whom ventilator settings were unchanged for more than 5 days because of lack of improvement in pulmonary function. The effects of dexamethasone in ventilator-dependent were included in the short-term dexamethasone therapy. 1) Eighteen BPD patients consisted of 15 premature infants (83%), 1 full-term infant, and 2 post-term infants, The mean gestational age of the patients were 30 weeks and the mean birth weight was 1,420gm. And there were 13 male and 5 female infants. 2) The underlying conditions which necessitated ventilatory support support were hyaline membrane disease in 13 patients (72%), apnea in 2 (11%), and meconium aspiration syndrome in 3. There patients with meconium aspiration syndrome were either full-term or post-term infants, of whom 2 had neonatal persistent pulmonary hypertension. 3) The mean age at the start of ventilator care was 8 hours and the mean PIP was 32 cm H2O. The mean duration of ventilator care of oxygen therapy and of high O2 requirement (FiO2>0.8) were 39 days, 75 days and 20 days, respectively. 4) Patent ductus arteriosus developed in 8 patients during mechanical ventilation, but they were all closed with the use of mefenamic acid, There were also 4 cases of pneumothorax, 2 cases of pulmonary parenchymal emphysema, and 1 case each of pneumomediastinum and pneumoperitoneum. 5) The mean gestational age of the dexamethasone-treated group was 30 weeks and the mean birth weight was 1,320gm, The mean age at which dexamethasone therapy was started was 39 days after birth, and in only 3.3 days 6 patients were successfully weaned from ventilator, In 5 cases the first trial of dexamethasone therapy was enough but the rest needed the 2nd trial for ventilator weaning. 6) In 6 BPD patient who were weaned from the ventilator after dexamethasone therapy, there were significant decreases in MAP (11.1 vs 8.0 cmH2O), and FiO2 (0.73 vs 0.61), but a significant increase in the urine output (2.56 vs 3.7ml/kg/hr) for the pretreatment (5 days prior to therapy) versus posttreatment period (first day of therapy). 7) The complications of dexamethasone treatment were transient hypertension and hyperglycemia in 3 patients, and systemic candidiasis and gastrointestinal bleeding in 2 patients who failed to be weaned after dexamethasone therapy. Our results suggest that the short-term dexamethasone therapy in bronchopulmonary dysplasia patients who are dependent on mechanical ventilation enables weaning in a short period of time. The inspiratory oxygen concentration and the mean airway pressure may be decreased and the urine output may be increased from the first day of medication, improves pulmonary function and decreases pulmonary interstitial edema.
Apnea ; Birth Weight ; Bronchopulmonary Dysplasia* ; Candidiasis ; Dexamethasone* ; Ductus Arteriosus, Patent ; Edema ; Emphysema ; Female ; Gestational Age ; Hemorrhage ; Humans ; Hyaline Membrane Disease ; Hyperglycemia ; Hypertension ; Hypertension, Pulmonary ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Male ; Meconium Aspiration Syndrome ; Mediastinal Emphysema ; Mefenamic Acid ; Oxygen ; Parturition ; Pneumoperitoneum ; Pneumothorax ; Respiration, Artificial ; Ventilator Weaning ; Ventilators, Mechanical ; Weaning

Fetal echocardiography is used by means of decleration of fetal cardiac anaztomy, to estabilish the diagnosis of congenital heart disease in utero. We attemped fetal echocardiography to ninty three pregnant women after intra uterine period 24 weeks, and estimated cardiac circumference, cardiac axis, pulmonary atery root diameter, arortic root diameter, diameter of inferior vena cava, diameter of superior ve studied how these estimates associate with following gestational na cava, and fractional shortening of ventricles. We ages. Cardiac axis was on the average 37.28 degree and cardiac apex was located in anterior left side of chest area. Aortic root diameter was 0.227 GA-0.043mm (GA=gestational age) at systolic phase, 0.203 GA+0.421mm at diastolic phase. Pulmonaly root diameter was 0.271 GA-0.029mm at systolic phase, 0.251 GA-0.067mm at diastolic phase. Thoracic aorta diameter was 0.195 GA+0.109mm at systolic phase, 0.198 GA+0.794mm at diastolic phase. Fractional shortening was 0.24 (1 Standard Deviation=0.11) in right ventricle, 0.23(1 SD=0.154) at left ventricle, and so ratio of right and left ventricle was 1.04(1 SD=0.51). Once normal fetal cardiac anatomy is understood, structural defects and/or alternation of function can be evaluated antenatally.
Aorta, Thoracic ; Axis, Cervical Vertebra ; Diagnosis ; Echocardiography* ; Female ; Heart Defects, Congenital ; Heart Ventricles ; Humans ; Pregnant Women ; Thorax ; Vena Cava, Inferior

Two cases of ureteral fibrous polyp showing serpiginous filling defect on IVP are presented with characteristic radiologic features; easy flow of contrast medium around polyp. Prolapsed polyp in urinary bladder, and less ureteral obstruction or renal damage than in epithelial lesions. These rediologic findings enable to differentiation of ureteral fibrous polyps from malignant tumor, which is helpful for determining therapeutic approach.
Polyps* ; Ureter* ; Ureteral Obstruction ; Urinary Bladder

The records for the tuberculosis patients who discharged from the health center during 1982 in Kangwha county were analyzed in order to study the characteristics and the patterns of treatments for the pulmonary tuberculosis patients with the history of previous treatment before registration and also the relationship between the previous history of treatment and the outcome at the time of discharge from the health center. The major findings are as follows. 1. Those who have a history of previous treatment were 58, 22.5% of those 258 patients who were studied. 2. There is no difference in sex however the rate of previous history of treatment was higher among middle age group (20-59) than young and old age group (under 19 or over 60). 3. The rate of previous treatment was rather higher in those lived in remote area from Eup. 4. As for the relationship with occupation, students and civil servants who easily exposured to the public relations of government's tuberculosis control program experienced lower previous treatment before registration than farmers or unemployed. 5. A total of 62.1% were previously treated less than 6 months, 29.3% between 6 and 12 months, and only 8.6% more than 12 months before registration to health center. 6. The most common used anti-tuberculosis drugs were isoniazid and ethambutol but only 13.8% used government-standardized prescription and 69.0% used secondary drugs from its beginning. 7. There was no statistical difference between the previous history of treatment and the outcome at the time of discharge from the health center. However the longer the duration of treatment before registration was the lower the cure rate at health center was.
Ethambutol ; Humans ; Isoniazid ; Middle Aged ; Occupations ; Prescriptions ; Public Relations ; Tuberculosis ; Tuberculosis, Pulmonary*

To study the relation between ectoparasite, Rickettsia and hantaan virus in bats, four order of Athropoda were collected from Rhinolophus ferrumequinum captured in Cheju and Eptesicus serotinus captured in Chungnamin from July 1989 to March 1998. Also antibody of Rickettsia and hantaan virus were detected by immunofluoroscent antibody technique and RT-PCR. The results are as follows. 1. Five species of Acarina were identified from E. serotinus: Leptotrobidium subakamushi of Trombiculidae, Macronyssus coreanus, Steatonyssuss spinosuss and Steatonychus superans of Macronyssidae, Argas vespertilionis of Metastigmata. 2. Ischnopsyllus needhami of Siphonaptera and Cimex of Hemiptera were identified from E. serotinus. 3. Cyteribia uenoi and Brachytarsina kanoi of Diptera were identified from R. ferrumequinum. 4. The positive rate of rickettsial antibodies in E. serotinus were 17.58%, 15.15%, 22.22%, 52.73% against R. tsutsugamushi, R. typhi, R. sibirica and R. thai tick typhus, respectively. The high positive rate of antibody related to the high content of Arthropoda. 5. The Positive rate of hantaan virus IFA antibodies were 3.4% (27 of 802) and hanntan virus infection rate 36.7% (22 of 60) by RT-PCR in bats. According these result, we showed that certain species of Athropoda isolated play a role as vector of Rickettsia in E. serotinus. Also bats play a role as a reservoir of hantaan virus in nature.
Antibodies ; Argas ; Arthropods ; Asian Continental Ancestry Group ; Bedbugs ; Chiroptera* ; Diptera ; Hantaan virus* ; Hemiptera ; Humans ; Jeju-do ; Rickettsia* ; Siphonaptera ; Ticks ; Trombiculidae ; Typhus, Epidemic Louse-Borne

A rare case of mucoid cyst of the penile skin in a 23 year-old man is reported, which has been presented as a movable, superficial and no tender nodule, measuring 0.8 cm in maximum diameter at the periurethral meatus of the glans for 6 months. This nodule was removed by simple excision and proved to be a mucoid cyst of penile skin, which was lined by pseudostratified columnar epithelium with occasional mucous epithelium and glands, suggesting its origin is most likely from sequestrated periurethral glands.
Male ; Humans ; Cysts

No abstract available.
Adipose Tissue* ; Apoptosis ; Lipodystrophy*

No abstract available.
Epidermal Cyst