The purpose of this study is to assess the maternal iron status during pregnancy and to evaluate the relationships between the iron indices of maternal, umbilical cord serum, placenta and pregnancy outcomes. Venous bloods samples were drawn from 54 pregnant women just before delivery and cord bloods of their newborn babies were collected immediately after birth. And also, placental tissues were extracted. We investigated the difference of the iron status indices of maternal, umbilical cord serum and placental tissue between two gestational age group (PT group, NT group : preterm delivery and normal term delivery at 34.9wk and 39.0wk of mean gestational length, respectively) and also assessed correlations of iron status indices of maternal, umbilical cord serum and placenta tissue. And lastly, we related between birth weight and iron status indices of maternal, umbilical cord serum and placental tissue. The concentrations of maternal serum ferritin and of placental iron were significantly higher in PT group (32.1 +/- 21.1 ng/ml, 68.5 +/- 16.7microgram / g), than those of NT group (20.8 +/- 11.6 ng / ml, 53.2 +/- 17.4 microgram / g) respectively (p < 0.001). However the serum ferritin of umbilical cord were significantly higher in NT group (PT : 109.4 +/- 65.7 ng/ml, NT : 147.0 +/- 56.8 ng / ml) than those of PT group (p < 0.05). Our results showed that a negative association between birth weight (r=-0.361) and maternal serum ferritin and that a positive association between birth weight and umbilical cord serum ferritin (r=0.261). Despite not a significant difference, there was tendency that highest concentration of maternal serum ferritin was associated with the lowest birth weight. These findings indicate that birth weight of newborn is dependent of multiple factors such as maternal iron status during pre-pregnancy, body size, general nutritional status. Although for women who enter pregnancy with low iron stores, enough intakes of iron during pregnancy could produce undesirable pregnancy outcome. Therefore we suggest for successful pregnancy outcome and delivery differential iron supplementation program will be carried out individual pregnant women on the basis of pre-pregnancy nutritional status.
Birth Weight* ; Body Size ; Female ; Ferritins ; Fetal Blood ; Gestational Age ; Humans ; Infant, Newborn ; Iron* ; Nutritional Status ; Parturition* ; Placenta* ; Pregnancy ; Pregnancy Outcome ; Pregnant Women ; Umbilical Cord*

PURPOSE: In spite of the karyotype and phenotype diversity in Turner syndrome patients, there are few reports about such differences in Korea. We reviewed the data of chromosome abnormalities, clinical manifestations, and comorbidities of Turner syndrome patients in Kyungpook National University Hospital to compare them to the recent hypotheses about sex chromosome gene loci related to Turner symptoms. MATERIALS AND METHODS: We identified the cytologic findings of 92 patients with Turner syndrome and the clinical findings of 62 patients among them. RESULTS: 54.3 percent of patients had 45,X while 45.7 percent showed other karyotype combinations (45,X/46,XX, 45,X/46,XX/47,XXX, 46,X,del(Xp), 46,X,del(Xq), 45,X/46,X,del(Xq), 46,X,i(Xq), 45,X/46,X,i (Xq)). The Turner symptoms found included short neck, high arched palate, broad chest, Madelung deformity, short metacarpals, scoliosis, cubitus valgus, low hair line, webbed neck, edematous extremities, pigmented nevus, and sexual infantilism. The specific diseases associated Turner syndrome included renal abnormalities, congenital heart disease, hearing defects, diabetes mellitus, hyperlipidemia, and decreased bone density. The phenotype of the mosaicism group was milder than that of the monosomy group. In the case of 46,X,del(Xp) and 45,X/46,X,del(Xq) groups, all had skeletal abnormalities, but the 46,X,del(Xq) group had none. In the case of 46,X,del(Xp) group, all showed short statures and skeletal abnormalities, but no sexual infantilism was observed. In the case of 46,X,i(Xq) and 45,X/46,X,i(Xq) groups, they all showed delayed puberty and had primary amenorrhea. CONCLUSION: It is important to study karyotype-phenotype correlations in patients with Turner syndrome to obtain interesting information about the genotype-phenotype correlations related to the X chromosome.
Bone Density ; Chromosome Aberrations ; Comorbidity ; Congenital Abnormalities ; Diabetes Mellitus ; Extremities ; Genetic Association Studies ; Growth Disorders ; Hair ; Hearing ; Heart Diseases ; Humans ; Hyperlipidemias ; Karyotype ; Korea ; Metacarpal Bones ; Monosomy ; Mosaicism ; Neck ; Nevus, Pigmented ; Osteochondrodysplasias ; Palate ; Phenotype ; Puberty, Delayed ; Scoliosis ; Sex Chromosomes ; Sexual Infantilism ; Thorax ; Turner Syndrome ; X Chromosome

Microsurgery of the larynx using direct laryngoscopy is becoming an increasingly popular technique for the otorhinolaryngologist. Many techniques of anesthesia have been developed for these procedures but they all have the same drawbacks. General anesthesia with endotracheal intubation decreases the field of vision for the surgeon or it requires unusual surgeon anesthetist co-operatives. Therefore neuroleptic analgesia has been adapted to the suspension laryngoscope. Because of the greater stability of the circulatery and respiratory systems associated with their use. Thalamonal(droperidol 2.5mg/ml with fentanyl 0.05mg/ml) was found to be preferable to other anesthstic for the production of neuroleptic analgesia. Thus in 28 patients requiring laryngomicrosurgery in Severance hospital duriag the past 4 years(May, 1975-March, 1979), a butyrophenon derivative, droperidol and fentanyl has been used for the production of neuroleptic analgesia. Consequently. we concluded that, in most cases of suspension laryngoscopy, we could gain a good analgesic and anesthetic condition with 3.02ml(mean value) Thalamonal adveres action for a 55 minute(mean value) operation without remarkable undesirable adveres effects. In addition to this. this technique was of great benefit to the operator, because not only the patient awake during operation and cooperative to the operation but also vocal cord mobility can be observed during the operation.
Analgesia ; Anesthesia ; Anesthesia, General ; Droperidol ; Fentanyl ; Humans ; Intubation, Intratracheal ; Laryngoscopes ; Laryngoscopy ; Larynx ; Microsurgery ; Respiratory System ; Vocal Cords

The osteopoikilosis is commonly known as harmatoma in which metaphyseal and epiphyseal area of long bones and the bone of pelvis, hands, feet and et al, contain islands of dense cortical bone with normal Harversian system without any symptoms. The radiologic findings of the osteopoikilosis is multitude of oval or well-circumscribed areas of increased density, 2 to 10 mm in size, in symmetrical distribution and normal uptake in bone scan. Buschke-Ollendorff syndrome, which is transmitted by autosomal dominant, is characterized by the association of osteopoikilosis and connective tissue nevi which are popular and symmetrically distributed lesions on chest, back, buttock, thigh or arm. Authors report three Buschke-Ollendorff syndrome, studied by CT scan, MRI, bone scan and bone and skin biopsy, among five patients associated with osteopoikilosis found by simple radiologic study from ten members in one family with their pedigree.
Arm ; Biopsy ; Buttocks ; Connective Tissue ; Foot ; Hand ; Humans ; Islands ; Magnetic Resonance Imaging ; Nevus ; Osteopoikilosis ; Pedigree ; Pelvis ; Skin ; Thigh ; Thorax ; Tomography, X-Ray Computed

BACKGROUND: Every practitioner, however skilled, will encounter patients who are unexpectedly difficult to intubation. The incidence of difficult laryngoscopy appears to be approximately 0.5% to 2%. So many methods are used to intubate the trachea, but endotraheal intubation by them is not always possible. The purpose of the this study is to evaluate the effectiveness of magnet on the endotracheal intubation. METHODS: Twenty patients(aged 30 to 59yr, ASA physical status 1) required general anesthesia with an endotracheal tube. Anesthesia was induced with thiopental sodium and succinylcholine, ventilation was controlled with 100% O2. The tip of the epiglottis was exposed wtih a No.3 MacIntosh laryngoscope. A catheter with ferrous stylet was placed behind epiglottis close to tracheal lumen and a magnet was placed over the cricoid cartilage allowing the stylet to be pulled. Endotraheal tube was guided into the trachea over the stylet. The time to intubation, the blood pressure and heart rate of pre- and postintubation, and the difficulty of intubation were recorded and the complications of the endotracheal intubation such as bronchial spasm, oral and tracheal mucosal trauma, and sore throat, were observed. RESULTS: The mean time to intubation was 31.2+/- 8(18 to 50)sec. There were statistically signigicant increase in blood pressure and heart rates following intubation. The incidence of excellent and good intubating condition were 14 and 6 respectively. Seventeen and three intubations were successful on the 1st and 2nd attempts respectively. There were no differences in incidence of complications of endotracheal intubation compared to other reports. CONCLUSIONS: Though magnet guided technique has some limitations to use in case of difficult laryngoscopy, it can be used with merits such as simplicity and cheapness when other methods are not available.
Anesthesia ; Anesthesia, General ; Blood Pressure ; Bronchial Spasm ; Catheters ; Cricoid Cartilage ; Epiglottis ; Heart Rate ; Humans ; Incidence ; Intubation* ; Intubation, Intratracheal ; Laryngoscopes ; Laryngoscopy ; Pharyngitis ; Succinylcholine ; Thiopental ; Trachea ; Ventilation

No abstract available.
Lip* ; Xanthomatosis*

Objective: This study investigated associations of life stressors and serum ghrelin levels with suicidal ideation (SI), and evaluated the potential mediating effect of ghrelin on associations between life stressors and SI in patients with acute coronary syndrome (ACS). Methods: In total, 969 ACS patients recruited from a tertiary university hospital in Korea within 2 weeks of disease onset were evaluated in terms of life stressors (using the List of Threatening Events Questionnaire), serum ghrelin levels, and SI (using the “suicidal thoughts” item of the Montgomery–Asberg Depression Rating Scale). Covariates included sociodemographics, depression, vascular risk factors, and disease severity. After 1 year, 711 patients were re-evaluated in terms of SI; logistic regression was performed with adjustment for covariates. Results: Life stressors were significantly associated with SI at baseline and follow-up. Serum ghrelin showed no such associations, but high levels thereof mediated associations of life stressors with SI; significant interaction terms were also observed after adjustment for covariates. Conclusion By evaluating life stressors and serum ghrelin levels, clinical prediction of SI in the acute and chronic phases of ACS could be improved.

Objective: We aimed to identify the individual and interactive effects of childhood abuse and suicidal ideation on antidepressant treatment response in 12 months. Methods: In this prospective research, 1,262 depressive patients were asked about their childhood abuse history, suicidal ideation, and other clinical characteristics and socio-demographic features at baseline, and 1,015 of them were followed during 1 year of stepwise pharmacotherapy. The individual and interactive relationships of the childhood abuse history and suicidal ideation on 12-month antidepressant non-remission were explored by logistic regression with relevant covariates. Results: Having a childhood abuse history and higher suicidal ideation significantly predicted a non-remission state in 12 months respectively. The interaction term of childhood abuse and suicidal ideation was also significantly related to a non-remission state at 12 months. To be specific, in the low suicidal ideation group, depressive patients with a childhood abuse history were more likely to be in a non-remission state after 12 months of medication. In the high suicidal ideation group, however, childhood abuse history was not significantly associated with the non-remission state at 12 months. Conclusion The childhood abuse history and the level of suicidal ideation are informative factors predicting the long-term results of antidepressant treatment, especially when they are combined. Clinicians may consider antidepressants with a higher affinity for patients with childhood abuse history even if they don’t have suicidal ideation. The cognitive intervention for suicidal ideation might be helpful in addition to pharmacological treatment.

BACKGROUND/AIMS: Percutaneous endoscopic gastrostomy (PEG) is performed to provide enteral nutrition to patients who require tube-feeding support due to impaired oral intake. As life expectancy increases, the need for, and use of PEG also tend to increase. We aimed to evaluate the indications and complications of PEG insertion, and to investigate any differences in the complication group. MATERIALS AND METHODS: We conducted a retrospective analysis of 109 patients who received a PEG procedure between April 2011 and April 2016 in the Korea University Ansan Hospital. We reviewed the indications and complications related to PEG insertion and time interval of tube change. RESULTS: Among 109 patients who underwent a PEG procedure, 71.6% were male, and the mean age was 68.2 years. The most common indications for PEG were central nervous system diseases, including stroke (33.9%), cerebral hemorrhage (29.4%), and hypoxic brain damage (8.3%). The overall complication rate was 14.7%, and the most common complication was peristomal infection (7.3%). Most of the complications occurred within 10 days in 14 of 16 patients (87.5%). The patients with complications were older than those without complications (74.6±11.1 vs. 67.1±14.0 years, P=0.043). The mean time interval for gastrostomy tube change was 7.3 months. CONCLUSIONS: The most common indication of PEG was brain disease, and the complication rate cannot be ignored. Careful attention is needed after a PEG procedure especially in elderly patients.
Aged ; Brain Diseases ; Central Nervous System Diseases ; Cerebral Hemorrhage ; Endoscopy ; Enteral Nutrition ; Gastrostomy* ; Gyeonggi-do ; Humans ; Hypoxia, Brain ; Korea ; Life Expectancy ; Male ; Retrospective Studies* ; Stroke

PURPOSE: Ventricular repolarization is assessed using the QT interval corrected by the heart rate (QTc) via an electrocardiogram (ECG). Prolonged QTc is associated with an increased risk of arrhythmias and cardiac mortality. As there have been few reports regarding the effects of hyperthyroidism on ventricular repolarization, we studied the association between serum free thyroxine (free T4 [fT4]) and thyroid stimulating hormone (TSH) levels and the QTc interval. METHODS: Thirty-eight patients with hyperthyroidism (<30 years old) were included, and we used their clinical records and available ECGs (between August 2003 and August 2011) to evaluate the association between their fT4 and TSH levels and their QTc interval. In addition, we studied the ECGs of 72 age-matched patients with no hyperthyroidism (control group) and compared their data with that from the patients group. RESULTS: The QTc duration in patients with hyperthyroidism was significantly prolonged compared to that in the control subjects (P<0.001). In addition, the number of hyperthyroid patients with abnormal prolonged QTc was significantly higher than that in the control group (P<0.001). Among the patients with hyperthyroidism, patients with prolonged QTc and borderline QTc had higher fT4 levels and there was positive correlation between their fT4 levels and their QTc interval (P<0.05). However, no correlation was observed between their TSH levels and their QTc interval. CONCLUSION: We report that hyperthyroidism is associated with QTc prolongation. The correlation between the fT4 levels and the QTc interval suggests that thyroid status is associated with QTc values and the risk of cardiac mortality.
Arrhythmias, Cardiac ; Electrocardiography ; Heart Rate ; Humans ; Hyperthyroidism* ; Long QT Syndrome ; Mortality ; Thyroid Gland* ; Thyrotropin ; Thyroxine