OBJECTIVE: The aim of study was to analyze obstetric and neonatal causes of Korean neonatal deaths. METHODS: The study subjects are a cohort of infants who were born during 1996 and who died before their first birthday. The data were collected through three stages of the study: the collection of existing data, a national infant mortality survey at medical facilities, and data integrating and adjusting process. The sources of existing data were health insurance data and the resident registration data. The National infant mortality survey was conducted by both 'Ministry of Health and Welfare' and 'Korea Institute for Health and Social Affairs'. 3930 medical and health facilities where obstetrics services are available were surveyed during November 1998. The survey results were computerized to match data sets, and any overlap among different data sets were filtered. Causes of deaths were grouped according to the KCD (Korean Standard Classification of Diseases). Causes of neonatal death were further analyzed using composite causes combining obstetric and neonatal conditions. RESULTS: Causes of 2,433 neonatal death were known out of 2,856 deaths. "Certain conditions originating in the perinatal period" comprised 77.1% of neonatal death, being the most common cause. The next common cause was 'congenital malformations, deformations and chromosomal abnormalities', constituting 15.7% of neonatal death. Among the 'certain conditions originating in the perinatal period', 'respiratory distress of newborn' constituted 17.1% of neonatal deaths and 'disorders related to short gestation and low birth weight', constituted 15.6% of neonatal deaths. Neonatal sepsis constituted 14.8% of neonatal death. Among congenital malformations 'congenital malformation of the heart' was most common, constituting 6.2% of neonatal death. 'Certain conditions originating in the perinatal period' was more important cause of preterm neonatal death. Of the related maternal condition, idiopathic preterm birth, multifetal pregnancy, premature rupture of the membranes and hypertensive diseases during pregnancy were common conditions. Congenital malformation was the most important cause of term neonatal death. CONCLUSION: Prematurity-related condition was more important cause of preterm neonatal death while congenital malformation was the most important cause of term neonatal death.
Cause of Death ; Classification ; Cohort Studies ; Dataset ; Gestational Age ; Health Facilities ; Humans ; Infant ; Infant Mortality ; Insurance, Health ; Membranes ; Obstetrics ; Parturition ; Pregnancy ; Premature Birth ; Rupture ; Sepsis

Abdominal pregnancy that is a life threatening variant of ectopic pregnancy, has been a rare event with high maternal mortality. It is very difficult to diagnose a abdominal pregnancy clinically. We have experienced a case of early abdominal pregnancy diagnosed at emergency laparotomy and this case was presented with a brief review of the literatures.
Emergencies ; Female ; Laparotomy ; Maternal Mortality ; Pregnancy ; Pregnancy, Abdominal* ; Pregnancy, Ectopic

BACKGROUND: With the advent of functional endoscopic sinus surgery, the importance of the ostiomeatal unit(OMU) has been known. Anatomic abnormalities, irreversible inflammatory changes, or obstruction of ostiomeatal unit lead to sinus ostial obstruction and subsequent chronic or recurrent sinusitis. For these reasons, septal deviation, concha bullosa and paradoxical middile turbinate may compress the uncinate process and occlude the infundibulum and then they may induce anterior paranasal sinusitis. OBJECTIVES: This study was conducted to evaluate the relationship between the existence of anatomical variations of sinonasal regions and Babbel's five patterns of chronic sinusitis based on coronal plane CT and to be helpful in treatment of chronic sinusitis. MATERIALS AND METHOD: From february 1994 to February 1996, Coronal plane CT scans of 150 patients with bilateral sinonasal disease were retrospectively reviewed. We examined anatomical variations-paradoxical middle turbinate, concha bullosa, and septal deviation-using PNS CT and analyzed the finding of PNS CT based on Babbel's five patterns of chronic sinusitis. One patient with bilateral sinonasal disease was considered as two different cases. RESULTS: In consequence of this study, the existence of anatomical variations don't show any influence on the paranasal sinusitis patterns. CONCLUSION: This study suggests that the existence of anatomical variations may not be significantly associated with respective incidence of the paranasal sinusitis patterns and may similarly influence in each patterns of chronic sinusitis.
Humans ; Incidence ; Retrospective Studies ; Sinusitis* ; Tomography, X-Ray Computed ; Turbinates

Nausea and vomiting during early pregnancy is a common phenomenon, but very little data is available about the mechanism of this condition, and the etiology of hypereme sis is still unknown. One of the most popular hypothesis is that abnormal hormone levels, especi-ally thyroid hormone, may be possible etiologic factor of nausea and vomiting. The object of this study is to investigate the relationship between the presence or ab- sence of nausea and vomiting in early pregnancy and thyroid function. Twenty patients suffering from hyperemesis gravidarum of first trimester of pregnancy and twenty from morning sickness were selected. 20 non-pregnant and 20 pregnant women without nausea and vomiting were selected to age-matched control groups. Thyroid function was evaluated by using T3, T4, and TSH radioimmunoassay. Comparison between groups were analyzed with the paired t-test. In this study, we found that a significant increase in serum total T4(p<0.001) and T3 (p<0.05), and a significant decrease in serum TSH(p<0.001) were observed in pregnancy with hyperemesis gravidarum relative to the level in normal pregnancy. These results were correlated with the severity of nausea and vomiting. In conclusion, highly elevated T3 and T4 were closely linked to the cause of the vomi- ting in pregnancy with hyperemesis gravidarum. Further study is needed to evaluate more clearly the thyroid status of patients with hyperemesis gravidarum and to seek a therapy.
Female ; Humans ; Hyperemesis Gravidarum* ; Morning Sickness ; Nausea ; Pregnancy ; Pregnancy Trimester, First ; Pregnant Women ; Radioimmunoassay ; Thyroid Gland* ; Tolnaftate ; Vomiting

PURPOSE: Despite a recent surge in the performance of laparoendoscopic single-site surgery (LESS), concerns remain about performing LESS pyeloplasty (LESS-P) because of the technical difficulty in suturing. We report our techniques and initial experiences with LESS-P using additional needlescopic instruments and compare the results with conventional laparoscopic pyeloplasty (CL-P). MATERIALS AND METHODS: Nine patients undergoing LESS-P were matched 2:1 with regard to age and side of surgery to a previous cohort of 18 patients who underwent CL-P. In both groups, the operating procedures were performed equally except for the number of access points. In the LESS-P group, we made a single 2 cm incision at the umbilicus and used a homemade port. We also used additional 2 mm needlescopic instruments at the subcostal area to facilitate suturing and the ureteral stenting. RESULTS: The preoperative characteristics were comparable in both groups. Postoperatively, no significant differences were noted between the LESS-P and CL-P cases in regard to length of stay, estimated blood loss, analgesics required, and complications. But, LESS-P was associated with a shorter operative time (252.2 vs. 309.7 minutes, p=0.044) and less pain on postoperative day one (numeric rating scale 3.7 vs. 5.6, p=0.024). The success rate was 94% with CL-P (median, 23 months) and 100% with LESS-P (median, 14 months). CONCLUSIONS: Our initial experiences suggest that LESS-P is a feasible and safe procedure. The use of additional 2 mm instruments can help to overcome the difficulties associated with LESS surgery.
Analgesics ; Cohort Studies ; Humans ; Laparoscopy ; Length of Stay ; Operative Time ; Stents ; Umbilicus ; Ureter ; Ureteral Obstruction

OBJECTIVES: This study was designed to evaluate the effects of risperidone on the schedule-induced polydipsia (SIP) which is one of animal model of obsessive-compulsive disorder in rats. We administered risperidone as a serotonin and dopamine blocking agent, fluoxetine as a selective serotonin reuptake inhibitor, and haloperidol as a dopamine antagonist to rats which showed schedule-induced polydipsic behaviour. METHODS: Sprage-Dawley rats weighing 200 - 250gm were individually housed and main-tained and allowed free access to water. The rats were placed on a restricted diet. To induce polydipsia, rats were placed in the cage where a pellet dispenser automatically dispensed 90mg pellets on a fixed-time 60 seconds (FT 60s) feeding schedule over 150 minute test session per day. Water was available at all times in the cage. After 4 weeks of daily exposure to the FT 60s feeding schedule, experimental rats met a predetermined criterion for polydipsic behavior (greater than 3 times of water per session on average). 5 groups of rats were administered risperidone (0.1mg/kg, i.p), risperidone (0.5mg/kg, i.p), fluoxetine (5mg/kg, i.p.), haloperidol (0.1mg/kg, i.p.), and vehicle (1cc/kg, i.p. ) for 3 weeks. The rats were tested once a week to access schedule induced polydipsic behavior. Water bottles were weighed before and after the 150-minute test session. The chronic effects of administration of experimental drugs on schedule induced polydipsic behavior were analyzed with ANOVA and Scheffe test as a posthoc comparison. In order to measure water consumption in non-polydipsic food-deprived rats, a separate group of rats (N=8) was individually housed and given a single bolus (14.5gm) of food per day which maintained them at their average body weight. RESULTS: The results were as follows; 1) After 4 weeks of scheduled feeding procedure, the experimental group showed significant differences than the bolus control in the amount of water consumption as compared with their average water intakes for 4 weeks. At the same periods, there were no differences between the experimental group and the bolus control in the body weight. 2) The fluoxetine group showed significant decrease in the amount of water intake at 1st, 2nd, and 3rd weeks of drug treatment as compared with their average amount of polydipsic water intakes. The risperidone 0.1mg group and the risperidone 0.5mg group showed significant decrease in the amount of water intake at the 3rd weeks of drug treatment as compared with their baseline of polydipsic water intakes. However, the haloperidol group and the vehicle control group showed no changes of amounts of water intake for 3 weeks of treatment as compared with their baseline of polydipsic water intakes. 3) The fluoxetine group (22.5+/-10.4ml) showed significantly lower amounts of water intake than haloperidol group (41.3+/-7.1ml) at 2nd weeks of drug treatment. And also the fluoxetine group (18.8+/-3.5ml) showed significantly lower amounts of water intake than the haloperidol group (35.0+/-11.7ml) and the vehicle control (34.4+/-6.8ml) at 3rd weeks of drug treatment. The risperidone 0.1mg group and the risperidone 0.5mg group showed significantly lower amounts of water intake than the haloperidol group (35.0+/-11.7ml) at 2nd weeks and the vehicle control (37.5+/-12.5 , 34.4+/-6.8ml) at 2nd and 3rd weeks of drug treatment. CONCLUSIONS: Above findings suggest that the fixed time feeding procedure for schedule induced polydipsia could be applied as an effective animal model of obsessive compulsive disorder for the evaluation of pharmacological challenge study. We confirmed that chronic treatment with risperidone revealed antipolydipsic effect as effective as fluoxetine on the schedule-induced polydipsic behaviour but the onset of effect was later than fluoxetine.
Animals ; Appointments and Schedules ; Body Weight ; Diet ; Dopamine ; Drinking ; Fluoxetine ; Haloperidol ; Models, Animal ; Obsessive-Compulsive Disorder ; Polydipsia* ; Rats* ; Risperidone* ; Serotonin ; Water

We report a case of hepatic cavernous hemangioma with computed tomographic findings of well demarcated nodular lesser attenuation foci within the main low attenuation mass on precontrast scans and non-enhancement of the foci even on the delayed contrast scans. These have been described as one of the atypical findings of cavernous hemangioma earlier in the literature. Surgery proved that sclerosis accounted for the hypodense nodular densities within the hepatic cavernous hemangioma.
Adult ; Case Report ; Female ; Hemangioma, Cavernous/*pathology/radiography ; Human ; Liver Neoplasms/*pathology/radiography ; Sclerosis ; *Tomography, X-Ray Computed

OBJECTIVES: The aim of this study was to investigate the relationship between job stress and the willingness of male workers in small and medium scale industry to cease smoking. METHODS: A structured self-reported questionnaire was used to assess each respondent's socio-demographics, job stress, and the will to cease smoking. A KOSS (Korean Occupational Stress Scale)- based questionnaire survey was conducted which targeted 4,435 male workers at 69 small and medium scale industries. 2,840 men returned these questionnaires with 1,663 of them being smokers. We analyzed 1,345 of the smoker returns. We estimated the relationship between the will to cease smoking and the employee job stress factors using logistic regression analyses. RESULTS: After adjusting for education, exercise, and tobacco use per day, the logistic regression analysis revealed a significantly positive association with the will to cease smoking and job stress. The odds ratios regarding insufficient job control were at 1.69 (95% CI, 1.26~2.27), organizational system at 1.37 (95% CI, 1.03~1.82), and lack of reward at 1.37 (95% CI, 1.03~1.82). CONCLUSIONS: These results indicated that job stress may play a significant role in the will to cease smoking. Further preventive efforts and studies are needed in order to reduce job stress.
Humans ; Logistic Models ; Male ; Odds Ratio ; Questionnaires ; Reward ; Smoke ; Smoking ; Smoking Cessation ; Tobacco

PURPOSE: The purpose of this study was to evaluate the clinical course and pregnancy outcome according to operative management of appendictis in the Department of Surgery. METHODS: We reviewed the charts of pregnant patients who went through a convential appendectomy and a laparoscopic appendectomy at the Department of Surgery, Catholic University of Korea St. Mary's Hospital, from May 1995 to June 2006. RESULTS: The incidence of acute appendicitis during pregnancy was the highest at the 2nd trimester and at ages from 25 to 30 years. The laparoscopic appendectomy was shorter than the open appendectomy in hospital stay and decreased leukocytosis faster in the first postoperative day, except in cases of perforated appendicitis, but the operation times were similar. There was a significant difference in gestational age at delivery between perforated appendicitis and suppurative. We found one fetal anomaly, but it was not related to either the appendicitis or the operation method. CONCLUSIONS: In this study, we found that a laparoscopic appendectomy was better than an open appendectomy for recovery and was safe in pregnant appendicitis patients at any gestational age. However, follow up and investigation in a larger population is needed to get more accurate results.
Appendectomy ; Appendicitis ; Female ; Follow-Up Studies ; Gestational Age ; Humans ; Incidence ; Korea ; Laparoscopy ; Length of Stay ; Leukocytosis ; Pregnancy ; Pregnancy Outcome

PURPOSE: Intestinal intussusception in adults is a rare entity and its clinical course and etiology differ from pediatric counterpart. About 90% have a primary pathologic lesion, especially malignancy consists of etiology as 30% in small bowel and 66% in large bowel. The purpose of this study is to investigate of accurate diagnosis, treatment, and timing of operation by review of clinical symptom, physical examination, laboratory finding, pathologic finding, and operation finding of adult intussusception patients. METHODS: We studied 20 adult patients who were diagnosed as intussusception between July 1993 and September 2005. Intussusception by operation and rectal prolapse were excluded. Clinicopatholgic findings were analyzed retrospectively through the medical record. RESULTS: There was 15 males and 5 females in all 20 patients, and mean age was 52.3 years with a range of 29 to 78 years. Preoperative diagnosis was suspected in 14 of 20 patients (70%). We performed emergency operation in 8 cases (40%) and elective operation in 12 cases (60%). Two cases of them which preoperative diagnosis were strangulation and peritonitis accompanied with small bowel necrosis and leukocytosis. There were 12 small bowel lesions (60%) and 6 colonic lesions (30%). In two cases, there were no primary lesions. Of the cases with a defined cause, 12 cases were malignant (60%) and 6 cases were benign (30%). CONCLUSION: The most useful diagnostic method is computed tomography to reveal adult intussusception. Two cases of all were strangulated and also had a leukocytosis. In adult intussusception, most common cause is malignancy. If there is no evidence of strangulation such as leukocytosis, we recommend that elective surgery is adequate.
Adult* ; Colon ; Diagnosis ; Emergencies ; Female ; Humans ; Intussusception* ; Leukocytosis ; Male ; Medical Records ; Necrosis ; Peritonitis ; Physical Examination ; Rectal Prolapse ; Retrospective Studies