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

Posterior reversible encephalopathy syndrome (PRES) is a disorder of reversible vasogenic edema which mainly involves the parieto-occipital lobes in various clinical settings. Isolated involvement of the brainstem, basal ganglia, and cerebellum is rare. An 81-year-old female was admitted because of a decreased level of consciousness, and she had a head trauma history a day before. Brain magnetic resonance imaging (MRI) showed extensive confluent T2 hyperintensity with swelling involving the bilateral thalami, brainstem, and cerebellar peduncle without cortical lesions. We reports a case of central-variant PRES after traumatic brain injury.

Posterior reversible encephalopathy syndrome (PRES) is a disorder of reversible vasogenic edema which mainly involves the parieto-occipital lobes in various clinical settings. Isolated involvement of the brainstem, basal ganglia, and cerebellum is rare. An 81-year-old female was admitted because of a decreased level of consciousness, and she had a head trauma history a day before. Brain magnetic resonance imaging (MRI) showed extensive confluent T2 hyperintensity with swelling involving the bilateral thalami, brainstem, and cerebellar peduncle without cortical lesions. We reports a case of central-variant PRES after traumatic brain injury.

Posterior reversible encephalopathy syndrome (PRES) is a disorder of reversible vasogenic edema which mainly involves the parieto-occipital lobes in various clinical settings. Isolated involvement of the brainstem, basal ganglia, and cerebellum is rare. An 81-year-old female was admitted because of a decreased level of consciousness, and she had a head trauma history a day before. Brain magnetic resonance imaging (MRI) showed extensive confluent T2 hyperintensity with swelling involving the bilateral thalami, brainstem, and cerebellar peduncle without cortical lesions. We reports a case of central-variant PRES after traumatic brain injury.

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

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

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

Superior vena cava syndrome can occur from benign conditions that might not alter life expectancy. Here we present a case of a superior vena cava (SVC) obstruction caused by soft tissue encircling the SVC, which was strongly suspected of being an unusual focal type of fibrosing mediastinitis. A 39-year-old man with no prior medical history presented with a four-week history of facial plethora, headache and dilated veins of the neck with a dark purple color change on the anterior chest wall. Radiology examinations, including venography, and computed tomography with a 3-dimensional volume-rendering image of the chest, had revealed severe narrowing of the SVC due to tiny encircling soft tissue and collateral vessels. A total occlusion of the SVC occurred as a result of a thrombus that developed within 1 day after the diagnostic SVC angiogram. The patient underwent stent deployment three days after the administration of thrombolytic therapy.
Adult ; Fibrinolytic Agents/therapeutic use ; Humans ; Male ; *Stents ; Superior Vena Cava Syndrome/*diagnosis/etiology/surgery