One fetal demise of twin pregnancy in the second or third trimester is an unusual and difficult problem in the managemcnt of pregnancy. It can be associated with an increased risk for mortality and morbidity in the remaining fetus and with maternal DIC. 255 twin gestations were delivered at our hospital between December 1984 and August 1998. 8 cases of twin pregnancies with one fetal demise were observed. We reviewed 8 cases of twin pregnancies with one fetal demise that had been managed conservatively. The incidence of twin pregnancies with one fetal demise was 3.14% in the study population. The incidence of preterm delivery was 87.5%. The perinatal mortality rate of surviving twins was 25%. There were no cases of maternal disseminated intravascular coagulation or infection. There were no cases of neurologic damages in the surviving twins. The main cause of neonatal death was prematurity. An expectant approach to the twin pregnancies with one fetal demise seems reasonable.
Dacarbazine ; Disseminated Intravascular Coagulation ; Female ; Fetus ; Humans ; Incidence ; Mortality ; Perinatal Mortality ; Pregnancy ; Pregnancy Trimester, Third ; Pregnancy, Twin*

This study was done to compare the nutritional status of antioxidant vitamins between college women smokers and nonsmokers. Dietary intakes and serum levels of antioxidant vitamins were determined in 33 smokers and 42 nonsmokers residing in the Seoul area. Dietary intakes of vitamin A and C were determined by a quick and convenient dietary intake method. Serum vitamin C level was measured by 2,4-dinitrophenylhydrazine method and serum levels of vitamin A and E were measured by HPLC. The mean A intake of nonsmokers and smokers was 504.3 microgram R.E./day and 450. 4 microgram R.E./day and the mean vitamic C intake of nonsmokers and smokers was 51.6mg/day and 50.2mg/day, reapectively. There was no difference in the dietary intakes of antioxidant vitamins between smokers and nonsmokers. The serum vitamin A level, 0.71mg/1 in nonsmokers was not significantly different from that of 0.74mg/1 in smokers. However, the serum vitamin C level, 7.94mg/1 in smokers was 15% lower(p<0.05) than that of 9.30mg/1 in nonsmokers. The serum vitamin E level, 18.15mg/1 in smoders was also 34% lower(p<0.05) than that of 27.58mg/1 in nonsmokers. There was no significant correlation between dietary intakes and serum levels of vitamin A and C for both smokers and nonsmokers. These results suggest that cigarette smokers need more dietary intakes of vitamin C and E than do nonsmokers to reach the same serum level.
Ascorbic Acid ; Chromatography, High Pressure Liquid ; Female ; Humans ; Nutritional Status* ; Seoul ; Tobacco Products ; Vitamin A ; Vitamin E ; Vitamins*

Burns is children result in the loss of precious life, or if the child survives, in much suffering from physical, emotional, social, and economic problems. These burn accidents to children happen in the bustle of family life and frequently without any warning. With this background information, this study was designed to identity types of burns in children and mother's attitudes towards, and knowledge of burn prevention, in order, to not only, in still a safety consciousness regarding the seriousness of burn accidents and the strengthening prevention, but also as basic data towards the development of an educational program aimed at prevention. From May 1 to May 25 in 1997, data were collected from the mothers of children attending five day care centers and kindergartens located in Seoul, which had been selected for the study. The tools used for the study, which were developed by the researchers, surveyed the type of burns suffered by children, mother's knowledge of burns and attitudes toward burn accidents. The data were analyzed through real numbers percentages and analysis was done using SPSS computer programs. The results of the study show that the most frequent type of burn accidents were those caused by hot water(55.4%) and these were frequently related to everyday habits that easily lead to danger. Further, the first aid treatment following a burn was weak. The majority of the mothers had not instructed their children on who to contact in the cape of a fire, first aid for burns, or how to take escape in the case of a fire. This left the children in a defenseless position in case of a fire. The mothers showed a lack knowledge, on what to do when a blaze is discovered, how to put out a fire, first aid for burns, escaping from a fire and appropriate water temperature, in that 50% of the time they answered incorrectly. From this study a prevention program, HIPP(Home Injury Prevention Program) could be developed that includes fire prevention habits and first aid for burns. This program can be used with kindergarten and elementary school children for group education fire prevention and can be used as a foundation for construction of a system of facilities and equipment to prevent fires and also prevent injury from fires.
Burns* ; Child* ; Consciousness ; Day Care, Medical ; Education ; Fires ; First Aid ; Humans ; Mothers ; Seoul ; United Nations ; Water ; Child Health

Obstructive jaundice of the bile duct resulting from tumor-producing copious, thick mucin, causing ductal obstruction and dilatation, has been reported very rarely. Also, the benign bile duct neoplasm is extremely rare. We report a case of a mucin-secreting villous adenoma of common hepatic duct causing obstructive jaundice and cholangitis. The patient was a 72-year-old male and had a 3 yeared history of common hepatic mass unchanged remarkably in size. The abdominal ultrasonogram and computed tomography revealed well circumscribed, more than 2cm sized mass on the CHD and ductal dilatation. We were able to get an interesting cholangioram showing irregular, nodular, ill defined filling defect in the extrahepatic bile duct, different from US and CT findings, And it was just caused by thick, copious mucin from the tumar. This case was confirmed as mucin-secreting villous adenoma after surgery.
Adenoma, Villous* ; Aged ; Bile Duct Neoplasms ; Bile Ducts ; Bile Ducts, Extrahepatic ; Cholangitis ; Dilatation ; Hepatic Duct, Common* ; Humans ; Jaundice, Obstructive ; Male ; Mucins* ; Ultrasonography

No abstract available.
Animals ; Diuresis* ; Heat-Shock Proteins ; HSP70 Heat-Shock Proteins* ; Rats* ; Urinary Bladder*

No abstract available.
Hypersensitivity* ; Meperidine* ; Skin*

A survey was conducted to study attitudes of physician, nurse and patient towards physician's and nurse's uniform, from March 1 to March 31, 1996. The study population was 130 physicians and 147 nurses engaged in Yeungnam University Medical Center and 211 inpatients of Yeungnam University Medical Center. A questionnaire method was used to collect data. The following are summaries of findings: In the respect of physician's uniform, both physicians and nurses preferred other type of gown to the traditional coat-typed one and especially, nurses preferred more than physicians. Patients showed no difference in the preference of the traditional one and other form of gown as a whole but those who had higher educational level preferred other form of gown(p<0.01). It tended to agree wearing casual wear of physician during the working time of weekend and holiday as a whole. Younger physicians showed significantly higher preference for it(p<0.05). Regarding the nurse's uniform, both physicians and nurses preferred trousers, and 96% of the nurses did. Especially, nurses who were forty years old or more and who served at outpatient department and administrative and aid parts expressed 100 percent partiality to trousers. For the patients, those who had lower educational level preferred skirt and those who had higher educational level preferred trousers. As to the color of nurse's gown, 46.7% of the physicians and nurses liked white color. The physicians preferred white and nurses preferred other color(p<0.01). Of the patients, 79.1% liked white color. Regarding the wearing cap, 95.9% of the nurses replied it didn't have to wear the cap. The nurses who were fifty or more and who served at outpatient department and special parts gave whole answers of not having to wear the cap. On the other hand, 77.7% of the patients answered nurse had to wear the cap. From the above findings, it would be advisable to give a change to the forms and colors of the gowns to match with the trend and sense of the time instead of insisting on the traditional typical ones.
Academic Medical Centers ; Hand ; Holidays ; Humans ; Inpatients ; Outpatients

No abstract available.
Mortality*

A 58-year-old female with an episode of gross hematuria two months before and fever and chill for the past three days presented oliguric acute renal failure. She has taken NSAID intermittently for 18 years due to rheumatoid arthritis, and herb medicine for one week two months ago when gross hematuria developed. Physical examination revealed mild tenderness on costovertebral angles. Her blood pressure was 170/100 mmHg, the urinalysis showed >300 mg protein with many RBCs and 10-20 WBCs and the serum creatinine was 5.8 mg/dl. A renal biopsy performed on the 4th hospital day showed that it was overwhelmed by severe tubular lesions which reveal intratubular obstruction by massive erythrocyte casts and tubular necrosis. The glomeruli showed focal minimal crescents with many red blood cells entrapped in the crescents and in the capillaries. Immune deposits were not present. A renal failure resolved spontaneously and the patient was discharged three weeks later with creatinine of 2.4 mg/dl. In this patient, acute renal failure was considered to be due to a tubular lesion related to the glomerular bleeding from focal glomerulonephritis revealing minimal crescents.
Acute Kidney Injury* ; Arthritis, Rheumatoid ; Biopsy ; Blood Pressure ; Capillaries ; Creatinine ; Erythrocytes ; Female ; Fever ; Glomerulonephritis* ; Hematuria* ; Hemorrhage ; Humans ; Middle Aged ; Necrosis ; Physical Examination ; Renal Insufficiency ; Urinalysis

BACKGROUND: Few studies have reported the results of arthroscopic coracoplasty concomitantly conducted with subscapularis tear. Therefore, this study was conducted to examine and compare the outcomes of arthroscopic subscapularis repair after arthroscopic coracoplasty using either the subacromial approach or rotator interval approach. METHODS: We retrospectively reviewed 51 patients who underwent coracoplasty with subscapularis repair. The patients were grouped according to whether the subacromial approach group (24 patients) or rotator interval approach group (27 patients) was used during coracoplasty. Preoperative and postoperative visual analogue scale scores, American shoulder and elbow surgeons scores, Korean shoulder scores, and range of motion (ROM) were assessed. Assessment of repaired rotator cuff tendon integrity was performed at 1 year after surgery using either magnetic resonance imaging or ultrasonography. RESULTS: At final follow-up, overall functional scores and ROM improved significantly in both groups when compared with preoperative values (p>0.05). The re-tear rates were not significantly different between groups; however, the rotator interval approach group showed a significant increase in ROM compared with that in the subacromial approach group (p<0.05). CONCLUSIONS: Arthroscopic coracoplasty conducted concomitantly with subscapularis repair can provide a satisfactory outcome. There were no significant differences between the two approach groups regarding final functional scores and re-tear rates. However, the rotator interval approach group showed a greater increase in ROM at final follow-up, especially in external rotation.
Arthroscopy ; Elbow ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Range of Motion, Articular ; Retrospective Studies ; Rotator Cuff ; Shoulder ; Surgeons ; Tears* ; Tendons ; Ultrasonography