Tethered cord syndrome is a kind of spinal dysraphism with low-lying conus frequently associated with intraspinal lipoma, diastematomyelia, or fibrous band. The clinical manifestations include spine abnormality such as spina bifida and variable neurological symptoms involving lower extremities and sphincters. Here are two cases of tethered cord syndrome associated with intraspinal lipoma. Both are diagnoses with CTMM (computed tomographic metrizamide myelography) and one is operated.
Conus Snail ; Diagnosis ; Lipoma ; Lower Extremity ; Metrizamide ; Neural Tube Defects ; Spinal Dysraphism ; Spine

BACKGROUND: Little research based on the artificial neural network (ANN) is done on preterm birth (spontaneous preterm labor and birth) and its major determinants. This study uses an ANN for analyzing preterm birth and its major determinants.
Adenomyosis ; Biopsy ; Body Mass Index ; Conization ; Diabetes Mellitus ; Female ; Forests ; Humans ; Hypertension ; Korea ; Logistic Models ; Machine Learning ; Mass Screening ; Myoma ; Obstetric Labor, Premature ; Parity ; Parturition ; Placenta Previa ; Pregnancy ; Premature Birth ; Seoul

Several studies have reported adequate patient transfer to higher level hospitals according to the risk for improving perinatal outcomes. According to these reports, countries across the world divide the levels of maternal care on the basis of the assessment of hospital facilities and medical services as well as the assessment of high-risk pregnancies while evaluating the cases of and risks associated with maternal care that can be addressed by these hospitals at each level. Because the level of and policies on maternal care vary across countries, we aimed to evaluate risk assessments and introduction of treatment facility classifications in different countries. In Korea, birth rate is declining and the number of elderly pregnant women is increasing, whereas the number of hospitals that can deliver a baby and care for mothers at high risk is decreasing. We, therefore, need to establish an infrastructure for medically vulnerable areas, a localization center, and a medical personnel supplement. Moreover, establishing detailed guidelines and criteria for different levels of maternal care is necessary. The new guidelines will also need to supplement the policies on the requirement of well-trained obstetricians and of low medical insurance fee.
Aged ; Birth Rate ; Classification ; Fees and Charges ; Female ; Humans ; Insurance ; Korea ; Maternal-Child Health Services ; Mothers ; Patient Transfer ; Pregnancy, High-Risk ; Pregnant Women ; Prenatal Care ; Risk Assessment

This study reviews recent advances on the application of artificial intelligence for the early diagnosis of various maternal-fetal conditions such as preterm birth and abnormal fetal growth. It is found in this study that various machine learning methods have been successfully employed for different kinds of data capture with regard to early diagnosis of maternal-fetal conditions. With the more popular use of artificial intelligence, ethical issues should also be considered accordingly.

Several vaccines have been developed to combat the coronavirus disease 2019 (COVID-19), including messenger Ribonucleic acid (mRNA, Pfizer-BioNtech, and Moderna) and viral vector (AstraZeneca and Janssen) types. Unfortunately, reports of COVID-19 exposure during pregnancy are scarce, as pregnancy and breastfeeding were among the exclusion criteria in the efficacy and safety studies of major COVID-19 vaccines. The U.S. Centers for Disease Control and Prevention recently included pregnancy as a risk factor for severe COVID-19 infection, although the absolute risk is low. Previous experience in pregnant women with mRNA vaccines is lacking despite such vaccines not using live viruses, being unable to cause disease, not interacting with an individual's DNA, and being unable to cause genetic mutations. In addition, previous studies in animals have not revealed any safety issues with such vaccine types for female reproduction or fetal development. Vaccine-induced antibody titers were equivalent in pregnant and lactating women versus non-pregnant women. Given the data on increased mortality and morbidity associated with COVID-19 during pregnancy, it may be unethical to withhold vaccinations based on a theoretical risk and a lack of clinical research in this population. Additionally, a careful review of the vaccination recommendations for pregnant women by the academic community and government through additional efficacy and safety studies tailored to the situation in Korea is needed.

No abstract available.
Tendons*

Spontaneous coronary artery dissection is a rarely identified entity whose exact incidence, etiology, pathogenesis, medium-term evolution and optimal treatment have not yet been firmly estabilished. The cause of spontaneous disection remains unclear but theories of etiology include a medial eosinophilic angiitis, pregnancy induced degeneration of collagen and rupture of the vasovasoum. Most paients die suddenly, but a clinical spectrum is seen including and unstable angina, myocardial infarction and cardiogenic shock. We experienced 4 cases with spontaneous coronary artery dissection found angiographically which caused myocardial infarction and unstable angina. Our patients were treated medically.
Angina, Unstable ; Collagen ; Coronary Vessels ; Eosinophils ; Humans ; Incidence ; Myocardial Infarction ; Myocardial Ischemia* ; Pregnancy ; Rupture ; Shock, Cardiogenic ; Vasculitis

PURPOSE: We studied the effect of LASIK and LASEK for correction of myopic astigmatism and the clinical results in relation to preoperative astigmatism and operative methods. METHODS: We retrospectively analyzed the results of 176 eyes of 97 patients in the LASIK group and of 56 eyes of 29 patients in the LASEK group. All patients had undergone LASIK or LASEK for correction of myopic astigmatism with MEL-70TM (Aesculap-Meditec, Jena, Germany). Patients were divided into groups I (or=3.00D) according to preoperative astigmatism, and into groups A (LASIK) and B (LASEK) according to operative method. Each patient was followed up for over 6 months with measurements of uncorrected visual acuity, manifested refraction, and spherical equivalent at 1, 3, and 6 months after operation. RESULTS: In groups IA, IB, IIA, IIB, IIIA, IIIB, IVA, and IVB, preoperative cylindrical errors were 0.56 +/- 0.17D, 0.61 +/- 0.13D, 1.27 +/- 0.28D, 1.24 +/- 0.21D, 2.18 +/- 0.25D, 2.10 +/- 0.25D, 3.39 +/- 0.66D, and 3.50 +/- 0.61D, and postoperative 6-month astigmatism measurements were 0.33 +/- 0.49D, 0.34 +/- 0.36D, 0.28 +/- 0.30D, 0.63 +/- 0.44D, 0.48 +/- 0.42D, 0.44 +/- 0.57D, 0.86 +/- 0.42D, and 1.00 +/- 0.78D, respectively. CONCLUSIONS: The correction of myopic astigmatism in LASEK was less effective than in LASIK at early postoperative periods, but they showed similar effect on the correction of astigmatism at 6 months after surgery, especially in the group with medium to low grade of astigmatism.
Astigmatism* ; Humans ; Keratectomy, Subepithelial, Laser-Assisted* ; Keratomileusis, Laser In Situ* ; Postoperative Period ; Retrospective Studies ; Visual Acuity

BACKGROUND: Healthcare-associated infections (HAIs) are among the most important threats to patient safety. When hospitalized children face these threats, there is morbidity, mortality, prolonged hospitalization, and increased healthcare costs. Research on local healthcare epidemiology is necessary to enhance collective knowledge and evidence formanaging this problem. METHODS: We performed a retrospective analysis of databases of patients who were diagnosed with HAIs at Chung-Ang University Hospital (CAUH) from 2007 through 2011. Cases were selected from the microbiology registry databases. The data on prevalence of HAIs in various wards and its annual trends were compared to previously reported nationwide data. Moreover, we analyzed the patterns of antibiotic susceptibility results for HAI pathogens. RESULTS: A total of 181 HAIs were identified in 122 patients. The HAI rate among pediatric patients at CAUH was 2.4/1,000 person-hospital days. Urinary tract infections (UTIs) (53 episodes, 29.3%) were the most common, followed by pneumonia (33 episodes, 18.2%). Staphylococcus aureus was found to be the most common gram-positive organism, whereas Escherichia coli was the most common gram-negative organism. Methicillin-resistant S. aureus (MRSA) comprised 84% of the S. aureus infections. Imipenem resistance was detected in 58.8% and 55.0% of Acinetobacter baumannii and Pseudomonas aeruginosa isolates, respectively. CONCLUSION: Between 2007 and 2011, UTIs were the most common type of HAIs, and MRSA was the most common pediatric HAI pathogen, both in the general ward and intensive care unit at the CAUH. Further research on the epidemiology and pathogenesis of HAIs is necessary and prevention measures should be implemented to prevent HAIs in children.
Acinetobacter baumannii ; Child ; Child, Hospitalized ; Delivery of Health Care ; Escherichia coli ; Health Care Costs ; Hospitalization ; Humans ; Imipenem ; Intensive Care Units ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Microbial Sensitivity Tests ; Patient Safety ; Patients' Rooms ; Pneumonia ; Prevalence ; Pseudomonas aeruginosa ; Retrospective Studies ; Staphylococcus aureus ; Urinary Tract Infections

No abstract available.
Animals ; Rats* ; Vitamin A* ; Vitamins* ; Wounds and Injuries*