OBJECTIVE: The purpose of this study was to evaluate of course of delivery & perinatal outcomes for postterm pregnancy compared with fullterm pregnancy. METHODS: This study included 360 cases of postterm pregnancy out of 16,992 cases delivered at Department of Obstetrics and Gynecology from January 1, 1993 to December 31, 1997. 16,143 cases of full term deliveries of 38 to 42 gestational weeks conducted in same period were used as the control group. Postterm pregnancy was defined as a pregnancy that it exceeds 295 days calculated from first day of the last menstrual period. RESULTS: The incidence of postterm pregnancy was 2.13% with the highest incidence occurring in the 26 ~30 years age group. This study group was significantly different from the control group in the incidence of fetal distress (10.28% vs. 2.20%), large fetus (10.83% vs. 6.95%), perinatal death (1.67% vs. 0.27%). CONCLUSIONS: Adverse perinatal outcomes were increased markedly as the gestational weeks to be prolonged. Therefore, careful prenatal care, accurate determination of delivery date is very important.
Fetal Distress ; Fetus ; Gynecology ; Humans ; Incidence ; Obstetrics ; Pregnancy* ; Prenatal Care

No abstract available.
Diagnosis* ; Female ; Pregnancy ; Pregnancy, Ectopic* ; Ultrasonography*

Clonorchiasis is known to be closely related with the development of recurrent pyogenic cholangitis and carcinoma of the bile ducts. In order to ascertain the cholangiographic signs for recurrent pyogenic cholangitis or carcinoma of the bile ducts arising in patients with clonorchiasis. we reviewed cholangiograms in 42 patients with proven clonorchiasis. The population consisted of 29 patients with clonorchiasis alone, six patients with clonorchiasis and recurrent pyogenic cholangitis, and seven patients with clonorchiasis and carcinoma of the bile ducts. Cholangiographic abnormalities in 29 patients with clonorchiasis alone, six patients with clonorchiasis and recurrent pyogenic cholangitis, and seven patients with clonorchiasis and carcinoma of the bile ducts. Cholangiographic abnormalities in 29 patients with clonorchiasis alone were intrahepatic multiple, oval, or elliptic filling defects measuring 2-10 mm in size, representing adult flukes (n=24). The peripheral bile duct were obstructed (n=18), and the margins were ragged (n=20) and hazy (n=12) the intrahepatic bile ducts were dilated diffusely (n=27), and the dilated peripheral small tributaries gave the impression of "too many ducts appearance" (n=7) and dilatation was mid (n=17) In six patients with clonorchiasis and recurrent pyogenic cholangitis, there were filling defects of stones, and the extrahepatic ducts and larger intrahepatic ducts were predominantly dilated. In seven patients with clonorchiasis and cholangiocarcinoma all the biliary tree proximal to the tumor was markedly and diffusely dilated In the latter two groups, filling defects of flukes and associated findings were less prominent, but there was disproportionately severe dilatation of too many intrahepatic ducts. In patients with recurrent pyogenic cholangitis or cholangiocarcinoma, clonorchiasis should be considered as a underlying cause when cholangiogram shows "disproportionately" severe dilatation of too many intrahepatic ducts. intrahepatic ducts.
Adult ; Bile Ducts ; Bile Ducts, Intrahepatic ; Biliary Tract ; Cholangiocarcinoma ; Cholangitis ; Clonorchiasis* ; Dilatation ; Humans ; Trematoda

Hypoglycemia due to non-islet cell tumor is usually associated with hypersecretion of big insulin-like growth factor II (IGF-II). This big IGF-II cannot form ternary IGF complex, and is biologically more active in peripheral tissue, inducing increased glucose utilization and hypoglycemia. A 57-year-old man developed severe hypoglycemia due to hepatocellular carcinoma. To control hypoglycemia, the patient required continuous glucose infusion. The circulating levels of cortisol and free T4 were in the normal range. The plasma levels of insulin, C-peptide, IGF-I, IGF binding protein-3 (IGFBP-3), and total IGF-II levels were decreased. Radioimmunoassay of IGF-II revealed that big IGF-II immunoreactivity markedly increased compared to that of normal control. In this patient, it was strongly suggested that big IGF-II might be a cause of severe intractable hypoglycemia.
C-Peptide ; Carcinoma, Hepatocellular ; Glucose ; Humans ; Hydrocortisone ; Hypoglycemia* ; Insulin ; Insulin-Like Growth Factor I ; Insulin-Like Growth Factor II* ; Middle Aged ; Plasma ; Radioimmunoassay ; Reference Values

BACKGROUND: Almost no study has been carried out to explore the cognitive characteristics of the oldest old population in Korea, even though Korean society is becoming very 'old'. The purpose of this study is to the examine basic cognitive functions of Korean elders over 100 years of age. METHODS: Data collection was completed with 87 elders, 12 males and 75 females. Their mean age was 103.2 for males and 102.3 for females. The average year of education for this population was less than 1 year(0.5 year). We evaluated cognitive functions by K-MMSE and the severity of dementia by CDR (Clinical Dementia Rating). RESULTS: Most of them were able to speak fluently(81.6%) and had reasonable vision(67.8%), but 55.2 % of subjects had full comprehension ability. There was no significant difference in results between elders from Seoul and from other country area. We have divided the sample population into 5 groups according to CDR score; 0(7.4%), 0.5(33.3%), 1(25.9%), 2(14.8%), 3(18.5%), to compare with K-MMSE score. There were significant differences in K-MMSE scores between CDR groups. DISCUSSION: About 7% of elders over 100 years of age are still maintaining normal cognitive function. Considering the physical handicaps of the subjects, probable dementia group(30%) can also be regarded as to possess near normal cognitive function. This study is the first study on Korean centenarians and will provide essential data for future studies on the oldest old.
Aged, 80 and over ; Comprehension ; Data Collection ; Dementia ; Education ; Female ; Humans ; Korea ; Male ; Seoul

A 34-year-old female patient was presented with leg and hip pain for 6 months as well as voiding difficulty for 1 year. Magnetic resonance imaging revealed a well-demarcated mass lesion at L2-3. The mass was hypo-intense on T1- and T2-weighted images with homogeneous gadolinium enhancement. Surgery was performed with the presumptive diagnosis of intradural extramedullary meningioma. Complete tumor removal was possible due to lack of dural adhesion of the tumor. Histologic diagnosis was clear cell meningioma, a rare and newly included World Health Organization classification of meningioma usually affecting younger patients. During postoperative 2 years, the patient has shown no evidence of recurrence. We report a rare case of cauda equina clear cell meningioma without any dural attachment.
Adult ; Cauda Equina ; Female ; Gadolinium ; Hip ; Humans ; Leg ; Magnetic Resonance Imaging ; Meningioma ; Recurrence ; World Health Organization

PURPOSE: Prostate cancer is rare in men younger than 50 years. Digital rectal examination (DRE) and measurement of prostate-specific antigen (PSA) concentrations are standard screening methods for detecting prostate cancer. We retrospectively investigated the risks and benefits of repeated transrectal ultrasonography-guided prostate needle biopsies in relation to the follow-up status of men younger than 50 years with a consistently high PSA concentration (>3.0 ng/mL). MATERIALS AND METHODS: During the period from January 2000 through February 2013, we reviewed patient's ages, dates of procedures, DRE results, frequencies of biopsies, results of the biopsies, periods of follow-up, PSA concentrations, and prostate volumes in Chonbuk National University Hospital records. We conducted telephone interviews in patients who did not undergo regular follow-up. RESULTS: The mean age of the patients was 44.7 years, and the mean PSA concentration was 8.59 ng/mL (range, 3.04-131 ng/mL) before biopsy. The PSA concentration was significantly different (p<0.001) between the patients with prostate cancer and those with benign prostatic hyperplasia (BPH). Nineteen patients underwent repeated prostate biopsy; however, in only one patient did the pathologic findings indicate a change from BPH to prostate cancer. We identified several complications after transrectal biopsy through an evaluation of follow-up data. CONCLUSIONS: All patients with benign prostatic disease based on their first biopsy were shown to have benign disease based on all repeated biopsies (15.83%), except for one patient; however, several complications were noted after biopsy. Therefore, the risks and benefits of repeated biopsy in young patients should be considered because of the low rate of change from benign to malignant disease despite continuously high PSA concentrations (>3.0 ng/mL).
Biopsy* ; Biopsy, Needle ; Digital Rectal Examination ; Follow-Up Studies* ; Hospital Records ; Humans ; Interviews as Topic ; Jeollabuk-do ; Male ; Mass Screening ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Diseases ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Retrospective Studies ; Risk Assessment* ; Young Adult

OBJECTIVES: This study presents a scientific basis for the establishment of an environmental health contingency plan for dealing with accidental coastal oil spills and suggests some strategies for use in an environmental health emergency. METHODS: We reviewed the existing literature, and analyzed the various fundamental factors involved in response strategies for oil spill. Our analysis included data derived from Hebei Spirit oil spill and used air dispersion modeling. RESULTS: Spill amounts of more than 1,000 kl can affect the health of residents along the coast, especially those who belong to vulnerable groups. Almost 30% of South Korean population lives in the vicinity of the coast. The area that is at the highest risk for a spill and that has the greatest number of people at risk is the stretch of coastline from Busan to Tongyeong. The most prevalent types of oil spilt in Korean waters have been crude oil and bunker-C oil, both of which have relatively high specific gravity and contain volatile organic compounds, polycyclic aromatic hydrocarbons, and metals. In the case of a spill of more than 1,000 kl, it may be necessary to evacuate vulnerable and sensitive groups. CONCLUSIONS: The government should establish environmental health planning that considers the spill amount, the types of oil, and the distance between the spot of the accident and the coast, and should assemble a response team that includes environmental health specialists to prepare for the future oil spill.
*Accidents ; Decision Support Techniques ; *Disaster Planning ; *Environmental Health ; Environmental Monitoring ; Environmental Pollution/*prevention & control ; *Petroleum ; Population Dynamics ; Risk Assessment

PURPOSE: To evaluate a role as over 35 years, maternal serum markers, and a false positive screen for Down syndrome were the predictor of adverse pregnancy outcome. Materials and METHODS: From Mar.1994, through Feb.1996, 5284 women were screened triple test to detect Down syndrome in the second trimester and were delivered Samsung Cheil hospital. The values of each maternal serum markers were measured with radioimmunoassay. And then, the screen positive of Down syndrome was calculated using alpha-software Version 4.0. The adverse outcome of the fetus and the mother included low birth weight(LBW) ( <2500gm), prematurity( <37 gestational weeks), placenta previa, preterm premature rupture of membranes(PPROM), pregnancy induced hypertension(PIH),abruptio placenta, and intrauterine fetal death(IUFD). The predictor markers included over 35years, elevated alpha-fetoprotein (AFP), elevated human chorionic gonadotropin(hCG), lowered unconjugated estriol (uE3), and a false positive screen for Down syndrome. RESULTS: Mean age and mean gestational weeks in the study were 30+/-4.8 years and 17.1 weeks respectively. The adverse pregnancy outcomes were 357 LBW(6.8%), 253 prematurity(4.8%), 108 placenta previa(2.0%), 68 PPROM(1.3%), 66 PIH(1.3%), 24 abruptio placenta(0.5%), and 20 IUFD(0.4%). In univariate analysis, over 35 years was significantly associated with abruptio placenta, prematurity, and placenta previa, elevated MS-AFP( >2.0 MoM) associated with IUFD, LBW, PIH, prematurity, and PPROM , elevated MS-hCG (>3.0 MoM) associated with IUFD, LBW, PIH, prematurity, and placenta previa, lowered uE3 (<0.75) associated with IUFD, abruptio placenta, LBW, and prematurity.(P <0.05). In multivariate logistic regression analysis, IUFD was significantly associated with only elevated MS-AFP, LBW associated with elevated MS-AFP, elevated MS-hCG, and lowered uE3, PIH associated with only elevated MS-AFP, PPROM only elevated MS-AFP, prematurity only elevated MS-AFP, and placenta previa over 35 years, elevated MS-hCG.(P <0.05). However, abruptio placenta was not significantly associated with predictor markers.(P >0.05) CONCLUSIONS: Some predictors such as over 35 year, elevated hCG, lowered uE3, a false positive screen for Down syndrome were significantly associated with adverse pregnancy outcome. Also in multivariate analysis, we identified especially elevated AFP to be the most reliable predictor for adverse pregnancy outcome.
alpha-Fetoproteins ; Biomarkers ; Chorion ; Down Syndrome ; Estriol ; Female ; Fetus ; Humans ; Logistic Models ; Mothers ; Multivariate Analysis* ; Parturition ; Placenta ; Placenta Previa ; Pregnancy ; Pregnancy Outcome* ; Pregnancy Trimester, Second ; Pregnancy* ; Radioimmunoassay ; Rupture

Leuconostoc species are Gram-positive coccobacilli and are used in dairy products and are intrinsically resistant to vancomycin. Leuconostoc infections are rare in humans, usually occurring in immune-compromised patients. We describe 6 patients with Leuconostoc bacteremia at Dong-A university hospital between 1990 and 2015. One isolate (L. lactis) was identified to species level using 16S rRNA gene sequencing analysis. All patients had underlying diseases and 5 patients underwent procedures that interrupted the normal integumentary defense. Four patients died within 30 days after being identified as carrying Leuconostoc species.
Bacteremia ; Dairy Products ; Genes, rRNA ; Humans ; Leuconostoc ; Vancomycin ; Vancomycin Resistance