No abstract available.
Glycemic Index ; Humans

No Abstract Available.
Electrophysiology* ; Neuroendocrine Cells*

OBJECTIVE: Currently, preparation for childbirth is becoming an increasingly popular addition to patient education. Because of this interest, it seems advisable to review the evidence on the effect of prepared childbirth. The objective of this study is to evaluate the effectiveness of Lamaze preparation on labor and delivery. METHODS: To investigate whether prepared-childbirth courses offer measurable physical advantages, we compared the labor and delivery characteristics of 80 primiparas who had taken Lamaze-training classes with 76 control patients who had not. We reviewed retrospectively obstetrical records of 156 pregnant women delivered in Ewha Womans University MokDong Hospital from January to December, 1997. RESULT: The length of the first stage of labor in the group that attended childbirth preparation classes was 5.70 hours and 6.93 hours in the comparison group. This difference was statistically significant (P= .040). The mean duration of the second stage of labor in attenders was 42.43 minutes and 41.16 minutes in the nonattenders(P= .719). Average duration of labor in attenders was 1.07 hours shorter than in nonattenders (P= .075). The cesarean section rate in attenders was 25% compared with 36.8% in nonattenders (P= .10920). CONCLUSION: No statistical significance was found in this study. However we need to be aware that the length of first stage of labor was shorter and the rate of cesarean section was lower in prepared group. Childbirth education should be integrated into prenatal health care to be readily available for all women.
Cesarean Section ; Delivery of Health Care ; Female ; Humans ; Parturition ; Patient Education as Topic ; Pregnancy ; Pregnant Women ; Prenatal Education ; Retrospective Studies

PURPOSE: To analyse the radiological findings of bizarre parosteal osteochondromatous proliferation (BPOP), a rare benign tumorous lesion with a high frequency of recurrence which frequently occurs around the short tubular bones of the hands and feet. MATERIALS AND METHODS: Between 1984 and 1998, 19 cases of BPOP were pathologically Proven, and in is of these, six men and nine women aged between 17 and 69(mean, 41) years, plain radiographs were available for analysis. We examined the location and size of lesions, and their relationship to adjacent bone. RESULTS: In all cases, trabecular bone formations were present. There were not separable from adjacent bones, which in all cases appeared normal. In nine of 15 cases margins were sharp, and in the remaining six they were irregular. Lesions were located around a phalanx of the hand (n=5), a metatarsal bone (n=3), a long bone (n=3), a phalanx of the foot (n=2), a metacarpal bone (n=1), and a metatarsophalangeal joint (n=1). Their average size was 2.5 x1.9cm, and in three of is cases the tumor recurred. CONCLUSIONS: BPOP showed a well-marginated mass of heterotopic mineral arising around short tubular bones. These findings were useful for diagnosis and differential diagnosis.
Diagnosis ; Diagnosis, Differential ; Female ; Foot ; Hand ; Humans ; Male ; Metatarsal Bones ; Metatarsophalangeal Joint ; Recurrence

Simple or unicameral bone cysts are metaphyseal lesions of long bones. They usually move away from the physiswith growth to become diaphyseal in location. Involvement of the physis and epiphysis by these cystic lesions isvery rare. This paper reports a case of simple bone cyst of the proximal humerus in a 11- year -old girl which wasshown by MR imaging to extend through the physis into the epiphysis.
Bone Cysts* ; Epiphyses* ; Female ; Humans ; Humerus* ; Magnetic Resonance Imaging

Subcutaneous emphysema is a complication of the pneumoperitoneum necessary to perform laparoscopy and will be seen more often as laparoscopic techniques are applied to a growing number of intraabdominal procedures. We report a case of subcutaneous emphysema and hypercarbia without pneumothorax or pneumomediastinum during laparoscopic cholecystectomy, which was treated by multiple puncture with 18G needle on emphysematous site. The suspected cause is inadvertent subcutaneous insufflation of carbon dioxide through the trocar sites by increased intra-abdominal pressure for the establishment of pneumoperitoneum. Immediate recognition, evaluation, and treatment of subcutaneous emphysema is necessary since this can be life-threatening complication.
Carbon Dioxide ; Cholecystectomy, Laparoscopic* ; Insufflation ; Laparoscopy ; Mediastinal Emphysema ; Needles ; Pneumoperitoneum ; Pneumothorax ; Punctures ; Subcutaneous Emphysema* ; Surgical Instruments

PURPOSE: Osteoarticular infections in children and adolescents are important because it can cause functional compromise if appropriate treatment is delayed. Therefore, this study was designed to describe the clinical presentations and causative organisms of osteoarticular infections in children and adolescents in order to propose early diagnosis method and an appropriate empiric antimicrobial therapy. METHODS: Forty-two medical records were reviewed retrospectively, which were confirmed as osteomyelitis (OM) or septic arthritis (SA) at Department of Pediatrics or Orthopedic Surgery in patients under 18 years old of Ewha Womans University Mokdong Hospital from March 2008 to March 2015. RESULTS: We identified 21 cases of OM, 13 cases of SA and 8 cases of OM with SA. There were 31 males and 11 females and mean age was 7.1 years old. The most common symptoms were pain and tenderness of involved site. Major involved bones were femur (10 cases, 34.5%), tibia (7 cases, 24.1%) and major involved joints were hip (9 cases, 42.9%), and knee (5 cases, 23.8%). Increased serum C-reactive protein and erythrocyte sedimentation rate were observed in 37 cases (88.1%) respectively. Magnetic resonance imaging was performed in 40 cases among 42 cases and was used to demonstrate osteoarticular infections and other adjacent infections. Nine cases (23.7%) among 38 cases and 20 cases (50.0%) among 40 cases were positive in blood culture and infected site culture respectively. The most common causative organism was Staphylococcus aureus, which was represented in 22 cases (75.9%), of which nine cases (40.9%) were resistant to methicillin. CONCLUSIONS: S. aureus was the most common causative organism of osteoarticular infections in children and adolescents and the proportion of MRSA was high in this study. Therefore, we recommend vancomycin as the first empiric antimicrobial therapy and suggest that further study is necessary to elucidate an appropriate guideline for treatment which takes into account MRSA proportion.
Adolescent* ; Arthritis, Infectious ; Blood Sedimentation ; C-Reactive Protein ; Child* ; Early Diagnosis ; Female ; Femur ; Hip ; Humans ; Joints ; Knee ; Magnetic Resonance Imaging ; Male ; Medical Records ; Methicillin ; Methicillin-Resistant Staphylococcus aureus ; Orthopedics ; Osteomyelitis ; Pediatrics ; Retrospective Studies* ; Staphylococcus aureus ; Tibia ; Vancomycin

Giant cell tumors of the bone commonly occur in the epiphyseal scar of a long tubular bone, representing about 5% of all primary bone tumors. A short tubular bone, such as one in the hand or foot, is the site of less than 5% of all giant cell bone tumors. The authors report two cases in which giant cell tumors arose in the short tubular bone, and describe the clinical manifestations and radiologic findings.
Bone Neoplasms ; Cicatrix ; Foot ; Giant Cell Tumors* ; Giant Cells* ; Hand

BACKGROUND: Endobroncheal intubation or extubation may occur accidentally when the patient's neck is flexed or extended even in the appropriate endotracheal intubation. The purpose of this study is to examine the effect of fixation or unfixation of the endotracheal tube at the teeth level on the displacement of its distal end when the patient's neck is extended or flexed. METHODS: This study was conducted in 37 patients who underwent endotracheal general anesthesia. The patients with the evidence of pathology in head, neck and chest were excluded from the study. Individual patient's displacement in endotracheal tube tip compared unfixed cases with fixed cases when the change of neck position. The moved distance was measured by fiberoptic bronchoscope. The data were statistically analyzed by Student's paired t-test. RESULTS: The endotracheal tube moved away from the carina when the patient's neck was extended, while it moved toward the carina when flexed in all cases. When the patient's neck was extended the average distance displaced 1.2 0.7 cm in fixed cases and 1.1 0.9 cm in unfixed cases. when the neck was flexed, they were 1.2 0.5 cm and 1.0 0.8 cm respectively. There were not statistically significant between the fixed and the unfixed cases. CONCLUSIONS: It is concluded that the displacement of the endotracheal tube is not related to its fixation or unfixation at the teeth level and therefore, unfixation does not provide any benefits in terms of the displacement of the distal end of the tube in adult trachea.
Adult ; Anesthesia, General ; Bronchoscopes ; Head ; Humans ; Intubation ; Intubation, Intratracheal ; Neck* ; Pathology ; Thorax ; Tooth ; Trachea

BACKGROUND: A long-term objective is to understand the pathogenesis of neurologic injuries associated with cardiac surgery, cardiopulmonary bypass, and circulatory arrest. Our specific aims are to establish a dose of air which results in moderate to severe neurologic defects in normothermic (37degrees C) rabbits. METHODS: To first establish a dose of air which would cause unequivocal neurologic impairment, anesthetized rabbits received either 0, 50, 100 or 150 microgram l/kg of air into the internal carotid artery(n=5 in each group). One hour later, anesthesia was discontinued and animals were recovered. Animal were neurologically evaluated at 24 hours using a zero(normal) to 97(coma) point scale. RESULTS: There was a clear relationship between the dose of air injected and the severity of neurologic impairment at 24 hours, p=1.1x10(-7). Rabbits receiving 50 micrograml/kg of air were minimally affected and were difficult to distinguish from controls. In contrast, rabbits receiving 150 micrograml/kg of air were uniformly and unequivocally impaired. CONCLUSION: we recommend for future cerebral air embolism studies, 150 microgram l/kg as the optimal dose of air which would reliably produce viable subjects for 24 hours with marked unequivocal, neurologic impairment.
Anesthesia ; Animals ; Brain ; Cardiopulmonary Bypass ; Embolism ; Embolism, Air* ; Rabbits ; Thoracic Surgery