No abstract available.
Glycemic Index ; Humans

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

No Abstract Available.
Electrophysiology* ; Neuroendocrine Cells*

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

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

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

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

PURPOSE: The purpose of this study is to evaluate the CT and MR findings of brain absecss with emphasis on the thickeness and signal intensity of abscess wall. MATERIALS AND METHODS: Twenty CT scans and seven MR studies of 23 patients with brain abscess (27 abscesses) were retrospectively reviewed with respect to thickeness and signal intensity of abscess wall, shape and size of abscess, etc. Thickness of abscess wall was measured in the greatest abscess diameter on the CT scans and MR images obtaihed after intravenous administration of contrast material. RESULTS: Enhancing abscess wall was 2mm--6mm (average 3mm) thick. The abscess wall was uniform in thickness in 14 cases (52%), thinner in the roedial wall than lateral wall in 8 cases (30%), and thicker in the medial wall than lateral wall in 5 cases (18%). Signal intensity of abscess wall was isointense relative to gray matter on Tl-weighted MR images and hypointense on both proton- and T2-weighted MR images in 7 out of 8 lesione (88%). The inner margin of the abscess wall was smooth in 14 (52%) and irregular in 13 lesions (48%). The outer margin was smooth in 15 (55%) and irregular in 12 lesions (45%). The size of the abscesses was variable, ranging from lcm to 6cm in diameter. They were round (16 cases), elliptical (6 cases), or multilobulated (5 cases) in shape. Satellite or daughter abscesses were found in 5 patients. CONCLUSION: Abscess wall showed variable thickness in the medial and lateral walls with no specific findings. Other CT and MR findings were also nonspecific, although hypointensity of abscess wall on T2-weighted MR images may be helpful in diagnosis of brain abscess.
Abscess* ; Administration, Intravenous ; Brain Abscess* ; Brain* ; Diagnosis ; Humans ; Nuclear Family ; Retrospective Studies ; Tomography, X-Ray Computed

Amniotic fluid embolism (AFE) is a rare peripartum complication with a mortality rate of 61 to 86%. The main clinical manifestations include shock, acute pulmonary edema, neurologic signs, and coagulopathies. Most diagnosis of AFE is made on the postmortem examination of the maternal pulmonary vasculature, but antemortem confirmation of amniotic fluid material by aspiration of pulmonary blood is rare. We report the first case in Korea who survived from amniotic fluid embolism confirmed by the identification of amniotic fluid debris in pulmonary artery blood. Serial echocardiographic changes of left ventricle systolic dysfunction are also described with a brief review of literatures.
Amniotic Fluid* ; Autopsy ; Diagnosis ; Echocardiography ; Embolism, Amniotic Fluid* ; Female ; Heart Ventricles* ; Korea ; Mortality ; Neurologic Manifestations ; Peripartum Period ; Pregnancy ; Pulmonary Artery ; Pulmonary Edema ; Shock