Apert's syndrome(acrocephalosyndactyly) is a rare congenital anomaly that is characterized by the combination of premature fusion of multiple cranial sutures primarily involving the coronal suture and severe symmetrical syndactyly of fingers and toes. Some patients of this syndrome have various abnormalities of the central nervous system. We experienced a case of Apert's syndrome with craniofacial malformations, symmetric syndactyly, occipital encephalocele and hypogenesis of corpus callosum. She had a oxycephalic head with small sized anterior fontanelle, elongated forehead, hypertelorism, down-slanting palpebral fissures, flattened nose, cleft palate, low set ears and short neck. A 5x3 cm sized scalp-covered soft mass protruded in the occipital area through defect of the occipital bone. MRI showed hypogenesis of corpus callosum, occipital encephalocele, dilatation of the lateral and the third ventricles. She also had hands and feet with symmetric syndactyly involved skin and soft tissue but not bones.
Central Nervous System ; Cleft Palate ; Corpus Callosum* ; Cranial Fontanelles ; Cranial Sutures ; Dilatation ; Ear ; Encephalocele* ; Fingers ; Foot ; Forehead ; Hand ; Head ; Humans ; Hypertelorism ; Magnetic Resonance Imaging ; Neck ; Nose ; Occipital Bone ; Skin ; Sutures ; Syndactyly ; Third Ventricle ; Toes

No abstract available.
Gestational Trophoblastic Disease*

OBJECTIVES: The trial was performed to obtain an unbiased comparison of the relative merits of endocervical and vaginal prostaglandin E2(PGE2) in the case of parous and nulliparous woman with favorable and unfavorable cervical features. This study was performed to determine the clinical usefullness of endocervical PGE2 comparing with the vaginal PGE2 in cervical ripening and induction of labor. METHOD: The randomized trial with 65 Participants was performed with sealed envelopes for parity and Bishop score (from March to september, 1998). PGE2 tablet(3mg Dinoprostone) was administrated intravaginally to the 32 pregnant women and endocervically to the 33 pregnant women every eight hours with maximum three times until the regular labor develped. RESULT: Outcomes of labor and delivery were clearly related to cervical score at trial entry. endocerval PGE2 had a more marked effect on cervical ripeness than did vaginal PGE2. There were no significant differences on age distribution, gestatioanal period, primiparity, cervical status, initial B-score in each group. There were no significant differences in cesarian section rate, fetal distress, uterine hyperstimulation, side effect and poor infant outcome between the groups The mean induction time was statistically shorter in cervical group with multiparous women than other group(p=0.0195). In the induction-active labor time, cervical with primi group was statistically shorter than other group(p=0.0245). Statistically significant differences were noted between the nulliparous woman and multiparous women in mean induction time, induction-active labor time, time to B-score 8. In the factor that effects induction-active labor, route was significantly better than other factor.(p=0.0001) CONCLUSION: edocervical PGE2 is more effctive than vaginal PGE2 in cervical ripening and induction of active labor. the endocervical PGE2 resulted in a significantly shorter induction to active labor time compared with vaginal PGE2 and has almost no side effect. Because differences in effectiveness between endocervical and vaginal PGE2 are marginal, preference of woman and clinicians can the choice between them.
Age Distribution ; Cervical Ripening ; Dinoprostone ; Female ; Fetal Distress ; Humans ; Infant ; Parity ; Pregnancy ; Pregnant Women

BACKGROUND: There are a few studies on the effects of job strain on the prevalence of sleep problems in the foreign countries. In Korea, it has not been studied till now. In this article, the combined effects of job strain, shift work and some life style on the prevalence of sleep proplems were studied among workers in middle aged men. METHODS: 998 cases were chosen from 1109 men who visited health screening center from October to November, 1999. Sleep problems were categorized to insomnia, sleep deprivation, daytime sleepiness and snoring on the base of result of factor analysis of 11 questions. Job strain was measured by 11 questions which developed by Karasek and Theorell. All data set were analyzed using Chi square test and multiple logistic regression analysis. RESULTS: The 4 sleep proplems were analyzed by multiple logistic regression analysis in relation to job strain, shift work, occupation, obesity, sedentary life style, smoking, drinking. Insomnia was increased significantly from highest job strain group(Odds ratio (OR:2.02)) and non exercise group(OR:2.05). In these groups, daytime sleepiness was increased significantly(OR=1.92 in the highest job strain group, OR=1.72 in non exercise group). Sleep deprivation was increased in the highest job strain group(OR=2.18), managers & clerks(OR:1.67) and non exercise group(OR:1.78). Snoring was increased from BMI(Body mass index)> OR =25(OR=1.77), BMI> OR =27(OR=2.80) and non exercise group(OR:1.87). CONCLUSION: In the highest job strain group, insomnia, sleep deprivation and daytime sleepiness was increased significantly. And sedentary life style increased all sleep problems.
Dataset ; Drinking ; Humans ; Korea ; Life Style* ; Logistic Models ; Male ; Mass Screening ; Middle Aged* ; Obesity ; Occupations ; Prevalence* ; Sleep Deprivation ; Sleep Initiation and Maintenance Disorders ; Smoke ; Smoking ; Snoring

PURPOSE: The aim of this study was to identify the experience of patients with liver cirrhosis. METHOD: This study was performed from march 2003 to June 2003. The participators were five men. Data collected through in-depth personal interviews, which were recorded and analysed according to the Colazzi's method. RESULT: Liver cirrhosis was classified into 20 themes, 70 formulated meaning, and 10 categories. The Result confirmed that the experience of liver cirrhosis patients were classified into 10 categories; unexpected change, limited daily living and role, difficult compliance with therapeutic regimen, unbelief so untreated with apathy, negative emotional change, lack of cause perception, self control, perceived family support, expectations for recovery and healing. CONCLUSION: We, cooperative researchers, realized that to reduce not only the days of hospital treatment and the economic loss, as well as the expenditure of insurance the importance of managing liver cirrhosis from early diagnosis and the physical, spiritual, social role in studying the patients who experience liver cirrhosis.
Apathy ; Compliance ; Early Diagnosis ; Health Expenditures ; Humans ; Insurance ; Liver Cirrhosis* ; Liver* ; Male ; Self Concept

OBJECTIVE: We compared the expression pattern of progesterone receptor, integrin 3, cyclooxygenase-2 (COX-2) in in-phased endomerium of patient with the disease related implantation and control group, and tried to confirm the clinical efficacy of the immunohistochemical markers for discrimination of occult uterine receptivity defect in in-phase endometrium. STUDY DESIGN: Endometrial tissues were obtained from 60 women with normal (group 1; n = 20), uterine synechiae (group 2; n = 15), and endometriosis (group 3; n = 25). On 7 ~ 8 days after ovulation (POD 7 ~ 8), sex hormone levels were measured and immunohistochemical staining of PR, integrin 3, and COX-2 expression were performed. RESULTS: PR was decreased in the group 2 and increased in the group 3 comparing with the group 1. integrin 3 expression was significantly decreased in the group 2 and 3. COX-2 expression was significantly decreased in the group 2. But, in the group 3, COX-2 expression was slightly increased in glandular epithelial cells, and significantly increased in stromal cells. CONCLUSIONS: In-phase biopsies from patients with endometriosis and uterine synechiae showed different expression pattern of integrin 3, COX-2, and PR compared to the control. The aberrant expression of immunohistochemical markers be associated with occult uterine receptivity defect and produce the useful diagnostic method.
Biopsy ; Cyclooxygenase 2* ; Discrimination (Psychology) ; Endometriosis ; Endometrium* ; Epithelial Cells ; Female ; Gynatresia ; Humans* ; Ovulation ; Progesterone* ; Receptors, Progesterone* ; Stromal Cells

OBJECTIVE: Ovarian failure is often common complication by the conditioning protocol used for bone marrow transplantation (BMT). To determine the frequency of recovery of ovarian function after allo-BMT and the major factor that predict recovery, we monitored ovarian function in 24 premenopausal women METHOD: Twenty-four women met the inclusion criteria, which were (1) moderate to severe aplastic anemia before BMT, (2) disease-free at least 18 month after transplantation, (3) age younger than 40 years and more than 3 years after menarche at transplantation and (4) regular menstrual periods before transplantation. Recovery of ovarian function was determined by regular menses without menopausal symptom and sign. we divided conditioning regimen to two groups, Group I : cytoxan alone(n=17), Group II : cytoxan plus total body irradiation (TBI)(n=7). RESULTS: All women became amenorrhea after BMT and the clinical characteristics were not significant between two groups. 17 patients who received only cytoxan all recovered ovarian function between 1 to 14 months(median : 7.28) after BMT. The median age at BMT of women with regained ovarian function was 26 years (range, 21 to 33) versus 30 (range, 21 to 37) for those who did not. The age at transplantation was not significant between two groups in our study and the most predictive independent factor in ovarian recovery is the presence of total body irradiation. None of women who received TBI regained ovarian function during 19-49 month follow up. CONCLUSION: Gonadal insufficiency due to pre-BMT conditioning is more severe in radiation based regimen than cytoxan alone. therefore, we recommend early hormone replacement therapy in radiation treated women to prevent the complication of premature menopause.
Amenorrhea ; Anemia, Aplastic* ; Bone Marrow Transplantation* ; Bone Marrow* ; Cyclophosphamide ; Female ; Follow-Up Studies ; Gonads ; Hormone Replacement Therapy ; Humans ; Menarche ; Menopause, Premature ; Whole-Body Irradiation

The most common surgically retained foreign body is t506e laparotomy sponge, and since cotton sponges are inert, they do not undergo any specific decomposition or biochemical reaction. Pathologically, however, two types of foreign body reaction occur: either type there is an aseptic fibrinous response that creates adhesions and encapsulation, resulting in a foreign-body granuloma, or the response is exudative in nature and leads to abscess formation with or without secondary bacterial invasion. We describe the case of a 52-year-old woman with a past history of cholecystectomy in whom a foreign-body abscess mimicked a hepatic tumor. Index words : Peritoneum, abscess Foreign bodies
Abscess* ; Cholecystectomy ; Female ; Fibrin ; Foreign Bodies* ; Foreign-Body Reaction ; Granuloma, Foreign-Body ; Humans ; Laparotomy ; Middle Aged ; Peritoneum ; Porifera

OBJECTIVES: To develop a new immunohistochemical marker system for supplementation of the Noyes histological classification of the endometrium in women of child bearing age with regular menstrual cycles, and to employ this system to evaluate pathologic factors involved in endometriosis, and thus to ascertain if it is useful in diagnosis. MATERIALS AND METHODS: Endometrial biopsies were sampled from the posterior fundus of 41 (24 proliferative phases, 17 secretory phases) women with regular menstrual cycles (28-32 days), and each sample was immunhistochemically stained according to Noyes et al (1975) for determination of expression for extrogen receptor (ER), progesterone receter(PR), integrin alpha1, alpha4, beta3, COX-1 and COX-2. Then, the PR, the integrin beta3, and COX-2 which were clearly expressed in the luteal phase was with endometrial samples were obtained from 20 cases of normal patients (group 1) and 25 cases with endometriosis (group 2) after confirming the day of ovulation by sex steroid level measurements 7-8 days after ovulation. RESULTS: In the regular menstruation group the expression of ER showed a tendency to be increased in the proliferative phase and decreased in the secretory phase, and was the highest in the proliferative phase. However, PR in the stromal cells showed no change in the entire menstrual cycle while in the epithelial cells, PR reached a peak in the late proliferative phase and was almost absent in the secretory phase. Integrin alpha 1, alpha4, and beta3 expression in the epithelial cells was absent in the proliferative phase but alpha1 was expressed strongly in the early and mid secretory phases and disappeared in the late proliferative phase, while beta3, appeared after the mid secretory phase and continued to be expressed until the late secretory phase. Expression in the stromal cells was weak overall and did not show any cyclic pattern. COX-1 expression was shown as a cyclic pattern in the stromal and epithelial cells and was partcularly strongly expressed in the mid secretory phase of epithelial cells, and in the mid secretory and menstruation phase of stromal cells. In the endometrial epithelial cells there was strong expression during the entire cycle with stronger expression in the secretory phase compared to the prolferative phase. COX-2 was clearly expressed in the late proliferative, early and mid secretory phased in the stromal cells. No expression was observed in the proliferative phase of the epithelial cells, but which began to appear in the early secretory phase reaching a significant pattern from the mid secretory phase onwards. There was almost no expression in the stromal cells. In the cases with endometriosis showing normal endometrial maturation according to the Noyes classification, PR expression was increased while Integrin-beta3 expression was significantly decreased compared to the normal group. Also, COX-2 expression was slightly decreased in the stromal cells of patients with endometriosis while it was significantly increased in the stromal cells. CONCLUSION: Immunohistochemical markers can supplement the original Noyes classification of histological endometrial dating and therefore ascertain existing pathologic conditions. Particularly for patients with endometriosis with normally mature endometrial cells, changes in COX-2 and integrin expression patterns may assist in elucidating pathophysiologic mechanisms and therefore aid in the diagnosis of abnormal implantation conditions, and consequently determine a treatment modality.
Biopsy ; Child ; Classification ; Diagnosis ; Endometriosis* ; Endometrium* ; Epithelial Cells ; Female ; Humans* ; Integrin alpha1 ; Integrin beta3 ; Luteal Phase ; Menstrual Cycle ; Menstruation ; Ovulation ; Progesterone* ; Prostaglandin-Endoperoxide Synthases* ; Receptors, Progesterone* ; Stromal Cells

OBJECTIVE: The purpose of this study was to assess the usefulness of combination of bone formation and resorption markers in predicting the bone mineral density (BMD), and to see there was a correlation with years since menopause(YSM) and BMD according to the combination of bone turnover marker and bone sites. METHOD: BMD and bone turnover marker(serum osteocalcin and urine deoxypyridinoline) was assessed in 266 healthy postmenopausal women at the time of first visiting in postmenopausal clinic and were divided into six groups based on combination of their reference range in bone turnover markers. RESULTS: We evaluated the discrimination power of the combination of bone turnover marker in assessing BMD among the six gorups, there was no statistically significant difference in BMD of Lumbar2-4 and Femur (Neck, Ward. Trochanter). In case of both higher than reference range of osteocalcin and deoxypyridinoline(D-pyr), BMD of Lumbar2-4 and Femur in postmenopausal women had a negative correlation with YSM. In case of higher than normal reference range of D-pyr and within the reference range of osteocalcin, BMD of Femur had a negative correlation with YSM. CONCLUSION: Thus each bone site had its own good combination of bone marker levels to correlate the BMD according to the YSM.
Biomarkers* ; Bone Density* ; Discrimination (Psychology) ; Female ; Femur ; Humans ; Menopause ; Osteocalcin ; Osteogenesis ; Reference Values