PURPOSE: To evaluate the NT in the first trimester associated with fetal chromosomal abnormality, fetal structural abnormality and adverse pregnancy outcome. METHODS: From Mar. 1993 to Dec. 1997, 133 cases of increased NT were reviewed retrospectively. All these fetues were taken a karyotyping and/or a high resolution ultrasonography for associated anomaly. The NT was measured by transvaginal ultrasonography(TVS) and transabdominal ultrasonography(TAS) if difficulty was encountered with TVS in the period of the 10th-14th week of gestation. The increased NT is approved when it is over 3mm. RESULTS: Of these 133 cases, 102 cases(76.7%) revealed normal outcomes and 31 cases(23.3%) revealed abnormal outcomes such as chromosomal abnormality, structural abnormality and adverse pregnancy outcome, The mean value of NT was 3.44+/-0.68mm in the normal group and 4.93+/-2.70mm in the abnormal group, respectively. The chromosomal abnormalities were found in 16 of the 31 cases: nine Down SD, two Patau syndrome, one Tuner synrome, one triploidy, one 46, XX,i(18q), one 47,iso(Xp)/46,XX one confined placental mosaicism. In 12 cases of the 31 cases, the structural anomalies were detected. Of these 12 cases, 3 cases were eventually developed to cytsic hygroma, 3 cases were cardiac anomaly, 3 cases were renal anomaly, 1 case was congenital diaphragmatic hernia, 1 case was skeletal dysplasia and 1 case was suspected syndrome. The adverse pregnancy outcome such as intrauterine growth restriction, intrauterine fetal death and preterm labor was revealed in 3 cases. In the cases of NT over 7mm, the result was 100% abnormal outcome. CONCLUSION: Increased NT in the first trimester could be a highly efficient the predictor for detection of chromosomal abnormality, structural anomaly and adverse pregnancy outcome.
Chromosome Aberrations ; Female ; Fetal Death ; Hernia, Diaphragmatic ; Humans ; Karyotyping ; Lymphangioma, Cystic ; Mosaicism ; Nuchal Translucency Measurement ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Outcome* ; Pregnancy Trimester, First ; Pregnancy* ; Retrospective Studies ; Triploidy ; Ultrasonography

STUDY DESIGN: Retrospective controlled study. OBJECTIVES: The aim of this study was to determine if unilateral TLIF is comparable to conventional PLIF with regard to radiologic and clinical outcomes, and to examine the viability of local bone for bone grafting in lumbar interbody fusion. SUMMARY OF LITERATURE REVIEW: TLIF, a modified form of PLIF, is a new spinal fusion technique that avoids the typical complications of PLIF. MATERIALS AND METHODS: We analyzed 32 cases of single-level TLIF or PLIF in patients with degenerative or isthmic spondylolisthesis, who were followed for more than 1 year. The patients in group 1 underwent TLIF, and the patients in group 2 underwent PLIF. The fusion rate, changes in disc height, and degree of anterolisthesis in the fused segment were analyzed radiologically. The clinical results were evaluated using the Oswestry Disability Index and visual analog scale. We also analyzed operative time, blood loss, and complications in both groups. RESULTS: Radiologically and clinically, there were no significant differences between the two groups in terms of fusion rate, changes in disc height, or degree of anterolisthesis in the fused segment. The mean operative time was 200 minutes in group 1 and 240 minutes in group 2. The mean blood loss was 854 ml in group 1 and 1102 ml in group 2(p>0.05). CONCLUSIONS: TLIF is a potentially useful alternative to conventional PLIF in patients with degenerative or isthmic spondylolisthesis. Additionally, local bone may be a viable source of bone grafts for single-level TLIF and PLIF.
Bone Transplantation ; Humans ; Operative Time ; Retrospective Studies ; Spinal Fusion ; Spondylolisthesis ; Transplants

Anemia is a common and significant complication of chronic kidney disease (CKD). However, its prevalence and current management status has not been studied thoroughly in Korea. We examined the prevalence of anemia, its association with clinical and laboratory factors, and utilization of iron agents and erythropoiesis stimulating agents using the baseline data from the large-scale CKD cohort in Korea. We defined anemia when hemoglobin level was lower than 13.0 g/dL in males and 12.0 g/dL in females, or received by erythropoiesis stimulating agents. Overall prevalence of anemia was 45.0% among 2,198 non-dialysis CKD patients from stage 1 to 5. Diabetic nephropathy (DN) as a cause, CKD stages, body mass index (BMI), smoking, leukocyte count, serum albumin, iron markers, calcium, and phosphorus concentration were identified as independent risk factors for anemia. Considering the current coverage of Korean National Health Insurance System, only 7.9% among applicable patients were managed by intravenous iron agents, and 42.7% were managed by erythropoiesis stimulating agents.
Anemia* ; Body Mass Index ; Calcium ; Cohort Studies* ; Diabetic Nephropathies ; Female ; Hematinics ; Humans ; Iron ; Korea ; Leukocyte Count ; Male ; National Health Programs ; Phosphorus ; Prevalence* ; Renal Insufficiency, Chronic* ; Risk Factors ; Serum Albumin ; Smoke ; Smoking

Streptococcus constellatus (S. constellatus) is a commensal microorganism belonging to the "Streptococcus milleri" group, but may cause infections in different locations in immunocompromised patients. The infection of S. constellatus has high mortality and morbidity due to its tendency to cause abscesses in infected patients, which require immediate surgical drainage for effective treatment. We report on a 72-year-old woman with end stage renal disease, who suffered from dyspnea and general weakness that had developed over 7 days. Chest CT showed loculated pleural effusion. S. constellatus was cultured from exudative pleural effusions and confirmed by an analysis of 16S rRNA sequence. The patient was treated with drainage of pleural effusion and piperacillin/tazobactam for 5 weeks.
Abscess ; Aged ; Drainage ; Dyspnea ; Empyema ; Female ; Humans ; Immunocompromised Host ; Kidney Failure, Chronic ; Pleural Effusion ; Streptococcus ; Streptococcus constellatus ; Streptococcus milleri Group ; Thorax

Foreign bodies in the upper esophagus should be removed as soon as possible to avoid serious complications. These foreign bodies can penetrate the bowel wall and cause severe complications. The peristalsis of the esophagus is not strong enough to prevent it from retaining swallowed objects. Hence, perforation from a foreign body is more likely to occur in the esophagus than in the rest of the gastrointestinal tract. A razor blade is a rare foreign body of the esophagus. Its sharpness and large size make it difficult to remove. A razor blade was very firmly impacted in the esophageal wall in our case, and the razor blade had not moved from the upper esophagus. A standard overtube has limitations to remove a razor blade inside the overtube's lumen. We report here on a case of using a wedge resected overtube made it possible to successfully extract a razor blade and no serious complications occurred after extraction of the razor blade.
Esophagus ; Foreign Bodies ; Gastrointestinal Tract ; Peristalsis

Ischemic colitis is generally considered a disease of the elderly. The causes of ischemic colitis include low-flow states due to cardiac dysfunction or hypovolemia and certain medications including estrogen. Here we report a case of ischemic colitis in a 26-year-old woman. She had no specific medical history except taking oral-contraceptives for a long time. The mechanism of estrogen-induced ischemic colitis is not clearly understood. But we recommend that oral-contraceptives should be considered as a cause of ischemic colitis in young women.
Adult ; Aged ; Colitis, Ischemic ; Contraceptives, Oral ; Estrogens ; Female ; Humans ; Hypovolemia

A pseudochylothorax, a chyliform pleural effusion, is a rare disease of pleural effusion that contains cholesterol crystals or high lipid content that is not the result of a disrupted thoracic duct. Most of the cases were found in patients with long-standing pleural effusion due to chronic inflammatory disease, such as old tuberculous pleurisy or chronic rheumatoid pleurisy. We experienced a case of pseudochylothorax in a 74-year-old man, who was being treated for pulmonary tuberculosis and pleurisy 10 years ago. The diagnosis was confirmed on pathological study of the pleural effusion, which contained cholesterol crystals having a diagnostic rhomboid appearance.
Aged ; Cholesterol ; Humans ; Pleural Effusion ; Pleurisy ; Rare Diseases ; Thoracic Duct ; Tuberculosis, Pleural ; Tuberculosis, Pulmonary

Pneumatosis cystoides intestinalis is a rare condition characterized by gas-filled cysts within the bowel wall. It may be idiopathic or secondary to a variety of disorders. Associated conditions include chronic obstructive pulmonary disease, the use of non-steroidal anti-inflammatory drugs, collagen vascular disease, organ transplantation, and necrotizing enterocolitis. Approximately 15% of cases are idiopathic. We present a case of pneumatosis cystoides intestinalis complicated by pneumoperitoneum in chronic respiratory failure due to a post-tuberculosis destroyed lung. Successful palliation involved paracentesis of the peritoneal air and oxygen therapy.
Collagen ; Enterocolitis, Necrotizing ; Lung ; Organ Transplantation ; Oxygen ; Paracentesis ; Pneumatosis Cystoides Intestinalis ; Pneumoperitoneum ; Pulmonary Disease, Chronic Obstructive ; Respiratory Insufficiency ; Transplants ; Vascular Diseases

BACKGROUND/AIMS: Improvements in dialysis therapies and patient care are leading to more patients receiving dialysis for longer periods of time. Survival rates with peritoneal dialysis (PD) are superior to those with hemodialysis (HD) during the initial 2-3 years; however, data comparing the outcomes of these two methods are lacking. Thus, we performed a retrospective study of patients treated with dialysis for longer than 3 years to investigate patient condition according to mode of dialysis. METHODS: A total of 80 patients currently being treated by dialysis for at least 36 months at the Eulji Medical Center were included in this study. Patients' laboratory data and admissions histories over the prior 3 years were reviewed. Dialysis adequacy, body composition, and cytokine levels were quantified. RESULTS: A total of 39 PD and 41 HD patients, with no difference in mean age or gender, were compared. Regarding dialysis adequacy, 97.5% of HD patients met the criterion of 1.2 Kt/V or higher, whereas only 58% of PD patients satisfied the required weekly Kt/V of 1.7. Inflammatory cytokines were significantly elevated in PD patients; however, PD patients with adequate dialysis expressed the same inflammatory cytokines as HD patients. CONCLUSIONS: The delivery of adequate dialysis to PD patients over extended periods of time is difficult. Thus, more rigorous management of PD patients is required to avoid insufficient dialysis and inflammation.
Body Composition ; Cytokines ; Dialysis ; Humans ; Inflammation ; Patient Care ; Peritoneal Dialysis* ; Renal Dialysis* ; Retrospective Studies ; Survival Rate

BACKGROUND: It is difficult to improve muscle strength with only aerobic exercise training in type 2 diabetes patients. Resistance training is effective for improving muscle mass, muscle strength and insulin sensitivity. One repetition maxima (1RM), or the maximum amount of weight a subject can lift in a single repetition, may be a useful unit for evaluating the results of resistance training in type 2 diabetic patients. This study was aimed to assess baseline values for 1RM in a sample of Korean type 2 diabetes mellitus patients that are scaled for intensity and load of exercise, and to assess the relationship of 1RM to age. METHODS: A total of 266 (male: 95, female: 171) Korean patients with type 2 diabetes mellitus were included in the study sample. Maximal muscle strength was assessed by measuring 1RM for each subject (KEISER, Fresno, CA, USA). Two different exercises were used to measure 1RM: the chest press for the upper extremities, and the leg press for the lower extremities. RESULTS: Both upper and lower values of 1RM decreased with age in men and women; upper 1RM: r = -0.454, P<0.001 in men, r = -0.480, P< 0.001 in women, lower 1RM: r = -0.569, P<0.001 in men, and r = -0.452, P<0.001 in women. Values of 1RM significantly decreased in men only after the age of 70. In women, values of 1RM continuously decreased after the age of 60. CONCLUSION: The maximal muscle strength of individuals with type 2 diabetes decreases with age. We believe that resistance training is especially beneficial for type 2 diabetes mellitus patients after the sixth decade of life.
Diabetes Mellitus, Type 2 ; Exercise ; Female ; Humans ; Insulin Resistance ; Leg ; Male ; Muscle Strength ; Muscles ; Resistance Training ; Thorax ; Upper Extremity