OBJECT: In order to compare several Obstetric characteristics and outmmes of teenage pregnancy. METHODS: The 10 year clinical records of 11,583 women undergoing Cesarean section and delivery were reviewed in the department of Obstetrics and Gynecology, Incheon Christian Hospital from July 1, 1989 to June 30, 1999. There were seventy-eight pregnancies under age 20 and we compared them with two hundred pregnancies aged 20-29 who were randomly chosen during the same periods as the control group. RESULT: The following results were obtained. The proportion of birth by teenagers increased from 0.5% of all birth in 1989 to 2.61% in 1999. The most of cases were in high teen group, age 14- 19.The majority(50.5%) were in the age of 19. Seventy two cases(92.3%) had no previous pregnant history. Six cases had one previous pregnant history. The frequencies of prenatal care were significantly lower than that of the control group(p<0.05). The mean gestational period was 36+4weeks, and showed significant difference between the study group and the control group(39+3 weeks). The incidence of preterm labor was significantly different between the two proups(p<0.05). But the incidence of postterm delivery were not significantly different between the two groups. The mean weight gain of pregnant teenagers revealed 10.64kg, significantly less profound than the control group. The matemal weight gain of control group revealed 12.95kg, respectively. The mean birth weight(2.54kg) of infant was significantly less profound than the control group. The incidence of birth of small for gestational age(birth weight 1,500-2,499gm ; 14.5%) was significantly increased among study group than the control group(1%). The rate of abdominal delivery(21.8%) were not significantly decreased than the control group(47%). The incidence of cephalopelvic disproportion and malpresentation for cesarean section were somewhat higher than the control group, and were statistically significant(p<0.05). During the antepartun period, anemia, pyelonephritis, and preterm labor occurred more frequently in the teenage pregnancy than the control group, but not statistically significant. Among postpartum complications, incidence of anemia(51.3%) increased significantly. The perinatal mortality, intrauterine growth retardation, congenital anomaly occurred more frequently than the control group. CONCLUSION: These results show that pregnancy of teenage will be comeout high risk and complications. And then we will be more concern and study about teenage pregnancy.
Adolescent ; Anemia ; Cephalopelvic Disproportion ; Cesarean Section ; Female ; Fetal Growth Retardation ; Gynecology ; Humans ; Incheon ; Incidence ; Infant ; Obstetric Labor, Premature ; Obstetrics ; Parturition ; Perinatal Mortality ; Postpartum Period ; Pregnancy ; Pregnancy in Adolescence* ; Prenatal Care ; Pyelonephritis ; Weight Gain

This research was focused on overall examination of tissue alteration, wound healing promotion. After the hair on the dorsal surface was shaved, 5x5mm oval skin defect was formed. Experimental wounds of right side were irradiated on every day for 90 second with Ga-Al-As semi-conductor laser. Left side wounds served as control group. The rats were sacrificed on the 1st, 3rd, 5th, 7th, 14th, 21th day. For light microscopically, parafin section were stained with H&E, MT. The outcomes were as follows : 1. On 1st day, experimental and control group were seen acute inflammatory cell infiltration, edema. 2. On the 3rd days, both groups were seen crust development, collagen, blood vessel proliferation. 3. On the 5th days, experimental group were reduced edema and inflammatory cell infiltration than control group. 4. On the 7th days, both groups were observed edema, inflammatory cell infiltration disappearance and keratinocytes motility from wound defect. 5. On the 14th days, experimental group appeared collagen, blood vessel proliferation and hair follicle than control group. 6. On the 21th days, both groups were seen normal status re-epithelization. According to the above results, The wound-healing stimulated by laser radiation involves an increased rate of epithelial growth. LLLT was confirmed that it has fibroblast, blood vessel proliferation, influence initial wound healing process.
Animals ; Blood Vessels ; Collagen ; Edema ; Fibroblasts ; Hair ; Hair Follicle ; Keratinocytes ; Low-Level Light Therapy* ; Rats* ; Skin* ; Wound Healing ; Wounds and Injuries*

OBJECT: In order to estimate the frequency and risk factors for adenomyosis. METHOD: The clinical records of 1127 women undergoing hysterectomy were retrieved in the Department of Obstetrics and Gynecology, Incheon Christian Hospital, during 7 years, from Jan. 1st 1991 to Dec. 31st 1997. RESULT: The following results were obtained. 1. Adenomyosis was found in 206 of 1127 patients(18.3%). 2. The highest incidence was 41-50 years of age group, an incidence of 55% and mean age group was 46.9 years. 3. Adenomyosis was more frequently observed in parous woman than non-parous woman, such as 8.3% and 91.7%, respectively. 4. Grossly, the size of uterus was enlarged more than 10 weeks gestational size in adenomyosis, an incidence of 62.4%. 5. Pelvic pain, dysmenorrhea and metrorrhagia were common symptom of adenomyosis, an incidence of 26.7%, 25.2% and 19.4%, respectively. 6. Myoma was the most combined disease in adenomyosis, showing the incidence of 53.4%. 7. Combined pelvic endometriosis was not observed in this study. 8. Endometrial findings of adenomyosis showed proliferative phase of normal endometrial cycle in the highest incidence, giving 72.3% of all cases. 9. Preoperative diagnostic accurracy of adenomyosis was 8.2%. CONCLUSION: This results show that deeply understanding of the common symptom and epidemiology of adenomyosis improve the preoperative diagnostic accuracy.
Adenomyosis* ; Dysmenorrhea ; Endometriosis ; Epidemiology ; Female ; Gynecology ; Humans ; Hysterectomy* ; Incheon ; Incidence ; Menstrual Cycle ; Metrorrhagia ; Myoma ; Obstetrics ; Pelvic Pain ; Risk Factors ; Uterus

PURPOSE: Bone bruises of patients with acute traumatic knee injuries, that are not found on simple radiograph, can be found on magnetic resonance imaging (MRI). The purpose of this study is to evaluate the frequency and locations of bone bruises on MRI in acute traumatic anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL) injury. MATERIALS AND METHODS: 25 and 19 MRls, in which acute traumatic ACL and PCL injury was pre sent and there was no abnormality in simple radiograph, were reviewed. MRI was taken within 51 days of injury. A bone bruise was determined as a geographic and nonlinear area of signal loss on T1 images and increased signal intensity on T2 images involving the subcortical bone. RESULTS: In 16 patients with bone bruises and acute ACL injury, bone bruises were found in the lateral compartment of the knee in 15 (93.8%) patients. The most common area was the lateral tibial plateau (11 cases, 68.8%) and the second was lateral femoral condyle (9 cases, 56.3%). In 5 patients with bone bruises and acute PCL injury, bone bruises were found in the lateral compartment of the knee in all 5 (100%) patients. The most common area was lateral tibial plateau (4 cases, 80%) and the second was lateral femoral condyle (2 cases, 40%). CONCLUSIONS: In patients with acute traumatic ACL or PCL injuries the bone bruises are often found on the lateral compartment of the knee, especially lateral tibial plateau and lateral femoral condyle on MRI.
Anterior Cruciate Ligament ; Contusions* ; Humans ; Knee ; Knee Injuries ; Magnetic Resonance Imaging* ; Posterior Cruciate Ligament

The purpose of this study was to evaluate cervical lymph node metastasis of oral squamous cell carcinoma patients by MRI film and neural network system. MATERIALS AND METHODS: The oral squamous cell carcinoma patients(21 patients, 59 lymph nodes) who have visited SNU hospital and been taken by MRI, were included in this study. Neck dissection operations were done and all of the cervical lymph nodes were confirmed with biopsy. In MR images, each lymph node were evaluated by using 6 MR imaging criteria(size, roundness, heterogeneity, rim enhancement, central necrosis, grouping) respectively. Positive predictive value, negative predictive value, and accuracy of each single MR imaging criteria were calculated. At neural network system, the layers of neural network system consisted of 10 input layer units, 10 hidden layer units and 1 output layer unit. 6 MR imaging criteria previously described and 4 MR imaging criteria (site I-node level 2, site II-other node level, shape I-oval, shape II-bean) were included for input layer units. The training files were made of 39 lymph nodes(24 metastatic lymph nodes, 10 non-metastatic lymph nodes) and the testing files were made of other 20 lymph nodes(10 metastatic lymph nodes, 10 non-metastatic lymph nodes). The neural network system was trained with training files and the output level (metastatic index) of testing files were acquired. Diagnosis from neural network was decided according to 4 different standard metastatic index-68, 78, 88, 98 respectively and positive predictive values, negative predictive values and accuracy of each standard metastatic index were calculated. RESULTS: In the diagnosis of using single MR imaging criteria, the rim enhancement criteria had the highest positive predictive value, 0.95 and the size criteria showed the highest at negative predictive value, 0.77. The highest accurate criteria was heterogeneity with the accuracy of 0.81 and the lowest one was central necrosis with accuracy of 0.59. In the diagnosis of using neural network systems, the highest accurate standard metastatic index was 78, and that time, the accuracy was 0.90. Neural network system was more accurate than any other single MR imaging criteria in evaluating cervical lymph node metastasis. CONCLUSION: Neural network system has been shown to be more useful than any other single MR imaging criteria. In future, Neural network system will be powerful aiding tool in evaluating cervical node metastasis.
Biopsy ; Carcinoma, Squamous Cell* ; Diagnosis ; Humans ; Lymph Nodes* ; Magnetic Resonance Imaging ; Neck Dissection ; Necrosis ; Neoplasm Metastasis* ; Population Characteristics

BACKGROUND: Atrial flutter is a common arrhythmia for which no entirely satisfactory treatment is available. Despite the growing number of antiarrhythmic agents available for arrhythmia prophylaxis many patients are either intolerant of drug treatment or achieve inadequate relief from their symptoms. Recently, catheter ablation using radiofrequency energy has been used to result in high success rate for immediate prevention of atrial flutter but significant recurrence rate. We report our initial experience on radiofrequency cather ablation(RFCA) of atrial flutter in 8 patients. METHODS: The electrophysiologic approach guided by the earliest artial activation was used in the first patient and then anatomically guided approach in the remaining patients. The end point of RFCA was both demonstration of conduction block across the linear lesion at the atrial isthmus between the inferior vena cava and the tricuspid ring and noninducibility of atrial flutter with atrial burst pacing and extrastimulation up to 3 during isoproterenol infusion. RESULTS: Eight consecutive patients underwent RFCA.All were male and mean age was 53+/-22 years. Initial success was achieved in 7 patients(88%). During the follow-up period of 4+/-2.3 months, early sympomatic recurrence occurred in 2/7 patients(29%) within 1 month after initial success and the second ablation procedure was successfully performed in one patient. Overall success rate at the end of the follow-up period was 6/8(75%). there were no serious complications during and after the procedure. CONCLUSION: 1) radiofrequency catheter ablation is safe and highly effective treatment modality for prevention of atrial flutter. 2) Demonstration of conduction block across the lesion at the atrial isthmus should be achieved as an endpoint.
Arrhythmias, Cardiac ; Atrial Flutter* ; Catheter Ablation* ; Follow-Up Studies ; Humans ; Isoproterenol ; Male ; Recurrence ; Vena Cava, Inferior

BACKGROUND AND OBJECTIVES: QT dispersion (QTd) represents the inhomogeneity of ventricular repolarization and has been suggested to predict ventricular arrhythmia in patients with coronary artery disease (CAD). This study investigates the short-term effect of percutaneous transluminal coronary angioplasty (PTCA) on QTd in patients with CAD and no history of previous myocardial infarct. MATERIALS AND METHODS: In 84 angina patients (65 men and 19 women, mean age of 58.3+/-9.0 yeras) who underwent successful PTCA of single coronary artery, ECG was checked in baseline, immediate, 1day and 1 month after PTCA. QTd and corrected QTd (c-QTd) were measured in these ECGs by digitizer. RESULTS: PTCA was performed at left anterior descending artery (LAD) in 56, left circumflex artery (LCx) in 12 and right coronary artery (RCA) in 16 patients. Mean and standard error of QTd (c-QTd) at baseline, immediate, 1day and 1month after PTCA was 51.3+/-4.2 (50.7+/-4.1), 54.2+/-4.5 (52.8+/-4.5), 47.7+/-4.3 (48.5+/-4.8) and 36.3+/-4.5 (37.5+/-4.6)msec, respectively. QTd and c-QTd significantly decreased at 1 month following PTCA. The difference was more prominent in pateints with LAD lesion than LCx or RCA lesion and independent of gender, severity of stenosis and use of beta-blockers. CONCLUSION: QTd decreases in CAD patients with no history of myocardial infarct at 1 month following successful PTCA. This may facilitate a favorable recovery from inhomogenous repolarization. These findings call for long-term follow-up of QTd and the incidence of ventricular tachyarrhythmias and sudden death following successful PTCA.
Angioplasty, Balloon, Coronary ; Arrhythmias, Cardiac ; Arteries ; Constriction, Pathologic ; Coronary Artery Disease ; Coronary Vessels ; Death, Sudden ; Electrocardiography ; Female ; Humans ; Incidence ; Male ; Myocardial Infarction ; Tachycardia

BACKGROUND: To treat anastomosis site stenosis and occlusion of the artificial vessels used in vascular surgery, tissue-engineered artificial vessels using autologous cells have been constructed. We developed artificial vessels using a polymer scaffold and autologous bone marrow cells and performed an in vivo evaluation. MATERIAL AND METHOD: We manufactured a vascular scaffold using biodegradable PLCL (poly lactide-co-epsilon-caprolactone) and PGA (poly glycolic acid) fibers. Then we seeded autologous bone marrow cells onto the scaffold. After implantation of the artificial vessel into the abdominal aorta, we performed an angiography 3 weeks after surgery. After the dogs were euthanized we retrieved the artificial vessels and performed histological analysis. RESULT: Among the six dogs, 2 dogs died of massive bleeding due to a crack in the vascular scaffold 10 days after the operation. The remaining four dogs lived for 3 weeks after the operation. In these dogs, the angiography revealed no stenosis or occlusion at 3 weeks after the operation. Gross examination revealed small thrombi on the inner surface of the vessels and the histological analysis showed three layers of vessel structure similar to the native vessel. Immunohistochemical analysis demonstrated regeneration of the endothelial and smooth muscle cell layers. CONCLUSION: A tissue engineered vascular graft was manufactured using a polymer scaffold and autologous bone marrow cells that had a structure similar to that of the native artery. Further research is needed to determine how to accommodate the aortic pressure.
Angiography ; Animals ; Aorta, Abdominal ; Arterial Pressure ; Arteries ; Blood Vessel Prosthesis ; Bone Marrow ; Bone Marrow Cells ; Constriction, Pathologic ; Dogs ; Glycosaminoglycans ; Hemorrhage ; Myocytes, Smooth Muscle ; Polymers ; Prostaglandins A ; Regeneration ; Seeds ; Tissue Engineering ; Transplants

Coronary artery aneurysm is a rare disorder. It is defined as abnormal dilatation of coronary artery with diameter exceeding 1.5 times the adjacent normal segments. The incidence of coronary aneurysm is 2.6% in Caucasians and 0.25% in Asians. Over half of the former were associated with atherosclerotic coronary artery disease. However, 70 percents of the latter were nonobstructive coronary artery aneurysms. Coronary artery fistula is a rare disorder. It has been identified in only 0.2% of routine cardiac angiographic studies conducted over a 10-year period. The clinical spectrums are various, asymtomatic, asymptomatic murmur, dyspnea on exertion, fatigue, and congestive heart failure. The right coronary artery (56%) and left coronary artery(36%) are mainly involved in the origin site of congenital coronary artery fistula. The draining site of fistula are right ventricle(39%), right atrium(33%), and pulmonary artery(20%) and so on. This 54 years-old woman had intermittent chest tightness and an abnormal mediastinal shadow on chest roentgenogram and chest C-T examination, which was diagnosed as a mediastinal mass such as teratoma. We performed the operation under left anterolateral thoracotomy for mass excision. However, we knew the mass had the pulsating arterial blood flow through a fine needle puncture of the mass and that it was attached to the left ventricle. We believed the excision of mass on beating heart would be very dangerous. Therefore, we closed the wound without excising the mass. After several days, we performed an echocardiography and coronary angiography, We knew it was cardiac tumor. Incidentally, the patient had a tortuous coronary fistula from the right coronary artery to pulmonary trunk. Using cardiopulmonary bypass with moderate systemic hypothermia, the mass was resected and the fistula was clipped with surgical clips. Pathology of the specimen was a giant coronary arterial aneurysm.
Aneurysm* ; Asian Continental Ancestry Group ; Cardiopulmonary Bypass ; Coronary Aneurysm ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels* ; Dilatation ; Dyspnea ; Echocardiography ; Fatigue ; Female ; Fistula* ; Heart ; Heart Failure ; Heart Neoplasms ; Heart Ventricles ; Humans ; Hypothermia ; Incidence ; Middle Aged ; Needles ; Pathology ; Punctures ; Surgical Instruments ; Teratoma ; Thoracotomy ; Thorax ; Wounds and Injuries

Superior sulcus or pancoast tumor refers to any primary lung cancer locating in thoracic inlet and causing pain in the periscapular region or arm. These originate in peripheral, and involve the extrapulmonary structures more than arenchyma of the lung. We experienced 1 case of superior sulcus tumor radically resected via anterior transcervical approach, which provided more safe exposure of cervical structures of thoracic inlet than classic posterolateral thoracotomy. Therefore we report this case with review of literature.
Arm ; Bays ; Lung ; Lung Neoplasms ; Pancoast Syndrome ; Thoracotomy