OBJECTIVE: We analyzed the clinical features of amniotic fluid embolism confirmed by autopsy or clinical dicision for making a plan of rapid diagnosis and intensive emergency care. STUDY DESIGN: We experienced 2 clincal cases in Ewha Mokdong Hospital and Severance Hospital at 1995, and reviewed the medical record & autopsy report of 15 cases in National Institute of Scientific Investigation from Jan, 1991 to Dec, 1995. RESULTS: The mean maternal age was 31+/-3 years. The mean gestational age was 40+/-1 weeks. The number of delivery were 1.4+/-0.8. The number of abortion history. were 2.6+/-2. The sexuality of fetus were six males (35 %), five females (29%), and unknown six cases (35 %) and the fetal mortality rate was 29 % (5 cases). The initial clinical symptoms and signs were hypotension (12 patients, 71%), vaginal bleeding(ll patients, 65%), cardiac arrest (6 patients, 35 %), dyspnea (5 patients, 29 %), and seizure (2 patients, 12%). In the case of normal spontaneous vaginal delivary (NSVD), the symptoms occurred during induction in 3 (18%), during delivery in 1 (6%), and after delivery in 9 (53%). In the case of Cesarean section, the symptoms occurred during section in 2 (12%), and after section in 1 (6%). There are one case whose symptoms occurred during 3rd gestational period. CONCLUSIONS: We should alert for the amniotic fluid embolism in the clinical findings of acute collapse and vaginal bleeding, respiratory symptoms, and seizure at any peripartum. With eary suspicion of this disease and aggressive intensive care we can reduce amniotic fluid embolism mortality rate and it's legal problem.
Abortion, Induced ; Amniotic Fluid* ; Autopsy ; Cesarean Section ; Diagnosis ; Dyspnea ; Embolism, Amniotic Fluid* ; Emergency Medical Services ; Female ; Fetal Mortality ; Fetus ; Gestational Age ; Heart Arrest ; Humans ; Hypotension ; Critical Care ; Male ; Maternal Age ; Medical Records ; Mortality ; Peripartum Period ; Pregnancy ; Seizures ; Sexuality ; Uterine Hemorrhage

Purpose: This study examined the changes in the body mass index (BMI) and the effects of BMI on the knee function and risk factors for an increase in BMI after total knee arthroplasty (TKA) in Asians. Materials and Methods: A prospective observational study was conducted on 100 cases of TKA performed by one surgeon. Obesity was defined as BMI ≥25 kg/m 2 . The BMI and Knee Society Score, consisting of the Knee Score and Function Score, were measured on the day before surgery and one year after surgery. Results: The BMI decreased or was maintained in 34 cases (34%) and increased in 66 cases (66%) one year after surgery. An increase in BMI of 5% or more was considered a clinically significant increase in BMI and occurred in 28 cases (28%). The patients with an increased BMI by more than 5% showed a significantly lower knee function score. The age and preoperative function score were significantly associated with an increased BMI by more than 5%. As the age increased by one year, the odds ratio at which the BMI would increase by more than 5% one year after surgery was 0.905. Moreover, as the preoperative function score increased by one point, the odds ratio that the BMI would increase by 5% one year after surgery was 0.902. In other words, a younger preoperative age and a lower preoperative function score mean a higher risk of a more than 5% postoperative increase in BMI. Conclusion The BMI increased by more than 5% one year after surgery in 28% of the TKA patients examined. They had a lower functional score. The risk factors for a more than 5% increase in BMI after TKA were young age and a low preoperative function score. Therefore, surgeons should educate patients, particularly those who are young or have a low preoperative function score, so that the patient’s BMI would not increase after surgery.

Cystic teratoma on the floor of the mouth is infrequent disease and known as congenital origin. Teratoma has no sex distribution. Treatrnent of the cystic teratoma is completely surgical excision and recurrence is rare. The authors have experienced a case of cystic teratoma on the floor of the mouth in neonate. We reported this case with review of literatures.
Humans ; Infant, Newborn* ; Mouth* ; Recurrence ; Sex Distribution ; Teratoma*

UItrasound provides the ideal means to examine the fetal developing organs and during the last few years urogenital anomalies in fetus have been discovered with increasing frequency. Obstuctive and non-obstructive urinary tract dilation have been diagnosed in utero as early as l4 weeks gestation and intrauterine intervention designed to relieve hydronephrosis have been performed even at 2l weeks gestation. The major benefit of prenatal ultrasound is to permit early identification of the fetus at risk and to enable treatment to be performed in the neonatal period before infection intervens to worsen the prognosis further. Recentry we have experienced 2 cases of fetal uropathy which was detected with obsterical ultrasonography and treated with neonatal corrective surgery.
Fetus ; Hydronephrosis ; Pregnancy ; Prenatal Diagnosis* ; Prognosis ; Ultrasonography ; Urinary Tract

Endometrial papillary serous carcinoma (EPSC) is a distinct variant of endometrial adenocarcinoma that histologically resembles ovarian serous papillary adenocarcinoma and has an aggressive clinical course. Usually, the tumor is diagnosed at the advanced stage. The tumor has well confused with metastatic ovarian tumor of identical histology. Dignosis of EPSC should be considered when the cervico-vaginal smear reveals numerous papillary clusters of tumor cells with macronucleoli and psammoma bodies. Recently, we have experienced two cases of EPSC diagnosed on cervico-vaginal smears, which revealed characteristic cytologic features including numerous papillary clusters of tumor cells with macronucleoli. The cytologic diagnoses were confirmed on histologic sections.
Adenocarcinoma ; Adenocarcinoma, Papillary ; Diagnosis ; Polycystic Kidney, Autosomal Recessive*

PURPOSE: To evaluate the radiologic findings of granulomatous colitis on double contrast barium enema and changes on follow-up studies. MATERIALS AND METHODS: Serial double contrast barium enemas of six patients with granulomatous colitis confirmed by endoscopic biopsy were reviewed. We analyzed the radiologic findings and their follow-up changes, including aphthous ulcers, lymphoid hyperplasia, deep ulcers, cobble stone appearance, geographic ulcers, asymmetric involvement of ulcers, skip lesions, sinus tract, fistula formation, pseudosacculation, focal stricture, and small bowel involvement. RESULTS: Pretreatment double contrast baruim enema findings were aphthous ulcers in five patients, deep ulcer in six, cobble stone appearance in five, longitudinal geographic ulcers in two, fistulas in one, pseudo-sacculations in two, focal stricture in one, and pseudopolyps in six. Also, anal ulcers were observed in two patients, asymmetric involvement of ulcers in three, skip lesions in four, and small bowel involvement in five in five patients proved to have inactive disease after treatment, aphthous ulcers and deep ulcers disappeared. Geographic ulcers of two patients and anal ulcer of one patients decreased in size or depth. Pseudosacculation in one patient disappeared. Pseudopolyps decreased in two patients, increased in one, and decreased after increase in two. One patient whose disease remained active after treatment showed maintenance or increase of ulcers or fistula. And their pseudosacculation or focal stricture unchanged and pseudopolyps decreased. CONCLUSION: The major radiologic findings of chronic granulomatous colitis on double contrst barium enema are aphthous ulcer, deep ulcer, cobble stone appearance, discontinuity of the lesion, and coexistence of ulcers and pseudopolyps. And, double contrast barium enema is good follow-up modality because its findings correlate with clinical course of the granulomatous colitis after treatment.
Barium* ; Biopsy ; Constriction, Pathologic ; Crohn Disease* ; Enema* ; Fissure in Ano ; Fistula ; Follow-Up Studies* ; Humans ; Hyperplasia ; Stomatitis, Aphthous ; Ulcer

PURPOSE: To evaluate the radiologic findings of granulomatous colitis on double contrast barium enema and changes on follow-up studies. MATERIALS AND METHODS: Serial double contrast barium enemas of six patients with granulomatous colitis confirmed by endoscopic biopsy were reviewed. We analyzed the radiologic findings and their follow-up changes, including aphthous ulcers, lymphoid hyperplasia, deep ulcers, cobble stone appearance, geographic ulcers, asymmetric involvement of ulcers, skip lesions, sinus tract, fistula formation, pseudosacculation, focal stricture, and small bowel involvement. RESULTS: Pretreatment double contrast baruim enema findings were aphthous ulcers in five patients, deep ulcer in six, cobble stone appearance in five, longitudinal geographic ulcers in two, fistulas in one, pseudo-sacculations in two, focal stricture in one, and pseudopolyps in six. Also, anal ulcers were observed in two patients, asymmetric involvement of ulcers in three, skip lesions in four, and small bowel involvement in five in five patients proved to have inactive disease after treatment, aphthous ulcers and deep ulcers disappeared. Geographic ulcers of two patients and anal ulcer of one patients decreased in size or depth. Pseudosacculation in one patient disappeared. Pseudopolyps decreased in two patients, increased in one, and decreased after increase in two. One patient whose disease remained active after treatment showed maintenance or increase of ulcers or fistula. And their pseudosacculation or focal stricture unchanged and pseudopolyps decreased. CONCLUSION: The major radiologic findings of chronic granulomatous colitis on double contrst barium enema are aphthous ulcer, deep ulcer, cobble stone appearance, discontinuity of the lesion, and coexistence of ulcers and pseudopolyps. And, double contrast barium enema is good follow-up modality because its findings correlate with clinical course of the granulomatous colitis after treatment.
Barium* ; Biopsy ; Constriction, Pathologic ; Crohn Disease* ; Enema* ; Fissure in Ano ; Fistula ; Follow-Up Studies* ; Humans ; Hyperplasia ; Stomatitis, Aphthous ; Ulcer

This report is a clinico-statistical review of our experience with 64 patients with circumferential hemorrhoids who were admitted to and treated at the Surgical Department of Seoul Adventist Hospital during 10 years from Jan. 1986 to Dec. 1995. 1) The indication for a modified Whitehead hemorrhoidectomy was third and or fourth degree circumferential hemorrhoid. 2) The sex ratio of male to female was 1.8 to 1. 3) The peak incidence was in the 3rd and the 5th decades(89.3%). 4) The frequent pre-operative anorectal symptoms were anal prolapse (81.5%), anal pain (52.3%), and anal bleeding (55.6%). 5) The mean average post-operative hospital stay was 9.9 days. 6) The early post-operative problems were urinary retention(35.4%), severe anal pain(21.5%), mild anal bleeding(8.9%) and constipation(1.5%). 7) The late post-operative complications were mild anal stenosis(3.3%), flatus incontinence(1.6%), fissure(3.3%) and a nonhealing wound(1.6%). 8) Attention to the proctologic anatomy and experience are essential for a good result and for prevention of anal stenosis or prolapse.
Constriction, Pathologic ; Female ; Flatulence ; Hemorrhage ; Hemorrhoidectomy* ; Hemorrhoids* ; Humans ; Incidence ; Length of Stay ; Male ; Prolapse ; Seoul ; Sex Ratio

This report is a clinico-statistical review of our experience with 64 patients with circumferential hemorrhoids who were admitted to and treated at the Surgical Department of Seoul Adventist Hospital during 10 years from Jan. 1986 to Dec. 1995. 1) The indication for a modified Whitehead hemorrhoidectomy was third and or fourth degree circumferential hemorrhoid. 2) The sex ratio of male to female was 1.8 to 1. 3) The peak incidence was in the 3rd and the 5th decades(89.3%). 4) The frequent pre-operative anorectal symptoms were anal prolapse (81.5%), anal pain (52.3%), and anal bleeding (55.6%). 5) The mean average post-operative hospital stay was 9.9 days. 6) The early post-operative problems were urinary retention(35.4%), severe anal pain(21.5%), mild anal bleeding(8.9%) and constipation(1.5%). 7) The late post-operative complications were mild anal stenosis(3.3%), flatus incontinence(1.6%), fissure(3.3%) and a nonhealing wound(1.6%). 8) Attention to the proctologic anatomy and experience are essential for a good result and for prevention of anal stenosis or prolapse.
Constriction, Pathologic ; Female ; Flatulence ; Hemorrhage ; Hemorrhoidectomy* ; Hemorrhoids* ; Humans ; Incidence ; Length of Stay ; Male ; Prolapse ; Seoul ; Sex Ratio

Unilateral absence of a pulmonary artery is an uncommon anomaly, which presents as an isolated lesion or in combination with other congenital heart disease such as TOF or PD^. We encountered three cases of isolated unilateral absence of a pulmonary artery;one was left pulmonary artery agenesis with right sided aortic arch and the others were right pulmonary artery agenesis with left sided aortic arch. Plain chest radiograph showed considerable loss of unilateal lung volume and lack of ipsilateral hilar shadow. Pulmonary angiogram which was done in two cases, revealed proximal interruption of a pulmonary artery. Chest CT was done in only one case, on which right pulmonary artery was absent and was replaced by adipose tissue. CT with its clean demonstration pulmonary artery without any evidence of aquired obstruction of a pulmonary artery by pulmonary embolism or tumor invasion, maybe a valuable method for evaluaton of the unilateral absence of a pulmonary artery.
Adipose Tissue ; Aorta, Thoracic ; Heart Defects, Congenital ; Lung ; Pulmonary Artery* ; Pulmonary Embolism ; Radiography, Thoracic ; Tomography, X-Ray Computed