Pure fetal blood was obtained by cordocentesis or cardiocentesis guided by USG in 160 fetuses at 15 to 37 weeks' gestation. Only 1 case failed to obtain cytogenetic result. Cytogenetic analysis of fetal lymphocytes yielded results within 5 days. Chromosomal abnormalities were found in 21 of 159 fetuses(13.2%). Abnormal karyotypes were found in 19 of 118 fetuses(16.1%) with structural malformations~8.6%(7/81) affected by isolated malformations vs. 32.4%(12/37) affected by multiple malformations. There were 12 cases of bradycardia which was the most common nonfatal complication (7.4%). One fetal death was recorded. Pregnancy outcome is as follows: 17 cases of stillbirth, 38 cases of termination of pregnancy, 15 cases of neonatal death, 5 cases of infantile death, 55 cases of living babies, and 29 cases lost to follow-up. It is concluded that rapid karyotyping by cordocentesis is advisable as effective method in fetuses at high risk of a chromosomal aberration, especially in advanced gestations.
Abnormal Karyotype ; Bradycardia ; Chromosome Aberrations ; Cordocentesis* ; Cytogenetic Analysis* ; Cytogenetics* ; Female ; Fetal Blood ; Fetal Death ; Fetus ; Karyotyping ; Lost to Follow-Up ; Lymphocytes ; Pregnancy ; Pregnancy Outcome ; Stillbirth

No abstract available.
Adenocarcinoma* ; Cervix Uteri* ; Female

Ectopia cordis is defined as a congenital malposition of the heart partially or completely outside the thorax and often associated with sternal and congenital heart defects:surgical repair is generally unsuccessful because of the magnitude of the deformity and the associat-ed intracardiac anormalies. Four types of ectopia cordis are described : cervical, thoracic, abdominal and thoracoa- bdominal. Cervical and thoracic type are often fatal within days, because the heart is expo- sed and malformed. Abdominal type carries a better prognosis because cardiac abnormalities are less often found. The prognosis of thoraco-abdominal type mainly depends on the pre- sence of intracardiac abnormalities. We have experienced a case of thoracic ectopia cordis at 25 weeks' gestation by ultra- sonography, so present the case and the review with literature briefly.
Congenital Abnormalities ; Ectopia Cordis* ; Heart ; Pregnancy ; Prenatal Diagnosis* ; Prognosis ; Thorax

BACKGROUND: Since 1992, we developed the technique for video endoscopic sympathectomy to treat palmar hyperhidrosis. It was soon proven to be a simple and effective therapy for essential hyperhidrosis. Compensatory hyperhidrosis, however, is the main cause of patient dissatisfaction after video-assisted thoracoscopic sympathectomy. According to many authors, initial satisfaction rate was high(94-98%), but it was declined with time (66%) due to mainly to embarrassing side effects. MATERIAL AND METHOD: From January 1992 to February 1998, the thoracoscopic T2 sympathicotomy, T2 sympathectomy and T2-4 sympathectomy were performed in 315 patients suffering from Essential hyperhidrosis in the Department of Thoracic and Cardiovascular Surgery in the Respiratory Center of Yongdong Severance Hospital Seoul, Korea. Eighty-nine patients underwent T2 sympathicotomy, and Eighty-eight patients underwent division T2 sympathectomy. RESULT: All of the treated patients obtained satisfactory alleviation of essential hyperhidrosis. The global rate of compensatory sweating were ; 64.0% in T2 sympathicotomy, 73.8% in T2 sympathectomy and 87.8% in T2-4 sympathectomy. The rate of embarrassing or disabling compensatory sweating was significantly higher in T2 sympathicotomy 15.7%(14/89) and in T2 sympathectomy 32.8%(28/88) than in T2-4 sympathectomy 58.0%(80/138) with significancy in statistic analysis(p<0.05). Video- assisted thoracoscopic sympathectomy is an effective minimally invasive and effective procedure. CONCLUSION: We suggest that the incidence and degree of compensatory hyperhidrosis was closely related to the extent of thoracic sympathectomy.
Humans ; Hyperhidrosis* ; Incidence ; Korea ; Respiratory Center ; Seoul ; Sweat ; Sweating ; Sympathectomy*

OBJECTIVES: Lateral cephalometry, computed tomography (CT) and full-night polysomnography were used to examine the correlation of obstructive sleep apnea (OSA) severity. MATERIALS AND METHODS: A total of 29 patients (5 females, 24 males) diagnosed with OSA were evaluated by lateral cephalometry, CT and full-night polysomnography. Lateral cephalometry was performed in the closed and open mouth states. The radiographic and polysomnography measurements of the patients with OSA were evaluated statistically to determine the association with OSA severity. RESULTS: A significant relationship was observed between the increased respiratory disturbance index and closing lateral cephalometry. With mouth opening, the airway space narrowed and the OSA worsened. Lateral cephalometry revealed OSA patients to have an inferiorly positioned hyoid bone, longer-than-normal soft palate and narrowing airway space. As OSA was severe, the airway shape was ovoid in the CT horizontal view. CONCLUSION: Polysomnography and the radiographic parameter can be used for diagnosing OSA.
Airway Obstruction ; Cephalometry ; Female ; Humans ; Hyoid Bone ; Mouth ; Palate, Soft ; Polysomnography ; Retrospective Studies ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive

BACKGROUND: This study are to identify the symptomatic changes and condylar stability after 2 jaw surgery without preceding treatments for Temporomandibular joints(TMJ) in class III patients with the TMJ symptoms; and to assess therapeutic effect of 2 jaw surgery and the necessity of preceding treatment for alleviation of TMJ symptoms. METHODS: 30 prognathic patients with preexisting TMJ symptoms were divided into 2 groups according to presence or absence of preceding treatments before the surgery. We evaluated symptomatic changes on both TMJ by questionnaires and clinical examinations. And we reconstructed 3D cone beam computed tomography images before 2 jaw surgery, immediately after the surgery, and 6 months or more after the surgery with SimPlant software, and analyzed the stability of condylar position on 3D reconstruction model. Significances were assessed by the Wilcoxon signed rank test on SPSS ver. 20.0. RESULTS: Both groups had favorable changes of TMJ symptoms after orthognathic surgery. And postoperative position of condyle had good stability during follow-up period. CONCLUSION: 2 jaw surgery without preceding treatments for TMD can have therapeutic effect for TMD patients with class III malocclusion.
Cone-Beam Computed Tomography ; Follow-Up Studies ; Humans ; Malocclusion ; Orthognathic Surgery* ; Surveys and Questionnaires ; Temporomandibular Joint

PURPOSE: Bisphosphonates have been used to treat osteoporosis for more than ten years. However, complications associated with long-term administration of bisphosphonates, such as nonunion after pelvic insufficiency fracture or osteonecrosis of the jaw, have been recently reported in the literature. We investigated the relationships among the mechanical properties of the intact rat femur as well as healing fracture calluses and the intraosseous concentration of pamidronate (ICP), after long-term administration of pamidronate in a rat osteoporosis model. MATERIALS AND METHODS: We performed bilateral ovariectomy in 25 3-month-old female Sprague-Dawley rats. Beginning three months after ovariectomy, disodium pamidronate (0.5mg/kg) was injected every month. After the six-month administration period, the left femoral shaft was fractured using the closed fracture technique. Five weeks after fracture, 23 rats were euthanized and both femora were removed. We checked the mechanical properties of the intact (right) and fractured (left) femora using a three-point bending technique. Intraosseous concentration of pamidronate was checked by high-performance liquid chromatography. RESULTS: The mean ICP was 61.8+/-15.7ng/mg of bone. High ICP decreased the ultimate load to failure, stiffness, and ultimate stress of the intact femora (p=0.015, 0.027, 0.039, respectively). There was a tendency to decrease the ultimate load to failure in the healing callus when the ICP increased (p= 0.183). High ICP decreased the bone mineral density of the femoral head (p=0.005). CONCLUSION: High concentrations of pamidronate in intact bone decreased the bone mineral density and weakened the mechanical strength of the rat femora. The mechanical strength of the early healing callus was not correlated with concentration of pamidronate in the bone.
Animals ; Bone Density Conservation Agents/*pharmacology ; Diphosphonates/*pharmacology ; Disease Models, Animal ; Female ; Femur/*drug effects/physiology ; Fracture Healing/physiology ; Osteoporosis/*metabolism ; Rats ; Rats, Sprague-Dawley ; Stress, Mechanical

The surgical management of patients with unruptured intracranial aneurysm continues to be controversial. To provide current data about surgical outcome of patients with unruptured intracranial aneurysm, we retrospectively reviewed 494 consecutive intracranial aneurysm patients who underwent surgery between January 1990 and May 1995. Among these 494, 16 patients with unruptured aneurysms were evaluated; those with unruptured aneurysm associated with ruptured aneurysm or arteriovenous malformation were excluded. Mode of presentation, location and size of aneurysm, surgical method and complications, and surgical result were analyzed. Evaluation revealed four patients with asymptomatic and 12 with symptomatic unruptured aneurysm. Of these 12, seven presented with mass effect, four with headache, and one with cerebral infarction. The aneurysms were located in the internal carotid artery(n=8), the middle cerebral artery(n=3), the vertebral artery(n=3), the anterior communicating artery(n=2), and the basilar artery(n=2). They ranged in size from smaller than 10mm to larger than 25mm(<10mm: 10 cases, 10-25mm: 5 cases, >25mm: 1 case). An excellent or good outcome was achieved in 12 patients, including four with asymptomatic intracranial aneurysm. In three patients there were complications or sequelae and one died due to premature rupture of the aneurysm. We concluded that in patients harboring an unruptured intracranial aneurysm, aggressive early detection and surgical treatment may improve the outcome by preventing the devastating effects of subarachnoid hemorrhage.
Aneurysm* ; Aneurysm, Ruptured ; Arteriovenous Malformations ; Cerebral Infarction ; Headache ; Humans ; Intracranial Aneurysm ; Natural History ; Retrospective Studies ; Rupture ; Subarachnoid Hemorrhage

OBJECTIVE: Our purposes were (1) to determine whether amniotic fluid concentrations of tumor necrosis factor- are of value in the diagnosis of histologic chorioamnionitis of preterm placenta and in the prediction of congenital sepsis in patients with preterm labor and intact membranes and (2) to compare the diagnostic performance of placental histologic finding and amniotic fluid culture with that of amniotic fluid tumor necrosis factor- for this outcome variable. METHODS: The relations among placental histologic finding, perinatal outcome, amniotic fluid culture, and amniotic fluid tumor necrosis factor- concentrations were examined in 61 consecutive patients with preterm labor and intact membranes who delivered preterm neonates within 72 hours after transabdominal amniocentesis. Tumor necrosis factor- was determined by enzyme-linked immunosorbent assays. Mann-Whitney U test, Fisher's exact test, receiver-operator characteristic curve, and multiple logistic regression were used for analysis. RESULTS: 1) Women with acute histologic chorioamnionitis had significantly higher median amniotic fluid tumor necrosis factor- concentrations than those without histologic chorioamnionitis (median 83.2 pg/ml, range 1.4 to 7241 pg/ml vs median 1.6 pg/ml, range 0 to 59.9 pg/ml, p <0.0001). Amniotic fluid tumor necrosis factor- concentrations > or =4.6 pg/ml had a sensitivity of 88% (28/32) and specificity of 80% (23/29) in the diagnosis of acute histologic chorioamnionitis. 2) Amniotic fluid concentrations of tumor necrosis factor- were significantly higher in neonates with congenital sepsis than in those without congenital sepsis (median 227.5 pg/ml, range 1.2 to 7241 pg/ml vs median 3.8 pg/ml, range 0 to 735 pg/ml, p <0.0005). Amniotic fluid tumor necrosis factor- concentrations > or =41 pg/ml had a sensitivity of 82% (23/29) and specificity of 79% (38/48) in the prediction of congenital sepsis. 3) Multiple logistic regression indicated that elevated amniotic fluid tumor necrosis factor- (> or =41 pg/ml) was the only independent predictor of congenital sepsis (odd ratio 12.9, 95% confidence interval 1.3 to 125.3, p<0.05) after correction for known confounding variables [i.e., low gestational age at birth (< or =32 weeks), positive amniotic fluid culture, histologic or clinical chorioamnionitis, low Apgar score (<7)]. CONCLUSION: Test of amniotic fluid tumor necrosis factor- is of value in the antenatal diagnosis of histologic chorioamnionitis and congenital sepsis in patients with preterm labor and intact membranes. Amniotic fluid tumor necrosis factor- is a better independent predictor of congenital sepsis than placental histologic finding or amniotic fluid culture.
Amniocentesis ; Amniotic Fluid* ; Apgar Score ; Chorioamnionitis* ; Confounding Factors (Epidemiology) ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Logistic Models ; Membranes ; Necrosis* ; Obstetric Labor, Premature* ; Parturition ; Placenta ; Pregnancy ; Prenatal Diagnosis ; Sensitivity and Specificity ; Sepsis*

Mannose-binding lectin (MBL) plays an important role in immune defense. This study was undertaken to investigate the association between hepatitis B virus infection and polymorphisms of MBL gene. We assessed the single nucleotide polymorphism at codon 54 in exon 1 of MBL in patients with hepatitis B virus infection and HBsAg negative controls in Korean population. A total of 498 enrolled subjects was classified into four groups. Group 1; Clearance, Group 2; Inactive healthy carrier, Group 3; Chronic hepatitis, Group 4; Liver cirrhosis. MBL gene polymorphisms at codon 54 led to three genotypes (G/G, G/A, A/A). When we divided subjects into clearance group (group 1) and persistence group (group 2-4), G/G genotype and A-allele carrier were observed in 55.6% and 44.4% in clearance group, 64.8% and 35.2% in persistence group (p=0.081), respectively. When hepatitis B virus persistent cases were divided into inactive healthy carrier (group 2) and disease progression group (group 3 and 4), MBL gene polymorphisms at codon 54 were not related to disease progression (p=0.166). MBL gene polymorphism at codon 54 was not associated with the clearance of hepatitis B virus infection nor progression of disease in chronic hepatitis B virus infection.
Adult ; Alleles ; Codon ; Disease Progression ; Female ; Fibrosis ; Genotype ; Hepatitis ; Hepatitis B/*genetics/*metabolism ; Hepatitis B virus/*metabolism ; Heterozygote ; Humans ; Korea ; *Lectins ; Male ; Mannose-Binding Lectin/*chemistry/*genetics ; Middle Aged ; *Polymorphism, Genetic ; Polymorphism, Single Nucleotide ; Research Support, Non-U.S. Gov't