Correct discrimination of the first and the second twin is important. Case: (1) The first fetus, whose amnionic cavity was closest to the cervix at 19 weeks, even though its body was higher than the second fetus, was found to be closer to the cervix by 23 gestational weeks than its twin. (2) The result of the chromosomal study of dichorionic twins at 17 gestational weeks was male with 9 inversion of the presumed first, and female with trisomy 21 of the presumed second. AT 19 gestational weeks, the sex and order of the two were found to be reversed at sonography for selective termination. In diamnionic twins, the fetus in the amnionic sac closest to the cervix is nominated as the first.
Amnion ; Cervix Uteri ; Diagnosis* ; Discrimination (Psychology) ; Down Syndrome ; Female ; Fetus* ; Humans ; Male ; Pregnancy, Twin* ; Twins*

No abstract available.
Alopecia* ; Hair* ; Humans ; Male* ; Tissue Expansion*

Intentional delay of aftercoming siblings in multiple gestation is an infrequent occurrence in obstetrics. After delivery of an immature twin, conventional treatment calls for induction and delivery of the aftercoming sibling. However, several case reports have documented the feasibility of an expectant management. And also, as in our case, an aggressive treatment consisting of cerclage, tocolysis, and broad-spectrum antibiotics has been shown to prolong pregnancy. We experienced an unavoidable delivery of a nonviable first twin after premature rupture of membranes at 16 weeks' of gestation. The placenta was left undisturbed. Twin B was confirmed to be alive within the intact second sac. Tocolysis was started and cervical cerclage was done directly after delivery of twin A. Pregnancy was successfully prolonged, which enabled the second fetus to remain in utero and grow for another 145 days. To our knowledge, this was the longest interval between deliveries in a twin pregnancy reported in the literature. A healthy 3,050 gm male was delivered by cesarean section at 37 weeks' of gestation. Below we present this case in detail and discussed with respect to the aggressive approach undertaken to prolong gestation.
Anti-Bacterial Agents ; Cerclage, Cervical ; Cesarean Section ; Female ; Fetus ; Humans ; Male ; Membranes ; Obstetrics ; Placenta ; Pregnancy* ; Pregnancy, Twin ; Rupture ; Siblings ; Tocolysis ; Twins*

No abstract available.
Tretinoin*

No abstract available.
Glaucoma* ; Manometry* ; Mass Screening*

PURPOSE: The purpose of this study was to identify effects of an obesity control program including rhythmical dance exercise, on body composition, knowledge about obesity, life habits and self-esteem among obese elementary school children. This program included obesity related health education and counseling based on behavior modification once a week, 1 hour-rhythmical dance class once a week and 40-minute jump rope classes twice a week for 8 weeks. METHOD: There were 29 students with obesity in the experimental and 28 in the control group. Participated was voluntary. The data were collected from April 16 to July 6 2007. chi-square-test, Fisher's exact test, paired t-test and t-test were used to analyze the data. RESULTS: Students in the experimental group showed significantly lower fat mass (t=-2.16, p=.036) and percent body fat (t=-2.93, p=.005) and significantly higher muscle mass (t=2.05, p=.045) and lean body mass (t=2.71, p=.009) than those in the control group. Knowledge of obesity increased significantly and eating habits changed significantly. But difference in exercise habits and self-esteem were not significant. CONCLUSION: This study provides evidence that an 8 week-obesity control program including rhythmical dance exercise is effective in decreasing body fat, increasing muscle mass and increasing knowledge of obesity in children who are obese.
Adipose Tissue ; Behavior Therapy ; Body Composition ; Child ; Counseling ; Eating ; Health Education ; Humans ; Muscles ; Obesity

A 33-year-old-woman with twin pregnancy underwent genetic amniocentesis in our hospital at 16 weeks of gestation. Fetal chromosomal analysis showed 46,XY,inv(9) and 47,XX,+21. The affected twin was terminated by ultrasonographically guided intracardiac injection of 3 ml potassium chloride solution at 19 weeks of gestation. A healthy 2570 g male infant was born by cesarean section with Apgar scores of 8 and 9 at one and five minutes, respectively.
Amniocentesis ; Cesarean Section ; Down Syndrome* ; Female ; Humans ; Infant ; Male ; Potassium Chloride ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy* ; Pregnancy, Twin ; Twins, Dizygotic*

We report an unusual case of primary extranodal non-Hodgkin's lymphoma combined with sinusitis in an AIDS patient. A 39-year-old male presented with sinusitis as initial manifestation. A nasal endoscopy revealed nasal polyposis with mucopurulent discharge in both middle meatus and paranasal sinus (PNS) CT scans demonstrated pansinusitis without lamina papyracea or skull base defect. He received antiretroviral and antibiotics therapy due to low CD4 count representing immunocompromised state. The patient was not followed up for observation and he returned with reduced right visual acuity and diplopia, and proptosis after 6 months. A PNS CT scan showed bilateral sinonasal polyposis with pansinusitis and soft tissue density in the right orbit and frontal lobe through bone defect of lamina papyracea and skull base. Endoscopic sinus surgery for orbital decompression and biopsy of intraorbital mass was performed under general anesthesia. The mass was infiltrated into orbital contents and was confirmed as an diffused large B-cell lymphoma with anaplastic variant. The patient received radiotherapy because his general condition was poor. Proptosis and ocular pain were decreased; however, he complained of a persistent headache. Brain CT and MRI showed diffused parenchymal edema around brain abscess in the right frontal lobe. Stereotactic evacuation of the right brain abscess was performed. He has no specific complaints for the last 14 months and antiretroviral therapy is concluded at the present.
Acquired Immunodeficiency Syndrome ; Adult ; Anesthesia, General ; Anti-Bacterial Agents ; B-Lymphocytes* ; Biopsy ; Brain ; Brain Abscess ; CD4 Lymphocyte Count ; Decompression ; Diplopia ; Edema ; Endoscopy ; Exophthalmos ; Frontal Lobe ; Headache ; Humans ; Lymphoma, B-Cell* ; Lymphoma, Large B-Cell, Diffuse ; Lymphoma, Non-Hodgkin ; Magnetic Resonance Imaging ; Male ; Orbit ; Radiotherapy ; Sinusitis* ; Skull Base ; Tomography, X-Ray Computed ; Visual Acuity

BACKGROUND AND PURPOSE: The optic nerve sheath diameter (ONSD) is an indirect marker of the intracranial pressure, but the normal range of ONSD as measured using magnetic resonance imaging (MRI) and its associations with clinical parameters and the eyeball transverse diameter (ETD) remain unclear. METHODS: We included 314 healthy adults who underwent brain MRI examinations for health screening between June 2014 and September 2017. The ONSD and ETD of each eye were calculated using time-of-flight magnetic resonance angiography. Linear regression analyses were performed to assess the relationships between ONSD and variables including age, sex, height, weight, body mass index (BMI), mean arterial blood pressure (MABP), intraocular pressure (IOP), and ETD. We further investigated a normative value for the ONSD/ETD ratio and its associated factors. RESULTS: The mean ONSD and ETD were 4.71 mm [95% confidence interval (CI), 4.66–4.75 mm] and 21.24 mm (95% CI, 21.13–21.35 mm), respectively. Multiple linear regression analysis showed that ONSD was only associated with ETD (p < 0.001), with it being independent of age, sex, height, weight, BMI, MABP, and IOP. The ONSD/ETD ratio had a mean value of 0.22 (95% CI, 0.22–0.22), and was not correlated with age, sex, height, weight, BMI, MABP, or IOP. CONCLUSIONS: This study determined the normative value of MRI-based ONSD in healthy Korean adults. There was a strong correlation between the ETD and ONSD, which can be presented as the ONSD/ETD ratio. This parameter needs to be investigated further in disease populations.
Adult* ; Arterial Pressure ; Body Weight ; Brain ; Humans ; Intracranial Pressure ; Intraocular Pressure ; Linear Models ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging* ; Mass Screening ; Optic Nerve* ; Reference Values

PURPOSE: In the finger, there are three major palmar arches in the arterial system. The location of this arches are constant. The middle and distal transverse arches are consistently large (almost 1 mm) and may be used for arterial vessel repairs either proximally or distally, depending on the length and direction needed. This paper describes our experiences in reconstruction and replantation of the finger using rerouting the transverse digital palmar arch. METHODS: 31 patients with injuries according to our classification were treated from March of 2005 to October of 2008. In this study the authors subdivided injuries into those with amputation distal to the insertion of the flexor digitorum profundus (Class I, 31 fingers); those with amputation distal to the insertion of the flexor digitorum superficialis (Class II, 4 fingers). Replantation was performed using the artery-only technique with neither vein nor nerve repair. Because the artery has been damaged, it is still possible to make a direct suture by transposing the arterial arch in an inverted Y to I arterial configuration or converting the arch. Venous drainage was provided by an external bleeding method with partial nail excision, medical leech, and repaired margin. RESULTS: The success rate was 87% (n=27) in class I and 75% (n=4) in class II. The authors conclude that crushing and complete avulsion injuries & amputations are salvageable, with acceptable functional results in select patients, especially those with amputation distal to the insertion of the flexor digitorum superficialis. CONCLUSION: We performed replantation and reconstruction with only-arterial transposing anastomosis successfully, resulting in good recovery of aesthetic and functional outcome. Three major digital palmar arches, especially distal two branches, give us additional treatment options. In the finger replantation and reconstructive techniques using rerouting healthy the transverse digital palmar arch increase the survival rate of the finger.
Amputation ; Arteries ; Drainage ; Fingers ; Glycosaminoglycans ; Hemorrhage ; Humans ; Nails ; Replantation ; Survival Rate ; Sutures ; Veins