A 24-year-old pregnant woman started to have severe hyperemesis gravidarum at 6 weeks' gestation. Six weeks later, dizziness, ataxia, visual disturbance, diplopia and confusion were developed. On admission, she presented ophthalmoplegia, nystagmus, deaeased tendon reflex, intention tremor, ataxia, confusion and memory disturbance. She was diagnosed to Wernicke-Korsakoff syndrome and 100mg of thiamine was administered intravenously daily till 28 weeks gestation and then intramuscularly. Her ocular symptns, together with neurological signs, were gradually improved. Memory disturbance slightly improved but remained at the time of delivery. The case will be presented in more details with a brief revie of literatures.
Ataxia ; Diplopia ; Dizziness ; Female ; Humans ; Hyperemesis Gravidarum* ; Korsakoff Syndrome* ; Memory ; Ophthalmoplegia ; Pregnancy ; Pregnant Women ; Reflex, Stretch ; Thiamine ; Tremor ; Young Adult

OBJECTIVES: The purpose of this study was to determine the clinical significance of residual amniotic fluid volume, as measured by the amniotic fluid index(AFI), on the prediction of latency period and perinatal outcomes in patients with preterm premature rupture of the membranes(PPROM). METHODS: Study population consisted of 103 singleton pregnancies with PPROM between 24 and 34 weeks' gestation. Amniotic fluid index was determined using transabdominal ultrasound at admission. Latency period was defined as time interval in hours between admission and delivery. All medical records of mothers and neonates were reviewed. Spearman's rho rank correlation, receiver-operator characteristic(ROC) curve analysis, survival analysis and Cox's proportional hazard model were used for statistical analysis. RESULTS: There was a statistically significant correlation between latency period and AFI at admission. ROC curve analysis showed that AFI at admission had a significant predictive value in the prediction of latency period < 48 hours. Survival analysis demonstrated that AFI < 5.0 was strongly associated with the likelihood of shorter latency period, Cox's proportional hazard model indicated that AFI < 5.0 was a significant independent predictor for the occurrence of latency period < 48 hours even after adjustment of other independent variables. The patients with AFI <5.0 had a higher rate of cesarean section due to fetal distress than those with AFI > 5.0 but the incidence of chorioamnionitis was not significantly different between two groups. Comparing the perinatal mortality and neonatal morbidity including infectious morbidity between the neonates born to mothers with AFI <5.0 and those with AFI > 5.0, there was no significance after adjustment of gestational age at birth. CONCLUSION: AFI at admission has a significant correlation with latency period and predictive value in prediction of latency period in the patients with PPROM. AFI <5.0 is a independent predictor for the shorter latency period.
Amniotic Fluid* ; Cesarean Section ; Chorioamnionitis ; Female ; Fetal Distress ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Latency Period (Psychology)* ; Medical Records ; Membranes* ; Mothers ; Parturition ; Perinatal Mortality ; Pregnancy ; Proportional Hazards Models ; ROC Curve ; Rupture* ; Ultrasonography

Recently the rate of adolescent smoking in Korea has increased rapidly, and various health problems related to smoking can be expected to increase in the future. Studies on smoking behavior report that assertiveness is important factor influencing on the adolescent smoking. PURPOSE: This study was conducted to develope a educational video for the purpose of adolescent's smoking prevention. METHOD: The 533 participating subjects, 269 in experimental group and 264 control group, in the study were 7th grade students. The content of video introduces three smoke tempting situations. The experimental group received 17 minute video education, and the control group did not receive any treatments. RESULT: The results show that the student's assertiveness was increased significantly in the experimental group after the video education. Student's attitude on smoking became more negative in the experimental group. However, in the control group, the intention, assertiveness, attitude was not changed. CONCLUSION: This assertiveness video can be useful educational resource for the smoking prevention program for adolescents. Also further study on longitudinal effect and application on drinking, drug abuse are needed.
Adolescent* ; Assertiveness ; Drinking ; Education ; Humans ; Intention ; Korea ; Smoke* ; Smoking* ; Substance-Related Disorders

No abstract available.
Adult* ; Hernia* ; Humans

No abstract available.
Hernia, Diaphragmatic*

No abstract available.

The angiotensin-converting enzyme (ACE) gene DD homozygote has been suggested to be a significant risk factor for the progression of diabetic nephropathy. We analyzed clinical parameters and ACE genotype distribution between type 2 diabetic patients at the extremes of renal risk, i.e. an end-stage renal failure (ESRF) group (n = 103, group 1) who were on dialysis therapy due to progression of diabetic nephropathy, and a no progression group (n = 88, group 2) who had maintained normal renal function and normoalbuminuria for more than 15 years. There were no significant differences in age, sex, body mass index, HbA1c level, or lipid profiles between the two groups (p > 0.05). Group 1 had a significantly higher prevalence of hypertension [group 1: 82.5% (85/103) vs. group 2: 50.0% (44/88), p < 0.05] and diabetic retinopathy [group 1: 103/103 (100%) vs. group 2: 28/88 (31.8%), p < 0.05] than group 2. Daily urinary albumin excretion was also higher in group 1 than in group 2 [group 1: 2873 +/- 2176 mg/day vs. 12 +/- 7 g/day, p < 0.05]. The frequencies of the DD, ID, and II genotypes of the ACE gene in group 1 and group 2 were 26.2%, 47.6%, and 26.2%, and 7.9%, 57.9%, and 34.2%, respectively. The ACE genotype frequencies between the two groups were significantly different according to a chi-square test with Bonferroni's correction (p = 0.004). The presence of the DD genotype increased the risk of ESRF 4.286-fold compared to the II genotype [odds ratio 4.286, 95% CI 1.60- 11.42, p = 0.005]. The frequency of the D-allele was higher in both male and female patients in group 1 compared to group 2, but reached statistical significance only in males [male, group 1: 50.8% vs. group 2: 35.0%, p = 0.018, female, group 1: 48.8% vs. group 2: 39.5%, p = 0.231]. This study, although limited by sample size, showed that type 2 diabetic ESRF patients more frequently expressed the DD genotype. These findings may substantiate the previously noted relationship between the ACE DD genotype and the progression of diabetic nephropathy in Korean type 2 diabetic patients.
Renal Dialysis ; *Polymorphism, Genetic ; Peptidyl-Dipeptidase A/*genetics/metabolism ; Middle Aged ; Male ; Kidney Failure, Chronic/diagnosis/*genetics ; Humans ; Homozygote ; Gene Frequency ; Female ; Diabetic Nephropathies/diagnosis/*genetics ; Diabetes Mellitus, Type 2/diagnosis/*genetics ; Aged

OBJECTIVE: To analyse neonatal outcomes of the very low birthweight infants born to women who underwent an indicated preterm delivery and spontaneous preterm delivery. METHODS: We performed an observational study of 150 very low birthweight(<1500 grams) infants delivered at Samsung Medical Center. The study population was limited to singleton infants without major congenital anomalies. The primary reason for delivery was categorized as indicated preterm delivery or spontaneous preterm delivery. Selected neonatal outcomes were compared between infants born to women in each of these groups. RESULTS: Univariate analyses showed some survival benefits in infants born to women who underwent indicated preterm delivery. Selected neonatal outcomes, however, did not differ between the groups in the multiple logistic regression analysis. CONCLUSION: There was no survival advantage to the very low birthweight infants born to women who underwent an indicated preterm delivery compared to those born to women with spontaneous preterm delivery.
Female ; Humans ; Infant* ; Logistic Models ; Observational Study

No abstract available.
Humans

BACKGROUND: The high pressure zone(HPZ) at the gastroesophageal junction is an important barrier for prevention of gastroesophageal reflux. Smooth muscle layers in the lower esophageal sphincter mainly contributes to HPZ at the throacoabdominal junction. The purpose of this study was to investigate the manometric characteristics of the thoracoabdominal junction in patients after surgical removal of the lower esophageal sphincter. MATERIAL AND METHOD: Twenty two patients with prior esophagogastrectomy(10 Ivor-Lewis method and 12 left thoracotomy) and 30 normal adults(control group) were studied manometrically. RESULT: Esophageal manometry showed a HPZ and pressure inversion point distal to the anastomosis in 12 of 22 patients(2 of 10 patients with Ivor-Lewis method and 10 of 12 patients with left thoracotomy) and a HPZ in 30 of 30 normal adults. The location of HPZ from nostril was not significant different between the two groups(42.5+/-0.9cm in patients and 43.9+/-2.1cm in the control), while the length of HPZ was shorter in patients than in the control(2.13+/-0.6cm vs 2.83+/-0.59cm). By SPT and RPT, pressures of HPZ at rest were lower in patients(13.78+/-1.63mmHg, 28.58+/-6.06mmHg) than in control(20.3+/-4.95mmHg, 42.80+/-15.91mmHg). The HPZ relaxed partially in response to deglutition(84.4% in patient, 90.5% in control group) and contracted in response to increased intra- abdominal pressure induced by leg lifts(HPZ/ Intra-abdominal pressure= 1.81+/-0.23 in patient, 2.13+/-0.58 in control group). CONCLUSION: This study shows an HPZ at thoracoabdominal junction after surgical removal of the lower esophageal sphincter. It may be important to perform a crural myoplasty during esophageal reconstruction after esophagogastrectomy because crural diaphragm acts as sphincter like HPZ at the thoracoabdominal junction.
Adult ; Diaphragm* ; Esophageal Sphincter, Lower ; Esophagogastric Junction ; Gastroesophageal Reflux ; Humans ; Leg ; Manometry ; Muscle, Smooth