One fetal demise of twin pregnancy in the second or third trimester is an unusual and difficult problem in the managemcnt of pregnancy. It can be associated with an increased risk for mortality and morbidity in the remaining fetus and with maternal DIC. 255 twin gestations were delivered at our hospital between December 1984 and August 1998. 8 cases of twin pregnancies with one fetal demise were observed. We reviewed 8 cases of twin pregnancies with one fetal demise that had been managed conservatively. The incidence of twin pregnancies with one fetal demise was 3.14% in the study population. The incidence of preterm delivery was 87.5%. The perinatal mortality rate of surviving twins was 25%. There were no cases of maternal disseminated intravascular coagulation or infection. There were no cases of neurologic damages in the surviving twins. The main cause of neonatal death was prematurity. An expectant approach to the twin pregnancies with one fetal demise seems reasonable.
Dacarbazine ; Disseminated Intravascular Coagulation ; Female ; Fetus ; Humans ; Incidence ; Mortality ; Perinatal Mortality ; Pregnancy ; Pregnancy Trimester, Third ; Pregnancy, Twin*

The purpose of this study was to find educational needs of toddler's mother in child-caring experience. The subject of the study was toddler's mother who visited one health care center in J city for immunization and had a child or children between twelve and thirty six months old. The subjects were 37 mothers. The instrument used for this study was a semi-structured questionnaire developed by researcher and based on Objective Content Test of Garretson(1967). The Collected data were analized by two researchers using the method of content Analysis. The results of this study are summarized as follows ; 1) Of the large categories, the need of the highest frequency was 'prevention and management of disease and injury', that of the lowest 'growth and development'. 2) In 'physical care' category, 'care of sleeping' was the highest. In 'nutrition and eating-habitual management' category, 'weaning management' was the highest. In 'prevention and management of disease and injury' category, 'disease management' was the highest. In 'discipline and teaching' category, 'discipline' was the highest. 3) In comparison with preceding references, the educational needs of child-caring which had not been shown in preceding references but had been shown in this study were hair-caring, kind of weaning diet, method of cure and nursing, management of deformity, and so on. In conclusion, educational needs of toddler's mother in child-caring experience were matter-of-fact and inclusive. Needs in management of special situation such as disease were higher than usual parenting procedure or method. In addition, there were higher needs in questions happened through child-caring experience or confirmation of procedures practicing now. Then, it is suggested that parent education program should be developed on the basis of educational needs found in this study to be more effective in preparing mothers's child-caring.
Child ; Congenital Abnormalities ; Delivery of Health Care ; Diet ; Education ; Humans ; Immunization ; Mothers* ; Nursing ; Parenting ; Parents ; Weaning ; Child Health ; Surveys and Questionnaires

Objective: Cerebral white matter changes (WMCs) and silent brain infarcts (SBIs) are common radiological findings in neurologically asymptomatic elderly people. Their presence is associated with an increased risk of stroke or dementia. Homocysteine (Hcy) can cause atherosclerosis and may thus act as a useful marker of stroke prior to symptom onset. This study aimed to evaluate the utility of Hcy as a surrogate marker for early intervention for stroke in community-dwelling healthy elderly persons with cerebrovascular lesions such as WMCs and SBIs. Methods: We assessed the relationship between the Hcy level and presence of WMCs/SBIs on brain computed tomography (CT) in 554 elderly individuals aged ≥65 years with no history of stroke or dementia. Results: The mean age of the participants was 74.43±7.32 years. Of the 554 patients, 106 (19.1%) had WMCs and/or SBI findings on brain CT. The mean Hcy level was higher in participants with WMCs/SBIs (P=0.001). The WMCs/SBIs group had a significantly greater number of participants with high Hcy levels than the non-WMCs/SBIs group (P<0.001). High Hcy levels (≥12.3 μmol/L) was significantly associated with WMCs and SBIs even after adjusting for age, Korean Mini Mental Status Examination score, education level, and vascular risk factors such as hypertension, diabetes, hyperlipidemia and smoking status. Conclusion: The result of our study suggests that regular monitoring of homocysteine level as a modifiable risk factor may be helpful for predicting the association of cerebrovascular lesions such as WMCs and SBIs for the prevention of future ischemic stroke and cognitive impairment.

No abstract available.
Breast* ; Child* ; Humans

No abstract available.
Thoracic Wall* ; Thorax*

No abstract available.
Adenocarcinoma*

No abstract available.
Stomach Neoplasms* ; Tuberculosis, Pleural*

OBJECTIVES: Cell adhesion molecules may play a role in integrating amnionic membrane. The objective of this study was to prove E-cadherin mRNA and proteins in cultured human amnionic cells. METHODS: We cultured amnionic cells from 4 women undergoing cesarean section without labor. E-cadherin was determined by immunohistochemistry and Western ligend blotting. To demonstrate E-cadherin mRNA, reverse transcription-polymerase chain reaction was performed. RESULTS: On immunohistochemistry, E-cadherin was abundantly showed on the cytoplasm of the cells. Western ligend blotting showed clear 120 kDa bands on four specimens, and relatively weak band on one specimen. Reverse transcription-polymerase chain reaction showed 432 BP bands. CONCLUSION: We proved E-cadherin and its mRNA by immunohistochemistry, Western ligend blotting and reverse transcription-polymerase chain reaction in cultured human amnionic cells.
Amnion* ; Cadherins* ; Cell Adhesion Molecules ; Cesarean Section ; Cytoplasm ; Female ; Humans ; Immunohistochemistry ; Membranes ; Pregnancy ; RNA, Messenger

No abstract available.

A prospective study had been performed in infants with hydronephrosis due to ureteropelvic junction stenosis to determine adequate management plan. Forty infants (47 renal units) were selected for the study during the period from January 1995 to July 1997 in the Department of Pediatrics, Asan Medical Center. They were diagnosed prenatally or early postnatally (<3 months of age) on the basis of renal ultrasonography and techotium-99m-mercap- toacetyltriglycerine (MAG3) scan. The antero-poste- rior pelvic diameter (APPD) was measured from serial renal ultrasonography and relative renal function and clearance half time (T1/2) were calculated from serial MAG3 scan. Those who had accompanying other urogenital anomalies or vesicoureteral reflux were excluded in this study. Follow-up tests (ultrasonography and MAG3 scan) and surgical corrections, if necessary, were performed according to the predetermined algorithrn. The male to female ratio was 3: 1. Hydronephrosis was involved the left side in 24 renal units, the right side in 9 renal units, and the bilateral sides in 14 renal units. All the hydronephrotic renal units were divided into 2 groups; Group A (19 renal units) those had taken surgical correction, and group B (28 renal units) those revealed spontaneous improvement without surgical correction. The mean follow-up duration was 7.2+/-6.3 months in group A and 14.1+/-12.6 months in group B. The mean APPD in the first postnatal renal ultrasonography was 19.4+6.8 mm in group A and 10.0+/-3.0mm in group B and this was statistically significant (P<0.01). The rela- tive renal function of group A in the first MAG3 scan was under 35% in 7 renal units and over 35M in 12 renal units. In group B, the relative renal function was over 35% in the all 28 renal units. Tl/2 in the first MAG3 scan was longer than 20 minutes in the all 19 renal units in group A. In group B, Tl/2 was shorter than 10 minutes in 15 renal units, between 10 minutes and 20 minutes in 6 renal units, and longer than 20 rninutes in 7 renal units. The mean APPD of the 7 renal units in group B of which Tl/2 was longer than 20 minutes was 12.62.6mm and that of group A was 19.4+/-6.8mrn and this was statistically significant (P<0.01). In conclusion, the renal ultrasonography and MAG3 scan can be used effectively to determine the degree of the stenosis of the ureteropelvic junction in hydronephosis during infancy. When the babies are diagnosed with hydronephrosis due to ureteropelvic junction stenosis in the early infantile period, serial renal ultrasonography and MAG3 scan play an important role in the decision of the management.
Chungcheongnam-do ; Constriction, Pathologic ; Female ; Follow-Up Studies ; Humans ; Hydronephrosis* ; Infant ; Male ; Pediatrics ; Ultrasonography* ; Vesico-Ureteral Reflux