Perinatal Outcome of Reduced Twin Pregnancies from Triplet by Multifetal Pregnancy Reduction in Patients underwent In Vitro Fertilization and Embryo Transfer / 대한산부인과학회잡지

OBJECTIVE: To investigate the perinatal outcome and complications of reduced twin pregnancies from triplet by multifetal pregnancy reduction (MFPR) in patients who underwent in vitro fertilization and embryo transfer. MATERIALS AND METHODS: From January 1995 to December 1999, a total of 71 twin pregnancies were included in this study. The patients were grouped into the MFPR group (n = 19) and the non-MFPR group (n = 59). The pregnancies in the MFPR group were reduced to twin from triplet by the MFPR. MFPR was performed by transvaginal sonography-guided fetal aspiration or mechanical trauma. The obstetric and perinatal outcomes were compared between the two groups. Statistical analysis was performed using Student's t-test, Fisher's exact test, and kappa2 test as appropriate. Statistical significance was defined as p < 0.05. RESULTS: There were no significant differences in mean gestational age and distribution of gestational age between the two groups. However, the fetal loss rate before 24 weeks of gestation was significantly higher in the MFPR group than the non-MFPR group. We did not find any significant differences in mean birth weight and weight discordancy between the two groups. There were no differences in obstetric and perinatal outcomes between the MFPR and non MFPR groups as well. CONCLUSIONS: These data suggest that pregnancy outcome of reduced twin pregnancies from triplet by MFPR in patients underwent IVF-ET might be comparable to that of non-reduced twin pregnancies.

The Association of Concentration of Serum Estradiol and Bone Mineral Density with Auditory Function in Postmenopausal Women / 대한산부인과학회잡지

OBJECTIVE: To clarify whether hearing sensitivity in postmenopausal women is associated with serum estradiol level or bone mineral density (BMD) MATERIALS AND METHODS: From January 1999 to December 1999, serum concentration of estradiol, bone mineral densities of the lumbar vertebrae and femoral neck, and hearing sensitivity were measured in 1162 postmenopausal women. Serum concentration of estradiol was measured by radioimmunoassay. Dual energy X-ray absorptiometry (DEXA) was used to measure bone mineral densities of the lumbar vertebrae and femoral neck. Pure tone thresholds were evaluated by screening pure tone audiometry. All data were analyzed with Student's t-test, multiple logistic regression analysis, and multiple linear regression analysis. RESULTS: A total of 1155 patients were analyzed; 155 patients were in the hearing-loss group and 1000 patients were in the control group. On univariate analysis, significant differences were found in mean age, concentration of serum estradiol, and BMD of the femoral neck between the two groups (mean+/-SD, 58.1+/-5.2 vs 56.0+/-4.3, 11.6+/-6.0 vs 13.1+/-12.0, 0.67+/-0.11 vs 0.70+/-0.11; p-value: 0.0001, 0.01, 0.02). On multiple logistic regression analysis and multiple linear regression analysis, significant association was found between age and hearing loss and between age and pure tone threshold (p-value: 0.0001, 0.0001, respectively). However, neither seum concentration of estradiol nor BMD was associated with hearing loss or pure tone threshold. CONCLUSION: This study suggests that hearing sensitivity in postmenopausal women is not directly associated with serum estradiol level or BMD.

A Case of Duplication of Chromosome 9q(q13-q21.3) as Polymorphism in Fetus of Patient with Habitual Abortion / 대한산부인과학회잡지

Habitual abortion or recurrent pregnancy loss has been defined as the occurrence of three or more clinically recognized pregnancy loss before 20 gestational weeks. A recognized cause of habitual abortion is a genetic abnormality, and karyotyping of couples will reveal that about 5% have some abnormality, most frequently a balanced translocation. However, it has been reported that duplication of chromosome is a rare condition associated with habitual abortion. We have experienced a case of chromosomal duplication 9q as polymorphism found in fetus of the patient with habitual abortion. Father of the fetus also has the same chromosomal duplication on 9q. This represents familial polymorphism and it is very rare variant. We presented with brief review of literatures.

The Relationship of Anorexia, Nausea, Vomiting, Oral Intake and Nutritional Status in Patients Receiving Chemotherapy / 간호학회지

Malnutrition is a common problem in cancer patients. In addition anticancer drugs used in chemotherapy as a major therapeutic mode are famous as the side effect like nausea, vomiting, which lead the patients to malnourished state. This study was to determine the relationship of anorexia, nausea, vomiting and oral intake and identify the influence these side effects on the nutritional status in patients receiving chemotherapy. To assess the nutritional status, anthropometry such as weight, height, body mass index(BMI), body fat proportion, and triceps skinfold thickness, and biochemistry test such as hemoglobin and lymphocyte were measured at the pre- and post- chemotherapy and the readmission time, all three times. During chemotherapy, anorexia, nausea, and vomiting using a VAS or 5-point scale and 24 hour oral intake using a food record were measured daily. Forty-nine patients knowing their diagnosis and receiving chemotherapy were recruited from an oncological ward in a general hospital for 5 months and they were reduced 31 at readmission time for a next chemotherapy. The results were as follows. Most subjects (93.6%) were in the 4th stage of cancer and 57.1% of subjects were in the first or the second chemotherapy. In most subjects(82.6%), their weight was decreased 10.7% than as usual. The degree of anorexia, nausea, and vomiting was significantly higher and the amount of oral intake was significantly less during the chemotherapy than at the pre-chemotherapy. Weight, BMI, triceps skinfold were reduced more at the post- chemotherapy than the pre-chemotherapy and were recovered the nearly same but less level at the readmission time. Body fat proportion was increased at the post chemotherapy and then decreased at the readmission phase. Hemoglobin and the number of lymphocyte were below normal at the pre-chemotherapy and more reduced at the readmission time. Anorexia, nausea, and vomiting were related positively and oral intake was negatively related with nausea and vomiting. The nutritional status at the post- chemotherapy and the readmission time was explained 20% over by the side effect like anorexia, nausea, vomiting and oral intake during the chemotherapy. The significant nutrition predictors at the post- chemotherapy were vomiting and the significant predictors at the readmission time were anorexia, vomiting, and oral intake. These results indicated the patients receiving chemotherapy were continued to deteriorate the nutritional status. Therefore nurse should have knowledge how much the nutritional status can be affected and assess the nutritional status periodically and try to find out the intervention for side effects from the series of chemotherapies.

Studies on preparation of 99mTc complexes of methionine isomers / 대한핵의학회잡지

No abstract available.

Clinical Observation of the Neurovascular Island Pedicle Flap in the Hand / 대한정형외과학회잡지

The skin defects or sensory impairment of the fingers, especially at the critical area for prehension(tips of thumb, index and middle fingers) should be reconstructed for the better function of hand. In our department, we performed neurovascular island pedicle flap transfer for the purpose of reconstruction of sensibility and skin defect simultaneousely to the critical area. 1. Since 1978, we had performed neurovascular island pedicle flap transfer in 14cases, among which 9 cases were followed for more than one year. 2. The operation was performed for the reconstruction of thumb in 8 cases, and index in 4 cases. The most common cause of injury was crushing by machine(8 cases). 3. The island flap was transferred from middle finger(9 cases) and from ring finger(4 cases). 4. Recovery of the protective sensation at the recipient sites was good or fair after one year, but reorientation and two point discrimination were poor. 5. Cold intolerance was developed in 3 cases and callosity was formed in 2 cases. 6. In all cases, the transferred flaps were good in circulation status and durability. 7. It is considered that the neurovascular island pedicle flap is an accepted method of restoring skin coverage as well as sensation to a localized tactile area in the hand.

The Role of Arthroscopy in Diagnosis and Treatment of the Knee Disorders / 대한정형외과학회잡지

Arthroscopy has now become a valuable method for the diagnosis and treatment of the internal derangement of the knee. Based on the experiences gained during the past three years, in which 93 knees with posttraumatic disorders were observed arthroscopically, several uncommon and interesting findings were encountered. Such illustrative findings have been summarized here. I. Injury at the parameniscal portion is readily overlooked and especially the middle and posterior one-thirds are inaccessible. A wavy undulation of the concave margin of the meniscus, when abnormally exaggera;ed by tibial rotation, possibly suggests the presence of this type of injury. 2. The discoid cartilage and the bucket-handle tear of meniscus occasionally show similar pattern arthroscopically. 3. The plica of the knee can sometimes be a cause of knee disorders. Any internal derangement, which tends to be localized around the patella, warrants close scrutiny for its presence. 4. A large foreign body within a knee joint could easily be removed by virtue of direct arthroscopic visualization.

Review of Trochanteric approach in 285 Total Hip Arthroplasties / 대한정형외과학회잡지

This paper is a consecutive series of total hip arthroplasties were performed over 6 years period by the same group surgeons utilizing the Charnley method as well as the lateral approach with trochanteric osteo. tomy. Trochanteric reattachment was accomplished in 285 hips and method of reattachment were basically standard Charnley technique which we used in most of our series. In addition, some modification of original Charnley technique which we used in early this trial were also included for this study. As far as trochanteric complications are concerned, there are 18 cases of hips where there was wire breakage, proximal drift of greater trochanter and 6 established cases of nonunion also reported. By the use of wire mash, we have performed a revisional surgery which has re-inforced of the greater trochanter. This was the case when the greater trocyhanter was very osteoporotic. Finally, biomechanical considerations of the re-attachment of the greater trochanter and new Charnley staple clamp method were introduced with review of our cases and analysed for technical failures.