Sequential Management of Pierre Robin Sequence: Case Report

The influence of gender or culture on determining esthetic facial profile / 대한치과교정학회지

Because many of patients seeking orthodontic treatment worry about the facial appearance and their chief motivation for orthodontic treatment is facial esthetics, it is critical to understand the influence of gender or culture on the evaluation of profile esthetics. The purpose of this study was to find out any influence of gender or culture on judging good facial profile. 4 different groups were asked to evaluate 133 facial profiles to test the influence of gender or culture on judging good facial profiles. Those 4 groups consisted of 10 Korean males, 10 Korean females, 10 Korean American males, and 10 Korean American females. 2 evaluation systems were introduced, absolute and relative. Soft tissues of selected good profile group were analyzed and statistic analysis was performed. Conclusions were as follows : 1. Inter-evaluator difference for judging good facial profile was statistically significant, even if there was general agreement for the best profile among 40 raters. 2. Gender difference under the same cultural environment was not significant statistically. 3. The same ethnic groups with different cultural background showed statistically different preference on judging good profile. 4. Good facial profile group had their own characteristics compared to remaining group in several soft tissue measurements which were vertical facial ratio, soft tissue facial convexity, and antero-posterior relative lip position.

Pegnancy Outcomes in Women with Unexplained Midtrimester Elevation of Maternal Serum Human Chorionic Gonadotropin Level / 대한산부인과학회잡지

OBJECTIVE: Our purpose was to determine whether unexplained elevation in maternal serum human chorionic gonadotropin without abnormal elevation in matemal serum alpha-fetoprotein (MSAFP) in the second trimester may be associated with adverse pregnancy outcomes. METHODS: Between January 1997 and December 1997, we evaluated 906 pregnant women undergoing second trimester triple marker screening tests who delivered at our hospital. Multiple pregnancy, fetal anomaly, intrauterine fetal death before 20 completed weeks of gestational age, insulin dependent diabetes mellitus and maternal serum alpha-fetoprotein level greater than 2.0 multiple of the median (MoM) were excluded fiom the study. Seventy-two women with hCG level greater than 2.0 MoM were included in the study group while 809 women with hCG level less than 2.0 MoM served as the control group. Adverse pregnancy outcomes were obtained from hospital delivery records and neonatal records. Statistical analysis were performed by students t-test and chi square test. RESULTS: Women with unexplained elevation of human chorionic gonadotropin level showed increased risks for intrauterine growth retardation (P<0.01) and pregnancy induced hypertension (P<0.05). There were no significant differences between study and control groups with respect to preterm delivery, placental abruption, fetal anomaly and intrauterine fetal death. CONCLUSION: Unexplained elevation of human chorionic gonadotropin in the second trimester was associated with intrauterine growth retardation and pregnancy induced hypertension.

The Clinical Significance of Apgar Score and Umbilical Arterial Blood Gas Analysis on Preterm Infant Delivered Vaginally / 대한산부인과학회잡지

OBJECTIVE: The Apgar score has long been used to determining birth asphyxia and assessing early neonatal status and long-term outcome. Unfortunately, some components of this system depend upon subjective interpretation. Also, although, low Apgar score, Most of newborns are relatively healthy. The objective of our studt is attempt to assure the linical significance of Apgar score and umbilical cord blood gas analysis on assessing status of uncomplicated preterm infants delivered vaginally. METHODS: The present study was performed in attempt to compare umbilical arterial blood gas values for uncomplicated preterm infants delivered vaginally with low 1 and 5 minutes Apgar score (7), each other, The present study included 82 uncomplicated term infants delivered vaginally and 24 preterm infants. Inclusion criteria of our study is as follows: 1) Singleton neonate with vertex presentation, 2) No congenital malformation, 3) Infants whose mother had no obstetrical and medical complications, 4) Immediately after delivery, umbilical arterial blood was sampled, before first breathing of neonate, 5) Infants applied Apgar score at I minute and again 5 minutes after birth, and 6) Infants whose mothers gestational age was estimated by ultrasonography during first-trimester of pregnancy. The statistical analysis was performed by Mann-Whitney U test and Fishers exact test. RESULTS: 1) There was no significant difference in umbilical arterial blood gas values between uncomplicated preterm infants delivered vaginally with low 1 and 5 minutes Apgar score (7). 2) There was no significant difference in umbilical arterial blood gas values between uncomplicated preterm infants delivered vaginally with low 1 and 5 minutes Apgar score (7). 3) There was significant difference in frequency of lower Apgar score (<7) between term (2%[2/82]) and preterm infants (38%[9/24]), but not in frequency of acidemia (defined as less than pH 7.2) (28%[23/82] Vs 33%[8/24]). CONCLUSION: The Apgar score is not a reliable indieator of well-being in preterm neonate. We recommend umbilical arterial blood sampling at delivery of preterm infant with low Apgar score, because umbilical cord blood gas indices on objective means of assessing birth status of the newbarn and more useful than Apgar score in ruling out birth asphyxia.