• Title/Summary/Keyword: multiple injection

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The Effect of Percutaneous Multiple Puncture BCG Vaccination on PPD 1TU, 2TU and 5TU Tuberculin Skin Test (경피용 BCG 백신의 PPD 1TU, 2TU 및 5TU 결핵 피부반응 검사에 대한 영향)

  • Kim, Bo Sun;Hwang, Min Ho;Kim, Chang Hwi;Park, Jae Ok;Shin, Sang Man
    • Pediatric Infection and Vaccine
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    • v.8 no.2
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    • pp.175-180
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    • 2001
  • Purpose : Recently in Korea since 1998, 2TU has been used instead of 5TU, which caused a confusion in interpreting tuberculin skin tests. We compared the tuberculin skin reaction to PPD(purified protein derivatives) 1TU, 2TU and 5TU. Methods : We studied tuberculin skin reaction to PPD 1TU, 2TU and 5TU on 92 infants who were vaccinated with percutaneous multiple puncture BCG vaccine(Tokyo 172 strain, Japan BCG Laboratory Co.) in neonatal period. Diameters of indurations were measured in millimeters 48~72 hours after the intradermal injection of PPD 1TU, 2TU and 5TU. Results : Among 92 infants(male : 56, female : 36), 1TU was used on 31 infants, 2TU on 31 infants and 5TU on 30 infants for tuberculin skin test. The mean diameter of induration for PPD 1TU, 2TU and 5TU were $5.7{\pm}4.2mm$, $7.1{\pm}3.7mm$, and $9.2{\pm}4.2mm$, respectively. There was no statistical difference in mean diameter of induration between 1TU and 2TU. However, when tested with 5TU, the diameter of induration was significantly larger than those of PPD 1TU and 2TU(P<0.05). Six subjects(19.4%) tested with 1TU, 9 subjects(29%) tested with 2TU and 16 subjects(53.3%) tested with 5TU had diameter of 10 mm or more. There was no statistical difference between 1TU and 2TU but for 5TU, number of subjects with diameter of 10 mm or more was significantly higher than PPD 1TU and 2TU(P<0.05). Number of subjects with induration diameter of 5 mm or more for 1TU, 2TU and 5TU was 19(61.3%), 22(71.0%) and 26(86.7%), respectively. However, there was no statistical difference. Conclusion : A new standard criteria for interpreting the tuberculin skin test with PPD 2TU should be established for clinical diagnosis of tuberculosis.

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Effect of intravenous deferoxamine in multiply transfused patients (대량 수혈을 받은 환아들에서 정맥 투여한 deferoxamine의 효과)

  • Oh, Sang Min;Kang, Joon Won;Kim, Sun Young
    • Clinical and Experimental Pediatrics
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    • v.50 no.12
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    • pp.1225-1230
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    • 2007
  • Purpose : Multiple transfusions in patients with chronic anemia can result in excessive iron deposition in tissues and organs. Effective iron chelation therapy in chronically transfused patients can only be achieved when iron chelators remove sufficient amounts of iron equivalent to those accumulated in the body from transfusions, thus leading to maintain body iron load at a non-toxic level. This study was retrospectively carried out to investigate the effect of intravenous iron chelation therapy with deferoxamine in patients who have received multiple transfusions. Methods : From March 2005 to January 2007, 15 patients who have received multiple transfusions were included in this study. Transfusion dependent patients were defined as those receiving >1 packed red blood cell (RBC) units/month for at least 6 months. They received intravenous deferoxamine for 7 days (10-30 mg/kg/day, 24 hour continuous infusions). Before and after deferoxamine infusions and 3 months later, we compared serum iron, TIBC, and ferritin in transfusion dependent patients and transfusion independent patients. Results : There were 6 males and 9 females and their age range was 5.6-21.3 (median 8.3) years. Transfusion dependent patients were 7 and 8 were transfusion independent states after stem cell transplantation or chemotherapy. There was no significant change in ferritin level after deferoxamine treatment for the transfusion dependent patients but significant falling of ferritin level was observed for the transfusion independent patients 3 months later compared with baseline ferritin level (P=0.046). Some adverse events were observed but symptoms were mild and tolerable. Conclusion : Seven days of intravenous deferoxamine was safe and effective in transfusion independent patients. In transfusion dependent patients, chelation therapy should be maintained, in order to minimize or prevent iron accumulation and storage in the tissues.

Comparison of IVF-ET Outcomes between GnRH Antagonist Multiple Dose Protocol and GnRH Agonist Long Protocol in Patients with High Basal FSH Level or Advanced Age (높은 기저 난포 자극 호르몬 수치를 가지는 환자와 고령 환자의 체외수정시술을 위한 과배란 유도에서 GnRH antagonist 다회 투여법과 GnRH agonist 장기요법의 효용성에 대한 연구)

  • Kim, JY;Kim, NK;Yoon, TK;Cha, SH;Kim, YS;Won, HJ;Cho, JH;Cha, SK;Chung, MK;Choi, DH
    • Clinical and Experimental Reproductive Medicine
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    • v.32 no.4
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    • pp.315-324
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    • 2005
  • Objectives: To compare the efficacy of GnRH antagonist multiple dose protocol (MDP) with that of GnRH agonist long protocol (LP) in controlled ovarian hyperstimulation for in vitro fertilization in patients with high basal FSH (follicle stimulating hormone) level or old age, a retrospective analysis was done. Methods: Two hundred ninety four infertile women (328 cycles) who were older than 41 years of age or had elevated basal FSH level (> 8.5 mIU/mL) were enrolled in this study. The patients had undergone IVF-ET after controlled ovarian hyperstimulation using GnRH antagonist multiple dose protocol (n=108, 118 cycles) or GnRH agonist long protocol (n=186, 210 cycles). The main outcome measurements were cycle cancellation rate, consumption of gonadotropins, the number of follicles recruited and total oocytes retrieved. The number of fertilized oocytes and transferred embryos, the clinical pregnancy rates, and the implantation rates were also reviewed. And enrolled patients were divided into three groups according to their age and basal FSH levels; Group A - those who were older than 41 years of age, Group B - those with elevated basal FSH level (> 8.5 mIU/mL) and Group C - those who were older than 41 years of age and with elevated basal FSH level (> 8.5 mIU/mL). Poor responders were classified as patients who had less than 4 retrieved oocytes, or those with $E_2$ level <500 pg/mL on the day of hCG injection or those who required more than 45 ampules of exogenous gonadotropin for stimulation. Results: The cancellation rate was lower in the GnRH antagonist group than in GnRH agonist group, but not statistically significant (6.8% vs. 9.5%, p=NS). The amount of used gonadotropins was significantly lower in GnRH antagonist group than in agonist group ($34.8{\pm}11.3$ ampules vs. $44.1{\pm}13.4$ ampules, p<0.001). The number of follicles > 14 mm in diameter was significantly higher in agonist group than in antagonist group ($6.7{\pm}4.6$ vs. $5.0{\pm}3.4$, p<0.01). But, there were no significant differences in clinical pregnancy rate (24.5% in antagonist group vs. 27.4% in agonist group, p=NS) and implantation rate (11.4% in antagonist group vs. 12.0% in agonist group, p=NS) between two groups. Mean number of retrieved oocytes was significantly higher in GnRH agonist LP group than in GnRH antagonist MDP group ($5.4{\pm}3.5$ vs. $6.6{\pm}5.0$, p<0.0001). But, the number of mature and fertilized oocytes, and the number of good quality (grade I and II) and transferred embryos were not different between two groups. In each group A, B, and C, the rate of poor response did not differ according to stimulation protocols. Conclusions: In conclusion, for infertile women expected poor ovarian response such as who are old age or has elevated basal FSH level, a protocol including a controlled ovarian hyperstimulation using GnRH antagonist appears at least as effective as that using a GnRH agonist, and may offer the advantage of reducing gonadotropin consumption and treatment period. However, much work remains to be done in optimizing the GnRH antagonist protocols and individualizing these to different cycle characteristics.

Effect of Multiple Superovulation and Parity on Embryo Production in Hanwoo (한우의 반복 과배란 및 산차가 수정란 생산에 미치는 영향)

  • Choi S. H.;Ryu I. S.;Son D. S.;Cho S. R.;Han M. H.;Kim H. J.;Choe C. Y.;Kim Y. K.
    • Journal of Embryo Transfer
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    • v.20 no.2
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    • pp.185-190
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    • 2005
  • This study was performed to investigate the effects of multiple superovulation and parity on embryo production in Hanwoo cows. Donors were superovulate 4 times $1\~2$ months interval and inserted CIDR plus (with the capsule of estradiol benzoate 10mg) on Day 10 from standing heat for 9 days and injected 2.5ml FSH (Antorin R-10) 2 times in a day on 6th day to 10th day from insertion of CIDR and the doses of FSH were decreasing 0.5ml on every 2 times. On 3th day of FSH injection, 25ml $PGF_2{\alpha}$ were injected i.m. and on 4th day, CIDR was removed. After 2 days from removing CIDR, AI was performed 2 times 12 hour apart with 2 straws of Korean Proved frozen Semen and simultaneously 200ug/ml GnRH was injected and embryos were recovered on 7th day from Al. The response rates of superovulated donors were $85.7\%,\;90.5\%,\;62.5\%,\;100\%$ from 1 to 4 times of superovulation, respectively. There were significant differences among No. of superovulation times (P<0.05). The results of transferable embryos were 3.7, 3.4, 3.4, 5.7 from 1 to 4 times of superovualtion, respectively. There were no differences among No. of superovulation times. The results of transferable embryos were 2.5, 3.0, 5.3, 3.0, 3.4 form heifer, first born to 4 the born, respectively. There were significant differences among the parities of donors (P<0.05). These results suggested that even 4 times of superovulations of Hanwoo donors could be able to recover transferable embryos, it might be used the donors maximally and improved the adaptation of embryo transfer to farms safely.

Comparisons of Antidiabetic Effect of Panax Ginseng on MLD STZ-induced Diabetic rats in Terms of Time of Administration (Multiple Low Dose Streptozotocin으로 유도된 당뇨 흰쥐에서 투여 시기에 따른 인삼의 항당뇨 활성 비교)

  • Park, Kyeong-Soo;Lee, Dong-Eok;Sung, Jong-Hwan;Chung, Sung-Hyun
    • Journal of Ginseng Research
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    • v.26 no.4
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    • pp.191-195
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    • 2002
  • In this study, we like to examine whether Panax ginseng water extract (PGWE) exerts antidiabetic activities in prevention and treatment modes in multiple low dose (MLD) streptozotocin (STZ) (20 mg/kg i.p injection for 5 days) induced diabetic SD rats. In the prevention mode,150 mg/kg of GRWE was administered intraperitoneally with STG for 3 weeks, and this group is called CO 150. In the treatment mode, we started to administer the same dose of PGWE on day 8 and for 3 weeks, and this group is called POST150. PGWE exerted significant hypoglycemic activities in both prevention (normal control, 97 ${\pm}$ 6 mg/dl; diabetic control, 331${\pm}$23; CO150, 211${\pm}$37) and treatment groups (normal control, 128${\pm}$4 mg/dl; diabetic control, 392${\pm}$33: POST150, 263${\pm}$44). Of great importance is the fact that plasma insulin levels in both groups were markedly increased as compared to the diabetic control (normal control,428.7${\pm}$62.1 pg/dl; diabetic control, 167.0${\pm}$91.7; CO150, 377.6${\pm}$68.7 in prevention mode, and in treatment mode normal control 417.9${\pm}$84.6 pg/dl; diabetic control, 166.1${\pm}$104.7; POST150, 315.2${\pm}$47.4). Blood glucose levels were closely associated with plasma insulin levels, and this result may suggest that PGWE showed the activity to enhance insulin secretion as well as preventing destruction of pancreatic islet cells. Food and water intakes were also determined at the last week of treatment i n both groups. Characteristic symptoms of diabetes were significantly improved in both groups. In the prevention mode, water intake (ml/rat/day) in normal control was increased from 30.6${\pm}$1.5 to 122.2${\pm}$3.4 in diabetic control rats. In the CO150-treated group, water intake was dramatically reduced to 68.3${\pm}$4.4 (p<0.001 vs. diabetic control). In the treatment mode, POST-treated group also reduced the water intake from 128.9${\pm}$2.2 to 113.3${\pm}$1.7. Taken together, our data suggest that PGWE showed comparable antidiabetic activities in prevention and treatment modes. Therefore, PGWE may have a potential as a prophylactic as well as therapeutic agent fur type 2 diabetes mellitus (T2DM).

Radionuclide Cisternographic Findings in Patients with Spontaneous Intracranial Hypotension (자발성 두개내 저압 환자의 방사성 동위원소 뇌조조영술 소견)

  • Jung, Dong-Jin;Kim, Jae-Seung;Ryu, Jin-Sook;Shin, Jung-Woo;Im, Joo-Hyuk;Lee, Myoung-Chong;Jung, Sun-Joo;Moon, Dae-Hyuk;Lee, Hee-Kyung
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.6
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    • pp.482-489
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    • 1998
  • Purpose: Radionuclide cisternography may be helpful in understanding pathophysiology of postural head-ache and low CSF pressure in patients with spontaneous intracranial hypotension. The purpose of this study was to characterize radionuclide cisternographic findings of spontaneous intracranial hypotension. Materials and Methods: The study population consists of 15 patients with spontaneous intracranial hypotension. Diagnosis was based on their clinical symptoms and results of lumbar puncture. All patients underwent radionuclide cisternography following injection of 111 to 222 MBq of Tc-99m DTPA into the lumbar subarachnoid space. Sequential images were obtained between 112 hour and 24 hour after the injection of Tc-99m DTPA. Radioactivity of the bladder, soft tissue uptake, migration of radionuclide in the subarachnoid space, and extradural leakage of radionuclide were evaluated according to the scan time. Results: Radionuclide cisternogram showed delayed migration of radionuclide into the cerebral convexity (14/15), increased soft tissue uptake (11/15), and early visualization of bladder activity at 30min (6/10) and 2hr (13/13). Cisternography also demonstrated leakage site of CSF in 4 cases and 2 of these were depicted at 30min. Epidural blood patch was done in 11 patients and headache was improved in all cases. Conclusion: The characteristic findings of spontaneous intracranial hypotension were delayed migration of radionuclide and early visualization of the soft tissue and bladder activity. These scintigraphic findings suggest that CSF leakage rather than increased CSF absorption or decreased production may be the main pathophysiology of spontaneous intracranial hypotension. Early and multiple imaging including the bladder and soft tissue is required to observe the entire dynamics of radionuclide migration.

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A Study on the Working Environment Recognition and the Caracter Disposition of Nurse Aides (간호조무사의 근무환경인식과 성격성향에 관한 연구)

  • Lee Sun Yi
    • Journal of Korean Public Health Nursing
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    • v.4 no.1
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    • pp.57-74
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    • 1990
  • As the whole world took on the tendency to be highly industrialized, it became necessary for each field of occupation to require professional man power. Especially, since the World War n, the participation of woman power in economic activities has been continually increasing. In our country also, because of the rapid economic growth, change in the way of thinking of women as well as their participation in economic activities are increasing. Thus, woman power is being utilized in various occupational fields from simple physical labor to those that require high-professional skill. Also, continued economic development policies, by setting the establishment of welfare society as the ideology to be fulfilled, brought expansion of medical facilities in the field of public health and increase in man power in that field. As for the nursing specialists, more than 6000 have been being produced per year and as of the end of 1988, the total number of nursing specialists, reached 123, 115. Therefore, this study is done to recognize the professional knowledge and ability of nursing specialists, who take up $40\%$ of the total public-health related man power in our country, through evaluating their working environment and their disposition of character. This study, which was done from September 18th to September 30th 1989, took on the method of using formed questionnaires that had been amended and supplemented during two preparatory investigations, 322 of such questionnaires were used as an analytical material. In the formation of questionnaires, 12 questions were related to the working environment, and 26 in fortotal were related to the disposition of character, 5 for wise-disposition, 11 for activedisposition and 10 for open-disposition. The measuring method, which used 5-point-standard, allowed 5 points for affirmative recognition of the working environment, also 5 points for showing wise, active and open disposition of character and only point in opposite cases. Collected materials were analyzed, through an electronic calculation, into the average value, the standard deflection percentage, pearson corelative number and stepwise multiple regression. Summarizing the results from this study is as follows: 1. It was shown that the nursing specialists with the average of 3.07 have affirmative recognition of their working environment. The questions which drew most affirmative reaction were those concerning finance-management system such as hand, the questions that received negative reaction were those concerning communication method with the average of 2.49. Such reaction seems to have resulted from the cramming regulation by the superior authorities. Concerning the recognition of working environment in relation to employment conditions, more affirmative recognition is shown with the average of 3.14. at hospitals where injection job is not performed. The nursing specialists working at regular hospitals show more affirmative recognition than those at general hospitals, the averages being respectiely 3.16 and 3.03. 2. As for the disposition of character of the nursing specialists, active-disposition was highest with the average of 3.38, next was wise-disposition with 3.20 and the lowest was open-diposition with 2.98. Variable-wise disposition of character shows that wise-disposition and academic background are beneficially correlated by 0.12. Ative-disposition and open-disposition show correlation to the office term by respectively 0.16 and 0.21. In other words. better academic background leads to higher wise-disposition and more - experience results in higher active and open disposition. Also, the class that performs the injection job, in relation to the working environment, might cause change in the self-conceit that identify those in that class with the nurses; however, as far as professional judgment and action, in dealing with nursing job, being wise, active and open is concerned, not much effect is made. 3. The relation between the recognition of the working environment and the disposition of character is that more afirmative recognition- a nursing specialist has about her working environment, the higher the active-disposition becomes by 0.13. The degrees of the relation between recongnition of environment and wise and open dispositions show respectively 0.06 and -0.06 and -0.06. That is to say that when having more affirmative recognition of the working environment, a nursing specialist shows wise but closed disposition of character. This, howerver, didn't mean much statistically. When observing the results mentioned above, it is conspicuous that the nursing specialists, working as substitutes for the nurse at medical institutions of various sizes, get the feeling of being somewhat equal to the nurses and to some extent, fulfill their desire to accomplish their ego; however, as far as professional ability expansion if concerned. they lack wise and open dispositions. Therefore, considiering upon the results of this study, in medical institutions where the work of nursing specialists is regaded equal to that of the nurses, as a medical member who deals with human lives, it is desirable to make the nursing specialists work under the supervision of the nurses and to offer them continuous education to strengthen and improve their natural dispositions.

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Clinical Usefulness of Contrast Echocardiography: The Dose Effect for Left Ventricle Visualization in Dogs (심초음파의 조영제의 임상적 유용성: 개에서 좌심영상화에 대한 조영제 용량의 영향)

  • Shin, Chang-ho;Hwang, Tae-sung;Yoon, Young-min;Jung, Dong-in;Yeon, Seong-chan;Lee, Hee-chun
    • Journal of Veterinary Clinics
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    • v.32 no.6
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    • pp.486-490
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    • 2015
  • Two-demensional echocardiography is routinely used for evaluation of cardiac function. Visualization of the endocardial border is essential for the assessment of global and regional left ventricular with cardiac disease. SonoVue$^{TM}$ is a microbubble contrast agent that consists of sulfur hexafluoride-filled microbubbles in a phospholipid shell. There were many studies about contrast echocardiographic examination using SonoVue$^{TM}$ contrast agent, and various doses of SonoVue$^{TM}$ were used. To our knowledge, in published veterinary medicine, there was not reported for diagnostic efficient dose of SonoVue$^{TM}$ to evaluate contrast enhanced left ventricular endocardial border delineation (LVEBD). The purpose of this study is to compare the visualization time of LVEBD and find efficient dose of SonoVue$^{TM}$ for using various doses in dogs. Ten healthy Beagles were recruited to the study. Three different doses (0.03 ml/kg, 0.05 ml/kg and 0.1 ml/kg) of SonoVue$^{TM}$ were injected. Endocardial segments were assigned based on previously established methodology, where by the four-chamber views of the LV were divided into 6 segments. In this study, Contrast enhancement of the LVEBD after each injection was evaluated visually at the time point of overall contrast enhancement (Segmental scoring 5+) in the LV by three investigators in a blind manner. Statistical analysis was performed with SPSS version 14.0. All data were analyzed using one-way ANOVA, the multiple comparison Scheffe test. When data for the three offsite readers were combined, mean durations of useful contrast were $3.54({\pm}2.14)$, $6.15({\pm}2.61)$, and $24.39({\pm}11.10)$ seconds for the 0.03 ml/kg, 0.05 ml/kg, and 0.1 ml/kg SonoVue$^{TM}$ doses, respectively. After injection of contrast agent, there were no significant change in side effects such as urticaria, angioedema, hypersensitivity reactions, and digestive system disorders. This study suggests that efficient dose of SonoVue$^{TM}$ contrast agent for improvement of the left ventricle visualization is 0.1 ml/kg. The duration of useful enhancement of LVEBD and the reproducibility were also the highest at the 0.1 ml/kg dosage.

Characterization of Optical Properties of Light-Emitting Diodes Grown on Si (111) Substrate with Different Quantum Well Numbers and Thicknesses

  • Jang, Min-Ho;Go, Yeong-Ho;Go, Seok-Min;Yu, Yang-Seok;Kim, Jun-Yeon;Tak, Yeong-Jo;Park, Yeong-Su;Jo, Yong-Hun
    • Proceedings of the Korean Vacuum Society Conference
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    • 2012.08a
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    • pp.313-313
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    • 2012
  • In recent years there have been many studies of InGaN/GaN based light emitting diodes (LEDs) in order to progress the performance of luminescence. Many previous literatures showed the performance of LEDs by changing the LED structures and substrates. However, the studies carried out by the researchers so far were very complicated and sometimes difficult to apply in practice. Therefore, we propose one simple method of changing the thickness and the numbers of multiple quantum wells (MQWs) in order to optimize their effects. In our research, we investigated electrical and optical properties by changing the well thickness and the number of quantum well (QW) pair in LED structures by growing the structure -inch Si (111) wafer. We defined the samples from LED_1 to LED_3 according to MQW structure. Samples LED_1, LED_2 and LED_3 consist of 5-pair InGaN/GaN (3.5 nm/ 4.5 nm), 5-pair InGaN/GaN (3 nm/4.5 nm) and 7-pair InGaN/GaN (3.5 nm/4.5 nm), respectively. We characterized electrical and optical properties by using electroluminescence (EL) measurement. Also, Efficiency droop was analyzed by calculating external quantum efficiency (EQE) with varying injection current. The EL spectra of three samples show different emission wavelength peaks, FWHM and the blueshift of wavelength caused by screening the internal electric field because of the effect of different MQW structure. The results of optical properties show that the LED_2 sample reduce the internal electric field in QW than LED_1 from EL spectra. the increase in the number of QW pairs reduces the strain and increase the In composition in MQW. And, the points of efficiency droop's peak show different trend from LED_1 to LED_3. It is related with the carrier density in active region. Thus, from the results of experiments, we are able to achieve high performance LEDs and a reduction of efficiency droop and emission wavelength blueshift by optimizing MQWs structure.

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Outcome of Twin Pregnancies after Selective Fetal Reduction (선택적 유산술에 의한 쌍태임신의 예후에 관한 연구)

  • Seo, Seong-Seog;Jo, Mi-Yeong;Kim, Mi-Ran;Hwang, Kyung-Joo;Kim, Young-Ah;Ryu, Hee-Sug
    • Clinical and Experimental Reproductive Medicine
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    • v.30 no.1
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    • pp.85-93
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    • 2003
  • Objective : To evaluate the safety and efficacy of selective fetal reduction (SFR) and compare the outcome of twin pregnancy after SFR in multiple pregnancy induced by assisted reproductive technology (ART) with that of natural twin pregnancy. Methods : From September 1995 to March 2002 in Ajou University Hospital, SFR was performed in 79 patients whose gestational sacs were more than 3. Of these 79 patients, 47 patents resulted in twin pregnancy after SFR. SFR was performed using transvaginal intracardiac KCl injection at gestational age of $6{\sim}9$ weeks. Control group was composed of 264 patients with natural twin pregnancy, who delivered after intrauterine pregnancy at 24 weeks, from June 1994 through December 2002. We compared Obstetric and perinatal outcomes between SFR group and natural twin group. Results: Among 47 patients with twin pregnancy after SFR, 2 spontaneous abortion were occurred at intrauterine pregnancy at 8 and 19 weeks. Obstetrical and perinatal outcomes were available in 43 patients. Single intrauterine fetal death was occurred in 1 of 43 (2.3%) patients in SFR group. Incidence of preterm labor, premature rupture of membrane, preeclampsia and placenta previa were similar, but gestational diabetes mellitus (GDM) was occurred more frequently in SFR group (3 (7.0%) vs 4 (1.5%), p=0.02). Mean gestational age, mean birth weight, incidence of discordancy, use of intubation and ventilation, incidence of fetal anomaly, low (<7) Apgar score and intrauterine growth restriction were similar in both groups. Conclusion: Twin pregnancy after SFR has the increased incidence for GDM but other obstetric and perinatal outcome was similar compared with natural twin pregnancy. So SFR is a safe and effective procedure, so we suggest SFR is needed in multifetal pregnancy more than triplet.