We report a 71 years old woman with transient periodic limb movement disorder and myoclonus that appeared after acute gastrointestinal bleeding. The abnormal movements dissolved as the blood loss was restored. The woman was later found to have an asymptomatic spine meningioma. Iron defi ciency due to acute bleeding may be the trigger resulting in the abnormal movements in this patient with subclinical spinal meningioma

OBJECTIVE: This study was performed to evaluate the feasibility, safety, and tolerance of early postoperative oral feeding in gynecologic patients who have underwent intra-abdominal surgery. Thus, we investigated the clinical efficacy of early postoperative oral feeding in gynecologic patients, prospectively. METHODS: From September 1998 to March 1999, we studied 80 gynecologic patients undergoing laparotomy at Department of Obstetrics and Gynecology, Yonsei University College of Medicine, prospectively. After surgery, the patients were grouped into two arms; the first early oral feeding group began a clear liquid diet on the first postoperative day and advanced to regular diet as tolerated. the second control group received nothing by mouth until return of bowel function. RESULTS: Although more patients in the study group developed nausea, the incidence of vomiting and abdominal distension were comparable in both groups. Time to development of bowel sound and flatus were significantly shorter in study group. Postoperative complications including pneumonia, atelectasis, wound complications, and febrile morbidity occurred insignificantly in both group. Postoperative changes in hematologic indices and electrolytes were comparable in both group. CONCLUSION: Early postoperative oral feeding in gynecologic patients undergoing intra-abdominal surgery is safe, well tolerated. We believe that re-evaluation of postoperative surgical care may increase our knowledge and better serve our patients.
Arm ; Diet ; Electrolytes ; Flatulence ; Gynecology ; Humans ; Incidence ; Laparotomy ; Mouth ; Nausea ; Obstetrics ; Pneumonia ; Postoperative Complications ; Prospective Studies ; Pulmonary Atelectasis ; Vomiting ; Wounds and Injuries

PURPOSE: Grave's disease is an autoimmune disease with chronic and systemic features. It affects the orbital fat and muscle bringing about defect in extrinsic eye motility, diplopia, optic nerve defect and lid retraction. In patients with lagopthalmos and resulting facial deformity, treatment can be done by rectus muscle recession or filling with various material. Autogenous auricular cartilage graft is often used and synthetic material such as synthetic acellular dermis, polyethylene meshs are also used for filling of the depressed area. Nevertheless, autogenous auricular cartilage grafts are difficult to utilize and synthetic materials sometimes result in protrusion or infection. Therefore, hard palate mucosa was considered as an alternative. We report two cases of patients with lower eyelid retraction corrected with autogenous hard palate mucosa. METHODS: We performed this operation in two patients of Graves' ophthalmopathy. The capsulopalpebral fascia was incised and elevated through an incision on the conjunctiva. Then, the harvested hard palate mucosa was sutured to the inferior border of the tarsus and covered with the conjunctiva. RESULTS: The lower eyelid retraction was corrected successfully. No hypertrophy or deformation of the transplanted hard palate mucosa was noted 6 months after the surgery. CONCLUSIONS: From the results above, we may conclude that the hard palate mucosa serves as an ideal spacer for the curvature and the inner lining in lower lid retraction. Hard palate mucosa is as sturdy as the autogenous cartilage but is much easier to utilize. It can be also used for lid retraction after lower lid aesthetic surgeries or traumas.
Acellular Dermis ; Ankle ; Autoimmune Diseases ; Cartilage ; Congenital Abnormalities ; Conjunctiva ; Diplopia ; Ear Cartilage ; Eyelids* ; Fascia ; Humans ; Hyperthyroidism ; Hypertrophy ; Mucous Membrane* ; Optic Nerve ; Orbit ; Palate, Hard* ; Polyethylene ; Transplants

OBJECTIVE: The purpose of this study is to reevaluate the prognostic factors by investigating the clinical and biological parameters concerned malignant gestational trophoblastic tumor in patients with hydatidiform mole. METHODS: From March 1995 to February 2000, 41 patients admitted to department of the Obstetrics and Gynecology, Yonsei University College of Medicine who were diagnosed with pathologically-proven gestational trophoblastic disease were selected. Parameters such as age, gravida, parity, presence of theca lutein cyst, ratio of uterine size to gestational age, hCG level, DNA ploidy, S-phase fraction were compared between malignant gestational trophoblastic tumor group and spontaneous remission group. RESULTS: Considering the clinical prognostic factors, the patients were divided into two age groups; the first group consisted of those older than 40 years of age and the second control group consisted of those under 40. The number of patients older than 40 in the spontaneous remission group and malignant gestational trophoblastic tumor group were 4(15.4%) and 7(46.7%), respectively, showing a significantly higher number in the group over 40years. Other parameters such as gravida, parity, presence of theca lutein cyst, ratio of uterine size to gestational age, hCG level, DNA ploidy, S-phase fraction showed no statistically significant difference between the two groups. CONCLUSION: The progression rate from hydatidiform mole to malignant gestational trophoblastic tumor was significantly higher in patients over 40 years of age. Therefore, more aggressive therapeutic approach should be considered in such patients.
DNA ; Female ; Gestational Age ; Gestational Trophoblastic Disease ; Gynecology ; Humans ; Hydatidiform Mole* ; Lutein ; Obstetrics ; Parity ; Ploidies ; Pregnancy ; Remission, Spontaneous ; Trophoblastic Neoplasms* ; Trophoblasts*

When hand injuries caused by human bite are overlooked and they can progress to pyogenic arthritis. Pyogenic arthritis is difficult to treat and can make severe sequelae in the joints. We report a case of pyogenic arthritis of the hand that occurred after human bite injury in adolescent treated with wide debridement and external fixator. Our literature searches revealed that the use of external fixator is good treatment option for the treatment of pyogenic arthritis of the hand.
Adolescent* ; Arthritis* ; Bites, Human ; Debridement ; External Fixators ; Hand ; Hand Injuries ; Humans ; Joints ; Metacarpophalangeal Joint*

OBJECTIVE: Obesity is considered a potential cause of several malignancies including endometrical cancer and breast cancer. We analyzed the relationship between obesity and cervical cancer to examine the role of obesity in developing cervical cancer and to prevent the cervical cancer. METHODS: A retrospective analysis was performed on 203 cervical carcinomas including 87 cervical adenocarcinoma and 116 cervical squamous cell carcinoma patients and as control group, 279 patients visiting severance hospital for PAP smear in the period 1994-2003. We analyzed medical records for patient characteristics and body mass index. The obtained data were analyzed using t-test, chi square test and logistic regression analysis by SPSS. RESULTS: There was no statistically significant risk factor in patient characteristics including body mass index between adenocarcinoma and control group. Between cervical squamous cell carcinoma and control group, patients age (odds ratio=0.952, p=0.06) and menopause status (odds ratio=2.420, p=0.02) were statistically significant risk factors. Body mass index was not significantly different among three groups (adenocarcinoma vs. control group, 23.0 +/- 3.4 vs. 22.4 +/- 3.2; squamous cell carcinoma vs. control group, 23.9 +/- 3.5 vs. 22.4 +/- 3.2). CONCLUSION: Our results were consistent with the concept that obesity was not a risk factor for cervical carcinoma. However menopause might be a potential risk factor in developing squamous cell carcinoma of the uterine cervix.
Adenocarcinoma ; Body Mass Index ; Breast Neoplasms ; Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Humans ; Logistic Models ; Medical Records ; Menopause ; Obesity* ; Retrospective Studies ; Risk Factors* ; Uterine Cervical Neoplasms*

OBJECTIVES: The purpose of this study was to evaluate the psychometric properties of the Korean version of the Richmond Compulsive Buying Scale (RCB-K). METHODS: Participants (n=598) included patients recruited through an online panel survey. For the semantic adaptation step, the scale was translated into Korean and then back-translated to English by one psychologist, one public health professional, one psychiatrist who could speak both Korean and English, and one professional translator, without communication between those involved. A confirmatory factor analysis was performed to test whether the factor structure of the RCB-K was consistent with the English version. Convergent validity was assessed by correlating the RCB-K scores with those of other scales (i.e., O'Guinn & Faber's Compulsive Buying Scale, Problem Gambling Inventory). RESULTS: The factor structure of the RCB-K was consistent with the two-factor structure established for the original RCB. Cronbach's α was high (0.906), indicating that the reliabilities of the items in each subscale were satisfactory. The RCB-K score was significantly correlated with those for the O'Guinn & Faber's Compulsive Buying Scale (r=0.7) and the Problem Gambling Inventory (r=0.422). CONCLUSION: The results of the present study indicate that the RCB-K is an effective and valid scale for evaluating the severity of compulsive buying. The findings suggest that the RCB-K is a promising assessment tool for use in the treatment and study of online compulsive buying behavior.
Gambling ; Humans ; Psychiatry ; Psychology ; Psychometrics ; Public Health ; Reproducibility of Results* ; Semantics ; Weights and Measures

OBJECTIVE: This study was carried out to investigate the relationship between DNA ploidy, S-phase fraction (SPF), expression of cyclin A and clinical prognostic factors including stage, grade, CA-125 and residual tumor size in epithelial ovarian cancer, and to evaluate the association between DNA ploidy, SPF, expression of cyclin A and 3-year survival. METHODS: Study group consisted of 31 cases of epithelial ovarian cancer, 10 of borderline ovarian tumor and 5 of benign ovarian tumor diagnosed at the department of Obstet. and Gynecol. in Yonsei University College of Medicine, Seoul, Korea from Feb. 2000 to Jan. 2003. All patients underwent staging-laparotomy and postoperative chemotherapy. The level of CA-125 was assessed after 6th postoperative chemotherapy with cut-off value of 35 U/mL. DNA ploidy and SPF were evaluated by flow-cytometry of fresh ovarian tissue obtained at the operative field. The expression of cyclin A was evaluated by immuno-histochemical stain. Expression of 5% was considered as positive. Statistical analysis was done by two-sample t-test, chi-square test, and Kaplan-Meier survival curve using SPSS ver 11.0 software. RESULTS: In 46 ovarian tumors aneuploidy, SPF and expression of cyclin A were significantly higher in epithelial ovarian cancer as compared with benign and borderline tumors (p=0.004, 0.001, 0.001, respectively). Number of aneuploidy, SPF and expression of cyclin A were significantly higher in patients with higher grade, more advanced stage, higher level of CA-125 (more than 35 U/mL) and more than 2 cm of residual tumor size (p=0.004, 0.009, 0.05, 0.002 in aneuploidy; p=0.06, 0.01, 0.04, 0.007 in SPF; p=0.03, 0.004, 0.06, 0.02 in cyclin A). Aneuploidy and expressions of more than 10% of SPF and cyclin A were also associated with poorer overall survival (p=0.02, 0.02, <0.0001, respectively). Significantly positive correlations were observed among these factors. CONCLUSION: Number of aneuploidy, percentage of SPF and expression of cyclin A were higher in more advanced stage, higher grade, higher CA-125 and more than 2 cm of residual tumor size and associated with poorer overall survival. Thus DNA flow-cytometry and estimation of expression of cyclin A may provide major information about prognosis of disease in epithelial ovarian cancer patients.
Aneuploidy ; Cyclin A* ; Cyclins* ; DNA* ; Drug Therapy ; Humans ; Korea ; Neoplasm, Residual ; Ovarian Neoplasms* ; Ploidies ; Prognosis ; Seoul

Although flexor tendon triggering due to stenosing flexor tenosynovitis is common clinically, extensor triggering is quite rare. Known common causes are impingement between extensor tendon and extensor retinaculum, stenosis of the tendon sheath, and impingement between extensor tendon and osteophyte. We report rare case of triggering in the little finger caused by impingement between extensor digiti minimi and synovial septum.
Constriction, Pathologic ; Fingers ; Osteophyte ; Tendons ; Tenosynovitis

BACKGROUND AND OBJECTIVES: The bacteriology of chronic sinusitis helps us to understand sinusitis and plays an important role in selecting appropriate antibiotics. In recent studies, a good correlation was found between middle meatus and maxillary sinus cultures. We correlate middle meatus, ethmoid sinus and maxillary sinus microbiology in patients with chronic sinusitis and try to determine whether middle meatus cultures can replace maxillary sinus and ethmoid sinus cultures as noninvasive alternative methods. STUDY DESIGN: Prospective study. PATIENTS AND METHODS: 32 patients with chronic sinusitis who didn't respond to medical therapy and received endoscopic sinus surgery were selected. Intraoperative middle meatus, anterior ethmoid and maxillary sinus samples from 32 patients under endoscopic visualization using sterile cotton swabs (BBL Culture Swab(R), BBL, USA) were collected. RESULTS: The overall correlation rate of middle meatus and ethmoid sinus cultures was estimated to be 84.4%. The overall correlation rate of middle meatus and maxillary sinus cultures was estimated to be 84.4%. The most frequently isolated bacteria were coagulase negative Staphylococci in middle meatus and Staphylococcus aureus in ant. Ethmoid and maxillary sinus. CONCLUSION: This study demonstrates that middle meatus cultures correlate well with anterior ethmoid and maxillary sinus cultures and can be used to guide antibiotics selection in chronic sinusitis.
Anti-Bacterial Agents ; Ants ; Bacteria ; Bacteriology ; Coagulase ; Ethmoid Sinus* ; Humans ; Maxillary Sinus* ; Prospective Studies ; Sinusitis* ; Staphylococcus aureus