No abstract available.
Cardiomyopathies* ; Peripartum Period*

Cervical pregnancy is a rare and dangerous form of ectopic pregnancy in which the blastocyst implants within the cervical canal below the internal os of the uterine cervix. The characteristic clinical sign is a severe asymptomatic uterine bleeding in early pregnancy or during curettage. Most cervical pregnancies result in early spontaneous abortion, complicated by severe hemorrhage from the eroded blood vessels within the cervical tissue. Because of uncontrolled profuse vaginal bleeding, total hysterectomy has been the mostly necessitated to control life-threatening bleeding. Transvaginal sonography allows early diagnosis, and conservative treatment (two-time treatment : first treatement with systemic or intraamnionic methotrexate, secondly with curettage or ligature of the uterine arteries) improves the patient's fertility. Successful treatment is defined as elimination of the cervical pregnancy with preservation of the uterus. We report two cases of cervical pregnancy managed, successfully with methotrexate, leucovorin and curettage.
Abortion, Spontaneous ; Blastocyst ; Blood Vessels ; Cervix Uteri ; Curettage ; Cytochrome P-450 CYP1A1 ; Early Diagnosis ; Female ; Fertility ; Hemorrhage ; Humans ; Hysterectomy ; Leucovorin ; Ligation ; Methotrexate ; Pregnancy* ; Pregnancy, Ectopic ; Uterine Hemorrhage ; Uterus

Measurement of the bulbocavernosus reflex is widely used to diagnose underlying neurologic disorders in erectile dysfunction. Because this single parameter of latency time in BCRL(bulbocavernosus reflex latency) testing has been used as the sole guideline to diagnose neurogenic impotence, problems in discriminating neurological disturbance from nonneurogenic impotence are frequently encountered especially when the value of latency time is within the borderline range, or when the outcome is difficult to interpret. In order to assess the useful parameters of conventional BCRL testing for the differential diagnosis of neurogenic impotence, we performed BCRL testing in 100 patients who compliance of poor erection. We compared these patients with a previously controlled group of 45 adult males without any erectile or neuronal disturbance. The results obtained were summarized as follows. . 1)Of 100 patients, 24 were diagnosed as neurogenic impotence. 2) In this neurogenic impotence group, as compared to the normal and non-neurogenic impotence group, there was a significant difference(P<0.05) in the values of sensory, pain, reflex threshold and bulbocavernosus reflex latency time. 3) The BCR measurement allowed to find lateralized neurologic disturbance. These results show that in BCRL testing the evaluated values of sensory, pain and reflex threshold, in addition to latency time, can be useful parameters for the differential diagnosis of neurogenic impotence.
Adult ; Compliance ; Diagnosis* ; Diagnosis, Differential ; Erectile Dysfunction* ; Humans ; Male ; Nervous System Diseases ; Neurons ; Reflex*

Hyperemesis gravidarum is characterized by severe nausea, vomiting followed by weight loss, dehydration, electrolyte imbalance and acid-base derangements. Its treatment was composed of adequate fluid therapy, electrolyte replacement and nutrient supply. In severe case, it also leads to a variety of neurological symptoms including confusion, gait disturbance and nystagmus, possibly due to thiamine deficiency and may result in so called Wernicke's disease. We have experienced a case of Wernicke's encephalopathy associated with severe hyperemesis gravidarum and this case is presented with a brief review of literature.
Dehydration ; Female ; Fluid Therapy ; Gait ; Hyperemesis Gravidarum* ; Nausea ; Pregnancy ; Thiamine Deficiency ; Vomiting ; Weight Loss ; Wernicke Encephalopathy*

OBJECTIVE: Chlamydia trachomatis is one of the most common causative microorganisms in pelvic inflammatory disease. The symptom of Chlamydia infection is nearly absent or weak in many cases, but its complication is clinically very important because of tubal obstruction, infertility, tubal pregnancy, and recurrent pelvic inflammatory disease. This study was performed to investigate the prevalence rate and clinical characteristics of Chlamydia trachomatis. METHODS: From May, 2001 to April, 2002, in Daerim St. Mary's Hospital, OB-Gyn department, the 68 inpatients of pelvic inflammatory diseases and 607 outpatients of routine gynecologic examination were studied on history taking, physical examination, laboratory test, and polymerase chain reaction for the detection of Chlamydia trachomatis. RESULTS: The prevalence rate of Chlamydia trachomatis was 20.6% (14/68) in pelvic inflammatory disease and 8.6% (51/593) in routine gynecologic examination. As regarding the age distribution of Chlamydia trachomatis positive group was the largest portion in the twenties, and symptom-free group was about 40%. Chlamydia infection was related to the history of artificial abortion, and showed no significant difference in parity. Most common site of infection was uterine cervix, and mixed infection rate with other bacteria was 43.1%. The treatments were given medically in 58 cases, surgically in 6 cases, and laparoscopy in 1 case were performed. CONCLUSION: Although the prevalence rate of Chlamydia infection is high in sexually active age group and Chlamydia infection has a serious bad effect on reproduction, the disease detection is difficult because symptom is weak or absent, but it reveals good cure rate. Therefore the screening and treatment of Chlamydia trachomatis are necessary to decrease the prevalence and prevention of complication.
Age Distribution ; Bacteria ; Cervix Uteri ; Chlamydia Infections ; Chlamydia trachomatis* ; Chlamydia* ; Coinfection ; Fallopian Tube Diseases ; Female ; Humans ; Infertility ; Inpatients ; Laparoscopy ; Mass Screening ; Outpatients ; Parity ; Pelvic Inflammatory Disease ; Physical Examination ; Polymerase Chain Reaction ; Pregnancy ; Pregnancy, Tubal ; Prevalence ; Reproduction

No abstract available.

Holoprosencephaly is a rare malformation complex or development defect including different degrees of incomplete cleavages of the embryonic prosencephalon and varying degrees of the midface defects, resulting from the defect of prechordal mesoderm, migrating forward into the area anterior to the notochord during the third week of fetal development. Early antenatal diagnosis of holoprosencephaly is important to find out its severity, to predict its prognosis, and to determine proper management according to its prognosis and severity. The possibility of early antenatal diagnosis of holoprosencephaly by ultrasound has been suggested, but occasionally missed and rarely confirmed. We present one case of lobar holoprosencephaly, diagnosed postnatally and one case of alobar holoprosencephaly, diagnosed antenatally in our hospitals.
Fetal Development ; Holoprosencephaly* ; Mesoderm ; Notochord ; Prenatal Diagnosis ; Prognosis ; Prosencephalon ; Ultrasonography

Spontaneous arterial bleeding has been reported rarely. In a patient consuming heavy amounts of alcohol with alcoholic liver cirrhosis, spontaneous bleeding can be evoked by thrombocytopenia, altered platelet function, and shear stress on fully dilated arteries by portal hypertension. Alcohol consumption itself can also predispose a patient to bleeding by influencing the aggregation and activation of platelets, and altering the coagulation and fibrinolysis pathway. All of these mechanisms could cause patients with alcoholic liver cirrhosis to bleed spontaneously; however, conditions inducing peripheral arterial bleeding are very rare. Here, we report three cases of spontaneous arterial bleeding in patients with liver cirrhosis consuming heavy amounts of alcohol. All of the patients bled without any physical trauma, and the involved arteries were the intercostal arteries in two cases and a gastroduodenal artery in the other case. The patients were treated by angiographic embolization. One expired due to recurrence of arterial bleeding despite repeated angiographic embolization and massive transfusion.
Alcohol Drinking ; Arteries ; Blood Platelets ; Embolization, Therapeutic ; Fibrinolysis ; Hemorrhage* ; Humans ; Hypertension, Portal ; Liver Cirrhosis ; Liver Cirrhosis, Alcoholic* ; Recurrence ; Thrombocytopenia

STUDY DESIGN: A biomechanical study using the porcine spine. OBJECTIVES: To investigate the efficacy of direct anterior vertebroplasty [Polymethylmetacrylic acid (PMMA) augmentation] with anterior vertebral screw fixation. SUMMARY AND LITERATURE REVIEW: We are not aware of any previous reports that described this technique. MATERIALS AND METHODS: Thirty out of 35 fresh porcine lumbar vertebral bodies (L1-5) were instrumented with single anteriorvertebral screws using different augmentation methods. In group 1 (n=10), the non-augmented group, each vertebral body was pre-drilled and an anterior vertebral screw was inserted unicortically at 90 degrees laterally. In groups 2 (n=10) and 3 (n=10), after the unicortical pre-drilling, 2 ml of PMMA were injected through an 11-gauge bone biopsy needle. The screw was inserted immediately after the cement injection in group 2, and after complete consolidation of the cement in group 3. Axial pullout loads to loosen the screws were measured. Conventional vertebroplasties via bilateral pedicles were performed in the other 5 vertebral bodies, the cement distribution areas of which were compared with the 5 specimens of groups 2 and 3, respectively, using radiomorphometry. The data were analyzed using the Mann-Whitney test. RESULTS: The mean pullout loads were 459+/-111N in group 1, 1510+/-165N in group 2, and 1241+/-189N in group 3. The PMMA augmented anterior vertebral screws (groups 2 and 3) provided more than 100% of an increase in pullout strength compared with non-augmented screws (group 1) (P < 0.001). Among the augmented screws, the screws that were inserted during the consolidation of PMMA (group 2) had a greater resistance against pullout loads than did those that were inserted after complete consolidation (group 3) (P < 0.01). The cement distribution areas after the direct anterior vertebroplasties (groups 2 and 3) was no different than that after conventional posterior vertebroplasties (P > 0.05) CONCLUSIONS: Direct anterior vertebroplasty is another effective augmentation method for anterior vertebral screw fixation. With this technique, we avoided an unnecessary posterior procedure and achieved a more rigid fixation because we could insert the screws during the consolidation of PMMA.
Biopsy ; Needles ; Polymethyl Methacrylate ; Spine ; Vertebroplasty*

Ischemic colitis is generally considered a disease of the elderly. The causes of ischemic colitis include low-flow states due to cardiac dysfunction or hypovolemia and certain medications including estrogen. Here we report a case of ischemic colitis in a 26-year-old woman. She had no specific medical history except taking oral-contraceptives for a long time. The mechanism of estrogen-induced ischemic colitis is not clearly understood. But we recommend that oral-contraceptives should be considered as a cause of ischemic colitis in young women.
Adult ; Aged ; Colitis, Ischemic ; Contraceptives, Oral ; Estrogens ; Female ; Humans ; Hypovolemia