No abstract available.
Female ; Ovarian Hyperstimulation Syndrome*

To evaluate the effect of allergic parameters, such as serum IgE, eosinophil, and skin test on the bronchial hyperresponsiveness (BHR) in patients with chronic airflow obstruction, we performed methacholine bronchial provocation test, pulmonary function test, skin prick test, and measured blood eosinophil counts and serum IgE level from seventy-nine patients who showed persistent fixed airflow obstruction, less than 75% of predicted value in FEV~ and FEV1/FVC, despite of conventional treatment without steroid therapy for more than 3 months. The results were as follows 1) There were 53 patients with BHR and 26 patients without BHR. There were no statistically significant differences in sex, age, and smoking duration between positive BHR group and negative BHR group (p>0.05). 2) There was no statistically significant difference in absolute and predicted value of FVC(p>0.05). But there were significantly lower absolute, predicted value of FEV1 and FEV1/FVC% in positive group compared with negative group (p<0.05). 3) There was somewhat higher trend of serum IgE level in positive group. Skin test was not significantly different between two groups (p > 0.05 ). 4) Blood eosinophil count was significantly higher in positive group than in negative group(p<0.05). Conclusion of this study is that increased bronchial responsiveness in patients with chronic airflow obstruction is inversely related to the level of pulmonary function and significantly associated with blood eosinophilia.
Bronchial Provocation Tests ; Eosinophilia ; Eosinophils ; Humans ; Immunoglobulin E ; Methacholine Chloride ; Pulmonary Disease, Chronic Obstructive* ; Respiratory Function Tests ; Skin ; Skin Tests ; Smoke ; Smoking

Steroid cell tumors, not otherwise specified (NOS), are infrequently encountered ovarian neoplasms. They constitute <0.1% of all ovarian tumors. They usually occur in younger individuals (mean age, 43 years) and, in contrast to other steroid cell tumors, occasionally occur before puberty. The majority of these tumors produce steroids with testosterone being the most common. Various virilizing symptoms such as hirsutism, temporal baldness, and amenorrhea are common in these patients; however massive ascites is an infrequent symptom. We report a case of steroid cell tumor, not otherwise specified, with hypertension, obesity, ascites and elevated CA 125 with brief review of literature.
Alopecia ; Amenorrhea ; Ascites ; Female ; Hirsutism ; Hypertension ; Obesity ; Ovarian Neoplasms ; Puberty ; Steroids ; Testosterone

A 41-year-old female complaining of easy fatigue, headache, thickened extremities and deepened facial folds was admitted to the hospital. As early as 6 years ago, she had been told by family members that her voice was changed and both hands was thickened. Cranial plain radiography indicated ballooning of sella turcica. Sella MRI disclosed 2.2cm sized pituitary tumor with suprasellar extension. The pituitary tumor with hypothalamic extension was removed via a transsphenoidal approach. The postoperative course was uneventful until hyponatremia with sudden headache and respiratory arrest was developed. The case was due to hyponatremic encephalopathy on the basis of the clinical course and symptoms, and 3% hypertonic saline was infused for 12 hours until the hyponatremia was corrected. We have experienced a mortality case of hyponatremic encephalopathy in which surgieal removal of a pituitary tumor from a female acromegalic patient in menstruant period was followed by the sudden occurrence of hyponatremia, which in turn was later associated with marked brain edema.
Adult ; Brain Edema ; Extremities ; Fatigue ; Female ; Hand ; Headache ; Humans ; Hyponatremia ; Magnetic Resonance Imaging ; Mortality ; Pituitary Neoplasms ; Radiography ; Sella Turcica ; Voice

OBJECTIVE: The aim of this study is to determine whether any association exists between preeclampsia and the maternal serum level of nitric oxide (NO) and platelet activating factor (PAF). METHODS: NO concentrations were measured using Stuehr's method and PAF concentrations were measured with [3H]PAF scintillation proximity assay (SPA) system (Amersham Pharmacia Biotech). Data were analyzed with SAS windows version 6.12, with significance established at p<0.05. RESULTS: The mean (+/-SD) maternal serum concentrations of NO were significantly higher in the group with severe preeclampsia (5.535+/-0.343 ug/ml) and mild preeclampsia (5.891+/-0.481 ug/ml) than in the normotensive pregnancy group (2.036+/-0.744 ug/ml) (p<0.05). The mean (+/-SD) maternal serum concentrations of PAF were significantly higher in the group with severe preeclampsia (928.9+/-32.3 ng/ml) and mild preeclampsia (789.1+/-63.9 ng/ml) than in the normotensive pregnancy group (435.8+/-59.5 ng/ml) (p<0.05). The mean birth weight was lower in the mild and severe preeclampsia groups than in the normotensive pregnancy group (p<0.05). CONCLUSION: Maternal serum NO and PAF concentrations were more increased in preeclampsia than normotensive pregnancy group. NO may therefore serve as compensatory mechanism for vasoconstriction of preeclampsia and PAF as a marker for the risk of preeclampsia.
Birth Weight ; Blood Platelets* ; Nitric Oxide* ; Platelet Activating Factor* ; Pre-Eclampsia* ; Pregnancy ; Vasoconstriction

An avulsion fracture of the second metacarpal base by the extensor carpi radialis longus is rare. There have been only 7 reports (in 10 patients) of this injury in the literature. We report upon a case of avulsion fracture of the second metacarpal base, which was treated successfully by open reduction and internal fixation.

Nephritis associated with a chronically infected ventriculoatrial shunt is known as shunt nephritis. A 6-year-old girl with prior history of a ventriculoatrial shunt presented complaining of fever and gross hematuria. Serum complement levels were decreased and a coagulase-negative S. epidermidis was cultured from her blood. The renal biopsy specimen showed features of membranoproliferative glomerulonephritis type I. Hydrocephalus was so severe that shunt removal was impossible. With antibiotic therapy, clinical symptoms and laboratory findings include complement levels were normalized although microscopic hematuria persisted. To our knowledge, this is the first case of shunt nephritis in Korea. In addition to the case report, a brief review of shunt nephritis has been added.
Case Report ; Child ; Female ; Human ; Nephritis/*etiology ; Ventriculoperitoneal Shunt/*adverse effects

PURPOSE: We investigated the localizing and lateralizing values of auras in patients with lesional partial epilepsy on an outpatient basis. MATERIALS AND METHODS: A total of 276 subjects were retrospectively selected for this study if they had a unilateral single lobar lesion based on magnetic resonance image (MRI) results, and their scalp electroencephalography (EEG) findings were not discordant with the MRI-defined lobar localization and lateralization. According to the lesion locations, subjects were considered as having mesial temporal (MTLE), lateral temporal (LTLE), frontal (FLE), parietal (PLE), or occipital (OLE) lobe epilepsies. Auras were classified into 13 categories. RESULTS: A hundred and seventy-six subjects (63.8%) had experienced at least one aura. FLE subjects had the fewest number of auras. Epigastric and psychic auras were frequent among MTLE subjects, while visual auras were common in those with PLE and OLE. Somatosensory auras and whole body sensations were more frequent in the subjects with PLE than those without. Autonomic auras were more common in MTLE subjects than in LTLE subjects. Dysphasic auras were more frequently found in left-sided epilepsies. Five pairs of aura categories showed concurrent tendencies, which were the epigastric and autonomic auras, autonomic and emotional auras, visual and vestibular auras, auditory and vestibular auras, and whole-body sensation and auditory auras. Autonomic and emotional auras had a concurrent tendency in left-sided epilepsies, but not in right-sided epilepsies. CONCLUSION: Our results support the previously known localizing value of auras, and suggest that dysphasic auras and the association of emotional and autonomic auras may have a lateralizing value.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Epilepsies, Partial/*pathology ; Epilepsy/*pathology ; Female ; Humans ; Infant ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Hyperreactio luteinalis rarely occurs in normal single pregnancy. About 50 such cases have been published. It is usually occurs in trophoblastic disease. This case is a huge hyperreactio luteinalis that detected in gestational age 16 weeks. The patient delivered a normal female infant at 41th week of gestation without any mass related problems. The hyperreactio luteinalis was a benign condition in itself with normal spontaneous remission in two months after delivery. Also the level of elevated human chorionic gonadotropin became normal. The conservative management was appropriated. This case is noteworthy because it resulted in spontaneous regression without surgical intervention and conserved ovarian tissue.
Chorionic Gonadotropin ; Female ; Gestational Age ; Humans ; Infant ; Pregnancy* ; Remission, Spontaneous ; Trophoblasts

BACKGROUND: Propofol, an ultrashort-acting anesthetic agent, is being increasingly used for sedation during regional anesthesia. The goal of this study was to characterize the pharmacodynamic relation between the effect site concentration of propofol and the occurrence of loss of consciousness (LOC) and apnea in elderly patients undergoing regional anesthesia. METHODS: Twenty patients aged 65 years or older presenting for elective surgery requiring regional anesthesia were enrolled. After performing spinal anesthesia, the target effect site concentration of propofol was set at 1.0 microg/mL. Effect site concentration was increased by 0.2 or 0.3 microg/mL until LOC and apnea were observed. LOC was determined by the loss of response to verbal command ("open your eyes") and apnea as the loss of spontaneous breathing for 20 seconds. The pharmacodynamic relation between effect site concentrations of propofol and LOC or apnea was characterized by population analysis using nonlinear mixed effects model. Approximate entropy (ApEn) as a surrogate measure of central nervous effect of propofol was calculated from raw electroencephalogram, retrospectively. The correlation between effect site concentration of propofol and ApEn was tested. RESULTS: The estimates (standard error) of Ce50 for LOC and apnea (the effect site concentration of propofol associated with 50% probability of LOC and apnea) were 1.74 (0.09) and 2.35 (0.11) microg/mL, respectively. The Spearman correlation coefficient between effect site concentration of propofol and ApEn was -0.8164 (p<0.0001). CONCLUSION: These results provide an adequate guidance for sedation in elderly patients for elective surgery under regional anesthesia.
Aged ; Anesthesia, Conduction ; Anesthesia, Spinal ; Apnea ; Electroencephalography ; Entropy ; Humans ; Propofol ; Respiration ; Retrospective Studies ; Unconsciousness