Acute puerperal uterine inversion is a rare postpartum obstetric complication; however, without rapid diagnosis and appropriate management, it is life-threatening. Substantial bleeding hinders the verification of a partially inverted uterus, possibly delaying the treatment. Herein, we present the report of a 32-year-old female presenting with massive postpartum bleeding managed by uterine artery embolization. The peculiar course of the uterine artery bowing inferiorly along the inverted fundus during embolization could uncover the uterine inversion, which was not diagnosed by physical examination and CT. In conclusion, uterine artery embolization is not only an effective therapeutic strategy for postpartum hemorrhage but also a valuable tool for diagnosing uterine inversion.

OBJECTIVE: To describe the prevalence and correlates of the postpartum depression and premenstrual dysphoric disorder. METHODS: One hundred sixty six women were assessed around 10th to 14th days after delivery in Gangneung Asan Hospital, Korea, from September 2011 to March 2012. We checked their risk factors for postpartum depressive disorders using the Beck Depression Inventory and the Edinburgh Postnatal Depression Scale. Premenstrual dysphoric disorder was evaluated retrospectively and was defined as having more than 5 of the following 10 symptoms: breast tenderness, bloating, headache, peripheral edema (hand and foot), depressive symptoms, anger, irritability, anxiety, oversensitivity, and exaggerated mood swings. RESULTS: The prevalence rate of postpartum depression using the Edinburgh Postnatal Depression Scale > or =10 and Beck Depression Inventory > or =10 was 13.9% (23/166). We found statistical differences (P<0.01) between the postpartum depression group and the postpartum non-depression group in smoking history, past history of psychiatric problems, and level of marital satisfaction. The prevalence rate of premenstrual syndrome (PMS) was 9% (15/166) and among 23 women in the postpartum depression group, eight were determined to have premenstrual dysphoric disorder, yielding a prevalence rate of 34.8% (8/23). Among 143 women in the postpartum non-depression group, seven were determined to have PMS, yielding a prevalence rate of 4.9% (7/143). A correlation between postpartum depression and PMS was thus found (P<0.01). CONCLUSION: PMS appears to be associated with postpartum depression. This means that a hormone-related etiology appears to be one risk factor for postpartum depression.
Anger ; Anxiety ; Breast ; Chungcheongnam-do ; Depression ; Depression, Postpartum* ; Depressive Disorder ; Edema ; Female ; Gangwon-do ; Headache ; Humans ; Korea ; Postpartum Period* ; Premenstrual Syndrome ; Prevalence ; Retrospective Studies ; Risk Factors ; Smoke ; Smoking

Factor VII (FVII) deficiency is an infrequent hereditary bleeding disorder that can make excessive bleeding in surgical interventions, such as a postpartum hemorrhage in a cesarean section. Although a recombinant form of activated FVII has been applied for bleeding control in FVII-deficient patients, its applications in the field of obstetrics are still limited, especially in Korea. Replacement of blood products is still preferred as first-line therapy, with antifibrinolytic agents used as adjunctive therapy. We report herein the case of a successful cesarean section in an 18-year-old woman with FVII deficiency.
Adolescent ; Antifibrinolytic Agents ; Cesarean Section* ; Factor VII ; Factor VII Deficiency* ; Female ; Hemorrhage ; Humans ; Korea ; Obstetrics ; Postpartum Hemorrhage ; Pregnancy

OBJECTIVE: To analyze the clinical experiences of patients who treated with levonorgestrel-releasing intrauterine system (LNG-IUS) for adenomyosis associated with dysmenorrhea and/or menorrhagia. METHODS: The LNG-IUS was inserted into 103 patients who were diagnosed with adenomyosis on ultrasound examination and suffered from dysmenorrhea or menorrhagia at CHA Gangnam Medical Center between January 2009 and December 2009. Symptomatic changes of dysmenorrhea and menorrhagia, side effects, and failure rates were evaluated, retrospectively. RESULTS: During the follow-up periods, dysmenorrhea was improved in 91.4% and menorrhagia was improved in 90.4% of patients. Most common side effects were prolonged vaginal spotting in 41 (39.8%), and expulsion of LNG-IUS in 32 (31.1%) patients. Six (5.7%) patients were premature removal of LNG-IUS and 9 (8.5%) patients were underwent hysterectomy. Overall 77 (74.8%) patients continued to use of LNG-IUS. CONCLUSION: The LNG-IUS is effective treatment option for management of dysmenorrhea and menorrhagia for patients with clinical diagnosis of adenomyosis. It seemed to be an alternative treatment method before hysterectomy.
Adenomyosis ; Dysmenorrhea ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Menorrhagia ; Metrorrhagia

There are many methods for achieving one-lung ventilation (OLV) during thoracic surgery in neonates and the accuracy of OLV may affect postoperative outcome. The authors have performed OLV using a 5 Fr Arndt endobronchial blocker (AEB, Cook Inc., Bloomington, IN, USA) on a neonate diagnosed with congenital cystic adenomatoid malformation and respiratory distress syndrome (RDS) associated with marked mediastinal shift. In spite of sufficient preoxygenation, sudden and severe fall in oxygen saturation had occurred. Since neonates with RDS may develop sudden and severe desaturation, rapid intubation with anticipation of potential difficulty is necessary as well as sufficient preoxygenation.
Anoxia ; Cystic Adenomatoid Malformation of Lung, Congenital ; Humans ; Infant, Newborn ; Intubation ; One-Lung Ventilation ; Oxygen ; Thoracic Surgery

Bradycardia may occur during spinal anesthesia with atropine commonly used as a treatment. A 44-year-old female with no known history of any underlying diseases, developed a coronary spasm following ventricular tachycardia when 0.5 mg of atropine was injected intravenously to treat bradycardia during spinal anesthesia. The imbalance caused by atropine in the sympathovagal activity may predispose the coronary artery to develop spasms with ventricular tachycardia. Therefore prudent use of atropine should be accompanied by close monitoring.
Anesthesia, Spinal ; Atropine ; Bradycardia ; Coronary Vessels ; Female ; Humans ; Spasm ; Tachycardia, Ventricular

Acute fibrinous and organizing pneumonia (AFOP) is a histological pattern consisting of intra-alveolar fibrin in the form of fibrin "balls" and organizing pneumonia, without hyaline membranes or prominent eosinophil infiltration. Some reports suggest that the clinical course and pathological findings of AFOP are different from typical findings of bronchiolitis obliterans organizing pneumonia (BOOP) or eosinophilic pneumonia (EP), and its prognosis can be better or similar to that of diffuse alveolar damage (DAD). We report two cases of pathologically demonstrated AFOP experienced recently at our institute. One fatal case revealed a rapid development of respiratory failure and the need for mechanical ventilation. Another nonfatal case revealed subacute diffuse bilateral lung infiltration without the need for mechanical ventilation. Judging from our experience, the patient who required a mechanical ventilator had a poorer prognosis than the one who did not need a mechanical ventilator.
Cryptogenic Organizing Pneumonia ; Eosinophils ; Fibrin ; Humans ; Hyalin ; Lung ; Membranes ; Pneumonia ; Prognosis ; Pulmonary Eosinophilia ; Respiration, Artificial ; Respiratory Insufficiency ; Ventilators, Mechanical

Acute fibrinous and organizing pneumonia (AFOP) is a histological pattern consisting of intra-alveolar fibrin in the form of fibrin "balls" and organizing pneumonia, without hyaline membranes or prominent eosinophil infiltration. Some reports suggest that the clinical course and pathological findings of AFOP are different from typical findings of bronchiolitis obliterans organizing pneumonia (BOOP) or eosinophilic pneumonia (EP), and its prognosis can be better or similar to that of diffuse alveolar damage (DAD). We report two cases of pathologically demonstrated AFOP experienced recently at our institute. One fatal case revealed a rapid development of respiratory failure and the need for mechanical ventilation. Another nonfatal case revealed subacute diffuse bilateral lung infiltration without the need for mechanical ventilation. Judging from our experience, the patient who required a mechanical ventilator had a poorer prognosis than the one who did not need a mechanical ventilator.
Cryptogenic Organizing Pneumonia ; Eosinophils ; Fibrin ; Humans ; Hyalin ; Lung ; Membranes ; Pneumonia ; Prognosis ; Pulmonary Eosinophilia ; Respiration, Artificial ; Respiratory Insufficiency ; Ventilators, Mechanical

BACKGROUND: It is well-known that patients with chronic fatigue or frequent pain seek complementary and alternative medicine therapies (CAT) in Western countries. We conducted this study to determine the pattern of CAT use and the factors related to CAT use in patients with chronic fatigue or pain in Korea. METHODS: This was a cross-sectional study. The participants (n = 143) with chronic fatigue or pain completed a self-reported questionnaire including demographic characteristics and lifestyle as well as disease-related and CAT-related items. RESULTS: The frequency of CAT use was 51.0& and 39.2& over the past 10 years and 1 year, respectively. The most common type of CAT used was herbal medicine. The therapeutic effects of the CAT were similar to physicians' prescriptions. CAT were most often used in combination with conventional medicine rather than alone. More than 70.0& of subjects did not consult their physicians for the use of CAT. The duration of illness, severity of fatigue and pain was signifi cantly related to the use of CAT. CONCLUSION: Many patients with chronic fatigue or pain use CAT. Most of these patients do not consult their physicians regarding CAT use.
Animals ; Cats ; Complementary Therapies ; Cross-Sectional Studies ; Fatigue ; Herbal Medicine ; Humans ; Korea ; Life Style ; Prescriptions

Endometriosis is a relatively common gynecologic disease. However thoracic endometriosis syndrome is exceedingly rare among various types of external endometriosis. We experienced a case of 35-year-old woman who presented with recurrent episodes of spontaneous right-sided pneumothorax that occurred during her menstrual periods. After the localization of the disease site by means of chest radiography and computed tomography of the thorax, a chest tube was inserted after which bullectomy and pleurodesis using doxycycline were performed. A hormonal treatment with gonadotropin-releasing hormone (GnRH) agonist for 12-months was also conducted. However, right-sided pneumothorax recurred two times after these procedures. Subsequently, surgical excision of diaphragmatic lesion along with pleurodesis was underwent. To prevent recurrence, we maintained long-term GnRH agonist administration with add back therapy using low dose estrogen-progesterone. Menstruation stopped, and the chest pain disappeared. During a 19-months follow-up period, pneumothorax did not recur. We report this case with a brief review of the concerned literatures.
Adult ; Chest Pain ; Chest Tubes ; Doxycycline ; Endometriosis* ; Female ; Follow-Up Studies ; Genital Diseases, Female ; Gonadotropin-Releasing Hormone ; Humans ; Menstruation ; Pleurodesis ; Pneumothorax* ; Radiography ; Recurrence ; Thorax