Cervical pregnancy is a rare form of ectopic gestation in which the blastocyst implants in the cervical mucosa below the histologic cervical os. Because of the serious vaginal bleeding, hysterectomy was usually done in the management of cervical pregnancy. Howerver, conservative treatment is desirable for women who want to be pregnancy in the future. Methotrexate has been utilized recently for conservative management of cervical pregnancy. We report a case of cervical pregnancy which was treated succesfully with intramuscular methotrexate injection.
Blastocyst ; Female ; Humans ; Hysterectomy ; Methotrexate* ; Mucous Membrane ; Pregnancy* ; Uterine Hemorrhage

PURPOSE: As allergy diseases including atopic dermatitis are increasing lately, many kinds of studies about the cause and the pathogenesis are in progress and the secrets of the of organization intestinal microflora and the relationship with inflammatory are reaction actively being revealed. METHODS: In this study, the subjects included 32 atopic dermatitis patients and 23 normal controls who visited the allergy clinics of the pediatrics department in Soonchunhyang University Hospital from June to October, 2003. Lactobacillus casei were cultured and counted. And serum total IgE, IgA and AST/ALT were examined. Also, the differences in lactobacillus counts between the atopic dermatitis patients and normal controls were analyzed. RESULTS: We were not able to find out a statistically significant differences between the atopic dermatitis patients and the control group. We were able to find out a statistically significant inverse correlation of serum total IgE and the number of Lactobacillus casei. CONCLUSION: The significant inverse correlations of serum total IgE and the number of Lactobacillus casei are expected to contribute to precognition and treatment of atopic dermatitis. It is hoped that more researches on the relationship between atopic dermatitis and intestinal flora should be carried out in the future.
Child* ; Dermatitis, Atopic* ; Hope ; Humans ; Hypersensitivity ; Immunoglobulin A ; Immunoglobulin E ; Lactobacillus casei* ; Lactobacillus* ; Pediatrics

BACKGROUND: Recently we have demonstrated that urinary cotinine test by an enzyme immunoassay is valid to discriminate smoking status among adults. This study was conducted for the same purpose among Korean high school students. METHODS: Questionnaire on smoking and urinary cotinine tests were performed for 1, 267 high school students. Cotinine concentrations in urine were measured by Cotinine Enzyme Immunoassay (Diag-nostic Reagents Inc., CA, USA) on 502X Multiple Chemistry Unit (A&T Co., Tokyo, Japan). RESULTS: The questionnaire was responded by 1, 227 of the 1, 267 students (96.8%); 6 male (0.8%) and 34 female students (5.9%) did not respond. Among the responders, 13.4% (92/685) of male students and 3.0% (16/542) of female students answered as smokers. By using 6 ng/mL as a cutoff, the sensitivity and specificity of the urinary cotinine test were 79.6% (86/108) and 91.4% (1023/1119), respectively. According to the results of urinary cotinine, 96 additional students were presumed as smokers. Of 85 abstainers and 40 non-responders, 41 (32.8%) tested positive for urinary cotinine. CONCLUSIONS: Unlike in a previous study with adults, the urinary cotinine test is shown not to be able to replace the self-reported questionnaire due to the lack of sensitivity for young adolescents. But the urinary continine test is valid to discriminate smokers among purported nonsmokers, espe-cially among non-responders and those who claimed abstinence.
Adolescent* ; Adult ; Chemistry ; Cotinine* ; Female ; Humans ; Immunoenzyme Techniques ; Indicators and Reagents ; Male ; Sensitivity and Specificity ; Smoke ; Smoking ; Surveys and Questionnaires

PURPOSE: The aim of this study was to investigate the efficacy of mirodenafil in middle-aged male patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). MATERIALS AND METHODS: Eighty-eight males with CP/CPPS were randomized to receive either levofloxacin (500 mg/d) (group L, 40 patients) or levofloxacin (500 mg/d) and mirodenafil (50 mg/d) (group ML, 48 patients) for six weeks. The International Prostate Symptom Score (IPSS), National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), and erectile function (EF) domain scores of the International Index of Erectile Function (IIEF) questionnaire were used to grade symptoms at baseline and 6 weeks after treatment. RESULTS: The mean change in total IPSS from baseline was higher in group ML than that in group L (group L, -1.1 vs. group ML, -4.3; p<0.05). Significant improvements were also seen in the IPSS voiding subscore (group L, -0.7 vs. group ML, -3.0; p<0.05). Changes observed in the NIH-CPSI of group ML at six weeks were greater than those at baseline (group L, -3.2 vs. group ML, -7.2; p<0.05). Significant improvements were seen in the NIH-CPSI voiding (group L, -0.5 vs. group ML, -1.7; p<0.05) and quality of life domains (group L, -1.0 vs. group ML, -1.8; p<0.05). Group ML showed a significantly greater increase in the IIEF-EF score than did group ML (group L, +0.2 vs. group ML, +7.8; p<0.05). CONCLUSIONS: Mirodenafil (50 mg once daily) was well tolerated and resulted in significant symptomatic improvement in middle-aged males with CP/CPPS.
Erectile Dysfunction ; Humans ; Levofloxacin ; Male ; National Institutes of Health (U.S.) ; Pelvic Pain* ; Phosphodiesterase 5 Inhibitors ; Prostate ; Prostatitis ; Quality of Life ; Surveys and Questionnaires ; Treatment Outcome

PURPOSE: In spite of the development of asthma management guidelines, there are discrepancies between the guidelines and real management. We surveyed the insights and the real management of asthma to assess the current status of its management in Korea. METHODS: The objects of the survey were 266 parents with asthmatic children, who attended an educational lecture by the Korean World Asthma Day Project Office (KWADPO). Face to face interviews with questionnaires of 11 questions about understanding of asthma maintenance therapy, actual conditions of taking medicine and the impact of asthma on the family life were undertaken. RESULTS: The Median age of the patients was 5.2 years old and their parents' age ranged from those in their twenties to those in their forties. The number of the patients actually taking asthma maintenance medicine (40.6 percent) was a little bit lower than the level of awareness (53.0 percent). As a controller, patients are using short-acting beta2 inhalers (35.3 percent), steroid inhalers (including combination inhaler) (31.6 percent), leukotriene receptor antagonists (24.8 percent), antihistamines (25.6 percent), theophylline (2.3 percent), etc. Regular visits to hospital or clinic were done in 53.0 percent of the patients. As a controllers, oral medications (69.2 percent) was preferred to inhalers (18.0 percent) due to better compliance and easier dosage adjustment. CONCLUSION: According to the survey, asthma had negative effects on the life quality of patients and their families. Remarkable discrepancies were noticed between the guidelines and the real-world status of taking medicine in asthmatic children. It is necessary to have patients participate actively in making asthma management plans to raise their efficacy.
Asthma* ; Child* ; Compliance ; Histamine Antagonists ; Humans ; Korea ; Leukotriene Antagonists ; Nebulizers and Vaporizers ; Parents ; Quality of Life ; Surveys and Questionnaires ; Theophylline

BACKGROUND: Advising lifestyle modification to patients suffering from hypertension is important. However, how strictly hypertensive patients in korea are adherent to non-pharmacologic recommendation has not been well known. This study was performed to determine the compliance of hypertensive patients to the recommendation for life style modification and to find out on factors related to compliance. METHODS: Ninety-six patients, diagnosed as hypertensives between November 1997 and April 1998 in the Department of Family Medicine, Samsung Medical Center were educated on lifestyle modifications by their physicians during routine outpatient consult questionnaires inquiring of demographic and clinical characteristics, and health habits were Self administered done before and after the education. Blood pressure, height, and weight were measured repeatedly. The relationships between various characteristics and the compliance with lifestyle modification and follow-up visits were evaluated using Chi-square test and multiple logistic regression analysis. RESULTS: Among 96 patients, 47 patients (49.0%) attended for regular check-up two months after being diagnosed as hypertension. Being prescribed with antihypertensive agent, non-smoking, and doing regular exercise were the significant factors related to higher compliance with regular check-up. A total of 19 patients (40.4%) among 47 patients who have attended for regular check-up were adherent to the recommendation for modification of one or more health habits. The proportion of patients doing regular exercise increased significantly after education. Although 15 patients(53.6%) among 28 patients whose body mass indices were over 25 kg/m2 reported that they had made efforts to reduce body weight, no significant differences were observed in the change of body mass index between patients who reported their efforts for reducing body weight and those who did not. There was no association between various characteristics and compliance with lifestyle modification. CONCLUSIONS: Low compliance with recommendation for lifestyle modification during routine outpatient consultation and no association between various clinical and demographic characteristics and patient compliance suggests the necessity of developing special program and its active application to all hypertensive patients.
Blood Pressure ; Body Mass Index ; Body Weight ; Compliance* ; Education ; Follow-Up Studies ; Humans ; Hypertension* ; Korea ; Life Style* ; Logistic Models ; Outpatients ; Patient Compliance ; Surveys and Questionnaires

Purpose: This study aimed to compare the surgical and oncological outcomes between totally laparoscopic pylorus-preserving gastrectomy (TLPPG) with intracorporeal anastomosis and laparoscopy-assisted pylorus-preserving gastrectomy (LAPPG) with extracorporeal anastomosis. Materials and Methods: A retrospective analysis was performed in 258 patients with cT1N0 gastric cancer who underwent laparoscopic pylorus-preserving gastrectomy using two different anastomosis methods: TLPPG with intracorporeal anastomosis (n=88) and LAPPG with extracorporeal anastomosis (n=170). The following variables were compared between the two groups to assess the postoperative surgical and oncological outcomes: proximal and distal margins, number of resected lymph nodes (LNs) in total and in LN station 6, operation time, postoperative hospital stay, and postoperative morbidity including delayed gastric emptying (DGE). Results: The average length of the proximal margin was similar between the TLPPG and LAPPG groups (2.35 vs. 2.73 cm, P=0.070). Although the distal margin was significantly shorter in the TLPPG group than in the LAPPG group (3.15 vs. 4.08 cm, P=0.001), no proximal or distal resection margin-positive cases were reported in either group. The average number of resected LN was similar in both groups (36.0 vs. 33.98, P=0.229; LN station 6, 5.72 vs. 5.33, P=0.399). The operation time was shorter in the TLPPG group than in the LAPPG (200.17 vs. 220.80 minutes, P=0.001). No significant differences were observed between the two groups in terms of postoperative hospital stay (9.38 vs. 10.10 days, P=0.426) and surgical complication rate (19.3% vs. 22.9%), including DGE (8.0% vs. 11.8%, P=0.343). Conclusions The oncological safety and postoperative complications of TLPPG with intracorporeal anastomosis are similar to those of LAPPG with extracorporeal anastomosis.

OBJECTIVE: To evaluate the relationship between depression and cognitive-behavioral characteristics of caregivers using social problem solving inventory (SPSI), social support or conflict scale (SSS or SCS) and somatic symptoms (SS). METHOD: Fifty five couples of brain-injured patients and caregivers participated in this study. We conducted a questionnaire survey of caregivers with Beck depression index (BDI), SPSI, SSS, SCS and SS for cognitive-behavioral characteristics. And also we studied demographic factors of patients and caregivers, clinical features of brain-injured patients, care- giving duration and time per day through interview and review of medical records. The statistical analyses were performed by independent t-test, one-way ANOVA, Pearson correlation test and linear regression analysis-stepwise method. RESULTS: BDI of the caregivers showed a negative correlation with SPSI, SSS, patients' MMSE and caregivers' education level, also a positive correlation with SCS, SS and patients' GDS (p<0.05). And married caregivers showed more depressive mood (p<0.05). Of these factors, the most influencing factors on BDI were GDS and SCS through linear regression analysis (p<0.01). CONCLUSION: MMSE, GDS and education level as cognitive- mental factors rather than physical and economic strain had a statistical correlation with depression of caregivers. Especially, SPSI, SSS and SCS as cognitive-behavioral characteristics should be considered on evaluation of depression of caregivers and will be helpful for successful rehabilitation for patients and caregivers.
Caregivers ; Demography ; Depression ; Family Characteristics ; Humans ; Linear Models ; Medical Records ; Surveys and Questionnaires ; Social Problems ; Sprains and Strains

Purpose: Laparoscopic pylorus-preserving gastrectomy (LPPG) has a nutritional advantage over laparoscopic distal gastrectomy (LDG), however, may be less beneficial in overweight patients in terms of weight loss. The purpose of this study was to compare LPPG and LDG in overweight patients with early gastric cancer. Methods: Clinicopathologic data of overweight patients (body mass index [BMI], ≥25 kg/m2 ) who underwent LPPG (n = 63) or LDG (n = 183) in 2016–2018 were retrospectively reviewed. In the LDG group, patients with Billroth-II anastomosis were separately grouped (LDG B-II, n = 66). Changes in BMI, hemoglobin, albumin, and total protein were compared among groups. Results: Changes in BMI were not significant different among groups. The LPPG group had significantly higher albumin than the LDG group at postoperative 6 months and 1 year. The LPPG group had higher total protein than the LDG group at postoperative 2 years. The LPPG group had a higher complication rate of Clavien-Dindo classification III or higher (20.6%) than the LDG group (8.2%, P = 0.007). However, after excluding pyloric stenosis, there was no significant difference among groups (LPPG vs. LDG, P = 0.290; LPPG vs. LDG B-II, P = 0.921). Conclusion LPPG and LDG groups showed similar weight loss. However, the LPPG group had higher albumin and protein levels than the LDG group of overweight patients. Thus, it is not necessary to select LDG only for weight loss. LPPG may be selected as one option due to its potential nutritional benefit when pyloric stenosis is properly managed.

Purpose: To evaluate the feasibility and safety of intracorporeal overlapping gastrogastrostomy between the proximal anterior wall and antrum posterior wall (PAAP;PAAP anastomosis) of the stomach in minimally invasive pylorus-preserving gastrectomy (PPG) for early gastric cancer (EGC). Materials and Methods: From December 2016 to December 2019, 17 patients underwent minimally invasive PPG with PAAP anastomosis for EGC in the high body and posterior wall of the stomach. Intraoperative gastroscopy was performed with the rotation maneuver during proximal transection. A longer antral cuff (>4–5 cm) was created for PAAP than for conventional PPG (≤3 cm) at the point where a safe distal margin and good vascular perfusion were secured. Because the posterior wall of the proximal remnant stomach was insufficient for intracorporeal anastomosis, the anterior wall was used to create an overlapping anastomosis with the posterior wall of the remnant antrum. The surgical and oncological outcomes were analyzed, and the stomach volume was measured in patients who completed the 6-month follow-up. The results were compared to those after conventional PPG (n=11 each). Results: PAAP anastomosis was successfully performed in 17 patients. The proximal and distal resection margins were 2.4±1.9 cm and 4.0±2.6 cm, respectively. No postoperative complications were observed during the 1-year follow-up esophagogastroduodenoscopy (n=10). The postoperative remnant stomach (n=11) was significantly larger with PAAP than with conventional PPG (225.6±118.3 vs. 99.1±63.2 mL; P=0.001). The stomach length from the anastomosis to the pylorus was 4.9±2.4 cm after PAAP. Conclusions PAAP anastomosis is a feasible alternative for intracorporeal anastomosis in minimally invasive PPG for highly posteriorly located EGC.