No abstract available.
Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Myositis*

The current case describes a case of uterine rupture from placenta percreta in a woman who had only a single gynecologic surgery. We met the case of intrauterine fetal death (IUFD) with hemoperitoneum and found uterine rupture from placenta percreta by CT imaging. A 25-year-old woman was admitted to the emergency service for acute upper abdominal pain and severe hypotension at 33 weeks' gestation. She had undergone a single pelviscopic surgery due to cornual pregnancy 11 months previously. Ultrasonogram detected IUFD and hemoperitoneum. CT showed uterine rupture from placenta percreta. An emergency laparotomy was performed to correct the defect. The current case presents that placenta percreta can occur in a woman who had a single gynecologic surgery and clinicians should consider possible placenta percreta in diagnosing pregnant patients who present with acute abdominal pain and shock.
Abdominal Pain ; Adult ; Emergencies ; Female ; Fetal Death ; Gynecologic Surgical Procedures* ; Hemoperitoneum ; Humans ; Hypotension ; Laparotomy ; Placenta Accreta* ; Placenta* ; Pregnancy* ; Shock ; Ultrasonography ; Uterine Rupture*

Cerebrovascular disorders (infarction and intracranial hemorrhage), otherwise collectively referred to as stroke, are an uncommon and feared complication of pregnancy. Collectively, these disorders contribute up to 12% of all maternal deaths. Because of the common presentation with seizures, hypertension, proteinuria, and visual disturbance there has been diagnostic confusion with eclampsia, especially when cerebrovascular disorders occur antepartum or intrapartum. This case is intended to assist the clinician with clues for prompt diagnosis and therapy for this uncommon and unpreventable medical complication of pregnancy.
Cerebral Hemorrhage* ; Cerebrovascular Disorders ; Diagnosis ; Eclampsia ; Female ; Hypertension ; Intracranial Hemorrhages ; Maternal Death ; Pre-Eclampsia* ; Pregnancy ; Proteinuria ; Seizures ; Stroke

BACKGROUND: Transmyocardial laser revascularization(TMLR) for revascularizing ischemic myocardium in patients was originally based on the assumption that laser channels remain their patency much longer. But recent studies show that laser channels did not remain open and that TMLR could achieve treatment benefits without long-term channel patency. The angiongencesis is currently thought to be induced by non-specific inflammatory response to mechanical tissue injury. This study is to evaluate hypothesis that various transmyocaridal mechanical revascularization(TMMR) may induce the angiogenic responses similar to that seen with TMLR, and transmyocaridal polymer stent revascularization(TMSR), the polymer stent in the myocardial tissue is hydrolyzed in 2 weeks, may enhance the non-specific inflammatory reaction resulting angiogenesis. Furthermore, polymer myocaridal stent channels remain long-term patency. MATERIAL AND METHOD: Eight domestic pigs underwent ligation of the proximal circumflex artery, and 2 weeks later they were randomized to undergo transmycardial acupunctural revascularization (TMPR, Group I) of the left lateral wall with 18-G needle(n=2), to undergo transmyocardial (TMDR, Group II) with industrial 2mm steel drill(n=2), to undergo transmyocardial polymer stent revascularization (TMSR, Group III) after drilling the infarcted myocardium(n=2), the stent is poly(lactic acid-co-glycolic acid), which is self-degradated in the myocardium, and to a control group the ischemic zone was unterated(n=2). All the pigs were sacrificed after 4 weeks TMMR. Sections from the ischemic zone were submitted for vascular endothelial growth factor (VEGF) ELISA and histology. RESULT: There were makedly increase in the VEGF immunoassay in the ischemic zone of the TMMR group compared to the ischemic zone of the control group(control: each 30.85 and 43.15pg/mg protein, TMPR: each 44.14 and 68.61 pg/mg protein, TMDR: each 65.92 and 78.65 pg/mg protein, TMSR: each 177.39 and 168.87 pg/mg protein). TMSR channels caused greatest VEGF expression than channels made by other group and the polymer stent channels remained vacuole after 4 weeks. CONCLUSIONS: Transmyocardial polymer stent revascularization promoted the most angiogenci response by the VEGF immunoassay, although our study did not show the statistical significancy. The channels remained but the flow patency was not verified. Transmyocardial polymer stent revascularization (TMSR) is desirable in future experimental trials and in view of the significant cost implications comparable to that of laser.
Arteries ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoassay ; Ligation ; Myocardium ; Polymers* ; Steel ; Stents* ; Sus scrofa ; Swine ; Vacuoles ; Vascular Endothelial Growth Factor A

The acardiac twin is very rare congenital malformation of monozygotic multiple gestations affecting 1% of monozygotic twins, or 1 in 35000 births. The acardiac twin has a parasitic existence and depends on the donor twin for its blood supply via placental anastomoses and retrograde perfusion of the acardiac umbilical cord. Acardiac twin places the normal twin at risk for high output cardiac failure and in utero fetal death and may lead to polyhydramnios and its related complications. The mortality rate is reported to be between 50% and 75% for the normal twin. We recently experienced a case of acadius anceps with a normal twin death in uterus, so present with a brief review of the literature.
Fetal Death ; Heart Failure ; Humans ; Mortality ; Parturition ; Perfusion ; Polyhydramnios ; Tissue Donors ; Twins, Monozygotic ; Umbilical Cord ; Uterus

Lymphoepithelioma-like carcinoma (LELC) of the uterine cervix is a rare tumor with 0.7% of all primary cervical malignancies. It may grossly range from no visible cervical lesion to a large exophytic cervical mass and histologically similar neoplasms occur in the nasopharynx. It has been classified as a subtype of squamous cell carcinoma. But, after reviewing the literature, this tumor is a distinct carcinoma of the cervix that differs from squamous cell carcinoma. LELC is composed of undifferentiated cells surrounded by a marked inflammatory infiltrate, characterized by plasma cells and lymphocytes in the stroma. It may represent a better prognostic group than the more common squamous cell carcinoma of the cervix because of lack of lymph node metastasis. Typically affects a younger population of women, is more prevalent in noncaucasian population (especially, those of Asian descent). However, it is not clearly understood, Epstein-Barr virus play in the pathogenesis of cervical LELC while humam papilloma virus (HPV) is a risk factor for squamous cell carcinoma. The prognosis is good only by surgical treatment. Radiation therapy also appears to be effective in eradicating localized, low-stage disease (radiosensitive). The authors have experienced one case of LELC of the uterine cervix. We report a case with a brief review.
Asian Continental Ancestry Group ; Carcinoma, Squamous Cell ; Cervix Uteri* ; Female ; Herpesvirus 4, Human ; Humans ; Lymph Nodes ; Lymphocytes ; Nasopharynx ; Neoplasm Metastasis ; Papilloma ; Plasma Cells ; Prognosis ; Risk Factors

OBJECTIVE: Escherichia coli (E. coli) O26 has been the most common type of non-O157 human isolates and it has been related with urinary tract infection and its sequelae. So we investigated the clinical significance of E. coli O26 among the cases of urinary tract infection. METHODS: From January, 2005 to December, 2007, the 22 E. coli isolates that were related with urinary tract infection were analyzed. The isolates were identified biochemically by Vitek 1. We performed antisera test by O157, O26, O111 diagnostic antisera about the 22 E. coli isolates. We reviewed clinical history of the same patients retrospectively. RESULTS: 331 E. coli isolates in the urine specimen were isolated from January, 2005 to December, 2007. 175 E. coli isolates that were related with urinary tract infection were analyzed by O157, O26, O111 antisera test. As a result, 22 isolates (13.5%) were O26 antisera positive. There were 8, 3, and 2 cases of watery diarrhea, hemolytic uremic syndrome, thrombotic thrombocytopenic purpura repectively. CONCLUSION: In our study, because E. coli O26 was pathogenic and developed major complications, we concluded that patients with urinary tract infection with E. coli. should examine the antisera test about E. coli O157 and O26.
Diarrhea ; Escherichia coli ; Hemolytic-Uremic Syndrome ; Humans ; Immune Sera ; Purpura, Thrombotic Thrombocytopenic ; Urinary Tract ; Urinary Tract Infections

Hyperfunctioning thyroid carcinoma is very rare. Hence, radionuclide imaging of thyroid hot nodules usually suggests a benign tumor, and less than 4% of cases have been reported as malignant. We would like to present a case of a hyperfunctioning papillary thyroid carcinoma that was initially treated with radioactive iodine. A 58-year-old woman was referred to our hospital for palpable thyroid nodule and a 5-kg weight loss within 6 months. Thyroid function test revealed thyrotoxicosis, and thyroid autoantibodies were absent. 99mTc thyroid scintigraphy showed a 2 x 2 cm-sized hyperactive hot nodule at the left lobe. Despite radioactive iodine treatment with a dose of 10 mCi 131I, thyroid function did not improve. Fine needle aspiration revealed papillary thyroid cancer. The patient underwent total thyroidectomy. Although clinical features and thyroid scans suggest a benign nodule, the possibility of malignancy should not be ruled out. Malignant thyroid hot nodules are rare; however, its possibility should be taken into account. Therefore, we suggest that ruling out malignancy by existing diagnostic guidelines can misdiagnose even a typical case with benign features. As thyroid nodule detection is getting sensitive and accurate, we present this case to discuss whether additional diagnostic approaches would be necessary for thyroid nodules.
Autoantibodies ; Biopsy, Fine-Needle ; Carcinoma ; Female ; Humans ; Iodine ; Middle Aged ; Thyroid Function Tests ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule ; Thyroidectomy ; Thyrotoxicosis ; Weight Loss

Background: The shelf life policies for central supply department (CSD) sterilized items and other devices should be determined by the healthcare facility's infection control program. We investigated effect of the sterility integrity of the CSD sterilized packs by wrapping-materials, storage period and environment to modify and extend current shelf-life. Methods: The first phase study was from May to October in 2000 and the second phase study was planned to extend further the shelf-life of the sterile packs from April 2001 to June 2002. Six hundred and fourty packs containing small gauze with four wrapping materials(100 times and 50 times washed two-ply reusable cotton, disposable craft paper, and disposable new pouch bag) and the 104 returned set after their shelf-life were stored on the top or middle of shelves or closed cabinets and storage durations from 1 to 20 weeks in the first phase study. The test packs were collected weekly and cultured in the laboratory. Five hundred seventy-six test packs were prepared with three wrapping materials (except 50 times washed cotton and returned set) and stored in the same location as the First phase study and collected and cultured monthly after three months storage (from July 2001) for one year in the second phase study. The temperature and relative humidity was monitored whenever the test pack was collected. Results: The gauze in the test packs were not contaminated until 154 days in the first study phase and until 423 days in the second phase study. The temperature and relative humidity of storage locations were 25.9degrees C and 55.2% in the first phase study and 26.0degrees C and 45.9% in the second phase study, respectively. Conclusions: There was no difference in the sterility integrity of the test packs with different wrapping materials. storage locations and environments. and storage durations. It was possible to extend shelf-life from two weeks to three and six months in the study hospital.
Delivery of Health Care ; Humidity ; Infection Control ; Infertility

A 17-year-old primigravida, who had an elective abortion in the second trimester of pregnancy in a local clinic, was transferred to our hospital in state of status epilepticus. During the last 2-hr period immediately prior to admission the patient had an unknown number of generalized convulsions together with intermittent episodes of vomiting. Despite the administration of anticonvulsants and sedatives her condition was one of wild agitated response to stimuli, alternating with deep coma. After a tentative diagnosis of dilutional hyponatremia, she was given hypertonic saline solutions in addition to anticonvulsant therapy. Fourteen hours after her seizure, the patient was awake, alert, and cheerful but totally amnescent about the previous period. This case of severe water intoxication associated with an infusion of oxytocin reported here may serve as a reminder of the potential hazards of a widely used procedure, and of the precautions which must be observed.
Adolescent ; Anticonvulsants ; Coma ; Diagnosis ; Dihydroergotamine ; Female ; Humans ; Hypnotics and Sedatives ; Hyponatremia ; Oxytocin* ; Pregnancy ; Pregnancy Trimester, Second ; Saline Solution, Hypertonic ; Seizures* ; Status Epilepticus ; Vomiting ; Water Intoxication*