Uterine arteriovenous malformation is a rare gynecologic condition, which is sometimes accompanied torrential vaginal bleeding and it can be aggravated with diagnostic dilatation and curettage. For proper management of vaginal bleeding, accurate diagnosis should be achieved before the intervention. In the past, the diagnosis was made retrospectively after hysterectomy, however recently it may be made by noninvasive method such as Doppler ultrasonogram before management. We have experienced 3 cases of uterine arteriovenous malformation, of which 2 cases were diagnosed with Doppler ultrasonogram.
Arteriovenous Malformations* ; Diagnosis ; Dilatation and Curettage ; Female ; Hysterectomy ; Retrospective Studies ; Ultrasonography ; Uterine Hemorrhage

1-Butanol ; Berberine ; Caesalpinia ; Cross Infection ; Dental Clinics ; Humans ; Methanol ; Methicillin-Resistant Staphylococcus aureus ; Mouth ; Staphylococcus aureus

Mivacurium is mainly metabolized by plasma cholinesterase, whereas atracurium is removed by Hofman elimination. The purpose of this study was to compare the infusion rate of atracurium and mivacurium in maintaining surgical relaxation, and to compare their recovery indices between parturients and non-pregnant women. Muscle relaxation was maintained by the continuous infusion of relaxants to retain the first response of train-of-four (TOF) at 5% of control. When mivacurium was used, Bolus-T5 (duration from the end of mivacurium bolus injection to 5% single twitch recovery) was measured. After discontinuing the infusion, the recovery index was measured. The infusion rate of mivacurium, not atracurium, was significantly lower in parturients and Bolus-T5 of parturients was significantly longer than that of non-pregnant women. There was no significant difference in the recovery indices of both relaxants. The authors concluded that the infusion rate of mivacurium in maintaining muscle relaxation in parturients should be reduced compared to the rate in non-pregnant women and measuring Bolus-T5 may be helpful in determining the infusion rate to maintain muscle relaxation.
Adult ; Atracurium/therapeutic use ; Atracurium/administration & dosage* ; Cesarean Section* ; Comparative Study ; Female ; Human ; Injections, Intramuscular ; Isoquinolines/therapeutic use ; Isoquinolines/administration & dosage* ; Neuromuscular Nondepolarizing Agents/therapeutic use ; Neuromuscular Nondepolarizing Agents/administration & dosage* ; Pregnancy

BACKGROUND: Refractory status epilepticus (RSE) requires urgent and effective treatment. Recently, midazolam was suggested as a useful drug in controlling RSE. In order to evaluate the effectiveness and adverse effects of midazolam, we compared midazolam with thiopental sodium. METHODS: Fourteen consecutive RSE in 13 patients from January 1998 to August 1999 were treated. Two RSE were happened in one patient. When the SE was refractory as a result of standard treatment, midazolam and thiopental sodium was alternatively used as therapeutic agent. RESULTS: Out of 9 RSE treated with midazolam, 5 were resolved. Four unresolved RSE received additional thiopental sodium. Thiopental sodium was initially administered in 5 out of 14 RSE. Among the 5 RSE improved by midazolam, no one had midazo-lam- induced hypotension or pneumonia. Three patients had respiratory suppression and needed artificial ventilation. RSE was controlled in 2 out of 4 patients treated with thiopental sodium after midazolam. In these patients, hypoten-sion was developed in 3, pneumonia in 2, and respiratory suppression in all. In 5 RSE treated with thiopental sodium alone, RSE were successfully treated in 3 patients. Complications were hypotension in 2, pneumonia/unknown infec-tion in 3, and respiratory suppression in 4. CONCLUSIONS: Midazolam was comparably effective as thiopental sodium in the treatment of RSE, with less adverse effects. We suggest that midazolam be used in the treatment of RSE before thiopental sodium is administered.
Humans ; Hypotension ; Midazolam* ; Pneumonia ; Status Epilepticus* ; Thiopental* ; Ventilation

BACKGROUND: Appetite control and weight reduction is important for the treatment of chronic disease such as obesity, hypertension, and diabetes mellitus. Visual analogue scales (VAS) is widely used to assess appetite. We investigated the reproducibility and the validity of the Korean version of VAS for appetite which will be helpful for clinical use. METHODS: The subjects received the same test meal and 8 VAS questionnaires between 6 weeks. They started to fill out the questionnaire before lunch, continued after lunch every hour, and ended after dinner. The questionnaire was asked about hunger, satiety, fullness, prospective consumption, sweet, salty, savoury, and fatty. During the test meal, the subjects could eat ad libitum until 'comfortable satisfaction'; and after the test meal we calculated energy intake. We assessed the correlation between test-retest VAS for each appetite and evaluated the validity of VAS for hunger with energy intake as "gold-standard". RESULTS: The VAS curves of each appetite were similar between the test and the retest. The VAS of each appetite on the test day was strongly correlated with that on the retest day. The CRs of 4.5 hour mean VAS (20~34 mm) was smaller than the CRs of fasting VAS (35~54 mm). The correlation coefficient of Hunger VAS before dinner and the energy intake was 0.436 on the test day and 0.400 on the retest day. The VAS of the sweet was correlated to the total glucose intake (P<0.05), and the VAS of salty to the salt intake. CONCLUSION: The validity of the VAS score for appetite, especially hunger, sweet and salty taste was good. Indeed, the reliability of VAS for appetite was good to use this scale in a clinical setting.
Appetite ; Chronic Disease ; Diabetes Mellitus ; Energy Intake ; Fasting ; Glucose ; Hunger ; Hypertension ; Lunch ; Meals ; Obesity ; Sensation ; Weight Loss ; Weights and Measures ; Surveys and Questionnaires

Background: The Jr a antigen is a high-prevalence red blood cell (RBC) antigen. Reports on cases of fatal hemolytic disease of the fetus and newborn and acute hemolytic transfusion reactions suggest that antibodies against Jr a (anti-Jra ) have potential clinical significance.Identifying anti-Jra is challenging owing to a lack of commercially available antisera. We developed an alternative approach to rapidly predict the presence of anti-Jra using the TaqMan single-nucleotide polymorphism (SNP)-genotyping method. Methods: Residual peripheral blood samples from 10 patients suspected of having the anti-Jr a were collected. Two samples with confirmed Jr(a–) RBCs and anti-Jra were used to validate the TaqMan genotyping assay by comparing the genotyping results with direct sequencing. The accuracy of the assay in predicting the presence of anti-Jra was verified through crossmatching with in-house Jr(a–) O+ RBCs. Results: The TaqMan-genotyping method was validated with two Jr(a–) RBC- and anti-Jra -confirmed samples that showed concordant Jr a genotyping and direct sequencing results.Jra genotyping for the remaining samples and crossmatching the serum samples with inhouse Jr(a–) O+ RBCs showed consistent results. Conclusions We validated a rapid, simple, accurate, and cost-effective method for predicting the presence of anti-Jra using a TaqMan-based SNP-genotyping assay. Implementing this method in routine practice in clinical laboratories will assist in solving difficult problems regarding alloantibodies to high-prevalence RBC antigens and ultimately aid in providing safe and timely transfusions and proper patient care.

Background: The Jr a antigen is a high-prevalence red blood cell (RBC) antigen. Reports on cases of fatal hemolytic disease of the fetus and newborn and acute hemolytic transfusion reactions suggest that antibodies against Jr a (anti-Jra ) have potential clinical significance.Identifying anti-Jra is challenging owing to a lack of commercially available antisera. We developed an alternative approach to rapidly predict the presence of anti-Jra using the TaqMan single-nucleotide polymorphism (SNP)-genotyping method. Methods: Residual peripheral blood samples from 10 patients suspected of having the anti-Jr a were collected. Two samples with confirmed Jr(a–) RBCs and anti-Jra were used to validate the TaqMan genotyping assay by comparing the genotyping results with direct sequencing. The accuracy of the assay in predicting the presence of anti-Jra was verified through crossmatching with in-house Jr(a–) O+ RBCs. Results: The TaqMan-genotyping method was validated with two Jr(a–) RBC- and anti-Jra -confirmed samples that showed concordant Jr a genotyping and direct sequencing results.Jra genotyping for the remaining samples and crossmatching the serum samples with inhouse Jr(a–) O+ RBCs showed consistent results. Conclusions We validated a rapid, simple, accurate, and cost-effective method for predicting the presence of anti-Jra using a TaqMan-based SNP-genotyping assay. Implementing this method in routine practice in clinical laboratories will assist in solving difficult problems regarding alloantibodies to high-prevalence RBC antigens and ultimately aid in providing safe and timely transfusions and proper patient care.

Background: The Jr a antigen is a high-prevalence red blood cell (RBC) antigen. Reports on cases of fatal hemolytic disease of the fetus and newborn and acute hemolytic transfusion reactions suggest that antibodies against Jr a (anti-Jra ) have potential clinical significance.Identifying anti-Jra is challenging owing to a lack of commercially available antisera. We developed an alternative approach to rapidly predict the presence of anti-Jra using the TaqMan single-nucleotide polymorphism (SNP)-genotyping method. Methods: Residual peripheral blood samples from 10 patients suspected of having the anti-Jr a were collected. Two samples with confirmed Jr(a–) RBCs and anti-Jra were used to validate the TaqMan genotyping assay by comparing the genotyping results with direct sequencing. The accuracy of the assay in predicting the presence of anti-Jra was verified through crossmatching with in-house Jr(a–) O+ RBCs. Results: The TaqMan-genotyping method was validated with two Jr(a–) RBC- and anti-Jra -confirmed samples that showed concordant Jr a genotyping and direct sequencing results.Jra genotyping for the remaining samples and crossmatching the serum samples with inhouse Jr(a–) O+ RBCs showed consistent results. Conclusions We validated a rapid, simple, accurate, and cost-effective method for predicting the presence of anti-Jra using a TaqMan-based SNP-genotyping assay. Implementing this method in routine practice in clinical laboratories will assist in solving difficult problems regarding alloantibodies to high-prevalence RBC antigens and ultimately aid in providing safe and timely transfusions and proper patient care.

Background: The Jr a antigen is a high-prevalence red blood cell (RBC) antigen. Reports on cases of fatal hemolytic disease of the fetus and newborn and acute hemolytic transfusion reactions suggest that antibodies against Jr a (anti-Jra ) have potential clinical significance.Identifying anti-Jra is challenging owing to a lack of commercially available antisera. We developed an alternative approach to rapidly predict the presence of anti-Jra using the TaqMan single-nucleotide polymorphism (SNP)-genotyping method. Methods: Residual peripheral blood samples from 10 patients suspected of having the anti-Jr a were collected. Two samples with confirmed Jr(a–) RBCs and anti-Jra were used to validate the TaqMan genotyping assay by comparing the genotyping results with direct sequencing. The accuracy of the assay in predicting the presence of anti-Jra was verified through crossmatching with in-house Jr(a–) O+ RBCs. Results: The TaqMan-genotyping method was validated with two Jr(a–) RBC- and anti-Jra -confirmed samples that showed concordant Jr a genotyping and direct sequencing results.Jra genotyping for the remaining samples and crossmatching the serum samples with inhouse Jr(a–) O+ RBCs showed consistent results. Conclusions We validated a rapid, simple, accurate, and cost-effective method for predicting the presence of anti-Jra using a TaqMan-based SNP-genotyping assay. Implementing this method in routine practice in clinical laboratories will assist in solving difficult problems regarding alloantibodies to high-prevalence RBC antigens and ultimately aid in providing safe and timely transfusions and proper patient care.

OBJECTIVE: To compare the clinical outcomes of GnRH antagonist (cetrorelix(R)) with those of conventional GnRH agonist for down-regulation in assisted reproductive cycle. Materials and Method: Ninety-nine women undergoing IVF or ICSI were treated with either GnRH antagonist (cetrorelix(R)) or GnRH agonist (Lucrin(R)) for pituitary down regulation. The patient characteristics, basal hormone profile and IVF outcome were compared. RESULTS: There were no significant differences in age and duration of infertility between two groups. E2 (pg/mL)/LH (mIU/mL)/FSH (mIU/ mL) on the 3 day of menstrual period as a baseline were also not significantly different between two groups. The number of hMG amples administered (30.5+/-11.2 versus 47.6+/-16.4 ample/cycle) and the duration of stimulation (11.0+/-1.7 versus 14.1+/-2.2 days) were significantly lower in the cetrorelix(R) group. There were no significant differences in the fertilization and pregnancy rates, the number of embryo transferred, the number of mature oocyte and the number of embryo obtained between two groups. CONCLUSION: The cycles using an antagonist protocol shows a shorter duration of stimulation with comparable outcomes with few injections than those with an agonist protocol. GnRH antagonist can be effectively used as GnRH agonist for pituitary down regulation in IVF-ET cycles.
Down-Regulation ; Embryonic Structures ; Female ; Fertilization ; Gonadotropin-Releasing Hormone* ; Humans ; Infertility ; Oocytes ; Pregnancy Rate ; Sperm Injections, Intracytoplasmic