A complete hydatidiform mole coexisting with a fetus is a rare condition, particularly when diagnosed after IVF-ET. In spite of the wide spread use of assisted reproductive technology, there have been, to our knowledge, only few reported cases of molar pregnancy after IVF-ET. At present, there are limited data to guide the antenatal management of a complete hydatidiform mole coexisting with fetuses. A complete mole can coexist with a normal, healthy fetus who can be carried to term, with good outcome. But, patients who desire to continue the pregnancy after such a diagnosis must be cautioned about the potential for severe medical complications and developing persistent gestational trophoblastic tumor. We report here a case of complete hydatidiform mole in a triplet pregnancy coexistent with two live fetuses following in IVF-ET.
Diagnosis ; Embryo Transfer* ; Embryonic Structures* ; Female ; Fertilization in Vitro* ; Fetus ; Humans ; Hydatidiform Mole* ; Pregnancy ; Pregnancy, Triplet* ; Reproductive Techniques, Assisted ; Triplets* ; Trophoblastic Neoplasms

PURPOSE: To evaluate abnormal neurosonographic (NSG) findings of thalami and basal ganglia in full term babies with hypoxic-ischemic encephalopathy and to correlate the findings with follow-up studies and prognosis. METHODS: We evaluated 13 full term babies with abnormal NSG findings of thalarni and basal ganglia. NSG was performed within 7 days after clinical abnormalities. Follow-up NSG was done in 11 cases; CT scan in 4 and MRI in 7. We classified NSG findings as diffuse, unilateral, and focal types according to increased echogenicity and evaluated prognosis based on follow-up studies and neurological sequelae. RESULTS: Nine cases of diffuse type had diffuse echogenic changes of bilateral thalami and basal ganglia, slit-like lateral ventricles suggesting cerebral edema, and increased parenchymal echogenicity. In diffuse type, follow-up studies showed more prominent echogencities and ventricular dilatations and cerebromalacia. One case of unilateral type caused by thromboembolism had unilateral echogenicity of right thalamus and basal ganglia with increased echogenicity of the ipsilateral cerebral hemisphere and compression of the lateral ventricle, suggesting cerebral infarction. Follow-up study showed unilateral cystic cerebromalacia. Three cases of focal type had a localized echogenic area in thalamus with lacunar infarction, which decreased in size during follow-up. Among nine cases of diffuse type, one died within 2 days, two were discharged against medical advice, and six had severe neurologic sequelae. One case of unilateral type had a moderate degree of neurologic sequelae. All 3 cases of focal type had normal development. CONCLUSION: Pattems of abnormal echogenicity in thalami and basal ganglia in fullterm infants with hypoxic-ischemic encephalopathy are correlated with the outcome and may be helpful for treatment planning.
Basal Ganglia* ; Brain ; Brain Edema ; Brain Ischemia* ; Cerebral Infarction ; Cerebrum ; Dilatation ; Encephalomalacia ; Follow-Up Studies ; Humans ; Hypoxia-Ischemia, Brain ; Infant* ; Lateral Ventricles ; Magnetic Resonance Imaging ; Prognosis* ; Stroke, Lacunar ; Thalamus* ; Thromboembolism ; Tomography, X-Ray Computed

PURPOSE: The aim of this study was to evaluate the stability and sterility of bevacizumab (Avastin, Genentech, Inc., San Francisco, CA, USA) after withdrawal into multiple doses from single-use vials. METHODS: Bevacizumab was repeatedly and aseptically drawn from new vials into 1 cc plastic syringes and refrigerated in the dark at 4degrees C for 0, 3, 6, 12, 28, 38, 46, 52, or 63 weeks or at -10degrees C for 0, 3, 6, 12, 38, 46, or 52 weeks. The stability of bevacizumab was assessed by enzyme-linked immunosorbent assay (ELISA) and compared with that of controls (0 weeks). The contents of the fractionated bevacizumab syringes were analyzed for microbial growth. RESULTS: When we assessed the relative stability of the bevacizumab stored at 4degrees C, there was no concentration change for up to 12 weeks. However, concentration decreased by less than 2% between 28 weeks and 46 weeks. Samples stored at -10degrees C were stable up to 52 weeks. All of the fractionated syringes maintained >90% stability compared with controls for up to one year in both the refrigerated group and the frozen group. The microbial study showed no significant positive results for up to 12 weeks. After intravitreal bevacizumab injection, the statuses of all patients improved, with no signs of intraocular infection. We observed no cases of intraocular infection or complications among the patients. CONCLUSIONS: Fractionating and storing smaller amounts from single-use vials is a safe method for intravitreal bevacizumab injection.
Enzyme-Linked Immunosorbent Assay ; Freezing* ; Humans ; Infertility* ; Intravitreal Injections ; Plastics ; Refrigeration* ; Syringes* ; Bevacizumab

BACKGROUND: Currently the most common treatment modality of refractory ascites in patients with liver cirrhosis was large volume paracentesis, but this procedure usually needed albumin infusion and occasionally developed unwanted complications. By reason of albumin shortage in Korea and occasional unfavorable complications, we studied the usefulness of dialytic ultrafiltration as an another treatment modality of refractory ascites. METHODS: Dialytic ultrafiltration was done in 10 patients (total 48 times) with liver cirrhosis or hepatocellular carcinoma. Two drainage conduit (via 16 gauge angio-catheter) of input and output were made by puncture of patient's right and left lower quadrant abdomen. The initial ultrafiltration rate of dialyser was 250mL/min. Ascitic fluid was removed continuously until the filtration rate down at 50mL/min. After ultrafiltration, ascitic fluid contained concentrated albumin and large molecules was reinfused via input conduit. Pre-treatment and post-treatment level of blood chemistry, plasma renin concentration, aldosterone, and electrolytes in serum; total protein and albumin in ascites were measured. During the ultrafiltration, we closely observed the change of blood pressure, heart rates and mental status. RESULTS: The mean ultrafiltration time was 231+/-28min, ultrafiltrated volume was 5.15+/-1.41 L. During dialytic ultrafiltration, patient's blood pressure and heart rate were stable and there was no change of mental status. After dialytic ultrafiltration, blood urea nitrogen level significantly decreased from 30.5+/-23.7mg/dL to 25.7+/-20.2mg/dL; serum aldosterone level decreased from 807.3+/-301.1pg/ml to 431.1+/-187.2pg/ml in serum (P<0.01). The albumin level in the ascitic fluid significantly increased from 0.67+/-0.28g/dL to 1.90+/-1.16g/dL (P<0.01). Plasma renin concentration level tend to decreased (P=0.06). The patient's serum total protein, albumin, electrolytes, and creatinine were not changed. Complications of dialytic ultrafiltration were peritonitis (one case) and hypotension (one case). But these unwanted complications were readily managed by adequate antibiotics and intravenous fluid therapy. CONCLUSION: The dialytic ultrafiltration can be used effectively without albumin infusion in the treatment of refrartory ascites in patients with advanced liver cirrhosis.
Abdomen ; Aldosterone ; Anti-Bacterial Agents ; Ascites* ; Ascitic Fluid ; Blood Pressure ; Blood Urea Nitrogen ; Carcinoma, Hepatocellular ; Chemistry ; Creatinine ; Drainage ; Electrolytes ; Filtration ; Fluid Therapy ; Heart Rate ; Humans ; Hypotension ; Korea ; Liver Cirrhosis* ; Liver* ; Paracentesis ; Patient Rights ; Peritonitis ; Plasma ; Punctures ; Renin ; Ultrafiltration*

Intussusception is the most common cause of acquired intestinal obstruction during infancy and early childhood and requires early diagnosis and treatment. We observed 431 cases of intussusception who admitted at Chungang Gil Hospital from January 1987 to June 1991, and compared the result of treatment with Barium Enema in 302 cases with that of Air Enema in 129 cases. The results were as follows; 1) In sex distribution, males were more affected than females as a ratio of 2:1. 2) In age incidence, 78.2% of the cases were between 3~10 months. 3) Slight seasonal prevalence was noted in spring and autumn. 4) The common symptoms and signs were cyclic irritability (89.1%), vomiting (78.9%), bloody stool (84.9%) and abdominal mass(43.1%). 5) The common diseases accompanied were URI (39.7%), AGE (13.0%) and UTI(1.2%). 6) 5.8% of cases were visited after the 48 hours of symptom onset, in these cases the operation rate was 39.1%. So the longer duration of symptoms persists, the lower reduction rate follows. 7) The most common type of intussusception was ileocolic type, and the lowest reduction rate was noted in ileoileocolic type. 8) In the reduction rate, 87.4% with Barium Enema and 89.1% with Air Enema. 9) After 24 hours of symptom onset, the reduction rate, 74.4% with Barium Enema and 78.6% with Air Enema. 10) Recurrence rate was 9.3% with Barium Enema and 7.8% with Air Enema. 11) In Barium Enema, 1 case of bowel perforation was observed, and he expired with barium peritonitis, in Air Enema, 2 cases of bowel perforation were observed, and cured after operation. 12) We observed some advantages in Air Enema such as simplicity, high reduction rate and absence of fatal complications. And we think that Air Enema is a useful diagnstic and treatment method of intussusception.
Barium* ; Early Diagnosis ; Enema* ; Female ; Humans ; Incidence ; Intestinal Obstruction ; Intussusception* ; Male ; Peritonitis ; Prevalence ; Recurrence ; Seasons ; Sex Distribution ; Vomiting

No abstract available.
Actinomycosis*

To understand the seroepidemiological patterns of haemorrhagic fever with renal syndrome in Korea, a nation-wide survey collaborated with fourteen clinics was carried out from 1994 to 1996. Sera of 4,547 patients with acute febrile episodes were tested by indirect immunofluorescent antibody test and the seroepidemiological analysis including sex, age, seasonal and regional distributions were performed. According to the results obtained in this study, the epidemiological characteristics of haemorrhagic fever with renal syndrome in Korea were summarized as follows: 1. Seropositive rate of hemorrhagic fever with renal syndrome among the patients with acute febrile episodes was 6.4% by the cut-off point of 1:40. 2. Among the seropositives, male outnumbered female and the ratio of males to females was 2.0:1.0. 3. Seventy six % of the seropositive patients were 21-60 years old. 4. The number of seropositive cases increased from October and reached maximum in December and began to decrease gradually from January. 5. The geographical distribution of the seropositives cover most areas including Cheju province in Korea.
Female ; Fever ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Jeju-do ; Korea* ; Male ; Seasons

BACKGROUND: The etiology of Parkinson's disease (PD) has not been established, but familial forms of the disease have some clues for its pathogenesis. Autosomal dominantly inherited familial PD induced by aberrations of the alpha-synucein gene has been known as a genetic model of PD and sheds light to the understanding of PD pathogenesis. Synphilin-1 is a protein which interacts with alpha-synuclein and constitutes the Lewy body. METHODS: Immortalized human neural stem cells were transfected with the alpha-synuclein gene and synphilin-1 gene, to define the role of Lewy body inclusions in neuronal cell death. RESULTS: Human neural stem cells with Lewy body-like inclusions showed an increased apoptotic cell death compared to those with diffuse alpha-synuclein-positive and synphilin-1-positive reaction after transfection with the alpha-synuclein gene and synphilin-1 gene. Tyrosine hydroxylase over-expressing cells produced a high level of levodopa and showed a higher rate of the apoptotic marker. CONCLUSIONS: These results suggest that the formation of Lewy body-like inclusions by the over-expression of alpha-synuclein and synphilin-1 could be an underlying cause of apoptotic neuronal cell death and the dopaminergic cell might be more susceptible.
alpha-Synuclein* ; Apoptosis ; Cell Death* ; Humans* ; Inclusion Bodies* ; Levodopa ; Lewy Bodies ; Models, Genetic ; Neural Stem Cells* ; Neurons ; Parkinson Disease ; Transfection* ; Tyrosine 3-Monooxygenase

Ischemic colitis is the most common vascular disorder of intestines, and usually affects older patients. Many predisposing conditions have been implicated in the pathogenesis of colonic ischemia, although many occurrences are spontaneous in nature. Ischemic colitis can induce a wide spectrum of radiological or endoscopic features, depending on the site, extend, and timing of its onset. The coexistence of colonic ischemia with carcinoma of large bowel is well documented. However It is less well recognized that a localized segment of ischemic colon can mimic a carcinoma. Here, we report a case of ischemic colitis mimicking colon cancer in a 66 year-old man.
Aged ; Colitis, Ischemic* ; Colon ; Colonic Neoplasms ; Humans ; Intestines ; Ischemia

No abstract available.
Coronary Artery Disease* ; Coronary Vessels*