Transvaginal cervical cerclage for the prevention of pregnancy loss in patients with cervical incompetence is well accepted. However, there is a small subject of patients with incompetence of cervix, congenital or surgical shortening of the cervix, previously failed transvaginal cerclage and deep cervical damage or tears in the fornices. We experienced a case of the transabdominal cervical cerclage. 'Ihe patient had a past history of deep cervical laceration due to vaginal delivery. Therefore, we present here a surgical technique of transabdominal cerdage and report it with brief review of literatures.
Cerclage, Cervical ; Cervix Uteri* ; Female ; Humans ; Lacerations ; Pregnancy

The bleeding duodenal varices ia uncommon and frequeintly present a difficult diagnostic problem While the bleeding duodenal varices is a complication of portal hypertension, the possibility of bleeding duodenal varices in the absence of eaophageal varix bleeding should be kept mind. For the surgeon, the mikin technical problem is that even when identified by frequently impalpable, and invisible to the naked eye unless they are actively bleeding at the time of surgery. We described simple intra-operative endoscopic technique successfully to identify and bleeding varices in the duodenal third portion prior to the partial duodenal resection. This report summarized our experience and review of literature.
Endoscopy* ; Hemorrhage* ; Hypertension, Portal ; Varicose Veins*

We analyzed 91 cases with seizures after stroke(except subarachnoid hemorrhage) to see, recurrence rate, onset time, lesion sites and electroencephalographic findings. Overall incidence of seizure was 5.73%[7.57% of all cerebral infarction(CI; 938 cases) and 3.0% of an intracerebral hemorrhage(ICH; 649 cases)] in all admitted stroke patient(l450) from Jan. 1980 to Jun. 1989 and all stroke patients visited out-patient department(137 ; from Sep. 1989 to Oct. 1989) in the department of neurology, Seoul National University Hosptal. And then, we excluded 22 cases because of insufficient clinical information.1) We followed up 69 patients and in those cases, seizures occurred rnore frequently in CI(51) than in ICH(18). 2) Seizures of ear!y onset(<2week) occurred in 25(49.0%) of 51 cases with cerebral infarction and in 12(66.7%) of 18 cases with IVH. 3) Seizures occurred more frequently in cortical lesions(71.0%)[CI: 71.4% and ICH ; 28.6%] than in subcortical lesions(24.6%)[CI ; 76.5% and ICH ; 23.5%]. 4) Recurrence rate (69.5%) of the patients without antiepileptic medication was signigicantly higher than (16.7%) of patients with medication[Spearman's Rho=0.52, p<0.001]. 5) Of those patients without medication, the recurrence rate was highest in the patients showing epileptiform discharge(100%) in EEG. Followed by focal slowing(66.7%), diffuse slowing(62.5%) and normal EEG features(33.3%)[Spearman's Rho=0.41, P=0.01]. 6) The recurrence of seizures was more frequent in the patients with CI(54.9%) than in ICH(22.2%).
Cerebral Infarction ; Electroencephalography ; Humans ; Incidence ; Neurology ; Outpatients ; Recurrence ; Seizures* ; Seoul ; Stroke

OBJECTIVE: The author evaluated the relationship between the loss of Fhit and prognostic factors of invasive cervical carcinomas. METHODS: The formalin prepared tissue specimens of 64 CINs and 27 invasive cervical carcinomas patients diagnosed and treated at the department of obstetrics and gynecology, Yeungnam university hospital from June 1977 to February 2001 were obtained. And then the tissue specimens were analysed & measured by immunohistochemical methods. RESULTS: The loss of Fhit was significantly reduced in invasive cervical carcinomas compared to CINs. But we found there is no relationships between the loss of Fhit and prognostic factors, stage, tumor marker, lymphatic spread and radiation therapy of invasive cervical carcinomas. CONCLUSIONS: Although the loss of Fhit was not related to the precancerous lesion of cervix, we could confirm that the loss of Fhit was important in the progression of precancerous lesions to invasive cervical carcinomas.
Cervix Uteri ; Female ; Formaldehyde ; Gynecology ; Humans ; Obstetrics

A case of traumatic carotid-cavernous fistula treated using Debrun's latex detatchable balloon catheter is reported. The patient was a 33-year-old man, who has complaints of proptosis and chemosis of left eye 2 months after motor vehicle accident. The cerebral angiography showed direct fistula between intracavernous portion of internal carotid artery and cavernous sinus as high flow-high pressure type. After complete radiologic and neurologic examination, the fistulous opening was successfully occluded by Debrun's latex detatchable balloon with transient ischemic attack, was resolved 2 hours after the procedure.
Adult ; Carotid Artery, Internal ; Catheters ; Cavernous Sinus ; Cerebral Angiography ; Exophthalmos ; Fistula ; Humans ; Ischemia ; Ischemic Attack, Transient ; Latex* ; Motor Vehicles ; Neurologic Examination

PURPOSE: We wanted to compare the fMRIs (functional magnetic resonance images) obtained during a lexical decision task and also during a word generation task, and we wanted to evaluate the usefulness of using a lexical decision task for the visualization of the brain language area and for the determination of language dominance. MATERIALS AND METHODS: Sixteen patients (9 women and 7 men) who had had undergone the Wada test were included in our study. All the patients were left dominant for language, as tested for on the Wada test. The functional maps of the brain language area were obtained in all the subjects during the performance of a lexical decision task and also during the performance of a word generation task. The MR examinations were performed with a 1.5 T scanner and with using the EPI BOLD technique. We used the SPM program for the postprocessing of the images. The threshold for significance was set at p<0.001 or p<0.01. A lateralization index was calculated from the number of activated pixels in each hemispheric region (the whole hemisphere, the frontal lobe and the temporoparietal lobe), and the hemispheric language dominance was assessed by the lateralization index; the results were then compared with those results of the Wada tests. The differences for the lateralization of the language area were analyzed with regard to the stimulation tasks and the regions used for the calculation of the lateralization indices. RESULTS: The number of activated pixels during the lexical decision task was significantly smaller than that of the word generation task. The language dominance based on the activated signals in each hemisphere, was consistent with the results of the Wada test for the word generation tasks in all the subjects. On the lexical decision task, the language dominance, as determined by the activated signals in each hemisphere and the temporoparietal lobe, correlated for 94% of the patients. The mean values of the lateralization index for the lexical decision task were higher than those mean values of the lateralization index of the word generation task. CONCLUSION: The lexical decision task allowed us to map the language area and to determine the language dominance. It could be a useful task for those patients who cannot perform the word generation task because of their cognitive retardation.
Brain ; Female ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging*

OBJECTIVES: Neurotensin (NT), of which functions are evoked by its interaction with neurotensin receptors (NTR), coexists with mesolimbic dopamine and regulates endogenous dopamine release. Recent studies have shown that NT with NTR exerts neuroleptic-like activity within the central nervous system and may play an important role in the pathogenesis and in the treatment of schizophrenia. We have examined the genetic association between schizophrenia and tetranucleotide repeat polymorphism in the 3'-flanking region of the NTR gene to investigate the possible contribution of the NTR gene to the schizophrenia susceptibility. METHODS: Among 23 alleles identified, the subjects were 120 patients (male 91, female 29) with schizophrenia and 106 normal healthy controls (male 84, female 22). They were unrelated native Korean. PANSS was used to determine positive or negative subgroup in the schizophrenic patients.Using polymerase chain reaction and polyacrylamide gel electrophoresis, tetranucleotide repeat polymorphism (CCTT and CTTT) in the 3'-flanking region of NTR gene was observed. For a comparison of NTR gene's allelic frequencies between patients with schizophrenia and normal healthy controls, chi-square test and Bonferroni's correction was performed. RESULTS: The frequency of A10 allele (base pair size=399) was significantly higher in normal healthy controls than schizophrenia (x2=16.4902, df=1, p<.000). In the comparison between schizophrenic patients with negative symptoms and normal controls, the frequency of A10 allele was significantly higher in normal healthy control subjects than patients with schizophrenia (x2=21.33, df=1, p<0.001). In the case of male, the frequency of A10 allele of schizophrenia was significantly higher than normal controls (x2=13.71, df=1, p<0.001). CONCLUSIONS: NTR gene was negatively associated with schizophrenia. NTR gene's tetranucleotide repeat polymorphism may provide some protective function against schizophrenia.
Alleles ; Central Nervous System ; Dopamine ; Electrophoresis, Polyacrylamide Gel ; Female ; Humans ; Male ; Microsatellite Repeats ; Neurotensin* ; Polymerase Chain Reaction ; Receptors, Neurotensin* ; Schizophrenia*

The medical records of 30 patients with histologically confirmed and angiographically occult intracranial vascular malformations(AOVM), who underwent surgery between May 1988 and May 1993, were reviewed retrospectively to determine whether their radiological and clinical characteristics are helpful in differential diagnosis. Histological diagnoses were cavernous angioma(CA) in 17 cases, arteriovenous malformation(AVM) in nine, venous angioma in one and unclassified vascular malformation in three. The most common initial presenting mode was intracranial hemorrhage(ICH ; 18 cases, 60.0%), followed by seizure(11 cases, 33.3%) and headache(two cases, 6.6%). CA, once it had bled, tended to bleed repeatedly, and this occurred before surgery in seven of nine cases of CA presenting with ICH. On CT scan, calcification was observed only in CA(two cases). On MRI images obtained in 28 patients, a mottled density mass with or without adjacent ICH(ten of 16 CA's) and multiple lesions(three of 16 CA's) were pathognomonic for CA, while single stage ICH(two of eight AVM's) and signal void(three of eight AVM's) were observed only in cases of AVM. Findings of MRI such as multiple stage hemorrhage, low signal intensity rim or edema around the lesion were not helpful in differential diagnosis of the histological type of lesions. After enhancement with gadolinium, one case of AVM and another of venous angioma showed a serpentine pattern of enhancement. In 29 cases, the results of surgery were excellent ; there was no mortality and morbidity in only one case. In conclusion, CA, once it had bled, tended to rebleed and MRI was helpful in the differential diagnosis of AOVM's. MRI findings such as a mottled density mass or multiple lesions were pathognomonic for CA, while single stage hemorrhage or signal void were findings of AVM.
Arteriovenous Malformations ; Diagnosis ; Diagnosis, Differential ; Edema ; Gadolinium ; Hemangioma ; Hemangioma, Cavernous ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Mortality ; Retrospective Studies ; Tomography, X-Ray Computed ; Vascular Malformations*

OBJECTIVE: To assess maternal circulating levels of lipid peroxides, superoxide dismutase and total antioxidants of women with pregnancy-induced hypertension. METHODS: Cross-sectional study consisting of 18 preeclamptic, 21 uncomplicated pregnant and 22 healthy non-pregnant women. Fasting venous blood samples were collected during the 3rd trimester of antepartum period and maternal circulating levels of malondialdehyde as a lipid peroxidation product, superoxide dismutase activity and total antioxidants were measured. RESULTS: In the preeclamptic group, lipid peroxides were significantly increased, otherwise the activity of superoxide dismutase in the erythrocytes was significantly decreased compared to normal pregnant women. The value of serum total antioxidants was similar in both groups. Strong correlation was detected between malondialdehyde and blood pressure in the pregnant women. CONCLUSION: Preeclampsia is associated with decrease of antioxidant enzyme activity while lipid peroxidation was increased during the 3rd trimester of pregnancy. Therefore, a significant elevated lipid peroxidation and reduced superoxide dismutase activity may contribute to pathophysiology and pathogenesis of preeclampsia via vascular endothelial cell damage.
Antioxidants ; Blood Pressure ; Cross-Sectional Studies ; Endothelial Cells ; Erythrocytes ; Fasting ; Female ; Humans ; Hypertension, Pregnancy-Induced* ; Lipid Peroxidation* ; Lipid Peroxides ; Malondialdehyde ; Pre-Eclampsia ; Pregnancy ; Pregnant Women* ; Superoxide Dismutase

OBJECTIVE: The surgical approach for recurrent pituitary adenoma after trans-sphenoidal approach (TSA) is challenging. We report the outcomes of the endoscopic TSA for recurrent pituitary adenoma after microscopic TSA. METHODS: From February 2010 to February 2013, endoscopic TSA was performed for removal of 30 recurrent pituitary adenomas after microscopic TSA. Twenty-seven (90%) patients had a clinically non-functioning pituitary adenoma. Twenty-four (80%) patients suffered from a visual disturbance related to tumor growth. The clinical features and surgical outcomes were retrospectively analyzed for the ophthalmological, endocrinological, and oncological aspects. RESULTS: The mean tumor volume was 11.7 cm3, and gross total resection was achieved in 50% of patients. The volumetric analysis based on the postoperative MR showed that the mean extent of resection rates were 90%. Vision was improved in 19 (79%) of 24 patients with visual symptoms, and endocrinological cure was achieved in all of three functioning pituitary adenomas; however, the post-operative follow-up endocrinological examination revealed a new endocrinological deficit in one patient. Two patients required antibiotics management for post-operative meningitis. CONCLUSION: The endoscopic TSA can be an effective treatment option for recurrent pituitary adenoma after microscopic TSA with acceptable outcome.
Anti-Bacterial Agents ; Endoscopy ; Follow-Up Studies ; Humans ; Pituitary Neoplasms* ; Retrospective Studies ; Tumor Burden ; Vision, Ocular