By means of hospital-based data over 8 years we sought to evaluate the clinical indications and incidence of emergency peripartum hysterectomy by demographic characteristic and reproduction history. From the obstetric record of all deliveries at Chung Goo Hospital between Jan. 1, 1990, and Nov. 31, 1997, we identified all women undergoing emergency cesarean hysterectomy, calculated incidence rates, conducted statistical tests of linear trends and heterogenety, and observed the clinical indicatons preceding the onset of this procedure. There were 16731 deliveries during this period, Cesarean hysterectomy was performed in 24 of 5993 cesarean sections(0.40%) and in 10 of 10738 vaginal deleveries(0.09%), so more frequently after cesarean section than vaginal delivery. The age of patients varied from 22 to 40 years old. The higher the age and the parity of patients, the higher incidence of cesarean hysterectomy was noted. The most common indication of cesarean hysterectomy was uterine atony(52.94%) followed by placental disorders(41.18%), uterine myoma with pregnancy(2.9%) and uterine rupture (2.9%). All patients who had hysterectomy received transfusion from 1 pint to 57 pints. The postoperative complications were bladder injury, febrile morbidity, disseminated intravascular coaguolopathy and wound disruption. There were three maternal deaths, the cause was disseminated intravascular coaguolopathy and amniotic embolism. The data identifiy uterine atony as the primary cause for gravid hysterctomy. The data also illustrated how the incidence of emergency peripartum hysterectomy increases significantly with increasing parity, especially when influenced by a current placenta previa or a prior cesarean section. Maternal morbidity remained high.
Adult ; Cesarean Section ; Embolism ; Emergencies ; Female ; Humans ; Hysterectomy* ; Incidence ; Leiomyoma ; Maternal Death ; Parity ; Peripartum Period* ; Placenta Previa ; Postoperative Complications ; Pregnancy ; Reproduction ; Urinary Bladder ; Uterine Inertia ; Uterine Rupture ; Wounds and Injuries

No abstract available.
Child* ; Humans ; Hypercalciuria*

OBJECTIVES: There are a lot of studies that analyze the interaction between the emotion of disgust and the functional brain images using fMRI and PET. But studies using sLORETA (standardized low resolution brain electromagnetic tomography) almost do not exist. The aim of this research is to explore the relationship of the emotion of disgust and the cortical activation using sLORETA analysis. METHODS: Forty five healthy young adults (27.1+/-2.6 years) participated in the study. While they were watching 4 neutral images and 4 disgusting images associated with mutilation selected from the international affective picture system (IAPS), participants' EEGs were taken for 30 seconds per one picture. Through these obtained EEG data, sLORETA analysis was performed to compare EEGs associated with neutral and negative images. RESULTS: During looking for visual disgusting stimulus, all participants reported unpleasantness, arousal and stress. In sLORETA analysis, the decrease of current density in theta wave was shown at left frontal superior gyrus (BA10) and middle gyrus (BA10, 11). This voxel cluster consists of a total of 11 voxels and the threshold of t value indicating statistically significant decreases in the current density (p<0.05) was -1.984. There were no differences between male and female in the degree of being disgusted by the stimuli. CONCLUSION: This finding may suggest that the activation of dorsolateral prefrontal cortex might be associated with regulating disgust emotion.
Arousal ; Brain ; Electroencephalography ; Female ; Humans ; Magnetic Resonance Imaging ; Magnets ; Male ; Prefrontal Cortex ; Young Adult

Dietary sodium intake is considered one of the major causal factors for hypertension. Thus, to control the increase of blood pressure and reduce the risk of hypertension-related clinical complications, a reduction in sodium intake is recommended. The present study aimed at determining the association of dietary sodium intake with meal and snack frequency, snacking time, and taste preference in Korean young adults aged 20-26 years, using a 125-item dish-frequency questionnaire. The mean dietary sodium intakes of men and women were 270.6 mmol/day and 213.1 mmol/day, which were approximately 310% and 245% of the daily sodium intake goal for Korean men and women, respectively. Dietary sodium intake was positively correlated with systolic blood pressure in the total group, and BMI in the total and men-only groups. In the total and men-only groups, those who consumed meals more times per day consumed more dietary sodium, but the number of times they consumed snacks was negatively correlated with dietary sodium intake in the total, men-only, and women-only groups. In addition, those who consumed snacks in the evening consumed more sodium than those who did so in the morning in the men-only group. The sodium intake was also positively associated with preference for salty and sweet taste in the total and women-only groups. Such a high intake of sodium in these young subjects shows that a reduction in sodium intake is important for the prevention of hypertension and related diseases in the future.
Adult ; Aged ; Blood Pressure ; Eating ; Female ; Humans ; Hypertension ; Male ; Meals ; Surveys and Questionnaires ; Snacks ; Sodium ; Sodium, Dietary ; Young Adult

Malignant salivary gland tumors only represent 0.08% of all childhood tumors and mucoepidermoid carcinoma (MEC) is the most common histologic type. Although there are many reports describing second malignant neoplasm (SMN) in patients treated for childhood cancer, salivary gland tumors rarely appears. In Korea, there has been no report about MEC that developed in children as a SMN. We report a MEC in a 4 years and 8 months old female child that developed after completing treatment for yolk sac tumor of lower abdomen. The primary tumor presented with metastasis at the time of diagnosis, and therefore, the child underwent high-dose chemotherapy with autologous peripheral blood stem cell transplantation along with surgery and radiotherapy. Three years and five months after completing treatment, MEC developed in her submandibular gland. She was treated with surgery and radiotherapy and is in disease free state for 5 months at the time of this writing.
Abdomen ; Carcinoma, Mucoepidermoid ; Child ; Diagnosis ; Drug Therapy ; Endodermal Sinus Tumor ; Female ; Humans ; Korea ; Neoplasm Metastasis ; Peripheral Blood Stem Cell Transplantation ; Radiotherapy ; Salivary Gland Neoplasms ; Salivary Glands ; Submandibular Gland ; Writing

Patients with chronic renal failure (CRF) are known to be more susceptible to tuberculosis infection due to impairment of the host defense mechanism. Although extrapulmonary tuberculosis is more prevalent in those subjects and it may induce dismal outcome, its diagnosis has been challenging since there is no specific symptoms of the disease and the clinical course is usually atypical. Herein, We report a case of disseminated tuberculosis diagnosed by ultrasound-guided liver biopsy in a 31-year-old CRF patient presenting sustained fever despite broad-spectrum antimicrobial therapy and progressive cholestatic jaundice.
Biopsy ; Fever ; Humans ; Jaundice, Obstructive ; Kidney Failure, Chronic ; Liver ; Tuberculosis

BACKGROUND: Recent studies indicate that reactive oxygen species (ROS) are involved in persistent pain, including neuropathic and inflammatory pain. Since the data suggest that ROS are involved in central sensitization, the present study examines the levels of activated N-methyl-D-aspartate (NMDA) receptors in the dorsal horn after an exogenous supply of three antioxidants in rats with chronic post-ischemia pain (CPIP). This serves as an animal model of complex regional pain syndrome type-I induced by hindpaw ischemia/reperfusion injury. METHODS: The application of tight-fitting O-rings for a period of three hours produced CPIP in male Sprague-Dawley rats. Allopurinol 4 mg/kg, allopurinol 40 mg/kg, superoxide dismutase (SOD) 4,000 U/kg, N-nitro-L-arginine methyl ester (L-NAME) 10 mg/kg and SOD 4,000 U/kg plus L-NAME 10 mg/kg were administered intraperitoneally just after O-ring application and on the first and second days after reperfusion. Mechanical allodynia was measured, and activation of the NMDA receptor subunit 1 (pNR1) of the lumbar spinal cord (L4-L6) was analyzed by the Western blot three days after reperfusion. RESULTS: Allopurinol reduced mechanical allodynia and attenuated the enhancement of spinal pNR1 expression in CPIP rats. SOD and L-NAME also blocked spinal pNR1 in accordance with the reduced mechanical allodynia in rats with CPIP. CONCLUSION: The present data suggest the contribution of superoxide, produced via xanthine oxidase, and the participation of superoxide and nitric oxide as a precursor of peroxynitrite in NMDA mediated central sensitization. Finally, the findings support a therapeutic potential for the manipulation of superoxide and nitric oxide in ischemia/reperfusion related pain conditions.
Allopurinol ; Animals ; Antioxidants ; Blotting, Western ; Central Nervous System Sensitization ; Horns ; Humans ; Hyperalgesia ; Inositol Phosphates ; Male ; Models, Animal ; N-Methylaspartate ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Peroxynitrous Acid ; Prostaglandins E ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; Reperfusion ; Reperfusion Injury ; Spinal Cord ; Superoxide Dismutase ; Superoxides ; Xanthine Oxidase

Epidural blood patch is an effective management for treatment of severe post-dural puncture headache. Here we describe a case of a patient with hip fracture, who was complained regarded as having suspicious post-dural puncture headache after epidural anesthesia, but it failed to be treated with 4 times of epidural blood patch, and later was diagnosed with multiple metastatic brain tumor.
Anesthesia, Epidural ; Blood Patch, Epidural ; Brain Neoplasms* ; Brain* ; Headache ; Hip ; Humans ; Post-Dural Puncture Headache*

The isotopic response defined by Wolf et al. describes the occurrence of a new skin disorder at the site of another, unrelated and already healed skin disease. In most of the reported cases, the first diseases were herpes zoster. We report a case of leukemia cutis developed on the exact same site of previous invasive cutaneous candidiasis, regarded as Wolfs isotopic response.
Candidiasis, Cutaneous* ; Herpes Zoster ; Leukemia* ; Skin ; Skin Diseases ; Wolves*

OBJECTIVE: To study the clinical characteristics on translocation of intrauterine device and the methods of removal. METHODS: A retrospective review was performed on 77 cases of translocation of intrauterine device from June 1994 to December 2002. RESULTS: Among 77 cases undergoing removal of intrauterine device, 17 cases (22.1%) were translocted intraperitoneally. Fifteen cases were removed by laparoscopy, 2 cases were by laparotomy and there was no specific postoperative complication. The incidence of intraperitoneal translocation was not related to the type of IUD. Between intrauterine and extrauterine translocation, the incidence of symptoms were not different, but low abdominal pain were slightly increased in extrauterine (35.3%) than intrauterine (10.0%) group. The time lapse after insertion of IUD was ranged from 1 month to 35 year, the mean duration was 9.39 year, that was not related to the incidence of intraperitoneal translocation. In the cases of extrauterine translocation, the mean hospital day was significantly increased (p=0.001), the mean duration was 2.5 day (1-7 day), compaired with 0.7 day (0-6 day) of the cases of not translocated. CONCLUSION: As the type of IUD or symptoms, it is difficult to anticipate the possibility of the intraperitoneal translocation of IUD. But, in cases of extrauterine translocation of intrauterine device, the incidence of low abdominal pain was slightly increased, and ring type IUD was rarely extrauterne translocated. So, it is necessary to further study what factors contribute the extrauterine translocation of IUD.
Abdominal Pain ; Incidence ; Intrauterine Devices* ; Laparoscopy ; Laparotomy ; Postoperative Complications ; Retrospective Studies