Extraperitoneal inguinal endometriosis often presents as an inguinal mass in women of reproductive age, Approximately 40 cases of inguinal endometriosis have been documented in the sutgical and gynecological literature. The overall incidence is in the range of 0.4% of patients with endometriosis. The right side is much more commonly involved than the left (almost 90% of the time in one series of 23 patients), and rarely is the condition bilateral. The most frequent complaint of patients with inguinal endometriosis is an inguinal mass, followed by pain and enlargement of the mass near menstruation. Authors have experienced two cases of endometriosis of the extraperitoneal portion of the round ligament of uterus and report with a brief literature review.
Endometriosis* ; Female ; Humans ; Incidence ; Menstruation ; Round Ligament of Uterus* ; Uterus

Primary sarcomas of the uteriae cerrix are exceedingly rare neoplasms. They comprise less than 1 percent of all cancers, with an incidence of 0.2 to 0.4 percent of those originating in the cervix. Indeed, only 19 cases of primary cervical leiomyosarcomas have been reported in the English literature. We have recently experienced one case of leiomyosarcoma arising from the cervix in a 40-year-old woman. Therefore, we the case with a brief review of the literature.
Adult ; Cervix Uteri* ; Female ; Humans ; Incidence ; Leiomyosarcoma* ; Sarcoma

PURPOSE: The aim of this study was to assess the accuracy and timeliness of using tracheal ultrasound for examination of endotracheal tube placement in cardiac arrest patients. METHODS: This was a prospective, observational study, conducted at the emergency department of a university teaching hospital. Patients underwent emergency intubation due to cardiac arrest. Airway ultrasonography was performed during emergency intubation with the transducer placed transversely at the trachea over the suprasternal notch. Quantitative waveform capnography was used as the criterion standard for confirmation of tracheal intubation. The main outcome was the timeliness between airway ultrasonography and capnography. RESULTS: A total of 16 patients and 19 intubations were included in the analysis. The endotracheal tube was placed in the trachea in 16 intubations and in the esophagus in three intubations. The overall sensitivity and specificity of ultrasound for confirmation of tracheal intubation was 100%, respectively. The capnography application time after intubation was 17.5(10.0~32.5) seconds. The capnograpny confirmation time after application was 30(10~120) seconds. The ultrasound confirmation time for endotracheal tube placement after application was 5(4~5) seconds. CONCLUSION: When patients were in a low pulmonary blood flow state, such as cardiac arrest, capnography confirmation of endotracheal tube placement was not rapid and needed a lot of times. Ultrasound confirmation was very rapid and accurate, and was not affected by pulmonary blood flow. Ultrasound confirmation of endotracheal tube placement is more useful in the emergency department.
Capnography ; Emergencies ; Esophagus ; Heart Arrest ; Hospitals, Teaching ; Humans ; Intubation ; Prospective Studies ; Sensitivity and Specificity ; Trachea ; Transducers

BACKGROUND: The deleterious cardiopulmonary side effects immediately after positioning in reverse Trendelenburg and CO2 intra-abdominal insufflation during a laparoscopic cholecystectomy are well tolerated in healthy patients but can lead to serious morbidity and mortality in patients with a limited cardiopulmonary reserve. Using a continuous and non-invasive cardiac output monitor based on partial CO2 rebreathing method, we investigated the immediate cardiopulmonary changes caused by positioning in reverse Trendelenburg and CO2 intra-abdominal insufflation during a laparoscopic cholecystectomy, and assessed the applicability of the partial CO2 rebreathing method for the measurement of cardiac output in a laparoscopic cholecystectomy. METHODS: The investigation was carried out on 11 patients undergoing a laparoscopic cholesystectomy. The control values of cardiac index (CI), cardiac output (CO), mean arterial pressure (MAP), heart rate (HR), central venous pressure (CVP), systemic vascular resistance (SVR), dynamic compliance (Cdyn), airway resistance (Raw), peak inspiratory pressure (PIP) and end tidal CO2 partial pressure (PETCO2) were measured in the supine position after induction with target-controlled infusion of propofol (5 microgram/ ml). Five minutes after positioning in reverse Trendelenburg and CO2 insufflation, the same cardiopulmonay variables were measured and compared with the control values. RESULTS: CI, CO and CVP were reduced 33.3%, 31.9% and 29.0%, respectively (P < 0.05). MAP and SVR were increased 39.8% and 154.1%, respectively (P < 0.05). Cdyn was reduced 38.0% (P < 0.05). Raw and PIP were increased 22.8%, and 34.8%, respectively (P < 0.05), whereas HR and PETCO2 remained unchanged. CONCLUSIONS: The non-invasive cardiopulmonary monitor using partial CO2 rebreathing method, could be used with ease and safety in a laparoscopic cholecystectomy.
Airway Resistance ; Arterial Pressure ; Cardiac Output ; Central Venous Pressure ; Cholecystectomy, Laparoscopic ; Compliance ; Heart Rate ; Humans ; Insufflation ; Mortality ; Partial Pressure ; Propofol ; Respiratory System* ; Supine Position ; Vascular Resistance

OBJECTIVE: This study aimed to estimate the association between total and ionized magnesium, and the changes in serum magnesium and calcium levels in patients with preterm labor during magnesium sulfate (MgSO4) administration. METHODS: The study population included 64 women who were candidates for intravenous MgSO4 treatment for preterm labor. Serial blood samples were taken and measured total magnesium (T-Mg), ionized magnesium (I-Mg), total calcium (T-Ca), and ionized calcium (I-Ca) levels every one-week interval (1st, 2nd, 3rd). RESULTS: There was no significant difference in T-Mg and I-Mg levels during MgSO4 administration (P>0.05). There was no significant difference in T-Ca and I-Ca levels during MgSO4 administration (P>0.05). Compared before and after administration of MgSO4, T-Mg and I-Mg levels and T-Ca levels were changed allow statistically significant (P < 0.05). But, there was no significant difference in the I-Ca serum levels before and after MgSO4 administration (P=0.495). The I-Mg levels for patients with adverse effect were higher than other group but did not reach statistical significance (P>0.05). There was significant correlation between levels of I-Mg and T-Mg (I-Mg=0.395×T-Mg+0.144, P < 0.01). CONCLUSION: There were no significant differences in serum Mg and Ca levels during MgSO4 administration for preterm labor. Compared to the before and after administration of MgSO4, only I-Ca levels were not substantially changed. There are significant correlations between I-Mg and T-Mg levels during administration of MgSO4 and I-Mg level seemed to have more correlation with adverse effect than T-Mg.
Calcium ; Female ; Humans ; Magnesium Sulfate ; Magnesium ; Obstetric Labor, Premature ; Pregnancy

OBJECTIVES: The present study was designed to determine the characteristics of shift work and the relationship between shift work and the level of self-rated health using the Korean Labor and Income Panel Study (KLIPS) data, which represents urban households in Korea. METHODS: Using the 9th wave of KLIPS, this study analyzed 2,087 male workers aged 25 to 64 years; participants missing data were excluded from analysis. To determine the impact of shift work on the level of self-rated health, logistic regression analysis was applied that controlled for socio-demographic characteristics, labor environment, and health-related behaviors. RESULTS: Shift workers comprised 13.4% of study subjects overall. The majority(69.2%) of participants were in 2-teams and in 2-shifts. Week 1 shift cycle changes were the highest, 56.3%. The risk of poor self-rated health was not significantly higher among shift workers compared to non-shift workers (OR=1.08, 95% CI=0.79~1.48). When divided by tenure, shift workers with more than 10-years experience (OR=1.79, 95% CI=0.91~3.50) tended to show greater risk than non-shift workers at marginal significance. CONCLUSIONS: In the present study, a significantly higher risk of self-rated poor health among shift workers was not observed. However, shift workers with more than 10-years experience tended to show increased health risk compared to non-shift workers. Further studies are required to determine time-series data and to consider both healthy worker effect and information bias.
Aged ; Bias (Epidemiology) ; Family Characteristics ; Healthy Worker Effect ; Humans ; Korea ; Logistic Models ; Male

We aimed; 1) to determine the validity of the EuroQol 5D (EQ-5D) for the health-related quality of life (HRQOL) of Korean patients with type 2 diabetes, and 2) to identify associated factors of the HRQOL of these patients. Follow-up surveys were conducted for consecutive patients with type 2 diabetes. HRQOL was assessed using the EQ-5D and the Short Form-36 (SF-36). The validity of EQ-5D was assessed with the perspectives of known group, convergent and discriminant validity. Additionally, a linear mixed model using a backward elimination was used for identify associated factors. Of the 1,072 patients included in the first survey, 858 (80.0%) completed the questionnaires in the follow-up. In the known group validity, the problem rates in each EQ-5D dimension were highest among women, elderly people, and less-educated subjects. The Spearman's rho between the EQ-5D and the SF-36 scales were larger in the comparable dimensions than those in the less comparable dimensions. In the final model, we found that sex, age, education, body mass index, atrial fibrillation, stroke, and retinopathy were statistically significant. Our data suggest that the EQ-5D is a valid tool for Korean patients with type 2 diabetes and that various factors could affect their HRQOL.
Adult ; Aged ; Aged, 80 and over ; Diabetes Mellitus, Type 2/complications/*physiopathology/psychology ; Female ; Humans ; Male ; Middle Aged ; *Quality of Life ; Quality-Adjusted Life Years ; *Questionnaires ; Republic of Korea ; Young Adult

Stress induced cardiomyopathy is a disease that shows a dysfunction of the ventricle, but it can be rapidly reversible. It often occurs in older women primarily who suffers from emotional or physical stress. There are some case reports about postpartum stress induced cardiomyopathy. Most of the patients are recovered naturally within days to weeks. We report a case of a 37 years-old woman, who had experienced postpartum stress induced cardiomyopathy 8 years ago, revisited hospital because of cardiomyopathy after secondary delivery. Herein we report a rare case of recurrent stress induced cardiomyopathy after secondary normal vaginal delivery.
Cardiomyopathies* ; Female ; Humans ; Postpartum Period* ; Recurrence

PURPOSE: To evaluate prospectively the results of early active exercise after open Bankart repair of traumatic anterior shoulder instability. MATERIALS AND METHODS: From January, 2001 to June, 2003, 26 patients who were followed up at least 1 year after open Bankart repair for traumatic anterior shoulder instability were evaluated. Average age was 23.9 years old (range, 19~43) with 24 males and 2 females. We evaluated them using the functional shoulder scores (modified Rowe score, ASES score), range of motion, VAS pain scale, patient's subjective satisfaction and return to unlimited daily living activity. RESULTS: The shoulder functional scores increased significantly. At last follow up, the final range of motion were flexion in average 5° deficit in comparison to normal side, external rotation in average 10o deficit, and internal rotation in T9. The patient's subjective satisfaction was good in 2l patients (81%). Return to unlimited daily activity was possible in 23 patients (88.5%), and 19 patients (73%) rejoined to sports activity before injury. There were complications including anterior recurrent subluxation in 1 case, weakness of subscapularis muscle in 1 case. CONCLUSION: In traumatic anterior shoulder instability, early active range of motion exercise after open Bankart repair does not decrease shoulder stability. Early exercise can be useful for returning to previous level of sports activity in young active patients.
Activities of Daily Living ; Female ; Follow-Up Studies ; Humans ; Male ; Prospective Studies ; Range of Motion, Articular* ; Shoulder ; Sports

Benign tumor in the cheek area such as hemangioma, lymphangioma and neurofibroma causes the drooping of affected side soft tissue involving cheek, mouth corner and nasolabial fold due to its heavy weight and bulkiness. The drooping of mouth corner may remain even after partial subcutaneous excision of the mass. The authors suspended the drooped mouth corner with dermal flap which could be elevated through the nasolabial fusiform de-epithelization simultaneously while the mass was removed by the incision. A total of 14 patients with hemangioma, lymphangioma and neurofibroma in the cheek area were operated between February 1998 and November 2001. The age distribution was 5 to 21-years-old and the follow-up period ranged from 5 to 37 months. There were 1 case of epidermal inclusion cyst and 1 case of hematoma, but no infection or facial nerve palsy was reported as complication. The aesthetic results were considered favorable. This technique prevents the drooping of mouth corner or asymmetry of mid-face without remaining any significant deformity at the donor site, and helps to make more normalized facial feature after the removal of soft tissue mass in the cheek.
Age Distribution ; Cheek* ; Congenital Abnormalities ; Facial Nerve ; Follow-Up Studies ; Hemangioma ; Hematoma ; Humans ; Lymphangioma ; Mouth* ; Nasolabial Fold ; Neurofibroma ; Paralysis ; Tissue Donors