The empty sella syndrome is characterized by obesity, frequent pregnancy, headache and high blood pressure, but its exact cause remains unknown. Usually the incomplete diaphragmatic sella has been considered as the cause of the empty sella syndrome, but some authors recently have suggested that the antipituitary antibody way be related to development of pituitary atrophy and the pituitary empty sella syndrome, and thus it may be clinically useful as screening test for the empty sella syndrome. We experienced two empty sella syndromes associated Graves disease and applied the antipituitary antibody as the diagnostic tool of the empty sella syndrome. But none of this two patients had antipituitary antibody and we report these cases with reviews of literatures.
Atrophy ; Empty Sella Syndrome ; Graves Disease ; Headache ; Humans ; Hypertension ; Mass Screening ; Obesity ; Pregnancy

BACKGROUND: Gabapentin is a safe and well-tolerated anticonvulsant with a wide therapeutic index, and it is used for neuropathic pain. The aim of this study was to compare previous dosing methods with the administration of four different doses of gabapentin while maintaining the same maximum daily dose for the safe administration of high doses of the medication. METHODS: The subjects were outpatients with various neuropathic pain syndromes, with at least two of the following symptoms: allodynia, burning pain, shooting pain, or hyperalgesia. The TID group received equal doses of gabapentin 3 times per day, while the QID group received 4 different doses of gabapentin per day. The pain score, frequency of breakthrough pain (BTP), severity and the duration of pain, sleep disturbance due to nocturnal pain, and adverse effects were recorded each day. RESULTS: The average daily pain score and sleep disturbance were significantly reduced in the QID group between days 3 and 10 of the experiment. The adverse effects of the medication were also reduced in the QID group. However, the frequency of BTP and severity and duration of pain were not significantly different between two groups. CONCLUSIONS: Administration of 4 different doses of gabapentin during the initial titration in outpatients with neuropathic pain resulted in a significant reduction in awakening from breakthrough pain and a reduction in the adverse effects of the medication.
Ambulatory Care ; Amines ; Breakthrough Pain ; Burns ; Cyclohexanecarboxylic Acids ; Drug Administration Schedule ; gamma-Aminobutyric Acid ; Humans ; Hyperalgesia ; Neuralgia ; Outpatients

Cholinergic urticaria with acquired generalized hypohidrosis, and its pathophysiology is not well known. Autoimmunity to sweat glands or to acetylcholine receptors on sweat glands has been mentioned as one of the possible etiologies. Systemic steroid therapy, antihistamines, anticholinergics, and avoidance of the stimulatory situations are recommended for treatment. We experienced a case of cholinergic urticaria with acquired generalized hypohidrosis in a patient who had no other associated disease, and the symptoms eased after repeated bilateral stellate ganglion block. Stellate ganglion block normalized the elevated sympathetic tone and may relieve symptoms in patients with this condition.
Autoimmunity ; Cholinergic Antagonists ; Histamine Antagonists ; Humans ; Hypohidrosis ; Receptors, Cholinergic ; Stellate Ganglion ; Sweat Glands ; Urticaria

OBJECTIVE: To assess the gestational age adjusted values of umbilical cord artery blood pH in term pregnancy METHODS: We retrospectively analyzed umbilical arterial blood pH values and obstetric data of 1,918 term singleton deliveries without maternal medical disease, pregnancy induced hypertension and fetal distress during labor periods at Kangnam St. Mary's Hospital, Catholic University medical college between January 2004 and December 2006. Low pH was defined as less than 7.10 as a stationary cutoff value, whereas pH less than (mean -2 standard deviations [SDs]) was used when gestational age was considered. We evaluated the risk of 5 minute Apgar score of less than 7 and meconium staining more than grade II at low pH. RESULTS: A significant negative correlation was found between gestational age and umbilical artery pH (p=0.000). We evaluated the umbilical artery pH value in different delivery mode. Vaginal delivery cases showed negative correlation (p=0.000), but elective cesarean section cases didnt. Low pH patients defined by both criteria of pH less than 7.10 and pH less than (mean -2SD) showed significantly increased risk of 5 minutes Apgar score of less than 7 (pH less than 7.10: p=0. 000, pH less than (mean -2SD): p=0.001) and meconium staining more than grade II (pH less than 7.10: p=0. 001, pH less than (mean -2SD): p=0.001). CONCLUSION: Our results suggest that umbilical cord pH has a negative relation with gestational age during term period.
Apgar Score ; Arteries ; Cesarean Section ; Female ; Fetal Distress ; Gestational Age ; Humans ; Hydrogen-Ion Concentration ; Hypertension, Pregnancy-Induced ; Meconium ; Pregnancy ; Retrospective Studies ; Umbilical Arteries ; Umbilical Cord

Placental mesenchymal dysplasia is a rare condition of pregnancy that present as macroscopic feature of molar change in the placenta and normal karyotype fetus, and has been reported at birth in 15 cases of Beckwith-Wiedmann syndrome and 25 cases of normal fetus in literatures. It may mimic the partial hydatidiform mole, but the mesenchymal dysplasia is different that it may be compatible with a normal fetus. A nulliparous woman was suspected to be a partial mole with a coexistent live fetus in gestational age of 14 weeks because of the partially cystic placenta on ultrasonography examination. She delivered a healthy female vaginally at 36+6 weeks of gestation and the histological examination of placenta established the diagnosis of mesenchymal stem villous dysplasia. We report here an unusual pregnancy.
Diagnosis ; Female ; Fetus ; Gestational Age ; Humans ; Hydatidiform Mole ; Karyotype ; Molar ; Parturition ; Placenta* ; Pregnancy ; Ultrasonography

OBJECTIVES: To evaluate the association of urinary 2-naphthol level and air pollution caused by exposure to smoking, traffic and residential factors. METHODS: The study subjects consisted of 300 university students in Incheon. The questionnaires concerning subject characteristics, smoking amount, traffic, distance between housing and main road, heating and cooking fuel including urinary cotinine levels were checked. RESULTS: There was not any significant association between urinary 2-naphthol level and age, sex, body mass index, distance from mainroad, traffic, heating and cooking fuel. The urinary 2-naphthol level was higher in smokers or high urinary cotinine level group(p=0.0001)than in nonsmokers or low urinary cotinine group. After adjusting for age, sex, and body mass index in the basic model, the 2-naphthol level was also higher in the smokers or high urinary cotinine level group, too(p<0.0005). The model included both traffic and residential variables and it had a good fitness as compared to other models. CONCLUSIONS: It has been known that as one of PAH metabolites, urinary 2-naphthol is a respiration-selective biological marker. We showed that tabacco smoking has a much stronger effects on urinary 2-naphthol levels than when subjects were exposed to air pollution, such as traffic, and other residential factors at the same time.
Air Pollution ; Biological Markers ; Body Mass Index ; Cooking ; Cotinine ; Heating ; Hot Temperature ; Housing ; Humans ; Incheon ; Questionnaires ; Smoke* ; Smoking*

BACKGROUND: High risks of fire alway exist for buildings in urban areas, especially those in downtown. Crowds, as well as more complex and larger structures, may cause more victims in the event of fire; therefore, emergency medical service plans must be established for such disastrous events. METHODS: On the evening of October 30, 1999, a fire broke out in downtown, Dong-Incheon Live-Hof restaurant; 56 people were killed and 76 were injured. Most of them were teenagers. We retrospectively reviewed the medical records of the victims. RESULTS: 1) Among the 56 dead, 54 died from smoke inhalation, one from extensive burns, and one from sepsis during treatment. 2) Among the 76 injured, 70 patients suffered from smoke inhalation, 53 from burns, and 9 from several types of trauma (sprains, contusions, lacerations, abrasions, fractures, etc.). 3) Later complications were laryngeal edema, pulmonary edema, scar contracture, and hypoxic brain damage, and so forth. 4) Post traumatic stress syndrome was unexpectedly more prevalent in mildly to moderately injured survivors and witnesses than in seriously injured survivors. CONCLUSION: Many complications exist after a fire. Some may be resolved in time, but others may result in permanent sequelae. Early rescue, early triage, and early management during transport by emergency medical service (EMS) personnel can result in fewer complications and a lower mortality rate. Therefore, we propose the establishment of plans to be followed during various major disasters.
Adolescent ; Burns ; Cicatrix ; Contracture ; Contusions ; Disasters ; Emergency Medical Services ; Fires* ; Humans ; Hypoxia, Brain ; Inhalation ; Lacerations ; Laryngeal Edema ; Medical Records ; Mortality ; Pulmonary Edema ; Restaurants* ; Retrospective Studies ; Sepsis ; Smoke ; Survivors ; Triage

OBJECT: To analyze the frequency and the types of chromosomal abnormalities in conceptus of spontaneous abortion method: 81 cases of products of conception aborted spontaneously were collected From Nov. 1999 to May, 2004 in the cytogenetic laboratory at Kangnam St. Mary's Hospital, Catholic University Medical College. The cytogenetic results,along with clinical information including gestational age at the time of the miscarriage and maternal age, were compiled in a database. RESULTS: Cytogenetic results were obtained from 76 cases (93.8%), of which 33 cases (43.4%) showed chromosome abnormalities. Of 33 chromosomal abnormalities, 12 cases (36.4%) showed monosomy X, including one case of 46,X,+7 and the other case of 44,X, t(13q14q). Autosomal trisomy was also detected in 12 cases (36.4%). The most frequent autosomal trisomy was that of chromosome 18 (4 cases), which occurred exclusively in old maternal age (37.8+/-7.5 years old). Mosaicism was found in 2 cases. Triploidy was identified in 4 cases. Structural abnormalities were identified in 3 cases. CONCLUSION: This study showed that monosomy X and trisomy were the most common chromosomal abnormalities in spontaneous abortion, and autosomal trisomy was dependant on maternal age.
Abortion, Spontaneous* ; Chromosome Aberrations ; Chromosomes, Human, Pair 18 ; Cytogenetic Analysis* ; Cytogenetics* ; Female ; Fertilization ; Gestational Age ; Humans ; Maternal Age ; Mosaicism ; Pregnancy ; Triploidy ; Trisomy ; Turner Syndrome

Fetal vesicoallantoic cyst is extremely rare anomaly of umbilical cord. This disorder is thought to be a remnant of the extraembryonic portion of the allantois and incomplete obliteration of the vesico-allantoic lumen results in a wide spectrum of urachal anomalies. A 23-years-old primigravida was referred to our hospital at 18 weeks of gestation age because of fetal abdominal cystic mass in basal part of umbilicus. On the ultrasonographic examination, the cystic mass appeared to be in direct communication with the urinary bladder markedly distended. The cytogenetic study by amniocentesis showed normal 46, XY. The fetus was dead at 21 weeks of gestation age. The results of autopsy showed multiple anomalies. We report this rare case with review on similar anomalies of the allantois.
Allantois ; Amniocentesis ; Autopsy ; Cytogenetics ; Fetus ; Pregnancy ; Ultrasonography* ; Umbilical Cord ; Umbilicus ; Urinary Bladder

OBJECTIVE: The aims of the present study were to investigate the women's perspective on influenza infection and vaccination and to evaluate how they influence vaccine acceptability, in Korean women of childbearing age. METHODS: This was a prospective study by random survey of women of childbearing age (20 to 45 years). They were asked to complete a questionnaire assessing their knowledge, attitudes and acceptability of influenza vaccination before and during pregnancy. This study utilized data from the Korea National Health and Nutrition Examination Survey (KNHANES) between 2008 and 2012, to analyze the recent influenza vaccination trends. RESULTS: According to KNHANES (2008-2012), influenza vaccination rates in women of childbearing age have increased up to 26.4%, after 2009. The questionnaire was completed by 308 women. Vaccination rate during pregnancy or planning a pregnancy was 38.6%. The immunization rate increased significantly with the mean number of correct answers (P<0.001). Women who received influenza vaccination were more likely to be previously informed of the recommendations concerning the influenza vaccination before or during pregnancy, received the influenza vaccination in the past, and of the opinion that influenza vaccination is not dangerous during pregnancy, with odds ratios of 14.6 (95% confidence interval [CI], 6.44 to 33.33; P<0.0001), 3.6 (95% CI, 1.84 to 6.97; P=0.0002) and 2.7 (95% CI, 1.34 to 5.47; P=0.0057). CONCLUSION: Influenza vaccination rate in women of childbearing age has increased in this study and national data. More information and recommendation by healthcare workers, especially obstetricians, including safety of vaccination, might be critical for improving vaccination rate in women of childbearing age.
Delivery of Health Care ; Female ; Humans ; Immunization ; Influenza, Human* ; Korea ; Nutrition Surveys ; Odds Ratio ; Pregnancy ; Prospective Studies ; Surveys and Questionnaires ; Vaccination*