Heterotopic pregnancy is the coexistency of intrauterine and extrauterine pregnancy. The incidence of heterotopic pregnancy is about 1 to 30,000 pregnancy in a natural cycle. However, the frequency of heterotopic pregnancy has steadily increased because of rising incidence of pelvic inflammatory disease, pelvic surgery and the development of ovulation induction and assisted reproduction. Because heterotopic pregnancy is difficult to diagnose and it has high morbidity and mortality rate, one should always take this into consideration and should conduct careful and thorough gynecologic evaluation. We have experienced a case of heterotopic pregnancy in a 29-year old woman who presented with acute abdominal pain in a natural cycle and report this case with a brief review of literature.
Abdominal Pain ; Adult ; Female ; Humans ; Incidence ; Mortality ; Ovulation Induction ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Heterotopic* ; Reproduction

Following the introduction of instrumentation for phacoemulsification and vitctomy, many other devices have been deaigned to perform the functions. In the past, there was a serious prblem that fluid flowed from the eye along the path of least resistance and the dutflow rate varied greatly with viscosity and consistency of material in the line. Recently a new computerized instrument the Heslin/Mackool Ocusystem that overcame these flow problems was developed and we studied about early experiences using this new helper. The results were as follows: 1. There was an advantage for time and place due to a single instrument and simple change from E.C.C.E. to vitrectomy. 2. The rupture of posterior capsule in aphakic group and the remained cortical material in pseudophakic group were the most common surgical complications during operation. 3. Descemet's membrane stripping was developed in a high rate due to the sharp titanum-covered cap of the handpiece for phacoemulsification. 4. The posterior capsule opacity was the most common postoperative complication in the group of visual acuity less than 0.5.
Descemet Membrane ; Phacoemulsification* ; Postoperative Complications ; Rupture ; Viscosity ; Visual Acuity ; Vitrectomy*

Carbapenem resistance is a serious clinical and public health threat. Carbapenemase can confer carbapenem resistance, and most carbapenemase genes are plasmid encoded so resistance can easily spread. In this study, we aimed to develop a novel system based on the TaqMan platform for the rapid detection of 6 clinically prevalent carbapenemase genes: Klebsiella pneumoniae carbapenemase, New Delhi metallo-β-lactamase, oxacillinase, imipenem-hydrolyzing, Verona integron-encoded metallo-β-lactamase, and Guiana extended-spectrum β-lactamase.

Purpose: The purpose of this study was to provide high-quality rehabilitation nursing through the analysis of academic big data in domestic rehabilitation nursing and to provide basic data for preparing a plan for supporting families who perform rehabilitation nursing. Methods: This study is a literature review to explore research trends in rehabilitation nursing. We collected quantitative and qualitative data in the educational and academic information database (RISS) defined as the big data, and extracted keywords by the 'rehabilitation', and 'rehabilitation nursing'. The data were analyzed by’R’ Program. Word cloud and social network analysis were performed. Results: In the field of domestic rehabilitation nursing study, the main keywords were patient, stroke, family, old man, depression, stress, and quality of life. As a result of sentiment analysis with the main keywords in domestic rehabilitation nursing, negative emotional words appeared 6 times higher than positive emotional words. Conclusion We suggested that it is also necessary to prepare emotional support plans for patients, family and nurses who are targeted for rehabilitation nursing.

BACKGROUND: Spinal anesthesia for cesarean section is regaining popularity because it can prevent pulmonary aspiration, failure of endotracheal intubation, depression of neonate by anesthetic agent in general anesthesia. Meperidine is unique in having significant local anesthetic properties that differentiate with morphine and fentanyl. Therefore, we compared the effects of adding meperidine 25 mg to intrathecal bupivacaine with fentanyl mixture. METHODS: Sixty parturients were allocated (n = 30 per group) to group 1; 0.5% hyperbaric bupivacaine 7.5 mg plus meperidine 25 mg and group 2; 0.5% hyperbaric bupivacaine 10 mg plus fentanyl 25 microgram in random order. Time to reach T4 sensory level, starting time of surgery, maximal spread of sensory block, incidence of complications, duration of motor block, perioperative analgesic effects, duration of postoperative analgesia were evaluated. We observed Apgar score and umbilical cord blood gas analysis for evaluation of the status of neonate. RESULTS: There were no significant differences in Time to reach T4 sensory level, starting time of surgery, maximal spread of sensory block, incidence of hypotension, perioperative analgesic effects, duration of motor block and neonatal status between two groups. The incidence of intraoperative nausea was greater in group 1 (60%) compared to the group 2 (20%) but the incidence of postoperative nausea and vomiting were not significantly different between two groups. Duration of postoperative analgesia was longer in group 1 (576.4 +/- 197.8 min) compared to the group 2 (192.6 +/- 75.5 min). CONCLUSIONS: Addition of meperidine 25 mg to intrathecal bupivacaine for Cesarean section improves intraoperative analgesia and also provides postoperative analgesia without significant adverse effects on the mother and neonate.
Analgesia ; Anesthesia, General ; Anesthesia, Spinal* ; Apgar Score ; Bupivacaine ; Cesarean Section* ; Depression ; Female ; Fentanyl ; Fetal Blood ; Humans ; Hypotension ; Incidence ; Infant, Newborn ; Intubation, Intratracheal ; Meperidine ; Morphine ; Mothers ; Nausea ; Postoperative Nausea and Vomiting ; Pregnancy

The effects of NMDA-receptor antagonist (MK-801) were assessed for the oxygen free radical mediated brain (hippocampus) injury with eighty rats which were exposed to carbon monoxide (CO) followed by hyperbaric oxygen (HBO) treatment. Superoxide dismutase (SOD) and malondialdehyde (MDA) were used as parameters of the oxygen free radical reaction. Experimental groups consisted of (1) control group (=breathing with air), (2) CO group (=exposed to CO after air breath), (3) CO-air group(exposed to CO after air breath followed by air breath), and (4) CO-HBO group (=exposed to CO after air breath followed by 3 ATA HBO). Each group was divided two subgroup according to the pretreatment (normal saline or MK-801). CO, CO-air and HBO groups increased in SOD activity as compared with control group. And CO-air and HBO groups increased in MDA as compared with control and CO group. Pretreatment of MK-801 decreased SOD activities significantly (p-value<.05) , but MDA amount not significantly (p-value=.107). These results suggest a useful protective effect of NMDA-receptor antagonist (MK-801) in CO induced hippocampal injury mediated by oxygen free radicals.
Animals ; Brain Injuries* ; Brain* ; Carbon Monoxide ; Dizocilpine Maleate ; Free Radicals ; Malondialdehyde ; Oxygen* ; Rats* ; Superoxide Dismutase

Lumber epidural analgesia is a well established method of providing pain relief during labor. Placement of a needle in the epidural space is probably one of the more tephnically demanding procedures which are performed by anesthesiologists. Two-hundred-thirty-four women receiving epidural analgesia during labor were studied. The distance from skin to the epidural space was measured with Portex disposable epidural needle marked at 1 cm intervals. The mean distance was found to be 4.18 cm. There was no correlation between distance from skin to the epidural space and height, hut was signifieant correlation with weight(p<0.001). The epidural depths were identified most frequently at 3 to 4 cm deep and 84.2% of total cases were less than 5 cm deep. This study suggests that, if the epidural space has not been identified within a depth of 6 cm, redirection or reinsertion of the needle should be considered.
Analgesia, Epidural ; Epidural Space* ; Female ; Humans ; Labor Pain ; Needles ; Pregnancy ; Skin*

The distribution of enkephalin, dynorphin, substance P and neurotensin in the periaqueductal gray[PAG] has been well established by immunohistochemical methods. However, there is little information about the regional distribution of these neuropeptide mRNA-containing neurons in the PAG. The present study was undertaken [1] to elucidate the distribution of these neuropeptide mRNA-containing neurons and to determine of the PAG, [2] to know how peptide expression relates to the proposed functional subdivisions of the PAG and [3] to know how neuropeptide mRNA levels in the PAG change following peripheral neuropathy The results obtained are as follows ; 1. Preproenkephalin[pENK] mRNA-containing neurons are found mostly in the ventrolateral portion at all levels of the PAG. 2. Prodynorphin[pDYN] mRNA-containing neurons are concentrated mostly in the ventrolateral portion at the caudal level of the PAG. 3. Preprotachykinin[pTAK] mRNA-containing neurons are localized mainly in the ventrolateral portion at all levels of the PAG. There is small numbers of pTAK mRNA-containing neurons in the dorsolateral and dorsal portion at all levels of the PAG. 4. Proneurotensin[pNT] mRNA-containing neurons are concentrated mostly in the medial part of ventrolateral portion of the caudal and mid PAG. 5. Peripheral neuropathy induces an increase of pNT mRNA levels in the PAG, while pENK, pDYN and pTAK mRNAs levels show no change. The present results indicate that the pENK, pDYN, pTAK or pNT mRNA-containing neurons are found mainly in the ventrolateral PAG, the area where analgesia is most easily produced and that neurotensin in the PAG may play an important role in modulating chronic neuropathic pain.
Analgesia ; Animals ; Dynorphins ; Enkephalins ; Gene Expression* ; In Situ Hybridization ; Neuralgia* ; Neurons* ; Neuropeptides* ; Neurotensin ; Periaqueductal Gray* ; Peripheral Nervous System Diseases ; Rats* ; RNA, Messenger ; Substance P

A complete atrioventricular block is seen in patients due to a variety of causes, including drugs. The resolution of a drug-induced atrioventricular block is often accomplished by drug discontinuation. We report a case of a complete atrioventricular block in a 31-year-old woman following a month of treatment with evening primrose oils. After excluding all other likely causes of conduction disorders, an adverse effect of the evening primrose oils seemed to be the most likely diagnosis. After discontinuation of the oils, no associated symptoms or conduction disturbances were observed for 4 months after discharge. We stress the reconsideration of taking medicines and functional foods continuously as most patients are not aware of the hazards they pose.
Adult ; Atrioventricular Block* ; Diagnosis ; Female ; Functional Food ; Humans ; Oenothera biennis* ; Oils

Ovarian granulosa cell tumor is a uncommon low-grade feminizing malignancy. Its natural history shows slow growth without pain. It often reveals to be very large sized mass when diagnosed, and is confined to the involved ovary in many cases. Complete surgical removal is primary treatment and recurrences thereafter are relatively common. Postoperative adjuvant therapy including reoperation, chemotherapy, radiation therapy or a combination therapy has been used with various degrees of success. We experienced a case of huge ovarian granulosa cell tumor occupying whole abdominal cavity by rapid growth, which is presented with a brief review of corresponding literatures.
Abdominal Cavity ; Drug Therapy ; Female ; Granulosa Cell Tumor* ; Granulosa Cells* ; Natural History ; Ovary* ; Recurrence ; Reoperation