Recurrent ectopic pregnancy of cesarean scar is very rare and its therapeutic management is still not established. We reported the first case of recurrent cesarean scar pregnancy that was successfully treated with concomitant intra-gestational sac methotrexate-potassium chloride injection and systemic methotrexate injection. This case study provides physicians with a safe and effective minimally invasive treatment option for recurrent cesarean scar pregnancy.
Cicatrix* ; Female ; Methotrexate* ; Potassium Chloride ; Pregnancy* ; Pregnancy, Ectopic

No abstract available.
Arteries* ; Hemorrhage* ; Ligation*

Three cases of synchronous carcinomas of endometrium-fallopian tube, endometrium-cervix and endometrium-ovary are reported. Case 1 is endometrial endometrioid adenocarcinoma with FIGO stageIb, Grade 2 and tubal serous adenocarcinoma with FIGO stage Ib, Grade 2. Case 2 is endometrial serous carcinoma with FIGO stage Ilb and squamous cell carcinoma with FIGO stage Ial. Case 3 is endometrial endometrioid adenocarcinoma with FIGO stage Ia, Grade 1 and ovarian mucinous adenocarcinoma with FIGO stage IIIa, Grade 2. There is much confroversy with respect to staging and management of such cases since these tumors may represent either two synchronously occuring primaries or single primary with metastases. It is suggested that when each tumor is different histological subtype the tumors may be considered as two separate primaries and treatment may be less aggressive. It may be a favorable prognosis. The authors present three cases of synchronous carcinomas with a review of literature.
Adenocarcinoma ; Adenocarcinoma, Mucinous ; Carcinoma, Endometrioid ; Carcinoma, Squamous Cell ; Neoplasm Metastasis ; Prognosis

The occurrence of a trigeminal neuropathy associated with connective tissue disease is rare. Trigeminal neuropathy in connective tissue disease is predominantly sensory and it is characterized by numbness, hypesthesia, slurred speech, and touch pain. Although the pathogenesis of trigeminal neuropathy associated with connective tissue disease remains obscure, the main pathologic findings are vasculitis and neuritis. A case of trigeminal neuropathy associated with mixed connective tissue disease is described, and the incidence, symptoms, pathophysiology, treatment of the disease is discussed.
Connective Tissue Diseases ; Hypesthesia ; Incidence ; Mixed Connective Tissue Disease* ; Neuritis ; Trigeminal Nerve Diseases* ; Vasculitis

BACKGROUND: Skin contact with, and the breathing in of air containing silver compounds can occur in the workplace. Occupational exposure to silver and its compounds is mainly via airborne dust, metal fumes, and mists of solutions containing silver compounds. Argyria results from increased serum silver levels and the deposition of silver-containing particles in the dermis and mucous membranes. The author reports a patient with generalized argyria, who worked on the manufacture of cellular phone cases. CASE REPORT: The patient was a 30 year-old male, with extensive blue-gray discoloration of the whole body, especially sun-exposed area, of 3 years duration. He had been exposed to silver in the processing of EMI for the past 4 years and gaskets for 1 year. EMI is the process by which the internal electromagnetic wave in cellular phone cases are shielded, and gaskets play an important role in shielding the electric clashes between electronic circuits, as well as increasing the durability of cellular phone cases to impact. EMI had been processed manually but this was changed to automatic spraying by robots in 2003. On physical examination, the patient had diffuse blue-gray discoloration of the skin, which was most prominent in the sun-exposed areas of his face, neck and V of the chest. Histopathological examination of a punch biopsy specimen from the posterior neck revealed fine, minute, round, and brown-black granules deposited in the basement membrane zone surrounding the eccrine glands. The laboratory findings were positive for hepatitis B antigen, with a serum silver concentration of 150.3 ppb. From this evidence, he was diagnosed with argyria due to silver exposure. DISCUSSION: The author reports a case of occupational systemic argyria due to inhalation exposure of silver compounds.
Adult ; Argyria* ; Basement Membrane ; Biopsy ; Cellular Phone* ; Dermis ; Dust ; Eccrine Glands ; Electromagnetic Radiation ; Hepatitis B ; Humans ; Hyperpigmentation ; Inhalation Exposure ; Male ; Mucous Membrane ; Neck ; Occupational Exposure ; Physical Examination ; Respiration ; Silver Compounds ; Silver* ; Skin ; Thorax

BACKGROUND: Infections and vascular disorders are the two most widely accepted probable causes of sudden hearing loss. Tumor necrosis factor alpha (TNF-alpha) is major pro-inflammatory cytokine that is thought to be important in the pathogenesis of sudden deafness. However, the functions of genetic polymorphism in this cytokine have not been throughly examined in the context of sudden deafness pathology. In an effort to discover polymorphism in genes whose variants have been implicated in sudden deafness phenotypes, we examined the genetic effects of TNF-alpha polymorphisms in Koreans with sudden deafness. METHODS: Two common single nucleotide polymorphism (SNP) in TNF-alpha gene were genotyped in a Korean sudden deafness. Ninety nine patients with sudden deafness (45 males and 54 females) were selected from Keimyung University Dongsan Medical Center. The control subjects consisted of healthy 285 males and 319 females. RESULTS: Human genomic DNA was extracted from peripheral blood sample. The SNP at position -863 C/A and -857 C/T of TNF-alpha promoter were analyzed by PCR and pyrosequencing. Genotype distribution and allele frquencies in subjects were in Hardy-Weinberg equilibrium (p>0.05). No significant association was found between TNF-alpha -863 C/A and -857 C/T polymorphism and sudden deafness. We examined whether the relation between TNF-alpha polymorphism and sudden deafness varied according to tinnitus. Statistical analysis of TNF-alpha polymorphism at -857 C/T showed that there was a significant difference between SD without tinnitus and the control in both genotype distribution (p<0.05) and allele frequency [OR (95% CI)=2.63 (1.29-5.34)], but not between SD with tinnitus. CONCLUSION: These findings suggest TNF-alpha polymorphisms at -863C/A, -857 C/T are likely to play a role in SD.
Alleles ; DNA ; Female ; Gene Frequency ; Genotype ; Hearing Loss, Sudden* ; Humans ; Male ; Pathology ; Phenotype ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide* ; Tinnitus ; Tumor Necrosis Factor-alpha*

Four cases of primary transitional cell carcinoma (TCC) arising in the ovary (3 cases) and the parovarium (1 case) were collected for clinicopathologic analysis. The mean age was 46.2 years (range, 39-57 years). Two patients complained abdominal discomfort and vaginal discharge, respectively. Other 2 cases were incidentally found from routine check. Grossly, the tumors were solid and cystic (2 cases), solid (1 case) and surface papillary growth on capsule (1 case). Microscopically, the tumor showed almostly same to the histologic features of TCC of urinary bladder. Three cases were pure TCC, and one was mixed TCC and serous carcinoma. FIGO stage were 1 IIa, 2 IIc, and 1 IIIc. Treatment was surgery with adjuvant chemotherapy. Two patients are alive with no evidence of disease, and two have lung or brain metastasis.
Brain ; Carcinoma, Transitional Cell* ; Chemotherapy, Adjuvant ; Female ; Humans ; Lung ; Neoplasm Metastasis ; Ovary ; Urinary Bladder ; Vaginal Discharge

Comparative Genomic Hybridization (CGH) is a recently developed molecular cytogenetic technique, which makes it possible to detect chromosomal alteration in solid tumors. To determine whether chromosome alterations are related to cervical carcinoma, we have analyzed 33 cases (24 squamous cell carcinomas and 9 adenocarcinomas, stage Ib-IIIb) from tumor tissues and paraffin embedded tissues by CGH. The cut off value of CGH profiles was 1.15 and 0.85 (green/red ratio). Chromosomal aberrations were detected in 30 out of 33 cases (90.9%). In 32 cases, chromosome 3q was most frequently affected and had greater copy numbers in 20 of tbe 33 cases (60.6%). Interestingly, out of those 20 cases, 10 cases were shown to have a high-level of amplification of chr 3q. In addition to chr 3q, chromosomal gains were observed in chr 1q, 1p, 5p, Sq, 12p, 15q, 19q, 20q, Xp, and Xq. Furthermore chromosomal loss was detected, most commonly in chromosome 11q (11/33). Although less frequent, common losses were also detected in chr 2q, 4p, 4q, Sq, 1 1p, 17p, and 18p. In addition, there were cases of gross chromosome loss for chr 4, 6, 10, 11, 13, 14, 16, 17, 18, 19, 20, 21, 22 and X. In cases involving whole arm deletion, we utilized fluorescence in situ hybridization (FISH) using specific probes a-satellite. We performed HPV typing for 16 and 18 usiag polymerase chain reaction (PCR) and Southem blot analyses. Out of 33 tumor samples, 24 cases (72,7%) were HPV 16 positive, while only 6 cases were positive for HPV 18. two cases were positive for both HPV 16 and 18. We believe that a gain of chromosome 3q as a reeurrent chromosomal aberration may contribute to the tumorigenesis of cervical cancer. However, we could not correlate a pattern of chromosomal aberration with tumor stage or histologic type in cervical cancer.
Adenocarcinoma ; Arm ; Carcinogenesis ; Carcinoma, Squamous Cell ; Chromosome Aberrations ; Comparative Genomic Hybridization* ; Cytogenetic Analysis ; Fluorescence ; Human papillomavirus 16 ; Human papillomavirus 18 ; In Situ Hybridization ; Paraffin ; Polymerase Chain Reaction ; Uterine Cervical Neoplasms

A two-month-old baby had acholic stool, neonatal hyperbilirubinemia and congenital heart disease. Atresia of the hepatic duct was confirmed by open cholangiography, which showed a non-opacified intrahepatic bile duct. Liver biopsy and the Kasai operation were performed. Because the liver biopsy pathology revealed a paucity of intrahepatic bile ducts, the patient was diagnosed with the Alagille syndrome. We report the case of an infant diagnosed with the Alagille syndrome with atresia of the hepatic duct.
Alagille Syndrome ; Bile Ducts, Intrahepatic ; Biopsy ; Cholangiography ; Heart Diseases ; Hepatic Duct, Common ; Humans ; Hyperbilirubinemia, Neonatal ; Infant ; Liver

OBJECTIVE: For evaluation of prevention program for neonatal vertical transmission from HBsAg positive mother in Korea METHODS: From January 15th to February 15th 2003, the status of neonatal vaccination, immunoglobuline injection and breast feeding of HBsAg positive mother was evaluated by using mailed questionnaire in 848 hostpitals with more than 100 deliveries in the year of 2001. 341 out of 848 (40.2%) hospitals returned questionnaires. RESULTS: 91.9% of total hospital reported that the vaccination of hepatitis B and immunoglobulin injection was done within 12 hours after birth in more than 90% of neonate. The most commonly used vaccine type was 0-1-6 method. In case of unknown result of HBsAg/ HBsAb in mother, 84.4% of hospitals delayed immunoglobulin injection until complete report, however 63% of hospitals gave hepatitis vaccine without delay before complete result. The breast feeding of HBsAg positive mother was recommended according to the result of HBeAg in 66.3% of hospitals while 24.9% of hospitals recommend breast feeding. CONCLUSION: Most hospitals in Korea reported that vaccination of Hepatitis B and immunoglobulin injection was done within 12 hours after in over 90% of neonate whose mother was HBsAg Positive. But continuous education and careful monitoring are required for injection method and vaccination policy in neonates of mothers with unknown result of HBsAg/HBsAb of mother.
Breast Feeding ; Education ; Hepatitis ; Hepatitis B ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens* ; Humans ; Immunoglobulins ; Infant, Newborn ; Korea* ; Mothers* ; Parturition ; Postal Service ; Surveys and Questionnaire ; Vaccination