The incidence of ectopic pregnancy is a marked increase in both the absolute number and rate in recent years. But dramatic decrease in death from ectopic pregnancies probably due to improved diagnosis and management. The aim of the study was to investigate the effect of intramuscular Methotrexate(MTX) injection on the treatment of ectopic pregnancy. The method of the study was made by the retrospective clinical observations on the 32 cases of unruptured ectopic pregnancies in Chung Goo Sung Sim hospital, department of Obstetrics & Gynecology. The results were as follows: 1) The most frequent age group was 25-29 year group(37.5%). 2) Nullipara was 31.3% and the case who experienced artificial abortion was 75%. 3) A previous history of abdominal or pelvic surgery was in 40.6% and pelvic inflammatory in 6.3%. 4) The mean ectopic gestational week was 6.4 weeks, 5) On symptomatological analysis, lower abdominal pain was encounted 53.1%, vaginal spotting was 40.6%. 6) The resolution of patients was obtained in 29 cases(90.6%)of 32 unruptured tubal pregnancies with intramuscular methotrexate treatment. 7) The mean resolution duration was 23.8 days. 8) The side effects of methotrexate were observed in 10 cases(31.2%)of 32 unruptured tubal pregnancies, but the severity of symptoms was mild. Consequently, tveatment by intramuscular injection of MTX expects to be one of the therapies alternating to surgery. However success rate remained 90.6% with and toxicity rate 31.2% with MTX injection. Therefore patients selection criteria and MTX dosage adjustment are more stricdy required for rising success rate and avoidance of toxic complication.
Abdominal Pain ; Diagnosis ; Female ; Gynecology ; Humans ; Incidence ; Injections, Intramuscular ; Methotrexate* ; Metrorrhagia ; Obstetrics ; Patient Selection ; Pregnancy ; Pregnancy, Ectopic* ; Pregnancy, Tubal ; Retrospective Studies

BACKGROUND: Stellate ganglion block (SGB) is known to increase blood flow to the innervations area of the stellate ganglion. Near infrared spectroscopy reflects an increased blood volume and allows continuous, non-invasive, and bedside monitoring of regional cerebral oxygen saturation (rSO2). We investigated the influence of SGB on bilateral cerebral oxygenation using a near infrared spectroscopy. METHODS: SGB was performed on 30 patients with 1% lidocaine 10 ml using a paratracheal technique at the C6 level and confirmed by the presence of Horner's syndrome. The blood pressure (BP), heart rate (HR) and rSO2 were measured before SGB and 5, 10, 15 and 20 minutes after SGB. Tympanic temperature of each ear was measured prior to SGB and 20 minutes after SGB. RESULTS: The increments of the rSO2 on the block side from the baseline were statistically significant at 5, 10, 15 and 20 minutes. The rSO2 on the non-block side compared with the baseline, however, decreased at 15 and 20 minutes. The difference between the block and the non-block sides was significant at 15 and 20 minutes. The BP at 10, 15 and 20 minutes was increased and the HR was increased at 10 and 15 minutes. CONCLUSIONS: We observed an increment of the rSO2 on the block side from the baseline; however, the rSO2 on the non-block side decreased.
Blood Pressure ; Blood Volume ; Ear ; Heart Rate ; Horner Syndrome ; Humans ; Lidocaine ; Oxygen ; Spectrum Analysis ; Stellate Ganglion

Morphological changes of the kidney after ESWL in 130 patients are analyzed with CT at Dept. of Urology, Chung-Ang University Hospital from March 1987 to May 1987. Of 130 patients, 9 patients(6.9%) showed renal hematoma. Among 9 patients, 5 patients (3.8%) had subcapsular hematoma and 4 patients(3.1%) had parenchymal hematoma. We analyzed these 9 patients radiologically and clinically. These hematoma were clinically insignificant and self-limited in all cases. So ESWL can be regarded as a safe modality for treatment of the renal and ureteral calculi.
Hematoma* ; Humans ; Kidney ; Shock* ; Ureteral Calculi ; Urology

High dose intravenous methyl prednisolone was administered to patients with multiple sclerosis (4), transverse myelitis (6), and arachnoiditis (I). Almost complete remission was noted in 5 cases (4 with transverse myelitis and one with multiple sclerosis) and partial improvement in 3 patients (2 with multiple sclerosis and I with arachnoiditis ) within 3 days after therapy. The benefits of this therapy, however, was not that dramatic when started late after the onset of neurologic deficits.
Arachnoid ; Arachnoiditis ; Humans ; Multiple Sclerosis ; Myelitis, Transverse ; Neurologic Manifestations ; Prednisolone

Electrodiagnostic studies were carried out in 4 patients with neurological complications of acute hemorrhatic conjunctivitis at Severance Hospital on 1983. Both motor and sensory nerve conduction studies were normal even in the involved limbs. The electromyography, however, reveals denervation potentials and neuropathic MUPs. The somatosensory evoked potentials taken in median nerve stimulated at the wrist and peroneal nerve stimulated around the knee showed normal latencies, shapes and amplitudes almost symmetrically.
Adult* ; Conjunctivitis ; Conjunctivitis, Acute Hemorrhagic* ; Denervation ; Electromyography ; Evoked Potentials, Somatosensory* ; Extremities ; Humans ; Knee ; Median Nerve ; Neural Conduction ; Peroneal Nerve ; Wrist

Primary germ cell tumor of the testis is rare, which occupies 1 to 2% of all reported malignant male neoplasms. Combined primary germ cell tumor of the testis composed of embryonal carcinoma and seminoma is more rare tumor. The authors experienced a case of 50-year old male who presented with painless enlargement of right testicle. He has had radical orchiectomy and diagnosed by pathologically as combined germ cell tumor of testis. The testicle is measuring 180 gm in weight and 9×6×5 cm in dimension, and almostly replaced by tumor mass. Grossly the tumor is rubbery solid smooth tumor mass, with variegated cut surface with geographically outlined diffuse necrotic area. Histologically the tumor is composed of two components of tumor, which are solid growth pattern of large round to polyhedral cells with clear or granular cytoplasm and distinct cell border, and anastomosing glandular and papillary arrangement of anaplastic epithelial cells. The former corresponds to seminoma, and the latter to embryonal carcinoma. Each tumor lobule is separated by abundant fibrous stroma.
Carcinoma, Embryonal ; Cytoplasm ; Epithelial Cells ; Germ Cells* ; Humans ; Male ; Neoplasms, Germ Cell and Embryonal* ; Orchiectomy ; Seminoma ; Testis*

Vertigo, a definite rotational sensation, consists of a variety of syndromes. The purpose of this study was to accumulate information on various aspects of vertigo or dizziness. We performed a retrospective study about vertigo patients, who had admitted to our hospital for recent 2 years. From January 1994 to December 1995, 214 patients with the complaints of 'vertigo' and 'dizziness', who admitted to the department of Neurology, Ewha Womans University Hospital, were accepted for this study. All data were recorded on computer-oriented questionnaires in digital forms. The study forms consisted of five parts; (1) history and associated symptoms, (2) physical, neurologic and bedside examinations, (3) laboratory and brain imaging studies, (4) special tests including brainstem auditory evoked potentials and (5) clinical diagnosis. Of these 214 patients, secure diagnosis could be made in 186 patients or 86.9%. Of these, 92 patients had peripheral causes of vertigo, and 94 had central causes. Vestibular disorders accounted for the largest proportion of complaints of vertigo(48/92 or 52%). Of 94 patients with central causes of vertigo, vertebrobasilar insufficiency was the leading cause(25/94 or 27%). The most common site of the brain lesion proved by MRI was cerebellum(23/94 or 25%). BAEP study revealed abnormal findings in 6 cases of the 16 patients with central causes. This study not only offered a clinical information about vertigo, but also could be beneficial for further researches.
Brain ; Diagnosis ; Dizziness ; Evoked Potentials, Auditory, Brain Stem ; Female ; Humans ; Magnetic Resonance Imaging ; Neuroimaging ; Neurology ; Surveys and Questionnaires ; Retrospective Studies ; Sensation ; Vertebrobasilar Insufficiency ; Vertigo

Necrotizing enterocolitis (NEC) is a devastating condition of hospitalized preterm infants. Numerous studies have attempted to identify the cause of NEC by examining the immunological features associated with pathogenic microorganisms. No single organism has proven responsible for the disease; however, immunological studies are now focused on the microbiome. Recent research has investigated the numerous bacterial species residing in the body and their role in diseases in preterm infants. The timing of initial microbial colonization is a subject of interest. The microbiome appears to transfer from the mother to the newborn, as well as to the fetus. Cross-talk between the fetus and fetal microbiome takes place continuously to generate a unique immune system. This review examined the transfer of the microbiome to the human fetus, and its potential relationship with NEC.
Colon ; Enterocolitis, Necrotizing* ; Fetus ; Humans ; Immune System ; Infant, Newborn ; Infant, Premature* ; Microbiota* ; Mothers

BACKGROUND: The ligation of the unilateral common carotid artery (CCA) in the gerbil has been known as an ischemic animal model showing various changes including selective neuronal necrosis as well as infarction. This study was performed to analyze the short and long term morphological changes of transient unilateral forebrain ischemia with special attention to astroglial proliferation. METHODS: 67 mongolian gerbils were subjected to 2 hr, 3 hr, 4 hr, or 5 hr of forebrain ischemia by the unilateral CCA ligation method. Each of the ischemic groups were examined after a 1 day, 3 day, or 7 day period of reperfusion. Long term reperfusion groups consisted of 2, 3, and 4 weeks of reperfusion after 5hr of unilateral CCA ligation. Morphological changes were analyzed by H-E staining and an immunohistochemical reaction with GFAP antibody. RESULTS: The ligation of the unilateral CCA, induced unilateral hemispheric infarction in 14 gerbils, selective neuronal necrosis (SNN) involving caudate in 1 gerbil, and delayed neuronal necrosis (DND) of the hippocampal CA1 neurons in 2 gerbils. Infarction was most frequent in 1 day reperfusion groups and did not show any differences according to the duration of ischemia. The GFAP reaction was strongly positive in the center of infarction at a 1 day period and negative at a 3 & 7 day period. The surrounding brain parenchyme progressively revealed increased positive reactions. Gerbils with SNN and DND showed moderately or markedly increased GFAP positive reactions in the unilateral caudate, thalamus, and hippocampus, whereas no apparent changes were shown by a H-E stain. CONCLUSIONS: Reactive astrogliosis is a stereotyped reaction of ischemic brain injury and is a more sensitive parameter than neuronal changes.
Brain ; Brain Injuries ; Carotid Artery, Common* ; Gerbillinae* ; Hippocampus ; Infarction ; Ischemia ; Ligation* ; Models, Animal ; Necrosis ; Neurons ; Prosencephalon ; Reperfusion ; Thalamus

This case report describes a patient with semipedunclated granuylar cell tumor(granular cell myoblastoma) of the proximal ascending colon removed by endoscopic polypectomy. A 39-year old femalie was visited to our hospital for intermittent abdominal pain and loose stool. Colonoscopic examination showed a semipedunclated lesion covered with yellowish white smooth mucosa in the proximal ascending colon. The tumor was removed by endoscopic polypectomy. The collected specimen was 0.9x0.8 cm in size. The cut surface of the specimen showed a white round firm tumor covered with mormal epithelium of the colon. Using immunohistochemical study, the tumor cells were to be positively stained by S-100 protein and negatively stained by desmin, which supports the concept of the Schwann cell origin of granular cell tumor. In Korea, 2 cases of granular cell tumor of the colon and rectum, which were treated by surgical removal, have been reported. This case in the first endoscopic polypectomy of granular cell tumor of the colon and retum in Korea. The endoscopic polypectomy is thought to be useful for the therapy of small pedunclated or semipedunclated granular cell tumor, intracolonic type.
Abdominal Pain ; Adult ; Colon ; Colon, Ascending* ; Desmin ; Epithelium ; Granular Cell Tumor* ; Humans ; Korea ; Mucous Membrane ; Rectum ; S100 Proteins