OBJECTIVE: To study the clinical characteristics of ovarian tumors accompanied with pregnancy. METHODS: A review was performed of 310 cases of ovarian tumors surgically resected during pregnancy from January 1990 to December 2001. RESULTS: The incidence of ovarian tumor in pregnancy was one in 181.5 deliveries and that of malignant neoplastic tumor was one in 6,251 deliveries. Among 310 cases undergoing ovarian surgery, tumor-like lesions were 110 cases (35.5%), benign tumors were 191 cases (61.6%), and malignant tumors were 9 cases (0.3%), respectively. One hundred and twenty cases of dermoid cyst (38.7%) occured most frequently, followed by 47 cases of corpus luteal cyst (15.2%), and 40 cases of simple cyst (12.9%). One hundred and ninety nine cases (64.2%) of ovarian tumors were greater than 6 cm in diameter and 189 cases (61%) were preoperatively diagnosed in 1st trimester, and 62 cases (20%) were detected incidentally during cesarean section. In complicated cases, the torsion of ovarian tumor was found in 48 cases (71.6%), the cases of rupture were 16 (23.9%), and misdiagnosed cases as appendicitis were 3 (4.5%). According to outcome of pregnancy, abortions were 19 cases (6.1%), vaginal deliveries were 43 cases (13.9%), and cesarean sections were 169 cases (53.5%). CONCLUSION: Although the incidence of malignant ovarian tumor is low, the overall incidence of ovarian tumor in pregnance is increasing. Because ovarian tumors complicating pregnancy are often entirely unsuspected, careful examination of all pregnant women in early pregnancy must be considered.
Appendicitis ; Cesarean Section ; Dermoid Cyst ; Female ; Humans ; Incidence ; Pregnancy* ; Pregnant Women ; Rupture

Isolated torsion of the fallopian tube is an uncommon event. It is a difficult condition to evaluate clinically before exploration. But once happened, promt surgical intervention may allow for preservation of the tube. Recently we experienced isolated tubal torsion with diagnosed hydrosalpinx, and report it with a brief review of literatures.
Fallopian Tubes ; Female

OBJECTIVE: To investigate the infection rate and clinical importance of Mycoplasma hominis (M. hominis) in comparison with Ureaplasma urealyticum (U. urealyticum) in association with preterm labor and preterm rupture of membranes. METHODS: We included 57 women with preterm labor or preterm rupture of membranes admitted at Kangnam St. Mary Hospital, University of Catholic, from March 2002 to April 2003. Mycoscreen kit (Mycoscreen, international microbio, Paris, France) was used for culture of all specimens. Statistical analysis was done by chi-square test (SPSS). RESULTS: The study subjects included 57 women, 15 of premature rupture of membranes (PROM), 16 of preterm prematurely rupture of membranes (PPROM), and 36 of preterm labor. There were 4 women infected by both M. hominis and U. urealyticum, 21 with single infection by M. hominis, 9 with single infection by U. urealyticum, and 23 with negative results from Mycoscreen test. M. hominis infection was noted on 6 of 15 PROM, 5 of 16 PPROM and 2 of 36 preterm labor. And thus, infection by M. hominis is statistically significant in preterm rupture of membranes group in comparison with preterm group (p=0.038). Among 15 cases with leukocytosis on the Gram stain, 2 cases resulted in bacterial growth on the culture. Therefore, leukocytosis on the Gram stain does not show the infection with M. hominis and U. urealyticum. CONCLUSION: Mycoplasma screening in prenatal care provides the predictable information on preterm labor or low birth weight, and could be useful in predicting preterm rupture of membranes. It is thought that further studies are needed with a large number of samples.
Female ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Leukocytosis ; Mass Screening ; Membranes ; Mycoplasma hominis* ; Mycoplasma* ; Obstetric Labor, Premature* ; Pregnancy ; Prenatal Care ; Rupture ; Ureaplasma urealyticum* ; Ureaplasma*

OBJECTIVE: To investigate the infection rate and clinical importance of Mycoplasma hominis (M. hominis) in comparison with Ureaplasma urealyticum (U. urealyticum) in association with preterm labor and preterm rupture of membranes. METHODS: We included 57 women with preterm labor or preterm rupture of membranes admitted at Kangnam St. Mary Hospital, University of Catholic, from March 2002 to April 2003. Mycoscreen kit (Mycoscreen, international microbio, Paris, France) was used for culture of all specimens. Statistical analysis was done by chi-square test (SPSS). RESULTS: The study subjects included 57 women, 15 of premature rupture of membranes (PROM), 16 of preterm prematurely rupture of membranes (PPROM), and 36 of preterm labor. There were 4 women infected by both M. hominis and U. urealyticum, 21 with single infection by M. hominis, 9 with single infection by U. urealyticum, and 23 with negative results from Mycoscreen test. M. hominis infection was noted on 6 of 15 PROM, 5 of 16 PPROM and 2 of 36 preterm labor. And thus, infection by M. hominis is statistically significant in preterm rupture of membranes group in comparison with preterm group (p=0.038). Among 15 cases with leukocytosis on the Gram stain, 2 cases resulted in bacterial growth on the culture. Therefore, leukocytosis on the Gram stain does not show the infection with M. hominis and U. urealyticum. CONCLUSION: Mycoplasma screening in prenatal care provides the predictable information on preterm labor or low birth weight, and could be useful in predicting preterm rupture of membranes. It is thought that further studies are needed with a large number of samples.
Female ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Leukocytosis ; Mass Screening ; Membranes ; Mycoplasma hominis* ; Mycoplasma* ; Obstetric Labor, Premature* ; Pregnancy ; Prenatal Care ; Rupture ; Ureaplasma urealyticum* ; Ureaplasma*

Malrotation is a congenital anomaly that becomes symptomatic more frequently during infancy. The indication for surgical treatment at that age is straightforward. In older children, the diagnosis may be more difficult because of chronic and vague complaint. The aim of this study is to compare the symptoms, rate of volvulus and surgical findings in children younger and older than one year. A retrospective study of 40 patients in a a single medical center diagnosed with malrotation from April 1996 to May 2010 was performed. There were 20 (50%) boys and 20 (50%) girls. At the time of operation, 27 (67.5%) patients were younger and 13 (32.5%) were older than 1 year. Vomiting was seen in 20 cases (74.1%) of the younger group compared to 2 cases (15.4%) of the older group. Abdominal sonography and upper gastrointestinal series showed a sensitivity of 100%. Operative findings: 12 (44.4%) of the younger group presented with volvulus compared to none of the older group. The Ladd's procedure was routinely performed with appendectomy in all cases and bowel resection was requires when volvulus included bowel necrosis or other anomalies were found. After definite procedures, surgical correction for adhesive obstruction was necessary in 5 menbers (18.5%) of the younger group and 1 patient (7.7%) in the older group. There was 1 death due to respiratory failure and pneumonia. Abdominal pain was more frequent symptom and bilious vomiting was less frequent. Volvulus did not occur in the older group. Malrotation should be diagnosed promptly in children over 1 year of age by upper gastrointestinal series and abdominal ultrasonography even though symptoms are not as clear cut as in infants.
Abdominal Pain ; Adhesives ; Appendectomy ; Child ; Humans ; Infant ; Intestinal Volvulus ; Necrosis ; Pneumonia ; Respiratory Insufficiency ; Retrospective Studies ; Vomiting

Background: Multiple system atrophy (MSA) is a sporadic neurodegenerative disease characterized by various combinations of parkinsonism, cerebellar ataxia, autonomic dysfunction and pyramidal signs. Two clinical subtypes are recognized: MSA with predominant cerebellar ataxia (MSA-C) and MSA with predominant parkinsonism (MSA-P). The aim of this study was to compare pathological features between MSA-C and MSA-P. Methods: Two autopsy confirmed cases with MSA were included from the Pusan National University Hospital Brain Bank. Case 1 had been clinically diagnosed as MSA-C and case 2 as MSA-P. The severity of neuronal loss and gliosis as well as the glial and neuronal cytoplasmic inclusions were semiquantitatively assessed in both striatonigral and olivopontocerebellar regions. Based on the grading system, pathological phenotypes of MSA were classified as striatonigral degeneration (SND) predominant (SND type), olivopontocerebellar degeneration (OPC) predominant (OPC type), or equivalent SND and OPC pathology (SND=OPC type). Results: Both cases showed widespread and abundant α-synuclein positive glial cytoplasmic inclusions in association with neurodegenerative changes in striatonigral or olivopontocerebellar structures, leading to the primary pathological diagnosis of MSA. Primary age-related tauopathy was incidentally found but Lewy bodies were not in both cases. The pathological phenotypes of MSA were MSA-OPC type in case 1 and MSA-SND=OPC type in case 2. Conclusions Our data suggest that clinical phenotypes of MSA reflect the pathological characteristics.

Inguinal hernia is the most common disease treated by the pediatric surgeon. There are several controversial aspects of management 1)the optimal timing of surgical repair, especially for preterm babies, 2)contralateral groin exploration during repair of a clinically unilateral hernia, 3)use of laparoscope in contralateral groin exploration, 4)timing of surgical repair of cord hydrocele, 5)perioperative pain control, 6)perioperative management of anemia. In this survey, we attempted to determine the approach of members of KAPS to these aspects of hernia treatment. A questionnaire by e-mail or FAX was sent to all members. The content of the questionnaire were adapted from the "American Academy of Pediatrics (AAP) Section on Surgery hernia survey revisited (J Pediatr Surg 40, 1009-1014, 2005)". For full-term male baby, most surgeons (85.7 %) perform an elective operation as soon as diagnosis was made. For reducible hernia found in ex-preterm infants already discharged from the neonatal intensive care unit (NICU), 76.2 % of surgeons performed an elective repair under general anesthesia (85.8 %). 42.9 % of the surgeons performed the repair just before discharge. For same-day surgery for the ex-premature baby, the opinion was evenly divided. For an inguinal hernia with a contralateral undescended testis in a preterm baby, 61.9 % of surgeons choose to 'wait and see' until 12 month of age. The most important consideration in deciding the timing of surgery of inguinal hernia in preterm baby was the existence of bronchopulmonary dysplasia (82.4 %), episode of apnea/bradycardia on home monitoring (70.6 %). Most surgeons do not explore the contralateral groin during unilateral hernia repair. Laparoscope has not been tried. Most surgeons do not give perioperative analgesics or blood transfusion.
Analgesics ; Anemia ; Anesthesia, General ; Blood Transfusion ; Bronchopulmonary Dysplasia ; Child* ; Cryptorchidism ; Diagnosis ; Electronic Mail ; Groin ; Hernia ; Hernia, Inguinal* ; Herniorrhaphy ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Korea* ; Laparoscopes ; Male ; Pediatrics ; Surveys and Questionnaires

The phosphorylated 43-kDa transactive response DNA-binding protein (TDP-43) was identified as a major disease protein in sporadic amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration. We present a case with progressive muscle weakness who was diagnosed with sporadic ALS. On postmortem examination, TDP-43 immunoreactive neuronal cytoplasmic inclusions were noted in motor cortex, hippocampus and anterior horns of spinal cord, which was compatible with ALS-TDP, stage 4. This is the first documented autopsy-confirmed ALS case with ALS-TDP pathology in Korea.