Over the past 30 years, there has been an increase in the incidence of multifetal pregna-ncies, primarily because of the introduction of ovarian stimulants for ovulation induction and assisted reproductive technology ( ART ) in infertile patients. It is well established that multifetal pregnancies are associated with an increased frequency of the maternal complications and gre-ater perinatal morbidity and mortyality. The adverse outcome of multifetal pregnancies is dire-ctly proportional to the number of fetuses, primarily as an consequence of prterm delivery. Re-duction in the number of fetuses in multifetal pregnancies has been proposed as a way to impr-ove the perinatal outcome in this situation. Therefore, selective fetal reduction ( SFR ) is sugges-ted as a therapeutic option for continuation of pregnancy with fetuses mature enough to survi-ve. In this paper, we report our infertility clinic experiences with 6 patients who carried mult- ifetal pregnancies including 1 quintuplet, 1 quadruplet, and 4 triplets. from January, 1991 to May, 1996, transabdominal SFR was accomplished by fetal intrathoracic KCl injection at 9~10 weeks of gestation. After the prcedure, 4 patients remained as twin pregnancies, and 2 patients as single pregnancy. There have been 3 sets of twin deliveries and the 2 sets of single delivery. One case was aborted. Two patients were delivered after 37 weeks of gestation, 2 patients were at 35 weeks, and 1 patient at 24 weeks. All babies have been healthy after birth in patients after 35 weeks gestation. There was no fetal anomaly related to the procedure in the 6 cases. We concluded that transabdominal SFR is a rather safe and useful procedure that may improve the outcome of multifetal pregnancies.
Fetus ; Humans ; Incidence ; Infertility ; Ovulation Induction ; Parturition ; Pregnancy Reduction, Multifetal* ; Pregnancy* ; Pregnancy, Twin ; Quadruplets ; Quintuplets ; Reproductive Techniques, Assisted ; Triplets ; Twins

Malignant acanthosis nigricans is very rare disease. The disease is related with internal malignancy, especially gastrointestinal tract malignancy. Reported occurrence rate of malignant acanthosis nigricans associated internal malignancies are 64% of stomach adenocarcinoma, 27% of other organs of abdomen (liver, gall bladder, small intestine, rectum, uterus, ovary), 9% of non-abdominal organs(breast, lung). We report a case of malignant acanthosis nigricans associated with stomach adenocarcinoma from 20-year-old female and discuss review of literature on a acanthosis nigricans briefly.
Female ; Humans ; Adenocarcinoma

No abstract available.

BACKGROUND: An epidemiologic study was performed after the outbreak of carbapenem-resistant Acinetobacter baumannii (CRAB) in the medical intensive care unit (MICU) from December 2006 to May 2007. METHODS: A retrospective case-control study was performed using the medical records of the patients. The case and control patients were compared for age, gender, total length of stay in MICU, prior carbapenem use, Acute Physiology and Chronic Health Evaluation II (APACH II) score, presence of central line, effect of mechanical ventilation, and sputum suction. Environmental and hand-washing studies were performed during the outbreak. RESULTS: Ten CRAB-affected patients and 29 controls were enrolled in this study. Univariate analysis showed that the age, total length of stay in MICU, presence of central line, and prior carbapenem use were associated with the CRAB outbreak. However, multivariate analysis showed that only prior carbapenem use was associated with the CRAB outbreak (odd ratio: 8.67, P=0.01). The outbreak disappeared after implementing a combined infection control strategy, including the sequential disinfection of MICU and strict compliance with cross-transmission prevention protocols. CONCLUSION: The use of carbapenem was associated with an increased risk of CRAB infection. This study suggests that the MICU contamination and infection transmission by health-care workers played a major role in the CRAB outbreak. Novel strategies such as restricted use of broad-spectrum antibiotics, strict hand hygiene, strict isolation of the patients, and MICU disinfection may be required to prevent the CRAB outbreak.
Acinetobacter ; Acinetobacter baumannii ; Anti-Bacterial Agents ; APACHE ; Case-Control Studies ; Compliance ; Disease Transmission, Infectious ; Disinfection ; Epidemiologic Studies ; Hand Hygiene ; Humans ; Infection Control ; Critical Care ; Intensive Care Units ; Length of Stay ; Medical Records ; Multivariate Analysis ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Sputum ; Suction

The primary malignant melanoma of the nasal cavity and paranasal sinuses is extremely rare and accounts for only between 0.6 and 2.5% of the total number of malignant melanoma at all sites. In the nose, the left side is involved in 60% of cases and the most frequent site is the septum followed by the inferior and middle turbinates. In the sinuses, the maxillary sinus is the site of origin 80% of cases, followed by ethmoid sinus. The tumors are sessile or polypoid, with variable color such as pink, white, brown or blank. Of all tumors, 10-30% are amelanotic, requiring special stains for melanin. When primary site of melanoma is mucosal origin, treatment of primary lesion is often hampered by anatomic restrictions and large size, which results from the delayed diagnosis caused by their location. We report 4 cases of primary malignant melanoma of nasal cavity with review of literature.
Coloring Agents ; Delayed Diagnosis ; Ethmoid Sinus ; Maxillary Sinus ; Melanins ; Melanoma* ; Nasal Cavity* ; Nose ; Paranasal Sinuses ; Turbinates

No abstract available.
Larva ; Tick Bites*

No abstract available.
Electrodes* ; Humans ; Infant, Newborn*

No abstract available.
Albuterol* ; Humans ; Infant* ; Ultrasonics*

This is a case report of a cystic hygroma with polycystic kidney in a fetus which was suspected by ultrasonography and was confirmed by autopsy. Recently, we have experienced this case in 25-year old woman repeatedly and we report that with a brief review of relevant literature.
Adult ; Autopsy ; Female ; Fetus ; Humans ; Lymphangioma, Cystic* ; Polycystic Kidney Diseases* ; Ultrasonography

No abstract available.
Compliance* ; Humans