A 36-year old Korean woman consulted a clinic for a regular gynecological examination, and a mass was noticed in her pelvis. She was referred to the Asan Medical Center, Seoul where transvaginal ultrasonography confirmed a pelvic mass exceeding 10 cm in diameter. She received total abdominal hysterectomy and bilateral salpingoophorectomy, and a borderline serous neoplasm with micropapillary features involving the left ovary and right ovarian serosa was histopathologically confirmed. In addition, a section of a nematode with numerous eggs was found in the parenchyma of the left ovary. The worm had degenerated but the eggs were well-preserved and were identified as those of Enterobius vermicularis. She is an incidentally recognized case of ovarian enterobiasis.
Adult ; Animals ; Enterobiasis/diagnosis/*parasitology/pathology ; Enterobius/isolation & purification ; Female ; Human ; Korea ; Ovarian Diseases/diagnosis/*parasitology/pathology ; Ovary/parasitology ; Parasite Egg Count

Leventhal, et al. described a preoperative scoring system for myasthenic patients undergoing transsternal thymectomy, which includes four key risk factors. There were : 1) duration of myasthenia gravis greater than 6 years (12 points); 2) a history of chronic respiratory disease not due to myasthenia gravis(10 points); 3) a dose of pyridostigmine greater than 750mg per day 48 hours before operation (8 points); 4) a preoperative vital capacity less than 2.9L(4 points). Thirty-seven patients with myasthenia gravis undergoing transsternal thymectomy under general inhalation anesthesia with or without muscle relaxants were applied to scoring system by leventhal, et al. retrospectively. The predicitive score was assessed for each patient and the duration of postoperative mechanical ventilation was also noted for each patient. in this study, there was correct in 23/37(62.2%) of the cases, with 9 out of 27 being incorrectly predicted to be ready for tracheal extubation(false positive) and 5 out of 10 being incorrectly predicted to need ventilation(false positve). In conclusion, the scoring system proposed by leventhal, et al. may be some value in predicting whether or not a particular myasthenic patient was likely to need mechanical ventilation following transsternal thymectomy.
Anesthesia, Inhalation ; Humans ; Myasthenia Gravis* ; Pyridostigmine Bromide ; Respiration, Artificial* ; Retrospective Studies ; Risk Factors ; Thymectomy* ; Ventilation ; Vital Capacity

Concern about body weight among adolescents is too much, so distorted body images and weight control are serious problems among Korean girl students. This study was carried out to investigate perception of body images, weight control, food habits and eating behavior of 237 high school girl students in Seoul and Incheon. The subjects were divided into four groups based on Body Mass Index (BMI)-under weight (21.3%), normal (62.6%), over weight (8.1%) and obesity (8.1%). The survey was conducted from June to July 2005. The mean weight, length and BMI of the subjects was 53.4 +/- 7.4 g, 101 +/- 4.8 cm, and 20.6 +/- 2.7, respectively. 56% of the under weight group and 40.8% of normal group had incorrect perception about their body images and 28.5% of the under weight group and 76.9% of the normal group had dissatisfaction about their body images. Most of the students were concerned about their body images and weight control. Dietary habit scores showed significant differences among the groups. These results suggested that effective nutritional programs should be developed including correct perception of body image and good dietary habits.
Adolescent ; Body Image* ; Body Mass Index ; Body Weight ; Feeding Behavior ; Female* ; Food Habits* ; Humans ; Incheon ; Obesity ; Seoul

Vascularized fibular graft is one of the treatment option for avascular necrosis of femoral head (ANFH) and has been known as providing a strut mechanical support and new vascular bed. It is very important to evaluate a healing process in femoral head after vascularization procedure. But a plain radiographic finding has a problem to assess pathological changes of ANFH treated with vascularized fibular graft. Authors analyzed chronogical changes of Tc-99m-HDP bone scan in 31 cases of ANFH treated with vascularized fibular graft from April, 1991 to May, 1994 and following results were obtained. l. Until 2 months after surgery, no change in size of cold defect area and no significant change in extent of RI uptake in reactive zone were noted. 2. During 2 months and 6 months after surgery, slight decrease in size of cold defect area and minimal changes in extent of RI uptake in reactive zone were observed. 3. During 6 months and 12 months after surgery, size of cold defect area decreased to 1/2 and changes in extent and degree of RI uptake in reactive zone were observed. 4. During 1 year and 2 years after surgery, size of cold defect area were minimal and sometimes faded away. RI uptake with decreased density in reactive zone broadened and moved to subchondral area. 5. After 2 years after surgery, cold area faded away and small increased RI uptake were observed in same site. In conclusion, Tc-99m-HDP bone scan which is economic and easily applicable in a patient is very useful for follow up study in ANFH treated with vascularized fibular graft.
Follow-Up Studies ; Head* ; Hip ; Humans ; Necrosis* ; Transplants*

Paraduodenal hernias are a rare congenital malformation, but they are the most common internal hernias. They develop secondary to a failure in midgut rotation, which may lead to small bowel obstruction or other clinical manifestations. The authors recently experienced a case of a left paraduodenal hernia presenting with unusual symptoms of left flank pain and vomiting.
Adult ; Hernia/*complications/*diagnosis/pathology/surgery ; Humans ; Intestinal Obstruction/*etiology/surgery ; Male

PURPOSE: The incidence of retinopathy of prematurity(ROP) which is one of the most common cause of childhood blindness has not decreased despite the restricted use of oxygen. There may be other factors responsible for ROP which could not be explained solely by improved survival of very low birth weight infants. We tried to clarify perinatal risk factors that are nrelated to the occurrence of ROP. METHODS: We enrolled 239 infants with gestational ages less than 33 wks or with birth weight less than 1,800 gm who had received ophthalrnologic examination between Jan. 1995 and Dec. 1997. The patients were categorized into two groups,' "No ROP" group as control(n=185) and ROP group as study population(n=54), and we compared the perinatal risk factors between the two. RESULTS: 54(22.6%) out of 239 infants were diagnosed as having ROP. The annual incidence of ROP decreased but the incidence of treated ROP increased. The incidence of ROP decreased with longer gestation and higher birth weight. Mean gestational age was 30.3 weeks in the study group vs 31.0 weeks in the control group, and mean birth weight was 1,390 gm and 1,586 gm, respectively. Significant factors contributing to increased incidence of ROP included: duration of oxygen therapy, ventilator therapy, total parenteral nutrition and hospitalization, frequency of hyperoxia, hypercarbia, and transfusion and respiratory distress syndrome, umbilical artery catheterization, intraventricular hemorrhage, sepsis, bronchopulmonary dysplasia, use of dexamethasone and aminophylline, pneumonia, air leak syndrome, and hyperglycemia. The incidence of ROP and treated ROP was not influenced by the mode of surfactant treatment(prophylactic vs rescue) in RDS patients and the mode of dexamethasone treatment(short vs long) in BPD patients. CONCLUSION: The risk factors for retinopathy of prematurity included gestational age, birth weight and duration of oxygen, as well as other aforementioned perinatal factors. The occurrence of ROP can be decreased by preventing preterm birth, minimizing the use of oxygen, and further morbidity can be prevented by performing proper ophthalmologic examination and doing an appropriate follow-up.
Aminophylline ; Birth Weight ; Blindness ; Bronchopulmonary Dysplasia ; Catheterization ; Catheters ; Dexamethasone ; Gestational Age ; Hemorrhage ; Hospitalization ; Humans ; Hyperglycemia ; Hyperoxia ; Incidence ; Infant ; Infant, Newborn ; Infant, Very Low Birth Weight ; Oxygen ; Parenteral Nutrition, Total ; Pneumonia ; Pregnancy ; Premature Birth ; Retinopathy of Prematurity* ; Risk Factors* ; Sepsis ; Umbilical Arteries ; Ventilators, Mechanical

This study was aimed to evaluate the clinical usefulness of sevaflurane including an adjustability for anesthetic depth and an efficacy in 30 healthy patients who had no previous anesthetic complications or have not experienced general anesthesia within 1 month. After premedication with intramuscular administration of midazolam and glycopyrrolate, anesthesia was induced with thiopental sodium and succinylcholine and endotracheal intubation was done for all the patients. Anesthesia was maintained with 0.5 to 2.0 vol% of sevoflurane according to changes of blood pressure in response to surgical stimuli in N2O(2 L/min)-O2(2 L/min) following 4-5 vo1% inhalation for initial 5 minutes. For the muscle relaxation, vecuronium or pancuronium bromide 0.08 mg/kg was injected initially with additional doses in needed. At the end of operation, administration of N2O and sevoflurane was discontinued. Pure oxygen with 5 L/min- flow rates was inhaled until full recovery. The emergence time interval from the discontinuation of sevoflurane to the response of verbal command was about 10 minutes. The systolic blood pressure during operation reduced by 10 mmHg from preinduction value (from 126 to 116 mmHg). And the heart rate just before incision inereased by 14 beats/min from the preinduction value (from 83 beats/min to 97 beats/min). Arterial blood gas study showed mild hyperventilation with PaCO2 of 30 torr during operation, but PaCO returned normocapneic state during spontaneous breathing after recovery from anesthesia. There was no evidence of respiratory depression during perianesthetic periods. Complete blood counts, biochemical studies, serum electrolytes, and urinalysis at the preanesthetic period, the 1st and 7th postoperative days revealed clinically nonisgnificant changes. However SGPT increased to 30 IU/L in the 7th postoperative day from the preoperative value of 13 IU/L. No arrhythmia did occur during anesthesia, and no complaint including headache, nausea and vomiting ect, was seen after recovery.
Alanine Transaminase ; Anesthesia* ; Anesthesia, General ; Anesthetics ; Arrhythmias, Cardiac ; Blood Cell Count ; Blood Pressure ; Electrolytes ; Glycopyrrolate ; Headache ; Heart Rate ; Humans ; Hyperventilation ; Inhalation ; Intubation, Intratracheal ; Midazolam ; Muscle Relaxation ; Nausea ; Oxygen ; Pancuronium ; Premedication ; Respiration ; Respiratory Insufficiency ; Succinylcholine ; Thiopental ; Urinalysis ; Vecuronium Bromide ; Vomiting

Swine is a common source of Campylobacter coli human gastroenteritis, for the treatment of which erythromycin and fluoroquinolones are recommended. The prevalence of antimicrobial-resistant C. coli differs significantly depending on countries. We investigated the prevalence of C. coli in swine from a farm in Buan-gun, Korea in 2010, and determined antimicrobial susceptibility of the isolates. Rectal swab specimens were used to inoculate Campylobacter Preston media and incubated microaerophilically at 42degrees C for 48 h. The species were identified by phenotypic tests and by detecting hipO and glyA genes. PCR was used to detect mutations of A2074C in 23S rRNA gene, and quinolone resistance-determining region (QRDR) of gyrA, which are associated with high level resistance to erythromycin, and with ciprofloxacin, respectively. Antimicrobial susceptibility was determined by the disk diffusion and agar dilution tests. Of the 100 specimens, 55 (55%) yielded C. coli, and 23 of them (41.8%) had A2074G mutation. A2074G mutated isolates showed the lowest MIC90 of imipenem, while those of ampicillin and clindamycin were relatively low. The majority of both A2074G mutation-positive and -negative isolate were susceptible to ampicillin, cefotaxime, and chloramphenicol. All isolates were resistant to ciprofloxacin, and had mutation in QRDR of gyrA. In conclusion, C. coli was detected in 55% of swine, and A2074G mutation was detected in 41.8% of the isolates. All isolates had gyrA mutation-mediated ciprofloxacin resistance.
Agar ; Ampicillin ; Campylobacter ; Campylobacter coli ; Cefotaxime ; Chloramphenicol ; Ciprofloxacin ; Clindamycin ; Diffusion ; Erythromycin ; Fluoroquinolones ; Gastroenteritis ; Genes, rRNA ; Humans ; Imipenem ; Korea ; Polymerase Chain Reaction ; Prevalence ; Swine

It is not a common case for neurosurgery department and the other departments to perform joint operation at the same time. Patients with severe head injury are a condition in which vital signs are unstable due to severe brain swelling and increased intracranial pressure, and emergency surgery is required. A 44-year-old man visited the trauma center with a motorcycle accident. The Glasgow Coma Scale score at the time of emergency department was 3 points, and the pupil was fixed at 6 mm on both sides. His medical history was unknown. His vital signs including blood pressure (BP), heart rate, respiratory rate and oxygen saturation were stable. Associated injuries included multiple fractures of whole body. Brain computed tomography revealed subarachnoid hemorrhage, intraventricular hemorrhage and severe cerebral edema. During the preparation of the craniectomy, abdominal ultrasonography performed because of decreased BP resulted in a large amount of hemoperitoneum. The bi-coronal craniectomy and splenectomy were performed simultaneously for about 4 hours. After fifty days of treatment, he was discharged with Glasgow Outcome Scale-extended 4 points and is undergoing rehabilitation. In severe polytrauma patients, active concurrent surgery is a good method to save their lives.
Adult ; Blood Pressure ; Brain ; Brain Edema ; Craniocerebral Trauma* ; Emergencies ; Emergency Service, Hospital ; Fractures, Multiple ; Glasgow Coma Scale ; Head* ; Heart Rate ; Hemoperitoneum ; Hemorrhage ; Humans ; Intracranial Pressure ; Joints ; Methods ; Motorcycles ; Multiple Trauma ; Neurosurgery ; Oxygen ; Pupil ; Rehabilitation ; Respiratory Rate ; Splenectomy* ; Subarachnoid Hemorrhage ; Trauma Centers ; Ultrasonography ; Vital Signs

Plasma inorganic fluoride concentrations were measured in adult patients without hepatic or renal disease following sevoflurane-N2O anesthesia (n = 7) or enflurane-N2O anesthesia (n = 6). The anesthetic dosage of sevoflurane and enflurane was 6.48 +/- 2.15 %-hours and 6.57 +/- 2.50 %-hours, respectively. The mean peak plasma inorganic fluoride concentration in the sevoflurane group was 19.5 +/- 13.4 mumol/L 1 hour after anesthesia, which decreased to preanesthetic levels 24 hours after anesthesia. In the enflurane group the values were 13.2 +/- 5.8 mumol/L at the end of anesthesia and decreased, but remained, still twice as high as the preanesthetic level 24 hours after anesthesia. The relationship of plasma inorganic fluoride concentration and anesthetic dosage was more pronounced in the sevoflurane group (r = 0.68, slope = 4.2) than in the enflurane group (r = 0.39, slope = 1.2). In conclusion, sevoflurane-N2O anesthesia results in similar subnephrotoxic levels of plasma inorganic fluoride as enflurane-N2O anesthesia, and although the fluoride concentration had a better correlation to anesthetic dosage in the sevoflurane group than in the enflurane group, its excretion was faster in the sevoflurane group than in the enflurane group.
Adolescent ; Adult ; *Anesthesia, General ; *Anesthetics ; Comparative Study ; *Enflurane ; *Ethers ; Female ; Fluorides/*blood ; Human ; Male ; Middle Age ; *Nitrous Oxide