BACKGROUND: It has been reported that nontuberculosis mycobacterium(NTM) isolates account for approximately 10% of patients with a positive Acid-Fast Bacilli(AFB) smear. Therefore, it is necessary to consider NTM pulmonary disease when such a positive test is encountered. The aim of this study was to evaluate the etiologies and clinical characteristics of patients with NTM pulmonary disease who had been treated at a national tuberculosis hospital. METHODS: The NTM isolates were recovered from the sputum or bronchial washing specimens submitted to a clinical laboratory of National Masan TB Hospital from August 2002 to July 2003. All samples were identified using a polymerase chain reaction-restriction fragment length polymorphism analysis method, which amplifies the rpoB gene. The patients were diagnosed with NTM disease according to the American Thoracic Society diagnostic criteria. RESULTS: One hundred NTM isolates were recovered from 57 patients. Of the 100 isolates, M. avium complex(MAC) was the most common species, which was found 55%(n=55) of patients, followed by M. abscessus(n=25), and M. fortuitum(n=9). 26(45.6%) patients had NTM disease. Twenty-six (45.6%) patients had NTM disease according to The American Thoracic Society classification. The main organisms involved in NTM disease were MAC(n=19, 73.1%) and M. abscessus(n=5, 19.2%). The pathogenic potential was 67.9% in M. intracellulare and 41.7% in M. abscessus. The predictive factors related to NTM disease were a positive sputum smear (OR 6.4, p=0.02) and the isolation of either MAC or M. abscessus(OR 6.9, p=0.007). Fifteen patients(57.7%) were cured. There were no significant factors associated with the treatment success. CONCLUSION: There was a relatively high proportion of NTM disease in NTM isolates and the common species were MAC and M. abscessus. The predictive factors for NTM disease were a positive sputum smear and the isolation of either MAC or M. abscessus.
Classification* ; Hospitals, Chronic Disease* ; Humans ; Lung Diseases* ; Mycobacterium avium Complex ; Nontuberculous Mycobacteria ; Sputum ; Tuberculosis*

Malignant transformation is a rare complication in a mature cystic teratoma of the ovary, usually being reported less than 2% of cases. The most common malignant tumor arising from a mature cystic teratoma of the ovary is a squamous cell carcinoma. However, adenocarcinoma is reported extremely rare, in most cases it was impossible to tell the source of the malignancy. We experienced a case of papillary carcinoma of thyroid glands arising from mature cystic teratoma of the ovary and report this case with a brief review of literature.
Adenocarcinoma ; Carcinoma, Papillary* ; Carcinoma, Squamous Cell ; Female ; Ovary ; Teratoma* ; Thyroid Gland*

OBJECTIVE: This study assesses the hypothesis that preeclampsia is associated with the change of oxidative system balance by measuring the lipid peroxidation and antioxidant activity in preeclampsia. METHOD: Venous blood samples were collected from twenty women with preeclampsia and twenty women with uncomplicated pregnancies. Total lipid peroxidation, total antioxidant activity, antioxidant enzyme activity and antioxidant concentration were measured using flow injection-chemiluminescent method. RESULTS: 1. Total lipid peroxidation(PCOOH) was higher in preeclampsia(717.22+/-93.08 pmol/ml) than in normal pregnant(486.86+/-43.15 pmol/ml) (P<0.05). 2. Total antioxidant activity was significantly higher in preeclampsia(46.02+/-5.95 % inhibition) than in normal pregnant(38.59+/-7.57 % inhibition) (P<0.05).3. Antioxidant enzyme, catalase activity in RBC was lower in preeclampsia(346.59+/-82.84 unit/gHb) than in normal pregnant(440.62+/-72.8 unit/gHb) (P<0.05).4. Antioxidant, alpha-tocopherol concentration in RBC was slightly lower in preeclampsia(33.21+/-7.82 ng/gHb) than in normal pregnant(36.06+/-6.86 ng/gH), but there was no statistically significant difference (P<0.05). CONCLUSION: This data seems to show that preeclampsia is associated with an imbalance between the lipid peroxidation and the antioxidant system.
alpha-Tocopherol ; Catalase ; Female ; Free Radicals ; Humans ; Lipid Peroxidation ; Pre-Eclampsia* ; Pregnancy

OBJECTIVE: To evaluate the efficacy of clinical use of a intrauterine Sengstaken-Blakemore tube (S-B tube) in postpartum hemorrhage not controlled with medication and conservative treatment. METHODS: Retrospective review was done in 18 women with insertion of S-B tube into intrauterine cavity who did not controlled with medication and conservative treatment for postpartum hemorrhage. After third stage of labor, women were treated with prophylactic intramuscular Methylergonovine 0.2 mg and intravenous infusions of oxytocin routinely. If the postpartum bleeding continued, Misoprostol 800 microgram (per rectal) and intravenous infusions of Dinoprost 2 mg mixed with 5% D/S 500 cc were employed. And then women were examined for retained placenta and laceration of birth canal. Where necessary, retained placenta was removed and lacerations were sutured. If the postpartum bleeding did not controlled despite all of procedures, we decided use of intrauterine S-B tube. RESULTS: The mean age of the patients was 30.9+/-4.4 (27-39) years, their mean body weights and parities were 67.8+/-8.2 (56.2-85.7) kg, 1.8+/-0.8 (1-4) and mean gestational age was 38.5+/-2.9 (37-42) weeks respectively. The mean time from delivery to insertion of S-B tube was 107.6+/-94.0 (24-360) minutes. The mean filled normal saline amount was 190.5+/-35.2 (120-230) cc. Of 18 who was inserted of S B tube, 15 cases needed not additional surgical therapy. So success rate was 83.3%. CONCLUSION: Insertion of intrauterine S-B tube appears as a simple and effective means of treating postpartum hemorrhage not controlled with medication and conservative treatment.
Body Weight ; Dinoprost ; Female ; Gestational Age ; Hemorrhage ; Humans ; Infusions, Intravenous ; Lacerations ; Methylergonovine ; Misoprostol ; Oxytocin ; Parturition ; Placenta, Retained ; Postpartum Hemorrhage* ; Postpartum Period* ; Retrospective Studies

OBJECTIVE: This study was designed to evaluate the effect of epidural analgesia on the course of labor and delivery mode. METHOD: Three hundred eighteen term pregnant women with singleton fetus in vertex presentation were admitted for vaginal delivery at the Department of Obstetrics and Gynecology, medical center Chung-ju hospital from January 1, 1998 to December 31, 1998. They were divided into two groups: epidural analgesia group and non-epidural analgesia group. Epidural analgesia group was 106 women (79 primiparas and 27 multiparas). Non-epidural analgesia group was 212 women (138 primiparas and 74 multiparas). Course of labor and delivery mode were compared between the two groups. RESULTS: 1. The duration of the first stage of labor was not significantly different between two groups (primiparas: 672+/-110 min vs 625+/-134 min, multiparas: 458+/-152 min vs 422+/-184 min), and that of the second stage of labor in the primiparas was significantly longer in epidural analgesia group than non-epidural analgesia group (62+/-25 min vs 42+/-20 min, p=0.03), but did not differ significantly in the multiparas groups (36+/-12 min vs 31+/-20 min).2. Cesarean delivery rates were not significantly different between two groups (19.8% vs 15.1%).3. Cesarean delivery rates due to failure to progress were not significantly different between two groups (85.7% vs 78.1%).4. Oxytocin augmentation rates were significantly higher in epidural analgesia group than in non-epidural analgesia group (primiparas: 42.3% vs 20.1%, p=0.008, multiparas: 38.5% vs 19.7%, p=0.01).5. The newborn birthweight, Apgar score and the incidence of meconium-stained amnionic fluid were not significantly different between two groups.6. The complication of the epidural analgesia were back pain (10.4%), shivering (7.5%), nausea and vomiting (1.3%), hypotension (0.9%), and voiding difficulty (0.9%). CONCLUSION: Though epidural analgesia prolonged second stage of labor in the primiparas and increased oxytocin augmentation rates but did not increased the cesarean delivery rates. So intrapartum epidural analgesia provided safe and effective pain control without undesirable effects on labor outcomes.
Amnion ; Analgesia ; Analgesia, Epidural* ; Apgar Score ; Back Pain ; Cesarean Section ; Chungcheongbuk-do ; Female ; Fetus ; Gynecology ; Humans ; Hypotension ; Incidence ; Infant, Newborn ; Nausea ; Obstetrics ; Oxytocin ; Pregnancy ; Pregnant Women ; Shivering ; Vomiting

Aneurysmal ruptures associated with middle cerebral artery(MCA) anomalies, such as a duplicated MCA and an accessory MCA, are quite rare. The authors reviewed the clinical relevance and possible etiology of these anomalies.
Aneurysm ; Aneurysm, Ruptured ; Intracranial Aneurysm* ; Middle Cerebral Artery* ; Rupture*

Heterotopic pregnancy is defined as simultaneous intrauterine and extrauterine pregnancy. The incidence of heterotopic pregnancy was about 1 to 30,000 pregnancies, but it has been increased. This increased incidence is explained by the rise in PID, pelvic surgery, IUD and assisted reproductive technologies-in vitro fertilization/gamate intrafallopian insemination/intrauterine insemination. Thus careful pelvic examination combined with serial beta-hCG determinations and transvaginal sonography to evaluate the adnexal region are necessary prerequisites for early diagnosis. We report a case of heterotopic pregnancy following in ovulation induction and intrauterine insemination with a brief review of literature.
Early Diagnosis ; Female ; Gynecological Examination ; Incidence ; Insemination* ; Ovulation Induction* ; Ovulation* ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Heterotopic*

This study was performed to investigate the anatomical features of vertebral artery between the atlas and the axis. For this, we examined four angles (angle I, angle II, angle III and angle IV) to identify tortuosity of vertebral artery and diameter between the atlas and the axis. Materials used in this study were 93 vertebral arteries obtained from 48 adult Korean cadavers (34 males, 14 females) ranging from 18 to 90 years in age. On the anterior view, the vertebral artery relatively ascended vertically from C6 to the axis and then laterally passed through the foramen transversarium (FT) of the axis. The average of this angle I was 83.3 degree. The average of the right and left sides of this angle I were 84.7 degree and 82.0 degree, respectively. The average of angle I (95.4 degree) in female was larger than that (80.5 degree) of male. The artery passed through the FT of the axis turned to the superior direction. The average of this angle II was 95.9 degree. The right and left sides of the angle II were 97.8 degree and 93.8 degree, respectively. As the angle I, the average of angle II (110.6 degree) in female was larger than that of angle II (93.1 degree) in male. On the lateral view, the vertebral artery relatively ascended vertically from C6 to the axis and then posteriorly passed through the FT of the axis. The average of this angle III was 71.3 degree. The artery passed through the FT of the axis turned to the superior direction. The average of this angle IV was 87.3 degree. In angle III and angle IV, the average of angle in female were larger than that of male. These results show that female has greater tortuosity than male. The average diameter of the vertebral artery was 3.7 mm and the average diameter of right and left are 3.5 mm and 4.0 mm, respectively. In 76% of the total, left vertebral artery diameter was larger than that of the right.
Adult ; Arteries ; Axis, Cervical Vertebra* ; Cadaver ; Female ; Humans ; Male ; Vertebral Artery*

We report here on a case of a ruptured left posterior communicating artery (P-com) aneurysm that was treated by clipping in a patient with idiopathic thrombocytopenic purpura (ITP) and steroids were used to control the platelet count during the perioperative period. A 34-year-old female who had been suffering from ITP for four years experienced the sudden onset of a headache and vomiting while showering. She was referred to our hospital as a case of subarachnoid hemorrhage (SAH) due to a ruptured P-com aneurysm. Aneurysmal neck clipping was performed via the left pterional approach 6 hours after the ictus. The aneurysmal clipping was successful without an increased bleeding tendency during the operation. Intravenous steroid injection was given after aneurysmal clipping for 7 days and then it was tapered off. It is important to maintain an adequate platelet count in SAH patients with chronic ITP in order to avoid hemorrhagic diathesis during surgery. Intravenous steroid injection is a helpful method for maintaining an adequate platelet count in these patients during surgery.
Adult ; Aneurysm ; Arteries ; Female ; Headache ; Hemorrhage ; Hemorrhagic Disorders ; Humans ; Intracranial Aneurysm ; Neck ; Perioperative Period ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic ; Steroids ; Stress, Psychological ; Subarachnoid Hemorrhage ; Vomiting

OBJECTIVE: The aim of this study is to assess the relationships between maternal plasma and umbilical cord leptin concentrations and their effects on newborn birth weights, maternal body mass indices and fetal sex in term normotensive (NT) and preeclampsia (PE) women. METHODS: Blood samples were obtained at delivery from 20 NT group and another 20 from PE group of at least 36 weeks of gestation. And the umbilical cord samples were also taken from their newborns at birth. Plasma leptin levels were determined in both groups using a human recombinant leptin 125-I radioimmunoassay. RESULTS: Mean maternal plasma and umbilical cord leptin concentrations were 16.16+/-2.05 ng/ml and 7.11+/-1.01 ng/ml in NT group, 17.09+/-1.67 ng/ml and 8.55+/-6.63 ng/ml in PE group, and there was no statistical significances among them. The differences of leptin concentrations in maternal plasma and umbilical cord according to baby sex were not significant in both NT and PE groups. Plasma leptin concentrations were related with maternal weight gain and BMI in NT group and with body weight in PE group. The BMI and birth weights of the neonates have significant effects on the umbilical cord leptin concentrations in both NT and PE groups. CONCLUSION: In this study, no correlation was found between maternal plasma and umbilical cord leptin concentrations in both NT and PE groups. But maternal plasma leptin concentrations had positive correlations with maternal body weight, BMI, and body weight changes during pregnancy in both NT and PE groups. There were also positive correlations among umbilical cord leptin concentrations, BMI and birth weights of the neonates of NT and PE groups term. Therefore umbilical cord leptin is considered to be the index of fetal birth weight.
Birth Weight ; Body Weight ; Body Weight Changes ; Female ; Fetal Blood* ; Fetal Weight* ; Humans ; Infant, Newborn ; Leptin* ; Parturition ; Plasma* ; Pre-Eclampsia* ; Pregnancy ; Radioimmunoassay ; Umbilical Cord ; Weight Gain