OBJECTIVE: To evaluate the results of second-trimester maternal serum triple-marker screening test for Down syndrome and open neural tube defects in singleton pregnancies conceived from in vitro fertilization, the screen positive rates and triple-marker level of patients conceiving singleton pregnancies by IVF were compared to those of pregnancies conceived naturally. METHODS: Two hundred singleton pregnancies conceived by IVF and naturally conceived pregnancies who had done maternal serum screening test during the second trimester were analyzed from January 1995 to April 1998. RESULTS: One (0.5%) of the 200 cases of IVF singleton pregnancies had a positive result for Down syndrome compared with 1% of screen positive rate in the 200 cases of naturally conceived pregnancies. The median level of the triple markers were 0.92 multiples of the median(MoM) for alpha-fetoprotein(AFP), 1.44 MoM for unconjugated estriol(E3) and 0.87 MoM for human chorionic gonadotropin(hCG) respectively. CONCLUSION: The positive rate of triple test for Down syndrome and open neural tube defect in the two groups were significantly not different. As additional data are collected, corrected standards should be determined.
Chorion ; Down Syndrome ; Female ; Fertilization in Vitro* ; Humans ; Mass Screening* ; Neural Tube Defects ; Pregnancy Trimester, Second ; Pregnancy*

Lyme disease is an infecious disease caused by Borrelia burgdorfieii and has been reported world-wide. The spirochete invades multiple organs and induces manifesations in the skin, joints, neri us and cardiovascular systems. 13espite a considerable amount of serological evidence and isolation of R burgdorferi in ticks, no human case has yet been reported in korea. In this report, we present the first clinical case of Lyme disease in Korea. A female patient, 26 years old, developed clinical signs of eryth m,i chronicum migpans about ten days after traveling to a rural area and responded well to treatment ith entibiotions. Laboratory tests showed elevated IgM and IgG responses to B. burgdorferi, and a spirociete was found in a skin biopsy by electron microscopy.
Adult ; Biopsy ; Borrelia ; Borrelia burgdorferi ; Cardiovascular System ; Female ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Joints ; Korea ; Lyme Disease* ; Microscopy, Electron ; Skin ; Spirochaetales ; Ticks

A retrospective study was designed to evaluate the clinical characteristics of canalicular injury including causes and associated ocular traumas, time of operation, and appropriate operating methods and materials. The authors retrospectively reviewed the charts of 60 patients who underwent repair of lacerated canaliculi from June 1992 to September 1997 at Chonnam University Hospital. Most injuries occurred at second and third decades(30, 50%). The most common cause was fist blow(19, 31.7%). Among a total of 44 patients who could be followed for more than 6 months, 30 of 32 eyes(93.8%) who were repaired with Mini-Monoka and 11 of 12 eyes(91.7%) with bicanalicular stent met with successful results. There were 8 prolapses of tube, 2 granuloma formations, 2 wound infections, one punctal slit, and one canalicular stenosis as the postoperative complication. All of them ware treated successfully. Canaliculoplasty was not successful in cases that operation was performed 48 hours after trauma and the tube was prolapsed within 3 months. No significant associations were found between presence of postoperative epiphora and sex, causes of injury, location of injury and type of canalicular stent. Canaliculoplasty with either Mini-Monoka or bicanalicular stent had successful postoperative outcomes without any significant complications.
Constriction, Pathologic ; Granuloma ; Humans ; Jeollanam-do ; Lacerations* ; Lacrimal Apparatus Diseases ; Postoperative Complications ; Prolapse ; Retrospective Studies ; Stents* ; Wound Infection

The schwannoma is a benign neoplasm originating from Schwann cell. Solitary nerve sheath tumors such as benign schwannomas arising in the pelvic retroperitoneum are infrequently reported. Those tumors can indeed be misdiagnosed for other more common conditions both clinically and instrumentally. We report a very rare case of a benign retroperitoneal pelvic schwannoma of the obturator fossa, which was incidentally found and misdiagnosed as adnexal mass preoperatively in fifty one-years-old postmenopausal women.
Female ; Humans ; Nerve Sheath Neoplasms ; Neurilemmoma*

Transepidermal elimination is a mechanism whereby foreign or altered constituents can be removed from the dermis. The phenomenon of transepidermal elimination may occur as a primary process characterizing disorders such as elastosis perforans serpiginosa, reactive perforating collagenosis and chondrodermatitis nodularis chronica helicis; as well as a secondary process characterizing disorders such as granuloma annulare, necrobiosis lipoidica diabeticorum, calcinosis cutis, pseudoxanthoma elasticum, spitz nevi, pimented nevi, porokeratosis plantaris discreta and metastatic tumors. A 17-year-old man presented with a 2X2 cm sized well-circumscribed slightly erythematous plaque with some black colored papules on the left dorsum of his hand. The histopathology of the lesion indicated angiokeratoma circumscriptum with transepidermal elimination.
Adolescent ; Angiokeratoma* ; Calcinosis ; Dermis ; Granuloma Annulare ; Hand ; Humans ; Necrobiosis Lipoidica ; Nevus ; Porokeratosis ; Pseudoxanthoma Elasticum

Generally chemical burns are managed with immediate water irrigation. Cresol is one of the few chemicals that cannot be safely washed off with water. If cresol chemical burn is washed off with small amount of water, the involved area may extend. Thus cresol chemical burn must be managed with caution if a generous supply of water is not available. We report a case of cresol chemical burn with a review of literatures.
Burns, Chemical* ; Water

A retrospective study was performed in 180 eyes (173 patients) with rhegmatogenous retinal detachment which underwent primary scleral buckling operations. One hundred and sixteen patients (67.1 %) were men. The most common age group was the seventh decade (34 patients, 19.6%). Moderate- to high- degree myopia were the most numerous (65 eyes, 38.0%) as the associated ocular findings and the peripheral retinal degenerations were next (44 eyes. 257%). One hundred and fifty eyes had retinal breaks preoperatively, 129 eyes (76.8%) had breaks distributed in the superior and/or inferior temporal quadrants, 84 eyes (56.0%) had breaks located in the equator and 82 eyes (54.7%) had atrophic holes. Among 180 eyes studied, 141 eyes (78.3%) achieved retinal reattachment by primary scleral buckling operations. Preoperative and/or postoperative proliferative vitreoretinopathy as causes of failure were presented in 18 eyes. Ten eyes had intraocular hemorrhage as intraoperative complications and the other 10 eyes developed cataract as postoperative ones. Fourty-seven eyes (33.3%) had corrected visual acuity below 0.1 in spite of successful retinal reattachment and 23 eyes had macular degenerations as the most common causes of poor vision.
Cataract ; Hemorrhage ; Humans ; Intraoperative Complications ; Macular Degeneration ; Male ; Myopia ; Retinal Degeneration ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Retrospective Studies ; Scleral Buckling ; Visual Acuity ; Vitreoretinopathy, Proliferative

BACKGROUND: The H-reflex has been used to assess the proximal nerve conduction in radiculopathy or peripheral neuropathy. The purpose of this study was to evaluate the clinical usefulness of the H-reflex in the diagnosis of subclinical diabetic polyneuropathy. METHOD: Thirty-four diabetic patients (17 women and 17 men) who had neither motor nor sensory symptoms were selected (mean age 57.6 +/- 12.9 years). The duration of diabetes varied from 0.5 to 24 years (mean 6.2 +/- 5.1 years). None of the patients had any known cause of peripheral neuropathy other than diabetes. Twenty-seven healthy subjects (16 women and 11 men) were evaluated as an age-matched control group. H-reflex studies were performed using Braddom and Johnson's methods. The presence and latencies of the H-reflexes were examined in both legs. RESULTS: Twenty-four of the 34 patients (70.6%) had abnormal H-reflex responses (absent H-reflex in 17, prolonged latency in 7). However, only three out of the 27 control subjects (11.1%) had abnormal H-reflex responses (absent H-reflex in 1, prolonged latency in 2). CONCLUSIONS: Abnormalities in H-reflex studies have often been seen in diabetic subjects without overt neurological symptoms. This study suggests that the H-reflex study may be a useful screening tool in the diagnosis of subclinical diabetic polyneuropathy.
Diabetic Neuropathies* ; Diagnosis ; Female ; H-Reflex* ; Humans ; Leg ; Mass Screening ; Neural Conduction ; Peripheral Nervous System Diseases ; Radiculopathy

A case of syndrome of inappropriate secretion of antidiuretic hormome (SIADH) associated with herpes zoster ophthalmicus is reported. A 77-year-old man was admitted for treatment of left facial pain and vesicular lesions during 7 days. On admission, physical examination revealed vesicular eruptions on the left face and on neurologic examination, he revealed an alert, well-oriented mentality. Neither sensory disturbance nor nuchal rigidity was noted. Further investigation revealed hyponatremia 115mEq/L, low serum osmolality, high urine osmolarity, high urinary sodium secretion, normal renal function, normal adrenal and thyroid function. Cerebrospinal examination revealed a pleocytosis, mild protein elevation, normal glucose. No malignant cells were present and microorganism examinations were negative. Only water restriciton was started. But he revealed confusional mentality and aggravation of hyponatremia(110m2q/L). Intravenous hypertonic saline also was started, and the patient's sensorium was improved in accordance with the increase in serum sodium concentration. In the absence of other recognized causes we suggest that the two conditions(SIADH and Herpes Zoster Infection) may have related and speculate on possible mechanisms. In this report, we postulate that the hyponatremia was due to SIADH and that SIADH was caused by the infection of varicella-zoster virus(VZV) in central nervous system.
Aged ; Central Nervous System ; Facial Pain ; Glucose ; Herpes Zoster Ophthalmicus ; Herpes Zoster* ; Humans ; Hyponatremia ; Inappropriate ADH Syndrome ; Leukocytosis ; Muscle Rigidity ; Neurologic Examination ; Osmolar Concentration ; Physical Examination ; Sodium ; Thyroid Gland ; Water

No abstract available.
Incidence