Myometrial pregnancy developing in an previous cesarean section scar is the rarest of all ectopic pregnancy and provavly one of the most dangerous because of the risk of rupture and hemorrhage. For a young patient wanting to maintain her fertility, an earlier diagnosis and more conservative treatment are highly desirable. We present a case of an ectopic pregnancy embedded in the myometrium of a previous cesarean section scar in which the patient preserved her fertility through more noninvasive method, transvaginal ultrasound-guided Methotrexate injection.
Animals ; Cesarean Section* ; Cicatrix* ; Diagnosis ; Female ; Fertility ; Hemorrhage ; Humans ; Methotrexate* ; Mice ; Myometrium* ; Pregnancy ; Pregnancy, Ectopic* ; Rupture

A clinical observation was performed on 2,122 cases of premature infants who were admitted to Ilsin Christian during the past 5 years from Jan. 1986 to Dec. 1990. The results were as follows; 1) The incidence of prematurity was 5.7%, overall mortality rate was 15.8%, and the sex ratio of male to female was 1.5:1. 2) Concomitant maternal diseases were premature rupture of membrane 457 cases (21.5%), preeclampsia & eclampsia 424 cases (19.9%), multiple pregnancy 250 cases (11.7%) etc, in the order of frequency. 3) Prematurity was most prevalent among multipara over 3. 4) Incidence of prematurity according to maternal age was frequent in woman more than 35 years old. 5) Mortality of prematurity was higher inversely propotional to birth weight & gestational age. 6) Main causes of death were IRDS 45 cases (43%), congenital anomaly 72 cases (21.6%), sepsis 31 cases (9.3%), and unknown 84 cases (25.0%). 7) Clinical problems were hyperbilirubinemia 38.9%, hypoglycemia 28.6%, IRDS 18%, sepsis & other infections 8.1% etc, in the order of frequency. 8) Most deaths were seen within first 24hr (74.5%).
Adult ; Birth Weight ; Cause of Death ; Eclampsia ; Female ; Gestational Age ; Humans ; Hyperbilirubinemia ; Hypoglycemia ; Incidence ; Infant, Newborn ; Infant, Premature ; Male ; Maternal Age ; Membranes ; Mortality ; Pre-Eclampsia ; Pregnancy ; Pregnancy, Multiple ; Rupture ; Sepsis ; Sex Ratio

No abstract available.
Mucocutaneous Lymph Node Syndrome*

OBJECTIVE: The authors evaluate the differences in the pedicle screw pull-out strength between an unaugmented screw and a screw augmented by high pressurized PMMA in an embalmed human lumbar cadaveric spine. METHODS: Pedicle screws were inserted in the 50 pedicles of cadaver lumbar spine after measuring the bone mineral density(BMD) of the specimens. The pedicle screw was inserted without augmentation on the left pedicle and with augmentation by a vertebral reconstruction with high pressurized PMMA on the right side. The pedicle screw was inserted before the hardening of bone cement on the right side. A computed tomographic scan was done to evaluate the location of the PMMA and PMMA/ screw interface. After that, a screw pullout strength test was performed. RESULTS: There were positive correlations between the pull-out strength and BMD in the control group (r=0.7339). The average pull-out strength of the augmented group was 168% greater than that of the control group(p<0.05). The pull-out strength of the augmented group was correlated with in the volume of the PMMA. CONCLUSION: A pedicle screw that is augmented with PMMA will provide a more rigid fixation than that of an unaugmented screw, especially in the low BMD group of the specimens.
Cadaver* ; Humans ; Polymethyl Methacrylate ; Spine

No abstract available.
Hyperpigmentation* ; Lichen Planus*

No abstract available.
Hyperpigmentation* ; Lichen Planus*

BACKGROUND: There are two kinds of mechanism for laser therapy according to selectie photothermolysis. Selective photothermolysis means that a chromophore can be selectively dei, stroyed with a laser of n appropriate wavelength and of a short pulse duration that is shortor than the thermal relaxation time of the chromophore. It is supposed that the side effects of the continuous wave laser, in which selective photothermolysis does not exist occur more often than when a pulsed wave laser is used. OBJECTIVE: We compar.d the side effects of flashlamp-pumped pulsed tunable dye laser(SPTL), whose treatment is baseal on selective photothermolysis, with those of copper vapor laser(CVL , which is a quasi-continuous thermal laser. METHODS: The laser cl arts of 498 patients with SPTL treatment and 485 patients with CVL, treatment in Asan Medical Center from 1989 to 1994 were examined, retrospectively. RESULTS: 1) Among 498 patients, with SPTL treatment, we observed various side effects in 47(9.4%). The incidences of individial side effects are as follows, hyperpigmentation in 6.2%(31), vesicl formation in 1.6% (8), surface texture change in 0.8% (4), Hypopigmentation in 0.6% (3), scar format,ion in 0.2% (1). 2) After CVL treatment, side effects occurred in 30(6.2%) among 485 patient.. Hyperpigmentation in 3.1%(15), vesicle formation in 2.5%(12), surface texture change in 0.2%(1), hypopigmentation in 0.2%(1), and scar formation in 0.1%(1) were observed. CONCLUSION: The total incidence of side effect.s after CVL treatment is not statistically different, from that after SPTL treatment, which contradicts the previous theory.
Chungcheongnam-do ; Cicatrix ; Copper* ; Humans ; Hyperpigmentation ; Hypopigmentation ; Incidence ; Laser Therapy ; Lasers, Dye* ; Lasers, Gas* ; Relaxation ; Retrospective Studies

Renal cell carcinoma, intimately associated with a sarcomatous component, is a rare malignant renal tumor. There is disagreement whether these represent true sarcomas or are sarcomatoid metaplasia. Therefore, this sarcomatous component is at times still a troublesome problem for pathologists. In March, 1986, we experienced a case of renal cell carcinoma associated with rhabdomyosarcomatous component in 47 year-old woman who had a rapidly enlarged, palpable abdominal mass. Grossly, a spherical renal cell carcinoma, 17x14x10 cm, in upper and middle portions of the right kidney showed extension through the renal capsule into the perirenal fat. Area of myxoid change was evident in the reanl cell carcinoma, with extensive hemorrhagic necrosis. Microscopically, in the myxoid area, there was malignant spindle cell proliferation in which many rhabdomyoblasts showing distinct cross striation could be demonstrated. This rhabdomyosarcomatous component intermixed with renal cell carcinoma of clear cell type could be also identified in the focal area.
Female ; Humans

"It was reported that polymorphism of TNF alpha gene was present in promoter region and involves the substitution of guanine by adenosine in the uncommon (TNFA 2) allele. In this study, we investigated the significance of TNFA gene polymorphism in relation to various clinical characteristics and autoantibody profiles in SLE as well as comparing it with that of other countries, and also studied its association with peripheral TNF-a production in vitro. TNFA genotyping was performed in 126 SLE patients and 300 controls using DNA extracted from peripheral leucocytes. The biallelic polymorphism at position -308 of the TNFA promotor was determined by Ncol- RFLP. Peripheral mononuclear cell production of TNF-a was investigated by bioassay using L-929 cell cytotoxicity. The TNFA ""1 homozygote was a predominant allele (77.0%) in SLE, which was not different from the controls. TNFA ""2 homozygate was extremely rare in both patients and controls (0.8%, 1.3% respectively). The clinical manifestations between TNFA '1 and TNFA""2 did not differ. The production of autoantibodies including dsDNA, anti-La, anti-nRNP and anti-Sm was not different between two alleles, whereas anti- Ro antibody was more frequent in TNFA""1/TNFA '1 than in TNFA'1/TNFA'2 (62.1% vs 38.4%, P=0.022). The polymorphism of TNFA gene did not influence the lipopolysaccharide stimulated peripheral mononuclear cell production of TNF-a (1356+/-293 vs 1119+/-385 pg/ml; TNFA'1/TNFA'1, TNFA'1/TNFA'2 respectively). These results suggested that promoter polymorphism of TNFA was not directly involved in the susceptibility of SLE and was not responsible for differential peripheral TNF-a production, but TNFA ' may be associated with anti-Ro antibody production."
Adenosine ; Alleles ; Autoantibodies ; Biological Assay ; DNA ; Guanine ; Homozygote ; Humans ; Lupus Erythematosus, Systemic* ; Polymorphism, Restriction Fragment Length ; Promoter Regions, Genetic ; Tumor Necrosis Factor-alpha*

Primary ovarian transitional cell carcinoma is extremely rare tumor. The histologic subtype was divided from malignant Brenner tumor due to it's own histologic characteristics and chemosensitive nature. Most of recent studies revealed that transitional cell carcinoma has a good response to chemotherapy and long-term survival. Recent histopathologic reports show that transitional cell carcinoma of the bladder and of the ovary are immunophenotypically different. We experienced a case of primary ovarian transitional cell carcinoma, and report this case with a brief review of the concerned literatures.
Brenner Tumor ; Carcinoma, Transitional Cell* ; Drug Therapy ; Female ; Ovary ; Urinary Bladder