Uterine prolapse with pregnancy is rare condition. The overall incidence is 1/10000- 15000 deliveries. The complications from uterine prolapse range from minor cervical ulceration and infection to fetal death or uterine rupture. The fetal mortality was as high as 22% mainly due to prematurity, respiratory infection. The management of this condition is focused on preventing late occurrence of prolapse during pregnancy and continued reduction. We present a case of uterine prolapse in pregnancy with a brief review of the literature.
Fetal Death ; Fetal Mortality ; Incidence ; Pregnancy* ; Prolapse ; Ulcer ; Uterine Prolapse* ; Uterine Rupture

We report a case with an isolated single coronary artery originating from the ascending aorta, which to our knowledge has never been described before. A 51-year-old man presented for evaluation of atypical chest pain, suffering from a short resting chest pain for 3 days. However, serial electrocardiogram showed no change during chest pain. Cardiac enzymes such as CK-MB, Troponin-I, and myoglobin were within normal limit. Aortography and coronary angiography revealed a single coronary artery originating from the postero-lateral wall of the ascending aorta above the left coronary siuns. However, this anomaly was not of clinical significance based on the atypical nature of the chest pain, negative exercise echocardiography and an absence of obstruction of the coronary artery.
Aorta* ; Aortography ; Chest Pain ; Coronary Angiography ; Coronary Sinus* ; Coronary Vessel Anomalies ; Coronary Vessels* ; Echocardiography ; Electrocardiography ; Humans ; Middle Aged ; Myoglobin ; Troponin I

BACKGROUND: In general, the outcomes of arthroscopic repair for superior labrum anterior to posterior lesions (SLAP) are favorable, however, persistent pain and limitation of motion are not rare complications. One of the possible cause is a “knot-ache”. This study evaluated the results of reoperation of symptomatic recurrent SLAP lesions and asked whether the knot is associated with postoperative complications. METHODS: Between 2005 and 2015, a total of 11 patients who had undergone arthroscopic SLAP repair were reoperated for recurrent symptomatic SLAP lesion. By retrospective chart review, operative findings, the visual analogue scale for pain (pVAS), the range of motion (ROM), and functional scores were analyzed. RESULTS: The mean age of the study participants was 38.3 years, and the mean follow-up period was 42.5 months. In the primary operation, there were nine cases of repairs with conventional knot-tying anchors and three cases with knotless anchors. Impingement of the knots during abduction and external rotation of the shoulder was observed in the all cases with knot-tying anchors. The mean pVAS, ROM, and functional scores significantly improved with reoperation. At the final follow-up, the mean satisfaction VAS was 8.3. CONCLUSIONS: The knots of suture anchor maybe a possible etiology of the pain, which we termed a “knot-ache”. Considering that reoperation is performed due to pain after primary repair, the use of knotless suture anchor may have benefits of eliminating one of possible cause, “knot-ache”. Therefore, authors suggest the use of knotless anchors during reoperation for recurrent or recalcitrant pain after primary SLAP repair.

Onycholysis is defined as a distal or distal lateral separation of the nail plate from the underlying or lateral supporting structures including nail bed, hyponychium, and lateral nail fold. Trauma, infection, psoriasis, thyrotoxicosis, and numerous drugs are common causes of onycholysis. However, there are few specific data on nail findings in Behcet's disease (BD). In this paper, we report on a 60-year-old man with BD, with no past history except BD, who developed recurrent onycholysis. The symptoms of onycholysis are considered to be recurrent depending on the activity of BD. The nail lesion showed improvement after classic treatment of BD and topical steroid ointment.
Humans ; Middle Aged ; Onycholysis* ; Psoriasis ; Thyrotoxicosis

To evaluate effect of coronary collateral circulation on left ventricular function in patients with acute myocardial infarction, global ejection fraction(EF), left ventricular end distolic pressure(LVEDP), peak creatine kinase(CK) level and regional wall motion were analysed and compared in 30 patients with acute myocardial infarction according to grade of coronary collateral circulation. Patients with total or near total(above 95% of diameter) occlsion of left anterior descending coronary artery without significant lesion in right coronary artery or left circumflex artery were selected and divided into 3 groups according to the degree of collateral circulation on coronary angiography, to be compared by the index of ejection fraction, peak creatine kinase level, left ventricular and diastolic pressure and regional wall motion. The result are as following : 1) There were no statistically significant differences in ejection fraction, peak creatine kinase level, left ventricualr and diastolic pressure among the groups. 2) Regional wall motion of infarct related area of G2+3 group(adequate collateral) were better than that of G0(no collateral) group(p<0.05). Therefore, adequate coronary collateral circulation in acute myocardial infarction is thought to have beneficial effect on left ventricular function especially in regional wall motion of infarct related area.
Arteries ; Blood Pressure ; Collateral Circulation* ; Coronary Angiography ; Coronary Vessels ; Creatine ; Creatine Kinase ; Humans ; Myocardial Infarction* ; Ventricular Function, Left*

BACKGROUND: Fiberoptic bronchoscope guided intubation is an important method of difficult airway management. The use of specific airways has been devised to assist the fiberoptic intubation. The authours compared effectiveness of separated airway with fiberoptic bronchoscope guided intubation and the hemodynamic responses. METHODS: 104 adult patients of American Society of Anesthesiologists grading (ASA) I-II who scheduled for surgery under general anesthesia were randomly divided into the Laryngoscope group (L group, n = 30) or the Fiberoptic bronchoscope group (F group, n = 36) or the Fiberoptic bronchoscope with separated airway (MF group, n = 38). A Fiberoptic bronchoscope guided intubation and a fiberoptic bronchoscope with separated airway and a direct laryngoscope was performed after inducing anesthesia. Intubation time, Jaw thrust incidence, mean blood pressure and heart rate after anaesthesia induction, at intubation and every two minute for a further 7 min were recorded. RESULTS: The intubation time was significantly shorter in the MF group (58.3 +/- 13.7 sec) than F group (71.9 +/- 22.1 sec). Jaw thrust incidence was lower in the MF group (60.5%) than F group (100%). The changes of MAPs and HRs during the observation were not significantly different in three group. CONCLUSIONS: Fiberoptic intubation using separated airway reduced intubation time and the incidence of jaw thrust.
Adult ; Airway Management ; Anesthesia ; Anesthesia, General ; Blood Pressure ; Bronchoscopes ; Heart Rate ; Hemodynamics ; Humans ; Incidence ; Intubation ; Jaw ; Laryngoscopes

PURPOSE: To investigate the efficacy of Gelfoam single use for the management of hemoptysis by analyzing patients with recurrence in embolized artery and other artery, respectively. MATERIALS AND METHODS: Between 1992 and 2000, 131 patients (104 men and 27 women, mean age: 54.4 years) with hemoptysis underwent BAE using gelatin sponge only. After puncturing the femoral artery using the Seldinger method, angiographies of the thoracic aorta, the bronchial arteries, the intercostal arteries, and the systemic collaterals which were suspected of bleeding focus and embolization were performed. Gelfoam was used 1x3 mm and 2x3 mm or 2x5 mm by the diameter of feeding arteries. The cumulative hemoptysis control rate and recurrence rate were analyzed from the previously embolized vessels. RESULTS: Hemoptysis were recurred among 34 of 131 patients. Twenty-two patients had a recurrence from the same vessels and 12 from the different ones. Using the Kaplan-Meier method, the cumulative hemoptysis control rate was obtained in the patients with a recurrence from the same vessels: 88.8% in 1 month, 79.9% in 1 year, and 77.3% in 2 year. The reasons for recurrences of the same lesions are as follows; due to the tortuosity of the vessel (n=3); partial embolization through the common trunk formation between bronchial and anterior spinal artery (n=3); by vessel spasms or autogenous thrombus (n=2); due to the contrast media hypersensitivity (n=1). These 9 patients were not treated successfully. In the remaining 13 cases, hemoptysis were recurred due to recanalization of embolized vessels. Among 161 procedure, complications consisted of fever (n=8), dyspnea (n=8), mild chest discomfort (n=7), lower back pain (n=1), and transient lower leg paralysis (n=1), which were improved within several days. There was no serious complication in this study. CONCLUSION: Bronchial artery embolization using Gelfoam alone maybe effective and safe to control hemoptysis.
Angiography ; Aorta, Thoracic ; Arteries* ; Bronchial Arteries* ; Contrast Media ; Dyspnea ; Female ; Femoral Artery ; Fever ; Gelatin ; Gelatin Sponge, Absorbable* ; Hemoptysis* ; Hemorrhage ; Humans ; Hypersensitivity ; Leg ; Low Back Pain ; Male ; Paralysis ; Porifera ; Recurrence ; Spasm ; Thorax ; Thrombosis

PURPOSE: The purpose of this study was to compare the changes in patients pattern retrospectively for pediatric supracondylar and lateral condylar humeral fractures. MATERIALS AND METHODS: We retrospectively studied 335 pediatrics treated operatively for supracondylar and lateral condylar fracture from March 1993 to February 2013. The pediatrics were divided depending on the 10-year time period: those who received treatment from March 1993 to February 2003 as group I, and those who received treatment from March 2003 to February 2013 as group II. By each group, the differences in age, gender, cause, season of incidence, whether the time of incidence was a weekend, and education level of the parents were compared and analyzed. RESULTS: Fractures in group I were mainly due to slip down and fall down, but sports injury was the main cause of fractures in group II. There were 112 cases and 121 cases of supracondylar fractures, and 65 cases and 37 cases of lateral condylar fracture in groups I and II. Significant differences were found in the incidence of lateral condylar facture (p=0.009). In terms of the education level of the parents, the number with high school or under decreased significantly from group I to group II, from 71 cases to 45 cases (p=0.040). CONCLUSION: The supracondylar fracture does not show any significant difference according to the time lapse in the age and cause of incidence. However, the incidence of lateral condylar fracture shows a decreasing trend which may be related to the decrease of the incidence of slipping and falling, and the improvement in the parent's education level.
Athletic Injuries ; Education ; Humans ; Humeral Fractures* ; Humerus ; Incidence ; Parents ; Pediatrics ; Retrospective Studies ; Seasons

OBJECTIVES: There has been a continued debate regarding the role of eye movements in Eye Movement Desensitization and Reprocessing(EMDR). This study examined the possible autonomic effect of horizontal eye movements after being exposed to fearful stimuli. METHODS: Fifty two healthy adult women were randomly allocated to eye movement or eye fixed groups after watching a five minute fear-inducing film clip. ECG was recorded during the resting state, after watching the clip, and the treatment. A spectral power analysis of the heart rate variability was performed. As the variables violated the rule of normal distribution and the number in each group is small the non-parametric test was used. RESULTS: Overall, we did not find the differences between the groups in both time and frequency domains. Some minor differences found were not consistent with results from previous studies. CONCLUSIONS: Effect of eye movement on autonomic nervous system during fear desensitization was not supported in this experiment. Further study with other psychophysiological measures is needed to understand the role of eye movements in treatment of traumatic memory.
Adult ; Autonomic Agents ; Autonomic Nervous System ; Electrocardiography ; Eye ; Eye Movements ; Female ; Heart ; Heart Rate ; Humans ; Normal Distribution