OBJECTIVES: To evaluate the relation between diagnostic clinical parameters and the depth of trophoblastic invasion in tubal pregnancy and decide the most predictable parameter. Methods: Total 50 patients who were confirmed as tubal pregnancy pathologically, from Jan. to Dec. 1997, were included in this study. Menstrual missed periods was calculated by clinical history, volume of gestational mass was calculated as sphere, beta-hCG was titered with preoperative blood sample. All surgical specimens were examined pathologically and divided into two groups such as intraluminal and extraluminal, defined as intact tubal musculature and trophoblastic invasion beyond musculature, n=22 and n=28, respectively. Statistical analysis was performed among three parameters and between each parameter and the depth of trophoblastic invasion. Statistical analysis included were Student's t-test, Chi square, linear regression, and linear correlation analysis using SPSS statistical package and statistical significance was determined as p<0.05. RESULTS: There was a correlation between volume of gestational mass and beta-hCG(p<0.05), but not between beta-hCG and missed period or volume of gestational mass and missed period. beta-hCG level was 1843.7+/-1524.7 mIU/ml(Mean+/-SD) in intraluminal and 12144.3+/-10561.6 mIU/ml(Mean+/-SD) in extraluminal. There was a predictive correlation between beta-hCG and the depth of trophoblastic invasion(p<0.05), and cut off level 3,500 mIU/ml showed the highest sensitivity, specificity, positive predictive value, negative predictive value, 0.79, 0.86, 0.88, 0.76, respectively. Two parameters(volume of gestational mass and missed period) had no ability to predict whether intraluminal or extraluminal. CONCLUSION: We suggest that successful medical treatment of tubal pregnancy depend on lesional intactness of vasculature for drug delivery. In patient selection for medical treatment, it should be important to predict intraluminal type because of intact vasculature. Of clinical parameters, beta-hCG is single most predictive parameter, cut off level of 3,500 mIU/ml was the most reasonable level in this study.
Female ; Humans ; Linear Models ; Patient Selection ; Pregnancy ; Pregnancy, Tubal* ; Sensitivity and Specificity ; Trophoblasts*

Faced with patients who underwent TURP and who were given antibiotics until catheter-removal, usually complain of urinary frequency or burning on ruination and showing sterile urine (less than l00 bacteria per ml., in clean-caught midstream about 24 hours after catheter-removal), we often hesitate to make a decision whether they should be given antibiotics or not. So we divided 27 such patients into three groups : group l ; 7 patients, no additional antibiotics after catheter-removal, group 2; 12 patients, antibiotics for one week after catheter-removal and we performed weekly urine culture for clarifying the necessity of additional antibiotic therapy and its appropriate duration, if necessary. The following results and conclusions were obtained. I. Group l showed bacteriuria in 86%(6 of 7 patients). 2.Group 2 and 3 showed bacteriuria 5%(1 of 20 patients). 3. These data suggested that additional antibiotic therapy rather than stopping antibiotic therapy might be justified(P : less than 0.001). 4. Group 2 showed no bacteriuria and group 3 showed bacteriuria in one patient which disappeared promptly. Namely, there was no practical difference in the incidence of bacteriuria between the two groups. 5. 9 cases of fungiuria were found, all of which developed in patients given antibiotics perioperatively for more than 2 weeks. 6. Considering the above items and cost-effectiveness, a week`s additional antibiotic therapy is probably an appropriate answer to treating the above-mentioned patients. 7. Main causative organism in post-TURP bacteriuria was Pseudomonas spp(4of 7 cases).
Anti-Bacterial Agents* ; Bacteria ; Bacteriuria ; Burns ; Humans ; Incidence ; Pseudomonas ; Transurethral Resection of Prostate* ; Urinary Catheters

46, XX male is a rare sex cluomasomal constitution characterized by the development of bilateral testis in persons who lack a Y chomosome. The majority of affected persons have normal external genitalia and usually seek medical advice due to infertility, hypogonadism and/or gynecomastia in adulthood. Although Y chromosomsl sequences can be detected in the majority of male subjects with 46, XX karyotype, several studies have shown thst approximately 10 % of patients lack Y chromosomal material including the SRY ( sex-determining region of Y-chromosome) gene. Several hypothesis have been proposed to explain the etiology of this constitution. 1. Translocation of the testis-determining factor (TDF) fiom the Y to the X chromosome or autosome. 2. Acquisition of Y chromosome function by a mutant autosomal or X-linked gene. 3. Undetected mosaicism with Y-bearing cell line 4. Loss of Y chmmosome hom the XXY Klinefelter zygote. We experienced a case of 46, XX male who was 30 years old. We report a case with review of the literature.
Adult ; Cell Line ; Constitution and Bylaws ; Genes, X-Linked ; Genitalia ; Gynecomastia ; Humans ; Hypogonadism ; Infertility ; Karyotype ; Male* ; Mosaicism ; Sex-Determining Region Y Protein ; Testis ; X Chromosome ; Y Chromosome ; Zygote

A case of right simple unilateral renal ectopia with left malrotated kidney in 26 years old female is presented with a brief review of literature. Right ectopic kidney was located between 4th and 5th lumber vertebra Numerous aberrant vessels of ectopic kidney disclosed during nephroureterectomy.
Adult ; Female ; Humans ; Kidney ; Spine

No Abstract Available.
Blepharoplasty*

No abstract available.
Infectious bursal disease virus*

No abstract available.
Hallux Valgus* ; Hallux*

The Pill Questionnaire (PillQ) has been proposed as a simple way to evaluate cognitive deficits and their impact on the daily lives of those with Parkinson’s disease (PD) by asking patients or caregivers about whether patients can independently manage their pills. We used the PillQ to investigate the association of ability to manage medication with cognition and activities of daily living (ADLs) in patients with PD. Patients were divided into two groups based on PillQ scores. The no-impact group was able to take their antiparkinsonian medication independently, and the impact group exhibited problems describing their treatment or taking their drugs independently. A total of 208 participants (93 men) were included. 111 patients (53.4%) were included in the no-impact group, and 97 (46.6%) were included in the impact group. The impact group showed significantly lower cognitive functioning, difficulties with the performance of ADLs, and severe motor dysfunction. PillQ scores were significantly correlated with Mini-Mental State Examination and the Montreal Cognitive Assessment, and Clinical Dementia Rating scores. Management of medication by PD patients is associated with cognitive function, and the PillQ is an easy and useful test for detecting cognitive impairment and its impact on daily life.

The method of ankle arthrodesis is variable but compression arthrodesis has been widely used because of better results than non-compression arthrodesis. Twenty-one cases of ankle arthrodesis were carried out at department of orthopaedic surgery of Korea Veterans Hospital from January 1980 to June 1986, and were analysed clinically. The results obtained were as follows; l. Among 11 cases of compression arthrodesis, Charnleys method was done in 8 cases and Monofixateur in 3 cases. 2. Among 10 cases of non-compression arthrodesis, Chuinard-Peterson method was done in 7 cases and anterior 'sliding graft in 3 cases. 3. The average duration of immobilization after ankle arthrodesis was 11.7 weeks, and average 4.2 weeks were less needed in the compression arthrodesis than non-compression arthrodesis. 4. The postoperative complications were developed in 8 cases (38%): wound infection in 4 cases,skin necrosis in 3 cases and incisional neuroma in 1 case. 5. Bony union was obtained in 20 cases(95.2%) out of 21 cases at average 15.7 weeks, and in the non-compression arthrodesis and in the cnmpression arthrodesis, respectively, 90% at 17.7 weeks and 100% at 13.9 weeks.
Ankle Joint ; Ankle ; Arthrodesis ; Hospitals, Veterans ; Immobilization ; Korea ; Methods ; Necrosis ; Neuroma ; Postoperative Complications ; Transplants ; Wound Infection

We report two cases of malignant schwannoma of skin in association with non-familial neurofibromatosis. Case 1, a 47 year old man, had a large subcutaneous tumor on the sacral area and case 2, a 62 year old woman, a painful, ulcerating tumor on the posterior aspect of the left arm. Both cases were histopathologically confirmed as malignant schwannomas and immunohistochemical studies showed 5-100 protein in the tumor cells. After surgical excision of the tumors, case 1 was lost to follow up, while case 2 remained without evidence of disease for more than one and half years.
Arm ; Female ; Humans ; Lost to Follow-Up ; Neurilemmoma* ; Neurofibromatoses* ; Skin ; Ulcer