The uterus with rudimentary horn occurs as a result of a lack of development during fetal life of the middle and lower parts of one of the Miillerian ducts, in which there is a failure of fusion of the two ducts, The incidence of this uterine anomaly is rare. Many cases of rudimentary uterine horn are not discovered since they do not become involved in a pregnancy, and thus remain symptomless and uncomplicated, and the diagnosis usually being made only with pregnancy with rupture. In this presentation, we describe a case of diagnosis and management of unruptured non-communicating rudimentary uterine horn pregnancy at the third trimester. The patient diagnosed by ultrasonography and MRI, was hospitalized for further evaluation and delivery under the impression of unruptured non-communicating rudimentary horn pregnancy. A living male infant weighing 1,930 gm was delivered by cesarean section at 33+l weeks due to impending preterm labor. Some articles concerned this subject were reviewed briefly to discuss relevant method of diagnosis, treatment, and clinical characteristics.
Animals ; Cesarean Section ; Diagnosis ; Female ; Horns* ; Humans ; Incidence ; Infant ; Magnetic Resonance Imaging ; Male ; Obstetric Labor, Premature ; Pregnancy Trimester, Third* ; Pregnancy* ; Rupture ; Ultrasonography ; Uterus

We experienced a case of vitamin B12 unresponsive methlymalonic acidemia in a 4 day old female, who had poor feeding, dehydration with metabolic acidosis, and hyperammonernia and died at 7 days of age. Diagnosis was made by gas chromatography and mass spectrometry, and this case is probably a methylmalonyl CoA mutase apoenzyme deficiency type.
Acidosis ; Apoenzymes ; Chromatography, Gas ; Dehydration ; Diagnosis ; Female ; Humans ; Mass Spectrometry ; Methylmalonyl-CoA Mutase ; Vitamin B 12

The purpose of this study was to identify how students majoring in nursing perceive cause of cancers and the effects of diet for preventing cancers. Data for the study were collected by 651 nursing students, who were registered in the second and third year in three technical colleges and third and fourth year in two universities. The research instruments included items on general characteristics of subjects, items about the degree of perception of the frequency of cancer onset and items on the perception of mortality, risk factors, preventive diets, knowledge, and high risk factor for cancer in specific body areas. The findings of this study are as follows : 1. Almost all subjects(92.8%) reported that the frequency of cancer onset increases and that it is 93.9% for people over 40. Degree of perception about cancer mortality was low at 33.0%. 2. As far as the perception of risk factors for cancer onset was concerned, smoking, stress, heredity, family history, and alcohol were rated high, over 80.0%. Risk factor in clouding, virus, hormones, pesticides were rated as low. 3. As to the perception of risk factor for body area as associated with diet salted and scorched food were rated at 44.5% for stomach cancer, alcohol, 50.4% for liver cancer, smoking, 72.8% for lung cancer, pregnancy times, 25.3%, and marriage age, 23.0% for uterine cancer, and no delivery experience, 40% for breast cancer. 4. The knowledge score for cancer was between 12 and 36, with a mean score of 26.75(SD=4.13). There was a statistically significant difference between experience in caring for cancer patients during clinical practice and knowledge score(t=3.09, p=.002).
Breast Neoplasms ; Diet* ; Heredity ; Humans ; Liver Neoplasms ; Lung Neoplasms ; Marriage ; Mortality ; Nursing* ; Pesticides ; Pregnancy ; Risk Factors* ; Smoke ; Smoking ; Stomach Neoplasms ; Students, Nursing ; Uterine Neoplasms

OBJECTIVES: The objective of this study is to analyze 1,068 cases of prenatal genetic amniocentesis and to compare the results with reported studies. METHOD: We analyzed 1,068 cases of midtrimester prenatal genetic amniocenteses from September 1994 to February 1999, and investigated the fetal chromosomal abnormality, obstetric outcomes and complications by the indications of genetic amniocentesis and prophylactic antibiotic use at the Department of Obstetrics and Gynecology, Ajou University School of Medicine. RESULTS: Abnormal maternal serum markers were the most common indication of amniocentesis (57.7%) and the most common age distribution was 25-29 years (39.2%). One case of early amniocentesis (14 gestational weeks) was performed. The overall incidence of chromosomal aberration was 5.2% (56/1,068), of which there were 28 cases (50.0%; 28/56) of numerical aberrations and 28 cases (50.0%; 28/56) of structural aberrations. There were 50 cases (4.7%) of autosomal chromosomal aberrations and 6 cases (0.6%) of sex chromosomal aberrations. The pregnancy outcome was full-term delivery in 86.5%, preterm delivery in 7.6%, termination of pregnancy in 4.0%. There were no cases of serious complications including fetal death except for a case of self-limited amniotic fluid leakage(high leakage) in which the pregnancy was maintained. There were no significant differences between prophylactic antibiotics user group and non-user group in obstetric complications and outcomes. CONCLUSION: We could confirm that the trend in the indication of genetic amniocentesis had changed from advanced maternal age(35 year-old) toward abnormal maternal serum marker(triple test), and we recognized the importance of genetic amniocentesis according to the various antenatal screening tests of maternal serum marker, antenatal ultrasound, past history of fetal anomaly or family history of fetal chromosomal anomaly in the younger age groups(< 35 year-old) that are involved in more than half of the chromosomal anomaly. Further study will be needed to elucidate the efficacy of using prophylactic antibiotics in amniocentesis.
Age Distribution ; Amniocentesis* ; Amniotic Fluid ; Anti-Bacterial Agents ; Biomarkers ; Chromosome Aberrations ; Female ; Fetal Death ; Gynecology ; Humans ; Incidence ; Obstetrics ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second ; Prenatal Diagnosis ; Ultrasonography

BACKGROUND: This study was to access the hemostatic effectiveness of transcatheter arterial embolization (TAE) in a blunt splenic injury. We evaluated the efficacy of using detailed angiographic examnination and embolization for the nonsurgical management of patients with spleen injury. METHODS: Blunt splenic injuries diagnosed by Computed tomography (CT) between January 1997 and December 1997 were prospectively studied according to our management algorithm. The first group (G1) consisted of patients who were observed only, the second grourp (G2) with consisted of patients receving a TAE, and the third group (G3) consisted of those receving a laparotomy. The criteria for a TAE were: 1) Type III or IV injury and 2) extravasation of contrast material revealed by CT. RESULTS: Of the total 46 patients with blunt splenic injury, 17 underwent emergency laparotomies because of associated injuries or unstable vital signs after resuscitation. Fourteen of the 17 had splenectomies and the other three had splenorrhaphies. The remaining 29 patients were considered for nonoperative management (63%), and 13 of them were selected for a TAE. Splenic angiography showed active bleeding in 12 and minor bleeding in one. The bleeding was successfully controlled by TAE in all 13 patients. Abdominal CT and scintigraphy taken after TAE disclosed well functioning spleens. The total splenic salvage rate was 63% in our patients. CONCLUSION: We could reduce the laparotomy rate and could preserve more spleens after application of TAE. Our success rate for splenic salvage should encourage more extensive use of a TAE for splenic injury.
Angiography ; Emergencies ; Hemorrhage ; Humans ; Laparotomy ; Prospective Studies ; Radionuclide Imaging ; Resuscitation ; Spleen ; Splenectomy ; Tomography, X-Ray Computed ; Vital Signs

Purpose: The purpose of this study is to compare the clinical features and complications of snake bite patients in urban and rural areas. Methods: A retrospective study was conducted on patients over 18 years of age who were hospitalized for snake bites from January 2013 to December 2019. Patients were categorized into urban and rural groups according to their respective locations at the time of the snake bite and the clinical characteristics and complications of the two patient groups were researched and compared. Results: Of the 77 snake bite patients, 44 patients were categorized into the rural group (57.1%). The rura1 group showed significant differences in old age (p=0.011), delayed hospital visits (p=0.010), far hospital distance (p<0.001), high local effect score (p<0.001), high traditional snake-bite severity grading scale (p=0.008) and use of large amounts of antivenins (p=0.026). There was a significantly higher incidence of acute kidney injury (p=0.030), rhabdomyolysis (p=0.026), and coagulopathy (p=0.033) in the rural group as well as a longer hospitalization period (p<0.011). Conclusion Snake bites that occurred in rural areas resulted in patients with more complications compared to urban areas due to farther distances from hospitals, causing a delay in antivenom treatment.

Tetramine toxicity due to sea snail ingestion is generally mild and has a good prognosis. Tetramine toxicity acts on the acetylcholine receptor, affecting the neuromuscular junction and autonomic nervous system. A 78-year-old female patient visited the emergency room with vomiting and dyspnea after eating sea snails. At the time of admission, the vital signs recorded were 140/80 mmHg-105/min-24/min-36.5。C, and 90% oxygen saturation. Arterial blood test revealed hypercapnia (pCO2 58.2 mmHg) and respiratory acidosis (pH 7.213, HCO3 - 22.5 mmol/L), whereas other blood tests showed no specific findings. Due to decreased consciousness and hypoxia, endotracheal intubation and mechanical ventilation were administered to the patient. Successful weaning was accomplished after 12 hrs, and the patient was discharged without any further complications. Although tetramine toxicity rarely results in acute respiratory failure due to paralysis of the respiratory muscle, caution is required whilst treating the patient.

Objective: To investigate the comprehensive outcomes in aphasic patients, including their cognitive and functional status after ischemic or hemorrhagic stroke. It also aimed to clarify whether aphasia is a prognostic factor for cognitive and functional improvements in stroke patients. Methods: Sixty-seven ischemic or hemorrhagic stroke patients in the subacute stage who had been diagnosed with aphasia using the Korean version of Frenchay Aphasia Screening Test (K-FAST) were included in the study. Forty-six stroke patients without aphasia were used as controls. All patients were examined with the Korean version of the Western Aphasia Battery (K-WAB). Cognitive and functional assessments of the patients including the Korean version of Mini-Mental State Examination (K-MMSE), and the Korean version of Modified Barthel Index (K-MBI) were performed during admission and 4 weeks after the initial assessments. Results: The initial and follow-up total K-MMSE and K-MBI scores were significantly lower in aphasic patients than in non-aphasic controls. The K-WAB scores highly correlated with the total K-MMSE scores at the follow-up stage in all aphasic stroke patients. The K-WAB scores moderately correlated with the follow-up scores of the K-MBI in ischemic stroke patients but not in hemorrhagic stroke patients. Conclusion Aphasia influences the cognitive and functional status of stroke patients and has a greater impact on cognitive improvement. Aphasia severity can be one of the prognostic factors for cognitive status in aphasic patients with stroke.

Mallory-Weiss syndrome is a laceration in the region of the gastroesophageal junction due to vomiting, retching, coughing preceding hematemesis in alcoholic patient. Bleeding from Malloly-Weise tears stop spontaneously without specific therapy in 80-90% of patient, but rebleeding occurs in 2 to 5% of patients. Thus most patients require only supportive care. Rarely endoscopic therapy or operative therapy may be required. We performed endoscopic mucosal ligation using intraluminal negative pressure with band ligation for uncontrolled Mallory-Weiss syndrome. In conclusion, Endoscopic O-ring band ligation in uncontrolled intractable Mallory-Weiss syndrome is safe and effective method, but its important that accurate endoscopic O-ring band ligation an bleeding site in laceration area. We experienced endoscopic O-ring band ligation in 6 cases of Mallory-Weiss syndrome.
Alcoholics ; Cough ; Esophagogastric Junction ; Hematemesis ; Hemorrhage ; Humans ; Lacerations ; Ligation* ; Mallory-Weiss Syndrome ; Vomiting

BACKGROUND: This research is to find out the object of Medical Phone Counsel rational and satisfactory by investigating in local clinic the actual state of Medical Phone Counsel, which is a form of medical care between doctor and patient, and by grasping the difference of expectation and recognition between doctor and patient on Medical Phone Counsel which is one of the service items of Attending Physician Registration System which is to be put into effect in near future. METHODS: This research conducted a se7-administered questionnaire targeting all practitioners to the number of forty four who gave primary care in Kangnung city from August to September in 1999, and each twenty patients Per Practitioner. This research compared and analyzed the difference of recognition between doctor and patient on the following contents of Medical Phone Counsel ; General Characteristic, Frequency, Contents, Time, Satisfiability, For or Against the Medical Phone Counsel to be executed under Attending Physician Registration System and Expectations. RESULTS: The questionnaire for doctor had a 70.5% of response rate, and the one for patient 17.2%. The 40.7% of the practitioners took a Phone Counsel actively, the 55.6% took part in Phone Counsel passively and the rest 3.7% did not participate in it. The 74.2% of them took this counsel for less than three minutes. Regarding recognition on Phone Counsel, the 48.1% of them answered that they executed it as it is their duty and the 48.4% responded that they took it reluctantly in spite of their busy business. The 3.2% answered that it is not their duty. Among those in favor of Phone Counsel under Attending Physician (or Prime Doctor) Registration System, the 28.6% agreed as it is their own duty and the 71.4% was for it subject to economic compensation. While, the 62.9% of the patients answered that they had never experienced the Phone Counsel, and the 34.4% responded that they had experienced it one or two times in a yea. Among those who had experienced Phone Counsel, the 46.4% was satisfied with it. As far as the difference of expectation and recognition between doctor and patient on Medical Phone Counsel is concerned, only 45.2% of the practitioners were in favor of Medical Phone Counsel under the Attending Physician Registration System. While, the 70.1% among the patients was in favor of its execution. These two values showed a significant difference between doctor and patient (P<0.05), And the 83.9% of the practitioners insisted that the charge should be paid against Phone Counsel and only 56.2% of the patients insisted the same. There was also a significant difference between two values. (P<0.05) CONCLUSION: The practitioners were taking part in Medical Phone Counsel at any form. To the contrary, most of the patients were not. As far as the systematization of Phone Counsel is concerned, most of the practitioners had mental reluctance if there is no economic compensation. On the other hand, most of the patients had high expectation regardless of economic matters. If Medical Phone Counsel becomes systematized, it is expected that there will be a great trouble between its supply and demand.
Commerce ; Compensation and Redress ; Hand ; Hand Strength ; Humans ; Primary Health Care* ; Surveys and Questionnaires