SUMMARY: Benign fibrous histiocytoma of the knee is a very rare entity. We report on one case of benign fibrous histiocytoma that involved the patellar fat pad, an areas of involvement not previously reported. Diagnostic arthroscopy was performed to show retrobulging of infrapatellar fat pad without specific synovial changes. The lesion was completely resected. At short-term follow-up, all symptoms were resolved. Arthroscopy can be used as an diagnostic tool for identification of intraarticular lesions of the knee, but appears not to be a good tool for clean removal of mass within patellar fat pad.
Adipose Tissue* ; Arthroscopy ; Follow-Up Studies ; Histiocytoma, Benign Fibrous* ; Knee

Midtrimester genetic amniocentesis is an important diagnostic tool in prenatal genetic diagnosis and counseling. We can identify karyotypes with metaphase chromosome analysis of cultured amniocytes. Marker chromosomes are defined as unidentified structurally abnormal chromosomes. Incidence of marker chromosomes in the previous reported studies was 0.6-1.5/1,000. They occurred more frequently with advanced maternal age. Ascertainment of chromosomal origin is important because it may be associated with malformation and developmental abnormalities. Recently, identification of the origin and composition of marker chromosomes has been made possible by the use of fluorescent in situ hybridization (FISH). Most marker chromosomes are known to be originated from chromosome 15 or 22, X, Y. We have experienced a case of non-15, non-22 marker chromosome prenatally detected in amniocentesis and FISH, so we reported it with a brief review of literature.
Amniocentesis ; Chromosomes, Human, Pair 15 ; Counseling ; Diagnosis ; Female ; Humans ; In Situ Hybridization, Fluorescence ; Incidence ; Karyotype ; Maternal Age ; Metaphase ; Pregnancy ; Pregnancy Trimester, Second

OBJECTIVE: Chlamydia trachomatis is one of the most common causative microorganism in pelvic inflammatory disease (PID). In this infection tubal obstruction, infertility, tubal pregnancy and recurrent pelvic infection has involved. Also, perinatal infection, spontaneous abortion and preterm labor of pregnant women increased in chlamydia infection. This study was performed to investigate the prevalence rate and clinical characteristics of Chlamydia trachomatis in symptomatic women. METHODS: From March, 2003 to March, 2004, in OB-Gyn development, endocervical swab were obtained in 218 patients (137 impatients of PID and 81 outpatients) by Amplicor Chlamydia Transfer Kits and Human papilloma virus kit. They were studied on history taking, physical examination, laboratory test, and polymerase chain reaction for the detection of Chlamydia trachomatis. Also, in this study we investigated the prevalence of human papilloma virus and N. gonorrhea in the Chlamydia infection group. RESULTS: The prevalence rate of Chlamydia trachomatis was 27.5% (61/218) in pelvic inflammatory disease. As regarding the age distribution of Chlamydia trachomatis positive group was the high prevalence rate in twenties (52.8%). Chlamydia infection was related to the history of artificial abortion, oral contraception, occupation status, history of gynecologic disease (PID, Ectopic pregnancy). Women with chlamydial infection were 2.5 times greater risk of coincidal HPV infection and 2 times greater risk of coincidal N. gonorrhea infection and both were statistically significant. CONCLUSION: The prevalence rate of Chlamydia infection is higher than any other sexually transmitted disease and Chlamydia infection has serious complication on reproduction. It appears weak symptom and detection is difficult. Therefore the screening and treatment of Chlamydia trachomatis are necessary to decrease the prevalence and prevention of complication.
Abortion, Spontaneous ; Age Distribution ; Chlamydia Infections ; Chlamydia trachomatis* ; Chlamydia* ; Contraception ; Fallopian Tube Diseases ; Female ; Genital Diseases, Female ; Gonorrhea ; Humans ; Infertility ; Mass Screening ; Obstetric Labor, Premature ; Occupations ; Papilloma ; Pelvic Infection ; Pelvic Inflammatory Disease* ; Physical Examination ; Polymerase Chain Reaction ; Pregnancy ; Pregnancy, Tubal ; Pregnant Women ; Prevalence ; Reproduction ; Sexually Transmitted Diseases

Persistent cloaca is a very rare congenital malformation with the incidence of 1/50,000-250,000 births. This malformations have a single common perineal opening for the genital, urinary and gastrointestinal tracts. Because of wide spectrum of abnormal anatomy involving upper urinary tract, gastrointestinal systems, cardiovascular system, central nervous system, and respiratory system, prenatal diagnosis is difficult through ultrasound during pregnancy. It has been reported that if the anomalies are diagnosed early, they can be corrected surgically. We present a case of persistent cloaca with meconium peritonitis and hydrometrocolpos confirmed by neonatal surgery after emergency cesarean section.
Cardiovascular System ; Central Nervous System ; Cesarean Section ; Cloaca* ; Emergencies ; Female ; Gastrointestinal Tract ; Incidence ; Meconium* ; Parturition ; Peritonitis* ; Pregnancy ; Prenatal Diagnosis ; Respiratory System ; Ultrasonography ; Urinary Tract

BACKGROUND: The inhalation of a high concentration of isoflurane transiently increases heart rate (HR) and blood pressure. The current study examined the effects of age on isoflurane-induced circulatory responses. METHODS: One hundred-ten patients were randomly allocated into one of four groups according to age: under 10 years (Group 1), 20 - 40 years (Group 2), 41 - 60 years (Group 3), and over 65 years (Group 4). In each group, the inspired concentration of isoflurane via mask was increased to 5.0 vol% abruptly. The target was to produce an end-tidal concentration of isoflurane (ETisof) of 2.6 vol% which was maintained until the end of the study by adjusting the vaporizer setting when necessary. HR, mean arterial pressure (MAP), ETisof, and end-tidal concentration of carbon dioxide were measured at baseline and every 30 seconds for 5 minutes after inhalation of isoflurane and for 2 minutes after intubation. RESULTS: HR and MAP significantly increased after inhalation of isoflurane in all four groups compared with the baseline. The time from administration of isoflurane to the maximal HR was less than that for MAP. However, there were no significant differences among the groups for ETisof at the maximal HR and MAP. In Groups 1 and 4, the times for maximal HR were shorter than in Groups 2 and 3. In aged patients (Group 4), the isoflurane-induced HR increase was less than in the other three groups. There were no significant differences among the groups in increases of MAP. CONCLUSIONS: The high concentration of isoflurane transiently increases HR and MAP during inhaled anesthesia induction. In aged patients, the increase in HR is less than in younger-aged patients.
Age Factors ; Anesthesia ; Arterial Pressure ; Blood Pressure ; Carbon Dioxide ; Heart Rate ; Humans ; Inhalation ; Intubation ; Isoflurane* ; Masks ; Nebulizers and Vaporizers

Induction of general anesthesia with direct laryngoscopy and tracheal intubation is a routine procedure. However, it is accompanied by varying degree of sympathetic stimulation as reflected by significant hypertension, tachycardia, and arrhythmia. These transient hemodynamic responses are undesirable, especially in patients with cardiovascular or intracranial diseases. Many approaches have been tried to attenuate these potentially adverse circulatory responses (topical or i.v. lidocaine, deep anesthesia with inhalation anesthetics, opioids, adrenergic blockers, calcium channel blockers, sedatives, etc), and several trials reduced the hemodynamic effects. This study was done to examine blunting effect of verapamil, labetalol, and fentanyl on the adverse hemodynamic changes following direct laryngoscopy and tracheal intubation. Eighty patients, ASA Physical Status I II, scheduled for elective surgery, were selected randomly. These were divided into four groups. Group 1: Control (saline) (n = 20) Group 2: Verapamil 100 ug/kg (n = 20) Group 3: Labetalol 0.25 mg/kg (n = 20) Group 4: Fentanyl 3 ug/kg (n = 20) These were injected 3 minutes before induction with thiopental sodium (5mg/kg) and succinylcholine (1 mg/kg) i.v. in alI groups. Laryngoscopy and endotracheal intubation were performed 5 minutes after study drugs injection. After the completion of intubation, 50% nitrous oxide in oxygen and 1.5 Vol% halothane were inhaled. The blood pressure and heart rate were measured with automatic noninvasive blood pressure device and E.C.G monitoring every minutes for 10 minutes. The data were analyzed with Student's paired t-test within the groups and unpaired t-test between the groups. Results were considered statistically significant if p < 0.05. All study drugs, verapamil, labetalol, or fentanyl significantly blunted the increase in heart rate, arterial blood pressure, and rate pressure product caused by direct laryngoscopy and endotracheal intubation. There was no significant difference between verapamil and labetalol, but the blunting effects on hemodynamic changes were very significant in fentanyl group. So, verapamil, labetalol, and fentanyl may offer on important role in patients in whom an inaease in blood pressure, heart rate, and/or rate pressure product should be avoided during the endotracheal intubation.
Adrenergic Antagonists ; Analgesics, Opioid ; Anesthesia ; Anesthesia, General ; Anesthetics, Inhalation ; Arrhythmias, Cardiac ; Arterial Pressure ; Blood Pressure ; Calcium Channel Blockers ; Fentanyl* ; Halothane ; Heart Rate ; Hemodynamics* ; Humans ; Hypertension ; Hypnotics and Sedatives ; Intubation ; Intubation, Intratracheal* ; Labetalol* ; Laryngoscopy ; Lidocaine ; Nitrous Oxide ; Oxygen ; Succinylcholine ; Tachycardia ; Thiopental ; Verapamil*

Blunt chest trauma can result in significant cardiothoracic injury, which can include a cardiac contusion, aortic injury, and myocardial valvular injury. Traumatic aortic regurgitation is an uncommon consequence of closed chest injury. Isolated aortic valvular injury following blunt chest trauma is difficult to diagnose in a patient with multiple injuries. We report a case of traumatic aortic regurgitation which was detected just before anesthesia induction in the operating room. This report is presented to emphasize the possibility of aortic regurgitation and the need for careful evaluation of the cardiac status in patients with blunt chest trauma.
Anesthesia ; Aortic Valve Insufficiency* ; Contusions ; Humans ; Multiple Trauma ; Operating Rooms ; Thoracic Injuries* ; Thorax*

BACKGROUND: Recently, functional direct cortical stimulation mapping is frequently used during craniotomy for the surgery of brain pathology (tumors, epileptic foci etc.) within or close to the central motor area. We reviewed and analyzed our experiences to evaluate the safety and efficacy of our hospital's anesthetic management regimens. METHODS: We used three anesthetic regimens (isoflurane fentanyl; propofol fentanyl; awake craniotomy, conscious sedation analgesia) in 44 patients. We evaluated the success ratio of mapping and the incidence of intraoperative problems (seizures, changes in vital signs etc) in each regimens. RESULTS: In awake craniotomy group, functional mapping is performed successfully in all patients but there were some intraoperative problems (hypertension; 3 in 11 patients, hypercapnia; 3 in 11 patients, change to general anesthesia required; 1 in 12 patients). In general anesthesia groups, there were no significant differences between isoflurane treated patients and propofol treated patients in the success ratio of mapping (17/20 vs 11/12) and the incidence of intraoperative problems (seizure; 3/20 vs 1/12, hypertension; 2/20 vs 1/12). CONCLUSION: This results suggest that the anesthetic management regimens used in our hospital provide suitable conditions for craniotomies when brain mapping is required.
Anesthesia, General ; Brain Diseases ; Brain Mapping ; Conscious Sedation ; Craniotomy* ; Fentanyl ; Humans ; Hypercapnia ; Hypertension ; Incidence ; Isoflurane ; Propofol ; Vital Signs

BACKGROUND: Physical disability may result in some impairment of the score for Instrumental Activities of Daily Living (IADL). The aim of this study was to evaluate the effect of physical disability on IADL in patients with Alzheimer's disease (AD), amnestic mild cognitive impairment (aMCI), subcortical vascular dementia (SVD), and vascular mild cognitive impairment of the subcortical type (svMCI). METHODS: Fifty-six patients with AD, 30 with SVD, 27 with aMCI, and 21 with svMCI were recruited consecutively from a memory clinic. Informants for the subjects completed a Korean version of the IADL (K-IADL). In addition, the informants were asked to choose the cause of each dependent activity of K-IADL from the following: cognitive impairment, physical disability, or both. The cause of the physical disability was defined as being focal neurologic symptoms, other physical disease, or both. RESULTS: Compared to AD patients, SVD patients had higher K-IADL scores [2.02+/-0.80 (mean+/-SD) vs. 1.45+/-0.90, p<0.01] and focal neurologic signs (FNS; 8.0+/-5.8 vs. 0.0+/-0.0, p<0.001), and lower Barthel Index scores (14.7+/-5.1 vs. 19.6+/-1.2, p<0.001). Patients with svMCI had higher FNS (3.8+/-4.5 vs. 0.0+/-0.0, p<0.001) compared to those with aMCI. The most common cause of dependency of activities in K-IADL was cognitive impairment in AD, aMCI, and svMCI patients, and the combined effect of cognitive impairment and physical disability in those with SVD. The cause of physical disability was FNS in 96% of SVD patients and in all patients with svMCI. CONCLUSIONS: The effects of FNS as well as cognitive impairment should be considered when measuring the IADL of the patients with SVD or svMCI.
Activities of Daily Living ; Alzheimer Disease ; Dementia, Vascular ; Dependency (Psychology) ; Humans ; Memory ; Mild Cognitive Impairment ; Neurologic Manifestations

PURPOSE: Premature ejaculation is a common male sexual dysfunction and has an adverse effect on QoL(quality of life). Chronic pelvic pain syndrome(CPPS) is also a common and serious health problem affecting QoL. Although both disorders are common their etiopathogeneses are not well understood. We investigated the prevalence and effect of premature ejaculation on erectile function in CPPS patients and compared these patients with healthy control subjects. MATERIALS AND METHODS: 638 CPPS patients and 102 healthy controls were enrolled in this study. Each patient was given a questionnaire consisting of 3 parts: a demographic data questionnaire, the Korean version of the NIH-CPSI(National Institutes of Health-Chronic Prostatitis Symptom Index), and IIEF(International Index of Erectile Function). Premature ejaculation was defined as intravaginal ejaculation latency of less than 3 minutes with the same partner for at least 6 months. RESULTS: 303 patients with CPPS and 83 healthy controls were eligible for the analysis. The rate of premature ejaculation was much higher in patients with CPPS(71.62%) than healthy controls(22.89%), and this difference was statistically significant(p < 0.01). In the patients with CPPS, the frequency of sexual intercourse per month during the last 3 months was 4.79+/-3.43. In the patients with CPPS, the mean scores for IIEF-EF(erectile function), IIEF-IS(intercourse satisfaction), IIEF-OF(orgasmic function), IIEF-SD(sexual desire) and IIEF-OS(overall satisfaction) were 21.7+/-6.4, 8.5+/-2.9, 7.4+/-2.5, 5.3+/-2.0 and 5.2+/-2.1, respectively. Each mean IIEF domain score was lower than healthy controls, and these differences were statistically significant. But in the patients with CPPS categorized in IIIa and IIIb, the frequency of sexual intercourse and each IIEF domain score showed no difference. CONCLUSIONS: The rate of premature ejaculation was higher in the patients with CPPS than healthy controls.
Academies and Institutes ; Coitus ; Ejaculation ; Humans ; Male ; Pelvic Pain* ; Premature Ejaculation* ; Prevalence* ; Prostatitis