Although uterine arterovenous malformation(AVM) is a rare cause of menorrhagia or postmenopausal bleeding, it is important to consider that curettage may precipitate life-threatening hemorrhage and therefore it is contraindicated when AVM is suspected. Special investigations such as hysteroscopy, Doppler flow ultrasound and angiography are important diagnostic tools, and transarterial embolization(TAE) has replaced hysterectomy as the treatment of choice in women who wish to retain their fertility. But due to the high incidence of collateral vessels, recurrence of the vascular malformation after TAE is common. We have experienced two cases of AVM, one of which was managed by TAE in combination with surgical arterial ligation.
Angiography ; Arteriovenous Malformations* ; Curettage ; Female ; Fertility ; Hemorrhage ; Humans ; Hysterectomy ; Hysteroscopy ; Incidence ; Ligation* ; Menorrhagia ; Recurrence ; Ultrasonography ; Vascular Malformations

Inability to tolerate discontinuation of mechanical ventilation or the need for reintubation has been reported .s much as 20% in mechanically ventilated patients. Many factors may be responsible for the .nsuccessful weaning outcome such as hypoventilation secondary to decreased respiratory c,nter output, respiratory muscle fatigue, impaired pulmonary gas exchange and excessive ventilatory requirements. We experienced a patient who was very difficult to wean from long term mechanical ventilation. The patient was 36 years old male with Guillain Barre syndrome. After 7 days admission, tracheostomy was taken and mechanical ventilation continued to 332 days. There was not any chance of pneumonia during the 11 months ventilation. His respiratory parameter improved to TV of 350 ml and VC of 1300 ml and he was able to breath himself without mechanical ventilator during day time. But he could not sleep without ventilator for fear of dying during sleep. We made him sleep with diazepam injection and carefully observed the patient with pulse oximetry and Sara capnography. We tried this method many times and the patient got the confidence that he cauld alive during sleep without mechanical ventilator. We could wean from long term mechanical ventilation during sleep by carefully observing patients respiratory pattern. Therefore we report here this successful weaning from long term ventilator in anxious and nervous patient.
Adult ; Capnography ; Diazepam ; Fatigue ; Guillain-Barre Syndrome ; Humans ; Hypoventilation ; Male ; Oximetry ; Pneumonia ; Pulmonary Gas Exchange ; Respiration, Artificial* ; Respiratory Muscles ; Tracheostomy ; Ventilation ; Ventilators, Mechanical ; Weaning*

Primary ovarian pregnancy is a rare form of ectopic pregnancy, and the prevalence rate is reported to be between 1/7,000 and 1/40,000 pregnancies. Ovarian pegnancy occurs within the ovary and on the corpus luteum, usually with rupture and massive bleeding. It is frequently misdiagnosed as a ruptured corpus luteum and the differentiation may be made only by micoroscopic examination of a tissue specimen. We have experienced four cases of ovarian pegnancy, which are presented with a brief review in the literature.
Corpus Luteum ; Female ; Hemorrhage ; Ovary ; Pregnancy ; Pregnancy, Ectopic* ; Prevalence ; Rupture

Mature cystic teratoma of the ovary is the most common ovarian germ cell neoplasm comprising (10-20%) of all ovarian tumors and almost always benign, but it can be developed into malignancy rarely. We have recently experienced one case of squamous cell carcinoma arising in mature cystic teratoma of the right ovary in 67-year-old postmenopausal woman. The ovarian tumor was measured 17x12.5x8 cm in size and had not intact capsule, and the peritoneal washing cytology was positive. The survival rate with cancerous dermoid is very poor. Neither of two forms of postoperative treatment (radiotherapy and chemotherapy) has any significant influence on survival. We report above case with a brief review of literature.
Aged ; Carcinoma, Squamous Cell* ; Dermoid Cyst ; Female ; Germ Cells ; Humans ; Ovary* ; Survival Rate ; Teratoma*

PURPOSE: This research was done to compare obstetric pain, anxiety and cervical dilatation between an epidural analgesia group and a control group. METHODS: Participants were assigned to the experimental or control group depending on their decisions for pain relief. Subjective / objective obstetric pain, anxiety level and cervical dilatation were measured and ANOVA was used for comparison of groups and paired t-test to make pre-post comparisons. RESULTS: Homogeneity of pain, anxiety and cervical dilatation were assessed at the latent phase. Cervical dilatation was larger in the control group than the experimental group, at both the active and the transitional phase (F=22.9, p<.001; F=39.9, p<.001 respectively). The degree of pain and anxiety were not significantly different between the groups. Within the experimental group, subjective / objective pain and anxiety level were significantly lower postanalgesia compared to pre-analgesia in the active phase. All variables, except for sweating in the objective pain measurement, changed significantly at the transient phase. CONCLUSION: The results of this evidence-based research indicate that epidural analgesia while effective in relieving pain and anxiety may have an adverse effect on the cervix during labor stage I. Epidural analgesia should be used carefully during cervical dilatation in labor stage I.
Analgesia ; Analgesia, Epidural ; Anxiety ; Cervix Uteri ; Female ; Labor Pain ; Labor Stage, First ; Pain Measurement ; Pregnancy ; Sweat ; Sweating

Almost all cases of acute methanol intoxication result from ingestion. Absorption of methanol following oral administration is rapid and peak concentration occurs within 30-60 min. Foromic acid converted metabolites of methanol are responsible for its toxic effect. Methanol poisoning typically induces nausea, vomiting, abdominal pain, and mild central nervous system depression. Then there is a latent period lasting, followed by an uncompensated metabolic acidosis and visual dysfunction, depending on the dose of methanol ingested. Here we report on three patients who were victims of methanol intoxication due to ingestion of windshield washer fluid, which was misidentified as an alcoholic beverage. One patient had a mild form, which included abdominal discomfort, another patient had a moderate case, which included nausea, vomiting, and acidosis, and the other patient had severe acidosis and altered mentality and visual dysfunction. Except one case of visual dysfunction, all three patients recovered successfully following medical treatment and hemodialysis.
Abdominal Pain ; Absorption ; Acidosis ; Administration, Oral ; Alcoholic Beverages ; Alcoholics ; Central Nervous System ; Depression ; Eating ; Humans ; Methanol ; Nausea ; Renal Dialysis ; Vomiting

Pulmonary siderosis is one kind of pneumoconiosis caused by the long term inhalation of iron dust. Iron is deposited in the lungs, usually in the form of iron oxides. Iron oxides are relatively inert particles with a minimal fibrotic response. It occurs in a number of occupations including welding, steel rolling and grinding, casting, iron ore mining and oxyacetylene cutters. We have experienced the first case of pulmonary siderosis in Korea. A 42-year-old woman who had engaged in a metalware manufacturing factory as a manager for 7 years was admitted because of dyspnea on exertion. A pulmonary function test disclosed a mildly obstructive ventilatory defect. Open lung biosy revealed deposition of iron-laden macrophages in most alveolar spaces by which confirmed the diagnosis of pulmonary siderosis. We report a case of pulmonary siderosis with a review of the literature.
Adult ; Diagnosis ; Dust ; Dyspnea ; Female ; Humans ; Inhalation ; Iron ; Korea ; Lung ; Macrophages ; Mining ; Occupations ; Oxides ; Pneumoconiosis ; Respiratory Function Tests ; Siderosis* ; Steel ; Welding

The purpose of this study was to understand the management status of food wastes in school meal to find the effective ways that would reduce and recycle them. Data was collected using questionnaires from 223 school dietitians located in Jeonbuk area. The results were as followed : 1) Waste was managed by the dietitians(54.7%) and cook(42.2%). The waste disposal contract was made by dietitians(65.0%), executives(31.4%). Therefore, school dietitians had primary responsibilities in the waste management. 2) As disposal ways, 48.9% processed municipal solid waste and food waste together and 46.6% processed separately. 3) A half of schools(52.9%) produced food wastes weighed under 10~15kg daily and using food wastes as animal food for farms was most popular method to dispose(87.4%). 4) Reasons to have food-wastes were disliking the taste of menu(50.2%) and the inappropriate ways of dealing with remaining food(64.1%) and donating to food bank(33.6%) in order. 5) The suggested ways to reduce the food-waste was to improve on cooking method(72.2%), changing of portion size(61.0%), measuring the amount of leftover food(53.4%) and requesting cooperation to educators(52.9%). 6) The reported consequences of reducing the food waste were: lowered grocery expenses(46.2%), and inspiring students on helping environmental preservation(23.8%). Therefore, the administration should work on finding a method to reduce food-waste and a way to use these resources efficiently. It is important to induct student's attitude on recycling remaining products by using food bank via nutrition education. Dietitian also should consider to reduce the leftover of food by using a standardized recipe.
Animals ; Contracts ; Cooking ; Food Services ; Humans ; Meals ; Surveys and Questionnaires ; Recycling ; Solid Waste ; Waste Management

A clinical analysis was performed on 326 cases of the non-penetrating rib fractures experienced in the department of thoracic and cardiovascular surgery, Chosun University Hospital and 102 cases of the non-penetrating rib fractures those has been admitted and treated in the department of thoracic and cardiovascular surgery, Jeonnam Hwasoon Jung-ang Hospital during a period from Jan. 1994 to Dec. 1995. 1. Sex ratio was 3.4:1 in urban and 3.6:1 in rural communities with male predominance. 2. Most common cause were traffic accident in both communities. 3. Hemothorax, pneumothorax and hemopneumothorax which needed thoracostomy were observed in 146 cases(44.7%) in the urban and 12 cases(11.7%) in the rural communities. 4. Left thorax was the spell site of rib fractures in both communities. 5. Rib fracture was prevalent from 3rd to 6th rib in both communities. 6. Open thoracotomy was performed in 37 cases(11.3%) in urban and 3 cases(2.9%) in rural communities. 7. Overall mortality was 4.29%(14 cases) in urban area and, 1.96%(2 cases) in rural communities, and cause of death were hypovolemic shock, brain edema, sepsis, respiratory failure, asphyxia, and cardiogenic shock.
Accidents, Traffic ; Asphyxia ; Brain Edema ; Cause of Death ; Hemopneumothorax ; Hemothorax ; Humans ; Jeollanam-do ; Male ; Mortality ; Pneumothorax ; Respiratory Insufficiency ; Rib Fractures* ; Ribs* ; Rural Population* ; Sepsis ; Sex Ratio ; Shock ; Shock, Cardiogenic ; Thoracostomy ; Thoracotomy ; Thorax

The development of a retropharyngeal hematoma following a trivial blunt trauma is a rare occurrence. A lateral c-spine X-ray or a cervical CT image that shows marked widening of the prevertebral space is sufficient evidence for the clinical diagnosis of retropharyngeal hematoma. When this complication does occur, it can become life-threatening if the airway is compromised. But the diagnosis is obscure and initially veiled in complaints of sore throat or hoarseness, suggesting infection. Thorough investigation of such complaints is necessary especially in patients receiving anticoagulation therapy. We now report a case of retropharyngeal hematoma that occurred as a delayed-onset consequence of a trivial blunt trauma with no evidence of a bony cervical spine injury. It occurred in a 52-year-old man who had been taking warfarin. We also reviewed the literature.
Hematoma ; Hoarseness ; Humans ; Middle Aged ; Pharyngitis ; Spine ; Warfarin