Heterotopic pregnancy is the coexistency of intrauterine and extrauterine pregnancy. The incidence of heterotopic pregnancy is about 1 to 30,000 pregnancy in a natural cycle. However, the frequency of heterotopic pregnancy has steadily increased because of rising incidence of pelvic inflammatory disease, pelvic surgery and the development of ovulation induction and assisted reproduction. Because heterotopic pregnancy is difficult to diagnose and it has high morbidity and mortality rate, one should always take this into consideration and should conduct careful and thorough gynecologic evaluation. We have experienced a case of heterotopic pregnancy in a 29-year old woman who presented with acute abdominal pain in a natural cycle and report this case with a brief review of literature.
Abdominal Pain ; Adult ; Female ; Humans ; Incidence ; Mortality ; Ovulation Induction ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Heterotopic* ; Reproduction

PURPOSE: To evaluate surgical effect of Medpor(R) Barrier Sheet, by comparing with postoperative outcomes using Medpor(R) Barrier Sheet and Medpor(R) in orbital wall reconstruction. METHOD: We have retrospectively analyzed clinical features and postoperative outcomes in two groups. One group is 29 patients who had undergone orbital wall reconstruction using Medpor(R) Barrier Sheet, the other group is 26 patients who had undergone orbital wall reconstruction using Medpor(R). RESULTS: The violence was the most common cause of the orbital wall fractures, the most common fracture site was inferior wall in the two groups. There were no significant differences between the two groups in improvement of diplopia and limitation of extraocular movement(p>0.05). The mean amount of enophthalmic correction were 1.15 mm in Medpor(R) Barrier Sheet group and 1.39 mm in Medpor(R) group. Three cases of Medpor(R) Barrier Sheet group and two cases of Medpor(R) group caused the infraorbital hypoesthesia, but prolapse or dislocation of implant was not found in the two groups. CONCLUSIONS: In this study, Medpor(R) Barrier Sheet had similar surgical effect to regular Medpor(R); its advantages over regular Medpor(R) were easy intraoperative manipulation and less adherence of extraocular muscle in reconstruction of orbital wall fractures. But when cost- effectiveness is considered, Medpor(R) Barrier Sheet may be a good available implant in orbital wall reconstruction for the selective cases with extraocular muscle exposed.
Diplopia ; Dislocations ; Humans ; Hypesthesia ; Orbit* ; Prolapse ; Retrospective Studies ; Violence

Aniridia is a relatively rare congenital anomaly and its incidence is about 1:100, 000.Main features of aniridia include congenitally partial or nearly complete absence of the iris and hypoplasia of optic disc and fovea. It is almost bilateral and occurred as an autosomal dominant trait.However, some patients develop both sporadic nonfamilial aniridia and Wilms 'tumor, and another group of patients is transmitted as an autosomal recessive trait. We observed aniridia in two generations, as mother and two daughters. They had cataract, nystagmus, neovascularization of corneal margin and pannus formation, as well as aniridia.We also found hypoplasia of optic disc and fovea in mother. We have operated on mother with phacoemulsified lens aspiration and posterior chamber IOL implantation in both eyes consecutively.The postoperative visual acuity following lens extraction improved, but was not corrected. In addition, intraocular pressure decreased.
Aniridia* ; Cataract ; Family Characteristics ; Humans ; Incidence ; Intraocular Pressure ; Iris ; Mothers ; Nuclear Family ; Visual Acuity

To investigate the transmission pattern of geographical area and temporal trends of the 2010~2011 foot-and-mouth disease (FMD) outbreaks in Korea, and to explore temporal intervals at which spatial clustering of FMD cases space-time analysis based on georeferenced database of 3,575 burial sites, from 30 November 2010 to 23 February 2011, was performed. The cases represent approximately 98.1% of all infected farms (n = 3,644) during the same period. Descriptive maps of spatial patterns of the outbreaks were generated by ArcGIS. Spatial Scan Statistics, using SaTScan software, was applied to investigate geographical clusters of FMD cases across the country. Overall, spatial heterogeneity was identified, and the transmission pattern was different by province. Cattle have more clusters in number but smaller in size, as compared to the swine population. In addition, spatiotemporal analysis and the comparison of clustering patterns between the first 7 days and days 8 to 14 of the outbreak revealed that the strongest spatial clustering was identified at the 7-day interval, although clustering over longer intervals (8~14 days) was also observed. We further discussed the importance of time period elapsed between FMD-suspected notice and the date of confirmation, and emphasized the necessity of region-specific and species-specific control measures.
Animals ; Burial ; Cattle ; Disease Outbreaks ; Foot-and-Mouth Disease ; Geographic Information Systems ; Korea ; Population Characteristics ; Republic of Korea ; Spatial Analysis ; Spatio-Temporal Analysis ; Swine

Systolic time interval measurements were made sequentially during second, third trimesters and postpartum period. Recordings were made in the supine position after bed rest for at least five minutes in order to obtain a steady state. In second trimester, pre-ejection period index (PEPI) was significantly shortened and left ventricular ejection period index(LVETI) remained normal while PEP/LVET decreased. Four possible mechanisms may be involved to account for the alterations in hemodynamic changes during this period(late stage of second trimester) : (1) increased metabolic demands of pregnancy: (2) hemodynamic effects of hypervolemia: (3) circulatory adjustments secondary to an arteriovenous shunt-like effect of the placental circulation: (4) cardiovascular effect of steroid hormone. The third trimester was characterized-by a markedly shortened LVETI, a prolonged PEPI and PEP/LVET. This findings are consistent with impaired left ventricular performance and are probably due to decreased left ventricular preload resulting from diminished venous return secondary to inferior vena caval obstruction by the large gravid uterus. In the postpartum period, the PEPI and PEP/LVET remained elevated and the LVETI shortened in the supine position. It is concluded that alterations in systolic time intervals occur normally during the course of uncomplicated pregnancy and persist into the postpartum period.
Bed Rest ; Female ; Hemodynamics ; Humans ; Placental Circulation ; Postpartum Period* ; Pregnancy ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third* ; Supine Position ; Systole* ; Uterus

PURPOSE: We retrospectively reviewed the cases of ureteroscopic stone removal at our institution to define the efficiency of ureteroscopy for treatment of ureteral calculi. MATERIALS AND METHODS: Ureteroscopic stone removal was performed in 376 cases of ureteral stone from August, 1989 to December, 1997. There are 241 males and 135 females, and mean age was 45.6 years. Nine stones were located in the upper ureter, 27 in the mid ureter, 340 in the lower ureter. The stone size was less than 5mm in 125 cases, from 5 to 10mm in 185 cases and more than 10mm in 66 cases. Ureteroscopy was performed with 9.5Fr, 10Fr or 12.5Fr rigid ureteroscope under spinal, general or epidural anesthesia. RESULTS: Overall success rate of ureteroscopic stone removal was 95.1 percent. The success rates of upper, mid and lower ureteral stones were 55.6, 88.9 and 97.1 percents, respectively. According to the stone size, the success rates was 97.6 percent in stones less than 5mm, 94.6 percent in stones of 5 to 10mm and 92.4 percent in stones more than 10mm. Over all complication rate was 9.6 percent. Complications consisted of severe ureteral mucosal tearing(20 cases), ureteral perforation(8 cases), gross hematuria(3 cases), infection(3 cases) and urethral stricture(2 cases). All complications were treated successfully with conservative treatment except 2 cases of urethral stricture that required visual urethrotomies. CONCLUSIONS: Ureteroscopic stone removal could offer rapid relief of obstruction and colic due to mid and lower ureteral calculi with high success rate and minimal complications.
Anesthesia, Epidural ; Calculi ; Colic ; Female ; Humans ; Lithotripsy ; Male ; Retrospective Studies ; Ureter ; Ureteral Calculi ; Ureteroscopes ; Ureteroscopy ; Urethral Stricture

Hemangioma is one of the most common congenital tumors in the region of the face and neck. Although histologically benign, these facial masses are clinically malignant for their deforming and inexorable growth, especially in so-called 'cavernous hemangioma'. Carvenous hemangioma is the most common primary tumor occurring in the adult orbit. This tumor has symptoms that characteristically develop over several years with slowly progressive proptosis, eyeball deviation, hyperopia, diplopia and optic nerve compression. Today, hemangiomas are being treated by various methods; steroids, electrocoagulation, injection of sclerosing agent, cryotherapy, radiation therapy, laser therapy, and surgical treatment, etc. In principle, surgical approaches to the orbit must provide maximum safety and optimal visualization. We have experienced a case of large cavernous hemangioma in the orbit inferolaterally. The surgical treatment of tumor was achieved by the bicoronal approach combined with inferomedial and inferolateral orbitotomy. This surgical approach allows better visualization of the tumor and greater protection of essential anatomic structures. We obtained satisfactory results in terms of aesthetic and functional consideration. We present our case with a brief review of the literature related to orbital cavernous hemangioma.
Adult ; Cryotherapy ; Diplopia ; Electrocoagulation ; Exophthalmos ; Hemangioma ; Hemangioma, Cavernous* ; Humans ; Hyperopia ; Laser Therapy ; Neck ; Optic Nerve ; Orbit* ; Steroids

No abstract available.
Adrenal Glands* ; Ganglioneuroma* ; Hyperplasia*

Oal contraceptives are one of the most frequently used methods of hormonal contraception. In general, oral contraceptives have proven to be safe for most women. However, the risk of deep vein thrombosis and pulmonary embolism are increased in women taking oral contraceptives. We have experienced a case of a woman who had superior mesenteric venous (SMV) and portal vein thromboses on taking oral contraceptives with antithrombin III, protein C, and protein S deficiencies.
Antithrombin III* ; Contraception ; Contraceptive Agents ; Contraceptives, Oral* ; Female ; Humans ; Portal Vein ; Protein C* ; Protein S Deficiency* ; Protein S* ; Pulmonary Embolism ; Thrombosis ; Venous Thrombosis*

OBJECTIVE: This study was performed to determine the anatomical landmarks and optimal dissection points of the facial nerve (FN) and the hypoglossal nerve (HGN) in the submandibular region to provide guidance for hypoglossal-facial nerve anastomosis (HFNA). METHODS: Twenty-nine specimens were obtained from 15 formalin-fixed adult cadavers. Distances were measured based on the mastoid process tip (MPT), common carotid artery bifurcation (CCAB), and the digastric muscle posterior belly (DMPB). RESULTS: The shortest distance from the MPT to the stylomastoid foramen was 14.1+/-2.9 mm. The distance from the MPT to the FN origin was 8.6+/-2.8 mm anteriorly and 5.9+/-2.8 mm superiorly. The distance from the CCAB to the crossing point of the HGN and the internal carotid artery was 18.5+/-6.7 mm, and that to the crossing point of the HGN and the external carotid artery was 15.1+/-5.7 mm. The distance from the CCAB to the HGN bifurcation was 26.6+/-7.5 mm. The distance from the digastric groove to the HGN, which was found under the DMPB, was about 35.8+/-5.7 mm. The distance from the digastric groove to the HGN, which was found under the DMPB, corresponded to about 65.5% of the whole length of the DMPB. CONCLUSION: This study provides useful information regarding the morphometric anatomy of the submandibular region, and the presented morphological data on the nerves and surrounding structures will aid in understanding the anatomical structures more accurately to prevent complications of HFNA.
Adult ; Cadaver ; Carotid Artery, Common ; Carotid Artery, External ; Carotid Artery, Internal ; Facial Nerve ; Humans ; Hypoglossal Nerve ; Mastoid ; Muscles