Malignant transformation is a rare complication in a mature cystic teratoma of the ovary, usually being reported less than 2% of cases. The most common malignant tumor arising from a mature cystic teratoma of the ovary is a squamous cell carcinoma. However, adenocarcinoma is reported extremely rare, in most cases it was impossible to tell the source of the malignancy. We experienced a case of papillary carcinoma of thyroid glands arising from mature cystic teratoma of the ovary and report this case with a brief review of literature.
Adenocarcinoma ; Carcinoma, Papillary* ; Carcinoma, Squamous Cell ; Female ; Ovary ; Teratoma* ; Thyroid Gland*

BACKGROUND: It has been reported that nontuberculosis mycobacterium(NTM) isolates account for approximately 10% of patients with a positive Acid-Fast Bacilli(AFB) smear. Therefore, it is necessary to consider NTM pulmonary disease when such a positive test is encountered. The aim of this study was to evaluate the etiologies and clinical characteristics of patients with NTM pulmonary disease who had been treated at a national tuberculosis hospital. METHODS: The NTM isolates were recovered from the sputum or bronchial washing specimens submitted to a clinical laboratory of National Masan TB Hospital from August 2002 to July 2003. All samples were identified using a polymerase chain reaction-restriction fragment length polymorphism analysis method, which amplifies the rpoB gene. The patients were diagnosed with NTM disease according to the American Thoracic Society diagnostic criteria. RESULTS: One hundred NTM isolates were recovered from 57 patients. Of the 100 isolates, M. avium complex(MAC) was the most common species, which was found 55%(n=55) of patients, followed by M. abscessus(n=25), and M. fortuitum(n=9). 26(45.6%) patients had NTM disease. Twenty-six (45.6%) patients had NTM disease according to The American Thoracic Society classification. The main organisms involved in NTM disease were MAC(n=19, 73.1%) and M. abscessus(n=5, 19.2%). The pathogenic potential was 67.9% in M. intracellulare and 41.7% in M. abscessus. The predictive factors related to NTM disease were a positive sputum smear (OR 6.4, p=0.02) and the isolation of either MAC or M. abscessus(OR 6.9, p=0.007). Fifteen patients(57.7%) were cured. There were no significant factors associated with the treatment success. CONCLUSION: There was a relatively high proportion of NTM disease in NTM isolates and the common species were MAC and M. abscessus. The predictive factors for NTM disease were a positive sputum smear and the isolation of either MAC or M. abscessus.
Classification* ; Hospitals, Chronic Disease* ; Humans ; Lung Diseases* ; Mycobacterium avium Complex ; Nontuberculous Mycobacteria ; Sputum ; Tuberculosis*

OBJECTIVE: This study assesses the hypothesis that preeclampsia is associated with the change of oxidative system balance by measuring the lipid peroxidation and antioxidant activity in preeclampsia. METHOD: Venous blood samples were collected from twenty women with preeclampsia and twenty women with uncomplicated pregnancies. Total lipid peroxidation, total antioxidant activity, antioxidant enzyme activity and antioxidant concentration were measured using flow injection-chemiluminescent method. RESULTS: 1. Total lipid peroxidation(PCOOH) was higher in preeclampsia(717.22+/-93.08 pmol/ml) than in normal pregnant(486.86+/-43.15 pmol/ml) (P<0.05). 2. Total antioxidant activity was significantly higher in preeclampsia(46.02+/-5.95 % inhibition) than in normal pregnant(38.59+/-7.57 % inhibition) (P<0.05).3. Antioxidant enzyme, catalase activity in RBC was lower in preeclampsia(346.59+/-82.84 unit/gHb) than in normal pregnant(440.62+/-72.8 unit/gHb) (P<0.05).4. Antioxidant, alpha-tocopherol concentration in RBC was slightly lower in preeclampsia(33.21+/-7.82 ng/gHb) than in normal pregnant(36.06+/-6.86 ng/gH), but there was no statistically significant difference (P<0.05). CONCLUSION: This data seems to show that preeclampsia is associated with an imbalance between the lipid peroxidation and the antioxidant system.
alpha-Tocopherol ; Catalase ; Female ; Free Radicals ; Humans ; Lipid Peroxidation ; Pre-Eclampsia* ; Pregnancy

Aneurysmal ruptures associated with middle cerebral artery(MCA) anomalies, such as a duplicated MCA and an accessory MCA, are quite rare. The authors reviewed the clinical relevance and possible etiology of these anomalies.
Aneurysm ; Aneurysm, Ruptured ; Intracranial Aneurysm* ; Middle Cerebral Artery* ; Rupture*

Heterotopic pregnancy is defined as simultaneous intrauterine and extrauterine pregnancy. The incidence of heterotopic pregnancy was about 1 to 30,000 pregnancies, but it has been increased. This increased incidence is explained by the rise in PID, pelvic surgery, IUD and assisted reproductive technologies-in vitro fertilization/gamate intrafallopian insemination/intrauterine insemination. Thus careful pelvic examination combined with serial beta-hCG determinations and transvaginal sonography to evaluate the adnexal region are necessary prerequisites for early diagnosis. We report a case of heterotopic pregnancy following in ovulation induction and intrauterine insemination with a brief review of literature.
Early Diagnosis ; Female ; Gynecological Examination ; Incidence ; Insemination* ; Ovulation Induction* ; Ovulation* ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Heterotopic*

Trisomy 18 is the second most common chromosomal anomaly which reach to live birth next to Down syndrome. Several methods were proposed to screen patients on the risk of Edward syndrome like maternal serum levels of total human chorionic gonadotropin (hCG), alpha-fetoprotein (AFP) and unconjugated estriol or free beta hCG with AFP, but the serum screening has only 67% detection rate with a 7.2% of false positive rate. Therefore, in order to overcome the limitations which the serum markers have, detailed ultrasound examination is also necessary and sensitivity of 80% was reported. We report a case of Trisomy 18 fetus in which choroid plexus cyst was the only abnormal sonographic finding.
alpha-Fetoproteins ; Biomarkers ; Chorionic Gonadotropin ; Choroid Plexus* ; Choroid* ; Down Syndrome ; Estriol ; Fetus ; Humans ; Live Birth ; Mass Screening ; Trisomy ; Ultrasonography

OBJECTIVE: To evaluate the efficacy of clinical use of a intrauterine Sengstaken-Blakemore tube (S-B tube) in postpartum hemorrhage not controlled with medication and conservative treatment. METHODS: Retrospective review was done in 18 women with insertion of S-B tube into intrauterine cavity who did not controlled with medication and conservative treatment for postpartum hemorrhage. After third stage of labor, women were treated with prophylactic intramuscular Methylergonovine 0.2 mg and intravenous infusions of oxytocin routinely. If the postpartum bleeding continued, Misoprostol 800 microgram (per rectal) and intravenous infusions of Dinoprost 2 mg mixed with 5% D/S 500 cc were employed. And then women were examined for retained placenta and laceration of birth canal. Where necessary, retained placenta was removed and lacerations were sutured. If the postpartum bleeding did not controlled despite all of procedures, we decided use of intrauterine S-B tube. RESULTS: The mean age of the patients was 30.9+/-4.4 (27-39) years, their mean body weights and parities were 67.8+/-8.2 (56.2-85.7) kg, 1.8+/-0.8 (1-4) and mean gestational age was 38.5+/-2.9 (37-42) weeks respectively. The mean time from delivery to insertion of S-B tube was 107.6+/-94.0 (24-360) minutes. The mean filled normal saline amount was 190.5+/-35.2 (120-230) cc. Of 18 who was inserted of S B tube, 15 cases needed not additional surgical therapy. So success rate was 83.3%. CONCLUSION: Insertion of intrauterine S-B tube appears as a simple and effective means of treating postpartum hemorrhage not controlled with medication and conservative treatment.
Body Weight ; Dinoprost ; Female ; Gestational Age ; Hemorrhage ; Humans ; Infusions, Intravenous ; Lacerations ; Methylergonovine ; Misoprostol ; Oxytocin ; Parturition ; Placenta, Retained ; Postpartum Hemorrhage* ; Postpartum Period* ; Retrospective Studies

BACKGROUND: Hypertension is the most common cause of left ventricular hypertrophy(LVH). Increased left ventricular mass(LVM) carries independent risk for congestive heart failure, coronary artery disease, sudden death, reduction of coronary reserve. The importance of treatment in systemic hypertension for cardiovascular morbidity and mortality has been estabilished. Regression of LVM occurs with a number of antihypertensive drugs. This study was designed to explore the relation between blood pressure control, LVM and left ventricular filling dynamics. METHODS: Twenty five patients (12 men, 13 women) with estabilished hypertension were studied. No patients had a previous history of antihypertensive therapy. We obtained the basal echocardiography at the diagnosis which were disclosed no definite LVH, and the follow-up echocardiography after 6 months antihypertensive therapy with angiotension converting enzyme inhibitor, fosinopril, in patients with untreated essential hypertension. RESULTS: 1) Baseline blood pressure was 150/125mmHg and fell to 104/85mmHg (p<0.001). There was no siginificant reduction in heart rate. LVM were reduced from 153gr/m2 to 129gr/m2. 2) Peak E velocity and Peak A velocity was 82.9cm/sec, 74.9cm/sec and reduced to 67.2cm/sec, 62.3cm/sec, (p<0.001). 3) Time velocity integral dimension E (Ei) and time velocity integral dimension A (Ai) was 13.0cm, 9.0cm and reduced to 8.6cm, 4.5cm respectively. But there was no significant inteval change in peak E/A velocity. Ei/Ai was increased from 1.7 to 2.1 (p<0.01). CONCLUSIONS: These results suggested that antihypertensive therapy with ACE inhibitor for 6 months reduced significantly the left ventricular mass in patients with untreated essential hypertension.
Antihypertensive Agents ; Blood Pressure ; Coronary Artery Disease ; Death, Sudden ; Diagnosis ; Echocardiography ; Follow-Up Studies ; Fosinopril ; Heart Failure ; Heart Rate ; Humans ; Hypertension* ; Male ; Mortality

OBJECTIVE: This study was performed to investigate the effects of metformin in PCOS patients undergoing IVF-ET. METHODS: From January 2002 to December 2004, 87 cycles in 32 PCOS patients undergoing IVF-ET at the Infertility clinic of Grace Women's Hospital were randomly divided into two groups and enrolled in this study. The diagnosis of PCOS was made by the criteria from 2003 Rotterdam Consensus. Metformin group (19 patients, 45 cycles) received metformin (Daewoong Pharma Co., Korea; 500 mg three times or two times a day from one or two months before and during IVF cycle) and control group (13 patients, 42 cycles) did not receive metformin. All patients received controlled ovarian hyperstimulation (COH) using gonadotropins (Fostimon, IBSA, Switzerland) with GnRH antagonist (Cetrotide, Serono, Germany). When leading follilces reached 18 mm in diameter, recombinant hCG 250 ?g (OVIDREL, Serono, Italy) was injected. Oocytes were retrieved transvaginally 35 hours later. The luteal phase was supported everyday by progesterone 50 mg IM (Progest, Samil, Korea) with micronized progesterone 200 mg vaginal insertion (Utrogestan, Besins, France). RESULTS: There was no statistical difference in the patients age (34.1+/-3.0 vs 33.5+/-2.9 years), the duration of infertility (4.3+/-1.3 vs 4.5.+/-1.3 years) and BMI (23.5+/-2.4 vs 24.01+/-2.7 kg/m2) among two groups (p> or =0.05 for each). There was also no statistical difference in the indications of IVF among two groups; ovulation factor (27 cycles vs 23 cycles), tubal factor (7 vs 8), male factor (8 vs 7) and other factor (3 vs 4) (p> or =0.05). The duration of ovulation induction in metformin group was significantly shorter when compared with control group (10.1+/-2.3 vs 13.8+/-2.2 days, p<0.05). Total doses of FSH-HP in metformin group were significantly less than that in control group (30.3+/-11.5 vs 39.9+/-11.7 ampules, p<0.05). There was no difference in the number of aspirated oocytes (10.5+/-4.7 vs 9.6+/-3.6), the fertilization rate (65.9+/-17.4% vs 63.2+/-25.9%), implantation rate (30.3+/-11.5% vs 38.1+/-17.3%) and the number of good quality embryo (5.0+/-1.8 vs 4.7+/-2.5, p< or =0.05). Clinical pregnancy rate was higher in metfomin group (33.3% vs. 23.8%), although statistically not significant. CONCLUSION: Although more randomized study is needed, metformin therapy in PCOS patients undergoing IVF has possibility of reducing the duration of COH and the gonadotropin doses.
Consensus ; Diagnosis ; Embryo Transfer* ; Embryonic Structures* ; Female ; Fertilization ; Fertilization in Vitro* ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Humans ; Infertility ; Korea ; Luteal Phase ; Male ; Metformin* ; Oocytes ; Ovulation ; Ovulation Induction ; Polycystic Ovary Syndrome* ; Pregnancy Rate ; Progesterone

This study was performed to investigate the anatomical features of vertebral artery between the atlas and the axis. For this, we examined four angles (angle I, angle II, angle III and angle IV) to identify tortuosity of vertebral artery and diameter between the atlas and the axis. Materials used in this study were 93 vertebral arteries obtained from 48 adult Korean cadavers (34 males, 14 females) ranging from 18 to 90 years in age. On the anterior view, the vertebral artery relatively ascended vertically from C6 to the axis and then laterally passed through the foramen transversarium (FT) of the axis. The average of this angle I was 83.3 degree. The average of the right and left sides of this angle I were 84.7 degree and 82.0 degree, respectively. The average of angle I (95.4 degree) in female was larger than that (80.5 degree) of male. The artery passed through the FT of the axis turned to the superior direction. The average of this angle II was 95.9 degree. The right and left sides of the angle II were 97.8 degree and 93.8 degree, respectively. As the angle I, the average of angle II (110.6 degree) in female was larger than that of angle II (93.1 degree) in male. On the lateral view, the vertebral artery relatively ascended vertically from C6 to the axis and then posteriorly passed through the FT of the axis. The average of this angle III was 71.3 degree. The artery passed through the FT of the axis turned to the superior direction. The average of this angle IV was 87.3 degree. In angle III and angle IV, the average of angle in female were larger than that of male. These results show that female has greater tortuosity than male. The average diameter of the vertebral artery was 3.7 mm and the average diameter of right and left are 3.5 mm and 4.0 mm, respectively. In 76% of the total, left vertebral artery diameter was larger than that of the right.
Adult ; Arteries ; Axis, Cervical Vertebra* ; Cadaver ; Female ; Humans ; Male ; Vertebral Artery*