Spontaneous rupture of subcapsular liver hematoma in pregnancy is rare but potential life threatening complication of preeclampsia. We experienced a case of spontaneous rupture of subcapsular hematoma of liver that was treated with conservative method. So, we present the case with a brief review of literatures as first report in Korea.
Hematoma* ; Korea ; Liver* ; Pre-Eclampsia ; Pregnancy* ; Rupture, Spontaneous

The major causes of small bowel obstruction are postoperative adhesion, hernia, intussusception and malignancies. However, in cases of uncommon causes of small bowel obstruction, surgeons are in a dilemma because the preoperative diagnosis and making a decision to operate are frequently difficult and delayed. Phytobezoars are unusual cause of small bowel obstruction. They are mostly due to ingestion of stringent immature fruits following gastric surgery. They are usually formed in stomach and do not migrate to the other intestinal tract, but can lead to the serious complication of acute small bowel obstruction. We are reporting a case of acute small bowel obstruction due to phytobezoar about 2x2x3 cm3 size in a 90 year old female.
Aged* ; Aged, 80 and over ; Bezoars ; Diagnosis ; Eating ; Female ; Fruit ; Hernia ; Humans ; Intestinal Obstruction* ; Intussusception ; Stomach

PURPOSE: To compare the outcomes of scleral buckling (SB) and primary pars plana vitrectomy (PPV) for treatment of simple rhegmatogenous retinal detachment (RD). METHODS: One hundred and fifteen Eyes undergoing SB or PPV for the treatment of simple rhegmatogenous RD were prospectively identified and followed up at least six months. Anatomic results, functional outcomes and complications were compared between eyes treated with SB and eyes treated with PPV. RESULTS: We detected no significant differences in overall success rates or final vision quality between the two treatment groups. However, the final vision quality of pseudophakic patients treated with PPV was significantly better than the final vision quality of pseudophakic patients treated with SB. Two treatment goups experienced similar rates of intraocular pressure elevation and proliferative vitreoretinopathy development. In phakic patients, the rates of cataract progression were higher in patients treated with PPV than in patients treated with SB. CONCLUSIONS: PPV can be an effective method for the treatment of simple rhegmatogenous RD, and maybe considered as a viable alternative to SB for simple cases. However, in phakic patients treated with PPV, simultaneous or follow-up cataract surgery should be considered as adjuvant treatments.
Cataract ; Eye ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Prospective Studies ; Retinal Detachment ; Retinaldehyde ; Scleral Buckling ; Vision, Ocular ; Vitrectomy ; Vitreoretinopathy, Proliferative

Toxoplasma lymphadenitis is the most common clinical manifestation of toxoplasmosis in an immunocompetent host. The cervical lymph nodes are the most commonly involved, whereas systemic manifestations are rare. The most common clinical presentations are asymptomatic or subclinical, with fever, maculopapular rash, and general malaise. In immunocompromised patients, the presentations may be devastating with disseminated disease resulting in encephalitis, myocarditis, and pneumonia. We are reporting a case of toxoplasma lymphadenitis in an immunocompetent host diagnosed by histologic and serologic evaluation.
Encephalitis ; Exanthema ; Fever ; Immunocompromised Host ; Lymph Nodes ; Lymphadenitis* ; Myocarditis ; Pneumonia ; Toxoplasma ; Toxoplasmosis*

OBJECTIVE: To determine whether the presence of fetal fibronectin in the cervicovaginal secretion could be used as a clinical marker to predict the outcome of labor induction. METHODS: The study group comprised 58 term pregnant women with intact amnionic membranes, 44 without labor and 14 with irregular labor. All patients had been admitted for induction of labor during Sept. 1, 1999 to Dec. 31, 1999 at the Department of Obstetrics and Gynecology of Yeungnam University Hospital. Fetal fibronectin was assayed with the cervicovaginal secretion. We analyzed the variables of labor outcome by the presence (positove) or absence (negative) of fetal fibronectin and the modified Bishop score. RESULTS: Cervicovaginal fetal fibronectin was detected in 75.0% (33/44) of the women without labor and 85.7% (12/14) with irregular labor, and 76.3% (29/38) with Bishop score 4 or less and 80.0% (16/20) with score 5 or above. There was no statistical differences in the positive rate of fetal fibronectin between the women without labor and those with irregular labor, and the women with Bishop score 4 or less and those with Bishop score 5 or above, respectively. The mean oral PGE2 tablets used for cervical ripening, the mean time interval from the beginning of labor induction to delivery, and the mean cesarean delivery rate were 1.97+/-2.56 tabs and 3.12+/-2.42, 10.12+/- 6.56 hours and 13.88+/-6.14, and 20.0% and 38.4%, in the women with positive fetal fibronectin and those with negative respectively, and 1.83+/-2.50 and 2.42+/-2.60, 10.11+/-7.17 hours and 11.28+/-6.26 hours, and 10.0% and 31.6% in the women with Bishop score 5 or above and those with Bishop score 4 or less, respectively. There were no statistical differences in the mean values between the women with positive and negative fetal fibronectin, and between Bishop score 5 or above and Bishop score 4 or less, respectively. There were no statistical differences in the mean oral PGE2 tablets used for cervical ripening (2.00+/- 2.65 vs. 4.40+/-1.82) and the mean time interval from the beginning of labor induction to delivery (10.11+/- 7.53 vs. 16.17+/-5.38), between the women with positive fetal fibronectin and Bishop score 5 or above and those with negative fetal fibronectin and Bishop score 4 or less, respectively. However, the cesarean delivery rate was significantly lower in the women with positive fetal fibronectin and Bishop score 5 or above than those with negative fetal fibronectin and Bishop score 4 or less (6.3% vs 44.4%, p=0.040). CONCLUSION: The assesment of cervicovaginal fetal fibronectin and Bishop score could be useful in predicting the success or failure of labor induction. But it was not helpful to predict the easiness of labor induction by the presence or absence of fetal fibronectin in the cervicovaginal secretion and/or modified Bishop score.
Amnion ; Biomarkers ; Cervical Ripening ; Dinoprostone ; Equidae ; Female ; Fibronectins* ; Gynecology ; Humans ; Membranes ; Obstetrics ; Pregnancy ; Pregnant Women ; Tablets

OBJECTIVES: The purpose of this study was to identify psychosocial factors associated with biological markers in Korean patients with human immunodeficiency virus (HIV) infection. METHODS: 50 patients with HIV infection were enrolled. We administered Stress Response Inventory (SRI), the Coping Scale, and the Korean version of Smithklein Beecham quality of life scale (QOL) to the 50 patients and measured CD4+ cell count and HIVRNA copies. RESULTS: Simple correlation analysis showed significant correlation between psychosocial factors and CD4+ cell count. Tension, aggression, depression, frustration subscale in SRI and distancing, self controlling in coping scale had negative correlation with CD4+ cell count, whereas QOL showed positive correlation. Multiple regression analysis showed significant negative association between distancing and CD4+ cell count. There were no differences in CD4+ cell count and HIVRNA between homosexual patients and heterosexual patients. However, aggression, confrontation in SRI, and distancing in coping scale scored significantly higher in heterosexual patients than homosexual patients. CONCLUSION: These results suggest that CD4+ cell count may be associated with psychosocial factors in Korean patients with HIV infection, and passive coping strategy like distancing may be one of important factors in the progression of HIV infection. These findings also suggest that psychosocial intervention programs are needed for Korean patients with HIV infection.
Aggression ; Biomarkers* ; CD4 Lymphocyte Count ; Depression ; Frustration ; Heterosexuality ; HIV Infections ; HIV* ; Homosexuality ; Humans ; Humans* ; Psychology* ; Quality of Life

This research focuses on four cases of patients having undergone eximer laser photorefractive surgery who were diagnosed with adenoviral keratoconjunctivitis during the postoperative period and who later developed epidemic keratoconjunctivitis (EKC)-like keratitis. Two of the patients had undergone laser-assisted subepithelial keratectomy (LASEK), one had undergone laser in situ keratomileusis and one had photorefractive keratectomy. After the surgery adenoviral keratoconjunctivitis and recurrent late-developing EKC-like keratitis were observed in the patients. Recurrent late-developing EKC-like keratitis occurred in one of the patients, who had received LASEK as many as three times. The others had only one or two episodes.The corneal infiltrates of keratitis mainly occurred in the central cornea. Successful resolution of recurrent late-developing EKC-like keratitis was achieved through the use of topical steroids without sequelae and the final best-corrected visual acuity was as good as the base line. These keratitis infiltrates have been presumed to represent an immune response to the suspected adenoviral antigens deposited in corneal stroma during the primary adenoviral infection. Previous reports argued that patients with a history of adenoviral ketatoconjunctivitis were succeptible to adenoviral keratoconjunctivitis becoming reactivated; however, in our research, our patients had their first adenoviral infections after the eximer laser photorefractive surgery and reactivation was confirmed. We recommend that attention be paid to adenoviral infection after laser refractive operations, because these patients seem to have more frequent recurrences.
Adenovirus Infections, Human/diagnosis/drug therapy/*etiology ; Adult ; Conjunctivitis, Viral/diagnosis/drug therapy/*etiology ; *Corneal Surgery, Laser ; Eye Infections, Viral/diagnosis/drug therapy/*etiology ; Female ; Glucocorticoids/therapeutic use ; Humans ; Keratectomy, Subepithelial, Laser-Assisted ; Keratitis/diagnosis/drug therapy/*etiology ; Keratomileusis, Laser In Situ ; Lasers, Excimer/therapeutic use ; Photorefractive Keratectomy ; *Postoperative Complications ; Recurrence ; Young Adult

Ischemic colitis is recognized as the most common vascular disorder of the intestines in the elderly. Correct diagnosis is usually made after the ischemic episide is over and ischemic colitis is frequently misdiagnosed. A case is presented in which an initial diagnosis of appendicitis was made. On operation, a tumor like mass was found in ascending colon. Pathological examination revealed ischemic colitis. We report a case of ischemic colitis in ascending colon mimicking colon cancer.
Aged ; Appendicitis ; Colitis, Ischemic* ; Colon* ; Colon, Ascending* ; Colonic Neoplasms* ; Diagnosis ; Humans ; Intestines

Gated blood pool scan(GBPS) may be used for evaluating patients with dilated cardiomyopathy(DCM) where it can assist in the diagnosis, and evaluation of severity, disease progression or therapeutic efficacy. In addition to the routine parameters that have been available by GBPS, relatively simple mathematical manipulations of the equilibrium time activity curve can derive parameters relating to the degree and sequence of ventricular emptying. This first harmonic phase analysis may enable quantitative and more specific measurements of wall motion abnormalities in DCM and may thus be useful for more accurate assessments in these patients. Thus, in an attempt to evaluate the findings of phase analysis in DCM and to determine their possible usefulness in this entity, we measured parameters of phase analysis from the resting GBPS of 25 DCM patients and 11 normal controls, and compared these with other parameters of ventricular function from GBPS or echocardiography. Parameters of the systolic as well as diastolic function were markedly depressed for both left and right ventricles (all p<0.001), and echocardiographic LV systolic diameter was increased in all patients. Phase analsis showed the mean and standard deviation of phase angle(Mph & SDph) of both ventricles to be singificantly greater, and the mean amplitude smaller in DCM patients compared to controls(p<0.01). SDph appeared to be a sensitive parameter(LV 100%, RV 92%), and LV SDph showed significant correlations with other GBPS parmeters such as LV ejection fraction(LVEF) and LV peak ejection rate(LVPER) (r=-0.85 and 0.75, respectively) (all p<0.001), and with LV systolic diameter (r=0.78, p<0.001). Also, LV mean amplitude correlated well with LVEF (r=0.79, p<0.001). Thus, phase analysis of GBPS was able to show and quantify significant asynchronity in contraction of both ventricles in DCM, and these parameters may by useful in evaluating ventricular performance in these patients.
Cardiomyopathy, Dilated* ; Diagnosis ; Disease Progression ; Echocardiography ; Heart Ventricles ; Humans ; Ventricular Function*

PURPOSE: This study was performed to compare the accuracy of noncontrast helical computerized tomography (NHCT) with that of intravenous pyelography (IVP) in the evaluation of urolithiasis in the emergency room (ER). METHODS: Between November 2003 and February 2004, a total of 47 consecutive patients presenting to the emergency department with acute flank pain were evaluated with NHCT followed by IVP. The mean of the time interval between NHCT and IVP was less than 5 minutes. All 47 sets of evaluations were later assessed randomly by an independent consulting radiologist for the presence, size, and location of a stone, ureteral dilatation, and secondary signs of ureteral obstruction. RESULTS: Forty-three of the 47 patients were diagnosed with urolithiasis. In 39 of the 43 patients diagnosed with ureteral calculi, the NHCT made the diagnosis. IVP made the diagnosis in 26 of the 43 patients. NHCT had a 90.7% sensitivity, 100% specificity, and 68% accuracy. Compared with IVP, using the McNemar test, NHCT was significantly better able to predict the presence of urolithiasis (p<0.001). CONCLUSIONS: Unnenhanced helical CT is superior to IVP in the demonstration of ureteral calculi in patients with suspected acute urolithiasis in the ER.
Diagnosis ; Dilatation ; Emergencies* ; Emergency Service, Hospital* ; Flank Pain ; Humans ; Sensitivity and Specificity ; Tomography, Spiral Computed ; Ureter ; Ureteral Calculi ; Ureteral Obstruction ; Urography* ; Urolithiasis*