Spontaneous spinal epidural hematoma are rare disease and the cause of bleeding in epidural hematoma remains unknown in most of the cause. The most frequently identified risk factor is coagulopathy or treatment with anticoagulants. Recently, authors experienced I case of spontaneous spinal epidural hematoma at thoracic location. Laboratory examination showed no evidence of coagulopathy and hepatic disease. The patient had good surgical outcome after emergent decompressive laminectomy.
Anticoagulants ; Hematoma ; Hematoma, Epidural, Spinal* ; Hemorrhage ; Humans ; Laminectomy ; Rare Diseases ; Risk Factors

The authors analyzed 52 cases of spinal cord tumor who had been operated upon at the department of neurosurgery of the Koryo General Hospital from 1983 to 1992. The results were summerized as followings: 1) The spinal cord tumor was most common in the 6th decade of age(52 cases, 28.8%) and the ratio of male to female was 1.26:1. 2) The pathologic diagnosis was neurogenic tumor in 25 cases(48.1%), metastatic tumor in 12 cases(23.1%), glial tumor in 6 cases(11.5%), and meningeal tumor in 3 case(5.7%) in order frequency. 3) The tumors were located most frequently in the thoracic area(19 cases, 36.5%) and in the intradural extramedullary space(28 cases, 53.9%). 4) The most common initial presentation was pain(27 cases, 51.9%) and on admission 14 cases(26.9%) showed paraparesis. 5) The rate of abnormality of the plain radiologic study was 59.6% and the most common positive finding was the pedicle erosion(15 cases, 28.8%). 6) The computed tomographic scanning with water soluble contrast media was useful in planning of operation to provide the exact relationship between the tumor, spinal cord and location of dura. 7) The total removal was possible in 27 cases(51.9%). 8) The follow-up results after 19.4 months of the mean follow-up duration in 46 cases were recovery in 29 cases(63.0%), improvement in 12 cases(26.0%), stationary state in 3 cases(6.5%), worse in 2 cases(4.3%). It was excellent particulary in cases of intradural-extramedullary tumor. 9) The incidence of metastatic tumor was 23.1%(12 cases) and the lung was most common primary focus. The follow-up result of metastatic tumor was poor than the other tumors.
Contrast Media ; Diagnosis ; Female ; Follow-Up Studies ; Hospitals, General ; Humans ; Incidence ; Lung ; Male ; Meningeal Neoplasms ; Neurosurgery ; Paraparesis ; Spinal Cord Neoplasms* ; Spinal Cord*

Heterotopic pregnancy, simultaneous intrauterine and extrauterine gestations, is a relatively rare conditon with an estimated incidence of 1 in 30,000 pregnancies in a natural cycle. But the incidence of heterotopic pregnancies has been increased because of rising incidence of pelvic inflammatory disease, pelvic surgery, intrauterine device, the use of various ovulation induction and assisted reproductive technologies, such as in vitro fertilization and embryo transfer, gamate intrafallopian insemination. The early diagnosis of heterotopic pregnancy is very difficult. So there is a higher maternal morbidity, mortality and fetal loss. Thus careful pelvic examination, combined with serial beta hCG determinations and transvaginal sonography to evaluate the adnexal region are important. We experienced a case of 34-years-old multiparous women with heterotopic pregnancy in natual cycle confirmed by surgical removal of ruptured right tubal pregnancy and sonographic finding of the intrauterine pregnancy, which carried the intrauterine pregnancy to term delivery without complication at 39+5 weeks of gestation, and report this case with a brief review of the literature.
Early Diagnosis ; Embryo Transfer ; Female ; Fertilization in Vitro ; Fertilization* ; Gynecological Examination ; Humans ; Incidence ; Insemination ; Intrauterine Devices ; Mortality ; Ovulation Induction ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Heterotopic* ; Pregnancy, Tubal ; Reproductive Techniques, Assisted ; Ultrasonography

OBJECTIVE: To compare the accuracy of three-dimensional (3-D) ultrasound-assessed fetal thigh volumetry in predicting birth weight with that of other commonly used formulas composed of biparietal dimeter (BPD), abdominal circumference (AC), and femur length (FL) by two-dimentional (2-D) ultrasonography. METHODS: From May 1999 to February 2000 we performed a prospective study of ultrasonography on 100 pregnant women. We assessed the thigh volume of 100 fetuses using 3-D ultrasonography. Meanwhile their BPD, AC, and FL were measured by 2-D ultrasonography. All infants were delivered within 48 hours after the ultrasound examinations. RESULTS: The thigh volume assessed by 3-D ultrasonography was highly correlated with birth weight (r=0.414, n=100, p<0.0001). The 3-D formula had small mean values of absolute mean error (gm) (64.26), absolute mean error (%) (10.20+/-0.80). As well, the 2-D formulas had similar mean values. However, no significant differences in predicting birth weight were found between 3-D formula and 2-D formulas. CONCLUSION: The 3-D ultrasound method assessed by thigh volume showed better accuracy in predicting birth weight than 2-D methed. Further studies may be needed to confirm our conclusions.
Birth Weight* ; Female ; Femur ; Fetus ; Humans ; Infant ; Parturition* ; Pregnant Women ; Prospective Studies ; Thigh* ; Ultrasonography*

The authors report two cases of high cervical spinal chordomas that were removed via the median labiomandibular glossotomy(MLG) approach. One patient was a 62-year-old female in whom an extradural chordoma was found at the level of C3 vertebra with huge prevertebral extension, and causing dyspnea and dysphagia; the other was a 47-year-old female, found to be suffering from a chordoma of C2 vertebral body, which was found incidentally. After removal of the tumors, ventral instrumented fusions were performed in both patients, who showed good recoveries with only minor complications. The MLG approach is radical, and rarely performed by neurosurgeons, but for treatment of an expanded high cervical lesion that needs ventral surgery and seems to be inaccessible via the conventional transoropharyngeal or anterolateral retropharyngeal route, it should be considered. The authors discuss the clinicopathological characteristics of spinal chordomas and general considerations of the MLG approach to high cervical lesions, and briefly describe the surgical techniques involved in this approach.
Chordoma* ; Deglutition Disorders ; Dyspnea ; Female ; Humans ; Middle Aged ; Spine

Cutaneous endometriosis seems to be more common in women who have had a pelvic or abdominal operation and primary cutaneous endometriosis is very rare. In our hospital we experienced a 41-year-old woman who complained of the appearance at the umbilicus of a nodule and had not had operation. This nodule was responsible for recurrent pain and increasing in size and it was excised. Pathology findings revealed cutaneous endometriosis. So we present a case of primary cutaneous endometriosis with a brief review of literature.
Adult ; Endometriosis* ; Female ; Humans ; Pathology ; Umbilicus

No abstract available.
Risk Factors*

Conjoined twins are rare congenital malformation that occurs one in 50,000-100,000 births. The site and fusion are variable. In recent years, prenatal diagnosis of conjoined twins with ultrasonogram (US), computed tomography (CT), and magnetic resonance imaging (MRI) has been reported. Early prenatal diagnosis and assessment of the degree of conjoining provided couples with the option for pregnancy termination via vaginal delivery. We report a case of cephalopagus diagnosed prenatally by ultrasonogram in the second trimester and subsequently which was terminated, with a brief review of literature.
Family Characteristics ; Female ; Humans ; Magnetic Resonance Imaging ; Parturition ; Pregnancy ; Pregnancy Trimester, Second ; Prenatal Diagnosis ; Twins, Conjoined ; Ultrasonography

Lower GI bleeding occurs less frquently than upper GI bleeding. Most of the lower GI bleeding is from the colon, with 15-20% of all episodes involving the small intestine. These episodes stop spontaneously in 80% of all cases, but bleeding is recurrent in 25% of these patients. The most common cause of small intestinal bleeding is angiodysplasia, and the next is benign tumors. More than 50% of benign lesions of the small intestine remain asymptomatic and are discovered during an autopsy. Diagnosis of small intestinal lesions is not easy because of nonspecific symptoms and anatomical specificity. For instance, a 47-year-old woman was admitted to us with a 2-day history of melena. A small bowel enema revealed a filling defect at the level of 20 cm below the ligament of the Treiz. An enteroscopy revealed an ovoid elevated lesion with a central black spot and an ulceration in the proximal jejunum. An enteroscopic biopsy revealed leiomyoma. A jejunal mass was excised through a segmental resection. Pathological diagnosis of the resected mass revealed the same leiomyoma.
Angiodysplasia ; Autopsy ; Biopsy ; Colon ; Diagnosis ; Enema ; Female ; Hemorrhage* ; Humans ; Intestine, Small ; Jejunum ; Leiomyoma* ; Ligaments ; Melena ; Middle Aged ; Sensitivity and Specificity ; Ulcer

BACKGROUND: The purpose of the research was to find significant factors that were related to the therapeutic compliance of hyper- tension(HT). METHODS: Hypertensive 354 patients from 932 rural elderly were measured blood pressure and administered the questionnaire during August 2003. Operational definition of therapeutic compliance was the state of care and management of HT. The data were analysed by univariate analysis and multivariate regression model. RESULTS: Results of univariate analysis, the seriousness, the barriers, the benefits, and the patients who have family members or friends suffering from HT, the motive of the behavior were significant variables for acceptance rate of the caring HT(p<0.01). Result of multiple logistic regression on participating caring process in HT, significant prediction variable were the subjects who had spouses, long ongoing caring process, no drinking habits, mind set that considers the high blood pressure as a serious disease, families and friends who had complications, didn't feel that taking the medication is not uncomfortable if they haven't experienced the side effect during the caring process. CONCLUSION: According to this result, we should consider major prediction variables to increasing the therapeutic compliance of hypertensive patients and developing the program for controlling hypertensive patients.
Aged* ; Blood Pressure ; Compliance* ; Drinking ; Friends ; Humans ; Hypertension* ; Logistic Models ; Surveys and Questionnaires ; Spouses