OBJECTIVE: To evaluate the association of level of CA-125 and severity of dysmenorrhea with lesion depth in adenomyosis. METHODS: Sixty-eight women who had undergone hysterectomy and were found to have pure adenomyosis on histopathologic examination were reviewed retrospectively. Specimens were stratified according to the degree of adenomyosis penetration into 4 groups: group A consisted of specimens with adenomyosis penetration into myometrium of up to 25%; group B, 26-50%; group C, 51-75%, and group D, >75%. All women were submitted to serum determination of CA-125. Severity of dysmenorrhea was assessed by means of a modification of 10-point verbal rating scale. RESULTS: Each group was not correlated with severity of dysmenorrhea (p=0.7394 Fisher's exact test). The means of serum CA-125 levels was increased corresponding to depth of adenomyosis (p=0.0441 ANOVA test). CONCLUSION: In this study, serum CA-125 level is associated with the depth lesion and severity of dysmenorrhea is not. Therefore, the level of serum CA-125 might be useful indicator in management of adenomyosis before surgery.
Adenomyosis* ; Animals ; Dysmenorrhea* ; Female ; Humans ; Hysterectomy ; Mice ; Myometrium ; Retrospective Studies

Aortic saddle embolus accounts for approximately 10% of all peripheral arterial emboli. The most common sources of emboli are left atrial thrombi associated with atrial fibrillation and vegetation. A 22-year-old male patient was admitted due to acute onset of orthopnea, tachypea and cough. Transthoracic and transeophageal echocardiography showed huge vegetation (3X2cm) of the posterior mitral valve leaflet which was associated with severe mitral regurgitation. On 14th hospital day, he suffered from sudden onset of weakness, pain, and coldness on both lower extremities. Follow-up echocardiography showed marked size reduction of the original mitral valve vegetation. Angiography showed aortic saddle embolus. The embolectomy of aortic saddle embolus was performed through the transfemoral approach with a Forgarty catheter. At the same time, removal of the infected mitral valve and mitral valve replacement were performed.
Angiography ; Atrial Fibrillation ; Catheters ; Cough ; Echocardiography ; Embolectomy ; Embolism* ; Follow-Up Studies ; Humans ; Lower Extremity ; Male ; Mitral Valve Insufficiency ; Mitral Valve* ; Young Adult

Amlodipine, a calcium channel blocker (CCB) belonging to the group of dihydropyridines, is characterized by a slower onset of action (6-8h), a longer duration of action (24-72h), a greater vascular, cardiac effect, and hyperglycemia. Case of intoxication with 300 mg of amlodipine in a 69-year-old female patient and with 450 mg of amlodipine and 120 mg of glimepride in a 64-year-old female patient caused severe hypotension and hyperglycemia. They were initially treated with fluids, dopamine and norepinephrine, but these therapy were ineffective. Then, the patients were given a bolus injection of insulin and continuous infusion of insulin. The former patient's hyperglycemia was not controlled. She expired in 47 hours. The latter one's hyperglycemia was controlled and then her hypotension improved. In conclusion, it is suggested that hyperinsulinemia-euglycemia therapy be considered as a first-line therapy in calcium channel blocker intoxication.
Aged ; Amlodipine* ; Calcium Channels ; Dihydropyridines ; Dopamine ; Female ; Humans ; Hyperglycemia* ; Hypotension ; Insulin ; Middle Aged ; Norepinephrine

BACKGROUND: Extubation is recommended to he performed at minimum pressure support (PSmin) during the pressure support ventilation (PSV). In field, physicians sometimes perform additional 1 hr T-piece trial to the patient at PSmin to reduce re-intubation risk. Although it provides confirmation of patient's breathing reserve, weaning could be delayed due to increased airway resistance by endotracheal tube. METHODS: To investigate the effect of additional 1 hr T-piece trial on weaning outcome, a prospective study was done in consecutive 44 patients who had received mechanical ventiIation more than 3 days. Respiratory mechanics, hemodymic, and gas exchange measurements were done and the level of PSmin was calculated using the equation (PSmin=peak inspiratory flow rate x total ventilatory system resistance) at the 15cm H2O of pressure support. At PSmin, the patients were randomized into intervention (additional 1 hr T-piece trial) and control (extubation at Psmin). The measurements were repeated at PSmin. during weaning process (in cases of intervention), and after extubation. The weaning success was defined as spontaneous breathing more than 48hr after extuintion. In intervention group, failure to continue weaning process was also considered as weaning failure. RESULTS: Thirty-six patients with 42 times weaning trial were satisfied to the protocol Mean PSmin level was 7.6 (+/-1.9)cm H2O. There were no differences in total ventilation times (TVT), APACHE III score nutritional indices, and respiratory mechanics at PSmin between 2 groups. The weaning success rate and re-intubation rate were not different between intervention group (55% and 18% in each) and control group (70% and 20% in each) at first weaning trial. Work of breathing, pressure time product, arid tidal volume were aggravated during 1 hr T-piece trial compared to those of PSmin in intervention group (10.4+/-1.25 and 1.66+/- 1.08 J/L in work of breathing)(191+/-232 and 287+/-217cm H2Os/m in pressure time product) (0.33+/-0.09 and 0.29+/-0.09 L in tidal volume) (P<0.05 in each). As in whole, TVT, and tidal volume at PSmin were significantly different between the patients with weaning success (246+/-195 hr, 043+/-0.11 L) and the Those with weaning failure (407+/-248 hr, 0.35+/-0.10L) (P<0.05 in each). CONCLUISON: There were no advantage to weaning outcome by addition of 1 hr T-piece trial compared to prompt extubation to the patient at PSmin.
Airway Resistance ; APACHE ; Humans ; Nutrition Assessment ; Prospective Studies ; Respiration ; Respiratory Mechanics ; Tidal Volume ; Ventilation ; Weaning* ; Work of Breathing