To determine the perinatal mortality and morbidity of fetuses with absent end-diastolic velocities (AEDV) of the umbilical artery in severe pre-eclampsia and eclampsia, the outcome of 5 fetuses with AEDV was compared with that of 35 fetuses with positive end-diastolic velocities (PEDV). The study population comprised 38 cases of severe pre-eclampsia and 2 cases of eclampsia with structurally normal singletons, who had had umbilical artery Doppler velocimetry weekly from admission to delivery. The Doppler velocimetry result was not used for the clinical management. Perinatal death and neonatal morbidity from both groups were further examined in gestational age category to control the influence of preterm births. The incidence of AEDV of the umbilical artery Doppler velocimetry in severe pre-eclampsia and eclampsia was 12.5% (5/40). The AEDV group had a significantly higher incidence than the PEDV group in terms of ceasarean section due to fetal distress (60% : 17%), Apgar score < 7 at 5 minutes (60% : 14%), perinatal death (25% : 0%) and assisted mechanical ventilation (67% : 9%) both at 32-36 weeks. Time intervals from the detection of AEDV to delivery of live neonates varied from the day to 15 days. In conclusion, AEDV in the umbilical artery might be of clinical value in routine surveillance of pregnancies complicated by severe pre-eclampsia and eclampsia, and predict hypoxic fetal condition which needs operative interventions before or during labor and mechanical ventilation after birth.
Apgar Score ; Cesarean Section ; Dystocia ; Eclampsia* ; Female ; Fetal Distress ; Fetus ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Maternal Death ; Mortality ; Parturition ; Parturition* ; Perinatal Mortality ; Pre-Eclampsia* ; Pregnancy ; Premature Birth ; Respiration, Artificial ; Rheology ; Trial of Labor ; Umbilical Arteries* ; Uterine Rupture

No abstract available.
Giant Lymph Node Hyperplasia* ; Neck*

Pseudomembranous colitis (PMC) was first described by Finney as postoperative diphtheritic enteritis in 1893 and was known to be associated with antibiotics by Reiner et al in 1952. Most cases of antibiotic-associated PMC are now associated with cytotoxigenic C. difficile. The association of PMC several antibiotics is well docamented; however, its association with clindamycin appeared to be most striking. We experienced a male patient who developed tarry stool, abdominal pain and diarrhea after having recieved clindamycin for two weeks. The PMC diagnosed by colonofiberscopy with biopsy and C. difficile was identified by tissue-culture study. The patient was treated by oral vancomycin and healed. Described here a case of PMC with some review of literature.
Abdominal Pain ; Anti-Bacterial Agents ; Biopsy ; Clindamycin ; Clostridium difficile* ; Clostridium* ; Diarrhea ; Enteritis ; Enterocolitis, Pseudomembranous* ; Humans ; Male ; Strikes, Employee ; Vancomycin

Actinomycosis is a subacute-to-chronic infection caused by gram-positive, anaerobic bacteria. Actino- mycetes reside in oral cavity, gastrointestinal tract, female genital tract as normal flora, but may provoke an opportunistic infection under certain circumstances, resulting in contiguous spread, suppurative and granu- lomatous inflammatory reaction, and formation of multiple abscesses. Abdominal and pelvic actinomycosis in women are related to a history of abdominal surgery or intrauterine contraceptive device (IUD) insertion and have variable nonspecific symptoms that make an initial diagnosis difficult. We experienced a case of pelvic actinomycosis related to IUD that diagnosed pathologically after laparotomy.
Abscess ; Actinomycosis* ; Bacteria, Anaerobic ; Diagnosis ; Female ; Gastrointestinal Tract ; Humans ; Intrauterine Devices* ; Laparotomy ; Mouth ; Opportunistic Infections

OBJECTIVE: To evaluate the effects of tibolone on lipid metabolism in comparison to continuous conjugated equine estrogen and medroxyprogesterone acetate in postmenopausal women METHODS: In a randomized, group-comparative study, the effects on lipid profiles (total cholesterol, triglycerides, HDL-cholesterol and LDL-cholesterol) were studied between tibolone 2.5 mg/day (N=48) and continuous combined regimen (conjugated equine estrogen 0.625 mg/day combined with medroxyprogesterone acetate 2.5 mg/day, CEE/MPA) (N=46) (CEE/MPA) for 12 month period.Satistical analysis were performed using Student's t-test for paired samples and independent groups. RESULTS: There were no statistical differences in age, age of menopause and body mass index (BMI) of both group before treatment. While treatment with tibolone significantly lowered plasma concentration of triglycerides, there were no significant changes in serum total cholesterol, HDL-cholesterol and LDL-cholesterol levels. In the CEE/MPA group, there were no significant changes of all variables. CONCLUSION: While there a statistically significant decrease in triglyceride concentration in tibolone group. there were no statistically significant differences in total cholesterol, HDL-cholesterol and LDL-cholesterol levels in both tibolone and CEE/MPA group, during 12 months of treatment period.
Body Mass Index ; Cholesterol ; Estrogens ; Female ; Hormone Replacement Therapy* ; Humans ; Lipid Metabolism* ; Medroxyprogesterone Acetate ; Menopause ; Plasma ; Triglycerides

OBJECTIVE: To investigate the expression of E-cadherin in benign, borderline, and malignant ovarian tumors. METHODS: An immunohistochemical technique was applied to formalin-fixed paraffin-embedded samples of 20 benign cystic ovarian tumors, 14 borderline ovarian tumors and 13 ovarian carcinomas. Expressions of E-cadherin immunostaining in three histological types were compared, and the survival rate in malignant ovarian cancer according to E-cadherin expression was also assessed. RESULTS: E-cadherin was positively or heterogeneously expressed in both benign and borderline ovarian tumors. But it was negatively, heterogeneously, or positively expressed in malignant ovarian tumors. The difference of expression of E-cadherin between borderline and malignant ovarian tumors was statisticaIly significant (p<0.05). In ovarian carcinoma, there was difference between negative and positive group in survival (p<0.05). CONCLUSION: Our results suggest that alterations in E-cadherin seem to occur at a later stage of the ovarian carcinogenesis, and may have some prognostic value in malignant ovarian tumor.
Cadherins* ; Carcinogenesis ; Ovarian Neoplasms ; Survival Rate

OBJECTIVE: Our purpose was to evaluate the clinical outcomes of fetuses with a single umbilical artery(SUA). METHODS: We studied 17 fetuses with a single umbilical artery retrospectively. The maternal age, maternal disease, gestational age, fetal sex, Apgar score, fetal weight, perinatal outcome, and fetal blood karyotype were reviewed. RESULTS: 1) Maternal age ranged 24-39 years old, mean age was 29.5 +/- 4.1 years. 2) Mean gestational age at birth was 38.3+/- 2.2 weeks, except one case of preterm labor due to cervical incompetence. 3) In three cases, low Apgar score, under seven, was recorded at one minute, and there was no case where Apgar score was low at five minute, except one case of preterm labor due to cervical incompetence. 4) Intrauterine growth retardation was found in two cases, and associated fetal malformations were noted in seven cases. 5) Among two cases of fetal blood karyotype, one case revealed normal and the other Patau syndrome. CONCLUSION: Our data suggest that fetuses with single umbilical artery may be risky because of its association with growth retardation and malformation including chromosomal anomaly. It is imperative to diagnose the congenital disease as early as possible and conduct appropriate treatment, with an aid of noninvasive diagnostic modality such as ultrasonogram, and through a delicate prenatal care, one should promote good perinatal outcome.
Apgar Score ; Female ; Fetal Blood ; Fetal Growth Retardation ; Fetal Weight ; Fetus* ; Gestational Age ; Karyotype ; Maternal Age ; Obstetric Labor, Premature ; Parturition ; Pregnancy ; Prenatal Care ; Retrospective Studies ; Single Umbilical Artery* ; Ultrasonography

Hemorrhagic radiation proctitis is infrequently seen in patients receiving pelvic irradiation. The treatment of hemorrhagic ralation proctitis is often difficult. Many patients need reyeated hospitalizations and blood transfusions. Occasionally patiets will develop severe or recurrent rectal bleeding. In case of massive bleeding requiring excessive transfusion, colonic diversion by construction of a colostomy or excision of the diseased segment may be inevitable. However, surgical procedures in these patients are associated with a high mortality and morbidity. Moreover, medical therapy is usually ineffective. Recently formalin therapy has been introduced as a simple and effective treatment for hemorrhagic radiation proctitis. We experienced a 69 year-old woman patient who developed severe homorrhagic proctitis 1 year after radiotherapy for carcinoma of the cervix. She had not improved by conservative management and required blood tranafusions and repetitive hospitalizations. After local application of a 4% formalin solution in the diseased rectum under caudal anesthesia, the bleeding immediately stopped and the patient was discharged from the hospital, and no recurrence has been observed until now.
Aged ; Anesthesia, Caudal ; Blood Transfusion ; Cervix Uteri ; Colon ; Colostomy ; Female ; Formaldehyde* ; Hemorrhage ; Hospitalization ; Humans ; Mortality ; Proctitis* ; Radiotherapy ; Rectum ; Recurrence

No abstract available.
Stomach Neoplasms*

OBJECTIVE: The aim of the study is to assess the effects of treatment with an extract from Cimicifuga racemosa for 1 year in postmenopausal women with symptoms. METHODS: In a randomised, open-label, group-comparative study, the change on the Kupperman menopausal index, serum FSH and E2 level, bone densitometry (BMD), and mammographic density by an extract from Cimicifuga racemosa (GYNO-Qx ) (N=40) were compared with an conjugated equine estrogen combined with medroxyprogesterone acetate (CEE/MPA) (N=36) during 12 months in menopausal women. RESULTS: There were no statistical differences in the change of Kupperman index, serum FSH and E2 level, and mammographic density between two groups after 12 months, except the effect of BMD that the CEE/MPA group (+6.6%) was significantly increased as compared to the extract from Cimicifuga racemosa (+1.1%) baseline. CONCLUSION: This study suggests that an extract of Cimicifuga racemosa is a safe, effective alternative to estrogen replacement therapy for patients in whom hormone replacement therapy is either refused or contraindicated.
Cimicifuga* ; Densitometry ; Estrogen Replacement Therapy ; Estrogens ; Female ; Hormone Replacement Therapy ; Humans ; Medroxyprogesterone Acetate ; Menopause