Intramural implantation is among the rarest forms of ectopic pregnancy.Since the first description by Perli, 21 cases were reported in worldwide literatures.The pathologic criteria required for intramural pregnancy is that the product of conception is completely surrounded by uterine musculature and is separated from the uterine cavity and the fallopian tube or round ligament.The previous history of uterine injury or adenomyosis is known as possible etiology of intramural implantation. Because the early diagnosis is very difficult, most cases is found after onset of complication such as a uterine rupture or hemoperitoneum. We have recently experienced a case of intramural pregnancy diagnosed and treated by laparoscopy in a 9 weeks gestation nulliparous woman without previous history of uterine injury or disease, and report with a brief review of literatures.
Adenomyosis ; Early Diagnosis ; Fallopian Tubes ; Female ; Fertilization ; Hemoperitoneum ; Humans ; Laparoscopy ; Pregnancy ; Pregnancy, Ectopic ; Uterine Rupture ; Round Ligaments

Tsutsugamushi disease is an acute febrile disease caused by Rickettsia tsutsugamushi, and which has been reported with increasing frequency thorough the nation since 1986. We experienced 21 cases of Tsutsugamushi Disease diagnosed with serologic test occurring in Taegu city and Kyungpook province during October-November, 1989. The results of survey are as follow. 1) Of 21 cases, 12 (57%) were males and 9 (43%) were females, and the peak incidence was the 4th decade. 2) The outbreak was in October to November and the peak incidence was in October. 3) The most frequent symptoms were fever and chill (100%), myalgia (95%), headache (90%), Eschar and rash were observed in 18 patients (86%) and the eschar was detected in all over the body, especially thorax (33%) and lower extremity (22%). 4) Laboratory features were SGOT elevation (83%), SGPT elevation (61%), LDH elevation (67%), leukocytosis (38%). 5) Indirect immunofluorescent antibody test was done in 18 patients and the antibody titer was above 1:320 in all patients. 6) The chloramphenicol, tetracycline or doxycycline regimens were very effective and mean duration of defervescence from initiation of therapy was 1.3 days. 7) The complication such as meningitis or shock, was not seen.
Alanine Transaminase ; Aspartate Aminotransferases ; Chloramphenicol ; Daegu ; Doxycycline ; Exanthema ; Female ; Fever ; Gyeongsangbuk-do ; Headache ; Humans ; Incidence ; Leukocytosis ; Lower Extremity ; Male ; Meningitis ; Myalgia ; Orientia tsutsugamushi ; Scrub Typhus* ; Serologic Tests* ; Shock ; Tetracycline ; Thorax

OBJECTIVE: The purpose of this study was to evaluate the relationship between the visual acuity and visual evoked potentials of the amblyopia patients and normal persons for the demonstration of the visual disability. METHOD: We performed visual evoked potential study, in 49 eyes of the 43 amblyopia patients and in 76 eyes of 38 normal young adults. Our study was carried out to evaluate the relationship of the visual acuity with N1, P1, N2, P2 latency, P1-N2 amplitude and to compare the latency of N1, P1, N2, P2, and P1-N2 amplitude in amblyopia patients and normal young adults. RESULTS: The mean values of N1, P1, N2, P2 latency were prolonged in amblyopia patients compared to normal young adults (p <0.05). There was no correlation between the visual acuity and P1 latency (p> 0.05), but significant correlation was noted between the visual acuity and P1-N2 amplitude (p <0.05). CONCLUSION: These results showed prolonged latency of N1, P1, N2, P2 in amblyopia group as well as significant correlation between visual acuity and P1-N2 amplitude in both groups. So, P1 latency and P1-N2 amplitude are good parameters in evaluating the visual disability.
Amblyopia* ; Evoked Potentials, Visual* ; Humans ; Visual Acuity ; Young Adult

Since the first cases of tsutsugamushi disease reported in Korea in 1986, many cases has been reported and its occurrence has been increasing. Only 2 cases has been reported in Taegu city and Kyungpook area. We experienced an outbreak of 26 cases of tsutsugamushi disease in this area and their clinical manifestations are; 1. The outbreak occurred in September to November in 1988 and its peak occurrence was in October. 2. Mean age was 52 years old (18 to 69 years old) and peak incidence was in the 6th decade. 3. Major symptoms and abnormal signs are fever/chills (88%), myalgia (65%), headache (54%), nausea and vomiting (31%), and abdominal pain (27%). The eschar was detected on lower part of body in most of cases, and more frequently in male (M:F 100 vs 58%). 4. Patients were treated with tetracyclines (TC) and/or chlorampenicol (CM) and mean duration of defervescence from initiation of antibiotic therapy was 2.1days with TC and 2.5 days with CM. 5. Complications are 2 cases of meningitis and 1 case of shock, and all cases were recovered without any sequelae. As above, tsutsugamushi disease occurs in Taegu city and Kyung Pook area as other part of Korea and clinical manifestations are similar to other reports.
Abdominal Pain ; Daegu* ; Gyeongsangbuk-do* ; Headache ; Humans ; Incidence ; Korea ; Male ; Meningitis ; Myalgia ; Nausea ; Scrub Typhus* ; Shock ; Tetracyclines ; Vomiting

Transcatheter arterial embolization (TAE) is widely used in the treatment of unresectable hepatocellular carcinoma. Its common complications are right upper quadrant pain, nausea, vomiting, and rare complications include focal pancreatic necrosis, gastric ulcer, renal failure, DIC, biliary tree necrosis and splenic infarction and so on. It has been reported that hepatobronchial fistula could develop as a pleuropulmonary complication of liver abscess. We report a case of hepatobronchial fistula caused by complicating liver abscess in a patient with hepatocellular carcinoma who was treated with TAE.
Biliary Tract ; Carcinoma, Hepatocellular* ; Dacarbazine ; Fistula* ; Humans ; Liver Abscess ; Nausea ; Necrosis ; Renal Insufficiency ; Splenic Infarction ; Stomach Ulcer ; Vomiting

BACKGROUND/AIMS: Paracentesis is an acceptable therapeutic modality for the symptomatic relief of dyspnea or abdominal fullness due to tense ascites in patients with cirrhosis. Whereas studies about the effects of paracentesis focused on the changes about hemodynamics, electrolytes and renal function in great detail, the effects of paracentesis on the changes about respiratory system have undergone limited investigations which are defined large-volume paracentesis. METHODS: We performed pulmonary function tests with arterial blood gas analysis just before and 24 hr after paracentesis. The paracentesis of average 2,300ml was carried out in ten liver cirrhosis patients with tense ascites who were free from underlying cardiopulmonary impairment. RESULTS: 1. The results of pulmonary function test just before paracentesis were as followings; FVC( functional vital capacity), FEV1(forced expiratory volume in 1 sec), FEF25 75(forced expiratory effort 25% 75%) and TLC(total lung capacity) were decreased as 78%, 79%, 62.3% and 89% of normal control value respectively, whereas RV(residual volume) was not decreased. DLCO(lung diffusion capacity of carbon monoxide)was decreased as 61.6%. 2. The results of pulmona function test 24 hr after paracentesis were as followings,' The symptomatic relief of dyspnea was achieved in all participated ten patients. Among lung volume parameters, FVC and VC were increased significantly(p=0.003, p=0.004). Whereas TLC was increased without statistical significance(p=0.228), and RV and FRC(functional residual capacity) showed no change. FEV1 was increased significantly(p=0.039), but FEF25 75 and the ratio of FEF1/FVC showed no change. DLCO was not increased. PaOy(partial pressure of oxygen in arterial blood) was impr'oved without statistical significance. CONCLUSIONS: These results suggest that the patients of liver cirrhosis with ascites have restrictive ventilatory impairment with additional obstructive ventilatory impairment. After paracentesis, the restrictive ventilatop impairment is improved by the relief of diaphragmatic motion limitation caused by ascites. Also, paracentesis of(not large volume, like 5000ml, but) relatively small volume, of 2000 3000ml can achieve objective improvement of dyspnea due to tense ascites.
Ascites ; Blood Gas Analysis ; Carbon ; Diffusion ; Dyspnea ; Electrolytes ; Fibrosis* ; Hemodynamics ; Humans ; Liver Cirrhosis ; Lung ; Oxygen ; Paracentesis* ; Respiratory Function Tests ; Respiratory System ; Transcutaneous Electric Nerve Stimulation

BACKGROUND: In Korea, the separation of prescribing and dispensing medicine was finally accepted as a medical policy in July, 2000, after a long period of discussion and study which was started in 1963. Now a year after the policy started, we investigated the knowledge, attitude, and practice of separation of prescribing and dispensing medicine. METHODS: Information, concerning whether the policy was effectively carried out and well understood, were gathered from 383 patients, who visited an university hospital from August 20 to September 1, 2001. RESULTS: The results revealed that 73.1% of the subjects knew the policy precisely. However, only 1.6% of them could answer all four questions on the purpose of the policy. The old-aged, the low educated, the low socioeconomic groups and the residents in agricultural area revealed poor understanding of the policy (P<0.05). Among the total, 74.9% showed negative response toward the policy. Time and cost increment were 75.7% and 75.2%, respectively. Among them 61.1% revealed negative attitude towards continuance the policy and 93.2% revealed dissatisfaction of the policy. CONCLUSION: The knowledge of the policy was relatively high. However, negative attitudes prevailed on the continuance of the policy. Therefore, more solutions and better strategies for the problems of prescribing and dispensing medicine would be needed.
Humans ; Korea

Methotrexate (MTX) has been widely used in the treatment of psoriasis and rheumatoid arthritis. But prolonged use of MTX can induce hepatic fibrosis and even cirrhosis. To date, in Korea, there have been very few reports on hepatotoxicity due to MTX, and no report on biopsy-proven chronic active hapatitis. We report one patient who developed chronic acitve hepatitis while taking long-term daily dose of MTX(10mg per day) for psoriasis for a prolonged period.
Arthritis, Rheumatoid ; Fibrosis ; Hepatitis ; Hepatitis, Chronic* ; Humans ; Korea ; Methotrexate* ; Psoriasis*

OBJECTIVE: To obtain the comparison data of the shoulder strength between handball players of college and general college students. METHOD: Fifteen subjects from each group, college handball players and general college students groups were tested. Peak torque, peak torque ratio of internal rotator to external rotator, peak torque to body weight ratio and average work during isokinetic exercise were studied. RESULTS: All of the parameters tested in handball players of college were greater than those of general college students. The peak torque in handball players was greater than that of general college students at 60o/sec, 180o/sec, which was statistically significant (p<0.05). The peak torque ratio of internal rotator to external rotator in dominant side of handball players was greater than the college group (p<0.05). The peak torque to body weight ratio at 60o/sec did not show significant differences between handball players of college and general college students. The average power at 60o/sec did not show significant differences between the two groups. CONCLUSION: The values of peak torque ratio of internal rotator to external rotator of the shoulder joint in dominant side of handball players were greater than those of the general college students. So it was suggested this result have to be considered in selecting handball players and exercise prescription.
Body Weight ; Humans ; Prescriptions ; Shoulder Joint* ; Shoulder* ; Torque

PURPOSE: To estimate the long-term therapeutic efficacy and safety of adefovir dipivoxil in children and adolescents with chronic hepatitis B who have developed lamivudine resistance. METHODS: Sixteen patients (12 boys and 4 girls; ages 4.3~20.9 years; mean age 14.2 years) with chronic hepatitis B infection resistant to lamivudine therapy received adefovir (0.3 mg/kg/day, maximal dose 10 mg) orally for at least 9 months between March 2004 and April 2008. Each patient was followed up for a mean period of 27 months (range 9~49 months) until April 2008 at Kyungpook National University Hospital in Korea. Therapeutic responses to adefovir were evaluated at 12, 24, 36, and 48 months from the initiation of therapy using the Kaplan-Meier method. Response measurements included ALT normalization, HBV DNA negativization, 2 log(10) IU/mL decrement of HBeAg titer, HBeAg loss, and HBeAg/Ab seroconversion rate. RESULTS: Three (18.8%) of the 16 patients treated with adefovir showed HBeAg/Ab seroconversion. Kaplan-Meier estimates of cumulative ALT normalization were 12.5% (12 months), 43.8% (24 months), 63.5% (36 months), and 92.7% (48 months), respectively. Cumulative HBV DNA negativization was 6.7%, 30.0%, 45.6%, and 78.2% at 12, 24, 36, and 48 months, respectively. Cumulative 2 log(10) copies/mL decrement of HBeAg titer was 12.5%, 43.8%, 56.3%, and 86.9% at 12, 24, 36, and 48 months, respectively. Cumulative HBeAg loss and HBeAg/Ab seroconversion were 6.7% (12 months) and 22.2% (24 months), respectively. CONCLUSION: The long-term therapeutic efficacy of adefovir dipivoxil was favorable in children and adolescents with chronic hepatitis B who had developed lamivudine resistance. The long-term use of adefovir should be safe in children.
Adenine ; Adolescent ; Child ; DNA ; Hepatitis B e Antigens ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Korea ; Lamivudine ; Organophosphonates