Inhalation of toxic gases can lead to pneumonitis. It has been known that methane gas intoxication causes loss of consciousness or asphyxia. There is, however, a paucity of information about acute pulmonary toxicity from methane gas inhalation. A 21-year-old man was presented with respiratory distress after an accidental exposure to methane gas for one minute. He came in with a drowsy mentality and hypoxemia. Mechanical ventilation was applied immediately. The patient's symptoms and chest radiographic findings were consistent with acute pneumonitis. He recovered spontaneously and was discharged after 5 days without other specific treatment. His pulmonary function test, 4 days after methane gas exposure, revealed a restrictive ventilatory defect. In conclusion, acute pulmonary injury can occur with a restrictive ventilator defect after a short exposure to methane gas. The lung injury was spontaneously resolved without any significant sequela.
Anoxia ; Asphyxia ; Gases ; Inhalation ; Lung Injury ; Methane ; Pneumonia ; Porphyrins ; Respiration, Artificial ; Respiratory Function Tests ; Respiratory Insufficiency ; Smoke Inhalation Injury ; Thorax ; Unconsciousness ; Ventilators, Mechanical

Pseudomembranous necrotizing bronchial aspergillosis (PNBA) is a rare form of invasive aspergillosis with a very poor prognosis. The symptoms are non-specific, and the necrotizing plugs cause airway obstruction. Atelectasis and respiratory failure can be the initial manifestations. Recently, we treated an immunocompromised patient with PNBA, who presented with a sudden onset of atelectasis and acute respiratory failure. There were no preceding signs except for a mild cough and one febrile episode. Bronchoscopy revealed PNBA, and Aspergillus nidulans was cultured from the bronchial wash.
Adult ; Female ; Humans ; Immunocompromised Host ; Invasive Pulmonary Aspergillosis/*complications/*diagnosis ; Leukemia, Myeloid, Acute/complications ; Neutropenia/complications ; Pulmonary Atelectasis/*etiology ; Respiratory Insufficiency/*etiology

Alveolar Process ; Bone Transplantation ; Cleft Lip ; Congenital Abnormalities ; Dentition ; Humans ; Incisor ; Palate ; Retrospective Studies ; Transplants

OBJECTIVE: To compare the clinical effectiveness of transvaginal radiofrequency myolysis of the patients with leiomyomas and the patients with adenomyosis which have similar clinical symptoms. METHODS: From May 2005 to May 2006 at Eulji university hospital, 108 women who were diagnosed of leiomyoma and adenomyosis had undergone transvaginal radiofrequency myolysis. Before and after the procedure size, number of uterine myomas, location and the volume of the leiomyomas and adenomyosis were measured by ultrasound. And on every visit after the procedure improvement of the symptom was checked by questionnaire of the symptom and life quality. Using Wilcoxon signed ranked test, the statistical significance was proved and the P value lower than 0.05 was judged to be significant. RESULTS: 76 women with leiomyoma who had undergone transvaginal radiofrequency myolysis, were followed up 1 month, 3 months, 6 months and 9 months after the procedure. The average maximal diameter of the myoma was decreased by 14.6%, 23.3%, 30.6%, 33.6% respectively, and the average volume was decreased by 35.7%, 53.3%, 67.3%, 72.2% respectively. 32 women with adenomyosis who had undergone transvaginal radiofrequency myolysis were followed up, at the same period after the procedure. The average maximal diameter of the adenomyosis was decreased by 8.9%, 13.6%, 14.6%, 11.9% respectively, and the average volume was decreased by 22.6%, 30.0%, 32.3%, 28.4% respectively. Before and after the procedure the symptom score was 62.3, 52.2, 40.6, 32.6, 28.6 respectively, and the quality of life score was 68.9, 78.1, 82.9, 85.7, 87.3 respectively in the leiomyoma group. In the adenomyosis group, before and after the procedure the symptom score was 77.7, 37.6, 30.6, 54.4, 67.5 respectively, and the quality of life score was 48.1, 76.5, 85.5, 66.5, 55.1 respectively. CONCLUSION: Transvaginal radiofrequent myolysis had benefits in conserving the uterus, and was less invasive, and had great effect on the reducing the size of the leiomyoma and improving the symptoms, and also returning to normal life pattern was earlier. But in women with adenomyosis the symptoms were worsened after approximately 6 to 9 months after the procedure. Therefore additional research and follow-up is required and a strict criterion is needed.
Adenomyosis ; Female ; Follow-Up Studies ; Humans ; Leiomyoma ; Myoma ; Quality of Life ; Surveys and Questionnaire ; Uterus

OBJECTIVE: To compare clinical results of laparoscopic assisted vaginal hysterectomy for uteri weighing 500 g or more with less than 500 g. And we compared clinical results between laparoscopic coagulation of uterine vessel (LH) and conventional LAVH. METHODS: We reviewed medical records of 296 patient who underwent LAVH from February 2004 to May 2006. They were divided into two groups, uteri weighing greater than 500 g and less than 500 g. And each group was divided into two groups, LH and conventional LAVH. Each groups were compared by operative time, hemoglobin change, complication, transfusion and hospital days. RESULTS: Operation time ,hemoglobin change on the 1st postoperative day and transfusion were significant greater in the uteri > or =500 g group than in the <500 g. However, there was no significant difference in hospital days, hemoglobin change on the 4th postoperative day and complication. In the <500 g group, LH group was lower than conventional LAVH group in operative time, hemoglobin change on the 1st and 4th postoperative day. In the > or =500 g group, there was no signicant difference in hospital days, operative time, hemoglobin change on the 1st postoperative day. However, hemoglobin change was smaller in the LH group than conventional LAVH group on the 4th postoperative day. CONCLUSION: This study demonstrates that despite the increased operating time and blood loss, LAVH can be safely performed for large uterus. However, surgeons need to be aware of high risk of blood transfusion. Modification of surgical method can decrease operating time and blood loss in LAVH.
Blood Transfusion ; Female ; Humans ; Hysterectomy ; Hysterectomy, Vaginal* ; Medical Records ; Operative Time ; Uterus*

OBJECTIVE: To compare the clinical results for women undergoing total abdominal hysterectomy (TAH), laparoscopic assisted vaginal hysterectomy (LAVH) and total vaginal hysterectomy (TVH). METHODS: We reviewed the medical records of patients who underwent TAH (n=97), LAVH (n=112) and TVH (n=95) from June 2002 to June 2005. We compared and evaluated patient's characteristics, previous abdominal operation histories, indication of hysterectomy, uterine weight, operative time, perioperative hemoglobin and hematocrit change, the degree of postoperative pain, hospital stay and complications. RESULTS: The patient's characteristic (age, weight, height, parity, perioperative hemoglobin and hematocrit change, complication rate) had no statistical difference in all three groups. In the TVH group, the rate of previous abdominal operations (25%) was significantly lower than TAH (56%), and LAVH (40%) (p=0.023). The mean uterine weight was the heaviest in TAH group (443.6+/-407.3 g), compared to LAVH group (301.9+/-133.9 g) and TVH group (225.3+/-91.8 g) (p<0.001). Operative time was the longest for LAVH group (p=0.001), and there was no significant difference between TAH group and TVH group (p=0.087). The TAH group had the highest postoperative pain scale and the length of hospital stay. The LAVH group and TVH group had almost the same postoperative pain scale and the length of hospital stay. CONCLUSION: Both LAVH and TVH had the following advantages compared with total abdominal hysterectomy: less pain, shorter hospital stay, cosmetic advantages. But limited operation field in TVH and expensive operative cost in LAVH were disadvantages. Specific guidelines for determining the route of hysterectomy result in decreased morbidity and lower costs, and thus the gynecologist can ensure that the patient receives the best possible surgical care.
Female ; Hematocrit ; Humans ; Hysterectomy* ; Hysterectomy, Vaginal* ; Length of Stay ; Medical Records ; Operative Time ; Pain, Postoperative ; Parity

OBJECTIVE: To compare the clinical results between laparoscopically assisted vaginal hysterectomy (LAVH) and total vaginal hysterectomy (TVH). METHODS: We reviewed the medical records of patients who underwent LAVH and TVH from January 2002 to December 2004 in 00 university hospital without the history of uterine prolapse or pelvic relaxation. We evaluated age, parity, previous abdominal operations, indication of hysterectomy, size of the uterus, operation time, hemoglobin change, hospital day, the degree of postoperative pain and initiation of diet and postoperative complications. RESULTS: The age and parity of the patients in both groups were not different statistically. There were history of previous abdominal operations in 20.8% of LAVH group and 25.3% of TVH group which didn't have statistic significance. Major indications of the operation were uterine myomas in both groups. The average weight of the extracted uterus were 272.9+/-114.5 gm and 225.6+/-87.0 gm in the LAVH group and the TVH group respectively which had significance, and the operation time were 81.1+/-23.4 minutes and 71.1+/-37.8 minutes respectively which had significance. There were no difference in the hemoglobin drop of the postoperative day 1, but the hemoglobin drop of the postoperative day 4 was larger in the LAVH group. Postoperative complications occurred more often in the TVH group (15.2%) than LAVH group (11.9%) but didn't have significance, and the complications were treated by conservative managements and observation of the progress. And also the hospital day, the degree of postoperative pain and initiation of diet had no significance. CONCLUSION: Both LAVH and TVH had no statistic difference in the postoperative morbidity and recuperation. Moreover the indications of operation for both surgeries had no statistic difference, but LAVH had a preference for the larger size of uterus. Furthermore in order to increase the satisfactions of patients and remedy the weak points of procedures, research on the indications and contra-indications between the operative approaches and training on the operative procedures are required.
Diet ; Female ; Humans ; Hysterectomy ; Hysterectomy, Vaginal* ; Leiomyoma ; Medical Records ; Pain, Postoperative ; Parity ; Postoperative Complications ; Relaxation ; Surgical Procedures, Operative ; Uterine Prolapse ; Uterus

Peripartum cardiomyopathy is a dilated cardiomyopathy of unexplained cause that occurs during the last trimester of pregnancy or within 5 months after delivery. And, It is a rare disease that has a frequency of 1 in 1,300-15,000 deliveries. It has not yet been reported that peripartum cardiomyopathy has occurred in an preeclampsia woman superimposed on idiopathic thrombocytopenic purpura. Moreover, the association between idiopathic thrombocytopenic purpura and peripartum cardiomyopathy has not been studied. Recently, we experienced a case of a woman who has undergone emergency Cesarean section due to complicated severe preeclampsia superimposed on idiopathic thrombocytopenic purpura. On the postoperative day, this patient developed respiratory distress and pumonary edema. Peripartum cardiomyopathy was diagnosed by echocardiography and we present with a brief review of literatures.
Cardiomyopathies* ; Cardiomyopathy, Dilated ; Cesarean Section ; Echocardiography ; Edema ; Emergencies ; Female ; Humans ; Peripartum Period* ; Pre-Eclampsia* ; Pregnancy ; Pregnancy Trimester, Third ; Purpura, Thrombocytopenic, Idiopathic* ; Rare Diseases

OBJECTIVE: The aim of this study is to prove the clinical significance by evaluating pregnancy outcomes from intrauterine growth restriction using waves of the Doppler velocimetry of uterine and umbilical artery and amniotic fluid index. METHODS: Throughout the period of January 2000 to May 2005 at our hospital, we reviewed 127 cases diagnosed with intrauterine growth restriction after 24 weeks of pregnancy and the existences of diastolic notch of uterine artery (DNUT), absent or reversed end-diastolic velocity of umbilical artery (AEDV) and oligohydramnios were considered abnormal. We set the group that had no abnormal signs as the control group (62 cases), and respectively compared the groups that had oligohydramnios (24 cases), unilateral DNUT (27 cases), bilateral DNUT (10 cases) and AEDV (13 cases) with the control group. And we compared the groups that had only one abnormal sign, that is oligohydramnios (20 cases), bilateral DNUT (7 cases), AEDV (7 cases) and the group showing 2 or more complicated abnormal signs those above (9 cases) with the control group. RESULTS: Perinatal outcomes such as preterm birth, low birth weight, lower 5-min Apgar score (A/S), neonatal acidosis, admission rate of neonatal intensive care unit (NICU) and perinatal mortality were poor statistically in groups with DNUT, AEDV and oligohydramnios compared to those which have none of these abnormal signs. And those with DNUT had worse results when affected on both sides. And those with AEDV showed worse perinatal outcomes compared to those with bilateral DNUT or oligohydramnios; any overlapping of these abnormal signs indicated worse perinatal outcomes, which had statistic significance. CONCLUSION: Close observation of the fetal well-being by analysis on the wave velocimetry of the blood flow such as the uterine arteries and umbilical arteries and the measurement of the amniotic fluid volume enables predicting the perinatal prognosis of the intrauterine-growth restricted fetuses which may contribute in reducing the perinatal morbidity and mortality.
Acidosis ; Amniotic Fluid ; Apgar Score ; Female ; Fetus ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care, Neonatal ; Mortality ; Oligohydramnios* ; Perinatal Mortality ; Pregnancy ; Pregnancy Outcome ; Premature Birth ; Prognosis ; Rheology* ; Umbilical Arteries ; Uterine Artery

Placenta accreta is a rare condition and is associated with considerable maternal morbidity and mortality. Though hysterectomy is a definitive therapy, there are some occasions that conservation of the uterus is desired by the patient and bleeding is not excessive. We report a case successfully treated using methotrexate in patient whose placenta was not detached from the uterus with a brief review of literature.
Hemorrhage ; Humans ; Hysterectomy ; Methotrexate* ; Mortality ; Placenta Accreta* ; Placenta* ; Uterus