The Rupture Risk of Aneurysm in the Anterior Communicating Artery: A Single Center Study

OBJECTIVE: The aim of this study was to evaluate the characteristics of ruptured aneurysms at anterior communicating artery (A com) with an analysis of clinical and morphological data, which could further our understanding of the risks of ruptured A com aneurysms. MATERIALS AND METHODS: An analysis of data with 86 ruptured and 44 unruptured A com aneurysms were analyzed using a digital subtraction angiography or 3-dimensional computed tomography angiography between January 2010 and December 2015 in a single center. RESULTS: Fifty-five percent of ruptured A com aneurysms were smaller than 4 mm in size. They had a smooth wall (44%), with a mean size ratio of 4.22 (range: 0.7-14.3) and mean height/width ratio of 1.48 (range: 0.5-2.9); 23 patients of A1 positive difference. Unruptured aneurysms were mostly 2-10 mm in size (94%) and had an irregular wall (43%), with a mean size ratio of 4.1 (range: 0.8-9.1) and mean height/width ratio of 1.2 (range: 0.1-2.6); 6 patients of A1 positive difference. In terms of the morphology of aneurysms, size of A com, maximum aneurysm size, neck width, aneurysm wall morphology, and size ratio were not different with statistical significance. However, dominance of A1 (p = 0.01) and height/width ratio (p = 0.03) were found to be a significant predictive factor for rupture of A com aneurysms. CONCLUSION: To better understand the rupture risk of A com aneurysms, a large, multicenter, collaborative, and prospective study should be performed in the future.

Langerhans Cell Histiocytosis of the Thoracic Spine in an Adult

We report a case of a 45-year-old man with a complaint of both leg weakness and hypoesthesia. Radiological evaluation revealed an osteolytic lesion of the ninth thoracic vertebra. The patient underwent posterior corpectomy with total excision of the tumor, mesh cage insertion with posterior screw fixation and subsequent radiotherapy. Histology confirmed the diagnosis of Langerhans cell histiocytosis (LCH). This case report presents the diagnostic work-up, histopathological evaluation, and the treatment procedures of rare LCH in the thoracic spine.

Comparison of Virulence Factor Expression between Blood Isolates of Candida albicans and Commensal Strain Isolated from Healthy Volunteers

In the present study, we investigated the differences in the levels of expression of virulence factors between blood isolates of Candida albicans and commensal strain isolated from the oral cavities of health volunteers, and correlations between virulence factors. Blood isolates of 33 and commenal isolates of 71 were characterized by putative virulence factors such as proteinase production (PROT), an ability to adhere to epithelial cells (ADH), cell surface hydrophobicity (CSH), phospholipase production (PLASE), and hyphal transition (GERM). In PROT, ADH, CSH, and PLASE, the means of expression of blood isolates were higher compared with those of commensal isolates, however statistical significance was only shown in CSH (p=0.036). On the contrary, mean expression of GERM of blood isolates was lower than that of commensal isolates. Of relationships between virulence factors, although a negative correlation of PROT with CSH was obtained, the correlation was relatively low (r=-0.316, p=0.001). These results suggest that higher expression of CSH is a more distinguishing character in virulent blood isolates of C. albicans and that the expression of virulence factors are independent.

Antimicrobial Susceptibilities and Serotypes of Group B Streptococci Isolated from Pregnant Women / 대한임상병리학회지

BACKGROUND: Recent data suggest that the colonization rate of group B streptococci(GBS) in pregnant women and the incidence of neonatal infections by GBS is increasing trend in Korea, but the antimicrobial susceptibilities and serotypes in pregnant women have not been reported in Korea. So, we studied to define the antimicrobial susceptibility patterns and frequency of serotypes of GBS in pregnant women. METHODS: The susceptibility and serotyping of 60 GBS isolates from 27 pregnant women and four isolates from their two neonates were tested by an agar dilution method and agglutination test, respectively. The typing sera used in this study were Ia, Ib, II, III, IV, and V. RESULTS: Minimal inhibitory concentration range of 60 GBS from pregnant women were penicillin G 0.015-0.12 microgram/ml, vancomycin 0.5-2 microgram/ml, clindamycin 0.015-4.0 microgram/ml, chloramphenicol 2-4 microgram/ml, erythromycin 0.015-2 microgram/ml, tetracycline 0.5-256 microgram/ml, cephalothin 0.12-0.25 microgram/ml, ceftriaxone 0.03-0.12 microgram/ml, respectively. The resistance rate of GBS were 6.7% to clindamycin, 0% to erythromycin, and 98.3% to tetracycline. Most of GBS serotypes from pregnant women in decreasing order were Ib(48.3%), Ia(24.1%), III(20.7%). CONCLUSION: All GBS strains isolated from pregnant women are highly susceptible to commonly used antimicrobial agents with the exception of tetracycline. The low prevalence of severe neonatal GBS infections in Korea is not due to the absence of serotype III, but probably due to a low genital carriage rate of GBS by pregnant women.

A Case of Ectrodactyly Fetus / 대한산부인과학회잡지

Split hand split foot(SHSF) is a rare human developmental defect characterized by mi-ssing digits, fusion of remaining digits, and a deep median cleft in the hands and feet. Cy-togenetic studies of deletions and translocations associated with this disorder have indicated that an autosomal dominant split hand/split foot locus maps to 7q21-q22. We have experienced a case of ectrodactyly in a 25-year-old primigravida woman and her baby and reported out our experience with a review of related literature.

A Case of Asphyxiating Thoracic Dysplasia / 대한산부인과학회잡지

Asphyxiating thoracic dysplasia(ATD;Jeunes's syndrome) is a rare variety of short limb dwarfism. It is characterized by an extremely small thorax when compared to the ab-dominal circumference, which frequently results in respiratory distress. Other anomalies as-sociated with Jeune's syndrome are pelvic bone malformations and renal dysplasia. It was first described and namely by Jeune et al. in 1954. Jeune's syndrome is an autosomal rece-ssive trait and has a 25% recurrence risk. These patients died at early age due to respirat-ory insufficiency. Death due to uremia has occurred in number of children surviving infan-cy, following progressive renal failure, hypertension and hepatic failure. About 50 cases have been reported in the world literature. We experienced a case of small thorax with short limb dwarfism on antenatal ultraso- und examination and then the baby was delivered by cesarean section. The diagnosis was confirmed to Asphyxiating thoracic dysplasia by clinical features, radiological findings and pathological findings. We reported a case of Asphyxiating thoracic dysplasia with review of literatures.

A Clinical Study on Cesarean Hysterectomy / 대한산부인과학회잡지

This study analyzed the outcome of 26 cases of cesarean hysterectomy performed at Wonju Christian Hospital, College of medicine, Yonsei university during 15 years from January, 1982 to May, 1996. There were 27,602 deliveries during this period. Cesarean hysterectomy was performed in 11 of 10,373 cesarean section(0.11 %) and in 15 of 17,229 vaginal deliveries(0.09 %). The age of patients varied from 20 to 48. Indications for emergency cesarean hysterectomy were uterine atony (46.2 %), uterine rupture(26.9 %), and placenta accreta(19.2 %). The relative risk of emergency hysterectomy was 1.22(95 % confidence interval 0.56 to 2.65) for cesarean deliveries, 1.91(95 % confidence interval 0.73 to 4.98) for prior cesarean deliveries and 20.56(95 % confidence interval 10.85 to 38.95) for placenta previa. The patients who had cesarean hysterectomy received from 750 ml to 11,500 ml of blood transfusion with a mean of 3,500 ml. No significant differences in length of operating time, amount of blood loss and postoperative complications were found between total abdominal hysterectomy and subtotal abdominal hysterectomy. In about 1/2 of total patients (46.2 %), there were no operative complications. Maternal death was found in 1 case. Hemorrhage still remains main cause of maternal mortality, the decision of hysterectomy must be conjunction with maternal life saving and free from various dangerous sequalae. So in this study, clinical evaluation for cesarean hysterectomy and an attempt to identify risk factor that might pridict those patients likely to require emergency hysterectomy was made.

Fatal pulmonary embolism following cesarean section / 대한산부인과학회잡지

No abstract available.