Clinical Characteristics of 2070 Korean Women Who Visited the Adolescent Gynecology Clinic / 대한산부인과학회잡지

OBJECTIVE: To analyze the clinical characteristics of Korean pediatric, adolescent and premarital women who visited the Adolescent Gynecology Clinic at Samsung Medical Center. METHODS: A retrospective study was performed on the 2070 women visiting the Adolescent Gynecology Clinic at Samsung Medical Center from Feb. 1995 to Sep. 2003. The patients were divided into 3 groups according to patients' age; group I (~9 years, 258 patients), group II (10-20 years, 911 patients), group III (21-30 years, 901 patients). Clinical characteristics were analyzed by chart review and compared among three groups. RESULTS: The mean patient age was 18.4 +/- 6.9 years (mean SD) and the mean age at menarche was 13.4 +/- 1.5 years. The most common disease entity and disorder according to age groups were infectious disease and vaginitis in group I, menstruation associated problems and abnormal uterine bleeding (AUB) in group II, and menstruation associated problems and amenorrhea in group III. Among gynecologic problems, AUB was cited as the most common problem for the patients visiting the Adolescent Gynecology Clinic (425 cases, 20.5%), followed by amenorrhea (393 patients, 19.0%). 51.0% of primary amenorrhea had a congenital defects. Among the patients with pelvic tumor (293 patients), 85.3% was due to ovarian tumor, and 166 patients (66.4%) with ovarian tumor underwent operation. The most common pathologic diagnosis for ovarian tumor was endometrioma (60 cases, 36.1%). In primary dysmenorrhea (214 patients, 76.2% of total dysmenorrhea), treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) resulted in symptomatic improvement in 82.6% of the patients. The most common infectious disease was vaginitis and the most commonly isolated organisms varied according to age group (group I, II: E. coli, group III: Candida albicans). CONCLUSION: The most common gynecologic problem in korean pediatric, adolescent and premarital women is menstruation related disorders, presenting in 58.8% of patients visiting the Adolescent Gynecology Clinic.

Epidural Anesthesia for Emergency Cesarean section in Thyrotoxic Paturient - A case report / 대한마취과학회지

Hyperthyroidism is usually caused by multinodular diffuse enlargement of the gland in Graves disease and can be associated with pregnancy. Ideally, appropriate medical therapy establishes a euthyroid state prior to anesthesia. However, if emergency surgery becomes necessary in an unprepared patient, the anesthesiologist must avoid situations that may exacerbate the disease and should prevent thyroid storm during perianesthetic period. In this case, a 26 years old female with poorly controlled thyrotoxicosis was scheduled for emergency Cesarean-section. The patient was successfully managed by epidural anesthesia and discharged uneventfully at the 9th postoperative day.