A Case of Pregnancy in Essential Thrombocythaemia with Low dose Aspirin Treatment / 대한주산의학회잡지

Essential thrombocythaemia (ET) is a chronic myeloproliferative disorder characterized by markedly elevated platelet count in the peripheral blood due to an excessive proliferation of bone marrow megakaryocytes. The pregnancy outcome among patients with ET is mostly successful but adverse outcome due to thrombotic and bleeding complications is a matter of concern: miscarriage, intrauterine growth retardation, abruptio placenta, intrauterine fetal death and preterm delivery. Various treatments such as acetylsalicylic acid, hydroxyurea, anagrelide, heparin, interferon alpha and plateletpheresis have been proposed to improve the pregnancy outcome. We report a case of pregnant woman in condition of ET who succeeded in normal vaginal delivery without specific obstetric complications after low dose aspirin therapy during pregnancy.

The Efficacy of Microvascular Decompression in Hemifacial Spasm over the Course of Time

OBJECTIVE: Microvascular decompression(MVD) at root exit zone(REZ) of the facial nerve has been largely popularized and it has become the standard treatment for patients with hemifacial spasm(HFS). This sturdy is performed to evaluate the efficacy of MVD over the course of time. METHODS: From 1994 to 2003, 50 patients with HFS who underwent MVD were followed up for more than 6 months. We retrospectively analyzed results with medical records and telephone researches. RESULTS: The mean age of patients at the time operation was 57.6 years and 84% of the patients were female. The mean duration of follow-up after operation was 3.4 years (range 0.5~7.8 years). One day after MVD, 54% of patients had complete relief of spasm immediately. Continuous improvements of HFS were observed during the follow-up period and these improvements were statistically significant with time (P<0.05). Until 6 months after operation, complete relief of spasm was observed in 84% of patients. The delayed relief of spasm was observed in 35.7% of our patients who experienced complete relief. CONCLUSION: The efficacy of MVD in HFS is improves with time. Continuous follow-up evaluations for the duration of more than at least 6 months after MVD are important for the decision of its clinical results because delayed relief of spasms occurs.

A Case of Ureteral Endometriosis associated with Hydronephrosis / 대한산부인과학회지

Endometriosis affecting the urinary tract is very rare disease. The ureteral endometriosis is mostly asymptomatic for a long time, and associated with nonspecific symptoms such as abdominal or flank pain, renal colic, voiding difficulty and gross hematuria. Radiologic and laboratory findings show nonspecific findings, and the diagnosis is difficult. We report a case of obstructive ureteral endometriosis associated with right hydronephorsis. This case is operated under the impression of direct compression of ureter by uterine myoma. Total abdominal hysterectomy and ureteroureterostomy were performed. Final diagnosis of ureteral endometriosis is documented by pathologic findings.

Activity of Moxifloxacin Against Ofloxacin-Resistant Mycobacterium Tuberculosis: A Study of Cross-Resistance Between Ofloxacin and Moxifloxacin / 결핵및호흡기질환

BACKGROUND: Moxifloxacin is an 8-methoxyquinolone compound which has been shown to have the best activity of the quinolones against M. tuberculosis but there is no literature showing the rate of cross-resistance between moxifloxacin and the other quinolones such as ofloxacin. Therefore, we tested the activity of moxifloxacin against ofloxacin resistant M. tuberculosis by a study of cross-resistance. METHODS: We tested MIC's of moxifloxacin and ofloxacin by proportion method against 34 M. tuberculosis isolates showing resistance against ofloxacin at 2.5microgram/ml concentration and 13 ofloxacin susceptible isolates from specimens submitted to clinical laboratory of National Masan Hospital from March 2003 to March 2004. RESULTS: For ofloxacin susceptible isolates, MIC(50) and MIC(90) of ofloxacin were all 1.25 microgram/ml, and MIC(50) and MIC(90) of moxifloxacin were 0.31 microgram/ml and 0.63microgram/ml respectively. For ofloxacin resistant isolates, MIC(50) of ofloxacin was over 10microgram/ml and MIC(50) of moxifloxacin was 5microgram/ml,MIC(90) of ofloxacin and moxifloxacin were all over 10microgram/ml. The rate of cross-resistance between the two was 67.6%(23/34) at 2.5microgram/ml concentration. CONCLUSIONS: Moxifloxacin showed activity against 82.4%(28/34) of ofloxacin resistant M. tuberculosis at 10microgram/ml, but more studies are needed so that moxifloxacin will be used for patient with multi-drug resistant tuberculosis including ofloxacin resistance.

A Case of Heterotopic Pregnancy in a Natural Cycle / 대한산부인과학회잡지

Heterotopic pregnancy is the coexistency of intrauterine and extrauterine pregnancy. The incidence of heterotopic pregnancy is about 1 to 30,000 pregnancy in a natural cycle. However, the frequency of heterotopic pregnancy has steadily increased because of rising incidence of pelvic inflammatory disease, pelvic surgery and the development of ovulation induction and assisted reproduction. The clinical diagnosis of heterotopic pregnancy is difficult due to low incidence. Many of the cases are diagnosed by rupture of ectopic mass that makes serious complication to mother and fetus. We experienced a case of heterotopic pregnancy in a 32-year old woman who presented with acute abdominal pain in a natural cycle and report this case with a brief review of literature.

The effect of the timing of human chorionic gonadotropin on in vitro fertilization / 대한산부인과학회잡지

No abstract available.

Induction of ovulation with follicle-stimulation hormone human menopausal gonadotropin and human chorionic gonadotropin: Correlation of multiple follicular-oocytes development and serum E2 levels as well as fertilizability in ovulatory patients for in vit / 대한산부인과학회잡지

No abstract available.

The serum levels of estradiol, progesterone, and ?hCG in ectopic pregnancy / 대한산부인과학회잡지

No abstract available.

Management of Unstable Thoraco / 대한정형외과학회잡지

Segmental wiring to treat the unstable fracture and fracture-dislocation of the thoraco-lumbar spine is more effective method than Harrington instrumentation as primary procedure which afforded immediate rigid internal fixation of the spine and permitted mobilization without external support and immediate rehabilitation. A clinical study was made of twenty seven patients who were hospitalized and treated at the Department of Orthopaedic Surgery, Wonju Christian Hospital from Feb. 1979 to Apr. 1983. The following results were obtained: l. Of twenty seven patients, nine(33.3%) had a flexion rotation, eight(29.6%) had a shearing, eight (29. 6%) had a flexion compression and two(7.5%) had a vertical compression by Holdsworths mechanism of injury and by Pauls classification of fracture, thirteen(48. 1%) had a flexion distraction fracture, twelve(44. 4%) had a translation fracture and two(7. 5%,) had a unstable burst fracture. 2. Fifteen(55. 6%) had a complete neural deficit and five(18. 5%,) had an incomplete neural deficit. Six(22.2%) of the fifteen patients with complete neural deficit and one(3. 7%.) of the five patients with incomplete neural deficit showed slight neurological recovery, but eight(29.6%) gained complete recovery. 3. Correction of kyphotic deformity was average 12. 4 degree in Harrington instrumentation and average 18. 0 degree in segmental wiring, and during the follow-up periods, there was a final loss of 6. 3 degrees of kyphotic correction in Harrington instrumentation and 3. 0 degrees in segmental wiring. 4. In external support, fourteen(51.9%) had body jacket cast and four(14.8%) had back brace in Harrington instrumentation, but all patients except one brace had no external support in segmental wiring. 5. In complication, two hook dislocations and two pseudoarthroses were occurred in Harrington instrumentation, but any complication except only one cases of wound infection was not occurred in segmental wiring.

Clinical Study of Clavicle Fractures / 대한정형외과학회잡지

A clinical study of 147 clavicle fracture patients (one patient had bilateral fractures) who were admitted and treated by the Department of orthopedic surgery of Wonju Christian Hospital, Wonju Medical College, Yon Sei University. The period covered was from September 1974 to August 1981, a total of seven years. The study focused on three fertors in relation to the pain and limitation of motion and these causes were comminution of fracture, shortening of the clavicle length and external deformity. The results were as followings; l. Of the 148 cases, 125 were male and 22 female (one with bilateral fractures). The majority were between 31 and 40 years of age. 2. The mid 1/3 fracture was most common and both sides showed no difference in incidence(left ; 73 cases, right; 75 cases). 3. The mean follow up ranged from 4 months to H3 months with a mean 49.5 months. 4. The complications resulting from comminution, shortening of clavicle length and malunion were shoulder joint pain-16 cases (10.8%), limitation of motion-17 cases(11.5%) and external deformity-18 cases(12.9%). 5. Using a rating scale of excellent(no apparent factors), good( one factor), fair(two factors), poor(more than three factors) the results showed, 106 excellent, 31 good, 9 fair and 2 poor. 6. On a percentage scale, the pain showed difference of 9 times with initial comminution, 7 times with shortening of clavicle length and 7 times with deformity. 8. On a percentage scale, the limitation of motion of shoulder joint showed difference of 6 times with initial comminution, 6 times with shortening of clavicle length and 17 times with deformity.

Traumatic Complete Dislocation of the Knee Joint: Report of 3 Cases / 대한정형외과학회잡지

No abstract available in English.

A Clinical Study of the Spine Injury / 대한정형외과학회잡지

In recent years the rate of the spine Injury tends to be on the increase year by year as the rate of traffic and industrial accidents are increased. During industrial, sports and automobile accidents are occurred, the various forces were exerted by the mechanism, “flexion, extension, flexlon-rotation, vertlcal compression and shearing.” These exercise their effects on the vertebral bodies, the neural arches and intervertebral disc and the contents of the spinal cord, depending on direction and intensity of the trauma, and the posture and muscular attitude existent at the movement. Once the neurological Iesion has been diagnosised and the type of vertebral injury has been established and particularly after a decision has been made as to whether the spinal injury is stable or unstable, a rational method of treatment can be decised upon: Our treatment consists of providing the best condition for recovery from the spine injury, preventlng further neurologlcal damage in the unstable area, achieving stable bone and llgament heallng ln satisfactory position, preventing metabolic compllcations from being fatal, mobllizing the patient early, and rehabilitating to provide maximum fuctlonal independence with the remaining-muscle power avallablc to the cord injury patient. One hundred and fifty seven spine fracture and dislocation patients were clinically observed and evaluated from Jan. 1972 to Dec. 1978 in our study. The result of this study may be summerized as follows: 1. Out of the patients, there were 135 male and 22 female cases. The ratio between male and female was 6.1:1. The majority (84.7%) of the spine injuries was found in the age of 20 to 50 years. Fifty-two percent of the cases was caused by industrial accidents. 2. The most common site of the lesion occurred between T-11 and L-2 vertebrae (71.8%). 3. In cervical injury, fracture dislocation type was most common (50%), and especially, pure dislocation by extension mechanism was 12.5% but in thoracolumbar iniury, simple anterior wedge compression fracture was most common (66.6%) and there were no pure dislocations just like cervical spine injury cases. 4. Fifty seven cases of the total were complicated by paraplegia, of which 62.5% in cervical region and 31.6% in thoracolumbar region were noticed. The most frequent type of the injury in which paraplegia developed was the fracture dislocation (73.8%) and the most common site of the lesion was between the T-12 and the L-2 vertebrae. 5. Open reduction was performed in 9 cases out of 24 cervical spine injury patients and in 41 cases out of 133 thoracolumbar injury patients. 6. Prognosis of neurologic recovery in initially complete lesion was poor, regardness of treatment. In the cervical lesion cases there were no patients who were recovered. But in the other sites about 10.5% of initially complete lesion showed partial neural recovery comparing to 62.5% of initially incomplete lesions. 7. Progressive deformity is often noted as a complication of spine fracture or dislocation when solid fusion fails to develop. The increment of kyphosis after treatment is as follows: Simple wedge fracture