Serious Complication of Cement Augmentation for Damaged Pilot Hole

Polymethl methacrylate (PMMA) screw reinforcement is frequently used in osteoporotic bone as well as in damaged pilot holes. However, PMMA use can be dangerous, since the amount of applied cement is uncontrolled. A 47-year-old male with traumatic cervical spondylolisthesis at C6-7 underwent anterior cervical plate fixation. During repeated drilling and tapping for false trajectory correction, a pilot hole was damaged. Although it was an unconventional method, PMMA augmentation was tried. However, PMMA was accidentally injected to the cervical spinal cord owing to lack of fluoroscopic guidance. The PMMA was surgically removed after corpectomy and durotomy. The patient had left side hemiparesis (Grade 2/5) immediately post operation. The patient improved spontaneously (Grade 4/5) except for 4th and 5th digit extension. Here, we report a rare complication of PMMA extrusion in the spinal cord during a damaged pilot hole injection, which has not previously been described.

Effects of Walking Exercise Program for Health Status in Patients on Continuous Ambulatory Peritoneal Dialysis / 대한신장학회잡지

BACKGROUND: It is necessary to exercise in Continuous Ambulatory Peritoneal Dialysis (CAPD) patients but it's difficult because of their physical condition and little motivation. The purpose of this study was to evaluate the effects of the walking exercise program on health status in CAPD patients. METHODS: A nonequivalent control group with pre- and post-test was designed to examine the effects of the program. Data collection was done from December, 2002 to June, 2003. The study participants were selected according to the criteria among the patients who were receiving CAPD at the department of Kidney Center, NIHC Ilsan hospital. The walking exercise program was consisted of an exercise education protocol, an exercise prescription, and a counselling protocol based on a framework of self-efficacy promotion. The exerciser group which was composed of 19 participants was educated based on an exercise education protocol and carried out walking exercise for two to four times a week upon taking verbal persuasion biweekly through telephone or face-to-face interview for 12 weeks, while 17 participants in control group were received no intervention. RESULTS: There was significant differences between two groups; the exerciser group showed better physical function (p=0.03), higher VO2 max (p=0.01) and higher serum albumin level (p=0.02) than the results of control group. However, there were no differences in lipid metabolism. CONCLUSION: The walking exercise program was found to have an effect to increase health status of CAPD patients. The results provided evidences for the importance of continuous physical activity in CAPD patients.

Conservative management of cervical pregnancy with H2O2 irrigation of cervical canal / 대한산부인과학회지

Prevent vaginal bleeding before and after conservative management of cervical pregnancy is the important part of the treatment. We can choose two methode for the conservative management of cervical pregnancy. One is curettage and bleeding control, and the other is using fetocidal agent. Most frequently used fetocidal agent is methotrexate. But additional treatment would be needed after single dose of MTX, and for multiple dosage of MTX, one should be hospitalized about 7 to 10 days. We have used H2O2 intracervical irrigation through enema syringe for conservative management of cervical pregnancy, which is very useful and has no risk of consequent bleeding. So we report it with brief review of literatures.

The effect of colpoperineoplasty on female sexual function / 대한산부인과학회지

OBJECTIVE: To evaluate female sexual function after colpoperineoplasty. METHODS: Women who visited regional clinic for colpoperineoplasty from June. 2004-Aug. 2004. filled in FSFI (The Female Sexual Function Index) questionnarie before and 4 months after surgery. Six weeks after surgery, they start pelvic muscle training with HMT 2000 (Korea, electric stimulator). RESULTS: Frequency of coitus, sexual desire, arousal, lubrication and orgasm was increased after colpoperineoplasty. Percentage of patients who had coitus more than once a week increased from 18% to 63%. In sexual desire, about 18% felt sexual arousal more than or about half the time before surgery, but increased to 45% after surgery. In sexual arousal, percentage of who felt sexually aroused during more than half of sexual activity increased from 34% before surgery to 69% after surgery. In Lubrication, percentage of who became lubricated during more than half of sexual activity increased from 44% before surgery to 82% after surgery. Who reached orgasm more than half of sexual activity increased from 29% before surgery to 70%. CONCLUSION: Colpoperineoplasty increased female sexual activity.