Secondary abdominal pregnancy in human immunodeficiency virus-positive woman

We report on an abdominal pregnancy in human immunodeficiency virus-positive mother, currently on antiretroviral therapy, which was discovered incidentally while training the obstetric ultrasound capacity building program. Although abdominal pregnancy is a rare form of ectopic pregnancy, it may be more common in women with HIV infection because they tend to have a higher rate of sexually transmitted diseases than the general population. The positive diagnosis of abdominal pregnancy is difficult to establish and is usually missed during prenatal assessment particularly in settings that lack routine ultrasound examination as is the case in most developing countries. For the management of abdominal pregnancy, surgical intervention is recommended and removal of the placenta is a key controversy. Ultrasonography is considered the front-line and most effective imaging method and an awareness with a high index of suspicion of abdominal pregnancy is vital for reducing associated high maternal and even higher perinatal mortality.

Effect of Low Power Laser Irradiation on Gentamicin-Damaged Vestibular System in Guinea Pigs

BACKGROUND AND OBJECTIVES: The purpose of this study was to investigate the characteristics of gentamicin-induced vestibulotoxicity of otolith organs and preventive effect of low power laser to vestibulotoxicity by assessing the result of earth vertical and the off vertical axis rotation tests. MATERIALS AND METHODS: Twenty guinea pigs were grouped into two groups, laser and no laser group. Vestibulotoxicity was induced by intratympanic injection of gentamicin. Prevention of the vestibulotoxicity was studied by irradiation of low power laser. Off vertical axis rotation tilted 30 degree relative to the earth vertical axis was applied to evaluate the otolithic function. Results and CONCLUSION: Gentamicin induced vestibulotoxicity was confirmed by gain decreasing in slow harmonic acceleration test and modulation decreasing in the off vertical axis rotation test. Prevention effect of low power laser to gentamicin induced vestibulotoxicity was confirmed by modulation maintaining in the off vertical axis rotation test and gain maintaining in the earth vertical axis rotation.

The Comparison of the Effect of Cigarette and Stop Smoking-aiding Cigarette on Release of IL-6 from Bronchial Epithelial Cell / 결핵및호흡기질환

BACKGROUND AND AIMS: Cigarette smoking induces an inflammatory response in the airways, which may play a key role in the pathogenesis of chronic obstructive pulmonary disease. Interleukin-6 (IL-6) is one of the cytokines that plays an important role in inducing bronchial inflammation. The aim of this study was to determine if the level of the pro-inflammatory cytokine, Interleukin-6 , is increased when the bronchial epithelial cells are exposed to a cigarette smoke extract (CSE) and an extract from stop smoking-aiding cigarettes, and examined the safety of these commercially available stop smoking-aiding cigarettes. METHOD: Bronchial epithelial cells were exposed to CSE from cigarette and stop smoking-aiding cigarettes for 24 hours. ELISA was used to measure the IL-6 levels in the supernatant from each condition. The IL-6 mRNA levels were measured by Taqman Real time RT-PCR. N-acetyl-L-cysteine(NAC) was added to each condition to determine if NAC can inhibit the release of IL-6 from the bronchial epithelial cells when they are exposed to CSE from cigarette and stop smoking-aiding cigarettes. RESULT: When bronchial epithelial cells were exposed to a CSE from cigarettes and stop smoking- aiding cigarettes, each type of CSE stimulated IL-6 production from the bronchial epithelial cells. The IL-6 mRNA level in the Bronchial epithelial cells was also elevated and NAC was found to inhibit the release of IL-6 from bronchial epithelial cells when they were exposed to the CSE from cigarettes and stop smoking-aiding cigarettes. CONCLUSION: Commercially available stop smoking-aiding cigarette can induce bronchial inflammation and can be harmful to smokers. Therefore, the safety of these cigarettes for smoking cessation should be evaluated.

A Case of Complicated BPPV(Benign Paroxismal Positional Vertigo)

Canalith repositioning maneuver is effective to treat benign paroxysmal positional vertigo(BPPV). This case showed complicated form of the BPPV such as changes of canalolithiasis to cupulolithiasis, involvement of one canal to two canals and from unilateral to bilateral involvement during the reposition maneuver. This patient was diagnosed as left lateral canalolithiasis at first. After left barbecue maneuver, the type was changed to the right posterior cupulolithiasis. Semont maneuver was performed and then the type of BPPV was changed to combined type with right posterior canalolithiasis and left lateral canalolithiasis. We performed left barbecue maneuver and right Epley maneuver. Then the type of BPPV was changed to left lateral cupulolithiasis. After Brandt-Daroff maneuver and left barbecue maneuver, nystagmus and dizziness disappeared finally.

A Clinicopathologic Study of Epiglottic and Vallecular Cysts / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The epiglottic and vallecular cysts are uncommon and almost benign lesions. Newman classified laryngeal cyst as an epithelial, tonsillar and oncocytic cyst (1984: Modified working classification). The purposes of this study are to find out the relationship between the anatomical location of cyst and the histopathology, and identify the effectiveness and advantages of CO2 laser excision of epiglottic and vallecular cysts. SUBJECT AND METHOD: A retrospective study of medical records was carried out for 34 patients with epiglottic and vallecular cysts. They underwent laryngomicroscopic surgery with CO2 laser between January 1995 and April 2003 at the Dankook university hospital. In this article, the authors review epiglottic and vallecular cysts from both the clinical and histopathological points of view. RESULTS: The epiglottic and vallecular cysts were more common in men than in women, and the mean age was 47 years old. The most common symptom was globus sensation in throat (67%). There was no complication such as bleeding or edema in all cases during operation and postoperative period. The mean hospital stay was 2 days. The epithelial cysts and tonsillar cysts were 28 and 6 cases, respectively. Most of epithelial cysts were located in lingual surface of epiglottis. All tonsillar cysts were located in the valleculae except for one case. We encountered recurrence in 2 cases, where the cysts ruptured during operation and reoperation was done. CONCLUSION: The most common histopathologic type of epiglottic cyst was epithelial cyst. However, that of vallecular cyst was tonsillar cyst. The CO2 laser excision was an effective modality for treatment of epiglottic and vallecular cysts.

A Case of Congenital Duodenal Atresia Diagnosed by Prenatal Ultrasonography / 대한주산의학회잡지

Congenital duodenal atresia is the most common cause of perinatal intestinal obstruction. Abdominal distension and projectile vomiting are the specific symptoms of neonatal gastro-intestinal obstruction. The incidence of duodenal atresia is between 1 in 2,710 and 1 in 10,000 live births.1 Most cases are thought to be failure of recanalization of the duodenal lumen during embryonic period.2 Duodenal atresia is associated with a high incidence of other associational anomalies, including esophageal atresia, biliary atresia, congenital heart disease and vertebral anomalies. Prenatal diagnosis, the ealry operation and the facotrs such as prematurity, combined abnormalities, nutirtion have a significant influence on complication and mortality.3,4 We report a case of congenital duodenal atresia diagnosed by ultrasonography prenatally in Andong general hostpital at 26 gestational weeks and operated the 7th day of cesarean section in Yeungnam university hospital with a brief review of literature.

A Case of Varix of the Fetal Intra-Abdominal Umbilical Vein and Review of the Literature / 대한산부인과학회잡지

Varix of the intraabdominal portion of the fetal umbilical vein is a rare entity. We present a case of varix of the intrafetal umbilical vein diagnosed by routine prenatal ultrasonography at 35 weeks of gestation. Color Doppler examination of the abnormal umbilical vein demonstrated turbulent flow through 23-mm diameter cystic dilatation of the fetal intra-abdominal umbilical vein consistent with a varix. No other sonographic abnormalities were detected, and a healthy infant was delivered at term.

Two cases of conservative management of 10 and 8 week cervical pregnancies / 대한산부인과학회잡지

Cervical pregnancy is a rare and dangerous form of ectopic pregnancy in which the blastocyst implants within the cervical canal below the internal os of the uterine cervix. The characteristic clinical sign is a severe asymptomatic uterine bleeding in early pregnancy or during curettage. Most cervical pregnancies result in early spontaneous abortion, complicated by severe hemorrhage from the eroded blood vessels within the cervical tissue. Because of uncontrolled profuse vaginal bleeding, total hysterectomy has been the mostly necessitated to control life-threatening bleeding. Transvaginal sonography allows early diagnosis, and conservative treatment (two-time treatment : first treatement with systemic or intraamnionic methotrexate, secondly with curettage or ligature of the uterine arteries) improves the patient's fertility. Successful treatment is defined as elimination of the cervical pregnancy with preservation of the uterus. We report two cases of cervical pregnancy managed, successfully with methotrexate, leucovorin and curettage.

Two Cases of Holoprosencephaly / 대한산부인과학회잡지

Holoprosencephaly is a rare malformation complex or development defect including different degrees of incomplete cleavages of the embryonic prosencephalon and varying degrees of the midface defects, resulting from the defect of prechordal mesoderm, migrating forward into the area anterior to the notochord during the third week of fetal development. Early antenatal diagnosis of holoprosencephaly is important to find out its severity, to predict its prognosis, and to determine proper management according to its prognosis and severity. The possibility of early antenatal diagnosis of holoprosencephaly by ultrasound has been suggested, but occasionally missed and rarely confirmed. We present one case of lobar holoprosencephaly, diagnosed postnatally and one case of alobar holoprosencephaly, diagnosed antenatally in our hospitals.