Clinical significance of QT interval and Cardiac Enzyme in Carbon Monoxide Poisoning

PURPOSE: This study was performed to investigate the value of corrected QT interval (QTc), corrected QT dispersion (cQTd), cardiac enzyme (Creatinine kinase; CK, CKMB) as a short-term prognosis and severity evaluation in CO poisoning. METHODS: This study reviewed 55 cases of CO poisoning that occurred form January 1, 2000, to June 31, 2005. We have analyzed the admission ECGs of patients with CO poisoning for QTc, QTd (QT dispersion), cQTd and measure CK, CK-MB, too. QTd was defined as the difference between the longest and the least QT intervals in any of the 12 leads. We evaluate short-term outcome with consciousness on discharge from ED and severity with receiving hyperbaric oxygen therapy (HBO). RESULTS: Eighteen of 55 patients received HBO and seven patients received two or more. On admission, cQTd intervals of the intoxicated patients were increased compared to normal (63.2+/-38 ms), but not the QTc, QT, QTd. QTc interval and CK of patients who received HBO were significantly increased compared to patients who not receive(472.0+/-4 7 ms VS 437.2+/-730 ms, p=0.006 158 3.1+/-43174 u/L 138.8+/-2363 u/L p=0.009). Whether or not consciousness on discharge was associated only CK (p= 0.02). CONCLUSION: The QTc interval and CK were prolonged at patients who received HBO. That means that the QTc interval and CK reflected the severity of CO poisoning. CK of Patients who not recover consciousness after HBO were increased significantly. To say, as CK were increase, the short-term prognosis of CO poisoning is the poorer.

Clinical Review on 93 Cases of Laparoscopic Myomectomy / 대한산부인과학회잡지

OBJECTIVE: The study was undertaken to evaluate clinical safety and usefulness of laparoscopic myomectomy with analyzing clinical course and postoperative complications of 93 patients underwent laparoscopic myomectomy at Yosu Chon-nam Hospital and to introduce operative methods executed in this hospital. METHODS: Total number of patients underwent laparoscopic myomectomy at Yosu Chon-nam Hospital from May 2001 to December 2002 was 93. With ward chart and admission recordings, Age, parity, symtom, size of myoma, number of myoma, location operation time and hemoglobin change were recorded. Data were analyzed with Microsoft Excel. RESULTS: The mean age of patients was 42.68 ( +/- 6.05) years. The mean parity was 2.02 ( +/- 0.96). The mean number of myoma was 1.70 ( +/- 1.27). The mean weight of myoma was 71.7 ( +/- 56.4) gm. The most common symtom was hypermenorrhea. The location of myoma was submucosal, intramural, subserosal in large order. The mean operation time was 101.1 ( +/- 30.2) minutes. The mean hemoglobin change after operation was 1.40 ( +/- 0.81) g/dL. Mean hospital stay was 3.90 ( +/- 1.20) days. The operative complication was trocar site bleeding (2 cases), surgical emphysema (2 cases). In 2 cases, Laparoscopic procedure was converted to laparotomic method. CONCLUSION: Indication of operation was extended in almost all age (including reproductive age) and 93 Laparoscopic myomectomy was done safely and effectively without severe complications. However, to obtain more safety and usefulness of laparoscopic myomectomy, adequate laparoscopic instrument and expertized operative technic should be demanded. In near future, laparoscopic myomectomy will be more popular and effective by variable technical development and ordered discipline.

A Case of Pelvic Actinomycosis Associated with Intrauterine Contraceptive Device / 대한산부인과학회잡지

Actinomycosis is a slowly progressive chronic suppurative infection noted for forming characteristic sulfur granule by an anaerobic gram-positive bateria. Pelvic actinomycosis occurs most commonly in association with IUD and has variable nonspecific symptoms that make an initial diagnosis difficult. Colonization of lower genital tract by Actinomyces occurs most often in IUD users and increases with the duration of IUD use. We experienced a case of actinomycotic pelvic abscess associated with IUD and report it with a brief review of concerned literature.

Tubal Pregnancy in a Unicornuate Uterus with Rudimentary Horn / 대한산부인과학회잡지

Several cases of ruptured pregnant uterine horn have been documented. However, there have been few reported cases of ectopic tubal pregnancy in a unicornuate with rudimentary horn. So we report this case with a brief review literature.

A Case Of Intrauterine Fetal Death Due To Stricture Of The Umbilical Cord / 대한산부인과학회잡지

Umbilical cord stricture is a very rare cord abnormality that cause intrauterine fetal death. An extreme focal deficiency of Wharton's jelly is suggested as a cause of cord stricture, and was most commonly occurred at the fetal end of umbilical cord. Antenatal detection of umbilical cord stricture is very difficult. We experienced a case of the intrauterine fetal death due to umbilical cord stricture, and we report this case with a brief review of literatures.

A Case of Pelvic Actinomycosis Simulating Metastatic Ovarian Cancer / 대한산부인과학회잡지

Actinomycosis is a rare disease in human and has variable clinical features, which make the diagnosis difficult. Actinomycosis may be confused with malignancy and other inflammatory diseases because of its infiltrative nature and its tendency to invade normal anatomic barriers. We have experienced a case of abdominal actinomycosis combined with ovarian mucinous cystadenocarcinoma and report this case with brief review of literatures.

A case of heterotopic pregnancy following in vitro fertilization and embryo transfer / 대한산부인과학회잡지

Heterotopic pregnancy, simultaneous intrauterine and extrauterine pregnancy, is an extremely rare case. The incidence of heterotopic pregnancy was about 1 to 30,000 pregnancies, but it has increased after wider use of assisted reproductive technology. The rising incidence presents a serious problem as the diagnosis of this potentially fatal condition is often missed. Careful pelvic examination combined with serial beta-hCG determinations, and transvaginal sonography to evaluate the adnexal region are necessary prerequisites for early diagnosis. We report a case of heterotopic pregnancy following in vitro fertilization and embryo transfer(IVF-ET) with a brief review of literature.