Pulmonary Hypertension in Patient with Neurofibromatosis Type 1 / 고신대학교의과대학학술지

Neurofibromatosis type 1 (NF1) is a rare genetic disease. Precapillary pulmonary hypertension (PH) with NF1 is an extremely severe complication. A 65-year-old woman was admitted in our hospital with 3-year history of gradually worsening dyspnea on exertion (New York Heart Association functional class III-IV). Considering her clinical feature and examination findings, she could be diagnosed as PH associated with NF1. She was treated with endothelin receptor antagonist. However her dyspnea was not significantly improved. This is the first Korean case of NF1 patient with PH which confirmed with right heart catheterization.

A Rare Coincidence of Esophageal Intramural Pseudodiverticulosis with Esophageal Web

We report a rare case of esophageal intramural pseudodiverticulosis (EIPD) associated with esophageal web in a 67-year-old man presenting with dysphagia. EIPD is characterized by multiple tiny flask-shaped outpouchings of the mucosa that extend into the muscular layer on esophagography. EIPD commonly presents with stricture and less commonly with esophageal web. Although etiologies of both EIPD and esophageal web are unclear, a chronic inflammatory condition has been proposed. Treatment of EIPD is usually directed at the associated conditions rather than at the pseudodiverticulosis itself. In our case, dysphagial was successfully relieved by endoscopic dilatation with incision methods for the esophageal web.

A Case of Type 2 Diabetes Mellitus Initially Presented as Monochorea Associated with Ketotic Hyperglycemia / 임상당뇨병

Monoballismus-monochorea is abnormal neurologic sign characterized by continuous, involuntary and irregular movement involving one extremity. Hyperglycemic ballism-chorea is predominantly observed in older type 2 diabetic patients and non-ketotic hyperglycemia, and is associated with contralateral striatal hyperintensities (i.e., putamen and caudate) on both brain CT and MRI. Movement disorders as the initial symptoms of diabetes mellitus are rare, especially in ketotic hyperglycemia. Here, we report one of these rare manifestations of transient monoballismus with during an episode of ketotic hyperglycemia without contralateral striatal abnormal findings on brain MRI in newly diagnosed diabetes mellitus.

Retrospective study of functional ovarian cysts on ultrasonographic findings / 대한산부인과학회지

OBJECTIVE: The purpose of this study is to identify the cooperation between histologic diagnosis and sonographic pattern of functional ovarian cyst. And also determine performances of ultrasound, computed tomography, and tumor markers in diagnosis of functional ovarian cyst. METHODS: We retrospectively reviewed the medical records of 129 patients with ovarian cystic tumors undergone an adnexectomy between 2006 and 2008 at Kyung Hee medical center. All patients performed sonographic examinations, and a computed tomography or CA-125 or CA-19-9 were done if needed. RESULTS: Among 129 patients, 35 patients were diagnosed to be functional ovarian cyst. Sensitivity and specificity of ultrasound for functional cyst was 37.1% and 82.9%, respectively. Sensitivity and specificity of computed tomography was 47.6% and 69.3%, respectively. Tumor markers were not useful to detect functional ovarian cyst. If any one of the two appeared functional ovarian cyst, the sensitivity and specificity was 66.6%, 67.7% each. CONCLUSION: Computed tomography can be used as an alternative option replacing ultrasound, but combination of computed tomography and ultrasound does not provide the additional benefit in early diagnosis of functional ovarian cyst.

A case of prenatally detected fetal scalp mass / 대한주산의학회잡지

Prenatal ultrasonographic appearance and Doppler characteristics of extracranial masses are variable, depending on the location, vasculature, amount of arteriovenous shunting, and degree of proliferation. Epidermoid cysts are found in a variety of locations around the skull and midface. They are thought to occur as a result of the persistence of ectodermal elements at sites of suture closure, neural tube closure, and diverticulation of the cerebral hemispheres. They contain ectoderm but no skin element. We experienced 33-year-old primigravida with fetal extracranial mass at 23 weeks gestation. We presumed that this extracranial mass was hemangioma. However, the mass was suspected as scalp epidermoid cyst on postnatal ultasonography.

Comparison of the efficacy of additional vaginal dressing disinfectants for reduction of wound-related complications in laparoscopic hysterectomy / 대한산부인과학회지

OBJECTIVES: To compare the efficacy of additional vaginal dressing disinfectants for reduction of wound-related complications in laparoscopic hysterectomy. METHODS: From September 2006 to June 2007, 226 of 243 patients underwent laparoscopic hysterectomy were enrolled. The patients were classified into three groups (no additional disinfectant (n=76), povidone-iodine (n=68), and chlorhexidine (n=82) for disinfectants) and the short term postoperative complications related with wound morbidity were recorded by 2 months out-patient follow up. RESULTS: The mean age of all patients was 46.6+/-7.6 years old, and the mean BMI (body mass index) was 24.2+/-3.4, mean operation time was, 137.2+/-48.0 minutes, and the mean estimated blood loss was 451.8+/-240.2 ml. There was no significant difference among three groups in their mean age, mean BMI, frequency of vaginal culture (+) before surgery, frequency of wound/stump infection after surgery, frequency of wound disruption, and frequency of fever. The significant difference was shown in mean operation time and mean estimated blood loss but those did not affect frequency of vaginal culture (+) before surgery, frequency of wound/stump infection after surgery, frequency of wound disruption, and frequency of fever. CONCLUSIONS: We conclude that the kind of disinfectant for additional vaginal dressing for laparoscopic hysterectomy does not matter deeply in causing short term wound-related complications after the surgery.