A Case With Suspected Tick Paralysis

Tick paralysis is caused by a neurotoxin secreted by female tick. Characteristic initial manifestation is bilateral flaccid ascending paralysis similar to Guillain-Barr? syndrome. The predominant electrophysiological abnormality is a reduction in complex muscle action potentials. Here, we present a 62-year-old man who initially experienced a sudden biting pain on his scalp. Subsequently he developed bilateral lower extremity paralysis that ascended symmetrically involving the upper extremities. Within 2 weeks, the patient showed a full recovery without treatment.

The clinical implications of acquired thrombophilia in patients with ovarian hyperstimulation syndrome / 대한산부인과학회지

OBJECTIVE: To investigate the clinical significance of thrombophilia in patients admitted with ovarian hyperstimulation syndrome (OHSS). METHODS: Twenty-five infertile women who were admitted into university hospital due to OHSS after ovarian hyperstimulation for intrauterine insemination or in vitro fertilization. Blood samples were drawn at the time of admission and three thrombophilic factors were assayed; antithrombin III, protein C and protein S. Subjects were divided into severe (n=18) and mild-to-moderate (n=7) OHSS, and laboratory parameters including three thrombophilic factors were compared. RESULTS: Antithrombin III level was abnormal in 40% of subjects, protein C in 12%, and protein S in 72%. There was no significant difference in the laboratory parameters between the patients with normal (n=15) and abnormal antithrombin III levels (n=10). However, the patients with abnormal antithrombin III levels had significantly more severe OHSS than those with normal value (100% vs 55.6%, P=0.013). The patients with at least one abnormal thrombophilic factor had significantly more severe OHSS than those with all normal value (94.4% vs 42.9%, P=0.012). CONCLUSIONS: Thrombophilic factors, particularly antithrombin III, may be associated with disease severity in patients with OHSS.

One case of placenta increta successfully treated with methotrexate / 대한산부인과학회지

Placenta increta is a kind of placental adhesion which can cause severe postpartum hemorrhage and life-threatening condition. It might necessitate a hysterectomy, but conservative management can be considerable for preserving reproductive potential when possible. A 34-years-old woman in her 41st week of pregnancy had normal full term spontaneous delivery. Retained placenta after removal by placenta forceps resulted in mild bleeding. Placenta increta was clinically diagnosed on computerized tomography. Remnant placenta in situ was nearly disappeared 2 months later after five-time intramuscular injection of 50 mg methotrexate and three-times curettage was done for conservative management.

A Case of Neurologic Symptom in Association with Intoxication after Ingestion of Codfish Intestine

No abstract available.

The Clinical Study of Fetal Death in Utero / 대한주산의학회잡지

OBJECTIVE: To investigate the clinical characteristics and etiologic factors of pregnancies with fetal death in utero (FDIU). METHODS: Retrospective review of medical records of 184 pregnancies with FDIU between March 1996 and March 2006 was conducted and descriptive analysis was done. Medical records were unavailable in 14 cases which were excluded in the analysis of etiology and diagnostic evaluation. RESULTS: The overall incidence was 1.31%. There was no significant difference in the yearly incidence during the study period. Age distribution of FDIU was between 18 and 44 and the incidence was highest in 25~29 year-old age group. The risk analysis showed statistically significant risk in the age group under 25 (OR, 2.455) and 25~29 (OR, 1.590) compared to 30~34 year-old age group. The risk of age group beyond 35 has a tendency to increase but was not statistically significant. FDIU was the most prevalent (38.58%) among pregnancies less than 29 weeks of gestation. Most of cases were delivered vaginally (86.5%). Etiologic factors included unexplained causes (37.1%), fetal factors (29.4%), placental and cord factors (18.2%) and maternal factors (15.3%). Autopsy was done in 128 cases (75.3%) and placental pathology was examined in 148 cases (87.1%). Among the workups done, autopsy and placental pathology were the most informative. CONCLUSION: Despite the advance of prenatal care, the incidence of FDIU was steady throughout the study period. The etiology of the largest proportion was unexplained. Once FDIU is diagnosed, prompt delivery should be done and appropriate diagnostic tests should be offered to aid in next pregnancy.