Variations of the Technique in Endoscopic Tympanoplasty / 대한이비인후과학회지

Endoscopic tympanoplasty is a surgical procedure for patients with tympanic membrane perforation with minimal middle ear or mastoid inflammation. Recent findings revealed that endoscopic tympanoplasty harvests equivalent or even superior results over microscopic tympanoplasty. However, a number of disadvantages are related to endoscpoic tympanoplasty, one of which is the single-handed procedure that may lead to recurrent perforation. We hereby illustrate a number of techniques involved in endoscopic tympanoplasty along with their pros and cons.

Influence of Radiologically Evident Residual Intimal Tear on Expansion of Descending Aorta Following Surgery for Acute Type I Aortic Dissection

BACKGROUND: Although a residual intimal tear may contribute to the dilatation of the descending aorta following surgical repair of acute type I aortic dissection (AD), its causal relationship has not been elucidated by clinical data due to the limited resolution of imaging modalities. METHODS: This study enrolled 41 patients (age, 55.2+/-11.9 years) who were evaluated with dual-source computed tomography (CT) imaging of the whole aorta in the setting of the surgical repair of acute type I AD. Logistic regression models were used to determine the predictors of a composite of the aortic aneurysm formation (diameter >55 mm) and rapid aortic expansion (>5 mm/yr). RESULTS: On initial CT, a distal re-entry tear was identified in 9 patients. Two patients failed to achieve proximal tear exclusion by the surgery. Serial follow-up CT evaluations (median, 24.6 months; range, 6.0 to 67.2 months) revealed that 14 patients showed rapid expansion of the descending aorta or aortic aneurysm formation. A multivariate analysis revealed that the residual intimal tear (odds ratio [OR], 4.31; 95% confidence interval [CI], 1.02 to 19.31) and the patent false lumen in the early postoperative setting (OR, 4.64; 95% CI, 0.99 to 43.61) were predictive of the composite endpoint. CONCLUSION: The presence of a residual intimal tear following surgery for acute type I AD adversely influenced the expansion of the descending aorta.

A Case of Cervical Pregnancy treated by Intraamniotic Injection of Methotrexate Guided by Transabdominal Ultrasonography / 대한산부인과학회잡지

Cervical pregnancy is a rare form of ectopic gestation and it can cause serious bleeding, shock and death. Although hysterectomies are still performed due to massive hemorrhages, there are some conservative approaches to cervical pregnancies to conserve fertility. Methotrexate is a very useful agent in the management of trophoblastic disease, and has been utilized recently for the successful management of tubal, interstitial, and cervical ectopic gestations. We report a case of viable cervical pregnancy treated successfully with intraamniotic injection of methotrexate guided by transabdominal ultrasonography.

A Case of Pregnancy-Associated Aplastic Anemia / 대한산부인과학회잡지

Pregnancy-associated aplastic anemia is an uncommon problem and conditions in which an acellular or markedly hypocellular bone marrow results in pancytopenia(anemia, neutropenia, and thrombocytopenia). In most cases, aplastic anemia and pregnancy appear to have been a chance association. We experienced one case of pregnacy-associated aplastic anemia and so we present it with brief review of literature.