Extra-amniotic Pregnancy with Congenital Amputation of the Distal Phalanx in Both Hands / 대한주산의학회잡지

Extra-amniotic pregnancy, which is caused by rupture of amniotic membranes only, is a rare event during pregnancy. This differs from extra-membranous pregnancy in which both chorionic and amniotic membranes rupture. Extra-amniotic pregnancy requires attention by an obstetrician not to miss fetal anomalies because extra-amniotic pregnancy may accompany with fibrous band syndrome. We experienced a case of extraamniotic pregnancy with congenital amputation of bilateral fetal hands. And we report it with brief review of literatures.

Extra-amniotic Pregnancy with Congenital Amputation of the Distal Phalanx in Both Hands / 대한주산의학회잡지

Extra-amniotic pregnancy, which is caused by rupture of amniotic membranes only, is a rare event during pregnancy. This differs from extra-membranous pregnancy in which both chorionic and amniotic membranes rupture. Extra-amniotic pregnancy requires attention by an obstetrician not to miss fetal anomalies because extra-amniotic pregnancy may accompany with fibrous band syndrome. We experienced a case of extraamniotic pregnancy with congenital amputation of bilateral fetal hands. And we report it with brief review of literatures.

Single-port access total laparoscopic hysterectomy in women with history of previous abdominal surgery / 대한산부인과내시경학회지

OBJECTIVE: The aim of the present study was to evaluate the impact of previous abdominal surgery on surgical outcomes of single-port access (SPA) total laparoscopic hysterectomy (TLH). METHODS: We reviewed the medical records of 111 women who underwent SPA-TLH at the Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University between January 2010 and December 2010. Women were classified according to their history of previous abdominal surgery. RESULTS: Of 111 women undergoing SPA-TLH, 74 women (66.7%) without history of previous abdominal surgery and 37 women (33.3%) with history of previous abdominal surgery were classified. There was no significant difference in surgical outcomes including operative time, estimated blood loss, change in hemoglobin, uterine weight, perioperative complications, transfusion, and additional port insertion between two groups. CONCLUSION: In our experience, previous abdominal surgery has no significant impact on SPA-TLH.

Neurogenic Bladder in Lyme Disease / 대한배뇨장애요실금학회지

Lyme disease is a multi-systemic, tick-borne infectious disease caused by a spirochete, Borrelia burgdorferi. Various urologic symptoms are associated with Lyme disease, which can be primary or late manifestations of the disease. Although voiding dysfunction is a rarely reported symptom in patients with Lyme disease, it is one of the most disabling complications of Lyme disease. Korea is not an endemic area of Lyme disease, thus, fewer cases have been reported. Herein, we report a case of a 32-year-old man with rapidly progressive bilateral ptosis, dysphagia, spastic paraparesis, and voiding difficulty in whom Lyme disease was diagnosed through serologic tests for antibodies and Western blot testing. A urodynamic study demonstrated detrusor areflexia and bulbocavernosus reflex tests showed delayed latency, indicating demyelination at S2-S4 levels. He received a 4-week course of intravenous ceftriaxone (2 g/day). The patient has recovered from the bilateral ptosis and spastic paraparesis but still suffers from neurogenic bladder.

The Significance of Family History, Immunoglobulin E, Total Eosinophils and Eosinophil Cationic Protein as a Predictor of Allergic Diseases

PURPOSE: Family history of allergy and cord blood immunoglobulin E concentration have been proven to be predictors of the development of allergic diseases in children. The purpose of this study is to evaluate whether maternal, cord and baby's blood total eosinophils or eosinophil cationic protein (ECP) in addition to the above two predictors could be a predictor of subsequent allergic diseases later in life. METHODS: Fifty pregnant women and their newborns with positive family history of allergic disease and fifty other pregnant women and their newborns with no family history were investigated and a clinical follow-up study was conducted in thirty-two infants for two years. Immunoglobulin E level, total eosinophils and ECP level were measured in maternal, cord and baby's blood. RESULTS: The group who developed allergic disease showed significantly high cord immunoglobulin E concentration than the group who did not develop allergic disease (P<0.01). There were no significant differences of immunoglobulin E level, total eosinophils, ECP level in maternal, cord, baby's blood between the group with positive family history of allergic disease and the group with no family history. The incidence of allergic disease was significantly higher in the group which had both positive family history and high cord blood immunoglobulin E concentration than the group which had no family history and low cord blood immunoglobulin E concentration (P<0.01). CONCLUSION: Family history of allergy and high-cord blood immunoglobulin E concentration are the best predictors of allergic diseases later in life.

A Case of Citrullinemia

Citrullinemia is one of the five urea cycle defects and is caused by argininosuccinic acid synthetase deficiency ; conversion of citrulline to argininosuccinic acid is blocked. Severe hyperammonemia typically develops in the neonate within a few days and symptoms such as vomiting, lethargy, convulsion, coma follows rapidly. The diagnosis is supported by high citrulline level in serum, urine, CSF and decreased activity of argininosuccinic acid synthetase in liver biopsy. We experienced a 3-day-old male neonate with poor activity, lethargy, convulsion, and coma who was diagnosed as citrullinemia by markedly elevated plasma and urine citrulline level with hyperammonemia. We report this case with brief review of the related literature.

A Case of Citrullinemia

Citrullinemia is one of the five urea cycle defects and is caused by argininosuccinic acid synthetase deficiency ; conversion of citrulline to argininosuccinic acid is blocked. Severe hyperammonemia typically develops in the neonate within a few days and symptoms such as vomiting, lethargy, convulsion, coma follows rapidly. The diagnosis is supported by high citrulline level in serum, urine, CSF and decreased activity of argininosuccinic acid synthetase in liver biopsy. We experienced a 3-day-old male neonate with poor activity, lethargy, convulsion, and coma who was diagnosed as citrullinemia by markedly elevated plasma and urine citrulline level with hyperammonemia. We report this case with brief review of the related literature.