Secondary Abdominal Pregnancy after Tubal Reanastomosis: Case Report / 대한산부인과학회잡지

Abdominal pregnancy is a very rare and life threatening varient of ectopic pregnancy with high maternal mortality and perinatal mortality. A 26-year-old woman, gravida 2, para 0, abortion 2, visited our emergency department for amenorrhea for 11 weeks and lower abdominal pain. Diagnostic transvaginal ultrasonographic finding suggested ruptured ectopic pregnancy. Serum Hemoglobin level was 8.1 mg/dL, and Hematocrit value was 25.2%. On laparatomy about 2.000 mL of blood was filled in the abdomen and severe adhesion was found on right adnexa, posterior cul-de-sac and omentum. A live fetus was attached to uterus. After adhesiolysis, we removed conceptus from uterine surface. We performed subtotal hysterectomy and excised right fallopian tube. 10 pints of packed red blood cell and 3 pints of fresh frozen plasma were given to the patient during and after the operation. Patient recovered postoperatively without any complications and discharged at postoperative seventh day. We experienced a case of first trimester secondary abdominal pregnancy after tubal reanastomosis and reported it with brief of a literature review.

Treatment of Orbital and Ocular Adnexal Malignant Lymphoma

PURPOSE: The aim of this study was to evaluate the clinical features, histologic classification and treatment outcomes of patients with malignant lymphoma of the eye. METHODS: The participants included 22 patients with malignant lymphoma of the orbit and ocular adnexa treated at our hospital between May 1994 and September 2001. The authors retrospectively analyzed the sex, age, location of mass, histopathologic type, stage and results of the treatment. RESULTS: Of the 22 patients, 14 cases were male and 8 were female. The age ranged from 26 to 68 years (mean age 43 years). The most common presenting complaint was slowly growing mass of the eye. Histopathologic studies revealed extranodal marginal zone B-cell lymphoma, MALT type in 20 cases (91%). The stages of lymphomas were included I AE in 14 cases (63%), II AE in 3 cases (14%), III AE in 3 cases (14%) and IV A in 2 cases (9%). Patients received radiotherapy and/or chemotherapy. Twenty out of 22 cases (91%) achieved a complete remission. During the mean follow-up of 26 months, two patients died of progression of the disease; one patient had extranodal marginal zone B-cell lymphoma, MALT type of stage III AE and the other patient had diffuse large cell lymphoma of stage II AE. CONCLUSIONS: Radiotherapy can produce durable remission in the majority of the patients with localized primary orbital lymphoma. Chemotherapy should be performed for the patients with highly malignant lymphomas or lymphomas with systemic manifestations.

Clinical Features and Surgical Results of Rhegmatogenous Retinal Detachment in Children

PURPOSE: The purpose of this study is to evaluate clinical characteristics and surgical outcomes of rhegmatogenous retinal detachment in children. METHODS: The medical records of 29 children (30 eyes, younger than 15 years of age) who underwent the surgery for retinal detachment at our hospital were reviewed retrospectively. RESULTS: Twenty-six (90%) of the 29 patients were male, and three (10%) were female. Their average age was 11 years old (range 4years~15years). Retinal detachment was caused by, in order of frequency, trauma, high myopia, Morning glory disc anomaly, previous intraocular surgery and had an unknown cause in 6 eyes. Proliferative vitreoretinopathy (PVR) was involved in eleven (37%) of the 30 eyes at presentation. The overall reattachment rate was 73% after the first operation and 93% after the second operation. CONCLUSIONS: Retinal detachments in children have poor surgical outcomes than that in adults due to delayed diagnosis, frequent macular involvement and presence of PVR. For the children with certain diseases, we should exam carefully and regularly for the subtle changes even in the absence of specific complaints.

Assessment of Autonomic Nervous System with Analysis of Heart Rate Variability in Children with Spastic Cerebral Palsy

The purpose of this study was to investigate the function of the autonomic nervous system in children with spastic cerebral palsy (CP) through an analysis of heart rate variability (HRV) occurring with orthostatic stress. Twelve children with spastic CP and twelve normal children participated in this study. The echocardiogram (ECG) signals were recorded for 3 minutes in both the supine and 70 degrees C head-up tilt positions, and then the HRV signals underwent power spectrum analysis at each position. Two components were measured; a low- frequency (LF) component (0.05 - 0.15Hz) primarily reflecting sympathetic activity during orthostatic stress and a high-frequency (HF) component (0.15 - 0.4Hz) reflecting parasympathetic activity. In the supine position, there was no significant difference between any of the HRV components of the two groups. In the head-up tilt position, absolute and normalized LF were significantly increased and absolute HF was significantly decreased in the normal children (p < 0.05), but not in the children with spastic CP. The results of this study suggest that cardiac autonomic functions, such as vagal withdrawal and sympathetic activation which occur during head-up tilt position, are not sufficient to overcome the orthostatic stress arising in spastic CP children.

Toluene Determination in Workplace by Charcoal Tube Method / 예방의학회지

In the determination of organic solvents in workplaces direct reading tube method have been in Korea for decades. But this method is less accurate and couldn't measure TWA (Time Weighted Average) for 8 hours. Authors tried to detect Toluene concentration in S factory by using charcoal tube according to NIOSH method. The concentration was 158.8ppm. We propose this charcoal tube method should be substituted to get accurate results and to protect employee in workplaces related with solvents.