Eosinophilic Polymyositis and DRESS (Drug Rash with Eosinophilia and Systemic Symptoms) Syndrome by Antitubercular Agents

Eosinophilic polymyositis (EPM) is a heterogeneous disorder characterized by eosinophilic infiltration into skeletal muscles. EPM is occasionally associated with a systemic disease, such as hypereosinophilic syndrome, connective tissue disease, or parasitic infection. However, EPM is rarely reported in drug rash with eosinophilia and systemic symptoms (DRESS) syndrome. We experienced a 17-year-old female who presented with EPM with DRESS syndrome associated with taking antitubercular agents.

Reduction of Disease Activity in Patient with Relapsing-Remitting Multiple Sclerosis after Switching to Teriflunomide from Interferon Beta

No abstract available.

Reduction of Disease Activity in Patient with Relapsing-Remitting Multiple Sclerosis after Switching to Teriflunomide from Interferon Beta

No abstract available.

A Case of Paraneoplastic Limbic Encephalitis Presented with Schizophrenic Symptoms / 신경정신의학

Paraneoplastic limbic encephalitis associated with ovarian teratoma has variable clinical manifestations, including hallucination, abnormal behavior, amnesia, mental change, fever, chorea and dystonia, and often has antibodies to N-methyl-D-aspartate receptor (NMDAR), however cases without tumor or antibodies to NMDAR have also been reported. Here, we describe a 35-year-old female who was initially misdiagnosed as schizophrenia because she presented with acute onset of psychiatric symptoms, including visual hallucination, abnormal behavior, confusion, and memory impairment. Three days after admission, she developed high fever refractory to antibiotics. Brain MRI and examination of cerebrospinal fluid were normal. Computerized tomography of the pelvis showed an ovarian teratoma. The patient showed complete improvement after surgical removal of the ovarian teratoma and steroid therapy. We suggest that physicians should consider the possibility of paraneoplastic limbic encephalitis in patients who present with acute onset of psychiatric symptoms with high fever or movement disorder.

Primary peritoneal serous papillary carcinoma presenting as a large mesenteric mass mistaken for ovarian cancer: a case of primary peritoneal carcinoma

Peritoneal origin serous papillary carcinoma is an uncommon primary malignancy occurring in the abdominal or pelvic peritoneum lining. It is characterized by peritoneal carcinomatosis with massive ascites, uninvolved or minimally involved ovary, and is histologically indistinguishable from ovarian serous tumors. Better recognition of this phenomenon in recent years has contributed to an increasing diagnostic frequency. We describe a rare case of peritoneal origin serous papillary carcinoma with unusual clinical presentations involving a solitary primary tumor originating from the peritoneal lining of the sigmoid colonal mesentery, without pelvic lymph node involvement or distant metastasis. Because of the location and morphological similarity, it was misdiagnosed as an ovarian malignancy. We aim to assist in the diagnosis of this disease with the following case report, thereby improving the management of patients with this condition.

Clinical Evaluation on 763 Cases of Laparoscopically Assisted Vaginal Hysterectomy (LAVH) / 대한산부인과학회지

OBJECTIVE: To report our clinical experience with 763 cases of laparoscopic assisted vaginal hysterectomy (LAVH) and to evaluate the efficacy and advantage of LAVH. METHODS: From Jan. 2000 to Feb. 2006, 763 cases of LAVH were performed at the Department of Obstetrics and Gynecology. we analyzed the results regard to the age, parity, surgical indication, previous abdominal surgery, operation time, weight of uterus, change of hemoglobin, hospital stay, concomitant procedures, and complication. RESULTS: The mean age was 45.7+/-7.1 years. The mean parity was 2.5+/-1.2. The average weight of patients was 58.59+/-9.5 kg. Leiomyoma was the most common surgical indication. Tubal ligation was the most common previous surgery. The mean operation time was 87.5+/-45.7 minutes. The mean hemoglobin change was 1.1+/-0.7 g/dL. The mean uterine weight was 251.34+/-131.5 gm. The mean hospital stay was 6.15+/-0.94 days. The complication rate was 3.4% (26 cases); bladder injury (7 cases), ureter injury (3 cases), vault bleeding (3 cases), trochar site bleeding (13 cases). CONCLUSIONS: LAVH is safe and effective surgical procedure for hysterectomy. The improvement of surgical skill and laparoscopic instrument can make more replace Total abdominal hysterectomy with LAVH.

A Case of Treatment with Methotrexate Local Injection on Intramural Pregnancy within a Previous Cesarean Scar / 대한산부인과학회지

Intramural pregnancy on a cesarean section scar is one of the rarest forms of ectopic pregnancy that may cause serious complications such as uterine rupture and massive bleeding. The common treatment in the past was laparotomy, but today early diagnosis is available thanks to the development of image diagnostic technology and, as a consequence, cases of less invasive conservative management are reported. Using vaginal ultrasonography and MRI, we made an early diagnosis on a case of intramural pregnancy on the scar of a previous cesarean section. We injected methotrexate locally into the gestational sac, and the intramural pregnancy was completely cured. Thus, here we report this case with a brief review of relevant literature.

Effect of the Hyaluronic Acid on Osteoarthritis of the Knee

PURPOSE: The Purpose was to evaulate the efficacy of sodium hyaluronate (HA) according to the degree of osteoarthritis, body mass index and tibiofemoral alignment. MATERIALS AND METHODS: 53 of 73 patients who had osteoarthritis of the knee were underwent intraarticular injection weekly for 5 weeks with hyaluronic acid (HA, hyruan(R), MW:1MDa) and 20 of 73 patients with placebo (normal saline). The patients were followed for 27 weeks. Results were evaluated with visual analogue scale for pain, Lequesne algofunctional index for functional severity and Tegner activity score for activity. The degree of severity of osteoarthrtis of knee was stratified by Kellgren classification. RESULTS: In the group treated with HA, the patients classified as Kellgren classification II and III showed much better improvement in efficacy for pain, function and activity compared with group IV. In the femorotibial alignment, neutral and valgus alignment group showed better results than varus group. There is no statistical significance in the knee pain and function between normal and overweight group. Best symptomatic improvement according to the subjective symptom revealed at 3 week in 25 patients (47.2%). Placebo treated patients had slight pain and improved functional perfomance but less effect in compared with HA treated patients. CONCLUSION: Intraarticular administration of HA relieve the symptom of osteoarthritis and improve the function of knee joint. Especially, the patients classified with Kellgren classification II, III and valgus, neutral tibiofemoral alignmen groups showed much better improvement than grade IV and varus group.

Analysis of Compression Behavior in Lumbar Spine Under Simple Vertical Load vs Follower Load / 대한척추외과학회지

PURPOSE: To clarify the behavior of the lumbar spine under vertical compressive load and follower compressive load and to confirm the effect of the follower load on the stability of the spinal column using finite element method. MATERIALS AND METHODS: Describing follower compression test to overcome underestimation of load carrying capacity, the problem in existing ex-vivo lumbar spine compression test, with finite element analysis, comparing with the result of simple vertical compressive load, we analyze the property of kinetic behavior. After performing finite element modelling about L1-L5 lumbar vertebral column, analyze it about vertical compressive load and follower compressive load. Intervertebral discs with complex structure and mechanical properties was modeled using spring element that compensate stiffness and tube-to-tube contact element was employed to give follower load. With compressive load, change of lumbar spinal curve is so much, that geometrical analysis should be done. RESULTS: Under the follower compressive load, the vertebral column was so stiff that vertical displacement of the upper end plate of L1 was markedly reduced, comparing with that under the simple vertical compressive load. Sagittal rotation of that upper end plate was also decreased in the opposite direction. Compressive load on the intervertebral disc was evenly distributed along the entire column. The bending moment at each disc was reduced in the opposite direction. A lesser A-P shear force occurred at the intervertebral disc. CONCLUSION: As a result of finite element interpretation of lumbar spine, the stability and load carrying capacity was increased largely, and the compressive load was transmitted through the column in a more pattern, when follower compressive load applied. This can provide the basis for explaining the difference of early buckling occurrence reported in ex-vivo testing, and load carrying capacity of the lumbar spine in-vivo, but, for more precise replication of behavior of lumbar spine in-vivo to variable loading. A invention of a more precious finite element interpretation model which consider the role of muscle around the spine is loaded.

Doppler evaluation of blood flow velocity waveforms of umbilical artery and descending aorta in normal and pregnancy-induced hypertension / 대한산부인과학회잡지

No abstract available.