Two Case of Peripartum Cardiomyopathy / 대한산부인과학회잡지

Peripartum cardiomyopathy is defined as a syndrome of cardiac failure occurring in tbe latter part of pregnancy or in the puerperium, without obvious cause and without prior evidence of heart disease. Despite its infrequency, this clinical problem may have devastating consequences upon maternal and fetal outcome. It is important to recognize the association of cardiac failure and pregnancy as a separate syndrome so that, once identified, peripartum cardiomyopathy can be treated promptly and aggressively. We experienced two cases of peripartum cardiomyopathy, and report these cases with a brief review of the literatures.

Analysis of Clinical Contents in a Family Practice Clinic of Rural Area according to the ICPC Method

BACKGROUND: Research of clinical contents and proper development of education program is essential in family medicine. Therefore, this study is carried out to obtain data for residency training, and to provide references to family physicians who give primary health care in rural community by analyzing prospectively the clinical contents of new patients in a local family practice clinic. METHODS: The authors visited family practice clinic in a rural area practiced by a family physician board certified in family medicine. There were 3,126 new patients from Jan. 1996 to Dec. 1996 evenly distributed by month and area, 1,000 patients were sampled randomly and the collected data were classified according to the ICPC(International Classification of Primary Care) coding system. RESULTS: Among the selected 1,000 patients, males were 432(43.2%) and females were 568(56.8%). Age distribution was highest In the fifties(50-59 years old) (20.7%). The total number of Reason For Encounter(RFE) was 1,417, the average RFE was 1.41 per patient and the kind of RFEs was 93, among which cough was the most frequent RFE by 233 cases(16.4% ). The 87 kinds of diagnoses were used and URl(Upper Respiratory Infection) accounted for the major portion by 287 cases(21.9%). The diagnostic examination per patient was 0.42. The most frequently used test was x-ray of an extremity by 68 cases(16.1% ). Referrals to other departments were made in 3.3% of visitors of which Internal Medicine was highest(39.4%). CONCLUSIONS: The clinical contents were classified more comprehensively by using ICPC with given code RFE, care process, and diagnosis. More study on ICPC is necessary for classification to help analyze clinical contents in primary care.

A Clinical Study Following Macrosurgical Procedures for Tubal REversal / 대한산부인과학회잡지

From January 1989 to December 1994, 105 cases of Macrosugical tubal reversal were performed and 87 cases of them were followed up for more than 1 year postoperatively in the Department of Obstetrics and Gynecology, Pohang St. Mary's Hospital. The result were as follows;1. The mean age of the patients was 31.7 years and 93.1% of them had been sterilized by laparoscopic sterilization. 2. Average inteval between sterilization and tubal reversal was 43.3 months. 3. The reasons for requesting reversal of sterilization were remarrigae 41.5%, chagne of attitude 33.3%, loss of children 25.2%. 4. The distributions of the site of tubal anastomosis were isthmic-ampullar 58.6%, isthmic-isthmic 24.1%, cornual-isthmic 8.1%. 5. The postoperative tubal length was 5.0 cm or more in 78.0%. 6. The overall pregnancy rate after tubal reversal was 68.9% and the outcome of the pregnancy was as follows; term pregnancy 74.6%, premature delivery 1.8%, opontaneous abortion 10.9%, ectopic pregnancy 9.1%, pregnancy state 3.3%.

Ultrasonography of hydronephrosis and renal masses

We have analyzed utrasonographic finding of 55 cases of hydronephrosis and 34 cases of renal maasses. The results are as follows; 1. 55 cases of hydronephrosis revealed renal enlargement in 55 cases, separation of central echo complex in 27 cases, multiple anechoic areas radiating from the center in 25 cases and dilated renalpelvis in 24 cases. 2. Among the renal masses in 34 cases, simple renal cyst were 15 cases, polycystic kidney in 8 cases, hypernephroma in 8 cases, Wilms' tmor in 2 cases and angiomyolipoma in 1 case. 3. Simple renal cystrevealed single in 14 cases (93%) and well defined anechoic mass with posterior enhancement in all cases. 4. Polycystic kidney revealed bilateral irregular shaped renal enlargement and multiple anechoic cysts throughout the kidney. 2 cases (25%) involved liver. 5. 6 cases (75%) of hypernephroma revealed ill defined modarately echogenicmass without posterior enhancement. 6. All cases of Wilms' tumor revealed well defined large mixed echogenic massin right kidney. 7. Angiomyolipoma revealed bilateral dense echogenic mass with large hemorrhagic cyst in rightkidney. 8. The ultrasonography is useful noninvasive diagnostic modality of evaluation of renal masses and hydronephrosis.