| Young Ju Kim | 21 Articles |
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Ectopic pregnancy (EP) refers to blastocyst implantation outside the uterine endometrium. EP is major cause of maternal morbidity and mortality. Treatment options include surgery, medical therapy with methotrexate, or expectant management. Methotrexate is the primary regimen used in cases of early, unruptured ectopic pregnancies. Most side effects of methotrexate are minor, including nausea, vomiting, abdominal discomfort, and photosensitive skin reaction. Serious side effects, including bone marrow suppression, and pulmonary fibrosis, are invariably observed when methotrexate is administered in high doses with frequent dosing intervals, in chemotherapeutic protocols for malignancy. These side effects are uncommon with the doses used to treat ectopic pregnancies. Since cases of methotrexate-induced pancreatitis are rare, we report a case of pancreatitis in a patient with EP treated with methotrexate and expect to consider pancreatitis as a side effect of methotrexate in a patient with upper abdominal pain undergoing methotrexate chemotherapy. Citations Citations to this article as recorded by
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ABSTRACT
To conduct a comparative study of children’s health in South Korea versus North Korea focusing on air pollution. We used annual mortality rate, prevalence, and environmental indicators data from the World Bank and World Health Organizations (WHO). Trend analysis of the two Koreas was conducted to evaluate changes in health status over time. Spearman’s correlation analysis was used to find out the correlation between environmental indicators and children’s health status. We found a distinct gap in children’s health status between the two Koreas. While North Korea reported a higher death rate of children than South Korea, both showed a decreasing trend with the gap narrowing from 2000 to 2017. The prevalence of overweight and obesity increased and that of thinness decreased in both Koreas. Except PM2.5 exposure, South Korea reported higher figures in most indicators of air pollutant emissions (South Korea, mean (SD)=28.3 (2.0); North Korea, mean (SD)=36.5 (2.8), P-value=0.002). This study empirically discovered the gaps and patterns of children’s health between South Korea and North Korea. North Korean children experienced more severe health outcomes than children in South Korea. These findings imply that epigenetic modification caused by environmental stressors affect children’s health in the two Koreas despite similar genetic characteristics. Considering the gaps in children’s health between the two Koreas, more attention and resources need to be directed towards North Korea because the necessary commodities and services to improve children’s health are lacking in North Korea.
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Listeriosis is an infectious disease caused by Citations Citations to this article as recorded by
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The rearrangement of c-ros oncogene 1 (
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With the aging population, more patients who have undergone previous coronary artery bypass grafting (CABG) are surviving long enough to require subsequent aortic valve replacement (AVR). Conventional redo AVR after prior CABG involves resternotomy, dissection and clamping of the patent bypass graft vessel. Favorable results have been reported for AVR following previous CABG; however, the problems of this procedure includes that injury to the patent bypass grafts can result in catastrophic complications. Increasing patient age and comorbidities may increase operative mortality, less invasive percutaneous aortic valve intervention has advanced. However, because there are no sufficient data comparing transcatheter aortic valve intervention with surgical AVR, currently, the surgical approach should still be consider as the standard of treatment for AVR following previous CABG. We report a patient in whom successful conventional AVR was underwent after previous CABG with patent left internal mammary artery.
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Primary amyloidosis has unfavorable prognosis, particularly with organ involvement. Here, we report a case of clinical remission of renal amyloidosis after autologous hematopoietic cell transplantation. A 51-year-old female patient visited our hospital due to generalized edema. Initial evaluation showed hyperlipidemia, hypoalbuminemia, and heavy proteinuria, which were consistent with nephrotic syndrome. However, IgM lamda type monoclonal gammopathy was detected in serum and urine electrophoresis studies. Renal biopsy showed Congo red-positive amyloid deposition in mesangial area, glomerular capillary walls, and arterioles and amyloid fibers were confirmed by electron microscopy. Immunohistochemial study of the biopsy tissue demonstrated systemic light-chain amyloidosis (AL amyloidosis). Multiple myeloma was not evident on bone marrow examination. She received autologous hematopoietic cell transplantation after high dose melphalan treatment. Complete remissions were achieved after the treatment, respectively. Our findings suggest the potential role of autologous peripheral blood stem cell transplantation in treatment of AL amyloidosis.
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The purpose of this study was to investigate the relationship of cord blood levels of soluble fms-like tyrosine kinase 1 (sFlt-1), placental growth factor (PlGF), and vascular endothelial growth factor (VEGF) in preterm infants with maternal preeclampsia. Thirty six preterm infants born at Ewha Womans University Mokdong Hospital from January 2006 to August 2006 were studied after prior parental consent at mid-pregnancy. sFlt-1, PlGF, and VEGF levels in the cord blood of preterm neonate, with or without maternal preeclampsia, were measured using enzyme-linked immunosorbent assay. There was no difference in sFlt-1 between infants with and without maternal preeclampsia. Infants with maternal preeclampsia had significantly lower PlGF levels (P=0.035) and higher sFlt-1/PlGF ratio (P=0.080) with borderline significance. Cord blood VEGF levels were not related to maternal preeclampsia. Infants with maternal preeclampsia had lower birth weight (P=0.030), lower neonatal platelet count without statistical significance (P=0.064) and more likely to be small for gestational age (P=0.057). Neonatal platelet count was significantly correlated with cord blood PlGF levels (r=0.674, P=0.032). Increased sFlt-1/PlGF ratio and decreased PlGF may not only be related to the pathophysiology of maternal preeclampsia but also affect the neonatal platelet count and birth weight. Citations Citations to this article as recorded by
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The purpose of this study is to deliver effective worksite health management by specifying job of occupational physician, occupational nurse, occupational hygienist and making job reference manual and health performance audit. Therefore, We can contribute to disease prevention and health promotion of workers by enhancing quality of worksite health management. The methodology of making performance audit is comprised of developing audit questions and weighting the questions. Measures are made by scoring the values. The questionnaires were grouped by the categories and sections. This occupational audit was distributed to the health personnel of 350 workplaces by mail. The self-administered results were returned and analyzed. We plot the field of occupational health service by basic policy, preventive health service, health care, administration, and other services. We gave the weight A on the primary job, B on the supplementary job, and C on the minor job. This weight was made through the delphi procedures where 30 specialists joined. Basic policy got score of 16.1% preventive health service got 36.5%, health care 20.4%, administration 10.9%, and other services 10.1%. Further weightings on the questionnaire sections were made through the survey on specialists and final weighting on each questionnaire was made by making formula considering weights of each stage. The audit was composed of 96 questions which has dichotomos scales and full score was 1,000. Person-nels from 80 workplaces (23%) replied the audit and the scores of physicians, nurses, and hygienists were 608.6, 587.1 and 535.4, respectively, all a little higher than 500. The health performance audit can be used by the sorksite health personnels providing health service. However, this work would not be complete without further comprehe-sion and application in the real settings. Citations Citations to this article as recorded by
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This 31 years old female patient visited our hospital on July 2000, with complaint of painful ulceration on vulvar with withish coated membrane and oral mucosa ulceration at 28 weeks of pragnancy. Behҫet's disease is an inflammatory disorder of unknown cause, characterized by recurrent oral aphthous ulcers, genital ulcers, uveitis, and skin lesion. We are present a case of Behҫet's disease in pregnancy with a brief review of literature.
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Neural tube defects are a heterogenous group of malformations resulting from failure of neural tube closure during early embryogenesis. Anencephaly is the commonest form of neural tube defect and results from failure of closure of the anterior portion of the neural tube. Anencephaly is characterized by absence of the cranium along with cerebral hemispheres that are rudimentary or absent and risk of recurrence after affected child is 2-3%. Periconceptual folic acid intake may decrease the incidence and recurrence of anencephaly. Most often, anencephaly is discovered by conventional two-dimensional ultrasonography at the time of attempted biparietal diameter determination for fetal age in the second trimester. Two-dimensional transvaginal ultrasonography has a limitation in a motion of the transducer shaft due to narrow space of the vagina. It is sometimes impossible to obtain information of the whole brain and to miss the fetal CNS(central nervous system) anomalies. Recent advanced three-dimensional ultrasonography has remarkably improved not only surface rendering but also multiplanar analysis of internal structure. Recently, we encountered one case of recurrent anencephaly that had occurred in a same pregnant woman and three-dimensional transvaginal ultrasonography enabled us to diagnose anencephaly at 113 weeks of gestation. We report this case with brief review of the literatures.
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This study has been composed of 5 cases of cordocentesis between 21 and 34 weeks of gestational age from February 1997 to January 1998 at the Ehwa Medical Center. Indications for cordocentesis were as follows : 1) rapid karyotyping 2) evaluation of hematologic status 3) intrauterine infection 4) evaluation of fetal acid-base status. The most common indication for cordocentesis was rapid karyotyping of fetal chromosome. All cases of this study were successful. In conclusion, cordocentesis is a safe and very useful procedure for evaluating fetal status.
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Down syndrome is the most common autosomal abnormality disease which has multiple congenital anomalies, occurring in 1 of every 800 liveborn infants. Neonates who are affected with this disease comprise majority of the mentally retarded children. To prevent the birth of this congenital anomaly, prenatal diagnosis of Doen syndrome is important. We experienced a case of Down syndrome, diagnosed by fluorescence in situ hybridization(FISH) in pregnancy for 15 weeks 6 days. We report here eith a brief review of the literatures.
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The purpose of this study is to establish the normal levels of α-fetoprotein in amniotic fluid between 15 and 22 weeks of gestation. Amniotic fluid Alpha-fetoprotein(AFAFP)levels were measured by enzyme-immunoassy in pregnant women between 15 and 22 weeks of gestation for variety of indication of amniocentesis from October, 1994 to July, 1996 at Mokdong Hospital Ewha Womans University. The study group was selected from normal karyotype at prenatal genetic diagnosis and no congenital anomaly of fetus. The normal level of AFAFP was the highest at 16weeks and then it declined gradually as gestational weeks increased. The mean±SD levels of AFAFP from 15 to 22weeks were 16.9±5.7, 20.4±9.8, 13.8±6.8, 10.9±3.0, 8.1±2.3, 6.9±3.9, 5.6±1.6, 4.7±0.6µg/ml respectively, the median levels of AFAFP from 15 to 22weeks were 14.7, 16.2, 12.3, 11.0, 7.8, 5.5, 5.3, 4.8µg/ml, respectively. We consider that this preliminary data normal AFAFP levels by each gestation weeks can be used as reference value for screening of anomalies or genetic disorder.
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The relation between clinically obvious polyhydramnios and poor perinataloutcome has been described. The purpose of the present investigation was to relate polyhydramnios to etiology and perinatal outcome. Mild and severe polyhydramnios was defined sonographically as an amnioticfluid index of 240~300, and more than 300 respectively. We diagnosed polyhydramnios in 16 cases of 3160 patients(0.5%) undergoing fetal testing at 26-42 gestational weeks. We compared mild and severe polyhydramnios in aspect of perinatal outcome. The severe polyhydramnios group showed a significantly higher incidence of neonatal death and associated congenital anomaly than mild polyhydramnios group. We conclude that severe polyhydramnios is associated with an increased risk of adverse perinatal outcome.
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Chronic maxillary sinusitis is one of the most common disorder in pediatric otolaryngology and it is remained also the major problem restrict to management. Management of the children with chronic maxillary sinusitis is a through search for underlying etiologic anatomical, systemical and local factor. As one of etiologic factors, hypertrophied tonsils and adenoid cause obstruction of narrow ansopharynx and stagenation and infection of paranasal sinus. But chronic maxillary sinusitis is remained uncontrolled disease in spite of tonsillectomy and adenoidectomy, maxillary antrum prncture and irrigation, and antibiotic therapy. This follow up research was performed in 104 cases that received tonsillectomy and adenoedectomy at department of otolaryngology, Ewha University Hospital during last 5 years(from 1986 January to 1990 December), they showed chronic maxillary sinusitis by preoperative PNS X-ray. The result was that improvement of chronic maxillary sinusitis was noted in 57% at survey study and in 63% at PNS x-ray study after tonsillectomy and adenoidectomy. was effective in treating chronic maxillary sinusitis in children.
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Thanatophoric dwarfism is a short limb dwarf condition which usually results in death shortly after birth. It has been confused with achondroplastic and another congenital short limb dwarf condition. We now report a case of thanatophoric dwarfism in a 29-year-old woman, based on prenatal sonographic, radiological and autopsy findings with a review of literatures.
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Leiomonas of the vulva are extremely uncommon tumors. Recently we experienced a case of vulva leiomyoma thus it is presented with a brief review of the case and its literature.
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Benign Symmetric Lipomatosis is a lesion characterized by symmetric and diffuse growth of adipose tissue. It is commonly found in the posterior neck or upper trunk, but oral involvement is extremely rare. Authors experienced a case of Benign Symmetrical Lipomatosis of tongue. The tumors was completely removed out under the general anesthesia. Histopathologic examination verified Benign Symmetric Lipomatosis of tongue. So, authors report this case with brief review of literatures.
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The patient was 30 year old male having longstanding otitis media on left ear since childhood. Although he had taken radical mastoidectomy(Lt.), brain abscess was developed 14 days after operation. So, emergency craniotomy with total resection of brain abscess was performed in neurosurgery department and abscess was healed well. Postoperative course was relatively good and he was discharged on 63th postoperative day.
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, Mina Kang
