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임신에 의해 악화된 원발성 하지불안증후군(restless leg syndrome)의 치료
김시선 ( Shi Sun Kim ),안치옥 ( Chi Ok Ann ),조은규 ( Eun Kyu Cho ),심현진 ( Hyun Jin Shim ),김윤숙 ( Yun Sook Kim ),배동한 ( Dong Han Bae ),양광익 ( Kwang Ik Yang ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.10
Restless leg syndrome (RLS) is characterized by intense restlessness and unpleasant creeping sensations deep inside the lower legs, occurring during periods of rest, evening and night. These symptoms can be improved by movement. There are two different phenotypes of RLS. One early-onset form starts before 36 years old. It has mostly a familial history, severe symptoms, and highly genetically determined. And it is a highly dependent to iron level of the brain. The other delayed-onset form starts after 36 years old, mostly secondary, without familial history, with a rapid evolution in two or three years. And it is associated with frequent low ferritin level of serum. Pathophysiology of RLS remains incompletely understood. However, advanced studies suggest that RLS may be generated by dopamine dysfunction locally within the central nervous system. Dopaminergic agonists are the treatment of choice, if the symptoms are severe. And iron therapy improves RLS symptoms in iron deprived patients. Early detection during pregnancy is needed because RLS gives an important impact on sleep efficiency and quality of life. Recently we have experienced a case of primary RLS patient diagnosed at 24+3 weeks, treated by dopaminergic agonist ropinirole and iron. We describe this case with a brief review of the literature.
조은규 ( Eun Kyu Jo ),안치옥 ( Chi Ok Ann ),심현진 ( Hyun Jin Shim ),김윤숙 ( Yun Sook Kim ),배동한 ( Dong Han Bae ),양승하 ( Seoung Ha Yang ),이지혜 ( Ji Hye Lee ) 대한산부인과학회 2011 Obstetrics & Gynecology Science Vol.54 No.5
Sacrococcygeal teratoma (SCT) is a rare subset of germ cell neoplasm and occurs in approximately 1 in 35,000 live births. Most SCTs are benign, but about 20% are malignant. They originate from totipotent cells from Hansen`s node or primitive germ cells, but the exact etiology remains uncertain. Antenatal diagnosis of SCT can be made by ultrasound. The fetus with SCT remains at high risk for perinatal complications and death. Perinatal mortality and morbidity are most strongly related to high-output cardiac failure because of arteriovenous shunting within the tumor, subsequent fetal hydrops, polyhydramnios, and preterm delivery. Recently we have experienced a case of immature SCT with hydrops and polyhydrmnios diagnosed by prenatal ultrasonography at 21+5 weeks, resulted in stillbirth. We describe this case with a brief review of the literature.
박보라 ( Bo Ra Park ),이나혜 ( Na Hye Lee ),안치옥 ( Chi Ok Ann ),심현진 ( Hyun Jin Shim ),조은규 ( Eun Kyu Jo ),김윤숙 ( Yun Sook Kim ),배동한 ( Dong Han Bae ) 대한산부인과학회 2011 Obstetrics & Gynecology Science Vol.54 No.4
Ectopic pregnancy accounts for approximately 2% of all pregnancies and is the most common cause of pregnancy-related mortality in the first trimester. Initial evaluation consists of β-hCG and pelvic ultrasonography. The fallopian tube is the most common location for an ectopic pregnancy. Other types of ectopic pregnancy include cornual, ovarian, cervical, scar, and abdominal pregnancy. In very rare cases, the abdominal pregnancy may be retroperitoneal. The diagnosis is seldom established before surgery and therapy is surgical resection of the ectopic mass. A 26-year-old woman visited our emergency department with sudden massive vaginal bleeding. She had undergone curettage 3 weeks before. But the transvaginal sonogram of the cul-de-sac revealed no fluid collection. She failed variable-dose methotrexate therapy. On laparoscopic operation, we found a cystic, conception-like structure in the retroperitoneum. Histology of resected structure showed chorionic villi. We describe this case with a brief review of the literature.