Clinical Features of Pregnancy and Delivery in Patients with Idiopathic Thrombocytopenic Purpura / 대한혈액학회지

BACKGROUND: Patients with the condition of idiopathic thrombocytopenic purpura (ITP) may present with, maternal and fetal hemorrhagic complications. Appropriate monitoring and treatment may be important in obstetric management. METHODS: A retrospective chart review was performed for obstetric patients with ITP at Bundang CHA hospital from March 1996 to March 2005. RESULTS: Nineteen women with ITP delivered 22 children in 22 pregnancies. The median age at delivery was 30 years (range, 21~37 years). The median platelet counts before pregnancy, during pregnancy, and at delivery were 44,000/microliter (range, 20,000~225,000/microliter), 40,500/microliter (range, 13,000~335,000/microliter), and 73,500/microliter (range, 40,000~308,000/microliter. Treatment for ITP was done in 14 cases (63.6%) during pregnancy and in 18 cases (81.8%) at delivery. Platelet transfusion was done for one case during pregnancy but, was performed in 17 cases (77.3%) at delivery. Vaginal delivery was done in 10 cases (45%) and a Cesarean section was done in 12 cases (55%). No obstetric complications were observed. The median platelet count of 17 infants was 220,000/microliter (range, 59,000~315,000/microliter). Four neonates were born with platelet counts below 150,000/microliter. No infant showed any clinical signs of hemorrhage and there were not any neonatal complications. CONCLUSION: In our study, obstetric patients with ITP and their neonates were safe with no hemorrhagic complication. However, when compared to the current guidelines, the treatment strategy used in the present study was excessive. Appropriate treatment according to the guidelines is necessary during the obstetric management of patients with ITP.

A Case of Gastric Duplication Cyst / 대한소화기내시경학회지

Duplicated cyst is a rare congenital disease that makes up 4% of all gastrointestinal duplications. It is two times more prevalent in women than in men. The majority of cases are detected by such symptoms as an abdominal mass, nausea, abdominal pain and anemia in infants, but these symptoms are uncommon in adults. Obstruction, hemorrhage and perforation are possible complications and malignancy can develop on rare occasions. Most cases are controlled by surgical resection. We report here on a case of gastric duplication cyst in a 20-year-old woman who presented with severe nausea and vomiting. She was managed by surgical resection after evaluation was done via endoscopic ultrasonography.

A Case of Mycoplasma Pneumoniae Infection Associated Acute Interstitial Nephritis / 대한신장학회잡지

Acute interstitial nephritis is an important cause of acute renal failure and result from immune mediated tubulointerstitial injury, initiated by medications, infections, and other variable causes. Since acute interstitial nephritis may present a variety of clinical and laboratory findings and progress more rapidly than expected and it is reversible with withdrawal of the etiologic drug or administration of steroid, its early detection is very important. Mycoplasma pneumoniae is a common pathogen in young-healthy adult but mycoplasma infection induced acute interstitial nephritis is rarely reported. Therefore considering mycoplasma infection as one possible cause of acute interstitial nephritis is clinically important. So we report a case of acute interstitial nephritis associated with mycoplasma infection.

Case reports of bone grafting in unilateral alveolar-palatal cleft patients / 영남의대학술지

We obtained successful functional and esthetic results by grafting of iliac marrow-cancellous bone in 2 cases of alveolar-palatal cleft patients. Bone graft of alveolar-palatal clefts provide bony support to adjacent teeth of cleft area, prevented from relapse of orthodontic arch expansion, closure of oroantral fistula and improvement of speech problem. 1. In one case, extraction of upper right central incisor that was little bone support, alignment of rotated teeth and expansion of collapsed arch segment were done with pre-orthodontic treatment. The other case. Bone grafting was done after removal of prosthesis with no pre-orthodontic treatment. 2. After mucoperiosteal incision in cleft area, the mucosal flap of labial area, palate and nose were separation and the raised nasal mucosa was sutured for closure of oroantral fistula. Then, the iliac marrow-cancellous bones were grafted to cleft site. 3. After 6 months of operation, we had seen the new bone deposition to cleft site in dental radiograph and prosthetic treatment of missing teeth were done.

Le Fort I Osteotomy and Posterior Maxillary Segmental Osteotomy for Correction of Malunioned Maxilla / 영남의대학술지

This is a case report of correction of malunioned maxilla after traffic accident by Le Fort I osteotomy and posterior segmental osteotomy. By this procedure, authors obtained the following results. 1. The malunioned maxilla after traffic accident which had anterior crossbite, posterior open bite and scissor's bite were corrected by Le Fort 1 osteotomy and posterior segmental osteotomy. 2. No postoperative infection and specific complication were seen in this case. 3. Postoperative intermaxillary fixation was maintained for 8 weeks. And then, the patient could open his mouth in normal range after a week of intermaxillary fixation removal. 4. For rigid fixation and reducing relapse, the osteotomized maxilla was fixed with miniplates.

A Case Report of Correction of Mandibular Prognathism by Intraoral Oblique Splitting Osteotomy of Mandibular Rami / 영남의대학술지

This is a report of 2-cases of mandibular prognathism corrected by Intraoral oblique splitting osteotomy of mandibular rami. The Intraoral oblique splitting osteotomy is a modification of sagittal split osteotomy of ramus and it is documented by Yoshida, on 1985. By this method, authors obtained the following results. 1. The patients' esthetic, psychological and functional problems were dissolved by setback of mandibular prognathism. 2. The postoperative infection splitted bone segments fracture, paresthesia of the face and T.M.J. dysfunction were not appeared. 3. Postoperative intermaxillary fixation was maintained for 8 weeks. The patients could open their mouths in normal range after a week of intermaxillary fixation removal. 4. The soft tissue changes of lower lip and chin were about 1:1 to the hard tissue changes. 5. During intermaxillary fixation period and postoperative orthodontic treatment, slight relapse was observed. Now, the patients are under postoperative orthodontic treatment.