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.
The thalassemias are a group of autosomal recessive genetic disorders of hemoglobin synthesis. The thalassemias are classifi ed into two main varieties, α-and β-, depending on which of the adult globin chain is produced in reduced amounts. The β-thalassemia is the homozygous and heterozygous state, and common in the Mediterranean region. Homozygous β-thalassemia is usually associated with severe anemia. β-Thalassemia minor, the heterozygous state, is characterized by hypochromia, microcytosis and an elevated of HgA 2 . No treatment is required for thalassemia minor, but it is important to exclude iron defi ciency anemia and postpartum genetic counseling. Recently, β-thalassemia minor keeps rising steadily in Korea due to the increase in international marriges. Recently we have experienced a vaginal delivery in a β-thalassemia minor Vietnam woman associated with mild anemia. We describe this case with a brief review of the literature.
Dilatation and curettage (D&C) is one of the most frequently performed procedures for first trimester surgical abortion, also nonobstetric D&C can be performed for both diagnostic and therapeutic indications. The mortality and morbidity of D&C are very low, and perforation of uterus is rare. But curettage of a large, soft postpartum uterus can be a formidable undertaking because the risk of perforation is high and the procedure commonly results in increased rather than decreased bleeding. Although many perforations are innocuous, others lead to infection, hemorrhage, and trauma to abdominal contents. Bowel perforation is an infrequent complication, it persists as an important cause of peritonitis and sepsis. The following cases describe two women, who suffered intestinal perforation after D&C at delayed postpartum period.
Endometriosis is a relatively common gynecologic disease. Thoracic endometriosis syndrome occupies half of various types of external endometriosis, however it is very rare condition. We experienced a case of 40-year-old woman who presented with recurrent episodes of spontaneous right-sided pneumothorax that occurred during her menstrual periods. After the localization of the disease site by means of chest radiography and high resolution computed tomography of the thorax, thoracoscopic assisted diaphragm endometriosis resection and suture were performed. After pathologic diagnosis, a hormonal treatment with gonadotropin-releasing hormone agonist was also conducted. We report this case with a brief review of the concerned literatures.
Necrotizing fasciitis (NF) is a rare, rapidly progressive and potentially fatal soft-tissue infection characterized by widespread severe infection of the deep soft tissue, including fascia. Predisposing conditions for NF include diabetes, malignancy, obesity, and chronic liver disease. Patients with suspected NF should be empirically and immediately managed with broad-spectrum antibiotics covering the commonly suspected organisms. And surgical debridement is the mainstay of treatment of NF. We experienced a very rare case of NF with 33-year-old healthy woman who presented with high fever, erythema, edema, and pustule on upper abdomen one day after cesarean section. NF was strongly suspected and immediate surgical intervention and broad spectrum antibiotics were used. We report it with a brief review of literatures.
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