No abstract available.
Spondylolisthesis*

OBJECTIVES: The most often perfomed major operation in gynecology is hysterectomy.Our purpose was to compare the indications, charateristics and outcomes of patients undergoing total abdominal hysterectomy and total vaginal hysterectomy and to help to establish guidelines to determine the route of hysterectomy. METHOD: The hospital charts of 400 women who underwent elective inpatient hysterectomy at Kyung-Hee University hospital from January 1994 to January 1999, were abstracted retrospectively. Data were collected regarding patients, age, parity, preoperative indications, the route of hysterectomy, uterine weight, operative and postoperative complications and the length of stay. The operative indications were benign uterine disease except from uterine prolapse. Bisection or combined morcellation were used in most cases to obtain reduction in uterine size. RESULT: Patients in whom the vaginal route was successful included 18% of those with uterine weights exceeding 280gm. There was statistically significant difference for uterine weight, operative time, bleeding amount, the length of stay in two camparative group. 4% of vaginal hysterectomy and 7% of total abdominal hysterectomy has documented operative complications. CONCLUSIONS: Vaginal hysterectomy is safe operation with few intraoperative and postoperative complications without notable blood loss. Vaginal hysterectomy allow one to shorten the operating time and allows early postoperative discharge of some patients from hospital. Skilled performance of vaginal hysterectomy is worth greater attention and should be used more often in gynecological study.
Female ; Gynecology ; Hemorrhage ; Humans ; Hysterectomy* ; Hysterectomy, Vaginal ; Inpatients ; Length of Stay ; Operative Time ; Parity ; Postoperative Complications ; Retrospective Studies ; Statistics as Topic* ; Uterine Diseases ; Uterine Prolapse ; Weights and Measures

Fournier's gangrene is a fulminating gangrene of the male genitalia. It is associated with severe systemic toxic effect and a high motality rate, and it requires early diagnosis and intensive care with surgical intervention. We report a case of Fournier's gangrene in 33-year-old man, who showed marked swelling and necrosis of the scrotum, and extending cellulitis on the right flank and chest. With prompt excision of all the gangrenous scrotal skin and drainage incisions made on the flank and chest, the healing was successful.
Adult ; Cellulitis ; Drainage ; Early Diagnosis ; Fournier Gangrene* ; Gangrene ; Genitalia, Male ; Humans ; Critical Care ; Male ; Necrosis ; Scrotum ; Skin ; Thorax

Ovarian cancer has the highest mortality rate among gynecologic malignancies in developed countries. Most women present with advanced disease and require a combination of surgery and chemotherapy. One patient presented with recurrent ovarian cancer was initially treated with taxol and platinum-based compounds. Although response to these agents occurred, tumor progression was evident by elevated CA 125 levels and CT findings after a period of 4 months. This patient was then treated with topotecan and exhibited a response and stopped therapy. Topotecan exhibited activity in this patient with ovarian cancer resistent to both platinum and paclitaxel. We report a case of advanced ovarian cancer which was treated with topotecan after taxol-cisplatin treatment failed.
Developed Countries ; Drug Therapy ; Female ; Humans ; Mortality ; Ovarian Neoplasms* ; Paclitaxel ; Platinum ; Topotecan*

Traumatic spondylolisthesis of the axis is the fracture of both pedicles and is called commonly as hangman' s fracture. The fractures with the anterior displacement more than 3mm and the angulation, more than 11 degrees were classified as unstable and the surgical methods were recommended for the treatment of the fractures. As for the surgical methods, anterior C2-3 fusion with plate fixation or transpedicular screw fixation were used. However, the differences between the clinical results of both methods were not reported in the literatures. In order to clarisy the clinical results of both methods, the authors evaluated the clinical results of 11 patients treated by anterior plate fixation and 7 patients treated by transpedicular fixation who were operated on between Mar. 1987 and,Jan: 1992. Minimum follow-up period was 12 months. 1. As the surgical complications, two cases of transient dysphagia in anterior fixation group and three cases of malinserted screw in transpedicular fixation group were observed. 2. Limitation of rotatory neck motion, less than 20 degrees in one direction was observed in four cases of transpedicular fixation group. 3. Anterior angulation, more than 10 degrees was noted in three cases of transpedicular group. 4. Mild intermittent neck pain was observed in two cases of anterior fixation group and two cases of transpedicular fixation group. Constant neck pain was present in three cases of transpedicular fixation group. 5. Over-all clinical results were excellent or good in all of anterior fixation group, and in four of seven transpedicular group. Although the clinical materials were limited in number, method of anterior plate fixation was recommended by the authors in the management of traumatic spondylolisthesis of axis, because of the easier technique and the better clinical results than the transpedicular screw fixation.
Deglutition Disorders ; Follow-Up Studies ; Humans ; Methods ; Neck ; Neck Pain ; Spine ; Spondylolisthesis

OBJECTIVES: Sleep problems has been consistently reported as a suicidal risk factor in adults and, recently, also in adolescents. In this study, dividing study subjects by the previous suicidal behaviors (suicidal vs non-suicidal), we compared the group differences of suicidal risk factors, and examined the possibility of sleep as a suicidal risk factor. METHODS: Study subjects were 561 (271 boys and 290 girls) from a community sample of high school students. Suicidal Risk Behavior Checklist, Center for Epidemiological Study-Depression (CES-D), Symptom Checklist-90-Revision (SCL-90-R) Anxiety and Aggression subscale, Pittsburg Sleep Quality Index (PSQI) were done. RESULTS: Forty six students (8.1%) reported previous actual self-harm behavior as a suicidal attempt, 181 students (32.4%) reported having suicidal thought only. Three hundred thirty four students (59.5%) reported no previous suicidal behavior (thought and attempt, both). Suicidal behavior group showed higher score on risk behaviors such as school violence, substance use and internet addiction. CES-D, SCL-90-R, PSQI showed significant group difference. Logistic regression analysis showed suicidal risk were significantly associated with depression, stress in suicidal risk factors and sleep latency, daytime dysfunction in PSQI. Analysis of variance (ANOVA) shows the most prolonged sleep latency and increased index of all PSQI components except sleep efficiency in suicidal attempt group. CONCLUSIONS: Sleep Problems had a strong association with the suicidal risk behavior in adolescents. Sleep problems, especially, prolonged sleep latency, daytime dysfunction might be important markers for suicidal behavior. Screening for sleep problems in adolescents are encouraged for the parents, school teachers, and related medical physicians.
Adolescent ; Adult ; Aggression ; Anxiety ; Checklist ; Depression ; Humans ; Internet ; Logistic Models ; Mass Screening ; Parents ; Risk Factors ; Risk-Taking ; Suicide ; Violence

No abstract available.
Lung* ; Neoplasm Metastasis* ; Uterus*

Hand injury in children was increased due to multiple environmental risks and failed attention of parents to children in rapidly developing society. By the results of this evaluation in 37 cases, it was summarized as follows. First, hand injuries in children most commonly occurs in spring, and occurs more commonly in the children at the age of high activity. The most common level of injury is zone I by microreplantation zone, and zone II by tendon injury zone. The more desirable results were obtained by full thickness skin graft and composite graft if it were possible. For the better functional results compare to adults, the methods and procedures must be constructed after more evaluation with more clinical cases. In the cases of pediatric hand injury, the most important fact is prevention of injury, with the close attention by parents, and the second is appropriate diagnosis and treatment for more functional results.
Adult ; Child ; Diagnosis ; Hand Injuries* ; Hand* ; Humans ; Parents ; Skin ; Tendon Injuries ; Transplants

PURPOSE: We evaluated the ability of endo-rectal coil MRI (ER-MRI) to predict the local pathological stage of prostate cancer prior to radical prostatectomy and compared the results with those of transrectal ultrasonography (TRUS). MATERIALS AND METHODS: ER-MRI using high field magnets (1.5 Tesla) were performed in 22 patients (mean age 62.8 years, range 51-73) with clinically localized prostate cancer before radical prostatectomy. Of the 22 patients, 17 patients were also assessed by TRUS. The results of the imaging techniques were compared with the post-operative histopathological findings. As one patient with pelvic lymph node metastasis, which was detected on frozen-section examination during surgery, was spared radical prostatectomy, the final evaluation included 21 patients. RESULTS: DSeven of the 21 patients (33%) were found to have extraprostatic extension (EPE), and 5 had seminal vesicle invasion (SVI). The sensitivity and specificity for diagnosing EPE using ER-MRI were 62.5% and 84.6%, respectively, and 16.7% and 100% with TRUS. The sensitivity and specificity for diagnosing SVI were 80.0% and 93.8%, respectively with ER-MRI, and 0% and 92.3% with TRUS. The accuracy of predicting SVI was 90.5% with ER-MRI compared to 70.6% with TRUS. CONCLUSIONS: ER-MRI was significantly better than TRUS for determining the local extent of prostatic cancer and for prediction of SVI in the preoperative staging of clinically localized prostate cancer.
Humans ; Lymph Nodes ; Magnetic Resonance Imaging* ; Neoplasm Metastasis ; Prostate* ; Prostatectomy ; Prostatic Neoplasms* ; Seminal Vesicles ; Sensitivity and Specificity ; Ultrasonography

OBJECTIVES: This study was aimed to examine the prevalence of neuroleptic-induced irregular menstruation and its related factors as well as the possible relationship of irregular menstruation with psychopathology and extrapyramidal symptoms in schizophrenic patients. METHODS: Thirty five schizophrenic inpatients at Naju National Mental Hospital who satisfied the diagnostic criteria of DSM-IV were selected. They had drug-free periods for more than 1 month before admission and had been taking neuroleptics for more than 3 months after admission. From all patients, reliable information regarding the sociodemographic characteristics, the menstrual histories before and after admission and clinical characteristics, including previous and current medications were investigated. The following were also evaluated: Serum prolactin level(by radioimmunoassay), psychopathology(by positive and negative syndrome scale: PANSS), and extrapyramidal symptoms(by extrapyramidal symptom rating scale: ESRS). RESULTS: Twelve patients(34%) showed regular menstruation and 23 patients(66%) were suffering from irregular menstruation. Of those with irregular menstruation, 13 patients(37%) had oligomenorrhea and 10 patients(29%) had amenorrhea. There were no differences in sociodemographic characteristics and menstrual histories before admission between the regular and irregular menstruation groups. But, the significant differences between the two were found in the following variables: The irregular menstruation group had shorter durations of illness, higher daily doses of current neuroleptics, higher serum prolactin levels, higher scores on the general psychopathology scale of PANSS, and higher scores on the parkinsonian symptom scale, hypokinetic symptom factor and clinical global impression of ESRS. CONCLUSION: The high prevalence of the irregular menstruation in schizophrenic patients reflects a state of hyperprolactinemia due to the interference of dopamine activity by high doses of neuroleptics.
Amenorrhea ; Antipsychotic Agents ; Diagnostic and Statistical Manual of Mental Disorders ; Dopamine ; Female ; Hospitals, Psychiatric ; Humans ; Hyperprolactinemia ; Inpatients ; Jeollanam-do ; Menstruation* ; Oligomenorrhea ; Prevalence ; Prolactin ; Psychopathology ; Schizophrenia