OBJECTIVE: To evaluate the efficacy of laparoscopic surgery in the treatment of deep endomtriosis, we have studied 30 cases of deep endometriosis. Endometriosis is classified into superficial(<1mm), intermediate(2-4mm), deep(>5mm) and very deep(>10mm) endometriosis by the infiltration depth from the peritoneal surface. In the treatment of deep endometriosis, medical hormonal therapy is not effective, so surgical treatment is required. There are many difficulties in surgiacal treatment ; hard lesion to excise, ditsorted pelvic anatomy after excision, easy to damage to ureter and uterine artery, and limitation for potentially morbid procedure to whom wants to conceive. Especially laparoscopic surgery in the treatment of deep endometriosis is very difficult because it is impossible to know the depth by palpation. In deep endometriosis type II, the lesion is concealed due to rectal adhesion to cul de sac, uterosacral ligament and in type III, the lesion is regarded as a small lesion or missed due to invagination into pelvic floor. The authors compared the laparoscopic surgery with laparotomy to evaluate the efficacy of laparoscopic surgery in the treatment of deep endomtriosis. METHODS: Deep endometriosis, 30 cases out of 102 cases, which were histologically comfirmed as endometriosis were studied. The authors compared the laparoscopic surgery(15 cases) with laparotomy(15 cases) in the surgical treatment of deep endometriosis for operation procedure, operation time, hospital stay and symptoms improvement. RESULTS: The mean operation time of laparoscopic surgeries in deep endometriosis was 178.7(+/-43.1)min while type I, II and III in deep endometriosis took 148.5(+/-21.2)min, 162.0(+/-30.7)min and 245.0(+/-36.1)min respectively and took a little more time than laparotomy. Mean hospital stay in laparoscopic surgeries was 5.7(+/-1.8)days and laparotomy took 10.0(+/-2.3)days that was statistically significant. CONCLUSION: If patients are chosen adequately and operator's skills are satisfactory, laparoscopic surgery is very valuable in the treatment of deep endometriosis. More datas will be required to confirm the efficacy.
Endometriosis* ; Female ; Humans ; Laparoscopy* ; Laparotomy ; Length of Stay ; Ligaments ; Palpation ; Pelvic Floor ; Ureter ; Uterine Artery

Aged ; Carcinoid Tumor ; diagnosis ; therapy ; Humans ; Laryngeal Neoplasms ; diagnosis ; therapy ; Male

The tibia is the most commoniy fractured of all the long bones of the body. Recently, the incidence of shaft fractured of tibia has risen as a result of rapid increase in automobile accidents, industrial accidents and other sports injuries. Fracture of the tibial shaft is extremely difficult to treat and a greater incidence of osteomyelitis, delayed union and nonunion of bone than in those of the full length of the tibia surface is throat, open fracture is more frequent in this bone than in any other major bones. Two hundred eighty patients (293 cases) of the fracture of tibial shaft were treated and managed at the Department of Orthopedic Surgery, Hanyang University Hospital from May, 1975 to December, 1977. The results were as follows: 1. The rate of fracture union was accelarated under the age of 20 years but it was slow in aged group. 2. A better prognosis (fracture union) was shown in proximal one third of the tibia than middle one third and lower one third of the tibia. 3. According to the classification of Ellis, the higher delayed and nonunion rate was shown in major severity group than moderate and minor severity group. 4. A better prognosis of the fracture type was shown in the spiral and oblique fracture than in the transverse, comminuted and segmental fractures. 5. Open fracture of the tibia united later than closed fracture, especially in positive culture sensitivity test. 6. There was a prolonged rate of union about 2 weeks in cases of associated fibula fracture. 7. The proper time of weight bearing of the shaft fracture of the tibia was helpful in fracture union. 8. A better prognosis was shown in the non-operative treatment than operative treatment, especially in PTB cast after long leg cast.
Accidents, Occupational ; Athletic Injuries ; Automobiles ; Classification ; Clinical Study ; Fibula ; Fractures, Closed ; Fractures, Open ; Humans ; Incidence ; Leg ; Orthopedics ; Osteomyelitis ; Pharynx ; Prognosis ; Tibia ; Weight-Bearing

Purpose: The imaging characteristics of two popular kV cone-beam CT (CBCT) and two MVCT systems utilised in image-guided radiation therapy (IGRT) were evaluated. Materials and methods: The study was performed on Varian Clinac iX, Elekta Synergy S, Siemens Oncor, and Tomotherapy. A CT phantom (Catphan-504, Phantom Laboratory, Salem, NY) was scanned for measurements of image quality including image noise, uniformity, density accuracy, spatial resolution, contrast linearity, and contrast resolution. The measurement results were analysed using in-house image analysis software. Reproducibility, position correction, and geometric accuracy were also evaluated with markers in a smaller alignment phantom. The performance evaluation compared volumetric image properties from these four systems with those from a conventional diagnostic CT (CCT). Results: It was shown that the linearity of the two kV CBCT was fairly consistent with CCT. The Elekta CBCT with half-circle 27-cm FOV had higher CT numbers than the other three systems. The image noises of the Elekta kV CBCT, Siemens MV CBCT, and Tomotherapy fan-beam CT (FBCT) are about 2-4 times higher than that of the Varian CBCT. The spatial resolutions of two kV CBCTs and two MV CBCTs were 8-11 lp/cm and 3-5 lp/cm, respectively. Conclusion: Elekta CBCT provided a faster image reconstruction and low dose per scan for half-circle scanning. Varian CBCT had relatively lower image noise. Tomotherapy FBCT had the best uniformity.

The ABCD2 score is validated for evaluating short-term stroke risk after transient ischemic attack (TIA); however, whether it is able to predict the long-term risk of vascular outcome remains uncertain. Recently a new tissue-based definition of TIA has been proposed. The ABCD2 scores of 145 TIA patients admitted to our hospital were retrospectively calculated and stratified into two categories: ≤ 3 points (low risk); 4-7 points (moderate-high risk). At a median follow-up of 81 months, new vascular events were recorded. Follow-up data were available in 107 patients. Seventy one patients had a moderate-high ABCD2 score. Sixty six patients experienced a cerebral ischemic event; 8 a myocardial infarction; 7 died of cerebrovascular or cardiovascular cause. Moderate-high ABCD2 score was significantly associated with the further cerebral ischemic events (hazard ratio [HR], 1.755; 95% confidence interval [CI], 1.019 to 3.024) and with the combined endpoint (HR, 1.818; 95% CI, 1.079 to 3.063). Our study shows that the ABCD2 score may also be used to predict long-term vascular outcome after tissue-based definition of TIA. Moderate-high ABCD2 score is associated with an increased general vascular risk in the long-term follow-up after TIA.
Stroke

STATEMENT OF PROBLEM: Titanium-Nickel alloy might be used in various prosthetic restorations since it has a unique property such as super-elasticity and high fatigue resistance. However, little is known about the casting ability of this alloy. PURPOSE: This in vitro study compared the casting accuracy and the porosity made with different investments and various sprue designs to ascertain what casting condition would be better for the fabrication of Ti-Ni cast restorations. MATERIAL AND METHODS: A total of 70 Ti-Ni alloy crowns were made and divided into 7 groups of 10 copings on a metal master die. For measuring the effect of the sprue numbers, two groups with one and two 8-gauge sprues were compared. Moreover, the results of the conventional sprue and the double thickness sprues were compared. Three investments were used; carbon free phosphate bonded investment, titanium investment and gypsum bonded investment. The cast restorations were evaluated at 48 points on the entire circumferential margin with a stereomicroscope measuring in micrometers. Each crown was radiographically examined for casting defects and porosity. Data on casting accuracy were analyzed using two-way and Post hoc Scheffe's comparison to determine whether significant differences existed at the 95% confidence level. Student-Newman-Keuls test were performed to identify significant differences in the number of voids. RESULTS: The double sprueing group and double thickness group had significantly less marginal discrepancy than the single sprueing group (P<.05 and P<.01, respectively). The castings with phosphate bonded investment showed the least marginal discrepancy and the smoothest surface. The castings invested in the gypsum bonded investment had the greatest gaps in margin and the largest failure rate. The double sprueing group and phosphate bonded investment group had significantly smaller void numbers and smaller void size than the other groups. CONCLUSION: Within the limitations of this in vitro study, the casting accuracy of the groups using thicker, double sprue design and the phosphate bonded investment was significantly superior. Moreover, void number and size were less than other groups.
Alloys ; Calcium Sulfate ; Carbon ; Celiac Disease ; Crowns ; Fatigue ; Investments ; Porosity* ; Titanium

No abstract available.
Humans ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn

Adreno-hepatic fusion is rare condition defined as adhesion of the liver and right adrenal cortex with close intermingling of the respective parenchyme. It is suggested to be an aging phenomenon, because its incidence is much higher in older age group. Clinically it may pose a problem of operability of the organ involved. We report a case of incidentally found adreno-hepatic fusion in a 49 year old female patient with adenocarcinoma of the sigmoid colon. The segementectomy of VIII segement of the liver was done due to a 6 4 cm sized metastatic nodule of adenocarcioma. Pathological examination of the liver revealed an ovoid shaped, 1 0.5 cm sized adrenal cortical tissue. It was subcapsularly located and about 1cm apart from the metastatic adenocarcinoma with an intervening normal hepatic tissue. The adrenal tissue was mainly composed of zona fasciculata without medullary tissue. In the interphase, the adrenal tissue and liver tissue were admixed closely and partially septated by thin fibrous tissue. There was no inflammatory response to the heterotropically located adrenal tissue and there was no symptom related to the adrenal gland.
Adenocarcinoma ; Adrenal Cortex ; Adrenal Glands ; Aging ; Colon, Sigmoid ; Female ; Humans ; Incidence ; Interphase ; Liver ; Middle Aged ; Zona Fasciculata

No abstract available.
Cytogenetics*

No abstract available.
Cytogenetics*