No abstract available.
Blood Glucose* ; Fetal Blood* ; Humans ; Infant, Newborn* ; Insulin*

The success and rapid spread of laparoscopic cholecystectomy have prompt the application of laparoscopic approach to abdominal surgical problems. As better in- strumentation is introduced, more complicated surgical procedrues will be performed. In some hematologic disorders, splenectomy was required to cope with these disorders. So laparoscopic splenectomy also has been perfomed inspite of several specific difficulties for handling and mobilization of a parenchymatous organ and the retrieval of the specimen. We experienced a case of idiopathic thrombocytopenic purpura which was treated safely and successfully by laparoscopic splenectomy in 35-year-old female. This technique allows the patient to return to normal activity sooner than with open splenectomy.
Adult ; Cholecystectomy, Laparoscopic ; Female ; Humans ; Purpura, Thrombocytopenic, Idiopathic* ; Splenectomy*

PURPOSE: Hyperhomocysteinemia has been identified as an independent risk factor in arterial and venous thrombosis. Mutations in genes encoding methylenetetrahydrofolate reductase (MTHFR), involved in the metabolism of homocysteine, may account for reduced enzyme activity and elevated plasma homocysteine levels. In this study, we investigated the interrelation of MTHFR C677T genotype and level of homocysteine in patients with arterial and venous thrombosis. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 146 patients who were diagnosed as having arterial and venous thrombosis. We excluded patients diagnosed with atrial fibrillation. We examined routinely the plasma concentration of total homocysteine level and MTHFR C677T polymorphism for evaluation of thrombotic tendency in all patients. Screening processes of MTHFR C677T polymorphism were performed by real-time polymerase chain reaction. RESULTS: Investigated groups consisted of thrombotic arterial occlusion in 48 patients and venous occlusion in 63 patients. The distribution of the three genotypes was as follows: homozygous normal (CC) genotype in 29 (26.1%), heterozygous (CT) genotype in 57 (51.4%), and homozygous mutant (TT) genotype in 25 (22.5%) patients. There were no significant differences among individuals between each genotype group for baseline characteristics. Plasma concentration of homocysteine in patients with the TT genotype was significantly increased compared to the CC genotype (P<0.05). CONCLUSION: We observed a significant interaction between TT genotypes and homocysteine levels in our results. The results might reflect the complex interaction between candidate genes and external factors responsible for thrombosis.
Atrial Fibrillation ; Genotype ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Mass Screening ; Medical Records ; Metabolism ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Plasma* ; Real-Time Polymerase Chain Reaction ; Retrospective Studies ; Risk Factors ; Thrombosis ; Venous Thrombosis

We studied the change in intraocular pressure (IOP) in 15 consecutive cataract patients who underwent extracapsular cataract extraction and posterior chamber lens implantation between Feb. 1993 and Apr. 1993 to evaluate the effect of this surgery on postoperative IOP. To evaluate the clinical usefulness of non-contact tonometer, the intraocular pressures were measured with Kowa non-contact tonometer (TM-2000, Japan) as well as Goldmann applanation tonometer. There was a decrease in IOP of 3.4±2.9mmHg (p<0.001) 3 months after this surgery and the intraocular pressure differences between pseudophakic eyes and contralateral phakin eyes at 3 months postoperatively were 2.4±3.8mmHg (p<0.05). The correlation coefficient between non-contact tonometer and Goldmann tonometer was 0.8876 (p=0.001) in the postoperative 76 eyes. Therefore, out results suggest that extracapsular cataract extraction and posterior chamber lens implantation alone can be a useful surgical method in cataract patient with ocular hypertension, and non-contact tonometer was relatively accurate in measuring the postoperative intraocular pressure.
Cataract Extraction* ; Cataract* ; Humans ; Intraocular Pressure* ; Methods ; Ocular Hypertension

No Abstract Available.
Glaucoma* ; Ligation* ; Silicones*

OBJECTIVES: To evaluate the effect of parity & delivery method on female fecal incontinence. METHOD: Based on 213 cases of 4 different delivery method and 40 cases of one non-delivery group, a retrospective analysis of the prevalence of female fecal incontinence, between January 1996 and December 1998, was done. With delivery mode, 4 different groups were: first vaginal delivery group , two or more vaginal deliveries group, first cesarean section group, and first vaginal delivery followed by cesarean section group. All subjects were examined by questionaire or phone about the experience of fecal incontinence after delivery. In cases of fecal incontinence , we reviewed the obstetric complications with medical records. RESULT: There was no fecal incontinence in the non-delivery group. The incidence of fecal incontinence in the two or more vaginal delivery group(11.7%, 9/77) and the first vaginal delivery followed by cesarean section group(18.1%, 8/44) was higher than the first vaginal delivery group(6.8%, 3/44), and the first cesarean section group(2.1%, 1/48)(P<0.05). The obstetric complications in fecal incontinence cases were: a prolonged second stage, anal sphincter laceration, vacuum extraction, a large baby etc. CONCLUSION: Fecal incontinence was significantly correlated with the number of vaginal deliveries and obstetric complications during delivery. Fecal incontinence after the first vaginal delivery or vaginal delivery followed by cesarean section are very important factors in choosing the next delivery method.
Cesarean Section ; Fecal Incontinence* ; Female* ; Humans ; Incidence ; Lacerations ; Medical Records ; Parity* ; Pregnancy ; Prevalence ; Psychosexual Development ; Retrospective Studies ; Vacuum

BACKGROUND AND OBJECTIVE: House dust mites have been known as the most important allergens in respiratory allergic disease. Since environmental factors may have influences on the pathogenesis of allergic disease, the study using Korean house dust mites for immune and biologic reactions in house dust mite-sensitive allergic disease is considered as significant. MATERIAL AND METHOD: We made two in-house allergenic extracts of Korean house dust mites (D. farinae and D. pteronpsssinus) and performed this study for the allergen standardization by in vivo methods and for the evaluation of the reliabilities for clinical applications. RESULT: As a results of biologic standardization using skin prick test teachnique, the activity of 1: 1,500w/v of D. farinae extract was estimated 1,000 biology unit(BU), concentration that elicits a wheal of the same size as that of histamine dihydrochloride 1mg/ml. The activity of 1: 1,000w/v of D. pteronyssinus was condiered as 1,000BU. The activity of 1:100w/v of both D. farinae and D. pteronpssiuns extracts were considered as 100,000 Allergy Unit(AU), based on intradermal skin testing of 30 subjects with strong sensitive reaction. The concordant rates between results of skin prick test done with 5,000BU/ml concentration of in-house allergenic extracts and thoae with the commercially available allergen(Bencard Co., UK) were 84.6% and 81.0% for D. farinae and D. pteronpssinus, respectively. The wheal erythema size and A/H ratios induced by in-house extracts were significantly correlated with those induced by Bencard allergen. CONCLUSION: This results suggest that in-house extracts of the whole bodies of two house dust mites have good allergenic activities in vivo. It is considered to be clinically useful and reliable allergenic extracts.
Allergens ; Biology ; Dust* ; Erythema ; Histamine ; Hypersensitivity ; Pyroglyphidae* ; Skin ; Skin Tests

Drowning is a leading cause of accidental deaths worldwide, but its pathological diagnosis remains a challenge for forensic pathologists owing to a lack of pathognomonic findings in drowning deaths and inconclusive autopsy findings caused by postmortem changes. The aim of the present study was to investigate the pathway taken by inhaled drowning medium through the airway after death in a variety of experimental conditions, including underwater pressurization. We used methylene blue dye to monitor the spread of drowning medium to the lungs. Results of theses experiments demonstrated that it is possible for a significant amount of downing medium to enter the airway during immersion after death. Our results suggest that autopsies of immersed bodies and interpretation of these findings should be performed with special care.
Animal Experimentation* ; Animals* ; Autopsy ; Diagnosis ; Drowning* ; Immersion ; Inhalation* ; Lung ; Methylene Blue* ; Postmortem Changes

In this study, clinical effectiveness of Pharmacia CAP system for determination of allergen specific IgE was evaluated depending on the results of Bencard skin prick tests in 100 atopic and 18 nonatopic asthmatics. The Pharmacia CAP specific IgE positive rates were higher as the SPT grades were increased : negative (n=623) (17.8%); + (n=81) (34.6%); 2+ (n=223) (56.5%); 3+ (n=106) (70.8%); and 4+/-< (n=127)3+ (92.1%), respectively. The overall concordant rate between Bencard SPT and Pharmacia CAP system was 81.7% with range of 70.7~92.1%. The Overall sensitivity of Pharmacia CAP system was 80.7%. The sensitivities for 10 allergens, which ranged from 57.5% to 100 %, were as followed; D.pteronyssinus (96.1%), D.farinae (96.7%), cat dander (61.5%), cockroach (65.2%), Aspergillus fumigatus (57.1%), ragweed (62.5%), mugwort (75.0%), Meadow fescue (100%), birch (62.4%), and oak (80.0%), respectively. Overall specificity of Pharmacia CAP system was 82.2%. The specificity of CAP system in nonatopic subjects (n=18, 160 test) was 94.4% which was quite different with the 77.6% of atopic subjects (n=100, 463 test). SPT A/H ratios were significantly correlated with Pharmacia CAP specific IgE concentration (KU/L) in D.pteronyssinus (r=0.520, p<0.001), D.farinae (r=0.490, p<0.001), A.fumigatus (r=0.315, p<0.01), mugwort (r=0.210, p<0.05), ragweed (r=0.213, p<0.05), birch (r=0.232, p<0.05), M.fescue (r=0.410, p<0.001). But, in cockroach (r=0.192, p<0.1), cat dander and oak pollen, SPT A/H ratios were not correlated with the concentration of specific IgE. These results suggest that Pharmacia CAP system is useful for etiologic evaluation of immediate hypersensitivity and quantitative evaluation of specific IgE in atopic asthma.
Allergens ; Ambrosia ; Animals ; Artemisia ; Aspergillus fumigatus ; Asthma* ; Betula ; Cats ; Cockroaches ; Dander ; Evaluation Studies as Topic ; Hypersensitivity, Immediate ; Immunoglobulin E* ; Pollen ; Sensitivity and Specificity ; Skin

BACKGROUND: Better effect of antiemetic drugs can be obtained by combination of multiple antiemetic drugs that have different mechanisms of action. However, if the combined drugs have similar mechanisms of action, the incidence of side effects may be increase. This study was conducted to evaluate the ability of using combination therapy consisting of metoclopramide and dexamethasone in control of postoperative nausea and vomiting. METHODS: Sixty adult female patients undergoing major gynecological operation under the general anesthesia were randomly divided into two groups according to administered drugs. The patients received a single IV dose of metoclopramide (10 mg, Group I) or metoclopramide plus dexamethasone (10 mg 8 mg, Group II) when as operator sutured the skin wound. The incidences of nausea and vomiting were assessed during the first 12, 24, and 48 hours after recovery from anesthesia. RESULTS: There were no prominent incidences of postoperative nausea and vomiting between two groups within postoperative 12 hours. But there were significantly increased incidences of nausea and vomiting in Group I (26.7%, 13.3%) compared to Group II ( 8.0%, 3.2%) during postoperative 24 hours and 48 hours. CONCLUSIONS: Combination therapy of metoclopramide with dexamethasone seemes to have no synergic effect in control of postoperative nausea and vomiting.
Adult ; Anesthesia ; Anesthesia, General ; Antiemetics ; Dexamethasone* ; Female ; Gynecologic Surgical Procedures ; Humans ; Incidence ; Metoclopramide* ; Nausea ; Postoperative Nausea and Vomiting* ; Skin ; Vomiting ; Wounds and Injuries