OBJECTIVE: The purpose of this study is to evaluate effect of patient age amenorrhea duration, motivation, purpose, regimen, side effect on compliance to hormonal replacement therapy(HRT). METHODS: Compliance to HRT was assessed in 86 postmenopausal women who began HRT in the Shin ob & gyn clinic. Fifty six women who had intact uterus received continuous combined therapy with 2 mg of Estradiol hemihydrate and 1mg of Norethinsterone acetate. Thirty women who were hysterectomized received only 0.625mg of conjugated equaine estrogen(premarin) RESULT: A total of 34(39.9%) women reported that they continued HRT at least for one year. Continuation of HRT was significantly more common among women who started HRT because of reconmendation by gyneocologist after hystectomy for improvement sexual function(p<0.05), A greater percentage of women who received only premarin without uterus continuous combined therapy(p<0.05) Duration of amenorrhea, reason for taking HRT and side effect such as irregular bleeding or breast tenderness were not related to the continuation of HRT. CONCLUSION: Education of menopausal women about the improvement of sexual function/ risk and side effect of HRT may be critical in improving compliance.
Amenorrhea ; Breast ; Compliance* ; Education ; Estradiol ; Estrogens, Conjugated (USP) ; Female ; Hemorrhage ; Hormone Replacement Therapy ; Humans ; Motivation ; Postmenopause* ; Uterus

No abstract available.

BACKGROUND: Recently developed electrically stimulated gracilis neosphicter or artificial sphincter is quite a promising trial in fecal incontinence However, surgical technique is not simple, the devices are expensive and only specialists can perform the procedures successfully. The aim of this study is to evaluate the efficacy of a newly developed simple silicon device in incontinent dog model. METHODS: A New Colostomy Device (NCD; US Patent No. 5,569,216) for fixing in the stoma or rectum of human body, includes an internal balloon, a ring figured extemal balloon surrounding the internal balloon, a connecting tube disposed under the both infernal and external balloons and supply tube containing a pair of air passages and an enema fluid passage. It is designed to be inserted into the rectum and is held in place by an inflatable external balloon and drains irrigated fecal matter through a thin collapsible connecting tube which exist in the anal canal. Six mongrel dog with 22~26 kg of body weight were prepared. Anal incontinence was made by bilateral severing of the internal and external sphincters and puborectalis muscle under the general anesthesia. Marlex mesh ring was applied to the anal canal as Thiersch wire for the prevention of NCD expulsion in straining. After then, NCD with 2.5 cm of luminal diameter was inserted to the rectum proximal to the Malex mesh ring. Daily irrigation and evacuation was done with 800~1000 cc of tepid water in each dogs. Daily food contained 30 gm of Psyllium dextrose. RESULTS: Initially 6 dogs were observed for 7 days. Daily irrigation made evacuation of fecal matter well in each dogs. There was no prolapse of device through the anal orifice. Anoscopic examination after 7 days showed no rectal and anal mucosal injury. Two dogs were kept for 40 days as same manner. Sometimes spontaneous bowel movement without water irrigation was noted when the stool were loose. Weelky anoscopic examination revealed no evidence of mucosal injuries for 40 days also. There was no septic or other complication. CONCLUSION: NCD evacuated fecal matter well enough to empty the rectum in all incontinence dog model. Adequate sized NCD could be used for clinical trials in selected incontinence patients.
Anal Canal ; Anesthesia, General ; Animals ; Body Weight ; Colostomy* ; Dogs* ; Enema ; Fecal Incontinence ; Glucose ; Human Body ; Humans ; Phenobarbital ; Polypropylenes ; Prolapse ; Psyllium ; Rectum ; Silicones ; Specialization ; Water

OBJECTIVE: We report here on two cases of pseudoaneurysms that were diagnosed using computed tomographic angiography (CTA), with one arising in the superficial temporal artery and the other arising in the occipital artery. METHODS: Case 1: A 29-year-old man presented with a slow growing, pulsatile mass on the left side of his forehead following a blow from a fist 10 days earlier. CTA revealed an 11 x 8 x 11-mm oval pseudoaneurysm arising from the frontal branch of the left superficial temporal artery. Case 2 : A 36-year-old man presented with a pulsatile mass in the right suboccipital region that had been present for the past year. He had no history of direct trauma. CTA revealed a 15 x 8 x 13-mm oval dye-filled sac arising from the right occipital artery. RESULTS: Based on the CTA images, the parent arteries were exposed and ligated proximally and distally to the pseudoaneurysms and then they were completely excised. CONCLUSION: CTA is a minimally invasive technique for making the diagnosis of scalp pseudoaneurysms and CTA is also useful for the preoperative planning.
Adult ; Aneurysm, False ; Angiography ; Arteries ; Diagnostic Tests, Routine ; Forehead ; Humans ; Parents ; Scalp ; Temporal Arteries

DNA isolated from human tumor cells can induce malignant transfarmation of tissue culture cells. The DNA is then called an oncogene. Its protein produets have been detected in animal and human tumors and are considered to play a significant role in carcinogenesis. In order to evaluate whether the oncogenes are involved in development of tumors of epidermis and whether they could be used as tumor markers, immunoperoxidase staining was performed for the ras product in sections of squamous cell carcinoma, Bowen's disease, actinic keratosis, keratoacanthoma and seborrheic keratosis. Three cases of sgamous cell carcinoma showed 10~20 positive cells per high power field(HPF). Three cases of Bowen's disease revealed 1-9 positive cells per HPF, whereas the actinic keratosis 1~9 or no positive cells per 10 HPF in all three cases. The keratoacanthoma and seborrheic keratosis showed 1~9 or no positive cells in all observed cases. The positive staining was observed in the cytoplasm. The increasing positivity in parallel with the increase of malignant potential strongly suggests that the ras oncogene is closely related to development of epidermal malignancy and also point out the possibility of ras as a cancer marker.
Animals ; Bowen's Disease ; Carcinogenesis ; Carcinoma, Squamous Cell ; Cytoplasm ; DNA ; Epidermis* ; Genes, ras* ; Humans ; Keratoacanthoma ; Keratosis, Actinic ; Keratosis, Seborrheic ; Oncogenes ; Biomarkers, Tumor

We performed 3 cases of pudendal-thigh flaps in patients with congenital absence of the vagina from June, 1996 through February, 1999. Pudendal-thigh flaps are posterior labial artery axial flaps based on the terminal vessels of the internal pudendal artery. The flaps are raised bilaterally in the groin crease just lateral to the labia majora and are then transposed toward the midline and sutured together to form a neovagina. With adequate flap dissection, reliable blood supply is maintained. Thus, complications such as flap necrosis do not occur and early wound healing is possible. It is s relatively simple technique which can be completed with little blood loss. This method can be completed in one stage, and the prolonged use of stents of dilators is not necessary, since the reconstructed vagina is stable. The linear scars of the donor sites are well hidden in the groin crease and perineum. Normal function is maintained postoperatively without change in sensation. The authors report these methods with a review of the literature.
Arteries ; Cicatrix ; Groin ; Humans ; Necrosis ; Perineum ; Sensation ; Stents ; Tissue Donors ; Vagina ; Wound Healing

BACKGROUND: As undergoing general anesthesia for Cesarean Section, we usually maintain a light anesthesia until delivery. It provokes the high incidence of waketulness for the mothers. We surveyed the incidence of maternal wakefulness when thiopental was used as an induction agent. METHODS: Forty pregnant women (ASA class I or II) at term who underwent general anesthesia and cesarean section received thiopental, 4mg/kg. As the 'isolated forearm technique', a pressure cuff was inflated to isolate one arm from the the effects of succinylcholine so that wakefulness during anesthesia could be assessed by asking the patient to move her hand. To assess wakefulness,the patient was commanded to squeeze the investigator's hand a specified number of times. If the patient promptly squeezed the investigator's hand the appropriate number of times, the command was repeated but a different number of times specified. Only if the patient responded correctly both times, then we noted as a positive response. This test was repeated at 1 minute intervals beginning 1 minute after thiopental injection through the delivery. RESULTS: Five of the forty patients (12.5%) showed wakefulness. Twenty nine of the forty patients showed 'reaching movements'. One patient showed both wakefulness and 'reaching movements'. CONCLUSIONS: When we undergo general anesthesia for Cesarean Section, especially using thiopental as an induction agent, we should consider the maternal wakefulness seriously.
Anesthesia ; Anesthesia, General ; Anesthesia, Obstetrical ; Arm ; Cesarean Section* ; Female ; Forearm* ; Hand ; Humans ; Incidence ; Mothers ; Pregnancy ; Pregnant Women ; Succinylcholine ; Thiopental ; Wakefulness*

No abstract available.
Child* ; Humans

No abstract available.
Hemorrhoids*

No abstract available.
Lung Neoplasms* ; Lung* ; Risk Factors* ; Spirometry*