OBJECTIVES: To evaluate the effectiveness and the value of Laparoscopic Assisted Vaginal Hysterectomy, and to evaluate the possibility whether to replace abdominal hysterectomy to LAVH. METHOD: A retrospective study of the surgical procedure was performed by one team with one experienced laparoscopist. The operations were carried out in a private hospital, where operative laparoscopic set was available. All 500 patients underwent LAVH from March 1998 to March 1999 at the department of Obstetrics and Gynecology, Eun hospital. Patients were required hysterectomy for uterine fibroid, chronic pelvic pain and carcinoma in situ of cervix,. etc. RESULTS: The average operating time was 56.4+/-11.8 minutes, and the mean estimated postoperative hemoglobin loss was 0.62+/-1.0 g/dL. The mean uterine weight was 223.9+/-129.7 gram (range from 60gram to 800gram). The most common pathologic finding was adenomyosis(59.6%),and the second most pathologic findig was uterine fibroid(47%). No serious complications occured, but 3 vault hematoma cases occured. The combined procedures were salpingoophorectomy, adhesiolysis, and anterior or posterior colporrhaphy, etc. CONCLUSIONS: LAVH that has been possible to replace abdominal hysterectomy, may be valuable for gynecologic uterine diseases, but the experience is important for laparoscopic surgery. The learning curve influences the results of surgery and incidence of complications. Therefore the procedure may only be carried out by experienced laparoscopists, then the maximum value and advantages of laparoscopic surgery can be obtained. Our experience indicates that LAVH is to reduce almost all incidence of abdominal hysterectomy(0.4%)
Carcinoma in Situ ; Cervix Uteri ; Female ; Gynecology ; Hematoma ; Hospitals, Private ; Humans ; Hysterectomy ; Hysterectomy, Vaginal* ; Incidence ; Laparoscopy ; Learning Curve ; Leiomyoma ; Obstetrics ; Pelvic Pain ; Retrospective Studies ; Uterine Diseases

Open fracture characteristically has higher chances of infection and sof tissue damage in comparison with closed fracture. In spite of the development of operation methods and antibiotics, complications such as infection, nonunion, delayed union, and joint stiffness are continuously confronted as problems in the field of orthopedics. Different methods of treatment have been advocated as regards the care of the open wound and the method of stabilization of the fracture fragments. Therefore a comparative analysis of the type of open fracture and the bone union time according to the initial treatment methods was made from 47 cases over the age of 20, who were followed up until bone union developed among the inpatients who were treated for open fracture of tibia in the period of 7 years from January, 1982 to December, 1988, and the results are as follows: 1. The highest incidence of fractures was encountered in 3rd decade(34%) and male to female ratio was 6:l. 2. The most common cause of fractures was traffic accident(76.6%). 3. The most common level of fracture was in mid one-third and the bone union time was longest in mid one-third. 4. The bone union time was longer, and the rate of complication was greater in order of type 1, 2 & 3 according to Gustilo's classification. 5. The good result was obtained in type 1 fractures, by using the closed reduction & cast immobilization and pin & plaster method; in type 2, the bone union time was shortest in the cases of pin & plater method; in type 3, the bone union time was shortest in the cases of closed reduction or open, reduction & external fixation. 6. Bone union was obtained in all cases of delayed union and nonunion and the bone union time was shortest in cases treated with plate & bone graft.
Anti-Bacterial Agents ; Classification ; Clinical Study ; Female ; Fractures, Closed ; Fractures, Open ; Humans ; Immobilization ; Incidence ; Inpatients ; Joints ; Male ; Methods ; Orthopedics ; Tibia ; Transplants ; Wounds and Injuries

Five cases of intracranial lipoma diagnosed by MR are presented. MR imaging was performed on a 0.2T permanent unit using T1 weighted, proton density-weighted, and T2 weighted spin echo sequences. In two patients, gadolinium-enhanced T1 weighted image was also obtained. The lipomas were located dorsolaterally to the splenium of the corpus callosum (n=1), inferior to the splenium (n=2), in quadrigeminal plate(n=1) and in the presumed corpus callosum area in the case of agenesis of corpus call?um (n=1). The size and shape of the lipomas were variable. No contrast enhancement was seen in post contrast study. Sagittal T1 weighted image appeared to be the most useful imaging plane for the demonstration of the relationship between the lipoma ad the adjacent normal structures. The Homogenous signal intensity paralleling the fat signal and the characteristic location of the lesion are considered to be helpful in the differential diagnosis from dermoid cyst or teratoma.
Corpus Callosum ; Dermoid Cyst ; Diagnosis, Differential ; Humans ; Lipoma* ; Magnetic Resonance Imaging* ; Protons ; Teratoma

Five cases of intracranial lipoma diagnosed by MR are presented. MR imaging was performed on a 0.2T permanent unit using T1 weighted, proton density-weighted, and T2 weighted spin echo sequences. In two patients, gadolinium-enhanced T1 weighted image was also obtained. The lipomas were located dorsolaterally to the splenium of the corpus callosum (n=1), inferior to the splenium (n=2), in quadrigeminal plate(n=1) and in the presumed corpus callosum area in the case of agenesis of corpus call?um (n=1). The size and shape of the lipomas were variable. No contrast enhancement was seen in post contrast study. Sagittal T1 weighted image appeared to be the most useful imaging plane for the demonstration of the relationship between the lipoma ad the adjacent normal structures. The Homogenous signal intensity paralleling the fat signal and the characteristic location of the lesion are considered to be helpful in the differential diagnosis from dermoid cyst or teratoma.
Corpus Callosum ; Dermoid Cyst ; Diagnosis, Differential ; Humans ; Lipoma* ; Magnetic Resonance Imaging* ; Protons ; Teratoma

In general. femoral neck fracture in young adult presents poor prognosis due to the high velocity injury, high angle shear fracture, and poor candidate for arthroplasty. In addition to the relative rarity of the injury, the high incidence of aseptic necrosis and nonunion have been reported in the management of these fractures. 25 cases of femoral neck fracture in young adult were treated with multiple pinning and analyzed at Sung-Ae general hospital from 1987 to 1994 after 28 months follow up in average with review of charts, X-ray and clinical result. There were 18 male and 7 female, 5 cases of them had significant polytrauma to other organs or skeletal system, authors tried to treat them as soon as possible to decrease the interval time between fracture and fixation (the average time was 39.7 hours.) Union occurred in all of Garden stage I (4 cases) and II (4 cases), but in Garden stage III (7 among 8 cases) and IV (7 among 9 cases) the union rate was lower. Average union time was 16.5 weeks. The incidence of complications (12%, 3 among 25 cases) was higher in displaced fractures group (Garden stage III, IV) and also in poorly reduced group of Garden’s alignment index. In conclusion, the prognosis of femoral neck fractures in young adult was related with mainly initial reduction and rigid fixation than the initial injury.
Agriculture ; Arthroplasty ; Female ; Femoral Neck Fractures ; Femur Neck ; Follow-Up Studies ; Hospitals, General ; Humans ; Incidence ; Male ; Multiple Trauma ; Necrosis ; Prognosis ; Young Adult

No abstract available.

PURPOSE: Recently developed BMS(TM) (Zassi Bowel Management System(TM): Hollister Inc., Illinois, USA) can provide effective nonsurgical fecal diversion without the risks associated with colostomy creation and subsequent closure. Our aim is to evaluate the effectiveness of the BMS in diverting feces from the perianal wide surgical wound in patients with Fournier's gangrene. METHODS: BMS(TM) was applied in five patients (male: 2, median age; 44) with Fournier's gangrene from January 2000 to September 2001. The treatments consist of three times a day wound dressing after wide surgical debridement and intravenous antibiotic therapy. For evacuation of feces, twice daily warm saline irrigation was administered via BMS(TM) or low daily doses of polyethylene glycol solutions were orally taken in. An endoscopic and anorectal manometric study was done to evaluate possible mucosal complications and anorectal functional changes. RESULTS: The average duration of the BMS application was 41 (range, 22~63) days. The result of a manometric study after immediate removal of the BMS(TM) showed a decreased mean resting pressure (range: 22~36 mmHg) and a decreased mean squeezing pressure (range: 32~39 mmHg). After 3 days, the sphincter pressure had improved markedly: mean resting pressures of 38, 45, 60, and 63 mmHg and mean squeezing pressure of 78, 89, 91, and 101 mmHg respectively. Fecal incontience was not noted in any patient. Other possible mucosal complications were not noted. There were no mortalit. CONCLUSIONS: BMS(TM) application in Fournier's gangrene patients after surgery successfully avoids a defunctioning colostomy. Furthermore, no significant complications were noted over a prolonged period up to 63 days.
Bandages ; Colostomy ; Debridement ; Fasciitis, Necrotizing ; Feces ; Fournier Gangrene ; Humans ; Illinois ; Polyethylene Glycols

Cisternography is isotopic demonstration of CSF dynamics, CSF rate & pathways, by scintillation scanning of the head after intrathecal administration of RISA. We have investigated the cisternographic findings in the hydrocephalus patients in view of the diagnosis and prognostic criteria. Cisternography provides the etiology & classification of hydrocephalus and reliable indication of CSF shunt operation. We found correlation between prolonged ventricular retention, delayed migration, inadequate clearance of the isotope and favorable response to shunting.
Classification ; Diagnosis* ; Head ; Humans ; Hydrocephalus*

A nineteen year-old boy with progressive enlargement of the joints and distal extremities, clubbing, coarse facial features and hyperhidrosis was investigated. In physical examination, thickening of the scalp with furrowing (cutis verticis gyrata) and greasy thickening of skin (pachyderma) was prominent. His endocrine profile was normal. Radiological studies demonstrated bilateral symmetrical periosteal new bone formation with acroosteolysis and incidental microadenoma of pituitay gland. After extensive investigation to exclude systemic and endocrine causes, the patient was diagnosed as pachydermoperiostosis (PDP). PDP is a rare syndrome manifested clinically by finger clubbing, extremity enlargement, hypertrophic skin changes, and periosteal bone formation. The pathogenesis of the disorder has not been clarified though few endocrine abnormalities were seen. To aware of these clinical phenotype would help to differentiate PDP from acromegaly.
Acro-Osteolysis ; Acromegaly ; Extremities ; Fingers ; Humans ; Hyperhidrosis ; Joints ; Male* ; Osteoarthropathy, Primary Hypertrophic* ; Osteogenesis ; Phenotype ; Physical Examination ; Scalp ; Skin ; Young Adult*

OBJECTIVES: The aim of this study was to examine the association of attention-deficit hyperactivity disorder (ADHD) in Korean populations with functional polymorphisms of six genes dopamine receptors (Ser311/Cys311 polymorphism, Taq1 A polymorphism, and Taq1 B polymorphism in DRD2, BalI polymorphism in DRD3, and promoter -521 C/T polymorphism and exon III 48 bp repeat polymorphism in DRD4) and one gene in dopamine transporter (DAT1). METHODS: Participants were 58 children with ADHD and 110 control children. The genotypes were determined by PCR. RESULTS: There was a statistically significant difference in genotype frequency of -521 C/T polymorphism within the promoter region of the DRD4 between two groups. Furthermore, in the male group, both genotype and allele frequencies showed statistically significant differences. CONCLUSION: Findings of the study indicate that -521 C/T polymorphism in promoter region of DRD4 appears to be a possible candidate gene for ADHD in Korean population.
Attention Deficit Disorder with Hyperactivity ; Child ; Dopamine ; Dopamine Plasma Membrane Transport Proteins ; Exons ; Gene Frequency ; Genotype ; Humans ; Male ; Promoter Regions, Genetic ; Receptors, Dopamine