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

BACKGROUND: The action of the volatile anesthetics on various organs in the body is not well known. Since Furchgott (1980) discovered endothelium derived relaxing factor (EDRF) from endothelium, many studies have been tried. Many investigators were studied about the relationship between the EDRF and the effect of the volatile anesthetics on blood vessels too. But the effect of volatile anesthetics and the site of action on the blood vessel were still controversial. In this study, we evaluated that the effect and the action site of halothane and isoflurane on isolated aortic rings of the rabbit. METHODS: Each of obtained thoracic aorta from rabbits (1.5~2.5 Kg) was divided into 3~5 mm sized rings, and a half of that were denuded. All of the aortic rings were preconstricted with phenylephrine 1.5 10-7 Mole in warm organ bath filled with modified Krebs' solution, and then LNAME (inhibitor of nitric oxide synthase, 3 10-4Mole) was administered to one group of aortic rings. MB (inhibitor of soluble guanylate cyclase, 2 10-5Mole) was administered to another one group and neither of LNAME nor MB was administered to the other group. And then isoflurane or halothane was administered (1~4%) to all of aortic rings. The polygraph recorded the changes of tension of aortic ring which was transmitted through the force transducer. RESULTS: It was proved that basal EDRF was released from endothelium by the fact that intact aortic rings were more constricted after LNAME or MB administration. The intact aortic rings were constricted in all concentration of isoflurane and both intact and denuded rings were relaxed in 4% concentration of halothane. CONCLUSION: It is concluded that isoflurane in all concentrations has an endothelium -mediated vasoconstriction and 4% halothane produced vascular relaxation directly independent of existence of the endothelium of vessel.
Anesthetics ; Aorta, Thoracic ; Arginine* ; Baths ; Blood Vessels ; Endothelium ; Endothelium-Dependent Relaxing Factors ; Guanylate Cyclase ; Halothane* ; Humans ; Isoflurane* ; Methylene Blue ; Nitric Oxide Synthase ; Phenylephrine ; Rabbits ; Relaxation ; Research Personnel ; Transducers ; Vasoconstriction

A few cases of reticulate acropigmentary disorders have been reported in Korea. Most of them were reticulate acropigmentation of Kitamura, but not acropigmentation symmetrica of Dohi. A 21 year-old male patient diagnosed as acropigmentation symmetrica of Dohi had been previously treated with various treatment methods unsuccessfully. Re-treatment with the Q-switched alexandrite laser(755 nm, 100nsec) showed a temporary improvement but a relapse of the lesion was experienced again. We describe a case of acropigmentation symmetrica of hi treated with the Q-switched alexandrite laser.
Humans ; Korea ; Lasers, Solid-State* ; Male ; Recurrence

BACKGROUND: Desflurane is a new inhaled anesthetic with the lowest blood/gas partition coefficient and enflurane is one of the major anesthetics in these days. But the effect of volatile anesthetics and the site of action on the blood vessel are still controversial. Since Furchgott (1980) discovered endothelium derived relaxing factor (EDRF) from endothelium, many investigators have studied about the relationship between the EDRF and the effect of the volatile anesthetics on blood vessels. In this study, we evaluated that the effect and the action site of enflurane and desflurane on isolated aortic rings of the rabbit. METHODS: Each of obtained thoracic aorta from rabbits (1.5~2.5 kg) was divided into 4~6 mm rings, and a half of that were denuded. All of the aortic rings were preconstricted with phenylephrine 1.5 10-7 Mole in warm organ bath filled with modified Krebs' solution, and then LNAME (inhibitor of nitric oxide synthase, 3 10-4Mole) was administered to one group of aortic rings. MB (inhibitor of soluble guanylyl cyclase, 2 10-5Mole) was administered to another one group and neither of LNAME nor MB was administered to the other group. And then enflurane (1%, 2%, 3%, 4%) or desflurane (6%, 9%, 12%) was administered to all of aortic rings. The polygraph recorded the changes of tension of aortic ring which was transmitted through the force transducer. RESULTS: It was proved that basal EDRF was released from endothelium by the fact that intact aortic rings were more constricted after LNAME or MB administration. The intact aortic rings were constricted in all concentration of enflurane and both intact and denuded rings were maintained from control tension in all concentrations of desflurane. CONCLUSION: It is concluded that enflurane in all concentrations has an endothelium-mediated vasoconstriction effect and desflurane in all concentrations has no effect on isolated aortic rings of rabbit.
Anesthetics ; Aorta, Thoracic ; Arginine* ; Baths ; Blood Vessels ; Endothelium ; Endothelium-Dependent Relaxing Factors ; Enflurane* ; Guanylate Cyclase ; Humans ; Nitric Oxide Synthase ; Phenylephrine ; Rabbits ; Research Personnel ; Transducers ; Vasoconstriction

BACKGROUND: The purpose of this study was to analyze the relationships between cardiorespiratory fitness and body mass index (BMI), metabolic syndrome risk factors, homeostasis model assessment-insulin resistance (HOMA-IR), and high sensitivity C-reactive protein (hsCRP) in male high school students in Korea. Furthermore, the effects of the cardiorespiratory fitness levels on these four factors were examined. METHODS: The level of cardiorespiratory fitness, BMI, percent body fat, waist circumference (WC), systolic blood pressure, glucose, triglycerides (TG), high-density lipoprotein-cholesterol (HDL-C), HOMA-IR, and hsCRP of 227 male high school students were measured. Analyses of multiple correlation and simple regression were applied. RESULTS: The results showed that the level of cardiorespiratory fitness correlated negatively with BMI, percent body fat, WC, TG, and HDL-C, in addition to HOMA-IR and hsCRP, and strongly influenced BMI, percent body fat, WC, TG, HDL-C, HOMA-IR, and hsCRP. Comparative analysis of our subjects showed that higher cardiorespiratory fitness levels had positive effects on BMI, metabolic syndrome risk factors, HOMA-IR, and hsCRP. CONCLUSIONS: This study found that there are close correlations between cardiorespiratory fitness and BMI, metabolic syndrome risk factors, HOMA-IR, and hsCRP. It also showed that, compared to lower levels of cardiorespiratory fitness, higher levels had beneficial effects on BMI, metabolic syndrome risk factors, diabetes, and cardiovascular disease risk factors.
Adipose Tissue ; Adolescent ; Blood Pressure ; Body Mass Index ; C-Reactive Protein ; Cardiovascular Diseases ; Glucose ; Homeostasis ; Humans ; Insulin ; Korea ; Male ; Physical Fitness ; Risk Factors ; Triglycerides ; Waist Circumference

Gastric mucosa shows continuous changes in surface epithelium as well as inflammatory reaction by various substances from the outside and their metabolic products. Gastric mucosal lesions are proven to be associated with bacterial infection by the discovery of Heliobacter pylori(H. pylori) and many studies about histopathologic changes of gastric mucosa associated H. pylori infection has been advanced. It is known that H. pylori associated gastritis displays surface foveolar epithelial changes, such as cytoplasmic vacuolation, mucin loss, juxtaluminal cytoplasm erosion, epithelial denudation, and mucosal irregularity. There have been many studies that H. pylori infection is associated with intestinal metaplasia, gastric dysplasia, and carcinoma. Also chronic H. pylori infection with its induction of gastric lymphoid follicle has been implicated as a precursor of gastric lymphoma of the unique B-cell type that arises from mucosa-associated lymphoid tissue(MALT). However, these gastric mucosal changes are also observed in gastritis with other causes. In this study, we aimed to define specific histopathiologic findings associated with H. pylori infection. A total of 463 gastric biopsy specimens were reviewed. They were Helicobacter-associated gastritis and were divided as many (MH), a few (AH), and no (NH), according to the number of H. pylori. 210 (MH), 131 (AH), and 122 (NH) biopsy specimens were included. Lymphocytes, plasma cells in lamina propria, eosinophils and neutrophils in surface epithelium and crypt as well as lamina propria were graded from 0 to 3. Surface epithelial changes including cytoplasmic vacuolation, mucin loss, juxtaluminal erosion, epithelial denudation and mucosal irregrarity were observed in 200 of 210 cases(95%) in MH group, 34 of 131 cases(26%) in AH group, and 6 of 122 cases(5%) in NH group. This result indicates there is significant difference in surface epithelial changes according to the number of H. pylori(p<0.001). Severity of eosinophil, neutrophil, lymphocyte, and plasma cell infiltration is increased in proportion to the number of H. pylori. Especially, neutrophilic infiltration is not identified in 95 of 122 cases(78%) in NH group, whereas MH group shows severe infitration (grade 3) in 127 of 210 cases(61%), and no (grade 0) in 11 of 210 cases(5%). This data well explains that the severity of neutrophil infiltration is associated with, the degree of H. pylori infection in chronic active gastritis, with statistical significance. The prevalence of lymphoid follicle formation was 17 of 120 cases(14%) in NH group, 24 of 131 cases(18%) in AH group, and 52 of 210 cases(25%) in MH group. This shows that lymphoid follicle formation correlates with the number of H. pylori, but without statistical significance. The prevalence of intestinal metaplasia in NH, AH, and MH was 43 of 122 cases(35%), 46 of 131 cases(35%), and 69 of 210 cases(33%), showing no association between intestinal metaplasia and H. pylori. In summary, H. pylori associated gastritis dispays characteristic histopathological changes in gastric mucosa, in which surface epithelial changes and various inflammatory infiltrates are increased in proportion to the number of H. pylori. Especially vacuolization of surface foveolar epithelium, cryptitis, and crypt abscess are specific findings of H. pylori associated gastritis.
Biopsy

No abstract available.

Authors measured the degree of posterior instability of the knee in 21 patitients who had posterior cruciate ligament(PCL) injury or have been reconstructed the PCL by using the manual maximal displacement test and quadriceps active test with KT-1000 arthrometer. To compare the reliability between the manual maximal displacement test and the quadriceps active test, two testers participated in the experiment. One tester was a novice and the other tester had substantial clinical experiences with the KT-1000 arthrometer. The quadriceps neutra! Angle was measured in the uninjured knee, and then quadriceps active test was done. Manual maximal displacement test and Quadriceps active test were done by each tester. In manual maximal displacement test, the Pearson correlation coefficient of the uninjured knee between two testers was 0.852 and that of PCL injured knee between two testers was 0.802. In quadriceps achive test, the Pearson correlation coefficient between two testers was 0.173. As a result, the manual maximal displacement test was more reliable for th measurement of the degree of the posterior instability in patients with posterior cruciate ligament tear or reccnstruction.
Humans ; Knee* ; Posterior Cruciate Ligament

A histological and electron microscopic study were conducted in order to observe a morphological changing pattern of patellar ligament autograft after endoscopic ACL reconstruction. Seventeen patients among 117 consecutive series which underwent endoscopic ACL reconstruction from January 1990 to March 1995, were involved in this study according to the various follow-up periods. In second-look arthroscopic finding at 6 months follow-up after ACL reconstruction, reconstructed ACL was covered with synovium and round-shaped, and after the biopsy active bleeding could be seen. In histological study, 6 months follow-up, spindle or ovoid shaped fibroblast with hypercellularity, high crmp patterns of collagen fiber, and parallel arrangement of fibroblast to collagen fiber were noted. The cellularity of fibroblast decreased in according to periods of follow up. At 12 months follow up, spindle or ovoid fibroblast, its cellularity and arrangement pattern and crimp pattern of collagen fiber seemed to be almost similar to those of normal ACL. This similaryity continued up to 2 years and 2 months after reconstruction. In EM study, until 6 months follow-up after reconstruction, the graft showed randomly arranged fibroblasts with hypercellularity, which had abundant cytoplasm with marked irregular cytoplasmic borders and prominent nuclear indentation, Collagen fibrils were immature and showed a unimodel distribution with small diameter. At 12 months follow-up, elongated fibroblasts appeared, but these cells contained folded nuclei and abundant cytoplasm. Collagen fibrils had parallel arrangement and sparse cross striation, and comprised of mainly small fibrils and scattered large fibrils. After 24 months follow-up, the cellularity decreased more. The regular arrangement of collagen fibrils with wavy pattern similar to normal anterior cruciate ligament was noted. Two distinctive population of the small and large diameter of fibrils was also observed (bimodal distribution). At 26 months, the large and small collagen fibrils compresed a characteric bimodal pattern with parallel arrangement, but the majority of fibroblasts had irregular cytoplasmic contour, and abundant cytoplasm with increased organelles, which indicated the active function. These findings suggest that the graft are still immature even at 26 months in postoperative follow up despite considerable maturation of collagen fibril.
Anterior Cruciate Ligament ; Autografts ; Biopsy ; Collagen ; Cytoplasm ; Fibroblasts ; Follow-Up Studies ; Hemorrhage ; Humans ; Organelles ; Patellar Ligament ; Synovial Membrane ; Transplants

Leri-Weill syndrome or Leri-Weill dyschondrosteosis represents a short stature syndrome that is characterized by symmetric shortening of the forearms and lower legs and a bilateral shortening and bowing of the radius with a dorsal subluxation of the distal ulna(Madelung deformity). Recent genetic analyses demonstrated that functional haploinsufficiency of SHOX(short stature homeobox-containing gene) accounts for Leri-Weill syndrome. Further studies are needed to explain phenotypic heterogeneity of SHOX defect. We experienced a case of Leri-Weill syndrome in a 11-year-old girl with short stature, who revealed typical Madelung deformity, mesomelic(middle segment) dysplasia, and a karyotype of 46,XX. In cases with dyschondrosteosis or Turner-characteristic dysmorphic skeletal features, detection of SHOX mutation is recommended.
Child ; Congenital Abnormalities ; Female ; Forearm ; Haploinsufficiency ; Humans ; Karyotype ; Leg ; Population Characteristics ; Radius