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

Pseudohypoaldosteronism type 1 is a genetic renal tubular disease of salt wasting, presenting in young infants. Tubular unresponsiveness to elevated endogenous and exogenous aldosterone is the suggested pathogenetic mechanism. Oral sodium chloride supplementation relieve the clinical symptoms and electrolyte distrubances. We experienced 2 cases of PHA type 1 in 38-day and 45-day old male infants who were presented with failure to thrive, vomiting and/or dehydration. Laboratory data showed hyponatremia, hyperkalemia, hypochloremia and metabolic acidosis. Renal and adrenal functions were normal. Plasma renin activity and plasma aldosterone concentration were markedly elevated. Under the diagnosis of pseudohypoaldosteronism type 1, oral supplementation of NaCl and/or kayexalate improved the clinical states of the patients.
Acidosis ; Aldosterone ; Dehydration ; Diagnosis ; Failure to Thrive ; Humans ; Hyperkalemia ; Hyponatremia ; Infant ; Male ; Plasma ; Pseudohypoaldosteronism* ; Renin ; Sodium Chloride ; Vomiting

No abstract available.
Humans* ; Knee* ; Synovial Fluid*

Arthrography is an invaluable procedure in critically verifyging the concentricity of closed reduction and the optimum position of stability. And it is known to be the most accurate and certain way of demonstrating lesser degrees of incongruity. It can visualize the intrinsic obstructive fractors, such as capsular attachment, the labrum, the psoas tendon and its relationship to the joint, the pulvinar, ligamentum teres, the inferior transverse ligament, and the shape of the femoral head and acetabulum. We analyzed 20 cases of congenital dislocation of the hip in 17 patients, which had been evaluated by arthrography. The results are as follows: 1. We found the inferior approach very efficient among many kinds of arthrographic techniques. 2. Among 20 cases, 12 cases could be treated with closed reduction and 8 cases were treated by open reduction such as capsuloplasty, partial limbusectomy, and removal of space occupying lesion in acetabulum, including 2 cases of Salter's innominate osteotomy and 1 case of derotational osteotomy. 3. Among the intracapsular obstructive factors which played major role in hindering closed reduction, capsular constriction was shown in 8 case, inverted or hypertrophic limbus in 5 cases, and other space occupying lesions in 2 cases. 4. We performed combined operation including bone and soft tissue for severe extra- and intracapsular lesions and closed reduction for mild to moderate extra- and intracapsular lesions. 5. Arthrography of the hip joint was indispensable in evaluating the intracapsular osstructive lesions as well as detecting the subtle incongruent reduction.
Acetabulum ; Arthrography ; Constriction ; Dislocations ; Head ; Hip Joint ; Hip ; Humans ; Joints ; Ligaments ; Osteotomy ; Pulvinar ; Round Ligaments ; Tendons

Nine patients with ipsilateral tibial shaft fractures and knee ligament injuries were retrospectively reviewed to determine the methods of the diagnosis and the results of the treatment. The incidence of this combined injuries was 5% in one hundred and eighty two tibial shaft fractures. The injuries of posterior cruciate ligament were combined most freqently. Five of nine patients were open fractures. Bone union was obtained in all cases and the mean duration of bone union was 22.5 weeks. Athroscopy and stress X-ray for the cruciate ligament were helpful to diagnose this combined injures. The ligament injuries were surgically managed in eight and conservatively in one. Better results were obtained when this combined injuries were operated early, but four of nine patients were disabled. The results suggest that the examination of the knee is necessary to document ligamentous injuries that occur with tibial shaft fractures.
Diagnosis ; Fractures, Open ; Humans ; Incidence ; Knee ; Ligaments ; Posterior Cruciate Ligament ; Retrospective Studies

The purpose of this study is to determine the prevalence of obesity and to examine the eating habits of elementary school students in Iksan dity. The study was carried out on 292 students(male: 151, female : 141)in May of 1997. The average height and weight of the subjects were 141 cm and 37 kg in males and 142 cm and 36 kg in females, which were similar to the average of Chonbuk. A Weight/Length Index(WLI), Broca Index, Rohrer Index(RI), Body Mass Index(BMI) and Waist Hip Ratio(WHR) were used as an obesity index to classify degree of obesity. WLI, Broca Index and RI were proper for judging child obesity and strict judgments were conducted in the order of RI, WLI and Brcoa Index. The subjects were classified as 30.8% underweight, 43.5% normal, 8.2% overweight and 17.5% obese by WLI and there were significant differences between height(p<0.05) and weight(p<0.01) according to obesity degree among the four groups. 50.3% of the boys and 55.3% of the girls are regularly, and the main reason they didn't ate regularly, and the maim reason they didn't eat breakfast(78.4%) was due to lack of time. The frequency of snacks were 1-2 times a week(40.4%), fruits(40.4%) from market and supermarket(68.2%). According to the survey 84.6%, 77.45, 78.1%, 69.9%, 59.9% and 86.6% of subjects didn't eat meat, fish, soysauce, instant food, sugar and seaweed respectively. Seaweed, meat, and soysauce showed low preferences. 69.5% and 74.75 of the subjects drink milk and ate kimchi respectively. By analyzing eating habits according to the degree of obesity, the rate of skipping breakfast(p<0.01), and eating meat or fish(p<0.05) were high in the overweight and obese groups of girls. In the boys case, the rate of not eating food in sugar(p<0.05) was high in the obese group. Obese children need to correct their eating habit. This reasserts the importance of nutrition education in children though teachers, parents, and dietitions. The findings of this study may be applied to nutrition education to ensure better physical fitness for chi......
Child ; Eating* ; Education ; Female ; Hip ; Humans ; Jeollabuk-do* ; Judgment ; Male ; Meat ; Milk ; Obesity* ; Overweight ; Parents ; Pediatric Obesity ; Physical Fitness ; Prevalence ; Seaweed ; Snacks ; Thinness

The purpose of this study was to assess the nutritional status of iron of the elderly residing in the Jeonju area. The anthropometric parameters, nutrient intake and biochemical status of iron, were measured for 60 Korean elderly(23 elderly men and 37 elderly women aged 60 - 79 years old). The level of hemoglobin(Hb), hematocrint(Hct), serum iron(Fe), total iron binding capacity(TIBC) and serum ferritin(Ferritin) were measured and transferrin saturation(TFsaturation) was calculated. Mean values of Hb, Hct, Fe, TIBC, TFsaturation and Ferritin were 14.49+/-0.93g/dl, 42.47+/-2.59%, 125.48+/-52,.46 microgram/dl, 338.13+/-45.92 microgram/dl, 193.00+/-125.03 microgram/l in elderly men and 12.82+/-0.99 microgram/dl, 37.66+/-2.90%, 100.08+/-42.82 microgram/dl, 356.41+/-54.65 microgram/dl, and 99.35+/-117.22 microgram/l in elderly women, respectively. Prevalence of iron deficiency varied greatly with biochemical indices of iron. It was 13.0% when judged by Fe(60 microgram/dl) and TFsaturation(15%) whereas 34.78% by Hct(41%) in elderly men. However 13.5% of the elderly women showed iron depletion(Ferritin<20 microgram/l) and 43.2% showed suppressed erythropoiesis with iron deficiency(TIBC>360 microgram/dl). The anemic subjects assessed with TFsaturation(<15%) represented 13.5% of the elderly women, whereas 18.9% of the subjects possessed less than 12g/dl of Hb. The Hb concentration was positively correlated with Hct(r=0.980, p<0.001), Fe(r=0.384, p<0.01) and TFsaturation(r=0.349, p<0.01). On the other hand, Ferritin concentration showed a significantly negative correlation with TIBC(r=0.349, p<0.05) and a positive correlation with TFsaturation(r=0.362, p<0.01). Major food groups of iron intake in the elderly were vegetables, cereals, and fish. The mean daily intake of iron was not significantly different between elderly men and women(12.82mg vs 10.35mg). Intake of heme iron however, was significantly higher(p<0.01) in elderly men(1.03mg) than women(0.42mg). Total absorbable iron caculated by the method of Monsen was 0.55mg, 0.40mg in elderly men and women, respectively and bioavailability of dietary iron 4.29% and 3.87%.
Aged* ; Biological Availability ; Edible Grain ; Erythropoiesis ; Female ; Ferritins ; Hand ; Heme ; Humans ; Iron* ; Iron, Dietary ; Jeollabuk-do* ; Male ; Nutritional Status* ; Prevalence ; Transferrin ; Vegetables

The purpose of this study was to assess the nutritional status of iron of the elderly residing in the Jeonju area. The anthropometric parameters, nutrient intake and biochemical status of iron, were measured for 60 Korean elderly(23 elderly men and 37 elderly women aged 60 - 79 years old). The level of hemoglobin(Hb), hematocrint(Hct), serum iron(Fe), total iron binding capacity(TIBC) and serum ferritin(Ferritin) were measured and transferrin saturation(TFsaturation) was calculated. Mean values of Hb, Hct, Fe, TIBC, TFsaturation and Ferritin were 14.49+/-0.93g/dl, 42.47+/-2.59%, 125.48+/-52,.46 microgram/dl, 338.13+/-45.92 microgram/dl, 193.00+/-125.03 microgram/l in elderly men and 12.82+/-0.99 microgram/dl, 37.66+/-2.90%, 100.08+/-42.82 microgram/dl, 356.41+/-54.65 microgram/dl, and 99.35+/-117.22 microgram/l in elderly women, respectively. Prevalence of iron deficiency varied greatly with biochemical indices of iron. It was 13.0% when judged by Fe(60 microgram/dl) and TFsaturation(15%) whereas 34.78% by Hct(41%) in elderly men. However 13.5% of the elderly women showed iron depletion(Ferritin<20 microgram/l) and 43.2% showed suppressed erythropoiesis with iron deficiency(TIBC>360 microgram/dl). The anemic subjects assessed with TFsaturation(<15%) represented 13.5% of the elderly women, whereas 18.9% of the subjects possessed less than 12g/dl of Hb. The Hb concentration was positively correlated with Hct(r=0.980, p<0.001), Fe(r=0.384, p<0.01) and TFsaturation(r=0.349, p<0.01). On the other hand, Ferritin concentration showed a significantly negative correlation with TIBC(r=0.349, p<0.05) and a positive correlation with TFsaturation(r=0.362, p<0.01). Major food groups of iron intake in the elderly were vegetables, cereals, and fish. The mean daily intake of iron was not significantly different between elderly men and women(12.82mg vs 10.35mg). Intake of heme iron however, was significantly higher(p<0.01) in elderly men(1.03mg) than women(0.42mg). Total absorbable iron caculated by the method of Monsen was 0.55mg, 0.40mg in elderly men and women, respectively and bioavailability of dietary iron 4.29% and 3.87%.
Aged* ; Biological Availability ; Edible Grain ; Erythropoiesis ; Female ; Ferritins ; Hand ; Heme ; Humans ; Iron* ; Iron, Dietary ; Jeollabuk-do* ; Male ; Nutritional Status* ; Prevalence ; Transferrin ; Vegetables

It has been known that childhood bipolar disorder is rare, especially combined with attention deficit hyperactivity disorder (ADHD). But, recent studies reported that childhood bipolar is more common than our guess. Many symptoms of childhood mania overlapped with ADHD, so it is difficult to differentiate from ADHD. It also often reported that psychostimulants, medication for ADHD, induce manic symptoms. Clinically, childhood mania has several characteristics. It is frequently chronic, mixed type, rapid cycling and often refractory to treatment. So it is important to diagnose, differentiate, treat childhood bipolar disorder and ADHD, but there is no report about comorbidity, treatment, clinical characteristics about that. We report a patient combined ADHD, mental retardation and childhood bipolar disorder.
Attention Deficit Disorder with Hyperactivity* ; Bipolar Disorder* ; Child* ; Comorbidity ; Humans ; Intellectual Disability*

Herpes simplex esophagitis can occur in those with normal immune function, but is more often seen in those who are immunocompromised. In one series, 5 percent of post-kidney transplant recipients had herpes esophagitis. We experienced a case of herpes simplex esophagitis, following renal transplantation in a 9 year old male. He complained of epigastric pain, nausea and blood-tinged vomiting. Endoscopic examination showed volcano ulcer, mucosal friability and multiple confluent ulcers covered by whitish exudates on elevated margin in the middle and lower esophagus. Microscopic findings revealed multinucleated giant cells, margination of chromatin, intense nonspecific inflammation and strong positive for herpes simplex virus immunohistochemical staining. Esophageal lesions and symptoms improved after acyclovir therapy.
Acyclovir ; Child* ; Chromatin ; Esophagitis ; Esophagus ; Exudates and Transudates ; Giant Cells ; Herpes Simplex* ; Humans ; Inflammation ; Kidney Transplantation ; Male ; Nausea ; Simplexvirus* ; Transplantation ; Ulcer ; Vomiting