From January 1995 to December 1997, a total of 219 cases pelviscopic surgery was performed at Il Sin Christian Hospital. To evaluate the safty and efficacy of pelviscopic surgery, we reviewed indication of operation, mean age, parity, history of abdominal operation, type of operation, duration of hospitalization and complication retrospectively. The number of pelviscopic surgery have risen from 33 cases in 1995 to 53 cases in 1996 and 133 cases in 1997. The most common indications were 118 cases for ectopic pregnancy (53.9%) and 42 cases for ovarian cyst (19.2%), 20 cases for infertility (9.1%) in order. Among the ovarian cyst, endometrioma was the most common. The mean age of patients was 31+/-6.7 years old and mean parity was 0.77. In most cases, mean blood loss was lesser than 100 cc except 500 cc in LAVH, 150 cc in CISH, 106.7 cc in ectopic mass removal. The postoperative hospital stay was varied from 0 day to 10 days, but usually 2 days. The 26 cases had complicated and the most common complication was fever above 38degrees C. In conclusion, it is evident that pelviscopic surgery is lesser invasive technique, has lower complication rate and shorter the length of hospitalization. So, we expect the number and indication of pelviscopic surgery will be increased in future.
Endometriosis ; Female ; Fever ; Hospitalization ; Humans ; Infertility ; Length of Stay ; Ovarian Cysts ; Parity ; Pregnancy ; Pregnancy, Ectopic ; Retrospective Studies

OBJECTIVES: The purpose of this study was to examine the effects of positive psychological characteristics on posttraumatic stress symptoms after traumatic experiences. METHODS: The subjects were 97 firefighters (83 males and 14 females), who completed the Life Events Scale, the Rosenberg Self-Esteem Scale, the Connor-Davidson Resilience Scale, and the Impact of Event Scale-Revised Korean version. Pearson product-moment correlation coefficients were computed to examine the relationships among the variables, and Structural Equation Modeling was used to investigate the mediation process in the relationships among traumatic experiences, positive psychological characteristics, and posttraumatic stress. RESULTS: The results showed that self-esteem had a mediating effect on the relationship between traumatic experiences and posttraumatic stress symptoms. Traumatic experiences affected posttraumatic stress symptoms not only directly, but also through self-esteem to posttraumatic stress symptoms. Therefore the lower firefighters' self-esteem was, the more posttraumatic stress symptoms occurred. Resilience, however, apparently had no function as mediating variable in the relationship between traumatic experiences and posttraumatic stress symptoms. Traumatic experiences and resilience each seemed to affect posttraumatic stress symptoms directly. Hence, the lower firefighters' resilience was, the more posttraumatic stress symptoms occurred. CONCLUSION: This study showed that self-esteem had a mediating effect on the relationship between traumatic experiences and posttraumatic stress symptoms. We also found that resilience affects posttraumatic stress symptoms directly, regardless of the number of traumatic experiences. Likewise, these results showed that we should be concerned in positive psychological characteristics such as self-esteem and resilience in order to prevent posttraumatic stress symptoms.
Firefighters ; Humans ; Male ; Negotiating

BACKGROUND: Anesthetic requirements are affected by the preoperative levels of some hormones. This study investigated to identify the hormonal status such as plasma level and maximal secretary capacity correlating with propofol and remifentanil requirements in pituitary adenoma patients who show various hormonal secretory states perioperatively. METHODS: From 51 adult female pituitary adenoma patients, preoperative basal values and maximal stimulated levels of various hormones related to the axis of hypothalamus-pituitary-target organs on combined pituitary function test were recorded. Total intravenous anesthesia using target controlled infusion with propofol and remifentanil was administered. The effect-site concentration (Ce) of propofol reaching anesthetic induction and the consumed dosages of propofol and remifentanil during operation were measured. Anesthetic maintenance was controlled within 30% of preanesthetic hemodynamic variables by remifentanil and within ranges of BIS 45 +/- 10 by propofol. Spearman correlations between hormonal status and anesthetic requirements such as propofol Ce for induction, total consumed doses of propofol and remifentanil were performed with a statistical significance at P of 0.05. RESULTS: The preoperative basal level of ACTH was correlated positively with propofol induction Ce and maintenance dose, and the maximal secretory capacity of prolactin also correlated positively with propofol induction Ce. Remifentanil consumption dose was not related with any hormones measured regardless of either preoperative basal levels or maximal secretory levels. CONCLUSIONS: Propofol requirements may be related with preoperative plasma level of ACTH or maximal secretory capacity of prolactin.
Adrenocorticotropic Hormone ; Adult ; Anesthesia, Intravenous ; Axis, Cervical Vertebra ; Female ; Hemodynamics ; Humans ; Piperidines ; Pituitary Function Tests ; Pituitary Neoplasms ; Plasma ; Prolactin ; Propofol

Background: A national immunization program (NIP) to prevent disease and reduce mortality from vaccine preventable diseases (VPD) is very important. Methods: We analyzed only the anaphylaxis cases that occurred between 2001 and 2016 that Korea Centers for Disease Control and Prevention (KCDC) determined had a definite causal relationship with a vaccine. The clinical symptoms were assessed according to the Brighton Collaboration case definition (BCCD) level. Results: During the period, there were 13 cases of vaccine-related anaphylaxis. The median age was 9 years (range, 1 month to 59 years). The incidence of anaphylaxis per million doses was 0.090 in 2005, 0.079 in 2012, 0.071 in 2013, 0.188 in 2015, and 0.036 in 2016. Of those cases, 23.1% were influenza vaccines, and 76.9% were BCCD level 2. Epinephrine was used in 46.2%. Conclusion Vaccine-related anaphylaxis seems to have been very rare in the past, but health care professionals must always be aware of anaphylaxis.

OBJECTIVE: The Connor-Davidson Resilience Scale (CD-RISC) measures various aspects of psychological resilience in patients with posttraumatic stress disorder (PTSD) and other psychiatric ailments. This study sought to assess the reliability and validity of the Korean version of the Connor-Davidson Resilience Scale (K-CD-RISC). METHODS: In total, 576 participants were enrolled (497 females and 79 males), including hospital nurses, university students, and firefighters. Subjects were evaluated using the K-CD-RISC, the Beck Depression Inventory (BDI), the Impact of Event Scale-Revised (IES-R), the Rosenberg Self-Esteem Scale (RSES), and the Perceived Stress Scale (PSS). Test-retest reliability and internal consistency were examined as a measure of reliability, and convergent validity and factor analysis were also performed to evaluate validity. RESULTS: Cronbach's alpha coefficient and test-retest reliability were 0.93 and 0.93, respectively. The total score on the K-CD-RISC was positively correlated with the RSES (r=0.56, p<0.01). Conversely, BDI (r=-0.46, p<0.01), PSS (r=-0.32, p<0.01), and IES-R scores (r=-0.26, p<0.01) were negatively correlated with the K-CD-RISC. The K-CD-RISC showed a five-factor structure that explained 57.2% of the variance. CONCLUSION: The K-CD-RISC showed good reliability and validity for measurement of resilience among Korean subjects.
Depression ; Female ; Firefighters ; Humans ; Reproducibility of Results ; Resilience, Psychological ; Stress Disorders, Post-Traumatic

BACKGROUNDS: It is to find out ins and outs of falls, and then to study risky factors that are preventable. METHODS: Total 260 elderly people living in Nonsan who are 60 years old and over were analyzed for data. Stereotyped of those are populational, social specific, physical functions, and basis diseases. And concerning falls, it was analyzed if they have had experience of up to 5 times within 3 years recently. RESULTS: The analyzed are total 260 people, men 112(43%), and women 148(57%). And the ones who answered they have had experience of falls are 108(41.6%), men 31(28.7%), and women 77(71.3%), showing a distinguishable difference between two groups. Women have had more experience than men have(p<0.001), and according to their age, the average age of those experienced falls showed to be higher than the one of those who have not(p=0.036). And according to their education, the ones who did not go to any schools have had more experience than those who did, showing the education has something to do with falls(p<0.001). The mean mass index(p=0.043) and average weight(p=0.023) also showed a mere difference between the group of the people who have had experience and the one of those who have not. Taking into account the fact that there were more women in the group who have had experienced falls, it is shown that there is nothing practical to pay attention to. In Activity of Daily Living(ADL) the experienced is 10.8(+/-4.2), and the unexperienced 9.1(+/-3.1), showing a mere difference between two groups(p<0.000). Concerning chronic diseases, there was no difference between those two groups, but individual patient histories showed that the experienced group had less rheumatic trouble than the unexpedenced(p=0.033). Looking at the difference of the causes for the falls according to their gender, the range of their movements(p=0.043), illumination(p=0.012), influence of alcoho1(p=0.001), and the shoes when they were falling down(p<0.001), the first aid treatments after falls(p=0.014), and influence of medications(p<0.001) showed a mere difference between men and women, while did not show any difference in seasons, time of falls, places, and the descriptions of the surfaces of the places. The mean number of falls within recent 3 years of the experienced was 1.79 times, and the comparison of the relation between the frequency and the causes of falls was done between the ones with experience of I fall, and the ones with experience of more twice falls. The average height(p=0.046) was much higher thai those with experience of more than 2 falls. There was also a mere difference between two groups in movements(p=0.009), illumination(p=0.005), influence of alcohol(p=0.003), the shoes (p=0.048), and first aid treatments after falls(p<0.001). CONCLUSION: The group with higher risk rate includes women, age, poor education, skinny physical figures, and lack of ability to act in daily life. Therefore, those results should be considered when a preventive program of falls for elderly people is designed.
Aged* ; Asian Continental Ancestry Group ; Chronic Disease ; Chungcheongnam-do ; Education ; Female ; First Aid ; Humans ; Male ; Middle Aged ; Prevalence* ; Seasons ; Shoes

Remote cerebellar hemorrhage (RCH) is a rare complication of neurosurgical procedures and is characterized by a typical bleeding pattern defined as the “zebra sign.” Only few cases of RCH have been reported in the English literature, and its pathophysiology remains unclear. In this report, we present the cases of three patients with RCH after three different procedures: burr-hole trephination and chronic subdural hematoma evacuation of bilateral cerebral convexity with subsequent subdural drain insertion, lumbar drainage for cerebrospinal fluid divergence for thoracic endovascular aortic repair, and combined bypass surgery for moyamoya disease.

PURPOSE: Adipose tissue-derived stem cells(ADSC) has an osteoconductive potential and demineralized bone matrix(DBM) is an osteoinductive material. A combination of DBM and ADSC wound probably create osteoinductive properties. The purpose of this study is to determine the effect of the combination of DBM and ADSC mixture on healing of rat calvarial defect. METHODS: Thirty adult male Sprague-Dawley rats were randomized into 3 groups(n=10) as 1) Control, 2) DBM alone, 3) DBM with ADSC mixture. DBM with ADSC mixture group has had a 3-day preculture of ADSC from groin fat pad. An 6 mm critical size circular calvarial defect was made in each rat. Defect was implanted with DBM alone or DBM with ADSC mixture. Control defect was left unfilled. 6 and 12 weeks after the implantation, the rats were sacrificed and the defects were evaluated by histomorphometric and radiographical studies. RESULTS: Histomorphometric analysis revealed that DBM with ADSC mixture group showed significantly higher bone formation than DBM alone group(p<0.05). Although radiographs from DBM alone group and DBM with ADSC group revealed similar diffuse radiopaque spots dispersed throughout the defect. Densitometric analysis of calvarial defect revealed DBM with ADSC mixture group significantly higher bone formation than DBM alone(p<0.05). There was correlation of densitometry with new bone formation(Spearman's correlation of coefficient=0.804, 6 weeks, 0.802, 12 weeks). CONCLUSION: The DBM with ADSC mixture group showed the best healing response and the osteoinductive properties of DBM were accelerated with ADSC mixture. It will be clinically applicable that DBM and ADSC mixture in plastic and reconstructive surgery, such as alveolar cleft and congenital facial deformities that bone graft should be required.
Adipose Tissue ; Adult ; Animals ; Congenital Abnormalities ; Densitometry ; Groin ; Humans ; Male ; Osteogenesis ; Rats ; Rats, Sprague-Dawley ; Transplants

OBJECTIVES: Exposure assessment is a major challenge faced by studies that evaluate the association between pesticide exposure and adverse health outcomes. The objective of this study was to investigate the reliability of information that farmers self-report regarding their pesticide use. METHODS: Twenty five items based upon existing questionnaires were designed to focus on pesticide exposure. In 2009 a self-administrated survey was conducted on two occasions four weeks apart among 205 farmers residing in Gyeonggi and Gangwon provinces. For a reliability measure, we calculated the percentage agreement, the kappa statistics and the intraclass correlation coefficient (ICC) between the two reports according to the characteristics of the subjects. RESULTS: Agreement for ever-never use of any pesticide was 96.4% (kappa 0.61). For both 'years used' and 'age at the first use' of overall pesticides, high agreement was obtained (ICC: 0.88 and, 0.78, respectively), whereas those of 'days used' and 'hours used' were relatively low (ICC: 0.42 and, 0.66, respectively). The kappa value for the use of personal protective equipment ranged from 0.46 to 0.59, and hygiene activities came out at 0.19 to 0.37. The agreement for individual pesticide use ranged widely and there was relatively low agreement due to the low response rates. The reliability scores did not significantly vary according to gender, age, the education level, the types of crop or the years of farming. CONCLUSIONS: Our results support that carefully designed, self-reported information on ever-never pesticide use among farmers is reliable. However, the reliability of data on individual pesticide exposure may be unstable due to low response rates and needs to be refined.
Adult ; Agriculture/*statistics & numerical data ; Female ; Humans ; Male ; Middle Aged ; Occupational Exposure/prevention & control/*statistics & numerical data ; *Pesticides ; Protective Clothing ; Self Report

Objective: To investigate the clinical feasibility of synthetic diffusion-weighted imaging (sDWI) at different b-values in patientswith breast cancer by assessing the diagnostic image quality and the quantitative measurements compared with conventionaldiffusion-weighted imaging (cDWI). Materials and Methods: Fifty patients with breast cancer were assessed using cDWI at b-values of 800 and 1500 s/mm2 (cDWI800and cDWI1500) and sDWI at b-values of 1000 and 1500 s/mm2 (sDWI1000 and sDWI1500). Qualitative analysis (normal glandulartissue suppression, overall image quality, and lesion conspicuity) was performed using a 4-point Likert-scale for all DWI setsand the cancer detection rate (CDR) was calculated. We also evaluated cancer-to-parenchyma contrast ratios for each DWI setin 45 patients with the lesion identified on any of the DWI sets. Statistical comparisons were performed using Friedman test,one-way analysis of variance, and Cochran’s Q test. Results: All parameters of qualitative analysis, cancer-to-parenchyma contrast ratios, and CDR increased with increasingb-values, regardless of the type of imaging (synthetic or conventional) (p< 0.001). Additionally, sDWI1500 provided better lesionconspicuity than cDWI1500 (3.52 ± 0.92 vs. 3.39 ± 0.90, p< 0.05). Although cDWI1500 showed better normal glandular tissuesuppression and overall image quality than sDWI1500 (3.66 ± 0.78 and 3.73 ± 0.62 vs. 3.32 ± 0.90 and 3.35 ± 0.81, respectively;p< 0.05), there was no significant difference in their CDR (90.0%). Cancer-to-parenchyma contrast ratios were greater insDWI1500 than in cDWI1500 (0.63 ± 0.17 vs. 0.55 ± 0.18, p< 0.001). Conclusion sDWI1500 can be feasible for evaluating breast cancers in clinical practice. It provides higher tumor conspicuity,better cancer-to-parenchyma contrast ratio, and comparable CDR when compared with cDWI1500.