For the clinical analysis and evaluation on the patients with gestational trophoblastic disease(GTD), a study was done retrospectively on 114 patients with GTD(60 in Hydatidiform mole, 10 in invasive mole, 44 in choriocarcinoma) treated from Jan. 1, 1985 to Dec. 31, 1994 at the Department of Obstetrics and Gynecology, Kosin Medical College, Pusan, Korea. We obtained the following results ; The incidence of GTD was 1 per 73 deliveries in H. mole, 1 per 437 deliveries in invasive mole, and 1 per 99 deliveries in choriocarcinoma. The most prevalent age was 21-40 groups. Abnormal vaginal bleeding was a main symptom and sign. 30.6% of H. mole was managed by dilatation and curettage. 90.0% of invasive mole and 51.4% of choriocarcinoma were managed by surgical treatment and chemotherapy. The overall remissinon rate of choriocarcinoma was 71.4%(100.0% in stage I, 66.7% in stage II, 54.5% in stage III, 50.0% in stage IV).
Busan ; Choriocarcinoma ; Dilatation and Curettage ; Drug Therapy ; Female ; Gestational Trophoblastic Disease* ; Gynecology ; Humans ; Hydatidiform Mole ; Hydatidiform Mole, Invasive ; Incidence ; Korea ; Obstetrics ; Pregnancy ; Retrospective Studies ; Trophoblasts ; Uterine Hemorrhage

To evaluate the effectiveness of conization in the diagnosis of cervical cancer, the histopathologic finding of 464 consecutive cases were analized with respect to the cytology, punch biopsy and hysterectomy. Cold knife conization was performed under direct visualization(naked eye conization) from January, 1987 to Octorber 1994 at department of Obstetrics and Gynecology, Kosin Medical Center. The results were summerized as follows : 1. The rate of agreement and underdiagnosis of between pap smear and naked eye conization were 43.7% and 47%. 2. The rate of agreement and underdiagnosis of between punch biopsy and naked eye conization were 64.5% and 21.8% 3. Subsequent hysterectomy was done on the 382 case and their incidence of residual disease rate was 44.2%(169 cases). Their incidence of residual lesion was increased with severity of the carcinomatous change. 4. The rate of complication undergoing conization was 8.4%(39 cases).
Biopsy ; Conization* ; Diagnosis ; Gynecology ; Hysterectomy ; Incidence ; Obstetrics ; Uterine Cervical Neoplasms

The purpose of this study was to explore the relationship between dietary behavior and the nutrient intake status in the youth of rural areas, based on their personal characters such as their sex, age, family type, number of family members, mother's age, occupation, and school career. This study was made by use of a self-administrated questionnaire with a 24-hour recall for 5days as an instrument with 439 randomly selected students. Statistical methods applied to analyze the data were frequency, percent, Willcoxon Rank-sum test, Kruskal-wallis test, x2-test by contingence table, and Spearman's correlation coefficient in non parametric statistical cases. Some of the interesting results are as follows : 1) The correlation between sex and breakfast is highly significant. That is, over 80% of male students had breakfast every day, whereas only about 60% of female students had breakfast every day. Bad table manners and some other problems are insignificant with respect to the personal characters in the relations between the personal characters and eating behaviors. However, the regularity of every meal, the frequency of having meals with other family members, and the frequency of meals eaten out and snacks show significant differences. 2) The mother's occupation does not have any influence on the nutrient intake of their students when the relationship between personal characters and nutrient intake was analysed. On the other hand sex, the mother's school career, the numbers of family members, the type of family, and the income of the family showed significant differences nutrient intakes. 3) The regularity and the frequency of having meals, meals eaten out with their family members, and the table manners during meals showed significant differences in the intake of nutrient elements such as calorie, protein, fat, fiber, calcium, iron, phosphorus, vitamin B1, vitamin B2, niacin and vitamin C. However some consideration during meals and problems in eating habit are insignificant with regard to nutrient intake.
Adolescent ; Ascorbic Acid ; Breakfast ; Calcium ; Eating ; Feeding Behavior ; Female ; Hand ; Humans ; Iron ; Korea* ; Male ; Meals ; Niacin ; Occupations ; Phosphorus ; Riboflavin ; Snacks ; Thiamine ; Surveys and Questionnaires

PURPOSE: Actinomycosis is still a relatively rare infection, characterized by multiple abscesses, draining sinuses and the appearance of sulfur granules, which are valuable in aiding the diagnosing the discharge of involved tissues. In most instances, the onset of an abdominal disease is preceded by inflammatory or a traumatic incident resulting in the perforation of the mucosa of the gastrointestinal tract. Intensive and prolonged antimicrobial therapy, and wide surgical excision of involved tissues are the two general principles of therapy. METHODS: We experienced 8 cases of abdominal actinomycosis after a laparotomy between March 1997 and February 2002. RESULTS: The results were as follows: 1) There was a 1: 1 male to female ratio of abdominal actinomycosis, and a mean age of 47 years. 2) The clinical features were different for each involved organ, -but, most of the clinical symptoms were nonspecific to suspect actinomycosis. 3) The frequently involved organs were mainly located lower abdomen, such as the appendix and cecum, sigmoid colon and small bowel. 4) In 60% of the patients, the predisposing factors were identifiable, these being: a previous abdominal operation, IUD and abdominal injury. 5) The preoperative diagnoses included: acute appendicitis, and periappendiceal and intra-abdominal abscesses. The pre-exploratory diagnoses were made by ultrasound and abdominal CT. 6) Explorations were performed in all patients, depending on their diagnosis, to afford the proper surgical treatment and correct diagnosis. After the operation, all the patients were treated with oral antibiotics for long period. CONCLUSION: The authors conclude that pre-exploratory cytological or culture studies, with careful history taking, for low abdominal tumors or abscesses may increase the rate of correct diagnosis, as could proper explorations.
Abdomen ; Abdominal Abscess ; Abdominal Injuries ; Abscess ; Actinomycosis* ; Anti-Bacterial Agents ; Appendicitis ; Appendix ; Causality ; Cecum ; Colon, Sigmoid ; Diagnosis ; Female ; Gastrointestinal Tract ; Humans ; Laparotomy ; Male ; Mucous Membrane ; Sulfur ; Tomography, X-Ray Computed ; Ultrasonography

Absence of one tube and a corresponding ovary is very rare anomaly.We reported a case of absence of one tube and a corresponding ovary and reviewthe literature briefly.
Female ; Ovary*

An increase in the dose of chemotherapy enhances the response of many experimental and clinical cancers, but the extent of chemotherapy dose escalation and repeated use is often limited by myelosuppression. The side effects of chemotherapy including bleeding and infection due to myelosuppression have resulted in delayed therapy and a reduction in the therapeutic dose, therefore it is necessary to overcome myelosuppression especially leukopenia in patients with gynecologic malignancies who recieved chemotherapy. This study is undertaken to investigate the clinical effects of rhG-CSF(recombinant human Granulocyte-colony stimulating factor) in 29 patients with gynecologic malignancy who recieved chemotherapy. It was given at a dose of 100 microgram bid/day subcutaneously until significantly increase of leukocyte count in leukopenic patient. The results showed, the rhG-CSF has significantly increased the number and function of leukocyte. The use of rhG-CSF was effective and useful to treat chemotherapy induced leukopenia and to accelerate the recovery from this complications.
Drug Therapy* ; Hemorrhage ; Humans* ; Leukocyte Count ; Leukocytes ; Leukopenia*

A study was to evaluate the efficacy and clinical utility of second look operation in the managements of malignant ovarian tumor at the Department of Obstetrics and Gynecology, Kosin medical colleage from January 1986 to September 1993. Of 220 patients diagnosed as ovarian cancer, 48 patients who had underwent primariy laparotomy were performed second look operation. Thirty-seven patients were found to have no evidence of disease. The result revealed that negative second look operation rate was noted 96.3% at stage I, 66.6% at stage II, 50.0% at stage III, and 42.9% at stage IV and total negative second look operation rate was 77.1%. The 2 year survival rate for stage I, II, III, IV were 85.2%, 66.6%, 50.0% and 42.9% respectively. The survival rate of negative second look operation was 86.5%, that of positive second look operation was 18.1%. In conclusion, second look operation in early stage ovarian cancer need to be justified.
Follow-Up Studies* ; Gynecology ; Humans ; Laparotomy* ; Obstetrics ; Ovarian Neoplasms* ; Survival Rate

BACKGROUND: Propofol has been used for the induction and maintenance of obstetric anesthesia for its potential benefit of rapid recovery and less post-anesthetic complications. In order to determine the safe application of target-controlled infusion of propofol and fentanyl during Cesarean section under general anesthesia, we have investigated the adequate target concentrations of each drug using the bispectral index and hemodynamic parameters. METHODS: Ninety-two pregnant women who received Cesarean section under general anesthesia were enrolled in this study. After preoxygenation, anesthesia was induced with thiopental 4 mg/kg and succinylcholine 1 mg/kg, and intubation was done. Vecuronium 0.1mg/kg I.V. was applied for muscle relaxation, and mechanical ventilation was maintained with N2O/O2 (2 L/2 L)-enflurane. EtCO2 was maintained between 30 35 mmHg. After delivery of the fetus, propofol and fentanyl was infused by a computer-assisted continuous infusion system with air/O2 (2 L/2 L). The bispectral index was monitored perioperatively. This study proceeded in three stages. In the first stage, thirty women were studied for titration of the target effect-site concentration of propofol that could maintain a bispectral index between 40 60 while maintaining the target concentration of fentanyl at 1.5 ng/ml. In the second stage, forty-two women were randomly assigned into the four different groups (F25, F50, F75, F100) at target fentanyl concentrations of fentanyl of 0.25, 0.50, 0.75 and 1.0 ng/ml for each group respectively. The adequate target concentration of fentanyl was titrated. In the third stage, twenty women were studied for assessment of the adequacy of target concentrations of propofol and fentanyl prospectively. RESULTS: The target effect-site concentrations (Ce, 95% confidence interval) that could maintain 50% and 95% of patients hemodynamically stable with the bispectral index within 40-60 were 2.41 (2.27-2.55) microgram/ml and 3.15 (2.95-3.50) microgram/ml for propofol, 0.32 (0.13-0.46) ng/ml and 0.84 (0.66-1.29) ng/ml for fentanyl. The pre-anesthetic bispectral index was 97.1+/-1.2 and it decreased maximally to 39.5+/-6.47 after thiopental injection and increased maximally to 83.6+/-6.3 before delivery and it was 80.6+/-6.9 for eye-open to verbal command during recovery. CONCLUSIONS: The adequate target effect-site concentrations of propofol and fentanyl for the maintenance of total intravenous anesthesia during Cesarean section were determined and these concentrations were validated prospectively.
Anesthesia ; Anesthesia, General ; Anesthesia, Intravenous* ; Anesthesia, Obstetrical ; Cesarean Section* ; Female ; Fentanyl* ; Fetus ; Hemodynamics ; Humans ; Intubation ; Muscle Relaxation ; Pregnancy ; Pregnant Women ; Propofol* ; Prospective Studies ; Respiration, Artificial ; Succinylcholine ; Thiopental ; Vecuronium Bromide

BACKGROUND: The relationship between viral hepatitis and lichen planus (LP) remains as a matter of controversy. Geographical variations are suggested to be a major factor influencing such association. Reliable figures from Korean patients are still lacking. OBJECTIVE: The aim of this study is to determine the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in Korean patients with lichen planus (LP) and to compare it with patients without LP. METHODS: The retrospective study was performed on 45 LP patients and 45 controls with matching age and gender. We examined for serological evidences of hepatic disease, hepatitis B surface antigen (HBsAg), and anti-HCV seropositivity. Statistical analysis was calculated by using an unpaired t-test and Fisher's exact test. RESULTS: No significant differences between the serum levels of alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were observed between the two groups. The prevalence of HBsAg in LP patients (4.4%) was not significantly higher (p>0.05) than those of the control subjects (2.2%). None of the patients with LP nor the control subjects had Anti-HCV. CONCLUSION: Korean patients with LP did not have any significant associations with liver diseases or HBV, and HCV infections. Although a large-scale multicenter study is needed to support our results, it is not advisable for Korean patients with LP to be tested for liver functions or HBV, and HCV infections as part of a routine screening test.
Alanine Transaminase ; Aspartate Aminotransferases ; Hepacivirus ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis* ; Humans ; Lichen Planus* ; Lichens* ; Liver Diseases ; Liver Function Tests* ; Liver* ; Mass Screening* ; Prevalence ; Retrospective Studies

BACKGROUND: Low values of lung compliance have been reported in patients with increased pulmonary blood flow due to intracardiac left to right(L-R) shunt. The compliance had returned to within normal limits 4 to 6 weeks after surgical correction of the shunt. We investigated whether lung compliance was improved immediately after surgical correction of the shunt. METHODS: Fifty four pediatric patients who were undergoing repair of intracardiac L-R shunt were evaluated. Lung compliance, arterial oxygen tension(PaO2) and arterial to end-tidal carbon dioxide tension difference(Pa-ETCO2) were measured after induction of anesthesia and at the completion of surgery. Left atrial pressure(LAP) was monitored. Lung compliance and end-tidal carbon dioxide tension were measured by monitoring system built in Cato anesthetic ventilator system. RESULTS: Lung compliance was significantly lower after surgery(6.57+/-6.46 ml/mbar) than after induction of anesthesia(7.71+/-7.18 ml/mbar). After surgery, PaO2 was significantly decreased and Pa-ETCO2 significantly increased than after induction of anesthesia. The decrease in lung compliance after surgery significantly correlated with a decrease in PaO2(r=0.43) and an increase in Pa-ETCO2 (r=0.47) but not correlated with LAP. CONCLUSIONS: Although surgical correction of intracardiac L-R shunt reduces pulmonary blood flow, the lung compliance decreases in immediate postoperative period. Therefore a deterioration of postoperative lung compliance may need judicious management for pulmonary and hemodynamic instability.
Anesthesia ; Carbon Dioxide ; Compliance ; Hemodynamics ; Humans ; Lung Compliance* ; Lung* ; Oxygen ; Postoperative Period ; Ventilators, Mechanical