PURPOSE: The present study proposes to examine the change of IOP in response to the rise of abdominal pressure and in response to position change during laparoscopic surgery. METHODS: The subjects of the present study included 28 patients who had laparoscopic appendectomy and 20 patients who had laparoscopic cholecystectomy. In both groups, the IOP was measured before surgery, after general anesthesia, after the occurrence of pneumoperitoneum, after position change according to operative method, after the removal of pneumoperitoneum and under general anesthesia. RESULTS: When comparing the IOP before and after the occurrence of pneumoperitoneum, the IOP after the occurrence increased by 3.70 +/- 0.96 mm Hg in the appendectomy group and by 3.15 +/- 0.5 mm Hg in the cholecystectomy group. After the occurrence of pneumoperitoneum, the IOP measured in the head-low position was 3.25 +/- 0.16 mm Hg higher than measured in the level position in the appendectomy group, and the IOP measured in the head-high position was 2 +/- 0.12 mm Hg lower than measured in the level position in the cholecystectomy group. Between the 2 groups, there was a significant difference of 6.5 mm Hg in IOP according to the change of head position. CONCLUSIONS: In the present study, the occurrence of pneumoperitoneum in laparoscopic surgery increased IOP, and position change according to operative method also changed IOP. In addition, IOP was significantly different between the 2 groups. In order to prevent the patient from being exposed to high IOP for a long period during laparoscopic surgery, keeping the duration of pneumoperitoneum and a head-low position to a minimum may be helpful.
Anesthesia, General ; Appendectomy ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Head ; Humans ; Intraocular Pressure ; Laparoscopy ; Pneumoperitoneum

Numerous open operations on the thoracic sympathetic ganglia for the treatment of palmar hyperhidrosis have been advocated, but have also produced several complications. A new therapeutic technique for this disorder has been introduced by combining a thoracoscope and video system. We performed thoracoscopic transthoracic sympathecomy safely and effectively in thirtyfour cases with palmar hyperhidrosis. Althought the follow up period was short, all hands of patients were dry immediately after the operation & there was no recurrence of palmar sweating. Based on our experience, this method is considered a relatively minor and safe procedure without producing significant postoperative complication, causing minimal discomfort and almost invisible scar.
Cicatrix ; Follow-Up Studies ; Ganglia, Sympathetic ; Hand ; Humans ; Hyperhidrosis* ; Postoperative Complications ; Recurrence ; Sweat ; Sweating ; Sympathectomy* ; Thoracoscopes

Endometriosis is defined as the presence of endometrial tissue(gland and stroma) outside the uterus. The incidence of scar endometriosis is quite rare, and must differentiate with cellulitis and abscess. We have experienced one case of perineal endometriosis and one case of abdominal wall endometriosis at the site of postoperative wound scar. The possible pathogenesis of endometriosis and treatment were discussed.
Abdominal Wall ; Abscess ; Cellulitis ; Cicatrix* ; Endometriosis* ; Female ; Incidence ; Uterus ; Wounds and Injuries

PURPOSE: We assessed the accuracy of urinary detection by visualization compared with a method using the urethral channel of a transurethral, three-channel urodynamic catheter. MATERIALS AND METHODS: This was a case series of 52 patients presenting with stress urinary incontinence over 2 years. Patients underwent video-urodynamic studies in both the supine and the erect positions by use of two techniques for measuring leak point pressure (LPP) by one examiner. LPP was determined as the intravesical pressure simultaneous to the starting point of urethral pressure changes through the urethral channel of a urodynamic catheter (LPP-ure) and then by visualization (LPP-vis) during different events. We also measured the time related to the provocations and the time to mark the leakage on the urodynamic machine by the examiner. RESULTS: The LPP-ure values (cough supine: 42.1+/-18.7, cough erect: 42.1+/-21.8, Valsalva supine: 42.2+/-23.3, Valsalva erect: 41.0+/-22.6 cmH2O) were significantly lower than the LPP-vis values (89.9+/-29.4, 97.4+/-30.4, 70.6+/-25.2, and 74.4+/-32.6 cmH2O, respectively, all p<0.001). Whereas the actual leakages happened during the pressure increases, urodynamic recording by visualization was done after those increases had finished. CONCLUSIONS: The use of visualization as a urinary detection method entails potential errors that cannot be adjusted for on that time scale. Our results emphasize the need to standardize the methodologies used for urinary leakage detection, because this measurement is closely related to the accuracy of measurement of leak point pressure.
Catheters ; Cough ; Female ; Humans ; Urinary Incontinence ; Urodynamics

PURPOSE: We assessed patients' understanding of benign prostatic hyperplasia (BPH) and their perspectives on the management of BPH through a questionnaire and evaluated changes in perspective after patient education. MATERIALS AND METHODS: From December 2007 to February 2008, 5 university hospitals participated in the study. A self-administered questionnaire was developed and was completed by patients before and after the patients read the patient's guide. The questionnaire was composed of 22 questions, which were grouped into 4 different categories. The patient's guide was written in everyday words and was based on the American Urological Association patient's guide. RESULTS: A total of 141 patients who visited the urology department for treatment of symptoms suggestive of BPH participated in the survey. Understanding about the statement, "BPH does not progress to become prostate cancer" was increased after reading the patient's guide (35.57%--> 73.87%, p<0.001). The most preferred treatment option was drug therapy (45.4%-->56.7%). Among the desirable effects of drug therapy, the patients' preferences were amelioration of symptoms within a few weeks (51.1%--> 48.9%), reduction in prostate size (18.4%-->24.1%), prevention of acute urinary retention (14.2%-->13.5%), and prevention of prostate surgery (7.8% -->8.5%). The potential side effect of drug therapy that patients were most concerned about was generalized weakness. Patients' reluctance to undergo surgery was increased after reading the patient guide (9.9%-->23.4%, p=0.002). CONCLUSIONS: Patients have considerable misunderstanding about BPH. More efforts should be exercised in patient education and in the development of public education programs. Because patients expect not only rapid symptom improvement but also a reduction in prostate size, physicians should consider these points when treating patients with BPH.
Hospitals, University ; Humans ; Patient Education as Topic ; Prostate ; Prostatic Hyperplasia ; Urinary Retention ; Urology

PURPOSE: To describe the normal sonographic anatomy of the submandibular duct and to assess the value of sonography in the diagnosis of sialolithiasis of the submandibular gland. MATERIALS AND METHODS: Using continuous injection of saline via a sialography needle, we evaluated the normal sonographic anatomy of the submandibular duct in healthy volunteers (n=5). We also reviewed sonographic findings in 47 patients with (n=29) or without (n=18) stones. In each case, the presence or absence of stone was proved by sialography or surgery. RESULTS: In control subjects, sonography accurately depicted the ductal anatomy of the submandibular glands and its relationship with adjacent tissues. For the detection of stones, sonography had a sensitivity of 86%, a specificity of 100%, and an accuracy of 91%. For ductal dilatation, its sensitivity was 91%, its specificity, 100%, and its accuracy, 94%. In 68% of cases with stones, a circumferential low echoic rim surrounding the stone ("rim sign") was present on sonogram. CONCLUSION: Ultrasound is a useful procedure and could replace sialography in most patients with sialolithiasis of the submandibular gland.
Diagnosis* ; Dilatation ; Healthy Volunteers ; Humans ; Needles ; Salivary Gland Calculi* ; Sensitivity and Specificity ; Sialography ; Submandibular Gland* ; Ultrasonography*

BACKGROUND: Increase of immunocompromised patients and frequent use of indwelling catheters cause staphylococcal bacteremia, especially due to coagulase-negative staphylococci (CNS), in contrast with Staphylococcus aureus in the past. And, infections of methicillin-resistant staphylococci have been increasing in number from 1970s. In this study, species of staphylococcal isolates from blood were demonstrated, and their methicillin susceptibilities were evaluated for the empirical choice of antibiotics. METHODS: One hundred and seventy-five staphylococcal strains isolated from blood culture at Pusan National University Hospital during the year 1999 were included. Species identification, susceptibility tests by agar dilution and disk diffusion methods, and mecA gene detection by polymerase chain reaction were performed. RESULTS: S. aureus (41%), S. epidermidis (30%), S. auricuralis, S. intermedius, S. haemolyticus, S. capitis, S. simulans, S. sciuri, S. homis, and S. warneri were identified. Thirty-one stains (43.4%) of S. aureus, 43 stains (83%) of S. epidermidis, and 24 stains (46%) of other CNS are resistant to oxacllin. The results of disk diffusion test were consistant with agar dilution tests in all S. aureus strains and 95.5% of CNS strains. The results of mecA gene detection were consistant with agar dilution methods in 96.8% of S. aureus and 89.6% of CNS. CONCLUSIONS: Not only S. aureus and S. epidermidis but also other various species of staphylococci were recovered from blood, and methicillin-resistant strains reached 43.2% of S. aureus, and 64.4% of CNS. These results would help for physicians to choose primary empirical therapeutic agents of patients who are suggestive of staphylococcal bacteremia.
Agar ; Anti-Bacterial Agents ; Bacteremia ; Busan ; Catheters, Indwelling ; Coloring Agents ; Diffusion ; Humans ; Immunocompromised Host ; Methicillin ; Methicillin Resistance ; Oxacillin* ; Polymerase Chain Reaction ; Staphylococcus ; Staphylococcus aureus

BACKGROUND: Chronic shoulder pain draws the attention of doctors since it is a very common and serious disease at primary care level. The patients with this pain usually have a tendency to see many doctors, to take an abundance of medication, and sometimes to even suffer from depression. The pain and the symp- toms thereof often disable the patients in their every day lives. This study aims to seek the most efficient way of treatment between two therapies, namely, the existing drug therapy based on NSAID and the intramuscular stimulation(herein after IMS) therapy, which has re- cently been introduced, by comparing them in accordance with the following method. METHODS: The two therapies were applied for 3 weeks to female patients aged between 50 and 70 who had visited a hospital over a period of more than 3 months due to this type of pain. The patients were randomly given each therapy although the treatment and monitoring was done by the same physiotherapist. The monitoring was performed four times, the day before the start of treatment, 1 week, 2 weeks and 3 weeks after respectively. It measured the following elements: (1) pain scale by VAS(Visual Analogue Scale), (2) Sleep hygiene scale by VAS, (3) ROM(Range of Motion), Repeated measure ANOVA was used for analysis. RESULTS: While both therapies reduced the pain significantly during the 3 weeks, the study showed that IMS was more effective than the drug therapy in every element monitored(p<0.05). IMS turned out to be more effective the 1st week in every measured element, however, the drug therapy was more effective the 3rd week if compared to the 2nd week in terms of Sleep VAS score. CONCLUSION: IMS is more effective in easing chro nic shoulder pain since it has better results than NSAID in pain VAS score, sleep VAS score and ROM.
Chronic Pain ; Depression ; Drug Therapy ; Female* ; Humans ; Hygiene ; Physical Therapists ; Primary Health Care ; Shoulder Pain* ; Shoulder*

PURPOSE: There were no accurate data of hematologic changes in the high school students in Korea since 1980'. Because of rapid growing of Korean students recently, it is necessary to reevaluate Korean data. So we compared hematologic changes in the students of general (GHS) and athletic high school (AHS) in Seoul city. METHODS: We reassured red cell count (RBC), hemoglobin (Hb), hematocrit (Hct), and related hematologic factors in the 452 GHS (male 290, female 162) as control group and the 138 AHS (male 70, female 68) as exercised group. Hematologic comparisons were performed between the students of AHS and GHS and the male and female students with t-test. RESULTS: 1) Values of RBC, Hb, Hct, MCHC, RDW were 4.6+/-0.3x1012/L, 13.4+/-1.2g/dL, 41.5+/- 3.4%, 32.2+/-0.5g/dL, 12.1+/-0.9% respectively in the male AHS and 5.2+/-0.3x1012/L, 15.2+/- 1.0g/dL, 46.7+/-3.0%, 32.5+/-0.5g/dL, 12.3+/-0.6% respectively in male GHS, and there were significant between compared data. 2) Values of RBC, Hb, Hct MPV were 4.5+/-0.3x1012/L, 13.6+/-1.2g/dL, 40.5+/-3.2%, 9.0+/- 0.6fl respectively in the female AHS and 5.0+/-0.5x1012/L, 14.9+/-1.3g/dL, 44.8+/-3.4%, 8.7+/- 0.8fl respectively in the female GHS, and significance were between compared data. 3) Values of MCH, MCHC, RDW, MPV were 30.1+/-1.8pg, 33.6+/-1.1g/dL, 12.8+/-1.1%, 9.0+/-0.6fl respectively in the female AHS and 29.3+/-1.8pg, 32.2+/-0.5g/dL, 12.1+/-0.9%, 8.7+/-0.9fl respectively in the male AHS, and there were significant between compared data. 4) Values of RBC, Hct, MCH, MCHC, RDW, PLT were 5.0+/-0.5x1012/L, 44.8+/-3.4%, 30.0+/-2.1pg, 33.4+/-1.1g/dL, 12.7+/-1.0%, 29.8+/-5.8x104/mm3 respectively in the female non-AHS, and 5.2+/-0.3x1012/L, 46.7+/-3.0%, 29.4+/-1.4pg, 32.5+/-0.5g/dL, 12.3+/-0.6%, 28.7+/- 5.8x104/mm3 respectively in the male non-AHS, and there were significant between compared data. CONCLUSIONS: Among the high school students, exercise caused several hematologic changes that were significant decline of the values of RBC, hemoglobin, hematocrit compared to control group regardless of sex. In female students, their values of MCH, MCHC, RDW were significantly increased compared to male students regardless of exercise.
Cell Count ; Female ; Hematocrit ; Humans ; Korea ; Male ; Seoul ; Sports

PURPOSE: There were no accurate data of hematologic changes in the high school students in Korea since 1980'. Because of rapid growing of Korean students recently, it is necessary to reevaluate Korean data. So we compared hematologic changes in the students of general (GHS) and athletic high school (AHS) in Seoul city. METHODS: We reassured red cell count (RBC), hemoglobin (Hb), hematocrit (Hct), and related hematologic factors in the 452 GHS (male 290, female 162) as control group and the 138 AHS (male 70, female 68) as exercised group. Hematologic comparisons were performed between the students of AHS and GHS and the male and female students with t-test. RESULTS: 1) Values of RBC, Hb, Hct, MCHC, RDW were 4.6+/-0.3x1012/L, 13.4+/-1.2g/dL, 41.5+/- 3.4%, 32.2+/-0.5g/dL, 12.1+/-0.9% respectively in the male AHS and 5.2+/-0.3x1012/L, 15.2+/- 1.0g/dL, 46.7+/-3.0%, 32.5+/-0.5g/dL, 12.3+/-0.6% respectively in male GHS, and there were significant between compared data. 2) Values of RBC, Hb, Hct MPV were 4.5+/-0.3x1012/L, 13.6+/-1.2g/dL, 40.5+/-3.2%, 9.0+/- 0.6fl respectively in the female AHS and 5.0+/-0.5x1012/L, 14.9+/-1.3g/dL, 44.8+/-3.4%, 8.7+/- 0.8fl respectively in the female GHS, and significance were between compared data. 3) Values of MCH, MCHC, RDW, MPV were 30.1+/-1.8pg, 33.6+/-1.1g/dL, 12.8+/-1.1%, 9.0+/-0.6fl respectively in the female AHS and 29.3+/-1.8pg, 32.2+/-0.5g/dL, 12.1+/-0.9%, 8.7+/-0.9fl respectively in the male AHS, and there were significant between compared data. 4) Values of RBC, Hct, MCH, MCHC, RDW, PLT were 5.0+/-0.5x1012/L, 44.8+/-3.4%, 30.0+/-2.1pg, 33.4+/-1.1g/dL, 12.7+/-1.0%, 29.8+/-5.8x104/mm3 respectively in the female non-AHS, and 5.2+/-0.3x1012/L, 46.7+/-3.0%, 29.4+/-1.4pg, 32.5+/-0.5g/dL, 12.3+/-0.6%, 28.7+/- 5.8x104/mm3 respectively in the male non-AHS, and there were significant between compared data. CONCLUSIONS: Among the high school students, exercise caused several hematologic changes that were significant decline of the values of RBC, hemoglobin, hematocrit compared to control group regardless of sex. In female students, their values of MCH, MCHC, RDW were significantly increased compared to male students regardless of exercise.
Cell Count ; Female ; Hematocrit ; Humans ; Korea ; Male ; Seoul ; Sports