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

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

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*

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

BACKGROUND: Almost no study has been carried out to explore the cognitive characteristics of the oldest old population in Korea, even though Korean society is becoming very 'old'. The purpose of this study is to the examine basic cognitive functions of Korean elders over 100 years of age. METHODS: Data collection was completed with 87 elders, 12 males and 75 females. Their mean age was 103.2 for males and 102.3 for females. The average year of education for this population was less than 1 year(0.5 year). We evaluated cognitive functions by K-MMSE and the severity of dementia by CDR (Clinical Dementia Rating). RESULTS: Most of them were able to speak fluently(81.6%) and had reasonable vision(67.8%), but 55.2 % of subjects had full comprehension ability. There was no significant difference in results between elders from Seoul and from other country area. We have divided the sample population into 5 groups according to CDR score; 0(7.4%), 0.5(33.3%), 1(25.9%), 2(14.8%), 3(18.5%), to compare with K-MMSE score. There were significant differences in K-MMSE scores between CDR groups. DISCUSSION: About 7% of elders over 100 years of age are still maintaining normal cognitive function. Considering the physical handicaps of the subjects, probable dementia group(30%) can also be regarded as to possess near normal cognitive function. This study is the first study on Korean centenarians and will provide essential data for future studies on the oldest old.
Aged, 80 and over ; Comprehension ; Data Collection ; Dementia ; Education ; Female ; Humans ; Korea ; Male ; Seoul

PURPOSE: To measure intraocular pressure (IOP) as a function of positional changes of the head during heavy weight lifting. METHODS: The subjects of this study were 30 healthy adult males in their twenties to forties. This study investigated their ophthalmic examinations, BMI (body mass index), and 1RM (one repetition maximum) according to the three bench press positions. RESULTS: Before exercising, the IOP was higher in the lowered head position in the decline bench press (18.20+/-2.89 mmHg) than in the incline bench press (14.38+/-2.32 mmHg) (p<0.001). The IOP increased significantly during the bench press exercise, relative to during the pre-exercise (p<0.001). Upon lift down, IOP increased by 3.72+/-1.85 mmHg greater than upon lift up, and mean IOP increased by 2.61+/-1.63 mmHg (p<0.001). In our experiments, IOP increased to a maximum of 22.10+/-2.79 mmHg, measured during lift down in the decline bench press configuration. The BMI and the IOP before exercise showed significant correlation (p<0.05). CONCLUSIONS: IOP increased more during exercise involving a lower head position. Further study is needed to know the extent to which this result is relevant for glaucoma patients and which activities and head positions during exercise may worsen glaucoma. In the meantime, patients with severe glaucoma may need to avoid lifting heavy objects with a lowered head position.
Adult ; Glaucoma ; Head ; Humans ; Intraocular Pressure ; Lifting ; Male ; Valsalva Maneuver ; Weight Lifting