PURPOSE: This study was undertaken to evaluate the safety and usefulness of laparoscopic myomectomy compare to abdominal myomectomy in pregnancy outcome through estimating the uterine wall thickness in second, third trimester pregnancy and delivery. MATERIALS AND METHODS: Total number of patients underwent operations for intramural myomectomy in Department of Obstetrics and Gynecology in Chonnam University Hospital was 95. Patients underwent laparoscopic myomectomy(Group A) patients are 42 and abdominal myomectomy (Group B) are 53 patients. Age, parity, size of fibroid, number of fibroid, indications of myomectomy, pregnancy loss, delivery methods and complications during delivery were evaluated. Uterine wall thickness in second and third trimester pregnancy was measured by Aloka SSD-2000 sonography. RESULTS: Mean age of patients was 32.84.6 years in Group A and 32.45.1 years in Group B. Operation time, admission period and postoperative complications were not sinificantly different but operative blood loss was significantly small amount in Group A(p=0.001). Pregnancy rates was 47.6%(20/42) in Group A and 49.1%(26/53) in Group B after surgery(p=0.182). Successful delivery was 80%(16/20) in Group A and 76.9%(20/26) in Group B(p=0.182). Early pregnancy loss was 20%(4/20) in Group A and 19.2%(5/26) in Group B. Therefore pregnancy rates and successful delivery was not significantly different in Group A and B. Complications of pregnancy were premature rupture of membrane, preterm labor, pregnancy induced hypertension. There were no difference between Group A and B. In delivery methods, elective cesarean section was done 15 in Group A and 16 in Group B. Vaginal delivery was done 1 in Group A and 4 in Group B. Early pregnancy loss was 4 in Group A and 6 in Group B. Mean gestational weeks was 38.02.2 in Group A and 38.21.9 in Group B. In operative findings, adhesion was 5 in Group A and 7 in Group B at previous myomectomy site. Only one case was uterine wall thinning in Group B but maternal and fetal conditions were good. Mean uterine wall thickness was 4.2 2.5mm in Group A and 4.0 2.8mm in Group B at 2nd trimester, 4.0 2.7mm in Group A and 3.8 2.5mm in Group B at 3rd trimester, 4.0 2.5mm in Group A and 3.9 2.7mm in Group B at delivery. CONCLUSION: We conclude that pregnancy after laparoscopic myomectomy is safe, useful method comparable to abdominal myomectomy without increased risk of pregnancy loss and complications.
Cesarean Section ; Female ; Gynecology ; Humans ; Hypertension, Pregnancy-Induced ; Jeollanam-do ; Leiomyoma ; Membranes ; Myoma* ; Obstetric Labor, Premature ; Obstetrics ; Parity ; Postoperative Complications ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Pregnancy Trimester, Third ; Rupture

PURPOSE: The purpose of this study was to develop a smartphone app for use in patient controlled analgesia (PCA) education and to identify PCA knowledge and pain management following lower extremity orthopaedic surgery under spinal anesthesia in patients who received smartphone app education. METHODS: Participants were 150 patients in an orthopaedic hospital located in Busan. The measurement variables used in this study were PCA knowledge, pain management and pain level. For data analysis, SPSS/WIN 21.0 program was used in the analysis of the relation of frequencies. In addition, percentage, mean and standard deviation, t-test, ANOVA, Duncan, Pearson's correlation coefficients were also assessed. RESULTS: The score for knowledge regarding PCA was 4.27±1.64. The correlations between knowledge and pain management (button push times Analgesia ; Analgesia, Patient-Controlled* ; Anesthesia, Spinal* ; Busan ; Education* ; Humans ; Lower Extremity* ; Methods ; Mobile Applications ; Orthopedics* ; Pain Management* ; Passive Cutaneous Anaphylaxis ; Smartphone* ; Statistics as Topic

Traditionally, radical hysterectomy is the main surgical method for the treatment of early cervical carcinoma and always results in the loss of fertility. But, large numbers of young women are recently being diagnosed with cervical carcinoma and fertility preservation has become a concern. So, there has been a move towards more conservative approaches for the treatment of cervical carcinoma in recent years. Radical trachelectomy, which allows preservation of uterus but removes the cervix, parametrium and upper one third of the vagina, is a conservative but locally radical procedure. We performed radical abdominal trachelectomy with pelvic lymphadenectomy for two cases of invasive cervical carcinomas, which may be the first report in korea. One patient was 37 years old single women who had stage Ib cervical cancer and was disease free for 17 months after treatment. The other patient was 19 years old student who was also single and had stage IIa cervical cancer and was disease free for 14 months after treatment. We report the first two cases and review the literature on radical trachelectomy.
Adult ; Cervix Uteri ; Female ; Fertility ; Fertility Preservation ; Humans ; Hysterectomy ; Korea ; Lymph Node Excision* ; Uterine Cervical Neoplasms ; Uterus ; Vagina ; Young Adult

No abstract available.
Female ; Ovulation* ; Pituitary Adenylate Cyclase-Activating Polypeptide*

The optimal and alternative antimicrobial regimens to treat neurosyphilis in human immunodeficiency virus (HIV) infected patients remain controversial. Little is known concerning the efficacy of ceftriaxone. A 75-year-old heterosexual man visited an outpatient clinic due to incidentally detected positive serum Venereal disease research laboratory (VDRL) and Fluorescent treponemal antibody absorbed tests in routine preoperative checkup. Because of benzathine penicillin was unavailable to use, 4-week regimen with doxycycline was started. After 2 weeks doxycycline treatment, a severe headache suddenly occurred. Cerebrospinal fluid (CSF) analysis showed mild lymphocyte-dominant pleocytosis, increased protein, and weakly reactive VDRL test. ELISA for HIV antibody and Western blot assay revealed he is infected with HIV. Initial CD4+ T cell count was 220/mm3 and the load of HIV RNA was 5,200 copies/mL. The most probable diagnosis was deemed to be neurosyphilis, considering the possibilities of Jarisch-Herxheimer reaction or doxycycline-induced pseudotumor cerebri. In the absence of procaine penicillin G in our hospital, intravenous ceftriaxone was administered and highly active antiretroviral therapy was started. After 14days of treatment, the patient no longer had a headache and the CSF profile was improved. Additional follow-up CSF analysis was done 3months after treatment. CSF pleocytosis and protein level were decreased and the CSF VDRL was converted to negative. Ceftriaxone may be a good alternative in the treatment of neurosyphilis in HIV infected patient.
Aged ; Ambulatory Care Facilities ; Antiretroviral Therapy, Highly Active ; Blotting, Western ; Ceftriaxone ; Cell Count ; Doxycycline ; Enzyme-Linked Immunosorbent Assay ; Ethylenediamines ; Follow-Up Studies ; Headache ; Heterosexuality ; HIV ; Humans ; Leukocytosis ; Neurosyphilis ; Penicillin G Benzathine ; Penicillin G Procaine ; Pseudotumor Cerebri ; RNA ; Sexually Transmitted Diseases

OBJECTIVES: The present study investigated the potential adverse effects of multi-wall carbon nanotubes (MWCNTs) on pregnant dams and embryonic development following maternal exposure in rats. METHODS: MWCNTs were orally administered to pregnant rats from gestational day (GD) 6 through 19 at dose levels of 0, 8, 40, 200, and 1000 mg/kg/day. During the test period, clinical signs, mortality, body weights, food consumption, serum biochemistry, oxidant-antioxidant status, gross findings, organ weights, and Caesarean section findings were examined. RESULTS: All animals survived to the end of the study. A decrease in thymus weight was observed in the highest dose group. However, maternal body weight, food consumption, serum biochemical parameters, and oxidant-antioxidant balance in the kidneys were not affected by treatment with MWCNTs. No treatment-related differences in gestational index, embryo-fetal mortality, or fetal and placental weights were observed between treated and control groups. CONCLUSIONS: The results show that 14-day repeated oral dosing of MWCNTs during pregnancy induces minimal maternal toxicity at 1000 mg/kg/day in rats. Under these experimental conditions, the no-observed-adverse-effect level of MWCNTs is considered to be 200 mg/kg/day for dams and 1000 mg/kg/day for embryonic development.
Animals ; Biochemistry ; Body Weight ; Carbon ; Cesarean Section ; Embryonic Development ; Female ; Kidney ; Maternal Exposure ; Nanotubes, Carbon ; No-Observed-Adverse-Effect Level ; Organ Size ; Oxidative Stress ; Pregnancy ; Rats ; Thymus Gland ; Weights and Measures

This study was conducted to investigate the potential effects of alpha-chlorohydrin (ACH) on epididymal function and antioxidant system in male rats. The test chemical was administered to male rats by gavage at doses of 0, 3, 10, and 30 mg/kg/day for 7 days. Twenty-four male rats were randomly assigned to four experimental groups, with six rats in each group. Spermatotoxicity was assessed by measurement of reproductive organ weight, testicular sperm head count, epididymal sperm motility and morphology, histopathologic examination, and oxidative damage analysis in rats. At 30 mg/kg/day, an increase in the incidence of clinical signs, epididymis weight, and gross necropsy findings of the epididymis, a decrease in the sperm motility, and an increased incidence of histopathological changes of the epididymis were observed in a dose-dependent manner. At 10 mg/kg/day, an increased incidence of clinical signs and histopathological changes and decreased sperm motility were observed. In the oxidative damage analysis, an increase in the malondialdehyde concentration and a decrease in the glutathione content and glutathione peroxidase and catalase activities in the epididymal tissue were detected at > or =3 mg/kg/day. The results show that graded doses of ACH elicit depletion of the antioxidant defense system and that the spermatotoxicity of ACH may be due to the induction of oxidative stress.
alpha-Chlorohydrin ; Animals ; Catalase ; Epididymis ; Glutathione ; Glutathione Peroxidase ; Humans ; Incidence ; Male ; Malondialdehyde ; Organ Size ; Oxidative Stress ; Rats ; Sperm Head ; Sperm Motility ; Spermatozoa

This study investigated the possible effects and molecular mechanisms of diallyl disulfide (DADS) against cyclophosphamide (CP)-induced hemorrhagic cystitis (HC) in rats. Inflammation response was assessed by histopathology and serum cytokines levels. We determined the protein expressions of nuclear transcription factor kappa-B (NF-kappaB), inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), and tumor necrosis factor-alpha (TNF-alpha), oxidative stress, urinary nitrite-nitrate, malondialdehyde (MDA), and 8-hydroxy-2'-deoxyguanosine (8-OHdG). Finally, we studied the involvement of mitogen-activated protein kinases (MAPKs) signaling in the protective effects of DADS against CP-induced HC. CP treatment caused a HC which was evidenced by an increase in histopathological changes, proinflammatory cytokines levels, urinary nitrite-nitrate level, and the protein expression of NF-kappaB, COX-2, iNOS, TNF-alpha, p-c-Jun N-terminal kinase (JNK), and p-extracellular signal regulated kinase (ERK). The significant decreases in glutathione content and glutathione-S-transferase and glutathione reductase activities, and the significant increase in MDA content and urinary MDA and 8-OHdG levels indicated that CP-induced bladder injury was mediated through oxidative DNA damage. In contrast, DADS pretreatment attenuated CP-induced HC, including histopathological lesion, serum cytokines levels, oxidative damage, and urinary oxidative DNA damage. DADS also caused significantly decreased the protein expressions of NF-kappaB, COX-2, iNOS, TNF-alpha, p-JNK, and p-ERK. These results indicate that DADS prevents CP-induced HC and that the protective effects of DADS may be due to its ability to regulate proinflammatory cytokines production by inhibition of NF-kappaB and MAPKs expressions, and its potent anti-oxidative capability through reduction of oxidative DNA damage in the bladder.
Animals ; Cyclooxygenase 2 ; Cyclophosphamide ; Cystitis* ; Cytokines ; DNA Damage ; Glutathione ; Glutathione Reductase ; Inflammation ; Malondialdehyde ; Mitogen-Activated Protein Kinases ; NF-kappa B* ; Nitric Oxide Synthase Type II ; Oxidative Stress ; Phosphotransferases ; Rats* ; Transcription Factors ; Tumor Necrosis Factor-alpha ; Urinary Bladder

Six hundred fifty-one metacarpal bones of Koreans were studied for variations in articular and non-articular surface and the number, position and direction of the diaphyseal nutrient foramina. The facets for articulation of the metacarpal bone with one another showed very frequent variations from the standard text-book description. The number and the sites of entry of the diaphyseal nutrient foramina also showed considerable variations. These findings show no apparent racial difference in variations of metacarpal bones between a Korean and an Indian.
Metacarpal Bones*

OBJECTIVE: To determine the efficacy and safety of labor induction in patients previously delivered by a low transverse cesarean section. METHOD: A retrospective review was done at Chonnam National University Hospital, Kwangju, Korea. All patients with a previous cesarean section who required labor induction from April, 1986 to June, 1999 were identified. Outcome of labor induction, including mode of delivery, maternal and perinatal morbidity, and birth trauma were evaluated. RESULTS: Trial of labor was undertaken by 1256 women(55.8%) who had previously been delivered by a low transverse cesarean section. 973 patients(77.5%) with a previous cesarean birth had a spontaneous onset of labor. Labor was induced in 283 patients(22.5%) with a previous cesarean birth. Successful vaginal delivery rate were 82.9%(807/973) in spontaneous labor and 79.2%(224/283) in induced labor group (p= NS). There were no differences in uterine dehiscence and rupture rate, perinatal and maternal mortality rate, and the rate of infants with low 1 or 5-minute Apgar scores between patients attempting a trial of labor after cesarean, spontaneous and induced. CONCLUSION: we conclude that labor induction in patients with a previous low transverse cesarean section is a safe procedure requiring close peripartum maternal and fetal surveillance.
Cesarean Section ; Female ; Gwangju ; Humans ; Infant ; Jeollanam-do ; Korea ; Labor, Induced ; Maternal Mortality ; Parturition* ; Peripartum Period ; Pregnancy ; Retrospective Studies ; Rupture ; Trial of Labor