No abstract available.
Portacaval Shunt, Surgical*

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

Azithromycin* ; Doxycycline* ; Scrub Typhus*

The recent introduction of chemotherapy in the treatment of the gynecologic malignancies has gained wide acceptance along with preoperative and postoperative adjuvant therapy and with preradiation and concurrent chemoradiaton therapy. But, the side effects of chemotherapy including bleeding and infection due to bone marrow suppression have resulted in increased morbidity and mortality of the patients and delayed treatment and a reduction in the chemotherapeutic agents used. In spite of the development of antibiotics and the supportive care of infection, sustained leukopenia in the patients during chemotherapy accounts for the high mortality rate due to sepsis. The early detection of the leukopenia during chemotherapy may enable clinicians to overcome infection problems by timely use of prophylactic broad spectrum antibiotics and G-CSF or GM-CSF. The author investigated the grade, duration, time of onset and other clinical features of the leukopenia and the effects of the age (> or =60 years vs <60 years), the number of the cycle of chemotherapy (> or =3 cycles vs < 3 cycles), fever and performance scale on the leukopenia. 79 cases (32 patients) of the leukopenia during chemotherapy of various gynecologic malignancies at the Department of Obstetrics and Gynecology at Hanyang University between January, 1996 and December, 1998 entered to this study. The results were as follows; 1. Leukopenia occurred at 14.2+/-6.1 day from the first day of chemotherapy, 2. The duration of leukopenia was 2.5+/-1.6 days 3. No significant difference was found between eldely patients ( > or =60 years, n=13) and younger patients ( <60 years, n=66) about the severity, duration and time of onset of leukopenia. 4. No significant difference was found between the patients with more than 3 cycles of chemotherapy (n=40) and less than 3 cycles (n=39) about the severity, duration and time of onset of leukopenia. 5. Febrile leukopenic cases (n=6) had significantly lower granulocyte count, longer leukopenic period and earlier onset of leukopenia than afebrile (n=73). 6. It is thought that performance status scale does not affect the grade of leukopenia, onset of leukopenia and the leukopenic period.
Anti-Bacterial Agents ; Bone Marrow ; Drug Therapy* ; Fever ; Granulocyte Colony-Stimulating Factor ; Granulocyte-Macrophage Colony-Stimulating Factor ; Granulocytes ; Gynecology ; Hemorrhage ; Humans ; Leukopenia* ; Mortality ; Obstetrics ; Sepsis

OBJECTIVE: The purpose of this study is to evaluate the clinicopathologic characteristics of the torsion of the ovarian tumor in postmenopausal women. METHODS: We reviewed the medical records of 20 postmenopausal patients with a postoperative diagnosis of torsion of the ovarian tumor in Department of Obstetrics and Gynecology, Hanyang University Hospital from January 1989 to December 1998. RESULTS: The postmenopausal patients with torsion of the ovarian tumor constitute 20/94 (21.3%) of all adnexal torsion patients encountered during this period. The mean (+/-SD) age of the 20 patients was 63.5+/-9.0 years, with a range of 52-90 years. The mean time since menopause was 16.5+/-10.3 years, with a range of 1-39 years. The mean parity was 5.4+/-2.0 (range of 3-10). Lower abdominal pain (65%) was the most frequently presenting symptom, palpable mass(20%) or diagnosed mass(15%) being the second. But, in 20% of cases there was no lower abdominal pain. The torsion occurred at the right side in 11cases (55%) and at the left side in 9 cases. The most frequent degree of torsion was those cases that was rotated twice (720 degrees). The neoplasms undergoing torsion ranged in diameter between 5cm and 30cm and the most prevalent size was 6 to 10 cm (8 cases). Most of the patients (17cases) were treated by total abdominal hysterectomy and bilateral salpingo-oophorectomy. The tumors that produce torsion varied histologically and the most common type was cystic teratoma (in 5 cases), simple cyst(in 3 cases), serous cystadenoma(in 2 cases), mucinous cystadenoma(in 2 cases). CONCLUSIONS: In our study, ovarian tumor torsion occurring in postmenopausal patients constituted approximately 20% of all torsion patients, therefore adnexal torsion should be considered when a postmenopausal woman presents with lower abdominal pain. When torsion is diagnosed, total abdominal hysterectomy and bilateral salpingo-oophorectomy is the usual treatment for postmenopausal patients. Histologically, in more than 90% of cases, the tumors that produce torsion were benign. If cancer is evident, more extensive surgery is required.
Abdominal Pain ; Diagnosis ; Female ; Gynecology ; Humans ; Hysterectomy ; Medical Records ; Menopause ; Mucins ; Obstetrics ; Parity ; Teratoma

The authors present the one case of a 22-year-old man admitted with intermittent quadriparesis and respiratory difficulty. On investigation, atlantoaxial instability and upper cervical cord compression due to abnormal soft tissue were revealed. We have performed transoral decompression and biopsy, and then posterior transarticular facet screw fixation with interspinous wiring and fusion. We could obtain immediate and long-term postoperative stability with Philadelphia collar only. The pathologic examination reveald connective soft tissue hypertrophy due to chronic mechanical irritation.
Biopsy ; Decompression* ; Humans ; Hypertrophy ; Quadriplegia ; Young Adult

The importance of vegetables as a allergen for the development of hand eczema has been a matter of debate. The aim of this study was to evaluate the clinical manifestations of hand eczema and to investigate the role of vegetables in the hand eczema of Korean housewives. In this study, clinical evaluatons and patch tests with Hollister-Stier standard allergens and 22 vegetable allergens wer performed in 32 patients with housewife's hand eczema. The results are summarized as follows : 1. The prevalence was highest in fourth(59.4%) and third(25.0%) decades of life and the peak age of onset was third(53.1%) and fourth(31.3%) decades. 2. Only 3 of 32 patients(9.4%) had past histories of atopic dermatitis ; however, childrens of 12 patients(37.5%) had atopic dermatitis. 3. The common skin signs were fissuring(90.6%), scaling(78.1%), erythema(75.0%), hyperkeratosis(71.9%), lichenification(62.5%), and vesicle(43.8%) in descending order. 4. The common aggravating factors were soap or detergent(93.8%), water(90.6%) and rubber glove(25.0%). 5. The most common involved areas of hand eczema were fingers including fingertips and fingertips only. 6. The results of patch test using vegetable allergens with 10 normal controls were all negative. Of the 32 patients with hand eczema, 13(37.5%) showed positive patch test with standard allergens and 5(15.6%) showed positive with vegetable allergens. 7. Among 30 standard allergens, cinnamic alcohol(9.4%). potassium dichromate(9.4%), nickel sulfate(6.3%), and wool wax alcohol(6.3%) were the common allergens which showed positive reactions. Of the 22 vegetable allergens, garlic, Chinese cabbage juice, Chinese cabbage extract, cucumber juice, spinach extract, potato juice showed weak positive reactions in only one patient(3.1%) respectively. From the above results contact sensitivity to vegetables is not significant in Korean housewives with hand eczema.
Age of Onset ; Allergens ; Asian Continental Ancestry Group ; Brassica ; Child ; Dermatitis, Atopic ; Dermatitis, Contact ; Eczema* ; Fingers ; Garlic ; Hand ; Humans ; Nickel ; Patch Tests* ; Potassium ; Prevalence ; Rubber ; Skin ; Soaps ; Solanum tuberosum ; Spinacia oleracea ; Vegetables* ; Wool

No abstract available.
Ameloblastoma*

A reproducible noninvasive technique for measuring right ventricular ejection fraction (RVEF) was developed using first pass quantitative radionuclide angiocardiography. Tests were carried out in the right anterior oblique position with a computerized multicrystal scintillation camera with high count rate capabilities. RVEF was calculated on beat to beat basis from the high frequency components of the background-corrected right ventricular time-activity curve. The following results were obtained; 1) In 10 normal adults, RVEF averaged 50.9+/-8.2. In 20 patients with chronic obstructive lung diseases (COPD), RVEF was 37.9+/-6.1% and significantly lower than that of normal persons(P<0.005). 2) There was meaningful correlation between RVEF and forced expiratory volume (FEVI) in patients with COPD (r=0.51). And there was significant difference of RVEF between 13 patients with FEVI less than IL/min (6 patients with right ventricular failure, 7 patients with patients without that) and 7 patients with FEVI IL/min or more (35.7+/-6.0%, 42.1+/-3.2% respectively. P<0.005). 3) All 6 patients with clinical manifestation of right heart failure had abnormal RVEF and had FEVI less than IL/min, which was significantly lower than that of 14 patients without clinical manifestation of right heart failure (33.6+/-4.8%, 39.8+/-5.6%, respectively. P<0.005). 4) In 14 patients without clinical manifestation of right heart failure, 11 patients among whom 7 patients had FEVI less than IL/min, had abnormal RVEF.
Adult ; Angiocardiography ; Forced Expiratory Volume ; Gamma Cameras ; Heart Failure ; Humans ; Lung Diseases, Obstructive* ; Pulmonary Disease, Chronic Obstructive ; Radionuclide Ventriculography* ; Stroke Volume ; Ventricular Function, Right*

PURPOSE: The goal of cystometry is the reproduction of the patient's clinical status to improve diagnosis and therapy. However practitioner should know that various factors such as temperature and speed of saline infusion can change the cystometry finding. The ice water test(IWT) is known as a simple method that it discriminate between upper and lower motor neuron lesion. The aim of this study is to clarify the relationship of factors occurred during cystometry and the usefulness of IWT. Materials and Methods: On the first study(Apr 1997 to Jun 1997), cystometry was performed in 60 patients with voiding difficulty. In this study we determined cystometry finding according to alteration of temperature(1 degrees C, 37 degrees C) and speed (20ml/min, 50ml/min) of saline infusion during consecutive cystometry. On the second study(Jun 1997 to Aug 1997), IWT was performed in 68 patients with voiding difficulty. The IWT was performed after cystometry with the patient in the supine position. The bladder was completely emptied, and 100ml of sterile 1 degrees C saline was infused within 250-300ml/min. In patient with a maximal cystometry capacity below 200ml, a volume of about half the capacity was infused. The test was considered positive if a sustained bladder contraction above 20cmH2O was registered or some of the cold saline was expelled within 1 minute. RESULTS: There was no relation between speed and temperature of infused saline about maximal bladder capacity, detrusor pressure and compliance during cystometry. Positive result of IWT was found in 31 (54.4%) among 57 patients with neurologic lesion and in 29(63.0%) among 46 patients with upper motor neuron lesion. In contrast, 10(90.9%) among 11 patients with non-neurological lesion and 8(72.7%) among 11 patients with lower motor neuron lesion was negative. Specificity for discrimination of upper motor neuron lesion and lower motor neuron lesion was 72.7%. CONCLUSIONS: It is concluded that cystometry finding was no relation between speed and temperature of infused saline about maximal bladder capacity, detrusor pressure and compliance during consecutive cystometry. The IWT is a simple supplementary urodynamic test that increases the precision of the diagnosis of upper motor neuron lesion. Thus, it was close enough to be used as a available procedure for subclinical upper motor neuron lesion.
Compliance ; Diagnosis ; Discrimination (Psychology) ; Humans ; Ice* ; Motor Neurons ; Reproduction ; Sensitivity and Specificity ; Supine Position ; Urinary Bladder ; Urodynamics ; Water*