No abstract available.
Endometriosis* ; Female ; Humans ; Hydronephrosis* ; Ureter* ; Uterine Cervical Neoplasms*

Recently, water birth - labor and/or delivery under warm water - is acceptable and natural to many foreign countries as a method of gentle birth. Although some limitations after water birth were reported, a recent international conference explored many of the issuses and indicated the potential scale and the advantages for its inclusion among the options for labor and delivery under water. We experienced a case of water birth who underwent labor and delivery under water. She delivered normal healthy female baby without conventional episiotomy. No obstetrical ans fetal complications were observed during entire procedure of water birth. So, we report this case with brief review of the literatures.
Episiotomy ; Female ; Humans ; Parturition*

OBJECTIVE: The aim was to evaluate whether the differences of PG concentration in follicular and peritoneal fluid during preovulatory phase exist between the women with and without endometriosis. MATERIAL AND METHODS: Twenty-three patients with endometriosis, 8 were stage I-II and 15 were stage III-IV, and another 23 patients without endometriosis were undergone laparotomy during late follicular phase. Peritoneal fluid from 46 patients and follicular fluid from 42 patients were obtained, and these samples were analyzed double times for PGF2alpha, PGE2 and estradiol. RESULTS: The mean level of PGF2alphain the peritoneal fluid was significantly higher in the group with endometriosis than in the control(P=0.0293), especially more significant in stage I-II endometriosis. Although there was no significant difference of PGF2alphaconcentration in the follicular fluid between the groups, the stage III-IV endometriosis group showed slightly higher PGF2alphalevel than both the stage I-II group and the control(P=0.0604). And also, there was significant positive correlation with the level of PGF2alphaand estradiol in the follicular fluid only in the endometriosis group(r=0.4988, P=0.0154), not in the control. However, there was no difference in the level of PGE2 and estradiol in the peritoneal or follicular fluid between the groups. CONCLUSION: Some alterations of PGF2alphalevel exist in the women with endometriosis. These are significantly higher PGF2alphalevel in peritoneal fluid with mild endometriosis and slightly higher PGF2alphalevels in follicular fluid with extensive endometriosis during preovulatory phase, which suggest that PGF2alphamay play some roles in subfertility associated with endometriosis.
Ascitic Fluid* ; Dinoprost* ; Dinoprostone ; Endometriosis* ; Estradiol ; Female ; Follicular Fluid ; Follicular Phase* ; Humans ; Infertility ; Laparotomy

No abstract available.
Blood Transfusion* ; Humans ; Infant, Newborn ; Infant, Premature*

BACKGROUND: One of the major limitations of curative resection in pancreatic cancer patients is local tumor extension to the mesenteric vessels. Thus, the purposes of our study were (1) to assess the clinical value of contrast enhanced spiral CT in predicting the resectability and survival of pancreatic cancer patients with suspicious vascular invasion and (2) to assess the influence of curative resection on survival in these patients. METHODS: Forty cases of the pancreatic cancer patients who were suspected of having involvement of adjacent large vessels and subsequently underwent operation with curative intent were enrolled in this study. Resectability and survival were correlated with CT findings such as segment length, degree of encasement, type and number of vessel involved. Survival rate was compared between curative and palliative resection groups. And survival was also compared between resected and non-resected groups. RESULTS: Of the 40 patients with adenocarcinoma of the pancreas, 14 patients had curative resections, and 26 patients had palliative resections. The probability of curative resection was higher in patients with segment length less than 2 cm, compared with those with more than 2 cm. However, there was no difference in survival between two groups. There were no differences of resectability and survival according to the degree of encasement, type and number of vessel involved. There were no difference in survival between curative and palliative resection groups, and between resected and non-resected groups. CONCLUSION: A survival benefit is not achieved by curative resection in pancreatic cancer patients with vascular invasion. So other non-operative treatments should be considered as effective tools prior to resection in these patients.
Adenocarcinoma ; Humans ; Neoplasm Invasiveness ; Pancreas ; Pancreatic Neoplasms* ; Survival Rate ; Tomography, Spiral Computed

BACKGROUND/AIMS: The predictory factors of the response to initial steroid therapy in active Crohn's disease has been controversial in numerous literature reviews. We evaluated any predictory factor of the response to initial steroid therapy in active Crohn's disease patients. METHODS: The medical records of 32 patients with active Crohn's disease who clinically responded to oral steroid therapy were retrospectively reviewed. The steroid responsive group was defined as the one showing maintenance of response for more than one month from steroid withdrawal and the steroid dependent group as the one showing relapse or exacerbation during steroid tapering or within 30 days from steroid withdrawal. The clinical, biochemical, and pathologic factors were evaluated. RESULTS: There were 22 male and 10 female patients. The mean age was 28.9 years. The number of steroid responsive and dependent group was 22 (68.8%) and 10 (31.2%), respectively. There were no significant differences between these two groups in age, sex, time to diagnosis, perianal lesion, extent of disease, extraintestinal manifestations, presence of granuloma, presenting features, hemoglobin, ESR, and CRP, except serum albumin level. CONCLUSIONS: Serum albumin level was significantly lower in steroid dependent group than steroid responsive group, reflecting severe inflammation in steroid dependent group.
Crohn Disease* ; Diagnosis ; Female ; Granuloma ; Humans ; Inflammation ; Male ; Medical Records ; Recurrence ; Retrospective Studies ; Serum Albumin

BACKGROUND/AIMS: The role of autonomic dysfunction in patients with functional dyspepsia has not been completely understood. The purposes of our study are (1) to prospectively assess the abnormalities of the autonomic function in patients with functional dyspepsia and (2) to assess whether the presence of autonomic dysfunction in patients with functional dyspepsia correlates with the presence of visceral hypersensitivity or with the severity of dyspeptic symptoms. METHODS: Twenty eight patients with functional dyspepsia (4 men and 24 women; age range, 29-57) and 14 healthy volunteers without gastrointestinal symptoms (6 men and 8 women; age range, 23-61) were included in this study. All patients and controls were submitted to a battery of five standard cardiovascular autonomic reflex tests and gastric barostat tests. A modified version of the Glasgow Dyspeptic questionnaire was used in this study. RESULTS: (1) Autonomic function tests showed that both sympathetic and parasympathetic scores of dyspeptic patients were significantly higher than those of the control group. (2) Visceral hypersensitivity could be confirmed in some of our dyspeptic patients in response to proximal gastric distension, demonstrating lower pain threshold in this group. (3) We could not find significant association between the presence of autonomic dysfunction and the presence of visceral hypersensitivity or severity of dyspeptic symptoms in patients with functional dyspepsia. CONCLUSION: Autonomic dysfunction was more prevalent in dyspeptic patients than in the control group. However, it did not correlate with the presence of visceral hypersensitivity or severity of dyspeptic symptoms. It is suggested that a defect in the spinal region or at the CNS level may be a major mechanism of visceral hypersensitivity in functional dyspepsia.
Dyspepsia* ; Female ; Healthy Volunteers ; Humans ; Hypersensitivity ; Male ; Pain Threshold ; Prospective Studies ; Reflex ; Surveys and Questionnaires

BACKGROUND: Among various methods for measuring colon transit time, radio-opaque marker study is simple, reproducible and economical method. The commonly used marker, Sitzmarks (Konsyl Pharmaceuticals Inc. Texas) had limitation in its use due to expensiveness and difficulty in importation. We thought that the new domestic marker comparable to Sitzmarks is necessary and made a Kolomark (Korean colon marker)TM. The comparison of radio-opaqueness and the measurement of colon transit times by two markers were done. METHODS: In two 1000 ml beakers, 350 ml of rice-gruel, several chicken-bones and ten rings of Sitzmarks and KolomarkTM were mixed separately. Then, X-ray films of the two beakers were taken. The digital image file was analyzed by Image and the value of pixels were obtained. These were repeated five times. Colon transit times were measured in 60 healthy persons stratified by age, 30 by Sitzmarks and 30 by KolomarkTM. RESULTS: The mean value of pixel of KolomarkTM was much lower than that of Sitzmarks. The difference between background or beaker and KolomarkTM was much greater than that of Sitzmarks . There was no significant difference between colon transit time studied by Sitzmarks and KolomarkTM. CONCLUSION: KolomarkTM, a more radio-opaque and cheaper marker than Sitzmarks will be applied usefully for measuring colon transit time.
Colon* ; Humans ; X-Ray Film

BACKGROUND: Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease of unknown etiology. The disease is relatively common in western countries, but so far, only about 20 cases have been reported in Korea. Thus, the purpose of our prospective study was to evaluate the clinical characteristics of PBC in Korea. METHODS: Between October 1994 and February 1999, 16 patients diagnosed as PBC at our department were enrolled in this study. We analyzed these patients for the distribution of age and sex, initial symptoms and signs, associated disorders, laboratory, endoscopic, and radiologic and histologic findings. RESULTS: Of the 16 patients, the ratio of male to female was 1:7 and the average age was 57.5 years. Pruritus (37.5%) was the most frequent presenting symptom followed by xerostomia and xerophthalmia (12.5%), jaundice (6.3%), chronic fatigue (6.3%), melena (6.3%). Associated disorders were Sj gren's syndrome (25%), arthropathy (12.5%), Raynaud's phenomenon (6.3%) and diabetes (6.3%). Abnormalities of liver function were found frequently. Antimitochondrial antibody (100%), antinuclear antibody (31.25%) and rheumatoid factor (31.25%) were found. Long-term administration of UDCA improved both clinical and biochemical signs in most patients, however, 2 patients experienced exacerbation during UDCA therapy. CONCLUSIONS: We experienced 16 cases of PBC within a short period. It is expected that we can find these patients more frequently if we suspect this disease in patients with pruritus and unexplained obstructive pattern of liver function abnormality.
Antibodies, Antinuclear ; Fatigue ; Female ; Hemolytic-Uremic Syndrome ; Humans ; Jaundice ; Korea ; Liver ; Liver Cirrhosis, Biliary* ; Liver Diseases ; Male ; Melena ; Pancreatitis ; Prospective Studies ; Pruritus ; Rheumatoid Factor ; Xerophthalmia ; Xerostomia

“Clinical Practice Guideline for Stroke Rehabilitation in Korea 2016” is the 3rd edition of clinical practice guideline (CPG) for stroke rehabilitation in Korea, which updates the 2nd edition published in 2014. Forty-two specialists in stroke rehabilitation from 21 universities and 4 rehabilitation hospitals and 4 consultants participated in this update. The purpose of this CPG is to provide optimum practical guidelines for stroke rehabilitation teams to make a decision when they manage stroke patients and ultimately, to help stroke patients obtain maximal functional recovery and return to the society. The recent two CPGs from Canada (2015) and USA (2016) and articles that were published following the 2nd edition were used to develop this 3rd edition of CPG for stroke rehabilitation in Korea. The chosen articles' level of evidence and grade of recommendation were decided by the criteria of Scotland (2010) and the formal consensus was derived by the nominal group technique. The levels of evidence range from 1++ to 4 and the grades of recommendation range from A to D. Good Practice Point was recommended as best practice based on the clinical experience of the guideline developmental group. The draft of the developed CPG was reviewed by the experts group in the public hearings and then revised. “Clinical Practice Guideline for Stroke Rehabilitation in Korea 2016” consists of ‘Chapter 1; Introduction of Stroke Rehabilitation’, ‘Chapter 2; Rehabilitation for Stroke Syndrome, ‘Chapter 3; Rehabilitation for Returning to the Society’, and ‘Chapter 4; Advanced Technique for Stroke Rehabilitation’. “Clinical Practice Guideline for Stroke Rehabilitation in Korea 2016” will provide direction and standardization for acute, subacute and chronic stroke rehabilitation in Korea.
Canada ; Consensus ; Consultants ; Humans ; Korea* ; Practice Guidelines as Topic ; Rehabilitation* ; Scotland ; Specialization ; Stroke*