No abstract available.

No abstract available.

OBJECTIVE: Pelviscopic surgery has been used in the treatment of some gynecologic disease. And now, it is applied in almost all cases of gynecologic disease. This study is performed to evaluate the clinical advantages of pelviscopic surgery. Mehtods: From March, 1997 to February 1999, total 310 cases were received laparoscopic surgery on dept. OBGY of Seonam University hospital and Chosun University hospital. We reviewed the chart and analyzed these cases about age, parity, clinical indication, operation type, duration of hospitalization, operation time and complication. RESULTS: The results of this study were summarized as follows : 1. The mean age of patients was 32.1 years old with ranges between 15 and 54 years old. 2. The mean parity of the patients was 1.33. 3. The common indications were ectopic pregnancy (33.5%), ovarian cyst (28.4%) and uterine myoma (16.5%). 4. The frequent types of surgery were salpingectomy (23.2%), adnexectomy (22.6%) and laparoscopy assisted vaginal hysterectomy (LAVH) (13.9%). 5. The operation time was variable according to the types of operation and difficulty. 6. The mean duration of hospitalization was 4.17 days. 7. The most frequent complication was hemorrhage at the trocar site. CONCLUSION: Pelviscopic surgery is useful and recommended for the treatment of gynecologic disease, because this is safe and has many advantages. So, we expect the number and indication of pelviscopic surgery will be increased in future.
Female ; Genital Diseases, Female ; Hemorrhage ; Hospitalization ; Humans ; Hysterectomy, Vaginal ; Laparoscopy ; Leiomyoma ; Middle Aged ; Ovarian Cysts ; Parity ; Pregnancy ; Pregnancy, Ectopic ; Salpingectomy ; Surgical Instruments

Radiofrequcy(RF) treatment has a long history, more than hundred years, for the management of chronic intractable pain of various causes. With better understanding of pain mechanism and advancement of technology, along with previous valuable experience, a simpler and safer method of delivering RF thermo coagulation to ideal sites are now available that can be expected to provide more beneficial effects to these patients with chronic disabling pain. This type of treatment will be especially helpful in aged in whom surgery is often contraindicated or highly risky due to medical problems. Here, using up-to-dated, evidence based knowledge and personal experience, authors have tried to introduce briefly the history and basic mechanism of RF technique and various clinical situations where this type of therapy is currently known to be indicated or effective in providing substantial pain relief. In summary, the RF thermocoagulation is proven to be effective way of providing significant pain relief in many chronic refractory pain states with numerous advantages such as minimal invasive, quantitative lesioning with temperature-controlled, well-circumscription of lesions, simplicity and feasibility of procedure, and most of all safety and cost-effectiveness. When it is selected based on careful investigation on type and cause of pain it can be expected to provide relatively long duration of pain relief and also to help to recover functional disabilities from such pain. However, judicious use is warranted because some painful conditions are known to be ineffective or contraindicated from this type of therapy and because there are possible serious complications, although very few. Use of latest technique of pulsed, high-frequency, low-temperatured thermocoagulation will possibly bring hope and new insights in the management of chronic intractable pain of neuropathic in nature. Further research and experience will be required before justifying this type of therapy in appling broader and more challenging situations.
Electrocoagulation ; Hope ; Humans ; Neuralgia ; Pain, Intractable*

Portal vein (PV) thrombosis (PVT) is a rare condition with development of thrombosis in the PV and its branches. Further extension to the splenic and superior mesenteric vein (SMV) causes intestinal infarction, with a reported mortality of up to 50%. A variety of treatments for PVT exist including anticoagulation, thrombolysis, surgical thrombectomy, insertion of shunts, bypass surgery, and liver transplantation. We experienced a case of successfully treated by surgical thrombectomy with direct thrombolysis into the thrombosed-PV and SMV. A 31-year-old male presented worsening abdominal pain for one week. Preoperative contrast enhanced computed tomography scan revealed complete PVT extending to splenic vein and SMV. The PV was accessed surgically and opened by thrombectomy; visual inspection confirmed proximal and distal flow. Urokinase was administered directly into the inferior mesenteric vein with successful decrease in thrombus burden. The complete angiography showed complete dissolution of thrombosis in PV and SMV.
Abdomen, Acute* ; Abdominal Pain ; Adult ; Angiography ; Humans ; Infarction ; Liver Transplantation ; Male ; Mesenteric Veins* ; Mortality ; Portal Vein ; Splenic Vein ; Thrombectomy* ; Thrombosis* ; Urokinase-Type Plasminogen Activator ; Venous Thrombosis

No abstract available.
Humans ; Renal Insufficiency, Chronic*

No abstract available.
Carcinoma, Hepatocellular* ; Recurrence*

Renal artery aneurysm (RAA) is uncommon, and the coexistence of an abdominal aortic aneurysm (AAA) is an extremely rare condition with potentially high life-threatening mortality in case of rupture. Aneurysms can be treated by endovascular intervention or open surgery. Although most of aneurysms are treated by endovascular intervention, open surgery is often necessary for RAAs associated with the proximal renal bifurcation or the branches in the distal renal arteries. We report a rare case of coexisting RAA with AAA treated by hybrid method, consisting of endovascular aneurysm repair for AAA and open surgery for RAA located adjacent to the distal branches of the renal artery.
Aneurysm* ; Aortic Aneurysm, Abdominal* ; Gallbladder Neoplasms* ; Humans ; Mortality ; Renal Artery* ; Rupture

PURPOSE: Angiogenesis is a critical determinant of tumor growth and the development of metastasis. Angiostatin and endostatin have been used in a variety of in vitro and in vivo animal models as effective inhibitors of angiogenesis. However, human angiostatin and endostatin have not been tested against an intact human tissue target in vitro to determine its ability to achieve an antiangiogenic response. We performed our study to determine if human angiostatin and endostatin would inhibit the development of an angiogenic response (initiation) and to determine the subsequent growth (angiogenic index) of human vessels in a dose-dependent manner with a human placental vein angiogenesis model (HPVAM). METHODS: We used full thickness human placental vein discs cultured in three-dimensional fibrin-thrombin clots with an overlay of liquid media. Human angiostatin and endostatin were evaluated in concentrations ranging from 10-9 M to 10-4 M. A positive control containing 20% fetal bovine serum and a negative control using heparin and hydrocortisone 21-phosphate were also tested. RESULTS: Human angiostatin did not inhibit the initiation of an angiogenic response and the subsequent development of the angiogenic response (angiogenic index) at any concentration. Human endostatin significantly inhibited the initiation rate of an angiogenic response at a concentration of 10-4 M (p<0.001) and the subsequent development of an angiogenic response (angiogenic index) from a concentrations of 10-5 M to 10-4 M (p<0.001, p<0.001, respectively). CONCLUSION: We conclude that a very high concentration of human endostatin can inhibit the angiogenic response in human vascular tissue and that human angiostatin will not inhibit angiogenesis of normal human blood vessels in vitroThese results suggest that human endostatin has a more powerful antiangiogenic effect than human angiostatin, but we need further investigations of human angiostatin against an intact human tissue target.
Angiostatins* ; Blood Vessels ; Endostatins* ; Heparin ; Humans* ; Hydrocortisone ; Models, Animal ; Neoplasm Metastasis ; Veins

OBJECTIVES: Depression, sleep complaints and cognitive impairments are commonly observed in the elderly. Elderly subjects with depressive symptoms have been found to show both poor cognitive performances and sleep disturbances. However, the relationship between sleep complaints and cognitive dysfunction in elderly depression is not clear. The aim of this study is to identify the association between sleep disturbances and cognitive decline in late-life depression. METHODS: A total of 282 elderly people who underwent nocturnal polysomnography in a sleep laboratory were enrolled in the study. The Korean version of the Neuropsychological Assessment Battery developed by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) was applied to evaluate cognitive function. Depressive symptoms were assessed with the geriatric depression scale (GDS) and subjective sleep quality was measured using the Pittsburg sleep quality index (PSQI). RESULTS: The control group (GDS< or =9) when compared with mild (10< or =GDS< or =16) and severe (17< or =GDS) depression groups, had significantly different scores in the Trail making test part B (TMT-B), Benton visual retention test part A (BVRT-A), and Stroop color and word test (SCWT)(all tests p<0.05). The PSQI score, REM sleep duration, apnea-hypopnea index and oxygen desaturation index were significantly different across the three groups (all indices, p<0.05). A stepwise multiple regression model showed that educational level, age and GDS score were predictive for both TMT-B time (adjusted R2=35.6%, p<0.001) and BVRT-A score (adjusted R2=28.3%, p<0.001). SCWT score was predicted by educational level, age, apnea-hypopnea index (AHI) and GDS score (adjusted R2=20.6%, p<0.001). Poor sleep quality and sleep structure alterations observed in depression did not have any significant effects on cognitive deterioration. CONCLUSION: Older adults with depressive symptoms showed mild sleep alterations and poor cognitive performances. However, we found no association between sleep disturbances (except sleep apnea) and cognitive difficulties in elderly subjects with depressive symptoms. It is possible that the impact of sleep disruptions on cognitive abilities was hindered by the confounding effect of age, education and depressive symptoms.
Adult* ; Aged ; Alzheimer Disease ; Depression* ; Education ; Humans ; Oxygen ; Polysomnography ; Sleep, REM ; Trail Making Test