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

Holoprosencephaly is a rare and complex malformation affecting the cleavage of the developing forebrain and is usually associated with defects of the mid Face. We have experienced a case of holoprosencephaly, diagnosed prenatally by ultrasound examination at 31 weeks of pregnancy in a 31-year-old primigravida woman. This case is characterized by holoprosencephaly, cleft palate, cleft lip, left renal aplasia and right renal hypertrophy. The chromosomal study showed a deletion of the long arm of chromosome 7, 46, XX, del(7)(q32), We report with a terminal deletion of chromosome 7q associated with atypical clinical picture and holoprosencephaly.
Adult ; Arm ; Chromosome Aberrations* ; Chromosomes, Human, Pair 7 ; Cleft Lip ; Cleft Palate ; Female ; Holoprosencephaly ; Humans ; Hypertrophy ; Multicystic Dysplastic Kidney* ; Pregnancy ; Prosencephalon ; Ultrasonography

No abstract available.
Humans ; Nephrotic Syndrome* ; Renal Veins* ; Thrombosis*

Pure ovarian choriocarcinoma of germ cell origin is exceedingly rare neoplasm, and even the presence of choriocarcinomatous elements admixed with other neoplastic germ cell elements is rare. In the most cases, the tumor is admixed with other neoplastic germ cell elemeats, and their presence is diagnostic of noagsatational choriocarcinoma, except for the remote of the tumor being a geatational choriocarcinoma metasttic to an ovarian germ cell tumor. We have experienced a case of nongestational ovarian choriocarcinoma in 10 year dld woman. So we report this case with a brief review of its literatures.
Choriocarcinoma* ; Female ; Germ Cells ; Humans ; Neoplasms, Germ Cell and Embryonal ; Pregnancy

Recently there has been a progressive increase of thoracolumbar fractures with neurologic symptoms. It has been thought that laminectomy increased instability and was therefore considered a contraindication. Currently, with the development of instrument for posterior stabilization, it is possible to perform posterior fusion and instrumentation, both with and without laminectomy. To compare the effect of neurologic recovery with and without laminectomy, we analyzed the clinical records of 38 patients with neurologic symptoms who were evaluated with plain radiographs and CT before and after surgery from 1989 to 1996 in Gyeong-Sang National University Hospital. We divided our cases into two groups, one group consisted open reduction with laminectomy and instrumentation with posterior fusion. The other group consisted of open reduction without laminectomy and instrumentation with posterior fusion. Twenty three of 38 were operated with open reduction and internal fixation with laminectomy and others were operated without laminectomy. The results were that both groups had improvement of neurologic symptoms after surgery and at follow-up. There was no significant statistical difference between the two groups. Depending on the time interval between injury and surgery, patients who were underwent emergency surgery had an marked improvement of neurologic symptoms. Except cases of complete paraplegia, incomplete paraplegic patients who were operated within 24 hours with laminectomy group had greater improvement than those without laminectomy. The improvement was statistically significant(P<0.05).
Emergencies ; Follow-Up Studies ; Humans ; Laminectomy* ; Neurologic Manifestations* ; Paraplegia

BACKGROUND: Disordered lactate metabolism which is due to tissue hypoxia and hypoperfusion is frequently encountered in critically ill patients. These patients suffer from a high hospital mortality rate and are at great risk of developing multiple organ failure. The present study was designed to evaluate the prognostic value of blood lactate as a determinant of mortality in comparison with the APACHE II score. METHODS: 29 adult ICU patients participated in this study. Blood lactate concentrations, arterial blood gas analysis, hemodynamic data and APACHE II scores were collected on the first and last days of ICU stay. These data were compared between survivor and non-survivor groups. RESULTS: On the day of admission, blood lactate concentrations and APACHE II scores of non-survivors were 48.5 +/- 27.0 mg/dl and 18.5 +/- 5.9, while those of survivors were 23.7 +/- 12.9 mg/dl and 6.7 3.1. On the day of discharge, arterial blood lactate concentrations and APACHE II scores of non-survivors were 143.2 +/- 54.0 mg/dl and 28.2 +/- 6.0, while those of survivors were 14.9 +/- 7.1 mg/dl and 4.7 +/- 2.2. There was a significant positive correlation between high arterial blood lactate concentration and fatal outcome in critically-ill patients. There was also a significant positive correlation between arterial blood lactate concentration and APACHE II score. Furthermore, decreases in arterial blood lactate levels during the course of ICU stay may indicate a favorable outcome. The mortality increased abruptly in critically-ill patients with an initial arterial blood lactate concentration higher than 40 mg/dl. CONCLUSIONS: The result shows that arterial blood lactate concentration can serve as a reliable prognostic predictor and clinical guide to therapy in critically ill patients.
Adult ; Anoxia ; APACHE* ; Blood Gas Analysis ; Critical Illness* ; Fatal Outcome ; Hemodynamics ; Hospital Mortality ; Humans ; Lactic Acid* ; Metabolism ; Mortality ; Multiple Organ Failure ; Survivors

PURPOSE: Though the etiology of this cancer has not been elucidated, it has been suggested that certain types of human papillomavirus (HPV) and alteration of the p53 gene are closely associated with uterine cervical cancer. The aim of the study was to investigate the role of high risk HPV, p53 and p21 gene in cervical intraepithelial neoplasia III (CIN3) and invasive squamous cell carcinoma. MATERIALS AND METHODS: The presence of high-risk HPV DNA (16, 18, 31, 33, 35, 45, 51, 52, 56) were detected from cervical swab in 240 patients by hybrid capture method. Expression of p53 genes were studied in paraffin-embedded specimens by immunohisto- chemical staining and p53, p21 gene alteration by RT-PCR SSCP using fresh cervical tissues. RESULTS: High risk HPV DNA were detected in 34%, 74.3% and 75.7% in control, CIN3 and invasive squamaus cell carcinoma respectively. In patients with high risk HPV DNA, type 16 were detected of 5.9%, 30.8%, 47.2% respectively. Relative concentration of HPV DNA to control was 16.3+-27.4 in CIN3 and 30.4+-40.8 in invasive squamous cell cancer. Of patients with high risk HPV DNA, p53 expression was found in 42.9% of CIN3 immunohistochemically, while patients with invasive squamous cell carcinoma was de- tected in 50%. In patients without high risk HPV DNA, p53 expression was detected in 17.1% in CIN3, 15.7% in invasive squamous cell carcinoma. But the mutation of p53 and p21 gene by RT-PCR SSCP were not observed in CIN3 and invasive squamous cell carcinoma. CONCLUSION: These observations suggest that carcinogenesis of invasive squamous cell carcinoma from CIN3 may be concerned with high risk HPV concentration and may be occurred via another pathway without HPV and p53 or p21 mutation.
Carcinogenesis ; Carcinoma, Squamous Cell ; Cervical Intraepithelial Neoplasia ; DNA* ; Gene Expression* ; Genes, p53 ; Humans* ; Neoplasms, Squamous Cell ; Polymorphism, Single-Stranded Conformational ; Uterine Cervical Neoplasms*

We tested the hypothesis that the extent of necrosis at the initial MRI predicts the subsequent risk of collapse of the femoral head in a randomized clinical trial conducted to compare the core decompression to the conservative treatment. After the initial clinical evaluation including plain roentgenography and MRI, 37 hips of early-stage osteonecrosis (ON) in 33 patients were randomly assigned to core decompression group or conservative treatment group. All the patients were regularly followed by clinical evaluation including plain roentgenography and MRI at three-month intervals. The extent of ON was estimated on the basis of the percentage of abnormal signal intensity in the weight-bearing portion of the femoral head as determined on a combination in coronal aod sagittal MR images. The angle of necrotic portion in mid-coronal image (A) and that in mid-sagittal image (B) were used to quantify the extent of necrotic portion by the formula; (A/180) x (B/180) x 100%. A strong association was observed between the percentage of necrotic portion and the development of collapse. We concluded that the extent of necrotic portion is a major risk factor of the collapse and proposed a systematic method of classifying the percentage of necrotic portion, which might be useful as a predictive index for the fate of early-stage ON.
Classification* ; Decompression ; Head* ; Hip ; Humans ; Magnetic Resonance Imaging* ; Necrosis ; Osteonecrosis* ; Radiography ; Risk Factors ; Weight-Bearing

To investigate the skeletal muscle changes, intramuscular injections of local anesthetics were performed using animal, Sprague-Dawley rat. The experiments were composed of two procedures, experiment I and II. In experiment I, single injection was performed using 0.4 cc of 1 and 2% of procaine and lidocaine. In experiment. II, repeated injection of 0.4 cc of 2% lidocaine on weekly bases 3 times were performed. The experimental rats were divided into five groups in five groups in experiment I: Four experimental group 40(10 rats for each local anesthetics) and Control 10 and were divided into two groups in experiment II: Experimental group 8 and Control 4. The muscle biopsies were performed in 15 minutes, 2, 4, 8 and 16 days after injection in two experiments. No muscle fiber changes were shown in control group, and 1~2% procaine, and 2% lidocaine injected groups of experiment I and control group of experiment II. In the groups of single and repeated injections of 2% lidocaine, muscular inflammatory changes were shown on 2 and 4 days after injection. The changes were more extensive in the group of repeated injections. The inflammatory reaction was usually abated on 8 days after injection and the muscles appeared to be normal in quality and quantity on 16 days after injection These histopathologic results indicated reversible muscular changes. Although the muscular changes are reversible after local anesthetics injection, the concentration of local anesthetics and injection interval should be considered to minimize the muscle fiber changes in the repeated injections.
Anesthetics, Local* ; Animals ; Biopsy ; Injections, Intramuscular ; Lidocaine ; Muscle, Skeletal* ; Muscles ; Procaine ; Rats ; Rats, Sprague-Dawley

Human gingival fibroblasts have proven to useful as a species specific cell culture system in various system on periodontal disease and regeneration. However, their use is limited, since they are hard to obtain and lifespan is short due to replicative senescence. To overcome these disadvantages, we transfected primary human gingival fibroblasts by the E6 and E7 genes of the Human papilloma virus(HPV) 16. The full length of HPV 16 E6 and E7 was cloned from the pBR322 into BamH1 and Sal I of a pBabe vector including hygromycin B resistance. Before pBabeE6/E7 plasmid transfection, peak 8 GFP including G418 resistance was transfected into primary GF to check the transfection efficency. PBabe E6/E7 plasmid was transfected using Lipofectamine plus following manufacter's instruction into primary normal human gingival fibroblasts in 60mm dishes with FBS free DMEM. After 2 days of transfection, the cells were treated with hygromycin for 2 weeks until the transfected control cells died. The resulting hygromycin resistant colonies were pooled, and clonned, and sucessful transfection was established for immortalized gingival fibroblast cell lines. Immoralized GF cells showed stellate shape, that is similar to that of orange grains, and more rapid growth and higher proliferation than that of primary gingival fibroblasts. This cell lines overcame crisis and could be cultured over 30 subcultured, could be use for three dimentional culture, epithelial-mesenchymal interaction study.
Cell Aging ; Cell Culture Techniques ; Cell Line* ; Edible Grain ; Citrus sinensis ; Clone Cells ; Fibroblasts* ; Human papillomavirus 16 ; Humans* ; Hygromycin B ; Papilloma ; Periodontal Diseases ; Plasmids ; Regeneration ; Transfection