The incidence of ectopic pregnancy is apparently increasing in recent years. In order to gain greater insight into the diagnosis and management of ectopic pregnancies, this study was undertaken on 100 patients with ectopic pregnancy(admitted via ER) who were operated and confirmed by histopathological study at the department of Obstetrics and Gynecology of Hallym University(Kangdong Sacred Heart Hospital) from January, 1996 to June, 1997. The results were as follows; 1. The hospital incidence of ectopic pregnancy was 1 in 11.6 deliveries(168/1954). 2. The most frequent age group was in 25-34 years of ages(58%). 3. Nullipara was 32 cases(32%) and number of cases who had 1, 2 and 3 deliveries were 35(35%), 31(31%) and 2(2%) respectively. 4. The most frequent number of pregnancy was second times(24%) and 65% of cases have been experienced artificial abortion. 5. In the past history, of possible predisposing factors, 65% had at least one abortion, 17% ectopic pregnancy, 17% cesarean section and 13% had previous laparoscopic tubal sterilization, but 19% showed no special distinct. 6. The main clinical symptoms are 96% in lower abdominal pain, 95% in amenorrhea and 65% in vaginal spotting and bleeding. 7. The most frequent interval between LMP and onset of symptoms was 6-8 weeks(49%). 8. Urine hcG test was positive in 94.9% and culdocentesis was positive in 94.3%. 9. In initial hemoglobin level, more than 11.0g% was 55%, however less than 10.0g% was 20%. 10. In initial systolic blood pressure at hospital, most of them were under normal condition, however 30% were under 90mmHg. 11. The amount of intraabdominal hemorrhage under 500cc was 42%(highest rate), 25% under 500cc-1000cc(second rate) and 6 cases overed 200cc. 12. The site of ectopic pregnancy was 88% in fallopian tube, 9% in uterine conus, 2% in intraabdomen and 1% in cervix. 13. The most common surgical procedure was ipsilateral salpingectomy(82%), of which 22 cases were operated by laparoscopy. 14. There was no fatal case in 100 ectopic pregnancy.
Abdominal Pain ; Amenorrhea ; Blood Pressure ; Causality ; Cervix Uteri ; Cesarean Section ; Conus Snail ; Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Fallopian Tubes ; Female ; Gynecology ; Heart ; Hemorrhage ; Humans ; Incidence ; Laparoscopy ; Metrorrhagia ; Obstetrics ; Pregnancy ; Pregnancy, Ectopic* ; Sterilization, Tubal

OBJECTIVE: Sixteen cases of blunt diaphragmatic injury were clinically reviewed during 10 years from Oct.1987 to Jun.1996 at the Kangdong sacred heart hospital. The age and sex distribution were ranged from 3 to 67-old-years. The most common age range was between third decades to fifth decades in 10 cases(62.50%) and occurred predominantly in male, the sex ratio was 4.3 : 1.(M:F 4.3:1) The modes of blunt diaphragmatic injury were due to motor vehicle accidents(MVA), motor cycle accidents(MCA), fall down(FD) and others. Most common injuries were responsible for MVA. MVA were pedestrian traffic accidents 5 cases (41.7%), driver 4 cases(33.3%) passenger 3 cases(25.0%). In the blunt diaphragmatic injury sites, the left-sided diaphragmatic injury had predominant[left-sided cases 10(62.50%), right-sided cases 6(37.50%)]. Cost common symptoms and signs were chest pain or chest discomfort(81.25%) and dyspnea(68.75%), abdominal tenderness(50.00%), decreased bowel sound and breath sound(50.00%) and others. All of 16 cases in blunt diaphragmatic injury were associated with other injuries. The associated injuries were hemopneumothorax 14(87.50%), hemoperitoneum 7(43.759o), liver injury 7(43.75%), orthopedics fracture 14(87.50%), head injury 5(31.25%) and others. The diagnostic methods were used with simple x-ray, ultrasonogram and computed tomogram. The preoperative diagnosis of blunt diaphragmatic injury were suggested in 10 cases(62.509o) and others were confirmed during operation. The thirteen cases of all of sixteen cases were performed emergency operation within eight hours. The herniated intraabdominal organs through ruptured diaphragm were presented in 10cases(62.5%) [stomach 7 cases(43.75%), spleen 6 cases(37.50%), colon 3 cases(18.75%), liver 3 cases(18.75%), small bowel and omentum 2 cases(12.50%), respectively]. The mean size of blunt diaphragmatic injury were 7.7cm, right-sided mean size were 9cm, left-sided mean size were 6.9cm. The most common site of blunt diaphragm- atic injury were presented in anteromedial site 7 cases(43.75%). Simple chest x-ray revealed abnormal finding [hemothorax 10cases(62.50%), pneumothorax 4cases(25.00%), herniated organ into thorax8 cases(50.00%), diaphragm elevation 3 cases(18.75%) and others]. The postoperative complication were associated in 10 cases(62.50%) out of 16 cases. Common complications were pleural effusion 6 cases(37.50%) and atelectasis 3 cases(18.75%). Injury severity score(ISS) value of 16 cases in the blunt trauma ranged from 10 to 59. It was presented with mean value of ISS(35.5),mean value of ISS survivors(35) and nonsurvivors(55.5). Revised trauma score(RTS) value ranged also from 4 to 12. There were revealed with mean value of RTS(9.7),mean value of RTS survivors(10) and nonsurvivors(6.5). All of the blunt traumatic injury, mortality rate was related to the values of ISS and RTS.
Accidents, Traffic ; Chest Pain ; Colon ; Craniocerebral Trauma ; Diagnosis ; Diaphragm ; Emergencies ; Heart ; Hemoperitoneum ; Hemopneumothorax ; Humans ; Liver ; Male ; Mortality ; Motor Vehicles ; Omentum ; Orthopedics ; Pleural Effusion ; Pneumothorax ; Postoperative Complications ; Pulmonary Atelectasis ; Sex Distribution ; Sex Ratio ; Spleen ; Thorax ; Ultrasonography

To study the biology of the endothelium and media under conditions that mimic the architecture of the vascular wall and the effects of low density lipoprotein(LDL) and oxidized lipoprotein(ox-LDL), three dimensional vascular wall model was constructed in vitro. In the vascular wall model, endothelial cells(EC) were grown on a collagen lattice containing multilayer of smooth muscle cells(SMC) and endothelial cell-free portion was made by a cloning ring on the culture disc. The availability of this vascular wall model promptly us to examine the extent LDL and ox-LDL affect ECs and SMCs when these cells were maintained with or without each other in coculture. The results were as follows; 1) Morphologic characteristics of three dimensional vascular wall model Artificial vascular wall was a whitish, non-transparent membrane. Outer boundaries and the zone of no ECs were thicker than that of central portion. By light microscope imaging, luminal surface was EC monolayer, and SMCs and collagen fibers were distributed between the PET membrane and EC monolayer. SMCs and collagen fibers were mainly located near the PET membrane. Venous SMCs were densely infiltrated as compared to arterial SMCs. By scanning electron microscopy, EC monolayer was clearly shown. 2) The effects of LDL and oxidized LDL on ECs and SMCs in artificial vascular wall (1) The effects of LDL Collagen fibers are infiltrated just beneath EC monolayer in venous SMCs-EC coculture model. In the zone of no EC, marked proliferation and synthesis of collagen fibers were noted. (2) The effects of ox-LDL Injured EC monolayer were clearly shown in both venous and arterial SMCs-EC coculture model. On high power field light microscopic examination, collagen fibers were exposed outside to the luminal surface and were pendendicularly arranged, and looked like as ciliary projection. Artificial wall of these experimental model were thicker than that of control, and proliferation of SMCs and collagen synthesis were increased than those of control and LDL experiment groups. On scanning electromicroscopic examination, ECs were more slender and cell-to-cell contact was loosened. As a conclusion, this vascular wall model is to be good experimental model for vascular research. And LDL and ox-LDL have toxic effects on vascular EC layer and stimulate proliferation of SMCs and collagen synthesis in vitro three dimensionally constructed vascular wall model.
Biology ; Clone Cells ; Cloning, Organism ; Coculture Techniques ; Collagen ; Endothelial Cells ; Endothelium ; Lipoproteins ; Membranes ; Microscopy, Electron, Scanning ; Models, Theoretical ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Phenobarbital

No abstract available.
Mitral Valve Insufficiency*

The present study has been undertaken to pursue the cytotoxic effects of cis-Platin on the osteoid formation in metaphysis of rat tibia. By using the immunohistological staining method for type I collagen in rat tibial osteoid, the author detected the deposition of type I collagen, which is the collagenous constituent of endochondral osteoid, after administration of cis-Platin in experimental animals. For the immunological reactions of type I collagen, we used the rabbit anti-rat collagen type I polyclonal antibody as primary antibody and biotinylated goat anti-rabbit IgG as secondary antibody. The distributions of immunohistological reactions in the each of metaphyseal osteoids were analyzed with an image analyzer, and we studied the variances of type I collagens by statistical probabilities. In 12 hours after cis-Platin injection, immunoreactive area in the osteoid of metaphysis was distinctly decreased. Immunoreactive area of type I collagen in osteoids of 1 day and 3 days group metaphysis was increased more than that of 12 hours group and the type I collagen in the metaphysis showed weak immunoreactions of type I collagens with an image analyzer. In the osteoids of 7 days group after cis-Platin injection, the immunoreactive area was similar to that of control group. It is consequently suggested that cis-Platin would induce the decrease of type I collagen in the osteoid. But the type I collagen in tibial osteoid shows the increase from a few days after cis-Platin injection.
Animals ; Collagen ; Collagen Type I* ; Goats ; Immunoglobulin G ; Rats* ; Tibia*

A case of Agenesis of gallbladder in 73-year old female patient who had an emergent operation due to obstructive jaundice with impacted CBD stones is reported. The patient suffered from icteric sclera and abdominal pain which waxed and waned for three days. Impacted CBD stones and an agenesis of the gallbladder was suggested by a computed tomogram of the abdomen. In the operating field, multiple adhesions around the biliary tree was noticed, but we could not find the gallbladder and cystic duct. She underwent choledocholithotomy, T-tube choledochostomy, operative cholangiography, and drainage. Operative cholangiogaphy showed no remained stones, and there was no structures suggesting gallbladder and cystic duct. The authors described the case with a recent review from the literature.
Abdomen ; Abdominal Pain ; Aged ; Biliary Tract ; Cholangiography ; Choledochostomy ; Cystic Duct ; Drainage ; Female ; Gallbladder* ; Humans ; Jaundice, Obstructive ; Sclera

BACKGROUND AND OBJECTIVES: Incidences of postoperative mucoceles of the frontal, ethmoid, or sphenoid sinuses are currently on the rise. The clinical rogression of the postoperative mucoceles in the frontal, ethmoid, or sphenoid sinuses are different from that of the maxillary mucoceles. In this study, we investigated the clinical patterns and treatments of postoperative mucoceles, which have developed in the frontal, ethmoid, or sphenoid sinuses. MATERIALS AND METHODS: Between June,1994 and August, 2005, twenty-six patients with thirty postoperative mucoceles were treated surgically. They had a previous history of operation and incidences of maxillary mucoceles were excluded from the study. A review of the clinical subjects were performed using their clinical records and radiological findings. RESULTS: The locations of the postoperative mucoceles were, in the order of frequency, the ethmoid, frontal, fronto-ethmoid, spheno- ethmoid, sphenoid, and fronto-ethmoidsphenoid sinus. Postoperative mucoceles occurs mostly in the form of ophthalmic symptoms and headache. The ophthalmic manifestations were different between the anterior, posterior and the antero-posterior mucocele group. The mean duration until diagnosed as postoperative mucocele since the previous sinus surgery was 9.9 years, and endoscopic sinus surgeries and intranasal ethmoidectomies with Caldwell-Luc operations were the majority among previous surgeries. Most postoperative mucoceles could be successfully treated with an endoscopic marsupialization. CONCLUSION: Frontal, ethmoid, or sphenoid postoperative mucoceles developed mostly on the ethmoid sinus and occurs mainly in the form of ophthalmic symptoms. Most postoperative mucoceles were successfully treated with an endoscopic marsupialization.
Ethmoid Sinus ; Headache ; Humans ; Incidence ; Mucocele* ; Paranasal Sinuses ; Sphenoid Sinus*

We report two cases of band keratopathy who were treated with thick amniotic membrane that contained a basement membrane structure as a graft, after ethylenediaminetetraacetic acid chelation with trephination and blunt superficial lamellar keratectomy in the anterior stroma. In each case, basement membrane was destroyed and calcium plaque invaded into anterior stroma beneath Bowman's membrane. The calcified lesions were removed surgically, resulting in a smooth ocular surface, and the fine structures of band keratopathy were confirmed by pathologic findings. After that, amniotic membrane transplantation was performed to replace the excised epithelium and stroma. Wound healing was completed within 10 days. Stable ocular surface was restored without pain or inflammation. During the mean follow-up period of 13.5 months, no recurrence of band keratopathy was observed. This combined treatment is a safe and effective method for the removal of deep-situated calcium plaque and allowing the recovery of a stable ocular surface.
Amnion/*anatomy & histology/*transplantation ; Calcium/metabolism ; Chelating Agents/*therapeutic use ; Cornea/pathology/surgery ; Corneal Diseases/*drug therapy/pathology/*surgery ; Edetic Acid/*therapeutic use ; Female ; Humans ; Male ; Middle Aged

Cyclins are proteins that activate different cyclin-dependent kinases(CDKs) and promote the cell cycles. Their correlations with several human cancers have been identified. Cyclin E, as one of G1 cylins, produces DNA replication through the progression of cell cycle G1 --> S phase. In contrast, cyclin-dependent kinase inhibitors(CDKI) bound with cyclin E-cdk2 complex control the cell cycle and inhibit the cell proliferation. P21(WAF1) proteins, which are CDKIs, are transcripted by a p53 gene and participate in the cell cycle inhibition. Variant p53 proteins produced by a mutated p53 gene lose the ability to control of the cell cycle resulting in cell proliferation. This study is aimed to reveal the expressions of cyclin E, p21(WAF1) protein, p53 variant protein in colorectal adenomas and carcinomas, and also reveal their correlations in the process of carcinogenesis. Twenty-one colorectal adenomas or adenomatous polyps, and thirty colorectal carcinoma tissues were obtained by operative resections or endoscopic polypectomies. Immuno histochemical stains of the above-mentioned three proteins and a statistical analysis of their correlations were made. The results were as follows: 1. P21 proteins were expressed in the upper-one third layer of all normal colonic mucosa, but cyclin E and variant p53 protein were not identified. 2. Cyclin E was expressed in 23.8% of adenomas and 76.7% of carcinomas. Variant p53 protein was expressed in 71.4% of adenomas and 83.3% in carcinomas. The degree of positivity of variant p53 expression was correlated with cancer staging. P21 protein was expressed in all adenomas, similar to normal mucosa, but was not expressed in 43.3% of carcinomas. 3. Expression of cyclin E was increased as to the positivity of variant p53 proteins but the correlations of p21 proteins and cyclin E, and p21 proteins and variant p53 proteins were not identified. Cancer staging was not correlated with the expressions of the three proteins. In conclusion, it can be thought that the overexpression of cyclin E and variant p53 proteins, and the loss of p21 proteins are related with the colorectal carcinogenesis. We can also identify the relationship of cyclin E and variant p53 proteins.
Adenoma* ; Adenomatous Polyps ; Carcinogenesis ; Cell Cycle ; Cell Proliferation ; Colon ; Colorectal Neoplasms ; Coloring Agents ; Cyclin E* ; Cyclins* ; DNA Replication ; Genes, p53 ; Humans ; Mucous Membrane ; Neoplasm Staging ; Phosphotransferases ; S Phase

The human sparganum mansoni infestation was reported 63 cases in Korea until 1974, but urogenital infestation of sparganum is relatively rare. We experienced a case of sparganosis in which one parasite migrated from the Left flank to the left scrotum and the other remained in the left flank. The white ribbon worm-like structure was crawling in the subcutaneous tissue of the left scrotum. This 51 year lod male patient had an episode of intake of raw snake as a tonic 2 year ago in Kyungki-do, Korea.
Gyeonggi-do ; Humans ; Korea ; Male ; Parasites ; Scrotum* ; Snakes ; Sparganosis* ; Sparganum ; Subcutaneous Tissue