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

There are many procedures described for the treatment of acromioclavicular seperation but there are still controversies concerning the best management of these injuries. Thirteen cases were operated on by technique of modified Phemister method and four cases by Bosworth method, Dept. of Orthopedic Surgery, Chonbuk National University Hospital from January 1980 to December 1984. The following results were obtained. The following results were obtained. 1. This injuries is more prevalent in male (76.4%) with peak incidence in the second, third and fourth decades(76.4%). 2. The most common causes of the injuries were traffic accidents and followed by falling from the height. 3. Fifteen patients were grade 3 by Allmans classification. 4. Operative method consists of modified Phemister method (76.4%) and Bosworth method (23.6%). 5. The operative procedures in Type 2 and Type 3 are good treatment of acromioclavicular seperation.
Accidental Falls ; Accidents, Traffic ; Classification ; Humans ; Incidence ; Jeollabuk-do ; Joints ; Male ; Methods ; Orthopedics ; Surgical Procedures, Operative

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

No abstract available.
Carcinoma, Renal Cell* ; Cell Line* ; Humans*

There have been increasing interests of diabetes in the realm of plastic surgery due to problems like foot ulcer as a complication, delayed wound healing or higher failure rates of flap surgery. Main pathology in diabetes is microvascular compromise as well as metabolic derangements. The disturbance in microvascular circulation results in ischemic environments in the body and acts as a main factor that determines the limit of reconstructive or aesthetic plastic surgery. A useful method to overcome such problems is the use of hyperbaric oxygen therapy, which is known to be effective in the treatment of ischemic skin ulcer or osteoradionecrosis. However, there have been few studies on the survival of diabetic random skin flap or the effects of hyperbaric oxygenation directed to increase survival of such flap. In our study, we supposed that the survival of diabetic random skin flap was diminished owing to compromised microvascular pathology and blood rheology, and metabolic derangements, so we hypothesized that hyperbaric oxygen therapy has both reversible and irreversible effects on the survival of ischemic random skin flap in Streptozotocin-induced diabetic rats. Increase of local transcutaneous oxygen concentration, O2 affinity in blood and dysmorphogenesis of red blood cells are reversible and relatively short-term effects and promotion of neoangiogenesis is irreversible or long-term effects. We intended to confirm that hyperbaric rats and to compare the effects between preoperative and postoperative hyperbaric oxygenation on the survival of such flap. And we expect the additional effects of hyperbaric oxygenation on metabolism in diabetic rat, such as lowering the blood glucose level and solving the arrested weight gain. We divided Streptozotocin-induced diabetic rats into three groups: the first was non-treatment diabetic group, the second was preoperative hyperbaric oxygen treated diabetic group(100% O2, 2 atm, 90min, 15sessions, twice a day), and the third was postoperative hyperbaric oxygen treated group(100% O2, 2atm, 90min, 15sessions, twice a day). After elevation of random skin flap on dorsum of diabetic rats, we evaluated the extent of flap survival by measuring the necrotic areas at 3rd, 7th, 10th, and 13th postoperative days. At that time, we intended to evaluate both effects on flap survival by preoperative and postoperative hyperbaric oxygen therapy. As a result, flap survival of non-treated diabetic group was 41% at 13th postoperative days. In diabetic groups with preoperative and postoperative hyperbaric oxygen therapy, flap survival were increased to 64.6% and 62.4% respectively. Diabetic groups with hyperbaric oxygen therapy have a tendency of meaningful decrement in blood glucose level. However, there were no meaningful differences between preoperative and postoperative hyperbaric oxygen therapy. Hyperbaric oxygen therapy has no effective correlations with body weight changes. We conclude that hyperbaric oxygen therapy has some useful effects on the survival of diabetic random skin flap.
Animals ; Blood Glucose ; Body Weight Changes ; Erythrocytes ; Foot Ulcer ; Hyperbaric Oxygenation* ; Metabolism ; Osteoradionecrosis ; Oxygen ; Pathology ; Rats* ; Rheology ; Skin Ulcer ; Skin* ; Surgery, Plastic ; Weight Gain ; Wound Healing

No abstract available.
Adenocarcinoma*

The soleal line in 115 (left; 61, right; 54) cases of tibiae was studied morphometrically by the method of Mysorekar and Nandedkar. 1. The soleal line showed a uniform character throughout in 26 cases and a mixed characters in 89 cases. The bones showing uniform character were seen generally as a lineal line or wide line. 2. The soleal line having mixed characters divided into three parts. In the upper and middle thirds, the major type of line was wide line. In the lower third, the line was commonly seen as a lineal line. In about 12% of the bones examined the line was seen as a groove, particularly in the middle and lower thirds. 3. The soleal line commenced 1-2cm below the fibular facet In about 61% of cases. 4. The length of the soleal line was 10.5cm, and the ratio to that of the tibia was about 30%. The results of this study provide the characters of the soleal tne of the tibia in Korean. The soleal line, unlike the textbook description, generally shows mixed characters of a line.
Methods ; Tibia*

Intussusception is a condition of invagination of the proximal segment of bowel into the more distal receiving bowel. Intussusception is one of the common pediatric and surgical emergencies of infancy and childhood in Korea. Intussusception is the most common cause of acquired intestinal obstruction in infancy and childhood, and it needs emergency treatment. 1) On the age and sex distribution, the age under 15 month was the most common(70.6%), and the peak incidence was 3-12 months of age(60.1%). In sex distribution, male to female ratio was 1.25:1. 2) The seasonal distribution was summer(27.4%), spring, autumn and winter in order of frequency. 3) As to the etiology of Intussusception treated by surgery, idiopathic was the most common(75%). 4) The cardinal symptoms and signs were vomiting(72.5%), bloody or bloody mucoid stool(57.5%), abdominal pain(49.7%), abdominal distention(20.9%), abdominal mass(19.6%) and others in order of frequency. 5) On the hematologic finding, 60.8% revealed leukocytosis above 10,000/mm3. 6) As to the duration from the onset of the symptom to admission, 84.2% was within 24 hours, 9.8% was from 24 hours to 48 hours, and 5% was over 48 hours. 7) The common anatomical types were ileocolic(73.2%), and ileocecal(17.0%). 8) The success rate of air reduction was 84.3%. 9) In the method of operation, manual reduction was performed in 91.7% and intestinal resection in 8.3%. 10) The recurrence rate after air reduction was 12.4% and after operative manual reduction was 8.3%.
Emergencies* ; Emergency Service, Hospital* ; Emergency Treatment ; Female ; Humans ; Incidence ; Intestinal Obstruction ; Intussusception* ; Korea ; Leukocytosis ; Male ; Recurrence ; Seasons ; Sex Distribution

OBJECTIVE: Our purpose was to investigate the relation between types of early diastolic notch and placental location and to evaluate the differences in perinatal outcomes. METHODS: We evaluated the Doppler waveform of the uterine artery in 149 pregnant women having an early diastolic notch after 26 weeks gestation, however we were unable to follow the obstetric outcomes in 20 women. Placental location was determined by transverse view of ultrasonography and classified as central and lateral placenta. The unilateral diastolic notches were divided into 3 groups depending on the placental location (ipsilateral: same side of the placenta, contralateral: opposite side of the placenta, and median: central placenta) RESULTS: In the bilateral notch group, the S/D ratio of the contralateral uterine artery was higher than the ipsilateral one(n=60, mean=3.22 Vs 2.80, p=0.0067). Of the 89 unilateral notches observed, the S/D ratio of the uterine artery in patients having early diastolic notch was higher compared to those without early diastolic notch.(t-test, mean=2.74,1.92, p=0.0001) Patients with bilateral notches were associated with poor perinatal outcomes significantly more than the patients with unilateral notches(p=0.003). Among the unilateral groups (ipsilateral: n=10, median: n=21, contralateral: n=58), there was no significant difference in perinatal outcomes. CONCLUSION: The early diastolic notch can be observed on both or either sides of the uterine artery independent on placental location. More bilateral notches were associated with poor pregnancy outcomes than unilateral notches. The pregnancy outcomes tended to be similar in unilateral notch irrespective of placental location, but showed worse outcomes than the control group. Careful analysis of the uterine artery in nonplacental side is necessary because of the frequent appearance of early diastolic notch and higher vascular resistance.
Female ; Humans ; Placenta ; Pregnancy ; Pregnancy Outcome ; Pregnant Women ; Rheology* ; Ultrasonography ; Uterine Artery* ; Vascular Resistance

End-to-side neurorrhaphy had been firstly reported at the beginning of this century, but no further clinical reports have been released. In some cases of end-to-end neurorrhaphy, donor nerve incision or even sacrification is inevitably necessary. In doing end-to-side neurorrhaphy, has not been widely accepted because previous results were not satisfactory. The purpose of this study is to evaluate the applicability of end-to-side neurorrhaphy in rats. Twenty female Sprague-Dawley rats, weighing approximately 200-250 g(232.50+/-12.6g) were used. In 10 rats, their right and left peroneal nerves were cut and the distal end of peroneal nerves were end-to-side neurorrhaphied to the tibial nerve. On the right side, the epineurium was left intact and on the left side, it was removed. The proximal end of peroneal nerves were imbedded in the thigh muscle. After 6 months, eletrophysiologic tests, including nerve conduction velocity, the amplitude and the areas of action potential of the tibial cranial muscle were done and then all rats were sacrificed for histologic analysis. The other 10 offspring rats were raised and used for control group. The mean weight of the tibial cranial muscle was 1.74(+/-0.30)g on the right side, 1.54(+/-0.31)g on the left side and 1.97(+/-0.28)g in the control group, which was statistically not significant. The number of muscle fibers in x 100 magnification was 106.10(+/-4.28) on the right side, 109.67(+/-4.69) on the left side and 107.80(+/-4.64) in the control group, which was also not significant. The amplitude and width of muscle action potential were not statistically different among the right side, the left side and in the control group. However, the nerve conduction velocity was bilaterally delayed if compared to control group. In histologic analysis, the presence of epineurium did not impact the results and end-to-side neurorrhaphy were successfully regenerated in all rats. End-to-side neurorrhaphy seem to be a functionally and histologically tolerable alternative when end-to-end neurorrhaphy is not available.
Action Potentials ; Animals ; Female ; Humans ; Nerve Regeneration* ; Neural Conduction ; Peripheral Nerves* ; Peroneal Nerve ; Rats* ; Rats, Sprague-Dawley ; Thigh ; Tibial Nerve ; Tissue Donors