OBJECTIVE: Peripartum emergency cesarean hysterectomy of 28 cases at our hospital for 10years were reviewed that the clinical indication, history, and annual incidence change. METHODS: A retrospective descriptive analysis from January, 1988 to December, 1997 was carried out. RESULTS: There were 28 cases of emergency cesarean hysterectomy identified during this period among total 24, 689 deliveries. The annual incidence of emergency cesarean hysterectomy was significantly declined statistically(p<0.005). Cesarean hysterectomy was performed in 20 of 6, 671 cesarean section(0.30%) and in 8 of 18, 018 vaginal deliveries(0.04%), so more frequently after cesarean section than vaginal delivery. The cesarean hysterectomy rate was more frequent in multiparous women(0, 22%) than in nulliparous women(0, 02%). The most common indication of cesarean hysterectomy was 13 cases of uterine atony(46%), followed by 5 cases uterine rupture(18%), 5 cases of placenta previa with placenta accreta(18%), 3 cases of placenta previa(11%), 2 cases of uterine myoma(7%). No significant difference in length of operating time, amount of blood loss and operative complications were found between total abdominal hysterectomy and subtotal hysterectomy. The all patient who had cesarean hysterectomy recieved from 1200ml to 15840ml of blood transfusion with a mean of 3673ml. In aspect of fetal outcome, 3 cases of FDIU(Fetal death in utero) in uterine rupture and 1 case of stillbirth in preterm were found. The maternal complications were wound disruption, DIC, wound hematoma, ureter injury, vaginal stump bleeding, UTI(Urinary tract infection) and retroperitoneal bleeding, CONCLUSION: We conclude that the incidence of emergency cesarean hysterectomy declined with prediction of antenatal risk factor, preparing of sufficient fresh blood, prophylactic antibiotics, vigorous uterotonics and close observation after delivery.
Anti-Bacterial Agents ; Blood Transfusion ; Cesarean Section ; Dacarbazine ; Emergencies* ; Female ; Hematoma ; Hemorrhage ; Humans ; Hysterectomy* ; Incidence ; Peripartum Period* ; Placenta ; Placenta Previa ; Pregnancy ; Retrospective Studies ; Risk Factors ; Stillbirth ; Ureter ; Uterine Rupture ; Wounds and Injuries

There are many difficult problems of reduction and its maintaining in the treatment of unstable intertrochanteric fractures. Especially, in cases of elderly patients with marked osteoporosis, prolonged immobilization brings more serious complication. In order to solve these problems, in cases of unstable intertrochanteric fractures with large lesser trochanteric fragment, we have carried out anatomical reduction and rigid internal fixation with compression hip screw and additional transfixation screw on posteromedial fragment. The unstable fractures have been convrted into the stable fractures by transfixation screw. We analyzed the 1 1cases with additional transfixation screw and they showed good results in one year follow up.
Aged ; Femoral Fractures ; Femur ; Follow-Up Studies ; Hip Fractures ; Hip ; Humans ; Immobilization ; Osteoporosis

No abstract available.
Twins, Conjoined*

No abstract available.
Anemia, Hemolytic, Autoimmune*

No abstract available.
Cardiac Tamponade* ; Leukemia, Myeloid, Acute*

This study aimed to evaluate current clinical assessments and management of obesity in the primary care setting in Korea since anti-obesity agents have become available. A questionnaire was sent to eligible primary care physicians selected from a national probability sample in two specialties: family physicians and internists. Of 939 randomly selected physicians, 452 (48.1%) replied. We found that 51.8% of physicians were aware of the definition of obesity, and 33.8% were aware of the definition of abdominal obesity proposed by Asia-Pacific guideline. When evaluating apparently obese patients, 50.0% of respondents measured body mass index (BMI) and 20.4% measured waist circumference. Fewer than 50% of physicians measured blood glucose or lipid profiles, both of which are risk factors for obesity. About 47.3% of physicians prescribed an anti-obesity medication without allowing sufficient time for nonpharmacologic therapy to take effect, and 68.8% of physicians prescribed anti-obesity medications to patients that requested them regardless of obesity status. The majority of respondents did not appropriately evaluate obesity and its risk factors, and were readily susceptible to prescribing anti-obesity medications. Our findings suggest that primary care physicians in Korea need additional education on obesity and its management.
Adult ; Age Factors ; Anti-Obesity Agents/*pharmacology ; Blood Glucose/metabolism ; Body Mass Index ; Family Practice/*methods ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Korea ; Lipids/metabolism ; Male ; Middle Aged ; Obesity/metabolism/*therapy ; Physician's Practice Patterns ; Physicians, Family ; Questionnaires ; Risk Factors ; Weight Loss

PURPOSE: To explore possible changes in awake cystometry and expression of beta-adrenoceptors (ARs) as a cause for bladder dysfunction in a male rat model of partial bladder outlet obstruction (pBOO). MATERIALS AND METHODS: Awake cystometry was performed in rats with pBOO (16) and sham-operated rats (16), 8 weeks after the operation. The expression of mRNA and protein of beta-ARs was assessed by real-time PCR and western blot. RESULTS: The bladders with pBOO (1030mg) were increased compared to those in control rats (230mg). In the cystometric studies, the maximum intravesical pressure significantly increased in the pBOO group compared to control group rats (p=0.001). The time to reach maximal intravesical pressure during micturition in the pBOO group was significantly longer than the sham group (p=0.003). The frequency of non-void contraction in the pBOO group was significantly more than the sham group (p=0.006). The mRNA expressions of beta2- and 3-ARs were increased insignificantly in pBOO group compared to sham group. The data of pBOO group expressed as folds of corresponding expression in sham group were 1.28 and 1.46 respectively in beta2- and 3-ARs. Compared to the sham groups, the density of 60Kda protein band recognized by beta2-AR antibodies and the density of 45Kda protein band recognized by beta3-AR antibodies were higher in the bladder from pBOO group rats. CONCLUSION: PBOO of male rats increase the maximal intravesical pressure and contraction time during micturition and the frequency of non-void contraction as well as weight of bladder. The expression of beta2- and 3-ARs subtypes was increased insignificantly compared to sham operated group. This study demonstrates that the changes of cystometric or non-void contraction parameters in pBOO is one of the pathophysiologic processes potentially associated with the alterations of bladder beta-ARs.
Animals ; Antibodies ; Blotting, Western ; Contracts ; Humans ; Male ; Rats ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Salicylamides ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urination

PURPOSE: Acute scrotum is a clinical syndrome that is defined as an acute painful swelling of the scrotum. It is well known that early surgical exploration is needed to prevent the testicular loss when testicu lar torsion breakouts. But most of reports were only focused on testicular torsion of prepubertal age group. This fact let us examine the acute scrotum with all age group and the significance of surgical exploration. MATERIALS AND METHODS: We retrospectively reviewed the results collected from 112 patients (131 cases) with acute scrotum who had been admitted to our hospital between June 1994 and November 1999 with the exception of scrotal trauma. RESULTS: The incidence of acute scrotum over 20 years old was 72.4% of total acute scrotum patients. The most common disease was acute epididymitis giving the rate of 71.8% (94 cases). In adult the incidence of testicular torsion was low (3 cases). Surgical torsion was 12 cases and acute epididymitis was 12 cases as the cause of acute scrotum. CONCLUSIONS: Most cases of testicular torsion have been below 20 years old and only 3 cases have been over 20 years old. Although the incidence of testicular torsion over 20 years old has been low. There were severe infectious diseases needing surgical approach in the cases of aged patient. this research shows that the treatment of acute scrotum goes with the need of surgical therapy.
Acute Pain ; Adult ; Communicable Diseases ; Epididymitis ; Humans ; Incidence ; Linear Energy Transfer ; Male ; Retrospective Studies ; Scrotum* ; Spermatic Cord Torsion ; Young Adult

No abstract available.
Carcinoma, Small Cell* ; Cisplatin* ; Drug Therapy, Combination* ; Etoposide* ; Leukemia, Myeloid, Acute* ; Lung*

No abstract available.
Acne Vulgaris*