This report is a review of experience with 45 patients plication methods of redundant rectal mucosa by longitudinal over and over suture who were admitted in department of surgery at Dongsan sacred Heart Hospital during 1997. This new technique was indicated by incomplete rectal prolapse, first degree complete rectal prolapse (internal rectal intussusception), 3rd degree hemorrhoids, redundant rectal mucosa in operation field, anal prolapse and severe external anal skin tag. At first, entire hemorrhoid-bearing area was dissected by excision and ligation methods. Within upward 1cm from ligationpoint, No.3 chromic catgut suture was done including rectal submucosa. Starting from this, linear continueous overlapping locking suture was done until redundant mucosa was tented by Chromic suture traction in range of 1 to 1.5 cm widths. If there is wide redundant mucosa not corrected one time, another linear continuous overlapping locking suture especially not circular may be done. This method is very easy and few complication-bleeding, pain, infection, mucosa loss, etc. The patients who have incomplete defecation sensation, rectocele and skin tag were satisfied with operation. This method may be an easy, effective new technique in patients who have anal prolapse, skin tag, rectocele and constipation etc.
Catgut ; Constipation ; Defecation ; Heart ; Hemorrhoids ; Humans ; Ligation ; Mucous Membrane* ; Prolapse ; Rectal Prolapse ; Rectocele ; Sensation ; Skin ; Sutures* ; Traction

Placenta previa percreta is an uncommon and lifetbreatening complication of pregnancy. tbe incidence of both placenta previa and placenta acaeta are increased in patients with scaned uteri, and patienth with uterine scars and placenta previa are at inaeased risk for also baving placenta accreta. A case of placents previa percreta involving the urinary bladder was experienced and treated with surgical management. We reported a case with concerned literatures
Cicatrix ; Humans ; Incidence ; Placenta Accreta* ; Placenta Previa ; Placenta* ; Pregnancy ; Urinary Bladder* ; Uterus

The acardius occurs with an incidence of one in 35,000 births and is presumed to result hom vascular anastomosis between the arterial circulation of the hemodynamically larger ""pump"" twin and that of the recipient ""perfused"" twin. The perfused twin displays severe anomalies, typically referred to as acardia, that are incompatible with life. The pump twin, because of its expanded cardiac demand, may also deveolp cardiac failure, with a mortality risk of 50-70%. We experienced one case of acardiac-acephalus twin gestation diagnosed by antenatal ultrasonography, and presented this.
Heart Failure ; Humans ; Incidence ; Mortality ; Parturition ; Pregnancy ; Twins* ; Ultrasonography*

Epidermal cyst in the fibroadenoma of the breast is very rare. A 29-year-old woman presented with a lump in the upper outer quadrant of the right breast. Clinically it was a fibroadenoma and the excisional specimen showed an encapsulated, firm lobulated lesion with a cystic area on cut surface. The cystic area showed squamous metaplasia of the ductal epithelium and keratinous cyst formation in the fibroadenoma. We report this unusual case with review of literatures.
Adult ; Breast ; Epidermal Cyst* ; Epithelium ; Female ; Fibroadenoma* ; Humans ; Metaplasia

BACKGROUND: Caudal anesthesia is considered a safe and reliable anesthetic technique for many pediatric surgical procedures. It is well known that extradural clonidine produces analgesia in adult. The purpose of this study is to assess its efficacy in children. METHODS: We randomized 45 pediatric patients aged under 10 years, weighted under 25 kg presented for lower abdominal surgery with duration of operation would be shorter than 2 hours, into three groups of 15 each. After sedation with the use of intravenous thiopental sodium, caudal anesthesia was performed with the use of 1 mL/kg of 0.25% bupivacaine. We allocated randomly the patients who received no additional medication in 0.25% bupivacaine (group I), with epinephrine 1/200,000 (group II), and with 1 mcg/kg of clonidine (group III). The degree of postoperative analgesia was evaluated using the Broadman ""Objective Pain/discomfort Scale"" (OPS) at hourly intervals for 24 hours. RESULTS: Duration of sleep in the recovery room was significantly longer in group III than in group I and group II, and statistical significant difference was found between the group I and group II. Duration of analgesia was significantly longer in group III than in group I and group II. Overall hourly OPS scores were lower in group III than in group I and group II. CONCLUSION: Duration of postoperative analgesia with caudal bupivacaine was increased by addition of 1 mcg/kg of clonidine.
Adult ; Analgesia ; Anesthesia, Caudal* ; Bupivacaine ; Child ; Clonidine* ; Epinephrine ; Humans ; Recovery Room ; Thiopental

OBJECTIVE: The objective of this study is to nfluence of sequential embryo transfers in an invitro fertilization was examined. METHOD: After in vitro fertilization, a maximum of 6 fertilized oocytes was enrolled in this study. At day 3 after an oocytes retrieval, embryos with good quality were transferred (mean 4.9), remaining embryos (mean 2.0/cycle) were cryopreserved at blastocyst stage (Group 1). At day 5 after oocytes collection, second a embryos had reached the blastocyst stage (Group 2) using P1 supplemented with 10 SSS and 30% Follicular fluid. No statistical difference in the pregnancy rate could be seen between the group without a second embryo transfer (n=21; 28.6%) and the group with a second transfer (n=52; 28.8%). RESULTS: The incidence of multiple pregnancy rate per embryo transfer was not statistically different between both group and no high-rank multiple pregnancy (greater than triplete) were observed (o.9%, 15.4%, respectively, p=0.74, chi2). Out of 114 cycles (506 embryos) cultured embryos in group 2, 52 cycles (159 embryos, 29.8%) reached the blastocyst stage. CONCLUSION: The second transfer did not have a significant effect on the pregnancy rate. The most important factor for the pregnancy seems to be the quality of the embryos transferred on day 3 following oocyte retrieval. We recommend embryo transfer is performed only one, day 2~3 or D5.
Blastocyst ; Embryo Transfer* ; Embryonic Structures* ; Female ; Fertilization ; Fertilization in Vitro* ; Follicular Fluid ; Incidence ; Oocyte Retrieval ; Oocytes ; Pregnancy ; Pregnancy Rate ; Pregnancy, Multiple

No abstract available.
Adenocarcinoma, Papillary*

In clinical setting, treatment-refractoriness, medication induced tardive dyskinesia and amenorrhea in chronic schizophrenia are frequently problematic. However, there are few guideline solving these problem available to clinicians. The goal of this study was collecting clinical data on clinical effeciveness and predictors of response of switching to olanzapine. We attempted to switch to olanzapine from risperidone and clozapine in chronic 31(risperidone 17, clozapine 14) schizophrenia and schizoaffective disorder patients suffering from sustained symptoms, weekly blood monitoring, medication induced tardive dyskinesia and amenorrhea. Previous antipsychotics dosage was gradually decreased for 2 or 3 weeks, at the same time olanzapine dosage was gradually increased. At baseline, after 1 week, after 2 weeks and after 4 weeks we checked Brief Psychiatric Rating Scale, Clinical Global Impression Scale, Sympson-Angus Rating Scale, Barnes Akathisia Rating Scale and Followed up after 12 months. Successful switch after 4 weeks was achieved in 25 patients(clozapine 9(64.2%), risperidone 16(94.1%). Overall, mean BPRS and CGI scores increased significantly. Successful maintenance after 12 months was achieved in 17 patients(clozapine 5(35.7%), risperidone 2(70.5%). Overall, mean BPRS and CGI scores increased significantly too. Switching to olanzapine from other atypical antipsychotics is recommendable in chronic schizophrenia with treatment refreactoriness and drug induced side effect.
Amenorrhea ; Antipsychotic Agents ; Brief Psychiatric Rating Scale ; Clozapine* ; Female ; Follow-Up Studies* ; Humans ; Movement Disorders ; Psychomotor Agitation ; Psychotic Disorders ; Risperidone* ; Schizophrenia

No abstract available.
Lipopolysaccharides* ; Otitis Media with Effusion* ; Otitis Media* ; Otitis*

The ideal breast reduction should create beautiful breasts with limited scars. Unfortunately, no surgeon has ever been able to produce such a result. Most recent breast reduction techniques tend to produce minimal breast scars and avoid the classic inverted-T incision. The vertical mammaplasty can be used in mild to moderate cases of breast reduction, producing consistently good, stable results with limited scars. This technique uses adjustable preoperative markings, an upper pedicle for the areola, and a central breast reduction with limited skin undermining. The shape of the breast is created by suturing of the gland and does not rely on the skin. The adjunctive use of liposuction in fatty breasts can be considered safe and efficient. We have performed reduction mammaplasty using the vertical mammaplasty technique in 12 patients. Overall number and extent of complications were small, and patient satisfaction was high for this procedures. The advantages of vertical mammaplasty technique compared with other methods are as follows ; 1. The markings are adjustable to nearly all patients. 2. Stable contours are produced because the gland is strongly sutured. 3. Few postoperative complications occur. 4. Limited scars(only vertical scars) are created 5. The procedure is easy to learn and perform.
Breast ; Cicatrix ; Female ; Humans ; Lipectomy ; Mammaplasty* ; Patient Satisfaction ; Postoperative Complications ; Skin