INTRODUCTIONIn line with the effort to evaluate feasible surgical options for vasectomy reversal and to increase patients' willingness to undergo the procedure, this study reported on a technique for ambulatory mini-incision microsurgical vasovasostomy using a double-ringed clamp (i.e. Moon's clamp). This technique does not require the use of dilators, approximators and other accessory devices.

METHODSAmbulatory mini-incision microsurgical vasovasostomy was conducted on 263 patients who satisfied the surgical eligibility requirements for vasovasostomy and the safety criteria for local anaesthesia. The operation time, details on postoperative recovery and results of the postoperative semen analysis were recorded and retrospectively analysed.

RESULTSThe mean time used to isolate the bilateral vas deferens was 25.5 minutes. All patients were discharged on the day of surgery and all patients returned to their normal activities within 24-48 hours after surgery. No haematoma or infection occurred except in one patient. Postoperative semen analysis showed that the surgery was successful in 182 (96.8%) of the 188 patients who complied with the postoperative patient instructions.

CONCLUSIONAmbulatory mini-incision microsurgical vasectomy reversal using Moon's clamp and under local anaesthesia is a surgically feasible option that offers the advantages of a low-risk operation. It also achieves successful vasovasostomy without other accessory devices and allows patients to return to their daily activities quickly with minimal complications.

Adult ; Anesthesia, Local ; methods ; Equipment Design ; Feasibility Studies ; Follow-Up Studies ; Humans ; Male ; Microsurgery ; methods ; Middle Aged ; Retrospective Studies ; Surgical Instruments ; Suture Techniques ; instrumentation ; Vasovasostomy ; methods

A total of 369 patients with abnoirmal cervical eytology and suspicious lesions of the cervix were colposcoped end 356 patients of whom were, taken directed biopsy to assess the lesions preeisely and compare the aeeuracy of the eaeh methods. The results of cervical cytology were elso compared with the colpoacopic impression and colposcopically directed biopsies. 252 patients with abnr;irmal colyoaeopie findings were performl conization, simple hiysterectomy or radical hysterectomy depending on their current idisease statua. The rate of one grade less or more advanced correlation between the cervical cytology and directed biopsy was 72.4% and thiat of two grade less wns 80.3% and as for the correletion between the colposcopic imprwssions and the colposcopically directed biopsies, the rate of ciompatibility was 91.5%. Bases on the hetopathologic findings of the surgical apeeimen, the eompatibility rotcs of eervical cytology, colposcopic impressions and colposcopilIy divected hiopsies were 70.2%, 90.6% and 98.0% respectively. With these results, we can reach a conclusion that the colpnscopic impression itself is almost as accurate as the colposcopicolly directed biosy and the directed biopsy can take the place of conization so far as the diagnostic accuracy is concerned.
Biopsy* ; Cervix Uteri ; Conization ; Female ; Humans ; Hysterectomy

No abstract available.
Animals ; Glomerulosclerosis, Focal Segmental* ; Lovastatin* ; Puromycin* ; Rats*

The finger extension reflex was performed to the 419 normal infants without CNS abnormalities that visited to the well baby clinic and out-patient department, and so to the patients with CNS abnormalities on the brain sonography and brain CT under the age of 2 months from May 1992 to September 1993 in the department of pediatrics, Hanyang university hospital. The results were summerized as follows 1) The positive rates of the finger extension reflex according to age in month on the normal infants from birth to 8 months of age were 100%, 100%, 100%, 72.3%, 57.1%, 28.6%, 17.5%, 6.3% and 0% respectively, and the reflex was almost lost after the age of 5 months. 2) Of 21 patients with brain pathology on the brain sonography and/or brain CT, the finger extension reflexes were absent on two patients with grade 3~4 intraventricular hemorrhage, one with hypoxic brain damage and one with severe brain parenchymal hemorrhage, partially responded on two patients with brain edema and one with moderate-sized brain parenchymal hemorrhage, and completely responded on 11 patients with mild intracranial hemorrhage, two with hydrocephalus and one with aneurysm of Galen vein. 3) Because there were no cases with localized brain pathology, we couldn't find the differences of the finger extension reflexes associated with the location of brain pathology. In conclusion, we found that the finger extension reflex may be lost from 3 months through 6 months of age. With further study of normal premature babies and more infants with brain pathology, we may use the finger extension reflex as one of the primitive reflexes and predict severe CNS abnormalities.
Aneurysm ; Brain ; Brain Diseases ; Brain Edema ; Cerebral Veins ; Fingers* ; Hemorrhage ; Humans ; Hydrocephalus ; Hypoxia, Brain ; Infant ; Intracranial Hemorrhages ; Outpatients ; Parturition ; Pediatrics ; Reflex*

No abstract available.
Emergencies* ; Emergency Service, Hospital*

Experiences with four cases of untreated clubfoot in adults are reported. Three of these were congenital and one was secondary to poliomyelitis. Difficulties encountered in the corrective surgery of the cases are presented and the pathogenesis of tibial torsion and contribution of the talus in the development of congenital clubfoot are discussed along with review of the literature.
Adult ; Clubfoot ; Humans ; Poliomyelitis ; Talus

This article reviewed achievements and challenges of the National Health Insurance of the Republic of Korea and shared thoughts on its future directions. Starting with large workplaces of 500 or more employees in 1977, Korea's National Health Insurance successfully achieved universal coverage within just 12 yr in 1989. This amazing pace of growth was possible due to a positive combination of strong political will and rapid economic growth. Key features of Korea's experience in achieving universal coverage include 1) gradual expansion of coverage, 2) careful consideration to maintain sound insurance finances, and 3) introducing multiple health insurance societies (multiple payer system) at the initial stage. Introduction of the health insurance has dramatically improved Korea's health indicators and has fueled the rapid growth of basic medical infrastructure including medical institutions and professionals. On the other hand, the successful expansion was not free from side-effects. Although coverage has gradually expanded, benefits are still relatively low. The current situation warrants concern because coverage expansion is driven by welfare populism asserted by irresponsible political slogans and lacks a social consensus on basic principles and philosophy regarding the expansion. Concentration of patients to a few large prestigious hospitals as well as the inefficiencies resulting from a colossal single-payer system should also be pointed out.
Delivery of Health Care/*economics ; Humans ; National Health Programs/*economics ; Republic of Korea ; Social Welfare

This study was conducted to examine the effect of mefenamic acid for treatment of PDA in premature newborns. Ductus arteriosus is reopened by locally produced prostaglandin E2 in a premature newborn during hypoxia. Mefenamic acid is one of non-steroidal antiinflammatory drugs acting by inhibition of cyclo-oxygenase in the prostaglandin synthesis pathway. For three premature newborns with PDA, we administered mefenamic acid and evaluated them with echocardiography to study the effect of mefenmic acid for closure of PDA. In all three babies, ductus arteriosus was closed successfully. We feel that mefenamic acid is safe and effective medication for treatment of PDA in premature newborns, but further-study need to be conducted with larger numbers of cases to confirm this effect.
Anoxia ; Dinoprostone ; Ductus Arteriosus ; Echocardiography ; Humans ; Infant, Newborn* ; Mefenamic Acid* ; Prostaglandin-Endoperoxide Synthases

Eosinophilic gastroenteritis is a rare disorder of unknown etiology characterized by protein losing enteropathy, peripheral eosinophilia and iron deficiency anemia secondary to gastrointestinal blood loss. It is often accompanied by signs of systemic allergy. This case of a 26-month-old male patient who developed scrotal edema and diarrhea for a month had peripheral eosinophilia ranged from 24 to 32% of total leukocyte, iron deficiency anemia and hypoalbuminemia with slightly increased level of serum lgE. Biopsies of the stomach and duodenum demonstrated marked eosinophilic infiltration of the mucosa and lymphatic dilatation, which was consistent with eosinophilic gastroenteritis. We report a case of eosinophilic gastroenteritis with a brief review who was treated with corticosteroid alone and had marked symptomatic improvement.
Anemia, Iron-Deficiency ; Biopsy ; Child, Preschool ; Diarrhea ; Dilatation ; Duodenum ; Edema ; Eosinophilia ; Eosinophils* ; Gastroenteritis* ; Humans ; Hypersensitivity ; Hypoalbuminemia ; Leukocytes ; Male ; Mucous Membrane ; Protein-Losing Enteropathies ; Stomach

No abstract available.
Electroencephalography* ; Humans ; Neurologic Manifestations* ; Seizures*