OBJECTIVES: To evaluate the effectiveness and the value of Laparoscopic Assisted Vaginal Hysterectomy, and to evaluate the possibility whether to replace abdominal hysterectomy to LAVH. METHOD: A retrospective study of the surgical procedure was performed by one team with one experienced laparoscopist. The operations were carried out in a private hospital, where operative laparoscopic set was available. All 500 patients underwent LAVH from March 1998 to March 1999 at the department of Obstetrics and Gynecology, Eun hospital. Patients were required hysterectomy for uterine fibroid, chronic pelvic pain and carcinoma in situ of cervix,. etc. RESULTS: The average operating time was 56.4+/-11.8 minutes, and the mean estimated postoperative hemoglobin loss was 0.62+/-1.0 g/dL. The mean uterine weight was 223.9+/-129.7 gram (range from 60gram to 800gram). The most common pathologic finding was adenomyosis(59.6%),and the second most pathologic findig was uterine fibroid(47%). No serious complications occured, but 3 vault hematoma cases occured. The combined procedures were salpingoophorectomy, adhesiolysis, and anterior or posterior colporrhaphy, etc. CONCLUSIONS: LAVH that has been possible to replace abdominal hysterectomy, may be valuable for gynecologic uterine diseases, but the experience is important for laparoscopic surgery. The learning curve influences the results of surgery and incidence of complications. Therefore the procedure may only be carried out by experienced laparoscopists, then the maximum value and advantages of laparoscopic surgery can be obtained. Our experience indicates that LAVH is to reduce almost all incidence of abdominal hysterectomy(0.4%)
Carcinoma in Situ ; Cervix Uteri ; Female ; Gynecology ; Hematoma ; Hospitals, Private ; Humans ; Hysterectomy ; Hysterectomy, Vaginal* ; Incidence ; Laparoscopy ; Learning Curve ; Leiomyoma ; Obstetrics ; Pelvic Pain ; Retrospective Studies ; Uterine Diseases

BACKGROUND/AIMS: Korea has been an endemic area of Hepatitis B infection. Recently, the Hepatitis B carrier population has been significantly decreasing because of Hepatitis B vaccination. The aim of this study was to analyse the Hepatitis B surface antigen (HBsAg) and the Hepatitis B surface antibody (anti-HBs) positive rates of children and adolescents in Jeju. METHODS: From January 2000 to August 2002, seropositivity of HBsAg and anti-HBs were evaluated by enzyme immunoassay (EIA) in 1,653 pediatric patients. From April 2002 to August 2002, seropositivity of HBsAg and anti-HBs were evaluated by reversed passive hemaglutination (RPHA) in 2,532 students. From July 1994 to February 2003, seropositivity of HBsAg was evaluated by EIA in 1,013 pregnant women. RESULTS: The positive rates of HBsAg and anti-HBs of children and adolescents in Jeju were 2.1% and 70.9%, respectively. The positive rates of HBsAg of pregnant women in Jeju was 4.7% and that of HBeAg in HBsAg positive pregnant women was 38.1%. In children born after 1995, as age increased, HBsAg seropositivity increased significantly and anti-HBs seropositivity decreased significantly. There was no significant difference in testing HBsAg positivity between the RPHA and the EIA tests, but testing anti-HBs positivity by EIA was significantly higher than by RPHA. CONCLUSIONS: To reduce HBsAg positive rate, regular testing for anti-HBs by EIA may be indicated until at least 15 years after the primary vaccination schedule, and booster vaccination may be indicated in subjects whose anti-HBs titer was under 10 mIU/mL. 29.1% of children and adolescents in Jeju, therefore, may need to be revaccinated.
Adolescent ; Adult ; Child ; Child, Preschool ; English Abstract ; Female ; Hepatitis B/diagnosis/*epidemiology ; Hepatitis B Antibodies/*blood ; Hepatitis B Surface Antigens/*blood ; Humans ; Infant ; Male ; Seroepidemiologic Studies

It has been proven that the newborn screening programs for congenital hypothyroidism are very important for its early detection and the early treatment of congenital It has been proven that the newborn screening programs for congenital hypothyroidism are very important for its early detection and the early treatment of congenital hypothyroidism can ameliorate and possibly reverse its consequences. Treatment with L-thyroxine is started in case of suspicious hypothyroidism at the first visit. Serum concentration of total and free thyroxine become normal within 1week after start of therapy but TSH values become normal from 2 months to 6 months after L-thyroxine therapy. The possible explanations for prolonged TSH elevation in congenital hypothyroidism are poor compliance for therapy, an inadequate dose of L-thyroxine, elevated threshold for thyrotropin suppression and two novel mutations in the thyrotropin (TSH) receptor gene in a child with resistance to TSH. Authors have experienced two cases of prolonged TSH elevation with normal T3 and T4 levels till 18months and 27 months of age after optimal L-thyroxine therapy and literature were reviewed.
Child ; Compliance ; Congenital Hypothyroidism* ; Humans ; Hypothyroidism ; Infant, Newborn ; Mass Screening ; Thyrotropin ; Thyroxine

PURPOSE:The incidence of glucose intolerance is increased in patients with Turner syndrome. Both noninsulin dependent diabetes mellitus and insulin dependent diabetes mellitus are increased. The purpose of this study was to investigate the impaired rate of carbohydrate metabolism in Turner syndrome after growth hormone treatment. METHODS:We investigated the incidence of carbohydrate intolerance and diabetes mellitus in 94 patients with Turner syndrome with NDDG and WHO criteria. The oral glucose tolerance test was performed in 78 patients. In 12 patients treated with growth hormone, the glucose tolerance test was performed before and after treatment. The insulin tolerance test was done in 20 patients. RESULTS:Only one patient had random plasma glucose level of more than 200 mg/dl. In results of the glucose tolerance test(n=78), 2 patients had glucose tolerance by NDDG criteria and 7 patients had it by WHO criteria. There was no change in glucose tolerance test results during growth hormone treatment. According to the results of the insulin tolerance test, we couldn't find any difference in insulin resistance between the growth hormone treatment group and the other treatments(oxandrolone, estrogen) group. CONCLUSION: The impaired rate of carbohydrate metabolism in Turner syndrome was much lower than in other reports. We observed that the impaired rate of carbohydrate metabolism did not increase after growth hormone treatment. However, the long-term effects in patients treated with growth hormone will be elucidated.
Blood Glucose ; Carbohydrate Metabolism* ; Diabetes Mellitus ; Glucose ; Glucose Intolerance ; Glucose Tolerance Test ; Growth Hormone* ; Humans ; Incidence ; Insulin ; Insulin Resistance ; Turner Syndrome*

Hand tumorsare many and varied, although benign tumors are common. The pathology and histology of these tumors are not unlike these characteristics of the tumor when it occurs elsewhere. Early diagnosis and proper treatment of all hand tumors have been emphasized since the growth of tumors and pain can cause disturbance of intrinsic function of the hand. For the period of 10 years from 1977 to 1986, 105 cases of hand tumor were treated surgically and the results of clinical observation were as follows ; l. Among 105 cases, benign tumor was 101 cases(96.2%) Bone origin tumor was 20 cases, in which enchondroma and enchondromatosis were 17 cases(70%). Soft tissue origin tumor was 85 cases, in which ganglion was 54 cases(63.5%). 2. Among 105 cases, 42 cases were male and 63 cases were female. In age distribution, it showed even distribution. 3. In the duration of wymptom, 51 cases were below 1 year(48.6%). 4. The tumor occured 85 cases in soft tissue, 14 in phalanx, 7 in metacarpal and 1 in carpal bone. 5. The tumors were treated by excision or curettage and bone graft with good improvement, but postoperatively recurred in 2 cases of Hemangioma. Ampuation was performed in 3 cases of malignant tumors without recurrence.
Age Distribution ; Carpal Bones ; Chondroma ; Clinical Study ; Curettage ; Early Diagnosis ; Enchondromatosis ; Female ; Ganglion Cysts ; Hand ; Hemangioma ; Humans ; Male ; Pathology ; Recurrence ; Transplants

We have examined the regenerative capabilities of the human scalp hair follicle after grafting the lower half of the follicle. Twenty-eight of 32 intact whole-hair follicles isolated from the human scalp regenerated hairs when grafted onto the forehead of the same person. Seven of the 15 lower-half follicles regenerated complete hair follicles 8 months after grafting showed that the lower-half follicle implant reconstituted the complete hair follicle. The sebaceous gland was not regenerated, but there was an outgrowth in the sebaceous gland regPark ion. Some grafts formed epithelial cysts. Two years after grafting, the histological examination of the regenerated follicle from the lower-half implant showed that the sebaceous gland was completely regenerated. While an intact follicle shows prominent naked shaft outgPark Park Parkrowth, the sheath grows concomitantly with the shaft in lower-half follicles in culture. If grafted lower-half follicles were located too deep, the regrown sheath could not reach the epidermal layer. In this situation, the formation of an epidermal cyst was likely.
Epidermal Cyst ; Forehead ; Hair Follicle* ; Hair* ; Humans ; Scalp ; Sebaceous Glands ; Transplants*

Cutaneous horn is a clinical diagnosis based upon the presence of a large protuberant mass of keratin. We report a case of cutaneous horn arising from dermatofibroma in a 31-year old woman. A silver whitish colored comical hyperkeratotic protruding lesion (1.0  0.7 cm size) from the red brown colored nodule was observed. Histopathologic findings showed characteristic findings of dermatofibroma and cutaneous horn. The lesion was removed by surgical excision.
Animals ; Diagnosis ; Female ; Histiocytoma, Benign Fibrous* ; Horns* ; Humans ; Silver

No abstract available.
Kidney Transplantation*

Parenteral reserpine was given intramuscularly to 32 hospitalized hypertensive patients: 10 hypertensive patients without renal insufficiency, 3 hypertensive patients with heart failure, 10 hypertensive patients of malignant phase or with uremia, and 9 hypertensive patients with cerebrovascular accident. Follwoings were the result. 1. In the majority of patients, the effective dose of reserpine was 2 to 3 mg. 2. Reserpine given intramuscularly lowered blood pressure in 2 to 4 hours, had its maximum effect in 3 to 6 hours and had a duration of 3 to more than 24 hours (average 9 hours). 3. When effective dose of reserpine was given, blood pressure was lowered significantly (more than 30mmHg in mean blood pressure) in 18 patients (81.7%) of 22 hypertensive patients without renal insufficiency, and in 4 patients (40%) of 10 hypertensive patients with renal insufficiency. 4. Major side effect was drowsiness which was more evident in the patients with renal insufficiency. 5. Reserpine administered parenterally is an effective and safe agent for the treatment of hypertensive emergencies on a short term basis especially in the patient without renal insufficiency.
Blood Pressure ; Emergencies ; Heart Failure ; Humans ; Renal Insufficiency ; Reserpine* ; Sleep Stages ; Stroke ; Uremia

No abstract available.
Azithromycin* ; Pregnancy* ; Scrub Typhus*