OBJECTIVE: This study was to evaluate the effectiveness and value of Ultrasonic surgical system on Laparoscopic assited vaginal hysterectomy (LAVH). METHODS: Retrospective study of 42 cases of LAVH with bipolar coagulator and 85 cases of LAVH with ultrasonic surgical system in Dept of OB/GYN, Chosun University Hospital from January 2001 to December 2002 was carried out and postoperative results were compared between 2 methods. Statistical analysis was performed using x2 test and student t-test as appropriate. Statistical significance was defined as p<0.05. RESULTS: The mean age of patients (bipolar coagulator vs ultrasonic surgical system) was 49+/-3 vs 48+/-4 years. The mean operating time was 54+/-13 min vs 37+/-6 min. The mean weight of uterus was 320+/-135 g vs 315+/-121 g. The mean hemoglobin drop was 2.42+/-0.85 g/dL vs 1.97+/-0.74 g/dL. CONCLUSION: In case of LAVH of myoma or adenomyosis using bipolar coagulator or ultrasonic surgical system. The advantages of ultrasonic surgical system were shortening of operation time, less bleeding during operation and less smoke caused by high temperature coagulation.
Adenomyosis ; Female ; Hemorrhage ; Humans ; Hysterectomy, Vaginal* ; Myoma ; Retrospective Studies ; Smoke ; Ultrasonics* ; Uterus

Thecomas make up only 0.5% to 1% of ovarian tumors. They occur in woman predominantly in the perimenopausal and menopausal years. The average patient's age is between 50 and 55 years.1-3 Thecomas only rarely occur in children.4 These tumors can be associated with estrogen production but not as frequently as are granulosa cell tumors. They are mostly unilateral and rarely malignant, so exicion of ovary is adequate treatment.5 Recently, we experienced thecoma, causing precocious puberty in 6 year old girl. and report with brief review of literatures.
Estrogens ; Female ; Granulosa Cell Tumor ; Humans ; Ovary ; Puberty, Precocious ; Thecoma

Mucocuaneous Lymph Node Syndrome(Kawasaki disease) is a new diseae entity that was first described by Kawasakiin 1967. It occures predominantly in children less than 5yrs old and acute febrile illness, which is mucocutaneousinvolvment associated with swelling of cervical lymph nodes. The coronary artery aneurysms have been revealed 20–30% of patients with Kawsaki disease. The authors report a case of multiple coronary artery aneurysms inKawasaki disease which was diagnosed by a coronary arteriography.
Aneurysm ; Angiography ; Child ; Coronary Vessels ; Humans ; Lymph Nodes ; Mucocutaneous Lymph Node Syndrome

No abstract available.
Pregnancy*

OBJECTIVE: Abnormal uterine bleeding is one of the most common disorder in gynecologic department. Organic causes of abnormal uterine bleeding are chronic cervicitis, submucosal myoma, endometrial polyp, endometrial malignancy. To find the exact cause of uterine bleeding and rule out the organic uterine disorder in the patients who considered dysfunctional uterine bleeding, hysteroscopic examination and endometrial biopsy were used. METHODS: Study group were 106 patients, who received hysteroscopic endometrial biopsy from 2. 2000 to 8. 2001.with abnormal uterine bleeding, negative in urine pregnancy test, normal in cervix cytology, and without organic lesion causing uterine bleeding in pelvic exam and ultrasonography. Age, parity, hysteroscopic biopsy result were analyzed retrospectively. RESULTS: Mean age of the study group was 43 and mean parity was 2.6. When final hysteroscopic biopsy histology were analysed, proliferative phase was most common (28.3%). Next were secretory phase (17.9%), simple hyperplasia (13.2%), endometrial polyp (10.6%), chronic endocervicitis (4.7%). Submucosal myoma, endometrial cancer, complex hyperplasia were detected in 3.8% each one. Of 106 patients, who considered dysfunctional uterine bleeding, only 63 (59.4%) patients were proved true DUB on hysteroscopic biopsy. Remainder had organic disorder (40.6%). CONCLUSION: When patients visited the hospital with abnormal uterine bleeding, doctors should be suspicious of endometrial organic disease and treat the patients with exact diagnosis. In these patients, hysteroscopic examination and biopsy were very useful and safe method to determine exact diagnosis and treatment plan.
Biopsy ; Cervix Uteri ; Diagnosis ; Endometrial Neoplasms ; Female ; Gynecological Examination ; Humans ; Hyperplasia ; Hysteroscopy ; Metrorrhagia ; Myoma ; Parity ; Polyps ; Pregnancy ; Pregnancy Tests ; Retrospective Studies ; Ultrasonography ; Uterine Cervicitis ; Uterine Hemorrhage

The authors report 3 cases of intracranial cysticercosis simulating brain tumor. The 2 cases of them had parenchymatous huge cysts in the cerebral hemisphere and the other one had large cyst in the 4th ventricle. In one case of parenchymatous cysticercosis, angiographic finding was less significant though C-T scan revealed huge cystic shadow in the frontal lobe bilaterally and multiple small cystic shadow in occipital lobe and cerebellum. The 4th ventricular cysticercosis was well delineated with Conray ventriculography. All cases were proved as cerebral cysticercosis by operation and the patients were uneventful postoperatively.
Brain Neoplasms ; Cerebellum ; Cerebrum ; Cysticercosis* ; Frontal Lobe ; Humans ; Occipital Lobe

A clinical analysis of vasospasm as seen angiographically after the onset of subarachnoid hemorrhage was carried out in 22 out of 4 cases of ruptured intracranial aneurysms experienced in our department from January, 1978 to May, 1979. The following results were obtained. The incidence of vasospasm was 50%. 2) Angiographic filling abnormalities(vasospasm) were morphologically classified into 4 types:tapering, diffuse, segmental and nodular types. 3) No significant difference was found in the location of the arteries with vasospasm in relation to the site of the ruptured aneurysm. In this study, the most frequent occurance of spasm was noted in cases of internal carotid aneurysm(69.2%). 4) Discrepancy in the incidence of angiographic spasm between the group with only one subarachnoid hemorrhage(41.9% out of 31 cases) and the other group with more than one hemorrhage(50% out of 44 cases) was demonstrated. While vasospasm occurred frequently within 9 days after the last hemorrhage in cases with more than two hemorrhage, the appearance of vasospasm was frequently seen angiographically between 10 to 17 days after hemorrhage in cases with only one hemorrhage. 5) There was no relationship between the age and the incidence of spasm, and most cases with spasm showed bloody and xanthochromic C.S.F. 6) Neurological findings were as follows:mental disturbance 12 cases, cranial nerve palsy 3 cases, paresis 3 cases, seizure 2 cases and visual disturbance 2 cases. These neurologic deficits may not be related to the spasm. 7) Follow up carotid angiography was performed in 9 cases of those treated by direct approach. Among 5 cases with vasospasm in preoperative angiogram, the spasm persited in 2 cases and was not no longer visualized in 3 cases. On the other hand, in 2 cases without preoperative spasm, postoperative spasm was detected. 8) Of 23 cases of ruptured aneurysms treated surgically(including 3 cases of carotid ligation), 2 out of 15 cases with spasm expired and all 8 cases without spasm were cured. 9) The diffuse type(using above classification) had the worst postoperative prognosis:i.e., among 9 cases with that type of spasm, 2 cases expired and one case resulted in a mild neurologic deficit. Other types of spasm had no special relationship with the postoperative prognosis.
Aneurysm, Ruptured ; Angiography ; Arteries ; Cranial Nerve Diseases ; Follow-Up Studies ; Hand ; Hemorrhage ; Incidence ; Intracranial Aneurysm* ; Neurologic Manifestations ; Paresis ; Prognosis* ; Seizures ; Spasm ; Subarachnoid Hemorrhage

Variable manifestations of neurofibromatosis are properly defined as a hereditary, harmatomatous disorder, probably of neural crest origin, involving not only neuroectoderm and mesoderm but also endoderm, with the potential of appearing in any organ system of the body. Recently, we have experienced 3 cases of neurofibromatosis, one case associated with glioblastoma multiforme in left frontal lobe, another case associated with multiple neurofibromas in thoracic region and cauda equina, the third case associated with retroperitoneal neurofibroma and dural ectasia.
Cauda Equina ; Dilatation, Pathologic ; Endoderm ; Frontal Lobe ; Glioblastoma ; Mesoderm ; Neural Crest ; Neural Plate ; Neurofibroma ; Neurofibromatoses*

BACKGROUND: Head injury is one of the most common causes of emergency department visits and hospital admission in the pediatric populations, and most injuries are mild. In mild head injury, grading of severity and decision of hospital admission are difficult in the emergency department. Recent studies have suggested that patients with a normal head CT scan and neurologic exam following head injury can be safely discharged from the emergency department. However, previous studies have relied on incomplete patient follow-up and been limited for the most part to adult population. So we performed this study to assess clinical course and the incidence of significant CNS sequelae in children with a normal head CT scan and no focal neurologic sign after mild head injuries during hospital admission and follow-up for 1 month. METHODS: We reviewal the records of children(n=209) admitted to the department of emergency medicine with closed head injuries from Jan. 1, 1996 to Dec. 31, 1996, who's initial Glasgow Coma Scale was 13 to 15, and have no focal neurologic sign and a normal head CT scan. RESULT: 209 patients were studied with a mean age of 6.8(range 3 months to 15years), and 66.5% were male. The most common mechanisms of injury were pedestrian T.A(50.2%) and fall(11.5%). Patients had a mean Glasgow coma scale of 14.8 and mean Abbreviated Injury Score of 1.3. Patients had clinical symptoms of headache(49.3%), vomiting(44.5%), loss of consciousness(LOC)(29.6%), amnesia(10.0%), sleepiness(8.6%), irritability(8.6%), confusion(2.9%) and seizure(1.9%). The mean duration of admission was 4.3 days(range: 6 hours-20 days) and the mean duration of symptom was 36.4 hours. No child developed significant CNS sequelae during hospital admission. However, during hospital admission, aye children(all were preschooler) had psychologic complication ; one child developed post-traumatic stress disorder requiring psychologic treatment for 3 months. Three children developed enuresis and two children developed night terror. During 1 month fallow-up, one child developed a symptomatic hemorrhagic contusion 5 days after the head injury, not requiring neurosurgical treatment. CONCLUSION: Among children with an initial Glasgow Coma Scale of 13 to 15, a normal head CT scan and no focal neurologic sign after mild head injuries, delayed intracranial sequelae are extremely uncommon. So these patient may be discharged home with parental supervision and education for dose observation.
Adult ; Child* ; Contusions ; Craniocerebral Trauma* ; Education ; Emergencies* ; Emergency Medicine* ; Emergency Service, Hospital ; Enuresis ; Follow-Up Studies ; Glasgow Coma Scale ; Head Injuries, Closed ; Head* ; Humans ; Incidence ; Male ; Neurologic Manifestations ; Organization and Administration ; Parents ; Stress Disorders, Post-Traumatic ; Tomography, X-Ray Computed

BACKGROUND: An adequate uteroplacental and fetal blood flow during labor and cesarean delivery is of prime importance for fetal well-being and neonatal outcome. METHODS: Using the vascular smooth muscle of the human isolated umbilical arteries, this study was performed to see whether commonly used local anesthetics (bupivacaine, lidocaine and 2-chloroprocaine) and opioids (morphine,fentanyl and meperidine) could induce contracion or relaxation of these resting and precontracted vessels. Rings from human umbilical arteries were prepared by microdissection. The vessel rings were mounted in tissue baths for an isometric recording of the contractile activity. For resting muscles, the reactivity to drugs is expressed as a percentage of a maximal KCl-induced contraction, and for precontracted muscle, it is expressed as a percentage of a submaximal KCl-induced contraction. RESULTS: Bupivacaine, lidocaine and 2-chloroprocaine all induced contractions. Bupivacaine showed a maximal contraction (46.7 +/- 10.5%) at concentrations of 43 micrometer, lidocaine 19.7 +/- 4.8% at 0.11 mM. and 2-chloroprocaine showed 14.6 +/- 2.9% at 0.65 mM. Morphine, fentanyl and meperidine all induced contractions. Morphine showed a maximal contraction (19.6 +/- 7.1%) at a concentration of 10 4 M, meperidine at 17.2 +/- 8.4% at 3 x 10 5 M, and fentanyl at 1.7 +/- 2.0% at 3 x 10(-6)M. When umbilical arteries were induced to contract with a submaximal concentration of KCl, bupivacaine and lidocaine showed an ability to increase the magnitude of the sustained contraction, but 2-chloroprocaine showed a relaxation of the sustained contraction. Morphine, fentanyl and meperidine showed no change in the sustained contraction. CONCLUSIONS: This study demonstrates these local anesthetics and opioids as vasoactive on human umbilical arteries. If applicable in vivo, these drugs might have some influence on umbilical vessel tone and thus might reduce umbilical blood flow.
Analgesics, Opioid* ; Anesthetics, Local* ; Baths ; Bupivacaine ; Fentanyl ; Fetal Blood ; Humans* ; Lidocaine ; Meperidine ; Microdissection ; Morphine ; Muscle, Smooth, Vascular ; Muscles ; Relaxation ; Umbilical Arteries*