By means of hospital-based data over 8 years we sought to evaluate the clinical indications and incidence of emergency peripartum hysterectomy by demographic characteristic and reproduction history. From the obstetric record of all deliveries at Chung Goo Hospital between Jan. 1, 1990, and Nov. 31, 1997, we identified all women undergoing emergency cesarean hysterectomy, calculated incidence rates, conducted statistical tests of linear trends and heterogenety, and observed the clinical indicatons preceding the onset of this procedure. There were 16731 deliveries during this period, Cesarean hysterectomy was performed in 24 of 5993 cesarean sections(0.40%) and in 10 of 10738 vaginal deleveries(0.09%), so more frequently after cesarean section than vaginal delivery. The age of patients varied from 22 to 40 years old. The higher the age and the parity of patients, the higher incidence of cesarean hysterectomy was noted. The most common indication of cesarean hysterectomy was uterine atony(52.94%) followed by placental disorders(41.18%), uterine myoma with pregnancy(2.9%) and uterine rupture (2.9%). All patients who had hysterectomy received transfusion from 1 pint to 57 pints. The postoperative complications were bladder injury, febrile morbidity, disseminated intravascular coaguolopathy and wound disruption. There were three maternal deaths, the cause was disseminated intravascular coaguolopathy and amniotic embolism. The data identifiy uterine atony as the primary cause for gravid hysterctomy. The data also illustrated how the incidence of emergency peripartum hysterectomy increases significantly with increasing parity, especially when influenced by a current placenta previa or a prior cesarean section. Maternal morbidity remained high.
Adult ; Cesarean Section ; Embolism ; Emergencies ; Female ; Humans ; Hysterectomy* ; Incidence ; Leiomyoma ; Maternal Death ; Parity ; Peripartum Period* ; Placenta Previa ; Postoperative Complications ; Pregnancy ; Reproduction ; Urinary Bladder ; Uterine Inertia ; Uterine Rupture ; Wounds and Injuries

Diabetes mellitus is known to be associated with a specific cardiomyopathy. This is evident from the clinical-pathological work and the epidemiologic data. An investigation was made in this study to determine whether diabetic cardiomyopathy in rats is associated with an alteration of biochemical characteristics of cardiac contractile proteins. Rats were made diabetic with intravenous injection of streptozotocin and hearts removed 8 weeks later for the isolation of myofibrils. The basal ATPase activity of myofibrils from diabetic hearts was significantly lower than that of the controls, suggesting the presence of some subtle structural and conformational changes in diabetic myofibrils. The activating effect of Mg ions on the myofibrillar actomyosin system of rat heart muscle was also demonstrated. Sodium dodecylsulfate gel electrophoresis showed the presence of myosin heavy chain, light chain 1 and 2, actin and troponin but failed to reveal differences in the patterns of these contractile proteins of light subunits between diabetics and controls. The deficiency in utilization of energy rich phosphates by the myofibrillar protein may be one of of the main mechanisms of cardiodepression observed in diabetic hearts. The cardiac myofibrillar ATPase activity may be one of useful measurements in evaluating pathophysiological states of cardiac contractile proteins.
Actins ; Actomyosin ; Adenosine Triphosphatases* ; Animals ; Cardiomyopathies ; Contractile Proteins ; Diabetes Mellitus ; Diabetic Cardiomyopathies ; Electrophoresis ; Heart ; Injections, Intravenous ; Ions ; Myocardium ; Myofibrils ; Myosin Heavy Chains ; Phosphates ; Rats* ; Sodium ; Streptozocin ; Troponin

Rapid progress in the development of communication devices has enabled us to use various and tremendous medical information regardless of time or place. Today, in Korea there are many homepages on the web which provide medical information, hospital information, and counseling on medical fields, but more detailed recent medical information, better quality control, and a greater variety of communication skills are needed. We analysed the data about breast cancer clinic on web from November 1998 to October 1999. The frequent questions were breast mass44%, breast pan 29%, and counseling on breast cancer 25%. The most frequent users were in their 3rd decades 55%, 4th decades 8%, and unknown cases 23%. The average number of visitors on wed was 454 per month. In near future, we believe that the use of the web as a information source will grow rapidly and we everyone will use internet in Korea. So, we should realize the virtual space is a reality, and we should use it as a proper education system for the people.
Breast Diseases* ; Breast Neoplasms ; Breast* ; Counseling* ; Education ; Internet* ; Korea ; Quality Control

No abstract available.
Cardioplegic Solutions* ; Heart* ; Thoracic Surgery*

The effects of KCI continus tablet(K-Contin(R)) on the serum level of K and uric acid during hydrochlorothizide therapy(25mg/day) were evaluated in 30 patients with essential hypertensien. The results are as follows : 1) During hydrochlorothiazide therapy(25mg/day), 23% of all patients showed hypopotassemia(<3.5mEq/1) while no patient developed hypopotassemia after potassium supplement therapy(8 mEq/day). 2) During the period of K supplement, the level of serum uric acid showed less elevation. 3) The side reaction of KCI continus tablet were mild indigestion which developed in two patients and disappeared soon without any particular treatment. In conclusion, the KCI continus tablet is useful in the prevention of hypopotassemia during chronic diuretic therapy.
Dyspepsia ; Humans ; Hydrochlorothiazide ; Hypokalemia ; Potassium ; Uric Acid*

The antihypertensive effect of nicardipine was studied in 31 cases of essential hypertension and following results were obtained. 1) Daily dose was 30-60mg for 10 weeks. 2) Mean systolic and diastolic pressure were decreased by 39.5mmHg 921%) and 17.2mmHg(15%) respectively(P<0.005) and in 84% of cases, good or fair control of blood pressure was proved. 3) There was no significant change in heart rates before and after treatment. 4) There were no significant side effects except two cases of mild headache and facial flushing which subsided spontaneously.
Blood Pressure ; Flushing ; Headache ; Heart Rate ; Hypertension ; Nicardipine*

PURPOSE: To evaluate differential points of clustered microcalcification in malignant and benign lesions on histopathology and correlate with mammographic findings. MATERIALS AND METHODS: Authors evaluated differential points of malignant and benign calcifications in histopathologically confirmed 24 cases. In two patients, mapping studies and paraffin block mammographic examinations were done to correlate calcification on mammography with histopathologic morphology. RESULT: On histopathology, malignant calcifications were located in ductal lumen, while benign ones were usually located in ductal epithelium(p<0.05). However, associated three benign lesions of the 10 malignant lesions showed still benign calcifications adjacent to proven cancer. The typical malignant calcifications were the shape of lamination, while benign calcifications showed granular and salty on light microscope. In 2 mapping studies, malignant-looking calcifications within the area of predominant benign calcifications yielded atypical ductal hyperplasia. Mammographic pepper, granular, punctate, salty and S-shaped calcifications were correlated with granular and salty calcification on light microscope. Mammographic linear, branching, comma, tadpole and wormiform calcifications were correlated with histopathologic laminated calcification. CONCLUSION: Authors have recognized about characteristics of malignant Vs. benign clustered microcalcifications on histopathology. Authors concluded that if malignant-looking calcification such as linear, branching, comma, tadpole and wormiform are present in an are a of predominant benign calcifications, specimen radiographic correlation and mapping study will be necessary for better demonstration of the atypical ductal hyperplasia, hidden or associated breast cancer.
Breast Neoplasms ; Humans ; Hyperplasia ; Larva ; Mammography* ; Paraffin

Purpose: To develop a Korean version of the practice environment scale that can verify the practice environment of advanced practice registered nurses (APRN) by verifying the validity and reliability of the Nurse practitioner's primary care organizational climate questionnaire developed by Poghosyan et al. Methods: After translation using a committee approach and an expert group’s verification of the content validity, items were classified as 'professional visibility', 'APRN-administration relations', 'APRN-physician relations', 'independent practice and support' A total of 29 questionnaire items were developed for the four factors. Data were collected from 200 advanced practice registered nurses working at two advanced general hospitals and six general hospitals. Results: In the confirmatory factor analysis, CFI, TLI, and RMSR evaluation indices were appropriate except for RMSEA. Partial validity was shown in convergent validity, and discriminant validity. Exploratory factor analysis revealed that the questions were well organized with four factors. Cronbach's ⍺ of the whole instrument was .93. Conclusion As a first attempt to measure the practice environment of the APRN in Korea, the results show that this questionnaire provides basic data for correct role setting and improvement of practice environment. This research will ultimately serve as a basis for cost-effective quality care.

This study was performed to evaluate the method of quantification of exercise thallium-201(201Tl) myocardial perfusion imaginges(M.P.I.) for the detection of coronary artery disease. Exercise 201 Tl MPI were interpreted objectively, reproducibly, quantitatively and easily by a computer assisted technique-Circumferential profile method. Exercise 201Tl MPI and redistribution images were taken in 32 patients(9 cases of post infarction angina, 13 cases of angina pectoris, 8 cases of atypical chest pain, 1 case of arrhythmial and 1 case of caridac neurosis). The results obtained were as follows: 1) Exercise 201Tl MPI of 3 cases of angina pectoris demonstrated transient perfusion defect in 5 cases, persistent perfusion defect in 2 cases, transient and persistent perfusion defect in 1 cases and no perfusion defect in 5 cases. Exercise 201Tl MPI of 9 case of post-infarction angina revealed persistent perfusion defect in 7 cases and transient and persistent perfusion defect in 2 cases. 201Tl MPI of 8 cases of atypical chest pain showed transient perfusion defect in 1 case and no perfusion defect in 7 cases. There was no perfusion defect in 1 case of arrhythmia and another case of cardiac neurosis. 2) The location of persistent perfusion defects in several views of 201Tl MPI in 9 case of postinfarction angina were consistent with those of infarction area in the electrocardiogram. 3) While visual analysis interpreted three cases to have no perfusion defect and one case to have transient perfusion defect respectively, objective analysis revealed that one of them had transient perfusion defect, another of them had persistent perfusion defect and the other had transient and persistent perfusion defect. 201Tl MPI of three cases could be done easily by circumferential profile method, which were difficult to interprete by subjective visual analysis. The results indicate that Exercise 201Tl MPI interpreted by circumferential profile analysis would be an objective, quantitative and noninvasive method for the detection of ischemic change and location in coronary artery disease.
Angina Pectoris ; Arrhythmias, Cardiac ; Chest Pain ; Coronary Artery Disease ; Electrocardiography ; Infarction ; Myocardial Ischemia* ; Neurocirculatory Asthenia ; Perfusion

OBJECTIVES: This study sought to evaluate the efficacy of collagen graft materials, as compared to other graft materials, for use in healing calvarial defects in rabbits. MATERIALS AND METHODS: Ten mm diameter calvarial defects were made in ten rabbits. The rabbits were then divided into 4 groups: control, autogenous bone graft, SureOss graft, and Teruplug graft. Bone regeneration was evaluated using histological and radiographic methods. RESULTS: Based on visual examination, no distinct healing profile was observed. At 4 weeks after treatment, histological analysis showed there was no bone regeneration in the control group; however, at 8 weeks after treatment, new bone formation was observed around the margin of the defective sites. In the autogenous bone graft group, new bone formation was observed at 4 weeks after treatment and mature bone was detected around the grafted bone after 8 weeks. In the SureOss graft group, at 4 weeks after treatment, acute inflammatory and multinuclear cells were noted around the grafted materials; at 8 weeks after treatment, a decrease in graft materials coupled with new bone formation were observed at the defective sites. In the Teruplug graft group, new bone formation was detected surrounding the bone margin and without signs of inflammation. There were statistically significant differences observed between the graft and control group in terms of bone density as evidenced by radiographic analysis using computed tomography (P<0.05), particularly for the autogenous bone graft group (P<0.001). CONCLUSION: These results suggested that autogenous bone, SureOss and Teruplug have the ability to induce bone regeneration as compared to an untreated control group. The osteogenic potential of Teruplug was observed to be lower than that of autogenous bone, but similar to that of SureOss.
Bone Density ; Bone Regeneration ; Collagen ; Durapatite ; Inflammation ; Osteogenesis ; Porifera ; Rabbits ; Transplantation, Homologous ; Transplants