No abstract available in English.
Tibia

OBJECTIVE: Our purpose was to investigate the relationship between the levels of IL-6 and tumor necrosis factor-alpha in the peritoneal fluid(PF) of women with and without endometriosis and infertile women. Design: Prospective and case-control study. Setting: University hospital. Patients: Twenty-nine women with laparotomy or laparoscopic findings of minimal to severe endometriosis, and twenty-eight women with no visual evidence of pelvic endometriosis and with benign gynecologic disease. Main Outcome Measures: PF IL-6 and tumor necrosis factor-alpha levels were determined using commercial ELISA. IL-6 and tumor necrosis factor-alpha concentrations were compared among women with and without endometriosis, and with infertile and fertile women, and then also compared according the revised American Fertility Society classification. RESULTS: IL-6 and tumor necrosis factor-alpha concentrations were higher than in the PF of women with endometriosis than in matched normal controls. Cyclic variations in IL-6 concentrations were seen in PF from patients with endometriosis: the concentrations in the secretory phase were significantly higher than those in the proliferative phase. IL-6 concentrations were higher than in the PF among of infertile women than in fertile women. A significant correlation between PF IL-6 and tumor necrosis factor-alpha concentrations and endometriosis stage III and IV was noted. CONCLUSIONS: Increased PF levels of IL-6 and tumor necrosis factor-alpha in patients with endometriosis may be relate to endometriosis-associated infertility and to the pathogenesis of endometriosis suggesting that partially contribute to the disturbed immune regulation observed in patients with endometriosis.
Ascitic Fluid* ; Case-Control Studies ; Classification ; Endometriosis* ; Enzyme-Linked Immunosorbent Assay ; Female ; Fertility ; Genital Diseases, Female ; Humans ; Immunity, Cellular* ; Infertility ; Interleukin-6 ; Laparotomy ; Outcome Assessment (Health Care) ; Prospective Studies ; Tumor Necrosis Factor-alpha

Deep vein thrombosis(DVT) after joint arthroplasty in tbe lower extmmity has been one of the major causes of death in postoperative complications. But, there is little information on incidence and clinical risk factors of DVT in Korea. Fifty-eight patients (sixty-two cases) who underwent TKR were included in this study for evaluation of the incidence of DVT and correlation with clinical risk factors after total knee replacement(TKR) in Korea. Venography were performed preoperatively and postoperatively, and clinical risk factors were examined. The preoperative venography was performed within seven days before the surgery, and postoperative venography seven to 14days after the surgery. There was no evidence of thrombosis in any patient preoperatively, but thrombi were observed in seven cases (11%) postoperatively. Six cases showed thrombi in the calf vein and one case showed thrombi in the femoral vein. There was no statistically significant difference in incidence rate of DVT according to clinical risk factors such as age, toumiquet time, BMI(body mass index), diastolic blood pressure, operation time and coagulation assay(platelet, PT, aPTT, Anti-thrombin III, fibrinogen).
Arthroplasty ; Arthroplasty, Replacement, Knee* ; Blood Pressure ; Cause of Death ; Femoral Vein ; Humans ; Incidence* ; Joints ; Knee ; Korea ; Phlebography ; Postoperative Complications ; Risk Factors* ; Thrombosis ; Veins ; Venous Thrombosis*

OBJECTIVE: Endometriosis is a disease affecting a large population of women all over the world. A local sterile inflammation occurs in the peritonel cavity of patients with endometriosis. It suggests that immunological events play a major role in the pathogenesis of endometriosis. We have studied the levels of serveral T cell and monocyte derived cytokines, especially IL-6 (promoter of immune response) and IL-10 (inhibitor of immune response), in the peritoneal fluid of patients with endometriosis to characterize the change of immune response that occurs at the site of endometriosis. Method: This study was performed in Hallym university hospital from October, 1997 to October 1998 and enrolled 29 women with gross or microscopic findings of minimal to severe endometriosis in case group, and 28 women without visual evidence of pelvic endometriosis and with benign gynecologic disease in control group. IL-6 and IL-10 levels in the peritoneal fluid were determined using commercial ELISA and compared between endometriosis and controls and between fertile and infertile women with endometriosis and according to the revised American Fertility Society classification. RESULT: IL-6 was higher and IL-10 was lower in the peritoneal fluid of endometriosis group than of control group. Cyclic variations in the IL-6 concentrations were seen in endometriosis group : the concentrations in the secretory phase were significantly higher than those in the proliferative phase. In endometriosis group, IL-6 concentrations of infertile women were higher than fertile women. Both IL-6 and IL-10 in the peritoneal fluid of endomtriosis group did not show significant correlation according to r-AFS stages. CONCLUSION: Increased IL-6 and decreased IL-10 levels in the peritoneal fluid may be related to infertility and pathogenesis in the endometriosis, suggesting that partially contribute to the disturbed immune regulation observed in endometriosis.
Ascitic Fluid* ; Classification ; Cytokines ; Endometriosis* ; Enzyme-Linked Immunosorbent Assay ; Female ; Fertility ; Genital Diseases, Female ; Humans ; Infertility ; Inflammation ; Interleukin-10* ; Interleukin-6* ; Monocytes

No abstract available in English.
Enterocolitis, Pseudomembranous

OBJECTIVE: To determine whether hysterectomy by the vaginal route is safe and feasible in patients with previous pelvic operation. METHODS: A retrospective study of the records of Hallym University Hospistal patients who underwent vaginal hysterectomy performed by the senior author. Between January 1990 and January 1997, 212 patients who had previous pelvic operation were studied with special reference to operative difficulties, previous operation type, intraoperative complications, surgical time, hospital stay. RESULTS: 1. Patients characteristics was that ; The average age was 44.5+/-6.6 years old, the average parity was 2.3 , the average stay of hospitalization was 7.5+/-0.89 days, the frequency of Morcellation was in 24.5%, the average surgical time including associated procedure was 82+/-16.2 minutes, the average uterine weight was 164+/-85.1gm. 2. The most common previous pelvic operation was cesarean section(95 cases). 3. The most common indication was uterine myoma(51.9%). 4. Surgical technique used to gain access to the pouch of Douglas was done anteriorly; 52 patients of previous cesarean section(24.5%) and 112 patients of others operation(52.8%) were easily opened by blunt dissection, 43 patients of previous cesarean section(20.3%) and 5 patients of others operation(2.4%) were required sharp dissection. posterioly ; 190 patients(89.6%) were easily opened by blunt dissection, 22 patients(10.4%) were required sharp dissection. 5. Significant complications were bladder injury(1 case) , postoperative transfusion due to bleeding(6 cases). No cases of postoperative laparotomy was done and other minor compications were fever(15 cases), bladder retention(11 cases), others. CONCLUSIONS: It was possible to perform vaginal hysterectomy safely in patients with previous pelvic operation. Vaginal hysterectomy remains the method of choice for removal of the uterus of the previous pelvic operations in the absence of other contraindications.
Cesarean Section ; Female ; Hospitalization ; Humans ; Hysterectomy ; Hysterectomy, Vaginal* ; Intraoperative Complications ; Laparotomy ; Length of Stay ; Operative Time ; Parity ; Pregnancy ; Retrospective Studies ; Urinary Bladder ; Uterus

PURPOSE: Deep vein thrombosis (DVT) after joint arthroplasty in the lower extremity has been a major cause of death postoperatively. However, there is few reports on incidence and risk factors of DVT in Korea. We evaluated the incidence of DVT, correlation between the DVT, and risk factors and effectiveness of color doppler ultrasonography for diagnosis of DVT after joint arthroplasty in the lower extremity. MATERIALS AND METHODS: One hundred and six cases (99 patients) of total hip or knee arthroplasties from March 1996 to August 1997 were included in this study. There were forty-four total hip arthroplasties and sixty-two total knee arthroplasties. No patients received prophylactic agents for DVT. Venogram and color doppler ultrasonogram were obtained within 7 days preoperatively and in 7 to 14 days postoperatively. Only venography was performed in 45 cases and both venography and color doppler ultrasonography were performed in 61 cases. RESULT: On venogram, there were no evidence of thrombi in all cases preoperatively but thrombi were observed in 9 cases (8.5%) postoperatively. Among these positive cases, eight cases showed thrombi in the calf vein and one case in the femoral vein. Color doppler ultrasonography could not detect any thrombi among 3 cases which had positive findings with venogram. In contrast to other reports, we did not identify a correlation between DVT and so-called risk factors such as age, tourniquet time, BMI (body mass index), diastolic blood pressure, operation time and coagulation assay (platelet, PT, aPTl, Anti-thrombin III, fibrinogen) CONCLUSIONS: We concluded that color doppler ultrasonography may not be an effective method in the diagnose is of DVT of calf vein in asymptomatic patients and that so-called risk factors had no relation to DVT.
Arthroplasty* ; Blood Pressure ; Cause of Death ; Diagnosis ; Femoral Vein ; Hip ; Humans ; Incidence ; Joints* ; Knee ; Korea ; Lower Extremity* ; Phlebography* ; Risk Factors ; Tourniquets ; Ultrasonography ; Ultrasonography, Doppler, Color* ; Veins ; Venous Thrombosis*

The total knee replacement is an excellent method for the treatment of osteoarthritis, rheumatoid arthritis, etc. of the knee joint. The tendency of the use of total knee prosthesis is increasing now in Korea. But domestic production of the prosthesis is not avaliable and all are imported from abroad. Moreover, these prosthesis are not well adapted to Korean people, and in occation, the custom-made prosthesis should be needed. So, domestic production of the prosthesis is required. For production of new prosthesis, in cooperation with KAIST(Korea Advanced Institute of Science and Technology), we developed the new alloy 15-57 for total knee prosthesis. We conducted an animal experimental study to confirm the biocompatibility of the new alloy. In this experiment, the Zimmer® company vitallium was compared with this new alloy as control study. The results are as follows: 1. Biocompatibility of the new alloy 15-57 is similar than that of Zimmer® company vitallium in histological study of metal-bone interspace area. 2. Surface corrosion of both metal was nearly absent. 3. In summary, the new alloy 15-57 is suggested as an acceptable metal for the production of total knee prosthesis.
Alloys ; Animal Experimentation ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Knee ; Corrosion ; Knee Joint ; Knee Prosthesis ; Knee ; Korea ; Methods ; Osteoarthritis ; Prostheses and Implants ; Vitallium

Severe limitation of knee motion is a complication of operative procedures or trauma about the knee. Physical therapy and occasionally manipulation of knee with anesthesia may improve results when performed soon after the onset of motion limitation. When performed later, these have been proven less useful. This is a review of 15 patients who had severe limitation of knee motion following open operative procedures or trauma about knee and were treated by percutaneous release of adhesions under arthroscopic control. There were eleven males and four females, ranging in age from 23-67years(mean 38 years). The interval between the last open operative procedure or trauma and arthroscopic adhesiolysis ranged from three and half months to four years(mean 11.5 months). The interval between arthroscopic adhesiolysis and final follow-up evaluation ranged from 6 months to 3 years(mean 1.5 years). Average preoperative knee motion was 38.2 degrees. After arthroscopic adhesiolysis, maximum knee motion under anesthesia was 120.3 degrees and average final motion at follow-up was 101.2 degrees. The results of treatment of treatment of Tbc knee sequalae with secondary osteoarthritis and pyogenic arthritis were less favorable for motion improvement. Arthroscopic adhesiolysis seems to be a useful method of treatment in knee ankylosis. Morbidity was low, complications were few and the duration of hospital stay was short.
Anesthesia ; Ankylosis ; Arthritis ; Arthroscopy ; Female ; Follow-Up Studies ; Humans ; Knee ; Length of Stay ; Male ; Methods ; Osteoarthritis ; Surgical Procedures, Operative

Background: The prevalence of sleep disorders increases as pregnancy progresses, which affects the health of pregnant women, fetal health, and the outcomes of pregnancy. The aim of this study is to evaluate the quality of sleep and life in pregnant women in Korea. Methods: This study is a prospective cross-sectional, case-control study of pregnant women and age-matched controls. From July to September 2019, all participants completed Korean-language versions of the sleep questionnaires including Pittsburgh sleep quality index (K-PSQI), Insomnia severity index, Epworth sleepiness scale, Back’s depression inventory-2(K-BDI), STOP (Snoring, Tiredness, Observed apneas, and high blood Pressure), and short-form 36 (K-SF-36). Results: A total of 422 participants consisted of 385 pregnant women and 137 controls. Second and third trimester were 200 and 185, respectively. K-PSQI scores were higher in pregnant women compared with the controls (7.87±3.49 and 8.50±3.55 vs. 5.79±2.76, p<0.001). Total score of K-SF-36 was lowest in third trimester (62.07±17.72) and highest in the control group(79.41±13.36). There was no statistical difference between groups in K-BDI. Conclusions This study demonstrated worsening of sleep quality as well as life quality during pregnancy. More attention to sleep of pregnant women is needed.