OBJECTIVE: Our purpose was to evaluate the pregnancy outcome and the advantages of laparoscopic tubal reanastomosis. METHOD: During 16 months, January 1996 to April 1997, thirty-two patient had underwent laparoscopic tubal reanastomosis in Pudang CHA General Hospital. The mean age of the patients was 36.1+/-4.3 years(mean+/-SD; range 26 to 47 years). RESULT: The intrauterine pregnancy rate of laparoscopic tubal reanastomosis was 72.4%(21/29). Data comparing laparoscopic procedure retrospectively to tubal reversal by laparotomy was also evaluated. The mean interval from operation to pregnancy was similar in the two groups (p=0.9). The operation time was sigoificantly longer for laparoscopy (215.3+/-35.5 minutes) than for laparotomy(159.7+/-52.3 minutes). Nevertheless, the intensity of postoperative pain was lower (p<0.05) in patient who underwent laparoscopy than in patient who underwent laparotomy. Also, the mean hospital stay (3.6+/-2.3 days for laparoscopy, 6.1+/-0.5 days for laparotomy) was shortened(p<0.05) after laparoscopy compared with laparotomy. CONCLUSION: Laparoscopic tubal reanastomosis may offer the benefits of lower postoperative pain and shorten recovery time in comparison with laparotomy. Therefore, considering the high pregnancy rate in minimal follow up period of 6 month, laparoscopic tubal reanastomosis could be an alternative procedure to microsurgical laparotomy in patients requesting reversal of sterilization.
Female ; Fertility* ; Follow-Up Studies ; Hospitals, General ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Pain, Postoperative ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Retrospective Studies ; Sterilization ; Sterilization Reversal*

Asphyxia is the most important perinatal cause of neurologic morbidity in infants. Recently, elevated levels of CK-BB have been demonstrated in serum after asphyxic insult in infants. To evaluate the possibility of using serial measurements of CK-BB activity as a diagnostic method and a predictor of neurologic outcome in asphyxiatic infants. We studied CK-BB activity in serum of asphyxiated infants (16 preterm babies, 41 term babies) and healthy infants (11 preterm babies, 12 term babies) from birth (cord) to 5 days of serially. The results were as follows 1) Serum CK-BB activites (cord 76.0IU/L, 12 hours 34.1 IU/L, 1 day 22.4 IU/L, 2 days 8.2 IU/L) of asphyxiated preterm infants were much higher than those (cord 4.4IU/L, 12 hours 2.4IU/L, 1 day 1.6 IU/L, 2 days 1.1 IU/L) of healthy preterm infants, but there were no significant differences (P values>0.05). 2) Serum CK-BB activities (cord 59.0 IU/L, 12 hours 23.6 IU/L, day 17.6 IU/L) of asphyxiated term infants were significantly higher than those (cord 2.4 IU/L, 12 hours 2.7 IU/L, 1 day 0.4 IU/L) of healthy term infants (P values<0.05) 3) There were no significant differences in serum CK-BB activities between asphyxiated preterm infants who showed late neurologic deficits (P values>0.05) 4) Serum CK-BB activity (131.7 IU/L) at birth (cord) of asphyxiated term infants who showed late neurologic deficits was significantly higher than that (49.8 IU/L) of asphyxiated term infants who did not show late neurologic deficits (P value<0.05) In conclusion, it is suggested that serial measurement of CK-BB activity in serum of asphyxiated term infants from birth (cord) to 1 day of age is an available test for diagnosis of neonatal asphyxia and for a prediction of neurologic outcome of neonatal asphyxia.
Asphyxia ; Diagnosis ; Humans ; Infant* ; Infant, Newborn ; Infant, Premature ; Neurologic Manifestations ; Parturition

No abstract available.
Autopsy* ; Endocarditis* ; Thromboembolism

Proliferating cell nuclear antigen (PCNA, PC10), an auxillary protein of DNA polymerase, plays a main role in the early stage of DNA Synthesis and is synthesized from Gl phase to s phase of the cell cycle. Nucleolar organizer region (NORs) are DNA loops encoding RNA proteins(AgNORs). To evaluate correlation with PCNA labelling index (LI)and AgNORs according to histological grades and clinical stages of transitional cell carcinoma of the urinary bladder, the authors analysed 54 transitional cell carcinoma using immunohistochemical stain for PCNA and silver stain for AgNORs in paraffin sections. The comparison of PCNA (PC10) LI and clinical stage showed a significant correlation (p<0.05), where as PCNA (PC10) LI according to histologic grade showed no significant correlation. High grade tumors showed increase PCNA LI. Superficial tumors (Ta-Tl) showed significantly lower PCNA LI than muscle invasive tumors (T2-T4)(p<0.05). There was no significant correlation between AgNORs and clinical stage, bur higher stage and higher grade tumors showed increased noubers of AgNORs. These results suggest that PCNA LI has a significant correlation with clinical stages of transitional cell carcinoma of the urinary bladder.

No abstract available.
Busan* ; Eclampsia* ; Female ; Pregnancy ; Singing*

Congenital esophageal stenosis due to tracheobronchial remnants is one of main forms of congenital esophageal stenosis, and it was first described by Frey and Duschel in l936. An 18-month-old male presented with underdevelopment and dehydration state due to persistent vomiting several times per day since 3 months after his birth. Esophagogram revealed an elongated and diiated esophagus with marked stenosis at distal portion. Partial distal esophagectomy was performed. Histologically, the thickened esophageal wall is composed of tracheobronchial remnants including hyaline cartilages, mucous glands, and ductal structures lined by ciliated respiratory epithelium under stratified squamous mucosa.
Male ; Humans

Congenital esophageal stenosis due to tracheobronchial remnants is one of main forms of congenital esophageal stenosis, and it was first described by Frey and Duschel in l936. An 18-month-old male presented with underdevelopment and dehydration state due to persistent vomiting several times per day since 3 months after his birth. Esophagogram revealed an elongated and diiated esophagus with marked stenosis at distal portion. Partial distal esophagectomy was performed. Histologically, the thickened esophageal wall is composed of tracheobronchial remnants including hyaline cartilages, mucous glands, and ductal structures lined by ciliated respiratory epithelium under stratified squamous mucosa.
Male ; Humans

The incidence of colorectal cancer has been increased gradually and it was about 6.9% of all malignancies in Korea. Early diagnosis was recognized as the most important factor influencing the prognosis of colorectal cancer and the incidence of early colorectal cancer was increasing. Thus great change was observed in the treatment of early colorectal cancer, endoscopic therapy as well as curative surgical resection is being accepted. We report a case of effective and safe endoscopic therapy for early rectal cancer in 5S-year-old male patient. He presented with rectal prolapse and bleeding of a year's duration. A large polypoid mass with fine nodular surface and thick, short stalk was seen in the rectum at 4cm above the anal verge during flexible sigmoidoscopy. After the histologic examination of specimen obtained by bite biopsy, CT scan of pelvic cavity and ultrasonogram of abdomen, the tumor was removed safe and completely by 2 sessions of piecemeal polypectomies and strip biopsy. He has been well without symptoms and signs of recurrence of rectal cancer for 20 months.
Abdomen ; Biopsy* ; Colorectal Neoplasms ; Early Diagnosis ; Hemorrhage ; Humans ; Incidence ; Korea ; Male ; Prognosis ; Rectal Neoplasms* ; Rectal Prolapse ; Rectum ; Recurrence ; Sigmoidoscopy ; Tomography, X-Ray Computed ; Ultrasonography

We report a case of a 13-year-old girl who was noted to have combined malformation of complete septate uterus, obstructed hemivagina and ipsilateral renal agenesis with complaints of dysmenorrhea. Hematometrocolpos was developed in the result of retained menstrual blood since menarche. This rare congenital anomaly is supposed to be derived from disorders of mesonephric and M llerian developement in embryogenesis of female genitouinary tract. An accurate preoperative diagnosis of this syndrome is critical because of the difference in therapeutic strategy and prognosis. Simple and definite treatment of the condition is excision of the obstructed vaginal septum with prompt exit of retained blood. We present here a interesting case of M llerian anomaly in attempt to alert gynecologist to the possible occurrence of such a malformation with a brief review of concerned literatures.
Adolescent ; Diagnosis ; Dysmenorrhea ; Embryonic Development ; Female ; Humans ; Menarche ; Pregnancy ; Prognosis ; Uterus*

We investigated the role of the tumor suppressor genes in the germ cell tumor. Immunohistochemistry (IHC) and polymerase chain reaction-single strand conformational polymorphism (PCR-SSCP) for p53 mutation were done in 46 cases of the germ cell tumor with paraffin embedded tissue. The immunohistochemical staining for Rb protein was also performed in the same specimens. The following results were obtained. The overexpression of the p53 protein was detected in 7 of 46 cases (15%). p53 mutation by PCR-SSCP was detected in 1 of 46 cases (2.2%). Expression of Rb protein was negative in 19 cases (41%). These results suggest that p53 mutation does not play an important role in the initiation and progression of germ cell tumors.
Genes, Tumor Suppressor ; Germ Cells* ; Immunohistochemistry ; Neoplasms, Germ Cell and Embryonal* ; Paraffin ; Retinoblastoma Protein*