OBJECTIVES: To evaluate the effect of parity & delivery method on female fecal incontinence. METHOD: Based on 213 cases of 4 different delivery method and 40 cases of one non-delivery group, a retrospective analysis of the prevalence of female fecal incontinence, between January 1996 and December 1998, was done. With delivery mode, 4 different groups were: first vaginal delivery group , two or more vaginal deliveries group, first cesarean section group, and first vaginal delivery followed by cesarean section group. All subjects were examined by questionaire or phone about the experience of fecal incontinence after delivery. In cases of fecal incontinence , we reviewed the obstetric complications with medical records. RESULT: There was no fecal incontinence in the non-delivery group. The incidence of fecal incontinence in the two or more vaginal delivery group(11.7%, 9/77) and the first vaginal delivery followed by cesarean section group(18.1%, 8/44) was higher than the first vaginal delivery group(6.8%, 3/44), and the first cesarean section group(2.1%, 1/48)(P<0.05). The obstetric complications in fecal incontinence cases were: a prolonged second stage, anal sphincter laceration, vacuum extraction, a large baby etc. CONCLUSION: Fecal incontinence was significantly correlated with the number of vaginal deliveries and obstetric complications during delivery. Fecal incontinence after the first vaginal delivery or vaginal delivery followed by cesarean section are very important factors in choosing the next delivery method.
Cesarean Section ; Fecal Incontinence* ; Female* ; Humans ; Incidence ; Lacerations ; Medical Records ; Parity* ; Pregnancy ; Prevalence ; Psychosexual Development ; Retrospective Studies ; Vacuum

PURPOSE: Delirium in the elderly is common in the postoperative period but there are only few reports on detailed studies of this condition. Number of urologic patients with postoperative delirium was increas ed in our hospital for recent 24 months. The clinical characteristics of patients with postoperative delirium was analyzed retrospectively. MATERIALS AND METHODS: We selected the patients with postoperative delirium from 1010 patients who had undergone urological surgery under general or spinal anesthesia in the period from Jan. 1997 to Dec. 1999. Diagnosis of postoperative delirium was established with Diagnostic and Statistical Manual of Mental Disorders(DAM-III-R) by psychiatric clinicians. Onset and recovery of symptoms, risk factors, previous psychiatric clinicians. Onset and recovery of symptoms, risk factors, previous psychiatric disorder, relationship with anesthesia, drugs, and surgical procedures, concomittant medical conditions, and complications were retrospectively reviewed. RESULTS: Postoperative delirium was observed in 13 patients (1.3%). All patients were male and mean age was 70.4 years (46-86 years). Surgical procedures included TURP(8 patients), cystectomy (3 patients), nephroureterectomy (1 patient), and bladder rupture repair (1 patient). Delirium became apparent between one day and two days after the operation (mean 32.2 hours) and lasted for up to 7 days (mean 53 hours). Several factors such as older age (>65 years), male patient, longterm medication, past history of CVA, memory impairment, hearing difficulty, traumatic brain contusion, and obsessive personality were thought to be risk factors of postoperative delirium. Treatment with Haloperidol(R) intramuscular injection (2.5-5mg, every 30 minutes, 2-4 times until symptom resolution was achieved) with or without Ativan(R) intravenous injection (2mg) were effective. Complete symptom recovery was seen in 92.3% (12/13) of patients. One patient (7.7%) with previous history of dementia had persistent memory disturbance and disorientation during follow-up periods. CONCLUSIONS: Generally, postoperative delirium is an acute transient confusional state without considerable sequeles. Treatment is sedation and prevention of inadvertent accident associated with confusional state. Urologic surgeon must be attentive to the development of this illness especially when high risk factors were present.
Aged ; Anesthesia ; Anesthesia, Spinal ; Brain Injuries ; Cystectomy ; Delirium* ; Dementia ; Diagnosis ; Follow-Up Studies ; Hearing ; Humans ; Injections, Intramuscular ; Injections, Intravenous ; Male ; Memory ; Postoperative Period ; Retrospective Studies ; Risk Factors ; Rupture ; Urinary Bladder

Uterine didelphys with unilateral hematometra, hemicolpos, and ipsilateral renal agenesis is a rare m01lerian duct malformation. Uterine didelphys with an obstructed hemivagina is frequently associated with renal agenesis, mostly ipsilateral to the blind vaginal pouch. Accurate early diagnosis and septal resection elevate pregnancy rate and birth rate but it is difficult to find these malfomations until the complication associated with pregnancy was developed. We report a case of successful gestational outcome in the presence of preterm labor due to hematometrocolpora caused by uterine didelphys with unilateral imperforated vagina and ipsilateral renal agenesis with brief review of the literatures.
Birth Rate ; Early Diagnosis ; Female ; Hematometra ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Rate ; Uterus* ; Vagina

No abstract available.
Adenocarcinoma*

Degenerative arthritis of the knee joint is one of the main causes of disability in middle-aged persons. This paper is planned by the necessity of objective information upon changes of tibio-femoral angle according to weight bearing in patients with degenerative arthritis of the knee joint. The authors studied the tibio-femoral angle in 29 cases of degenerative arthritis of the knee ranging fmm 5th to 6th decades of age, and compared with 27 cases of the control group, in the Dept. of Orthopedic Surgery, S.N.U.H. fmm Mar. 1983 to May 1984. The following observations were obtained: 1. In patients with degenerative arthritis of the knee, changes of the tibio-femoral angle according to weight bearing were +2.2±1.94 in 5th decade, +2.3±2.02 in 6th decade. 2. Compared to control group, the degenerative arthritis group showed a significant varization with weight bearing. 3. It was seemed that the weight bearing radiography is essential in diagnosis and treatment of degenerative arthritis of the knee joint.
Diagnosis ; Humans ; Knee ; Knee Joint ; Orthopedics ; Osteoarthritis ; Radiography ; Weight-Bearing

Congenital tuberculosis is an infection that is established in the fetus by hematogenous spread or by the aspiration or inhalation of infected amniotic fluid either before or during labor. The diagnosis can be confirmed only if both the tuberculous nature of the lesion and the antenatal origin of the infection can be proved. The authors analysed roentgen findings of two cases of pulmonary tuberculosis, thought to be congenital; 1. Diffuse distribution of nodular densities and some confluent densities were seen in the entire lungs in the inital film.The pulmonary markings were decreased in some degree. 2. Air bronchogram was noted. 3. Hepatosplenomegaly was associated.
Amniotic Fluid ; Diagnosis ; Female ; Fetus ; Inhalation ; Lung ; Tuberculosis ; Tuberculosis, Pulmonary

The purpose of this study was to evaluate the position of tongue and hyoid bone in relation to vertical facial patterns in the adult and child. Lateral cephalograms taken in adults(63 cases, 11.7 years in average age) and children(69 cases, 22.6 years in average age) were traced and measured about position and posture of tongue and hyoid bone using the horizontal and vertical reference lines. The angle of mandibular plane to SN plane was employed to classify the samples into groups of hypodivergent and hyperdivergent. The comparison of the tongue/hyoid bone measurements between hypodivergent group and hyperdivergent group in the adult and child were statistically executed with Student's t-test. The results were as follows; 1. The tongue height was lower in the hyperdivergent group than in hypodivergent group, and higher in children than in adults. 2. The vertical height of hyoid bone was higher in hypodivergent group than in hyperdivergent group and also higher in children than in adults. 3. The anteroposterior position was of no significant difference in relation to age or vertical facial pattern. 4. The inclination of hyoid bone in relation to cranial base was steeper in children than in adults.
Adult ; Child ; Humans ; Hyoid Bone* ; Malocclusion* ; Posture ; Skull Base ; Tongue*

No abstract available.
Guillain-Barre Syndrome* ; Pregnancy*

BACKGROUND: Acromioclavicular (AC) stability is maintained through a complex combination of soft-tissue restraints that include coracoclavicular (CC), AC ligament and overlying muscles. Among these structures, the role of the CC ligament has continued to be studied because of its importance on shoulder kinematics, especially after AC injury. This study was designed to determine the geometric change of conoid and trapezoid ligaments and resulting stresses on these ligaments according to various scapular motions. METHODS: The scapuloclavicular (SC) complex was isolated from a fresh-frozen cadaver by removing all soft tissues except the AC and CC ligaments. The anatomically aligned SC complex was then scanned with a high-resolution computed tomography scanner into 0.6-mm slices. The Finite element model of the SC complex was obtained and used for calculating the stress on different parts of the CC ligaments with simulated movements of the scapula. RESULTS: Average stress on the conoid ligament during anterior tilt, internal rotation, and scapular protraction was higher, whereas the stress on the trapezoid ligament was more prominent during posterior tilt, external rotation, and retraction. CONCLUSIONS: We conclude that CC ligament plays an integral role in regulating horizontal SC motion as well as complex motions indicated by increased stress over the ligament with an incremental scapular position change. The conoid ligament is the key structure restraining scapular protraction that might occur in high-grade AC dislocation. Hence in CC ligament reconstructions involving only single bundle, every attempt must be made to reconstruct conoid part of CC ligament as anatomically as possible.
Biomechanical Phenomena ; Cadaver* ; Dislocations ; Ligaments* ; Muscles ; Scapula ; Shoulder

Meigs' syndrome is defined as a hydrothorax with ascites and a pelvic tumor, both of which resolve on removal of the tumor. Pseudo-Meigs' syndrome is a variant not possessing the original tumor cell types described by Meigs. Both these syndromes should be considered in otherwise healthy women who present with either new or recurrent hydrothorax and ascites. Pseudo-Meigs' syndrome occurs with the clinical triad of (1)ascites, (2)pleural effusion and (3)Brenner tumors, struma ovarii, benign thecomas, extreme ovarian edema, uterine leiomyomas or other benign pelvic tumors. A case of Pseudo-Meigs' syndrome associated with Brenner tumor is presented with a brief review of literatures.
Ascites ; Brenner Tumor ; Edema ; Female ; Humans ; Hydrothorax ; Leiomyoma ; Meigs Syndrome ; Struma Ovarii ; Thecoma