Vesicovaginal fistula is a uncommon status in the developed countries. In the past it was mostly by obstetric causes. But now a days, posthysterectomy fistulas are seen. Fistula is a discomfort to the patient because of urine leakage, odor, and its inconvenience. We have experienced one case of fistula after abdominal hysterectomy and have repaired it by Latzko partial colpocleisis. So we report a case with some references.
Developed Countries ; Fistula ; Humans ; Hysterectomy ; Odors ; Vesicovaginal Fistula*

The result of artificial skins made with collagen is poor after grafting over the full thickness wounds due to their rapid degradation by enzymatic cleavage. This study is an in vivo study of an artificial skin made with a biodegradable polymer, which can better address the problem of the collagenous artificial dermis. To investigate the availability of a biodegradable polymer for an artificial dermis and to get an information about the optimal degradation rate of a polymer for an artificial dermis, we made an artificial dermis by seeding of fibroblasts within the vicryl mesh and made a bilayer artificial skin by covering the artificial dermis with cultured keratinocytes. And these artificial dermis and artificial skin were evaluated in a full thickness wound model. The results are as followings: 1. The artificial dermis was available for grafting for 1 week culture of vicryl mesh-fibroblast. 2. The artificial dermis retarded the contraction of full thickness wounds. 3. The artificial dermis generated the granulation tissue and accepted the STSG completely. 4. The generated tissue from the artificial dermis had incorporated into the surrounding tissue by 4 weeks postgrafting. 5. Vicryl in the artificial dermis became to biodegrade from the culture period and absorbed completely by 5 weeks. 6. The epidermal portion was poorly differntiated during in vitro culture period. In conclusion, the polymer-fibroblast graft can retard the wound contraction and generate a new tissue permitting a useful dermal replacement. And to get more optimal results, another polymer which has slower biodegradation rate than vicryl should be used for the artificial dermis and the epidermal portion should be differentiated after in vivo grafting.
Collagen ; Dermis* ; Fibroblasts ; Granulation Tissue ; Keratinocytes ; Polyglactin 910 ; Polymers ; Skin, Artificial ; Transplants ; Wounds and Injuries

PURPOSE: This study was done to analyze survivals, patterns of failure, and complications of early uterine cervix cancer after curative radiotherapy. METHODS AND MATERIALS: Eighty patients with uterine cervix cancer FIGO Stage IB (48 cases) and Stage IIA (32 cases) treated with radiotherapy were analyzed retrospectively. Patients were treated from November 1985 to May 1993, and minimum follow up period was 24 months. and 6 cases were lost to follow up. All of them were treated with external radiotherapy and different fractions of high dose rate intracavitary radiotherapy. Survival rates, failure patterns, complication rates and degrees of severity were analyzed according to several factors. RESULTS: Overall 5 year survival rate and relapse free survival rate were 72.3%, and 72.8% respectively. Prognostic factors were stage, size, pathology, RT response and there was no significant survival difference among the reasons of radiotherapy choice. There were 19 cases of treatment failure, another 3 cases were not tumor related death, and most of treatment related failure occurred within 24 months. Late complication rate of bladder and rectum were 8.8%, 15% respectively, frequency and severity of complication were correlated with ICR fractionation dose and total dose. CONCLUSION: These results showed that survival rates of early stage radiation treated cervix cancer patients were comparable to surgical series, but more aggressive treatment methods needed for stage IIA poor prognostic patients, To decrease late complication, choice of proper ICR dose and meticulous vaginal packing is needed.
Cervix Uteri* ; Female ; Follow-Up Studies ; Humans ; Lost to Follow-Up ; Pathology ; Radiotherapy* ; Rectum ; Recurrence ; Retrospective Studies ; Survival Rate ; Treatment Failure ; Urinary Bladder ; Uterine Cervical Neoplasms

As the traffic accidents and occupational accidents increase, the pure blow out fracture has been increased. If we could know the prognostic information of the pure blowout fracture according to the fracture sites, it would be of benefit in consulting the patients preoperatively and in planning the treatment. In this study we defined the posterior wall fracture as that extending 2 cm from orbital rim and the anterior wall fracture as that presenting within 2 cm from orbital rim. These fractures were individually classified into inferior wall fractures, medial wall fractures, and combined inferior and medial wall fractures, based on the operative finding and the preoperative CT scanning. We experienced 76 cases of pure blowout fracture patients underwent surgical correction and followed up the subsidence of diplopia and extraocular muscle limitation with ophthalmic Hess test. The results obtained are as following: 1. Posterior wall fractures were improved more slowly than anterior wall fractures. 2. Combined inferior and medial wall fractures were improved more slowly than isolate inferior wall or medial wall fractures. These results may be related to the difference of the traumatic forces and the anatomical structure of the fracture sites. These results inform the importance of accurate anatomical reconstruction of fracture sites and can be used as a prognostic information of the pure blow out fractures.
Accidents, Occupational ; Accidents, Traffic ; Diplopia ; Humans ; Orbit ; Orbital Fractures* ; Tomography, X-Ray Computed

PURPOSE: We designed this study to identify and suggest the reasonable timing of adjuvant radiotherapy in the treatment of uterine carcinosarcoma according to the surgical intent and patterns of progression. MATERIALS AND METHODS: We retrospectively analyzed a total of 50 carcinosarcoma patients diagnosed between 1995 and 2010. Among these 50 patients, 32 underwent curative surgery and 13 underwent maximal tumor debulking surgery. The remaining five patients underwent biopsy only. Twenty-six patients received chemotherapy, and 15 patients received adjuvant radiotherapy. RESULTS: The median follow-up period was 17.3 months. Curative resection (p < 0.001) and stage (p < 0.001) were statistically significant factors affecting survival. During follow-up, 30 patients showed progression. Among these, eight patients (16.0%) had loco-regional progression only. The patients who had received adjuvant radiotherapy did not show loco-regional progression, and radiotherapy was a significant negative risk factor for loco-regional progression (p = 0.01). The time to loco-regional progression was much earlier for non-curative than curative resection (range, 0.7 to 7.6 months vs. 7.5 to 39.0 months). CONCLUSION: Adjuvant radiotherapy in the treatment of carcinosarcoma might be related to a low loco-regional progression rate. Radiotherapy should be considered in non-curatively resected patients as soon as possible.
Biopsy ; Carcinosarcoma ; Follow-Up Studies ; Humans ; Radiotherapy, Adjuvant ; Retrospective Studies ; Risk Factors

OBJECTIVES: Radiofrequency(RF) ablation is an effective and low risk curative treatment for supraventricular arrhythmias. Catheter ablation produced cardiac lesions primarily through formation of coagulation necrosis. We evaluated the degree of myocardial injury after RF catheter ablation by means of serial measurement of myocardial enzyme. METHODS: Fifty-one patients with symptomatic supraventricular tachycardia were included. There were 32 men and 19 women(mean age. 39.5+/-15.4 years)All patients underwent electrophysiologic study to detect accessary pathway and ablation with radiofreguency current. A mean of 18.3+/-14.2 radiofrequency pulses were delivered. The pulses were at a power of 50 to 60 Volts for a duration of 20 to 30 seconds. Unipolar method and a 6F or 7F catheter with a 4 mm tip electrode was used. LDH, CPK and Ck-MB as a kind of cardiac enzyme were measured before and after ablation. RESULTS: 1) The concentration of LDH and CPK were elecated at 8 hours and 16 hours after ablation (p<0.05). 2) The concentration of CK-MB was elevated at 8 hours, 16 hours, 24 hours and 72 hours after ablation(p<0.05). 3) There was no correlation between the number of applications and amounts of radiofrequency current and rise in LDH, CPK, CK-MB concentration. CONCLUSION: The concentration of LDH, CPK and CK-MB were elevated after ablation but they were within normal limits. RF catheter ablation produced myocardial damage inevitably but were within normal limits. RF catheter ablation produced myocardial damage inevitably but minimally, then RF ablation is an effective and safe therapeutic modality for patients with symptomatic tachyarrhythmias.
Arrhythmias, Cardiac ; Catheter Ablation* ; Catheters ; Electrodes ; Humans ; Male ; Necrosis ; Tachycardia ; Tachycardia, Supraventricular*

OBJECTIVE: This study examined the overall mental health consequences of the bereaved parents after the Sewol ferry accident. METHODS: Eighty-four bereaved parents participated in the study. Self-report scales assessing the severity of psychiatric symptoms and other related psychosomatic problems were used at 18 months following the accident. Univariate descriptive statistics and regression analyses were performed to report the prevalence, severity, and correlates of psychiatric symptoms. RESULTS: 94% of the participants appeared to suffer from complicated grief based on scores on the Inventory of Complicated Grief (ICG). Half of the participants were categorized as having severe depression and 70.2% reported clinically significant post-traumatic symptoms according to scores on the Patient Health Questionnaire-9 (PHQ-9) and PTSD Check List-5 (PCL-5). No significant differences by gender were observed in the severity of psychiatric symptoms. A higher educational level was associated with more severe psychiatric symptoms in fathers. CONCLUSION: The loss of a child due to a disaster caused by human error may continue to have a substantial impact on parental mental health at 18 months after the event. A longitudinal study following parents' mental health state would be necessary to investigate the long-term effects of the traumatic experience in the future.
Bereavement* ; Child ; Depression ; Disasters ; Fathers ; Grief ; Humans ; Longitudinal Studies ; Mental Health* ; Parents* ; Prevalence ; Stress Disorders, Post-Traumatic ; Weights and Measures

Fourty-seven patients with non-aneurysmal spontaneous subarachnoid hemorrhage were reviewed retrospectively. Attention was directed to the distribution and amount of subarachnoid hemorrhage on computerized tomography scans. Though the hemorrhage could be distributed in all cisterns, the frequency and amount of hemorrhage were higher in infratentorial cisterns than in supratentorial cisterns. Among infratentorial cisterns, the hemorrhage was distributed to cisterns around the brain-stem mainly and it had a predilection for interpeduncular cistern. Also the telangiectasia of thalamoperforating artery might be one of the causes of non-aneurysmal spontaneous subarachnoid hemorrhage.
Arteries ; Hemorrhage ; Humans ; Retrospective Studies ; Subarachnoid Hemorrhage* ; Telangiectasis

Sialoblastoma and hepatoblastoma of neonate were very rare cancer. We present a case of concurrent sialoblastoma with hepatoblastoma associated with chromosomal anomaly.
Hepatoblastoma* ; Humans ; Infant, Newborn*

BACKGROUND: Recently in Europe, some epidemiologic studies reported that various physical symptoms and social, psychological wellbeing are related to low blood pressure. But in Korea, none has been studied on symptoms related to low blood pressure yet. In this study, we would like to see if the somatic symptoms and social, psychological wellbeing shown t,o be related to low SBP is truly associated with it. METHODS: Questionnaire interview was done to the people who have visited Department of family practice in two university hospitals and two health promotion center from April, 1996 to August, 1996. Seven somatic symptoms and Psychosocial Wellbeing Index(PWI) for the evaluation of social, psychological health status were included in the questionnaire. SAS statistics packages was used in statistical precess. We used logistic regression to see the frequency of somatic symptoms related to the systolic blood pressure(SBP) group and the confirmation of confounding variables was done by ANOVA. RESULTS: Total of 304 completed the questionnaire. Average age was 44 years old and average SBP was 115.4+/-16.4. 84 of them (27.6%) felt that they had a low BP & 69 were women compared to 21 men, being meaningfully more common. 107(35.2%) people answered that they had heard that their blood pressure was low and 66% were from doctors. Only 32(38.1%) of the group who felt of having hypotensive symptoms and 38 of the group who heard of having hypotension actually had SBP of below 100 mmHg. Vocation, income, smoking & alcohol history, present illness, marital status were not significant as a confounding variable. SBP of 100 or below group had a less presentation of fatigue & significantly higher PWI than the group of above 100mmHg (p<0.05). The group who felt that they had a low BP had more complaints of fatigue, dizziness, palpitation, cold hands and feet and had significnatly higher PWI than the group who didnt. CONCLUSIONS: SBP of 100mmHg or below group has more frequent manifestion of fatigue and low level of sociopsycholgiacl health index than the above 100mmHg group. But most of the people who complained of hypotensive symptoms didnt have low blood pressure and a lot of them misunderstand of having low blood pressure and after checking blood pressure by doctors, so great deal of caution is called for when seeing patients.
Adult ; Blood Pressure* ; Confounding Factors (Epidemiology) ; Dizziness ; Epidemiologic Studies ; Europe ; Family Practice ; Fatigue ; Female ; Foot ; Hand ; Health Promotion ; Hospitals, University ; Humans ; Hypotension ; Korea ; Logistic Models ; Male ; Marital Status ; Occupations ; Smoke ; Smoking ; Surveys and Questionnaires