To assess the value of CT and MR in the detection of local tumor recurrence after hysterectomy, we evaluate CT and MRI findings of the vaginal stump in fifteen patients who underwent hysterectomy for uterine cervical carcinoma (N=14) or endometrial carcinoma (N=1). The presence of stump recurrence was confirmed by needle biopsy in 7 patients and by reoperation in 1 patient. The absence of stump recurrence was diagnosed by needle biopsy in 3 patitients and by clinical follow-up in 4 patients. In eight patients with vaginal stump recurrence, six patients were correctly diagnosed by CT and seven patients by MRI. In remaining seven patients who had no evidence of tumor recurrence, four patients were correctly diagnosed with CT and all the rester patients with MRI. ON the bases of our results, MRI seems to be superior to CT in the evaluation of local tumor recurrence after hysterectomy.
Biopsy, Needle ; Endometrial Neoplasms ; Female ; Follow-Up Studies ; Humans ; Hysterectomy* ; Magnetic Resonance Imaging* ; Recurrence* ; Reoperation

To assess the value of CT and MR in the detection of local tumor recurrence after hysterectomy, we evaluate CT and MRI findings of the vaginal stump in fifteen patients who underwent hysterectomy for uterine cervical carcinoma (N=14) or endometrial carcinoma (N=1). The presence of stump recurrence was confirmed by needle biopsy in 7 patients and by reoperation in 1 patient. The absence of stump recurrence was diagnosed by needle biopsy in 3 patitients and by clinical follow-up in 4 patients. In eight patients with vaginal stump recurrence, six patients were correctly diagnosed by CT and seven patients by MRI. In remaining seven patients who had no evidence of tumor recurrence, four patients were correctly diagnosed with CT and all the rester patients with MRI. ON the bases of our results, MRI seems to be superior to CT in the evaluation of local tumor recurrence after hysterectomy.
Biopsy, Needle ; Endometrial Neoplasms ; Female ; Follow-Up Studies ; Humans ; Hysterectomy* ; Magnetic Resonance Imaging* ; Recurrence* ; Reoperation

The mirtazapine is a relatively new antidepressant that has noradrenergic and specific serotonin antagonist action(NaSSAs). This has been known as one of the most safest drugs because of its few side effects. Until now, there have been only one case report that mirtazapine causes a EPS side effect(restless leg syndrome). But the peculiar mechanism of this drug makes it impossible to explain the exact reasons why the mirtazapine could induce EPS symptoms. Authors obseved three cases of mirtazapine indeced akathisia. We could not explain the phenomenon the other way except akathisia. So here we presents the three case of mirtazapine induced akathisia and a few possible hypothesis of this phenomenon.
Leg ; Psychomotor Agitation* ; Serotonin

The authors dissected and examined a horseshoe kidney from the cadaver of a 54-year-old Korean female. The results were as follows. Other congenital anomalies or complications were not found, and no renal stones showed on plain radiography of the horseshoe kidney. The horseshoe kidney was located in the area between the 12 th thoracic vertebra and the 4th lumbar vertebra, with the superior extremity of the left kidney 10mm more inferior than that of the right. The isthmus connecting the bilateral kidneys was located at the level of the 3rd lumbar vertebra. The size of the kidney was 102mm × 52mm × 44mm (right) and 108mm × 62mm × 34mm (left), and the superoinferior and anteroposterior lengths of isthmus were 22mm and 10mm, respectively. The abdominal aorta and inferior vena cava passed posteriorly to the isthmus, with the inferior mesenteric artery and lumbar splanchnic nerve passing anteriorly. Some grooves were found on the anterior surface of the bilateral kidney. The hilum of the right kidney faced the anteromedial direction and that of the left kidney faced the anterolateral direction. At the hilar plane, the right renal arteries and veins passed anteriorly and posteriorly to the renal pelvis ; the left renal arteries passed posteriorly to the renal pelvis, with the left renal veins passing anteriorly and posteriorly. Three branches of the right renal arteries passed renal hilum, while two branches did not, and two branches of the left renal arteries passed renal hilum, while six branches did not. The two arteries arising from the aortic bifurcation were distributed to the isthmus. The number of renal veins passing the renal hilum were three in the right, and two in the left. The right and left ovarian veins drained to the renal veins. There were 12 minor calyces distributed normally in the right kidney, 13 minor calyces distributed radially in the left kidney, and 3 minor calyces in the isthmus, composed of parenchyme. The left portion of the horseshoe kidney was concluded to have developed poorly, on the basis of incomplete ascension and abnormal rotation during development, the imperfect configuration of the renal shape, and the abnormal distribution of the renal vessels and renal calyces.
Aorta, Abdominal ; Arteries ; Cadaver ; Extremities ; Female ; Fused Kidney* ; Humans ; Kidney ; Kidney Pelvis ; Mesenteric Artery, Inferior ; Middle Aged ; Radiography ; Renal Artery ; Renal Veins ; Spine ; Splanchnic Nerves ; Veins ; Vena Cava, Inferior

No abstract available.
Amniotic Fluid* ; Animals ; Embryonic Structures* ; Female ; Humans* ; Mice*

No abstract available.
Amniotic Fluid* ; Animals ; Embryonic Structures* ; Female ; Humans* ; Mice*

STATEMENT OF PROBLEM: With increasing demand of the implant-supported prosthesis, it is advantageous to use the different platform width of the fixture according to bone quantity and quality of the patients. PURPOSE: The purpose of this study was to assess the loading distributing characteristics of two implant designs according to each platform width of fixture, under vertical and inclined loading using finite element analysis. Material and method : The two kinds of finite element models were designed according to each platform width of fixture (4.1mm restorative component x 11.5mm length, 5.0mm wide-diameter restorative component x 11.5mm length). The crown for mandibular first molar was made using UCLA abutment. Each three-dimensional finite element model was created with the physical properties of the implant and surrounding bone. This study simulated loads of 200N at the central fossa in a vertical direction, 200N at the outside point of the central fossa with resin filling into screw hole in a vertical direction and 200N at the buccal cusp in a 300 transverse direction individually. Von Mises stresses were recorded and compared in the supporting bone, fixture, and abutment screw. RESULTS: The stresses were concentrated mainly at the cortex in both vertical and oblique loading but the stresses in the cancellous bone were low in both vertical and oblique loading. Bending moments resulting from non-axial loading of dental implants caused stress concentrations on cortical bone. The magnitude of the stress was greater with the oblique loading. Increasing the platform width of the implant fixture decreased the stress in the supporting bone, fixture and abutment screw. Increased the platform width of fixture decreased the stress in the crown and platform. CONCLUSION: Conclusively, this investigation provides evidence that the platform width of the implant fixture directly affects periimplant stress. By increasing the platform width of the implant fixture, it showed tendency to decreased the supporting bone, fixture and screw. But, further clinical studies are necessary to determine the ideal protocol for the successful placement of wide platform implants.
Crowns ; Dental Implants ; Finite Element Analysis ; Humans ; Molar ; Prostheses and Implants*

Traumatic abdominal wall hernia after blunt abdominal trauma is rare. The prevalence of traumatic abdominal wall hernia in published series is approximately 1%. Recently, by the use of computed tomography has increased the number of occult traumatic abdominal wall hernias (TAWH). A 47-year-old woman presented to the emergency room soon after a traffic accident. She was fully conscious and complained of diffuse, dull, abdominal pain. She had a seat belt on at the time of the accident. Initial computed tomography showed that the lower left abdominal wall had a defect and that a part of the small bowel had herniated through the defect. During the operation, we made an incision at the defect site and confirmed the defect. The defect size was about 15x5 cm. The muscle layers were repaired in layers with absorbable sutures. Prolen mesh was layed down and fixed on the site of the repaired muscle defect. After 6 months, hernia had not recurred, and no weakness of the repaired abdominal wall layers was identified. The patient`s postoperative body functions were normal.
Abdominal Pain ; Abdominal Wall ; Accidents, Traffic ; Emergencies ; Female ; Hernia ; Humans ; Middle Aged ; Muscles ; Prevalence ; Seat Belts ; Sutures

This study is to find out changes in medical practice at a university hospital before and after covering intraocular lens (IOL) from the health insurance benefit. The coverage started on March 1, 1993 and a total of 596 cases who were discharged from July 1 to December 31, 1992 and 580 cases who were discharged from July 1 to December 31, 1993 were analyzed. Since the standard reimbursement scheme was changed from March 1, 1993, the charges for 1992 were transformed into 1993 scheme. Major findings are as follows: Average length of stay was statistically significantly decreased from 8.24 days in 1992 to 6 86 days in 1993. Charges except IOL has been statistically significantly decreased from 501,000 won in 1992 to 444,000 won in 1993. Charges for drugs and injection have been reduced. However, charge per day for them was not much different. This is due to decrease in length of stay. Charges for laboratory tests and radiologic examination were quite the same. charges which are not covered by the insurance remained the same. The revenue of the hospital was reduced as expected. However, the hospital reduced the length of stay and increase the turnover rate in order to compensate the potential loss of revenue due to the difference of reimbursement between the out-of-pocket expense and the insurance coverage. By introducing the IOL benefit in the insurance, the insured pays less, hospital generates more revenue through shortening the hospital stay, and the total medical care cost becomes less nationwidely.
Health Care Costs ; Insurance ; Insurance Coverage ; Insurance, Health* ; Length of Stay ; Lenses, Intraocular*

Gastric surgery is one of the most frequently performed operations in Korea. Retroanastomotic hernia is a rare complication ingastric surgery. We experienced this hernia and herein report it with a review of the literature. A 69-year-old male patient suffered from periumbilical pain for 3 days. Positive physical findings were tenderness around the umbilicus and decreased bowel sound. Simple abdominal findings revealed a mechanical obstruction. This patient had a history of gastrectomy 13 years prior to admission. At operation field, we were able to find the defect consisting of the transverse mesocolon, stomach, jejunum and retroperituneum. In Korea, since its first report by Petersen, only a few reports about this hernia have been reported. After increased incidence of operations for morbid obesity, reports on retroanstomotic hernia have increased.
Aged ; Gastrectomy ; Hernia ; Humans ; Incidence ; Jejunum ; Korea ; Male ; Mesocolon ; Obesity, Morbid ; Stomach ; Umbilicus