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

There are substantial evidences indiacting that anesthesia and surgery produce significant suppression of immune function. It is generally recognized that immunosuppressive manifestations such as lymphopenia, granulocytosis, decreased transformation to various antigens and impaired neutrophil chemotaxis could be followed by surgical operation. anesthetic agents may also have both direct and hormone-mediated indirect effects on immune systems. Recent evidences indicate that immunosurveillance mechanisms are not only important in the management of emerging infection and malignancy, but also critical to successful elimination of microscopic residual tumor after operation. This study was done to investigate the effeets of halothane anesthesia on T-lymphocyte subpopulations in patients undergoing hysterectomy. Lymphocyte, granulocytes and T-lymphoeyte subpopulations were counted before, during and after anestesia. The results showed that the decrease in the CD4+ cells (helper/inducer T-cells) was bigger than the decrease in the CD8+ cells (suppressor/ cytotoxic T-cells). CD3+ cells (total T-cells) and CD45R+ cells were also decreased. However, these decrease turned to normal values in 5 days. The overall result of this study suggest that anesthesia with halothane may bring temporal suppressive effect on the immunologic responses.
Anesthesia* ; Anesthetics ; Chemotaxis ; Granulocytes ; Halothane* ; Humans ; Hysterectomy ; Immune System ; Lymphocyte Subsets* ; Lymphocytes* ; Lymphopenia ; Monitoring, Immunologic ; Neoplasm, Residual ; Neutrophils ; Reference Values ; T-Lymphocytes

Purpose: To evaluate the efficacy of the preventive abduction brace in dementia patients after bipolar hemiarthroplasty of the hip. Materials and Method: A review of 30 patients who had dementia prior to bipolar hemiarthroplasty of the hip. 20 females and 10 males were evaluated and their mean age was 80.4 years old (range, 68 to -92 years old). The average MMSE-K in dementia patients was 14.2 (range, 8 to 20). The reasons for the bipolar hemiarthroplasties were femoral neck fractures in all the cases. We analyzed the dislocation rates of those who had preventive abduction braces applied prospectively. Results: The average follow-up period after hemiarthroplasty was 2.2 years. All 30 patients had preventive abduction braces and no dislocations occurred after the bipolar hemiarthroplasties. Conclusion: Hip dislocations were not detected in those patients who preventive abduction braces applied. The present findings suggest that having a preventive abduction brace will definitely reduce the dislocation rate in dementia patients who have difficulties with rehabilitation after their operations.
Braces* ; Dementia* ; Dislocations ; Female ; Femoral Neck Fractures ; Follow-Up Studies ; Hemiarthroplasty* ; Hip Dislocation ; Hip* ; Humans ; Male ; Prospective Studies ; Rehabilitation

This study was carried out to reveal the epidemiologic characteristics of psoriasis in Korea. Seventeen university hospitals were engaged in this study, and the results were as follows : 1. The number of psoriasis patients during the 10 years from January 1977 to March 1987 was 1.05% of all the outpatients; the male to female-ratio was 1.08:1. 2. In the prospective study, the number of psoriasis patients was 2.3% of all the outpatients in 1987, 2.8% of all the outpatients in 1988 and the male to female ratio was 1.26:1. 3. The most prevalent age of onset was 20-29 years ; 81.1% were living in urban areas; and a family history was obtainable in 19.8% with parents holding the highest rank of 7.8%. 4. The most frequent duration of disease activity was under 5 years in 63.3%; the most common age for the worst condition was 20-29 yrs. The most common area size of skin involvement at the peak of the worst condition was less than 10%. 5. The most common initiating skin lesion began on the scalp in 20.2%, on the nail in 17.2%, pruritus in 63.0% with joint symptoms in 10.8%, and Koebner phenomena in 50.6%. 6. Emotional stress was the most common aggravating factor in 34.4%. The method of treatment that attained the best result was the combination therapy of oral medication and a topical agent. The best treatment modality was said to be the application of ointment with p.o.medication by as many as 28.4% of patients who took the leading rank. Photo-chemotherapy, effective with few complications, was not used much as it was not well-known in Korea until after 1980. Most people had an accurate knowledge of psoriasis.
Age of Onset ; Epidemiologic Studies* ; Epidemiology ; Female ; Hospitals, University ; Humans ; Joints ; Korea ; Male ; Methods ; Outpatients ; Parents ; Prospective Studies ; Pruritus ; Psoriasis* ; Scalp ; Skin ; Stress, Psychological

No abstract available.
Respiratory System* ; Respiratory Tract Infections* ; Roxithromycin*

We performed keratoplasty and did not remove suture material in 189 patients (189 eyes) after operation. Among them, 48 eyes which had clear grafts with spontaneous suture breakage had been analyzed retrospectively for the age, the sex distribution, the time and the site of broken suture, the preoperative diagnosis and the relationship between the suture breakage and the presence of vasculized recipient bed or suture method. The time when suture was broken after keratoplasty ranged from 3 months to 80 months(average 30 months). Leukoma cornea, 25 eyes(52.1%) and keratoconus, 13 eyes(27.1%) were the most common cause of keratoplasty and the others were corneal dystrophy, Fuchs dystrophy and re-keratoplasty. The most common site of broken suture was at superior quadrant(30 eyes, 62.5%), The vasculized recipient bed was found in 16 eyes, 13 eyes of leukoma cornea and 3 eyes of fe-keratoplasty in preoperative state. The statistical analysis showed significant relationship between the presence of vasculized recipient bed and the suture breakage(p<0.05). Suture was broken in 28 eyes(26.7%) of 105 eyes with single continuous suture, 6 eyes(21.9%) of 20 eyes with combined interupted suture and 14 eyes(21.9%) of 64 eyes with combined interupted and continuous suture. The statistical analysis showed no significant relationship between the suture method and the suture breakage(p>0.05).
Cornea ; Corneal Opacity ; Corneal Transplantation* ; Diagnosis ; Fuchs' Endothelial Dystrophy ; Humans ; Keratoconus ; Retrospective Studies ; Sex Distribution ; Sutures* ; Transplants

No abstract available.
Gait* ; Humans ; Spinal Cord Diseases*

BACKGROUND: Because of wide individual variations in response to sedative and the level of sedation desired by different patients, inadequate sedation is frequent during surgery. Patient-controlled sedation is a logical extension of patient-controlled analgesia to find and maintain their own steady-state of sedation by self-administration of sedatives during surgery. The purpose of this study was to evaluate the feasibility of patient-controlled sedation compared with anesthesiologist-controlled sedation during surgical spinal anesthesia. METHODS: Unpremedicated forty adult patients who received spinal anesthesia for lower extremity surgery were randomly allocated into two groups (n=20 for each group). After selection of target state of sedation according to sedation scale, patient-controlled sedation (PCS) group self-administered 0.5 mg (1 ml) intravenous midazolam in increments using a Walkmed PCA infusor and anesthesiologist- controlled sedation (ACS) group administered by the anesthesiologist as the same manner to achieve previously selected sedation state. Sedation score, vital signs, SpO2 were checked 5, 10, 20, 30, 40min after start of drug injection. RESULTS: The sedation scores patient desired were 4.4 +/- 0.8 in PCS group and 4.3 +/- 0.7 in ACS group. These scores were achieved 20min after start of injection in PCS group and 40 min in ACS grou p (p<0.05). Degree of satisfaction was higher in PCS group compared with ACS group (1.5 +/- 0.6 vs 2.1 +/- 0.8, p<0.05). No complications were detected in two groups. CONCLUSIONS: PCS using midazolam was better than ACS in terms of early achievement of sedation state patient desired and degree of satisfaction.
Adult ; Analgesia, Patient-Controlled ; Anesthesia, Spinal ; Humans ; Hypnotics and Sedatives ; Infusion Pumps ; Logic ; Lower Extremity ; Midazolam* ; Passive Cutaneous Anaphylaxis ; Vital Signs

In order to evaluate the clinical application of the Nd:YAG laser(Coherent model 9900(R)) to correct the astigmatism, we observed the change in corneal curvature, thickness and endothelium after laser radiation to the rabbit cornea. The experiment composed of 14 rabbit eyes divided into two groups according to the power setting; 7 eyes of 2.5mJ group, and 7 eyes of 5mJ group. Lader pulse was focused at corneal epithelium and an average of 25-30 applications were required to make the single pair of transverse line like conventional lineal corneal transverse incision for one eye. Changes ir keratometry and pachymetry were measured postlaser application for 3 months. Seven days after radiation, two rabbit eyes(2.5mJ and 5mJ) were enucleated for scanning electron microscopy. The results were as follows: 1. The mean flattening induced at 900 meridian was 1.91 diopter in 2.5mJ group and 1.98 diopter in 5mJ group 3 months after laser radiation, and the difference between the two groups was not statistically significant(p>0.5). 2. The steepening at 1800 meridian induced only one week after laser radiation in both groups, thereafter the flattening was shown. 3. The significant mean corneal thickness increase of 30.72pm in 2.5mJ group and 33.47 micrometer in 5mJ group was noted at postlaser 7 days and returned to normal range at postlaser 2 months, but the corneal thickness showed no significant statistical difference between two group(p>0.5). 4. Scanning electron microscopy findings showed changes of the ultrastructure of the endothelial cell: edematous changes of the endothelial cell and cell membrane destruction were much less in 2.5mJ group than 5mJ group.
Astigmatism ; Cell Membrane ; Cornea ; Endothelial Cells ; Endothelium* ; Epithelium, Corneal ; Microscopy, Electron, Scanning ; Rabbits* ; Reference Values

In order to evaluate the clinical application of the Nd:YAG laser(Coherent model 9900(R)) to correct the astigmatism, we observed the change in corneal curvature, thickness and endothelium after laser radiation to the rabbit cornea. The experiment composed of 14 rabbit eyes divided into two groups according to the power setting; 7 eyes of 2.5mJ group, and 7 eyes of 5mJ group. Lader pulse was focused at corneal epithelium and an average of 25-30 applications were required to make the single pair of transverse line like conventional lineal corneal transverse incision for one eye. Changes ir keratometry and pachymetry were measured postlaser application for 3 months. Seven days after radiation, two rabbit eyes(2.5mJ and 5mJ) were enucleated for scanning electron microscopy. The results were as follows: 1. The mean flattening induced at 900 meridian was 1.91 diopter in 2.5mJ group and 1.98 diopter in 5mJ group 3 months after laser radiation, and the difference between the two groups was not statistically significant(p>0.5). 2. The steepening at 1800 meridian induced only one week after laser radiation in both groups, thereafter the flattening was shown. 3. The significant mean corneal thickness increase of 30.72pm in 2.5mJ group and 33.47 micrometer in 5mJ group was noted at postlaser 7 days and returned to normal range at postlaser 2 months, but the corneal thickness showed no significant statistical difference between two group(p>0.5). 4. Scanning electron microscopy findings showed changes of the ultrastructure of the endothelial cell: edematous changes of the endothelial cell and cell membrane destruction were much less in 2.5mJ group than 5mJ group.
Astigmatism ; Cell Membrane ; Cornea ; Endothelial Cells ; Endothelium* ; Epithelium, Corneal ; Microscopy, Electron, Scanning ; Rabbits* ; Reference Values