OBJECTIVE: Peripartum emergency cesarean hysterectomy of 28 cases at our hospital for 10years were reviewed that the clinical indication, history, and annual incidence change. METHODS: A retrospective descriptive analysis from January, 1988 to December, 1997 was carried out. RESULTS: There were 28 cases of emergency cesarean hysterectomy identified during this period among total 24, 689 deliveries. The annual incidence of emergency cesarean hysterectomy was significantly declined statistically(p<0.005). Cesarean hysterectomy was performed in 20 of 6, 671 cesarean section(0.30%) and in 8 of 18, 018 vaginal deliveries(0.04%), so more frequently after cesarean section than vaginal delivery. The cesarean hysterectomy rate was more frequent in multiparous women(0, 22%) than in nulliparous women(0, 02%). The most common indication of cesarean hysterectomy was 13 cases of uterine atony(46%), followed by 5 cases uterine rupture(18%), 5 cases of placenta previa with placenta accreta(18%), 3 cases of placenta previa(11%), 2 cases of uterine myoma(7%). No significant difference in length of operating time, amount of blood loss and operative complications were found between total abdominal hysterectomy and subtotal hysterectomy. The all patient who had cesarean hysterectomy recieved from 1200ml to 15840ml of blood transfusion with a mean of 3673ml. In aspect of fetal outcome, 3 cases of FDIU(Fetal death in utero) in uterine rupture and 1 case of stillbirth in preterm were found. The maternal complications were wound disruption, DIC, wound hematoma, ureter injury, vaginal stump bleeding, UTI(Urinary tract infection) and retroperitoneal bleeding, CONCLUSION: We conclude that the incidence of emergency cesarean hysterectomy declined with prediction of antenatal risk factor, preparing of sufficient fresh blood, prophylactic antibiotics, vigorous uterotonics and close observation after delivery.
Anti-Bacterial Agents ; Blood Transfusion ; Cesarean Section ; Dacarbazine ; Emergencies* ; Female ; Hematoma ; Hemorrhage ; Humans ; Hysterectomy* ; Incidence ; Peripartum Period* ; Placenta ; Placenta Previa ; Pregnancy ; Retrospective Studies ; Risk Factors ; Stillbirth ; Ureter ; Uterine Rupture ; Wounds and Injuries

As the number of diabetic patient increases, it is important to manage diabetic retinopathy. Clinically sufficient pupillary dilatation should be obtained for fundoscopic examination and laser photocoagulation theraphy of diabetic patient but we experienced insufficient and delayed pupillary dilatation after instillation of mydriatics. In order to examine abnormality of pupillary dilatation and its relationship to the stage of diabetic retiniopathy, the course of pupillary diameter was measured with Haab's pupillometer after instillation of one drop of 1% Mydriacyl(R) and 2.5% Mydfrin(R) in 72 patients with diabetes mellitus (40-69 years old) and 11 normal controls (40-69 years old). The following results were obtained. After instillation of 1% Mydracy(R), the maximum pupillary diameter was smaller in diabetic retinopathy group than in controls. As the severity of diabetic retinopathy was increased, maximum pupillary diameter was decreased. After instillation of 2.5% Mydfrin(R), the delay of the average time to reach maximal mydriasis in diabetic group was larger than that in controls. This delay was proportional to the severity of diabetic retinopathy. Therefore it was considered that the abservation of the course of pupillary diameter after instillation of mydriatics would be useful for diagnosis of the severity of diabetic retinopathy.
Diabetes Mellitus ; Diabetic Retinopathy* ; Diagnosis ; Dilatation* ; Humans ; Light Coagulation ; Mydriasis ; Mydriatics*

While retinal detachment is not rarely associated with posterior staphyloma and macular hole, very few cases of retinal detachment with equatorial scleral staphyloma are reported until recentily. In the course of retinal detachment surgery, an equatorial staphyloma is found unexpectedly and makes surgical treatment difficult. We experienced a 70 year old woman who had retinal detachment due to a hole at the 1 o'clock equator. During the retinal detachment surgery, a large equatorial staphyloma was noted right over the retinal hole. Scleral surface buckling procedure and graft using the preserved human sclera were performed. After the follow up period of 6 months, retina was still reattached.
Aged ; Female ; Follow-Up Studies ; Humans ; Retina ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Sclera ; Transplants

No abstract available.
Estradiol* ; Female ; Humans ; Plasma* ; Progesterone*

While retinal detachment is not rarely associated with posterior staphyloma and macular hole, very few cases of retinal detachment with equatorial scleral staphyloma are reported until recentily. In the course of retinal detachment surgery, an equatorial staphyloma is found unexpectedly and makes surgical treatment difficult. We experienced a 70 year old woman who had retinal detachment due to a hole at the 1 o'clock equator. During the retinal detachment surgery, a large equatorial staphyloma was noted right over the retinal hole. Scleral surface buckling procedure and graft using the preserved human sclera were performed. After the follow up period of 6 months, retina was still reattached.
Aged ; Female ; Follow-Up Studies ; Humans ; Retina ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Sclera ; Transplants

BACKGROUND: Left ventricular hypertrophy is a major cardiovascular risk factor for sudden death, acute myocardial infarction and congestive heart failure. The left ventricle is generally thought to adapt to sustained arterial hypertension with increased total peripheral resistance by developing concentric hypertrophy. In recent years, the echocardiogrphy has been developed as a noninvasive method for evaluation of left ventricular geometry and left ventricular mass. However, left ventricular adaptation to hypertension has been shown to be more complex than expected. In fact, many patients with mild to moderate hypertension exhibit normal left ventricular mass and wall thickness, other hypertensive patients have eccentric ventricular hypertrophy that is not related to systolic dysfunction, but rather to increased cardiac output and preload and in some hypertensive patients absolute and relative wall thickness is increased with normal ventricular mass(concentric remodeling). There are differences in the hemodynamics, systolic function and diastolic function in each group. METHODS: From september 1992 to August 1994, in 144 patients with untreated essential hypertension and 50 age and gender matched normal adults studied by two-dimensional, M-mode and Doppler echocardiography. In the present study we used echocardiographically derived left ventricular mass and relative wall thickness to assess the patterns of ventricular geometric adaptation to systemic hypertension and their relations to systemic hemodynamics, left ventricular load and contractile performance. RESULTS: Hypertensive group was 144 cases(M:F=68:76), the mean age 56+/-13years. Normotensive group was 50 cases(M:F=22:28), the mean age 52+/-9years. Among hypertensive patients, left ventricular mass index and relative wall thickness were normal in 42 cases(29%), 24 cases(17%) had increased relative wall thickness with normal ventricular mass(concentric remodelin),48 cases(33%) had both increased relative wall thickness and ventricular mass(concentric hypertrophy), 30 cases(21%) had increased left ventricular mass with normal relative wall thickness(eccentric hypertrophy). Concentric hypertrophy and normal left ventricle group are more common in untreated hypertensive patients in Korea. Systemic hemodynamics showed tendency to paralleled ventricular geomety. In groups with concentric remodeling and hypertrophy, perpheral resistance was increased. Cardiac index was midly increased in eccentric hypertrophy. Diastolic dysfunction was prominent tn concentric hypertrophy. CONCLUSION: Each patterns of left ventricular geometry had different systemic hemodynamics, ventricular pressure overload and ventricular volume overload. Therefore, appropriate selection of antihypertensive agent for the patients with each patterns of hypertrophy reduce the left ventricular hypertrophy and may improve the prognosis.
Adult ; Cardiac Output ; Death, Sudden ; Echocardiography ; Echocardiography, Doppler ; Heart Failure ; Heart Ventricles ; Hemodynamics ; Humans ; Hypertension* ; Hypertrophy ; Hypertrophy, Left Ventricular* ; Korea ; Myocardial Infarction ; Prognosis ; Risk Factors ; Vascular Resistance ; Ventricular Pressure

Uterine metastasis from stomach carcinoma occurred in a patient who five years previously had undergonegastrectomy for gastric adenocarcinoma. CT scans showed an ill-defined lobulated low density mass in the center ofthe uterus. T1-weighted MRI imaging showed that the lesion was indistinct from the myometrium; on T2-weightedimaging it showed increased signal intensity and had infiltrated the myometrium. After Gd-DTPA administration, thelesion showed very little enhancement.
Adenocarcinoma ; Animals ; Female ; Gadolinium DTPA ; Humans ; Magnetic Resonance Imaging* ; Mice ; Myometrium ; Neoplasm Metastasis ; Stomach ; Stomach Neoplasms* ; Tomography, X-Ray Computed ; Uterus

PURPOSE: Stress, depending on its intensity and duration, results in either adaptive or maladaptive physiological and psychological changes in humans. Also, it was found that stressful experiences increase the signs of behavioral despair in rodents. On the other hand, exercise and melatonin treatment is believed to have many beneficial effects on health. Thus, this study was designed to evaluate the anti-depressant effects of physical activity and melatonin against chronic stress-induced depression in rats. METHODS: Adult male Sprague-Dawley(SD) rats(200-250g, 7 weeks of age) were subjected to depression induced by chronic stress. Chronic depression was induced with forced-swim stress (FSS) and repeated change of light-dark cycle for 4 weeks. In the last 2 weeks, some rats were confined in a cage enriched with a running wheel, seesaw and chewed a ball from 19:00 to 07:00 every day. Melatonin was injected intra-peritoneally (I.P), and the rats received intraperitoneal injections of melatonin (15 mg/kg). The Forced Swim Test (FST) was performed to evaluate the immobility behaviors of rats for a 5 min test. RESULTS: It was found that, the immobility time in FST was significantly (p<.05) lower in physical exercise (M=58.83+/-22.73) and melatonin (M=67.33+/-37.73) than in depressive rats (M=145.93+/-63.16) without physical activity. Also, TPH positive cell in dorsal raphe was significantly (p<.05) higher in exercise (M=457.38+/-103.21) and melatonin (M=425.38+/-111.56) than in depressive rats (M=258.25+/-89.13). CONCLUSION: This study suggests that physical activity and melatonin produces antidepressant-like effect on stress-induced depression in rats. So, physical exercise and melatonin may be a good intervention in depression patients.
Adult ; Animals ; Depression* ; Exercise ; Hand ; Humans ; Injections, Intraperitoneal ; Male ; Melatonin* ; Models, Animal* ; Motor Activity* ; Photoperiod ; Rats* ; Rodentia ; Running

No abstract available.
Doxorubicin* ; Etoposide* ; Stomach Neoplasms*

No abstract available.
Humans ; Teicoplanin*