OBJECTIVES: The most often perfomed major operation in gynecology is hysterectomy.Our purpose was to compare the indications, charateristics and outcomes of patients undergoing total abdominal hysterectomy and total vaginal hysterectomy and to help to establish guidelines to determine the route of hysterectomy. METHOD: The hospital charts of 400 women who underwent elective inpatient hysterectomy at Kyung-Hee University hospital from January 1994 to January 1999, were abstracted retrospectively. Data were collected regarding patients, age, parity, preoperative indications, the route of hysterectomy, uterine weight, operative and postoperative complications and the length of stay. The operative indications were benign uterine disease except from uterine prolapse. Bisection or combined morcellation were used in most cases to obtain reduction in uterine size. RESULT: Patients in whom the vaginal route was successful included 18% of those with uterine weights exceeding 280gm. There was statistically significant difference for uterine weight, operative time, bleeding amount, the length of stay in two camparative group. 4% of vaginal hysterectomy and 7% of total abdominal hysterectomy has documented operative complications. CONCLUSIONS: Vaginal hysterectomy is safe operation with few intraoperative and postoperative complications without notable blood loss. Vaginal hysterectomy allow one to shorten the operating time and allows early postoperative discharge of some patients from hospital. Skilled performance of vaginal hysterectomy is worth greater attention and should be used more often in gynecological study.
Female ; Gynecology ; Hemorrhage ; Humans ; Hysterectomy* ; Hysterectomy, Vaginal ; Inpatients ; Length of Stay ; Operative Time ; Parity ; Postoperative Complications ; Retrospective Studies ; Statistics as Topic* ; Uterine Diseases ; Uterine Prolapse ; Weights and Measures

Astrocytes are the most numerous cellular elements in the cerebrum, and they normally have a very slow turnover rate. But during regeneration after injury, they proliferate markedly resulting in astrogliosis. The extracellular matrix in the central nervous system is present in the vessel walls and in the external glia limitans as a basal lamina. The presence of an intact extracellular matrix framework is important in regeneration after injury. Understanding the properties of astrocytic proliferation will be helpful to find out new treatment for functional recovery in the central nervous system. In this study, after cryogenic injury was performed on the cerebral cortex in rats, changes in astrocytes and the extracellular matrix were observed using light microscopy, immunohistochemical stain for glial fibrillary acidic protein(GFAP), proliferating cell nuclear antigen(PCNA), fibronectin, laminin, and type IV collagen, autoradiography and electron microscopy. The results were as follows; 1) The coagulative necrosis, which followed cryogenic injury on the cerebral cortex was healed, forming a new pia mater above the lesion. 2) Some of the PCNA positive cells were astrocytes and some of the GFAP positive cells showed a positive reaction to PCNA. 3) Proliferating astrocytes labelled by autoradiography or immunohistochemical stain for PCNA reached maximal numbers 3days after the injury and they were no longer found 2 weeks after injury. 4) In autoradiography with immunohistochemical stain for GFAP, about 1% of GFAP positive astrocytes were labelled by autoradiography and in double immunohistochemical stain for PCNA and GFAP, about 8-16% of GFAP positive astrocytes were also stained by PCNA. 5) In immunohistochemical stain for fibronectin, laminin and type IV collagen, laminin and type IV collagen were present in the newly formed blood vessel walls and fibronectin showed a diffuse positive reaction within the lesion. The new pia mater was formed within 2 weeks after the injury. 6) On electron microscopic examination, basal lamina material was found in the vessel wall 1 week after the injury and at 2 weeks, a nearly complete and continuous basal lamina was formed although the thickness was uneven. According to these findings, astrocytes in the cerebral cortex of adult rats proliferate very early in the regenerative period after cryogenic injury. At 2 weeks after the injury, this regeneration ceases and the damaged basal lamina of pia mater and vessel wall were reconstituted.
Adult ; Male ; Female ; Humans ; Rats ; Animals

This mycological and cultural investigation was made in 86 cases of onychomycosis diagnosed on positive KOH wet mount at Chosun University Hospital from October, 1989 to February, 1990. The results were as follows : l. The ratio of male to female was 1.2:1. According to Zaiass classificat.ion, distal subungual onychomycosis (DSO) was the most predominant type(79 cases) and others, in decreasing frequency, were superficial white onychomycosis (SWO) (Fcases), total dyst,rophic onychomycosis (TDO) (1 cases, and proximal subungual onychomycosis (PSO) was not. found. 2. In DSO, isolat,ed fungi were T. mentagrophyte(31 cases), "i'. rubrum(23 c
Female ; Fungi ; Humans ; Male ; Mycology* ; Onychomycosis*

Ovarian cancer has the highest mortality rate among gynecologic malignancies in developed countries. Most women present with advanced disease and require a combination of surgery and chemotherapy. One patient presented with recurrent ovarian cancer was initially treated with taxol and platinum-based compounds. Although response to these agents occurred, tumor progression was evident by elevated CA 125 levels and CT findings after a period of 4 months. This patient was then treated with topotecan and exhibited a response and stopped therapy. Topotecan exhibited activity in this patient with ovarian cancer resistent to both platinum and paclitaxel. We report a case of advanced ovarian cancer which was treated with topotecan after taxol-cisplatin treatment failed.
Developed Countries ; Drug Therapy ; Female ; Humans ; Mortality ; Ovarian Neoplasms* ; Paclitaxel ; Platinum ; Topotecan*

No abstract available.
Child* ; Humans ; Hypertension, Portal*

A follow-up study was made of 26 knees of 21 patients who underwent arthroscopic synovectomy between October 1982 and August 1983 in Catholic Medical College and Center. The patient's ages ranged from 3 to 66 years of age. There were 14 female patients and 7 male patients in this series. The follow-up period of all patients was a minimum of twelve months to a maximum of 20 months. The average follow-up of the whole group was 16.8 months. The abnormal findings were rated from 0 to 4 according to Marmors rating system. Final clinical evaluations of the patients were done according to the modified criteria of Sledge et al. The results were as follows; 1. Rheumatoid Arthritis Of 14 knees, 3 joints(21.4%) were rated “excellent”, 6(42.9%) were “good”, and 5(35.7%) were “fair”. There was no case of “unimproved”. 2. Juvenile Rheumatoid Arthritis The results of all 5 knees were satisfactory. Of 5 knees, 4 joints(80%) were rated excellent and one joint (20%) was good. 3. There were 3 knees of osteoarthritis, 3 knees of chronic synovitis and one knee of pigmented villonodular synovitis. Their final results were all satisfactory. Three joints were rated excellent and the other 3 joints were good. 4. Of 26 knees, as a whole, 10 joints (38.5%) were rated “excellent”, 11 joints (42.3%) were “good”, 5 joints (19.2%) were “fair” and no joint was “unimproved”. There were 5 recurrences of active synovial disease in this series, and these patients all were “classic” rheumatoid arthritis. But surprisingly the average patient in this group of recurrence did well even after recurrence. These patients all had less pain and effusion than before operation. 5. The major cause of unsatisfactory results other than recurrence of synovitis were articular degeneration (joint space narrowing) and patellofemoral osteoarthritis (4 knees). 6. A good range of motion with the shortest rehabilitation period can be expected if alternate flexion and extension splints are applied on alternate days for less than a week following the surgery. In conclusion, one may state that the arthroscopic synovectomy is worth considering for the treatment of various kinds of synovitis of the knee joint and when the rheumatoid process follows a favourahle course.
Arthritis, Juvenile ; Arthritis, Rheumatoid ; Female ; Follow-Up Studies ; Humans ; Joints ; Knee Joint ; Knee ; Male ; Osteoarthritis ; Range of Motion, Articular ; Recurrence ; Rehabilitation ; Splints ; Synovitis ; Synovitis, Pigmented Villonodular

Congenital lymphedema is a rare disorder of unknown etiology which affects the extremities, preponderantly the lower extremities, at or immediately after birth. We experienced a case of congenital lymphedema in a newborn with generalized edema on the left lower extremity. We performed lymphangioscintigraphy and MRI for diagnosis. Microlymphaticovenous anastomosis was done on 16 days after birth and the patient showed clinical improvement. We report this case with brief review of the related literature.
Diagnosis ; Edema ; Extremities ; Humans ; Infant, Newborn ; Lower Extremity ; Lymphedema* ; Magnetic Resonance Imaging ; Parturition

PURPOSE: To investigate the visual prognosis, the interval, and the rate of development of after-cataract following cataract surgery in atopic dermatitis. METHODS: Twenty eyes of 13 patients diagnosed as cataract associated with atopic dermatitis were operated between January, 1994 and January, 2000. Visual acuity, postoperative inflammatory reaction, the interval, and the rate of development of after-cataract were investigated and compared with the cataract cases without atopic dermatitis. RESULTS: The average preoperative best corrected visual acuity of 20 eyes was 0.23+/-0.22. The average postoperative best corrected visual acuity at 1, 2, 7, and 12 months after surgery were 0.78+/-0.23, 0.83+/-0.16, 0.78+/-0.23, 0.83+/-0.26, respectively. These values showed no significant difference compared to the postoperative visual acuity of the cataract cases without atopic dermatitis. Aqueous flares measured with laser flare meter were 15.09+/-9.20, 11.15+/-4.68, and 7.38+/-0.75 photon counts/millisecond at 10 days, 1, and 2 months after surgery, which did not seem to influence the final visual acuity and the development of after-cataract (p>0.05). Among the 20 eyes, 66.67% finally developed after-cataract and the average time interval of the development of after-cataract was 11.25+/-4.22 months. CONCLUSIONS: Visual prognosis following cataract surgery in atopic dermatitis is good, while after-cataract seems to develop more frequently and earlier compared to the cases without atopic dermatitis.
Aqueous Humor ; Cataract* ; Dermatitis, Atopic* ; Humans ; Prognosis* ; Visual Acuity

We intended to evaluate the Young's modulus of trabecular bone and apparent density from Computed Tomography(CT) and Spherical Indentation test and to quantify relation ship between them. The distal femurs(31 age, male, left and right) were prepared for exprimentatin and were embedded with repect to anatomical orientation. Then the specimens were scnned at 1 mm intervals on GE9800 CT scanner and the Hounsfield Units(HU, or CT number) were extracted from each CT image. After scanning, the bones were sectioned with diamond saw, producing 8 mm cubes of trabecular bone(72 eachs) from the metaphyseal region of both distal femur. The cubes were mechanically tested in inferior-superior(IS), anteriorposterior(AP), and medial-lateral(ML) direction with custom-made device, Spherical Indentatin Tester. After testing, the real apparent density of specimens were measured. The results of this study showed that the IS modulus was singificantly greater than both the AP and ML modulus and the AP modulus was also greater than ML modulus significantly(p<0.01). A linear relation ship between HU and real apparent density was found to be significant(R2=0.68) and significant power relationship between the apparent density and the tangent moduli(either by CT or physical measures) was also found.
Diamond ; Elastic Modulus* ; Femur ; Humans* ; Male ; Ships

PURPOSE: We analysed the role of modified Gianturco self-expandable stents in the treatment of tracheobronchial stenosis in 13 patients. MATERIALS AND METHODS: We inserted modified Gianturco self-expandable stents under the fluoroscopic and bronchoscopic guidance. There were stenosis in the trachea(n--2), the right main bronchus(n=2), and the left main bronchus(n=9). The causes of the stenosis were endobronchial tuberculosis(n=10), intubation granuloma (n=l), restenosis after surgical reconstruction(n=2). RESULTS: Dyspnea or wheezing was improved within 1 or 2 days following the procedure. There were 32% and 22% respective increase in average FEV1 and FVC. Lung perfusion scan showed 9.6% increase of perfusion in the involved lung. No complications related to the procedure were encountered. During follow-up period of up to 31 months, 2 patients showed tracheal or bronchial restenosis, at 3 and 6 months, retrospectively. There was a distal migration of the stents in one case. CONCLUSION: During the follow up period after stent insertion, improvement of the obstructive changes and dyspnea persisted in 10 out of 13 patients. The modified Gianturco self-expandable metallic stents may be a good choice for the treatment of tracheobronchial stenosis, either as a primary treatment, or when the reconstruction failed.
Constriction, Pathologic* ; Dyspnea ; Follow-Up Studies ; Granuloma ; Humans ; Intubation ; Lung ; Perfusion ; Respiratory Sounds ; Retrospective Studies ; Stents*