This study was undertaken for the clinical analysis and evaluation on 121 patients with incompetent internal os of the cervix, who were admitted and treated with McDonald operation or Shirodkar operation at the Soonchounhyang Medical Center from January 1991 to December 1995. The results of this study were as follows : 1. The incidence of this IIOC was 1.1% of 11,116 cases of total delivery. 2. The mean age of IIOC was 31.7 years old. 3. The average number of gravida was 3.2. 4. The most common contributary factor was previous history of artificial abortion (51.2 %), and midtrimester abortion (17.4 %), cervical laceration due to previous vaginal delivery (8.3 %) etc. was followed. 5. The success rate of operation was 76 %, and the highest success rate (85.7 %) was reveald with period from 15th weeks to 16th weeks of gestation. 6. When cervical dilatation was abscent or small, the success rate of operation was high. 7. The factors of failed operation were preterm labor (58.7 %), PROM (34.5 %), and PIH, bleeding. 8. The delivery method after operation was vaginal delivery in 83 cases (68.6%) and cesarean section in 38 cases (31.4 %).
Cervix Uteri* ; Cesarean Section ; Female ; Hemorrhage ; Humans ; Incidence ; Labor Stage, First ; Lacerations ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Trimester, Second

No abstract available.
Cervix Uteri* ; Female

Primary ovarian transitional cell carcinoma is extremely rare tumor. The histologic subtype was divided from malignant Brenner tumor due to it's own histologic characteristics and chemosensitive nature. Most of recent studies revealed that transitional cell carcinoma has a good response to chemotherapy and long-term survival. Recent histopathologic reports show that transitional cell carcinoma of the bladder and of the ovary are immunophenotypically different. We experienced a case of primary ovarian transitional cell carcinoma, and report this case with a brief review of the concerned literatures.
Brenner Tumor ; Carcinoma, Transitional Cell* ; Drug Therapy ; Female ; Ovary ; Urinary Bladder

This study was done to present a criterion in selection of the most proper light sources and materials by measuring metamerism index(MI) of the light curing composite resins with spectrocolorimeter. Metamerism is defined when two objects appear to be the same color in one illuminant but different in another. This is due to the fact that they have different spectral curves that fail to match under the second illuminant. In this study, A1 & A3 shade of five light curing composite resins (Esthet-X, Filteck Z250, Filteck A110, Charisma, Vitalescence) were chosen based on Vita shade. Five samples were made for shade of each product with Teflon mold (diameter: 15mm, thickness: 2mm). Metamerism index of each samples on a Barium sulfate plate (L*=96.54, a*=0.19, b*=0.01) prepared for sample fixation were measured with spectrocolorimeter(Miniscan XE plus, Model 4000s, Hunter Lab, USA) by applying standard light source D65, C, Fcw, TL84 and A. Standardization was done with reference standard (X=80.8, Y=85.7, Z=90.8) and light trap. The results were as follows. 1. Different resins with same Vita shade showed recognizable color difference(DeltaE*>2). 2. All composites had MI below accepted value 0.5 between standard illuminant(D65, C, & A) and below 1.5 under fluorescent condition (Fcw & TL84). 3. MI value between D65 and A showed higher value than MI value between other source of light(p<0.01). 4. All resins except Z250 showed MI value that A3 is higher than A1 between D65 and A(p<0.05).
Barium Sulfate ; Composite Resins* ; Fungi ; Polytetrafluoroethylene

BACKGROUND: Gallstones have been one of the most common gastrointestinal diseases to surgeons which open cholecystectomy has been the standard operation for the past one hundred years. Recently, operations with a laparoscope have become popular and are spreading worldwide. METHODS: A clinical analysis of 200 cases who had been treated by laparoscopic cholecystectomy for gallstone disease in Seoul Red Cross Hospital for 4 years from July 1993 to June 1997 was done according to age, sex, advantage, and complication. RESULTS: The results were as follows. 1) Among the 200 cases, there were 69 male patients and 131 female patients, with a female to male ratio of 1.9:1. The most prevalent age group was the 6th decade with 59 cases (29.5%) and the 7th decade with 43 cases (21.5%), the 5th decade with 41 cases (20.5%) and the 4th decade with 29 cases (14.5%) in order of frequency. 2) The associated diseases were hypertension with 25 cases (12.5%), diabetes mellitus with 12 cases (6.0%), cardiopulmonary disease with 11 cases (5.5%), and hepatitis with 10 cases (5.0%) in order of frequency. 3) The cases of previous abdominal operations were 75 cases (37.5%). The most frequent operations were appendectomy with 33 cases (16.5%), C-section with 12 cases (6.0%), laparoscopic tubal ligation with 11 cases (5.5%), salphingo- oophorectomy with 8 cases (4.0%) and T.A.H with 8 cases (4.0%) in order of frequency. 4) The most frequent pathologic diagnosis was chronic cholecystitis with 187 cases (93.5%). 5) The operation time ranged from 30-180 minutes with an average of 81 minutes. The operation time for the first 10 cases was 77 minutes, but it was been reduced to 58 minutes in the last 10 cases. 6) Conversion to an open cholecystectomy during the operation was done in 6 cases (3.0%), and the cause of conversion were uncontrolled bleeding with 2 cases (1.0%), severe adhesion with 2 cases (1.0%) and GB empyema with 2 cases (1.0%). 7) Postoperative analgesics were needed in 81 cases (40.5%) on the operative day, 71 cases (35.5%) on the 1st postoperative day, 26 cases (12.5%) on the 2nd postoperative day, 6 cases (3.0%) on the 3rd postoperative day, and 3 cases (1.5%) on the 4th postoperative day, and the use of analgesics was reduced as times went by. 8) The length of hospital stay ranged from 2 to 10 day with an average of 4.13 day, and 74 cases (37.0%) experienced a 3 to 6 day hospitalization, which was the most common hospital stay. 9) The total postoperative complication rate was 5.0% (n=10) with 2 cases (1.0%) of wound infection and 2 cases (1.0%) of ileus, and there was no postoperative mortality.
Analgesics ; Appendectomy ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cholecystitis ; Diabetes Mellitus ; Diagnosis ; Empyema ; Female ; Gallstones ; Gastrointestinal Diseases ; Hemorrhage ; Hepatitis ; Hospitalization ; Humans ; Hypertension ; Ileus ; Laparoscopes ; Length of Stay ; Male ; Mortality ; Ovariectomy ; Postoperative Complications ; Red Cross ; Seoul ; Sterilization, Tubal ; Wound Infection

PURPOSE: This study is aimed at identifying the effects of telephone counseling as nursing support on distress, anxiety, depression, and adverse events in cancer patients undergoing their first chemotherapy. METHODS: This was a randomized controlled trial (pretest-posttest design). A total of 70 patients who showed 4 or higher distress scores were selected from the screening process. Four patients dropped out; therefore, 66 patients participated in this research. Thirty-two and 34 patients were randomly assigned to the experimental and the control group, respectively. After a preliminary survey, telephone counseling support was given to the experimental group at three time points. The post survey was done before the second cycle of chemotherapy. RESULTS: Regarding distress, both groups showed a statistically significant decrease in the scores: 3.4 for the experimental group and 1.8 for the control group (p=.002). Furthermore, the experimental group demonstrated a statistically significant decrease relative to the control group. Anxiety and depression showed no statistically significant difference between the two groups. CONCLUSION: This study concludes that nursing support through phone counseling is effective in decreasing distress in patients undergoing chemotherapy for the first time.
Anxiety* ; Counseling* ; Depression* ; Drug Therapy* ; Humans ; Mass Screening ; Nursing ; Telephone*

This study was performed to evaluate the temperature rise on various position of the Buchanan plugger, the peak temperature of plugger's type and the temperature change by its touching time of heat control spring. The heat carrier system 'System B'(Model 1005, Analytic Technologies, USA) and the Buchanan's pluggers of F, FM, M and ML sizes are used for this study. The temperature was set to 200degrees C which Dr. Buchanan's "continuous wave of condensation" technique recommended on digital display and the power level on it was set to 10. In order to apply heat on the Buchanan's pluggers, the heat control spring was touched for 1, 2, 3, 4 and 5 seconds respectively. The temperature rise on the surface of the pluggers were measured at 0.5 mm intervals from tip to 20 mm length of shank using the infrared thermography (Radiation Thermometer-IR Temper, NEC San-ei Instruments, Ltd, Japan) and TH31-702 Data capture software program (NEC San-ei Instruments, Ltd, Japan). Data were analyzed using a one way ANOVA followed by Duncan's multiple range test and linear regression test. The results as follows. 1. The position at which temperature peaked was approximately at 0.5 mm to 1.5 mm far from the tip of Buchanan's pluggers (p<0.001). The temperature was constantly decreased toward the shank from the tip of it (p<0.001). 2. When the pluggers were heated over 5 seconds, the peak temperature by time of measurement revealed from 253.3+/-10.5degrees C to 192.1+/-3.3degrees C in a touch for 1 sec, from 218.6+/-5.0degrees C to 179.5+/-4.2degrees C in a touch for 2 sec, from 197.5+/-3.0degrees C to 167.6+/-3.7degrees C in a touch for 3 sec, from 183.7+/-2.5degrees C to 159.8+/-3.6degrees C in a touch for 4 sec and from 164.9+/-2.0degrees C to 158.4+/-1.8degrees C in a touch for 5 sec. A touch for 1 sec showed the highest peak temperature, followed by, in descending order, 2 sec, 3 sec, 4 sec. A touch for 5 sec showed the lowest peak temperature (p<0.001). 3. A each type of pluggers showed different peak temperatures. The peak temperature was the highest in F type and followed by, in descending order, M type, ML type. FM type revealed the lowest peak temperature (p<0.001). The results of this study indicated that pluggers are designed to concentrate heat at around its tip, its actual temperature does not correlate well with the temperature which Buchanan's "continuous wave of condensation" technique recommend, and finally a quick touch of heat control spring for 1sec reveals the highest temperature rise.
Hot Temperature ; Linear Models ; Thermography

OBJECTIVE: Previous studies have suggested that hyperhomocysteinemia and methylenetetrahydrofolate reductase (MTHFR C677T) mutations are associated with increased risk of recurrent spontaneous abortion (RSA). Recently, a second site polymorphism in MTHFR, 1298A-->C, which changes a glutamic acid into an alanine residue, was shown to be associated with a decreased enzyme activity. We tested whether the variant alleles of MTHFR C677T and A1298C are risk factor (biomarker) for RSA. MATERIALS AND METHODS: We analyzed DNA from a case-control study in the Korean DNA was extracted from blood samples of 118 patients with RSA and 123 healthy fertile patients as the controls. MTHFR variant alleles were determined by a PCR-restriction fragment length polymorphism assay. RESULTS: We found no evidence for an association between 677TT genotype and risk of RSA (OR=1.95, 95% CI=0.84~4.50, p=0.12). However, the MTHFR 1298AC (OR=0.36, 95% CI=0.20~ 0.63, p=0.0004) and 1298AC+CC (OR=0.35, 95% CI=0.20~0.61, p=0.0002) genotypes were lower among 118 RSA cases compared with 123 controls, conferring a 2.8-fold decrease in risk of RSA, respectively. Moreover, the combined genotypes of MTHFR 677CC/1298AC (OR=0.30, 95% CI= 0.10~0.88, p=0.029) and 677CT/1298AC (OR=0.77, 95% CI=0.60~0.99, p=0.043) also showed significantly lower risk than those with MTHFR 677CC/1298AA type. CONCLUSION: MTHFR 1298AC, MTHFR 677CC/1298AC and 677CT/1298AC genotypes may represent genetic markers for the protection of RSA at least in Korean women.
Abortion, Spontaneous* ; Alanine ; Alleles ; Case-Control Studies ; DNA ; Female ; Genetic Markers ; Genotype ; Glutamic Acid ; Humans ; Hyperhomocysteinemia ; Methylenetetrahydrofolate Reductase (NADPH2) ; Oxidoreductases* ; Pregnancy ; Risk Factors ; Vascular Diseases

OBJECTIVE: To analyze the methylenetetrahydrofolate reductase (MTHFR) mutation in patients with recurrent spontaneous abortion. MATERIAL AND METHOD: The blood samples of patients with recurrent spontaneous abortion were tested by PCR-RFLP method. RESULTS: Of 51 cases of study group, 14 (27.5%) were normal, 25 (49.0%) were heterozygosity, and 12 (23.5%) were homozygosity. Of 58 cases of control group, 20 (34.5%) were normal, 30 (51.7%) were heterozygosity, and 8 (13.8%) were homozygosity. But the difference between two groups was not significant (p=0.190). CONCLUSION: Hyperhomocysteinemia due to MTHFR mutation is a cause of recurrent spontaneous abortion. Therefore, the study for MTHFR mutation should be included in the workup of recurrent spontaneous abortion.
Abortion, Spontaneous* ; Female ; Humans ; Hyperhomocysteinemia ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Pregnancy

BACKGROUND: We evaluated the current status of diabetes management and the predictors for poor glycemic control in an urban area. METHODS: This study included 1,138 community-dwelling adults (> or =50 years) with diabetes, of which 584 participated in the diabetes care survey. Logistic regression was used to identify the factors predicting poor glycemic control (hemoglobin A1c[HbA1c]> or =7%) in the total sample and to evaluate the relationship between the history of diabetes management checkup and poor glycemic control in the diabetes care survey sample. RESULTS: Of the 1,138 patients, 53.2% had blood pressure less than 130/80 mmHg, 41.7% had fasting glucose between 70 and 130 mg/dL, 48.6% had HbA1c below 7.0%, 60.1% had triglycerides below 150 mg/dL, 41.4% had low density lipoprotein cholesterol below 100 mg/dL, and 59.1% had normoalbuminuria (urine albumin-to-creatinine ratio <30 mg/g creatinine). Of the 584 patients completing the diabetes care survey, 63.9% had one or more lipid tests, 32.0% had one or more HbA1c tests, 43.8% had one or more microalbuminuria tests, and 42.5% had one or more fundoscopic examinations annually. Female gender (odds ratio [OR], 1.71; 95% confidence interval [CI], 1.23-2.36), duration of diabetes (OR, 1.07; 95% CI, 1.06-1.09), and alcohol use (OR, 1.40; 95% CI, 1.06-1.85) were associated with an increased risk for poor glycemic control while age (OR, 0.97; 95% CI, 0.96-0.99) and antihypertensive medication (OR, 0.64; 95% CI, 0.50-0.83) were associated with a decreased risk. CONCLUSIONS: This study shows that glycemic control is likely to be poor in urban areas. We need to develop appropriate community-based strategies to achieve optimal glycemic control and prevent diabetes complications.
Adult ; Blood Pressure ; Cholesterol ; Cholesterol, LDL ; Diabetes Complications ; Diabetes Mellitus ; Fasting ; Female ; Glucose ; Hemoglobin A, Glycosylated ; Humans ; Lipoproteins ; Logistic Models ; Triglycerides