BACKGROUND: The aim of the present study was to determine the correlation between the amount of pain reduction after local anesthetic injection into the subacromial space preoperatively and clinical outcome after arthroscopic rotator cuff repair. METHODS: A total of 127 patients who underwent arthroscopic rotator cuff repair and followed up at least 1 year were analyzed retrospectively. Preoperatively, a visual analogue scale (VAS) for pain was measured in all patients before and after the ultrasound guided impingement test. The participants were divied into four groups according to pain reduntion ater impingement test (Group A: >75%, Group B: 50%–75%, Group C: 25%–50%, Group D: <25%). VAS for pain, shoulder range of motion, shoulder isometric strength, ASES score were evaluated preoperatively and at 3, 6, 9, and 12 months postoperatively. RESULTS: After surgery, the amount of pain reduction shows significantly at 3, 6 months in Groups A, B as compared to Groups C, D (p<0.05). Among the range of motion of shoulder joint, forward flexion was significantly improved in Group A at 3 months (p<0.05). The ASES score significantly improved at 3, 6 months in Groups A, B as compared to Group C, D (p<0.05). CONCLUSIONS: Preoperative degree of pain reduction after impingement test correlates with the improvement of pain after arthroscopic rotator cuff repair, especially in the early phase. Therefore, the impingement test could be effectively used.
Humans ; Range of Motion, Articular ; Retrospective Studies ; Rotator Cuff* ; Shoulder ; Shoulder Joint ; Shoulder Pain ; Ultrasonography

OBJECTIVE: Endometriosis is a disease affecting a large population of women all over the world. A local sterile inflammation occurs in the peritonel cavity of patients with endometriosis. It suggests that immunological events play a major role in the pathogenesis of endometriosis. We have studied the levels of serveral T cell and monocyte derived cytokines, especially IL-6 (promoter of immune response) and IL-10 (inhibitor of immune response), in the peritoneal fluid of patients with endometriosis to characterize the change of immune response that occurs at the site of endometriosis. Method: This study was performed in Hallym university hospital from October, 1997 to October 1998 and enrolled 29 women with gross or microscopic findings of minimal to severe endometriosis in case group, and 28 women without visual evidence of pelvic endometriosis and with benign gynecologic disease in control group. IL-6 and IL-10 levels in the peritoneal fluid were determined using commercial ELISA and compared between endometriosis and controls and between fertile and infertile women with endometriosis and according to the revised American Fertility Society classification. RESULT: IL-6 was higher and IL-10 was lower in the peritoneal fluid of endometriosis group than of control group. Cyclic variations in the IL-6 concentrations were seen in endometriosis group : the concentrations in the secretory phase were significantly higher than those in the proliferative phase. In endometriosis group, IL-6 concentrations of infertile women were higher than fertile women. Both IL-6 and IL-10 in the peritoneal fluid of endomtriosis group did not show significant correlation according to r-AFS stages. CONCLUSION: Increased IL-6 and decreased IL-10 levels in the peritoneal fluid may be related to infertility and pathogenesis in the endometriosis, suggesting that partially contribute to the disturbed immune regulation observed in endometriosis.
Ascitic Fluid* ; Classification ; Cytokines ; Endometriosis* ; Enzyme-Linked Immunosorbent Assay ; Female ; Fertility ; Genital Diseases, Female ; Humans ; Infertility ; Inflammation ; Interleukin-10* ; Interleukin-6* ; Monocytes

OBJECTIVE: Our purpose was to investigate the relationship between the levels of IL-6 and tumor necrosis factor-alpha in the peritoneal fluid(PF) of women with and without endometriosis and infertile women. Design: Prospective and case-control study. Setting: University hospital. Patients: Twenty-nine women with laparotomy or laparoscopic findings of minimal to severe endometriosis, and twenty-eight women with no visual evidence of pelvic endometriosis and with benign gynecologic disease. Main Outcome Measures: PF IL-6 and tumor necrosis factor-alpha levels were determined using commercial ELISA. IL-6 and tumor necrosis factor-alpha concentrations were compared among women with and without endometriosis, and with infertile and fertile women, and then also compared according the revised American Fertility Society classification. RESULTS: IL-6 and tumor necrosis factor-alpha concentrations were higher than in the PF of women with endometriosis than in matched normal controls. Cyclic variations in IL-6 concentrations were seen in PF from patients with endometriosis: the concentrations in the secretory phase were significantly higher than those in the proliferative phase. IL-6 concentrations were higher than in the PF among of infertile women than in fertile women. A significant correlation between PF IL-6 and tumor necrosis factor-alpha concentrations and endometriosis stage III and IV was noted. CONCLUSIONS: Increased PF levels of IL-6 and tumor necrosis factor-alpha in patients with endometriosis may be relate to endometriosis-associated infertility and to the pathogenesis of endometriosis suggesting that partially contribute to the disturbed immune regulation observed in patients with endometriosis.
Ascitic Fluid* ; Case-Control Studies ; Classification ; Endometriosis* ; Enzyme-Linked Immunosorbent Assay ; Female ; Fertility ; Genital Diseases, Female ; Humans ; Immunity, Cellular* ; Infertility ; Interleukin-6 ; Laparotomy ; Outcome Assessment (Health Care) ; Prospective Studies ; Tumor Necrosis Factor-alpha

Adenomyotic cyst is very rare disease, their sizes are mostly lesser 5mm. The intrauterine adenomyotic cyst may arise from progressive expansion of cyst due to progressive menstrual bleeding. Authors experienced a case of large adenomyotic cyst within myometrium occuring in a l9-year-old woman, and who was accompanied with endometriosis. The cyst was about 3 x 3em sized, and had chocolate colored thick viscous contents, We experienced one case of adenomyotic cyst which was thought to be degenerated uterine myoma, so we report the case with a brief review of the concerned literatures.
Animals ; Cacao ; Endometriosis* ; Female ; Hemorrhage ; Humans ; Leiomyoma ; Mice ; Myometrium* ; Rare Diseases

No abstract available.
Cytomegalovirus* ; DNA* ; Humans* ; Polymerase Chain Reaction*

OBJECTIVE: To determine whether hysterectomy by the vaginal route is safe and feasible in patients with previous pelvic operation. METHODS: A retrospective study of the records of Hallym University Hospistal patients who underwent vaginal hysterectomy performed by the senior author. Between January 1990 and January 1997, 212 patients who had previous pelvic operation were studied with special reference to operative difficulties, previous operation type, intraoperative complications, surgical time, hospital stay. RESULTS: 1. Patients characteristics was that ; The average age was 44.5+/-6.6 years old, the average parity was 2.3 , the average stay of hospitalization was 7.5+/-0.89 days, the frequency of Morcellation was in 24.5%, the average surgical time including associated procedure was 82+/-16.2 minutes, the average uterine weight was 164+/-85.1gm. 2. The most common previous pelvic operation was cesarean section(95 cases). 3. The most common indication was uterine myoma(51.9%). 4. Surgical technique used to gain access to the pouch of Douglas was done anteriorly; 52 patients of previous cesarean section(24.5%) and 112 patients of others operation(52.8%) were easily opened by blunt dissection, 43 patients of previous cesarean section(20.3%) and 5 patients of others operation(2.4%) were required sharp dissection. posterioly ; 190 patients(89.6%) were easily opened by blunt dissection, 22 patients(10.4%) were required sharp dissection. 5. Significant complications were bladder injury(1 case) , postoperative transfusion due to bleeding(6 cases). No cases of postoperative laparotomy was done and other minor compications were fever(15 cases), bladder retention(11 cases), others. CONCLUSIONS: It was possible to perform vaginal hysterectomy safely in patients with previous pelvic operation. Vaginal hysterectomy remains the method of choice for removal of the uterus of the previous pelvic operations in the absence of other contraindications.
Cesarean Section ; Female ; Hospitalization ; Humans ; Hysterectomy ; Hysterectomy, Vaginal* ; Intraoperative Complications ; Laparotomy ; Length of Stay ; Operative Time ; Parity ; Pregnancy ; Retrospective Studies ; Urinary Bladder ; Uterus

This experiment was designed to investigate the histochemical and ultrastructural changes of the proximal tubules and glomeruli of rabbits treated with cyclosporin A (CsA) or cyclosporin A and concomitant administration of prednisolone (PD). Rabbits were given with CsA for 1 week (CsAlW) and for 2 weeks (CsA2W) and CsA plus PD for 1 week (CsA +PDIW) and for 2 weeks (CsA+PD2W). The dose of CsA was 5mg/kg/day i.v. and PD was 1 mg/kg/day i.m. At 1 week and 2 weeks after the treatments, the following items were studied of alkaline phosphatase (ALPase). peroxidase, 5'-nucleotidase (SNU) with the ultrastructural enzymatic changes and electron microscopic changes. CsAlW, CsA2W and CsA +PD2W groups showed a decrease of ALPase activity and CsA+PD2W and CsA2W groups showed weakly increased peroxidase activity CsA2W and CsA+PD2W showed a decrease of 5NU activity. Ultrastructural changes of CsAlW CsA2W and CsA+PD2W groups revealed swollen and disrupted mitochondria, loss of brush border in the proximal tubules and thickening of basement membranes, edematous podocytes and fusion of root processes of podocytes in the glomeruli showing the early stage of nephrotoxicity. The concomitant treatment of PD with CsA eased the nephrotoxicity of CsA within 1 week after the treatment.
5'-Nucleotidase ; Alkaline Phosphatase ; Basement Membrane ; Cyclosporine* ; Kidney* ; Microvilli ; Mitochondria ; Peroxidase ; Podocytes ; Prednisolone* ; Rabbits

No abstract available.
Erythrocytes*

A total of 48 cases of tuberculous lesion in the lymph nodes (43 cases), lung (3 cases) and soft tissue (2 cases), was subjected to fine needle aspiration cytology(FNAC). The age of the patients ranged from 19 to 77 year-old (average 33.6 years in age) and the male to female ratio was 1: 4. Thirty-four cases (70.8%) demonstrated distinct granulomatous reaction with or without caseation necrosis, nine cases (18.8%) showed no granulomas, but large amount of necrotic debris with numerous polymorphonuclear cells and histiocytes, and five cases (10.4%) revealed acellular material only. The overall AFB positivity in smears was 62.5%. In areas associated with granulomatous reaction and necrosis, AFB positivity was 55.8%, while it was 80.0% in cases with acellular necrotic material. There were 2 cases of parasitic infestation which could not be easily differentiated from tuberculosis based on aspiration smears only.
Aged ; Biopsy, Fine-Needle ; Child* ; Female ; Granuloma ; Histiocytes ; Humans ; Lung ; Lymph Nodes ; Male ; Necrosis ; Tuberculosis ; Vesico-Ureteral Reflux*

Multiple cerebral aneurysms in children are rare lesions, occurring at a frequency of approximately 0.5% to 4.6%. In children, infective endocarditis from congenital or rheumatic heart disease are the important causes of cerebral mycotic aneurysms. Subarachnoid hemorrhage, most commonly caused by the rupture of an intracranial anurysm is associated with mortality and morbidity. We reported a case of multiple cerebral aneurysms in a 7 year old child with ventricular septal defect (VSD) in operation of the two times performed under general anesthesia. He was scheduled for elective surgery for clipping of cerebral aneurysm in ASA physical status II. For premedication, he was administered triflupromazine 10 mg (Veprin ) and glycopyrrolate 0.1 mg IM 1 hour prior to induction. Induction was established with thiopental, vecuronium after preoxygenation. N2O/O2 (2 L/min:2 L/min), isoflurane and vecuronium were administered for maintenance. For monitoring, ECG, direct arterial pressure, CVP, ETCO2 were performed. In second operation, we were performed the general anesthesia the same as the first operation. He had discharged in coma state on 4 day after the second operation hopelessly.
Anesthesia* ; Anesthesia, General ; Aneurysm, Infected ; Arterial Pressure ; Child* ; Coma ; Electrocardiography ; Endocarditis ; Glycopyrrolate ; Heart Septal Defects, Ventricular* ; Humans ; Intracranial Aneurysm* ; Isoflurane ; Mortality ; Premedication ; Rheumatic Heart Disease ; Rupture ; Subarachnoid Hemorrhage ; Thiopental ; Triflupromazine ; Vecuronium Bromide