No abstract available.
Ectromelia*

PURPOSE: Traditional anterior colporrhaphy repair can have a high recurrence rate. Therefore, the use of synthetic mesh to reinforce the anterior vaginal wall support has been proposed to prevent recurrence. The objective of our study was to compare the anatomic recurrence rates in patients that underwent the traditional anterior colporrhaphy with patients who add a monofilament polypropylene mesh repair(Gynemesh PSTM). MATERIALS AND METHODS: We reviewed the charts of patients who underwent transvaginal cystocele repair between January 2003 and June 2006. All patients had a physical examination and staging of the prolapse; the International Continence Society(ICS) system was used for the staging. Mid urethral sling operations were performed when stress incontinences was an associated feature. An anatomic recurrence was defined as an ICS stage 2 or greater anterior prolapse on the last recorded physical examination. The subjective patient satisfaction was also recorded. RESULTS: Seventy-one patients were available for study with a mean follow- up of 18.4 months. Thirty-eight patients underwent traditional anterior colporrhaphy, while 33 patients underwent cystocele repair using the monofilament polypropylene mesh(Gynemesh PSTM). Among the 71 patients, 9(12.7%) had recurrence of the cystocele. Based on the type of repair, 21.1%(8/38) of the patients with traditional repair had a recurrence compared to 3.0%(1/33) of the patients with the polypropylene mesh repair(p=0.03). With regard to satisfaction, 76.3%(29/38) of the patients with anterior colporrhaphy and 97.0%(32/33) with the mesh repair were satisfied with the outcome of the surgery(p=0.02). One patient had erosion of the mesh, at the midline, in front of the vaginal scar, at 12 months after the procedure. CONCLUSIONS: Our results suggest that the monofilament polypropylene mesh(Gynemesh PSTM) repairs improved the outcomes of anterior colporrhaphy with regard to the prevention of recurrent cystoceles.
Cicatrix ; Cystocele ; Humans ; Patient Satisfaction ; Physical Examination ; Polypropylenes ; Prolapse ; Recurrence ; Suburethral Slings

Endosulfan is an agricultural chemical of organic chlorine, is toxic in both the central nervous system and the cardiovascular system, and causes respiratory system disorder and deaths by status epilepticus, respiratory distress, and so on. The use of this agricultural chemical of organic chlorine is limited by its toxicity. However, it is still used as a common insecticide, so it is readily to available. Four elderly people were admitted with depression of consciousness and convulsions after eating pan-fried food. During their treatment, the patients were diagnosed with endosulfan intoxication, completely by accident. We are reporting these cases of endosulfan intoxication that showed variable clinical findings from mild sequelae to death.
Aged ; Cardiovascular System ; Central Nervous System ; Chlorine ; Consciousness ; Depression ; Eating ; Endosulfan* ; Humans ; Respiratory System ; Seizures ; Status Epilepticus

PURPOSE: It has been customary to perform brain ultrasonogram (brain US) for the early detection of intraventricular hemorrhage (IVH) during intensive care of neonates. On the other hand magnetic resonance imaging (MRI) has been greatly restrictioned due to its complicated procedures. This study was conducted to identify changes in neonates' brain structure and to gain basic data for the long-term follow-up of neurologic sequelae in the future. For this purpose, the findings obtained from both brain US performed within one postnatal week and MRI at the time of discharge were compared and analysed. METHODS: Brain US within one postnatal week and MRI at discharge were carried out on 67 neonates who were discharged from the neonatal intensive care unit of Fatima Hospital from July 01, 1996 to June 30, 1998. We compared and analysed IVH found in the brain US, and focal parenchymal hemorrhage, periventricular leukomalacia (PVL), basal ganglia hemorrhage, and encephalomalacia revealed the MRI performed at discharge. RESULTS: It was found that out of 67 cases from the brain US, there were 13 with IVH of Grade l & ll, 11 with IVH of Grade lll or higher, one with focal parenchymal hemorrhage, and three with PVL. Also the MRI found seven with focal parenchymal hemorrhage, one with basal ganglia hemorrhage, six with PVL, three with encephalomalacia, and one with ventricular dilatation. CONCLUSION: For infants with IVH of Grade lll or higher, MRI performed at discharge is considered to be very useful in identifying structural parenchymal abnormality and the presence or absence of its associated lesions as well as in carrying out long-term follow-up.
Basal Ganglia Hemorrhage ; Brain* ; Dilatation ; Encephalomalacia ; Follow-Up Studies ; Hand ; Hemorrhage ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Critical Care ; Intensive Care, Neonatal ; Leukomalacia, Periventricular ; Magnetic Resonance Imaging* ; Ultrasonography*

Various candidate biomarkers have been investigated for the early and accurate diagnosis of Kawasaki disease (KD). We aimed to evaluate platelet activity using platelet indices (PI) in patients with KD or simple febrile illness to determine whether these indices might support a diagnosis of KD. Another objective of the study was to delineate the changes in PI from the acute to convalescent phases of KD. A total of 225 patients with complete KD (cKD), 110 with incomplete KD (iKD), and 71 with simple febrile illness (control) were enrolled. PI included mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT). We serially measured the serum PI four times for each patient with KD from the acute to convalescent phases: on D0 (day of intravenous immunoglobulin (IVIG) treatment) and repeated on days 2 (D2), 14 (D14), and 56 (D56) after IVIG therapy. Data from the control group were collected during the acute stage of the disease (D0). The platelet counts in the cKD (341±103×10 3 /mm 3 ) and iKD (374±135×10 3 /mm 3 ) at diagnosis were higher than the control group (290± 128×10 3 /mm 3 ). The PCT in the cKD (0.284±0.085%) and iKD (0.313±0.109%) groups at diagnosis were also higher than the control group (0.246±0.108%). However, the MPV and PDW levels in the KD group were not statistically significant. Therefore, platelet count and PCT are adjuvant parameters for the differential diagnosis of KD from a simple febrile illness.

PURPOSE: As a sedative hypnotic agent, etomidate has a little side effect like respiratory depression and has an excellent pharmacokinetics and hemodynamics. The objective of this study is comparison of etomidate effect in the two groups, only lidocaine injection group and combinational administration group, during closed thoracostomy in the emergency department. METHODS: The patients with respiratory problems, which needed a closed thoracostomy, from March 1, 2003 to February 29, 2004 were enrolled in this prospective study. Thus, we were enrolled 68 patients. etomidate were used for 34 patients and only lidocaine local injection was used for 34 patients. Patients of combinational administration were randomized to receive intravenous boluses of etomidate (0.2 mg/kg) prior to fentanyl (1.0 ug/kg) during PSA (procedural sedation anesthesia). We recorded pre-administration and interval of 5 minute, 10 minute, 15 minute and transcutaneous oxygen saturation, heart rate, respiratory rate, blood pressure, degree of sedation, satisfaction of sedation, and side effects after administration. RESULTS: Of all combinational administration group, significant hemodynamic, as hypotension or bradycardia etc. and respiratory depression, as apnea or tachypnea etc. were absent. With comparison of two groups, significant clinical problems and statistics were not different and degree of sedation was fast and impaired conscious was effective in the combinational administration group. CONCLUSION: We conclude combinational administration with etomidate and fentanyl during procedural sedation is safty and excellent effectiveness. Therefore we recommened the use of etomidate for emergency procedural sedation in emergency department.
Apnea ; Blood Pressure ; Bradycardia ; Emergencies ; Emergency Service, Hospital ; Etomidate* ; Fentanyl* ; Heart Rate ; Hemodynamics ; Humans ; Hypnotics and Sedatives* ; Hypotension ; Lidocaine ; Oxygen ; Pharmacokinetics ; Prospective Studies ; Respiratory Insufficiency ; Respiratory Rate ; Tachypnea ; Thoracostomy*

PURPOSE: To find the factors influencing the immediate and late outcome of replantation and revascularization of the digits, we carried out a prospective study from 1998 to 1999 with at least a 1-year followup. Traumatic total and subtotal amputations with inadequate circulation of the digits distal to the metacarpal head were included in the study. METHODS: This study was carried out as a prospective study from 1998 to 1999 with at least a 1- year followup. The relationship between age, sex, extent of injury, type of injury, ischemic time, regular smoking, level of injury, and survival rate were analyzed. There were 234 patients with 155 males (254 digits) and 79 females (129 digits). RESULTS: Successful operation was found in 203 patients (86.3%), 314 digits (82%). Although male patients seemed to have poorer survival rates than female, it should be noted that male patients had more severe injuries than female patients. All patients who were regular cigarette smokers were males. Cigarette smoking has been shown to cause cutaneous vasoconstriction, decrease the digital blood flow, and impair the wound healing. These two reasons might explain the lower survival rate in males than in females. Type of injury significantly affected the survival rate. The survival rate was very low in extensive crushed amputation (11.1% survival rate), followed by degloving (21.1% survival rate) and avulsion (64.7% survival rate) amputation. The level of injury also seemed to determine the survival rate as injury at Zone I (65% survival rate) resulted in a poor survival rate compared to the injury at Zone II, III, or IV (92%, 97.6%, or 90.9% survival rate). Ischemic time longer than 8 hours might lessen the survival rate. CONCLUSION: All patients who had successful replantation and revascularization were satisfied with the results even though they had rather poor hand movement. In single digital replantation, no patients needed reamputation, but all preferred to have their finger replanted than udergo a primary amputation. All could accommodate and adapt their injured digits to their work.
Amputation ; Female ; Fingers ; Follow-Up Studies ; Hand ; Head ; Humans ; Male ; Prospective Studies ; Replantation* ; Smoke ; Smoking ; Survival Rate ; Tobacco Products ; Vasoconstriction ; Wound Healing

PURPOSE: Hysterectomy, regardless of the surgical technique, increases the risk of having to undergo stress urinary incontinence surgery later in life. Furthermore, transvaginal hysterectomy may cause some changes in the normal architecture and tension of the tissues surrounding the pelvic floor, and this may also cause some changes in the continence mechanisms of the bladder and urethra. We investigated if there are any adverse effects of concomitant vaginal hysterectomy on the outcomes of a tension-free vaginal tape procedure. MATERIALS AND METHODS: The outcomes of the tension-free vaginal tape (TVT)/transvaginal total hysterectomy(VTH) group were compared with that of the TVT group in terms of cure and improvement of incontinence, satisfaction with the procedure and the complications. The preoperative evaluation included history taking, physical examination and stress tests and determining the stress-related leakage, the emptying ability, the anatomy, the protection and the inhibition(SEAPI) scores. The outcomes were evaluated at over one year after operation. RESULTS: The cure and improvement rates were 77.5% and 15% in the TVT group, and 88.9% and 7.4% in the TVT/VTH group, respectively, without any statistical difference between the two groups. The rates of patient- satisfaction with the procedure were similar in two groups. There were no serious or long term complications related to the procedure except for a case of local hematoma in the hysterectomy site, which was controlled conservatively. CONCLUSIONS: Our findings suggest that a TVT operation can be done simultaneously with vaginal hysterectomy with similar results as those of TVT operation only. In addition, it is thought that the simultaneous TVT operation in a patient who is undergoing hysterectomy and has urinary stress incontinence deserves to be recommended in a positive light
Exercise Test ; Female ; Hematoma ; Humans ; Hysterectomy ; Hysterectomy, Vaginal ; Pelvic Floor ; Physical Examination ; Suburethral Slings ; Urethra ; Urinary Bladder ; Urinary Incontinence ; Urinary Incontinence, Stress

Leiomyoma is a benign myogenic tumor found mainly in the uterus, skin and the alimentary tract. However, leiomyoma of the nasal septum is very rare and only four cases have been reported in the literature. We present a case of leiomyoma that had rose from the nasal septum and had been removed by endoscopic sinus surgery. This case might well be the fifth case in the world.
Leiomyoma* ; Nasal Septum* ; Skin ; Uterus

Reelin, an extracellular glycoprotein has an important role in the proper migration and positioning of neurons during brain development. Lack of reelin causes not only disorganized lamination of the cerebral and cerebellar cortex but also malpositioning of mesencephalic dopaminergic (mDA) neurons. However, the accurate role of reelin in the migration and positioning of mDA neurons is not fully elucidated. In this study, reelin-deficient reeler mice exhibited a significant loss of mDA neurons in the substantia nigra pars compacta (SNc) and a severe alteration of cell distribution in the retrorubal field (RRF). This abnormality was also found in Dab1-deficinet, yotari mice. Stereological analysis revealed that total number of mDA neurons was not changed compared to wild type, suggesting that the loss of mDA neurons in reeler may not be due to the neurogenesis of mDA neurons. We also found that formation of PSA-NCAM-positive tangential nerve fibers rather than radial glial fibers was greatly reduced in the early developmental stage (E14.5) of reeler. These findings provide direct evidence that the alteration in distribution pattern of mDA neurons in the reeler mesencephalon mainly results from the defect of the lateral migration using tangential fibers as a scaffold.
Animals ; Brain ; Cerebellar Cortex ; Dopaminergic Neurons ; Glycoproteins ; Mesencephalon ; Mice ; Mice, Neurologic Mutants ; Nerve Fibers ; Neurogenesis ; Neurons ; Substantia Nigra