OBJECTIVE: To evaluate the safety and efficacy of the silicone ring pessary in the management of pelvic organ prolapse. METHODS: This study was evaluated for the clinical analysis of 58 pelvic organ prolapse patients who visited our hospital and weared silicone ring pessary from January 1997, to December 1998. RESULTS: Among 58 patients, failure rate was 13.7%(8/58) and complication rate was 50%(29/58). Main causes of failure were vaginal ulcer(4 cases) and recurrent falling out of pessary(3 cases). Most common problems were recurrent falling out of pessary(10 cases) and vaginal erosion with or without ulcer(9 cases), vaginitis(6 cases). There was no significant difference of failure rates and complication rates between hysterectomized patients and the non-hysterectomized patients. CONCLUSION: In management of pelvic organ prolapse which unsuitable for operation, pessary is noninvasive, simple and effective alternative method.
Humans ; Pelvic Organ Prolapse* ; Pessaries* ; Silicones*

In this paper, two unusual cases of fetal giant lymphangiomas diagnosed before delivery is reported in 18 and 26-week pregnant woman. They were diagnosed by ultrasound. Although the cause of lymphangioma is not clearly established, they probably arise from a failure of the developing lymphatic tissue to establish normal connection with the draining lymphatics. These anomalies are most often cervical (about 70~80%) but occasionally present in the axilla (about 10%), thorax and abdomen. Lymphangioma arising at posterior nuchal region is called cystic hygroma. Lymphangioma may be divided histologically into three types ; simple, cavernous or cystic. Ultrasound examination is essential method in prenatal diagnosis of fetal lymphangioma. The differential diagnosis of these fetal lymphangioma should include meningomyelocele, benign cystic teratoma, nuchal edema, encephalocele, and subchorial placenta cyst. About 60 to 70% of lymphangioma is accompanied with chromosomal abnormalities, and most common type is Turner's symdrome (40~80%), but occasionally trisomy 21, 18, 13 and 47 XXY. But chromosomal studies of these cases showed normal findings. The 26-week fetus was IUFD at 29 gestational weeks and terminated by hysterotomy. Other 18-week fetus was terminated by vaginal delivery after intrauterine decompression.
Abdomen ; Axilla ; Chromosome Aberrations ; Decompression ; Diagnosis, Differential ; Down Syndrome ; Edema ; Encephalocele ; Female ; Fetus ; Humans ; Hysterotomy ; Lymphangioma* ; Lymphangioma, Cystic ; Lymphoid Tissue ; Meningomyelocele ; Placenta ; Pregnant Women ; Prenatal Diagnosis ; Teratoma ; Thorax ; Ultrasonography

OBJECTIVE: Our purpose was to evaluate the pregnancy outcome and the advantages of laparoscopic tubal reanastomosis. METHOD: During 16 months, January 1996 to April 1997, thirty-two patient had underwent laparoscopic tubal reanastomosis in Pudang CHA General Hospital. The mean age of the patients was 36.1+/-4.3 years(mean+/-SD; range 26 to 47 years). RESULT: The intrauterine pregnancy rate of laparoscopic tubal reanastomosis was 72.4%(21/29). Data comparing laparoscopic procedure retrospectively to tubal reversal by laparotomy was also evaluated. The mean interval from operation to pregnancy was similar in the two groups (p=0.9). The operation time was sigoificantly longer for laparoscopy (215.3+/-35.5 minutes) than for laparotomy(159.7+/-52.3 minutes). Nevertheless, the intensity of postoperative pain was lower (p<0.05) in patient who underwent laparoscopy than in patient who underwent laparotomy. Also, the mean hospital stay (3.6+/-2.3 days for laparoscopy, 6.1+/-0.5 days for laparotomy) was shortened(p<0.05) after laparoscopy compared with laparotomy. CONCLUSION: Laparoscopic tubal reanastomosis may offer the benefits of lower postoperative pain and shorten recovery time in comparison with laparotomy. Therefore, considering the high pregnancy rate in minimal follow up period of 6 month, laparoscopic tubal reanastomosis could be an alternative procedure to microsurgical laparotomy in patients requesting reversal of sterilization.
Female ; Fertility* ; Follow-Up Studies ; Hospitals, General ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Pain, Postoperative ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Retrospective Studies ; Sterilization ; Sterilization Reversal*

The structures forming the shoulder joint are very complex and the biomechanical effects of them on the joint are not clearly lunderstood. Frequently the long head of the biceps brachii muscle is dislocated naturally and it has been said that the supratubercular ridge, the depth, and angle of medial wall of the intertubercular groove are important. And the angles between the long axis of the humerus and the axis of head and neck are important clinically. So the authors studied them in the 105 specimens of the Korean adults humerus. The results are as follows: 1. The complete type of the supratubercular ridge was present in 22.9% and the partial type was in 53.3% 2. If the ridge was present, the spur of the lesser tubercle was present in 67.5% and if not present, the spur was in 8%. 3. The angle of medial wall of the intertubercular groove was variable, and the angle less than 45 was 13.41°. 4. The angles between the long axis of the humerus and the axis of head and neck were much greater in male than female (P<0.05). 5. The average diameter of the head of the humerus was 4.42±0.4cm in male and 4.4±0.4cm in female (P < 0.05).
Adult ; Female ; Head ; Humans ; Humerus ; Joints ; Male ; Neck ; Shoulder Joint

Renal blood flow was measured by single injection technique of HippuranI13 in 13 patients with chronic glomerulonephritis and 11 control subjects. There was a significant decrease in renal blood flow in chronic glomerulonephritis particulary in those with elevated blood urea nitrogen. Renal blood flow was inversely proportionate to renal vascular resistance but no correlation was noted between renal blood flow and creatinine clearance.
Blood Urea Nitrogen ; Creatinine ; Glomerulonephritis* ; Humans ; Renal Circulation* ; Vascular Resistance

Emergency cerclage commonly known as that performed in the setting of advanced cervical dilatation with bulging membranes and associated with significantly increased failure rates. We experienced a successful emergency cerclage for advanced incompetent internal os of cervix ( IIOC ). Pregnancy was prolonged and we delivered viable fetus. Hereby we report this case with the brief review of literature.
Cervix Uteri ; Emergencies* ; Female ; Fetus ; Labor Stage, First ; Membranes ; Pregnancy

The cardiac dimensions and functions were studied by analyzing simultaneously recorded M-mode echocardiograms and phonocardiograms in 24 cases of essential hypertension with no evidence of heart faliure, and also in 20 healthy adults for comparison. Thirteen hypertensives out of 24 had findings consistent with left ventricular hypertrophy on either routine chest roentgenograms or electrocardiograms or both(group II) and the remaining 11 had no such findings(group I). The posterior wall and septal thickness, and isovolumic relaxation time were significantly was increased even in the group I as well as in the group II. The isovolumic relaxation time was correlated well with the septal thickness in both groups. In contrast, a significant increase in left atrial and left ventricular systolic dimensions was noted only in the group II, and so was a significant reduction in the fractional shortening and mean velocity of circumferential fiber shortening. These findings suggest that the echocardiographic examination is useful in patients with essestial hypertension for the early dagnosis of the increased thickness of the posterior wall and the septum, and the abnormality during early diastolic relaxation of the left ventricle, prior to the appearance of the ventricular hypertrophy on the routine chest films amd/or electrocardiograms, and also that echocardiograms enable early detection of the systolic dysfunction of the hypertrophied left ventricle in the absence of apparent failure.
Adult ; Echocardiography* ; Electrocardiography ; Heart ; Heart Ventricles ; Humans ; Hypertension* ; Hypertrophy ; Hypertrophy, Left Ventricular ; Relaxation ; Thorax

The antihypertensive effect of trimazosin was studied in 24 cases of essential hypertension, which include 9 cases with pretreatment diastolic pressure of 114mmHg or more, for a period of 4 weeks. The average pretreatment systolic and diastolic blood pressures were approximately 175mmHg and 114mmHg, respectively. The treatment was started with 100mg of trimazosin daily in 2 divided doses and and the drug was titrated upward at weekly interval by 100mg up to 400mg/day depending on the response of the blood pressures. Routine blood counts, urinalyses, liver and kidney function tests, electrolyte balance, total serum cholesterol and triglyceride were determined before and at the end of treatment. The diastolic blood pressure fell 10mmHg or more in 20 out of 24 cases(83.3%), and in 12 cases out of 20 favorable responders it fell to 90mmHg or below. The pretreatment diastolic blood pressure in 4 nonresponders was all 115mmHg or more. The antihypertensive effect appeared during the first week of therapy and progressively increased until the end of treatment week without causing postural hypotension. Unpleasant symptoms appeared in 12 cases during treatment, which include dizziness, headache, numbness in the extremities and tinnitus in the decreasing order of frequency. However, these symptoms were mild and transient in all cases disappearing spontaneously despite continued medication. No significant biochemical changes in the blood were recorded after treatment. We conclude that trimzosin seems to be a safe and effective antihypertensive drug particularly useful for the treatment of mild to moderate hypertension.
Blood Pressure ; Cholesterol ; Dizziness ; Extremities ; Headache ; Hypertension* ; Hypesthesia ; Hypotension, Orthostatic ; Kidney Function Tests ; Liver ; Tinnitus ; Triglycerides ; Urinalysis ; Water-Electrolyte Balance

Hysterosalpingography and Hysteroscopy have been used for the detection of intraute-rine pathology such as polyps, submucous myomas, intrauterine adhesion and endometrial hyperplasia or cancer. Recently the ultrasound has also been utilized for the detection of uterine pathology. Therefore the purpose of this study was to evaluate the diagnostic efficacy of SonoHysterography in detection of intrauterine pathology compared with HSG and Hysteroscopy. 32 patients underwent Sono-Hysterography and Hysteroscopy for the evaluation of the uterine pathology from september 1995 to January 1996. Nine of 32 patients had infertility problem and HSG performed prior to Sono-Hysterography and Hysteroscopy. The results are as follows : 1. The patients' ages ranged from 20 to 50 years(median 37.9). 2. All 9 patients with infertility who had positive HSG findings in uterine cavity showed the intrauterine pathology in Sono-Hysterography as well as Hysteroscopy. The detail findings are as follows :septated uterus(n=2), intrauterine adhesion :IUA(n=3), endometrial polyp(n=3), and IUA combined endmetrial hyperplasia(n=1). 3. Twenty two of 23 patients with abnormal uterine bleeding showed the intrauterne pathology and one patient had negative finding in Sono-Hysterography. However, Hysteroscopy revealed positive intrauterine pathology in 22 patients who had abnormal uterine bleeding. One patients who had positive finding in Sono-Hysterograply showed negative by Hysterography. In contrast, one patient who had negative finding in Sono-Hysterography had positive uterine pathology with polyp in Hysteroscopy. The histologic pathology in all 23 patients reported endometrial polyp(n=12), placental polyp(n=2), submucous myoma(n=1), endometrial hyperplasia(n=5), endometrial cancer(n=1), normal endometrial finding(n=2). 4. Sono-Hysterography, therefore, has a sensitivity and positive predictive value of 96.6%, 93.5% respectively. Our study showed a positive Sono-Hysterography is very predictive of the intrauterine pathology. Sono-Hysterography is safe, quick and minimal invasive procedure. So it is an invaluable technique in the evaluation of uterine cavity.
Endometrial Hyperplasia ; Female ; Humans ; Hysterosalpingography ; Hysteroscopy* ; Infertility ; Myoma ; Pathology* ; Polyps ; Ultrasonography ; Uterine Hemorrhage

Leiomyoma of vagina is relatively rare benign tumor. And majority of these lesions occur in labia major and anterior vaginal wall. The recurrence of this tumor is extremely rare and its cellular atypism, mitotic activity, tumor size and contour are known as important factors in its recutrence. A case of recutrent leiomyoma causing urinary frequency in vesicovaginal septum was reported with a brief review of literature.
Leiomyoma* ; Recurrence ; Vagina