OBJECTIVE: Intrafascial vaginal hystrectomy(IVH) is an intrafascial cylindriform enucleation of the cervix and supracervical amputation of the uterus through vagina, leaving the highly vascularized extrafascial cervical tissue and corresponding nerves intact. The supracervical amputation of the uterus through vagina and intrafascial cylindriform enucleation of cervix enable to perform an minimal invasive surgery and organ-preserving surgery. Pelvic floor support is maintained and sexual sensation is preserved. Physical stress to the patient is minimalized. Our purpose is to evaluate the outcomes of IVH. METHOD: 21 patients were performed IVH from January 1996 to July 1998. RESULT: The mean age was 43.4+7.2 years and the mean parity was 2.6+0.8. The mean operation time was 116.1+21.4 minutes and the mean postoperative hemoglobin change was 2.0+1.6gm/dL. The mean postoperative hopitalization time was 8.2 + 2.7days. CONCLUSION: The IVH is an operation technique for the patients who are sexually active and want to remain their uterus.
Amputation ; Cervix Uteri ; Female ; Humans ; Parity ; Pelvic Floor ; Sensation ; Uterus ; Vagina

OBJECTIVE: To examine the association between age at menopause and mortality in a population-based sample of women in Kangwha, Korea. METHODS: From the Kangwha Cohort, followed-up from 1985 to 1999, the data of the over 55 year old female group(n=3,596) was used in this study to examine the association between age at menopause and mortality. We calculated the all causes mortality risk ratio and the cancer mortality risk ratio by age at menopause grouping using the Cox Proportional Hazards Model with adjustments for age, BMI, smoking, education, chronic disease, self-rated health status, alcohol consumption and age at first birth. RESULT AND CONCLUSION: Compared to women who had menopause at 45-49 years, the all causes mortality risk ratio was 1.24 for women with menopause at less than 40 years(95% CI=1.01-1.53) and 1.05 for women with menopause at over 50 years(95% CI=0.92-1.20). Also, compared to women who had menopause at 45-49 years, the cancer mortality risk ratio was 1.53 for women with menopause at less than 40 years(95% CI=0.78-2.98) and 1.17 for women with menopause at over 50 years(95% CI=0.77-1.80).
Alcohol Drinking ; Birth Order ; Chronic Disease ; Cohort Studies* ; Education ; Female ; Humans ; Korea ; Menopause* ; Middle Aged ; Mortality ; Odds Ratio ; Proportional Hazards Models ; Smoke ; Smoking

Catecholamine-induced cardiomyopathy associated with neuroblastoma is rarely reported. We report a case of catecholamine-induced cardiomyopathy associated with neuroblastoma in a 33-month-old female that was treated with extracorporeal membrane oxygenation (ECMO). She was tentatively diagnosed with acute myocarditis and presented with hypertension. Because of rapid patient deterioration despite pharmacological treatments, ECMO was applied. ECMO can be helpful in cases of catecholamine-induced cardiomyopathy associated with neuroblastoma.
Cardiomyopathies* ; Catecholamines ; Child, Preschool ; Extracorporeal Membrane Oxygenation* ; Female ; Humans ; Hypertension ; Myocarditis ; Neuroblastoma*

The aim of the present work is to evaluate the most accurate technique for analysirig low levels of serum IgE. Following results are obtained from experiments by PRIST, Overnight PRIST, PRIST using RAST anti-IgE tracer and Overnight PRIST using RAST anti-IgE tracer methods with cord serum and maternal serum of 21 individuals respectively. 1) There was no statistical significance in maternal serum IgE titer using above 4 methods. However, the higher level of IgE titer was found in PRIST method when IgE was over 190 IU/ml(5 cases) estimated by PRIST method and in Overnight PRIST using RAST anti-IgE tracer method when Ig.E was below lgp IU/ml (16 cases) (p40.05). 2) In cord serum IgE titer, only Overnight PRIST using RAST anti-IgE tracer method showed statistical significance. 3) The most desirable correlation coefficient between maternal serum and cord serum IgE titer was estimated by Overnight PRIST using RAST anti-IgE tracer method than any other rnethods.
Immunoglobulin E*

Angiokeratoma circumscriptum is present at birth or early childhood and is an uncommon dermatosis characterized by papules and small nodules that may coalesce to form plaques. Histopathologically, there are varying degrees of hyperkeratosis, papillomatosis, and irregular acanthosis. In the papillary dermis, greatly dilated capillaries are observed, The acanthotic epidermis encircles the vascular spaces(blood cysts) where, occasionally, organized thrombi may be found. The use of pulsed-dye lasers to treat cutaneous vascular lesions is based on the theory of selective photothermolysis. We report a case of an angiokeratoma circumscriptum in an 48-year-old woman for whom the flashlamp pulsed tunable dye laser proved to be a highly successful means of treatment.
Angiokeratoma* ; Capillaries ; Dermis ; Epidermis ; Female ; Humans ; Lasers, Dye* ; Middle Aged ; Papilloma ; Parturition ; Skin Diseases

No abstract available.
Diuretics*

Deep skin and soft tissue defects with exposed bone and tendon is difficult to treat, because skin graft rarely survives and flap surgery is sacrifice of donor site. Since "Stage I" membrane was developed by Yannas and Bruke in 1980, numerous kinds of artificial skin have been developed. The adaptability of "Terudermis", developed by the Terumo Co., as an artificial skin composed of sponge made of a fibrillar atelocollagen and a heat-denatured atelocollagen, was clinically evaluated on application to 13 cases presenting deep skin and soft tissue defect with exposed bones and tendons from October 1997 to march 1998. Terudermis has the advantage of allowing early incorporation of fibroblasts and capillaries into its collagen sponge due to very weak dehydrothermal cross-linking. Before Terudermis graft, several days of wet dressing and debridement were required to prepare healthy well-vascularized bed because Terudermis was weak on unsanitary wounds. After bed preparation, Terudermis was grafted like usual skin graft. Tie-over bolster dressing or compressive dressing was used case by case. The dressing was opened 2~3 days after Terudermis grafting. Wet dressing was done daily until the skin graft was done. Autologous skin graft was done 2-3 weeks after Terudermis graft. Our clinical results indicated that Terudermis was beneficial in treating 77% of our patients. Through the use of this new method, treatment of severe skin and soft tissue defects that are usually treated by musculocutaneous or other conventional skin flaps can be replaced by Terudermis as an new artificial dermis.
Bandages ; Capillaries ; Collagen ; Debridement ; Dermis ; Fibroblasts ; Humans ; Membranes ; Porifera ; Skin ; Skin, Artificial ; Tendons ; Tissue Donors ; Transplants ; Wounds and Injuries*

Male breast cancer is a rare disease, representing approximately 1% of breast cancer and less than 1.5% of malignant tumors occurring in men. We report a case of cuaneous metastasis of male breast cances. a 64-year-old male who presented with multiple nodules and erythematous plaque on the right anterior chest and enlargement of the right axillary lymplinodes. The histopathologic findings of the nodule showed atypical tumor cells with a somew eat gland-like pattern. The cells showed potive reactions in PAS, DPAS and alcian blue stains, and also positive for estrogen and roiesterone receptors. Biopsy specimens taken from the plaque showed cellular arrangement in show line, referred to as Indian filing, between thiclenecin collagen bundles. He was treated not, tamoxifen, 5-fluorouracil, adriamycin, cyclophosphamide and megestrol acetate. 5 months after nitiation of the treatment, the skin lesions were improved vvith a decreased number and size or dules and decreased intensity of erythema.
Alcian Blue ; Biopsy ; Breast ; Breast Neoplasms ; Breast Neoplasms, Male* ; Collagen ; Coloring Agents ; Cyclophosphamide ; Doxorubicin ; Erythema ; Estrogens ; Fluorouracil ; Humans ; Male ; Male* ; Megestrol Acetate ; Middle Aged ; Neoplasm Metastasis* ; Rare Diseases ; Skin ; Tamoxifen ; Thorax

OBJECTIVES: This paper presents the information on the incidence of cancer from the population-based cancer resistry in Kangwha County. Material and METHODS: This investigation is based on Kangwha cancer registry. The data included cases of cancer diagnosed from 1986 through 1992. The diagnosis of cancer was confirmed by a team of physicians and nurses with the medical records kept in the clinics and hospitals based on the diagnostic criteria recommended by WHO. Home visitings were also made to cancer patients confirmed in every 6 months for the follow up and for the collection of relevant information directly from the patients. RESULTS: A total of 992 cancer cases were registered during 1986 - 1992. The age-adjusted cancer incidence rate of all site is 201.7 in men and 110.7 in women. The most common cancer is the stomach cancer in both sexes. The age-adjusted incidence rate of the stomach cancer is 65.9 in men and 25.0 in women per 100,000 population. The lung cancer(33.8) and liver cancer(27.7) are next common cancers in men. The cervical cancer(21.8) and lung cancer(8.4) are next in women. CONCLUSION: The most common cancer is the stomach cancer in both sexes. The annual age-adjusted incidence rate of the stomach cancer is 65.9 in men and 25.0 in women per 100,000 population.
Diagnosis ; Female ; Follow-Up Studies ; House Calls ; Humans ; Incidence* ; Liver ; Lung ; Male ; Medical Records ; Stomach Neoplasms

No abstract available.
Fetus* ; Humans ; Pregnancy, Twin*