OBJECTIVE: To evaluate the efficacy of laparoscopic surgery in the treatment of deep endomtriosis, we have studied 30 cases of deep endometriosis. Endometriosis is classified into superficial(<1mm), intermediate(2-4mm), deep(>5mm) and very deep(>10mm) endometriosis by the infiltration depth from the peritoneal surface. In the treatment of deep endometriosis, medical hormonal therapy is not effective, so surgical treatment is required. There are many difficulties in surgiacal treatment ; hard lesion to excise, ditsorted pelvic anatomy after excision, easy to damage to ureter and uterine artery, and limitation for potentially morbid procedure to whom wants to conceive. Especially laparoscopic surgery in the treatment of deep endometriosis is very difficult because it is impossible to know the depth by palpation. In deep endometriosis type II, the lesion is concealed due to rectal adhesion to cul de sac, uterosacral ligament and in type III, the lesion is regarded as a small lesion or missed due to invagination into pelvic floor. The authors compared the laparoscopic surgery with laparotomy to evaluate the efficacy of laparoscopic surgery in the treatment of deep endomtriosis. METHODS: Deep endometriosis, 30 cases out of 102 cases, which were histologically comfirmed as endometriosis were studied. The authors compared the laparoscopic surgery(15 cases) with laparotomy(15 cases) in the surgical treatment of deep endometriosis for operation procedure, operation time, hospital stay and symptoms improvement. RESULTS: The mean operation time of laparoscopic surgeries in deep endometriosis was 178.7(+/-43.1)min while type I, II and III in deep endometriosis took 148.5(+/-21.2)min, 162.0(+/-30.7)min and 245.0(+/-36.1)min respectively and took a little more time than laparotomy. Mean hospital stay in laparoscopic surgeries was 5.7(+/-1.8)days and laparotomy took 10.0(+/-2.3)days that was statistically significant. CONCLUSION: If patients are chosen adequately and operator's skills are satisfactory, laparoscopic surgery is very valuable in the treatment of deep endometriosis. More datas will be required to confirm the efficacy.
Endometriosis* ; Female ; Humans ; Laparoscopy* ; Laparotomy ; Length of Stay ; Ligaments ; Palpation ; Pelvic Floor ; Ureter ; Uterine Artery

We are calling the erupting ground water as drug water or mineral water in Korea and thinking those water and food making water. Authors tried to investigate the evidence of contamination by user on the 10 erupting ground water and gained following results: 1. All of the mineral waters on 10 area in Seoul were unfittable to drinking water standard. 2. In the view of the bacteriology 80% were contaminated by coliform group. 3. The highest value of the free carbon dioxide contents were 652.96 ppm at Sam Sun Mineral Water.
Bacteriology ; Carbon Dioxide ; Drinking Water ; Groundwater ; Korea ; Mineral Waters* ; Seoul* ; Solar System ; Thinking ; Water

No abstract available.
Hemodynamics* ; Hepatocytes* ; Ischemia* ; Liver* ; Urokinase-Type Plasminogen Activator* ; Verapamil*

No Abstract Available.
Cadaver* ; Humans* ; Spinal Cord* ; Spine*

No abstract available.
Cervical Ripening* ; Female ; Pregnancy

No abstract available.
Nifedipine* ; Vasopressins*

No abstract available.
Colon* ; Polyps*

BACKGROUND: The effects of a muscle relaxant may differ in elderly compared with young adult patients for a variety of the pharmacokinetic and pharmacodynamic reasons. Atracurium is eliminated by nonorgan dependent pathway, Hofmann elimination and ester hydrolysis. So there are some arguments for age-related differences. The purpose of this study was to compare the differences of the onset and duration of atracurium in young and elderly. METHODS: Eighteen young adults (21-54 yr) and 18 elderly (>65 yr) patients anesthetized with nitrous oxide and enflurane. Atracurium (0.5 mg/kg) was given and then intubation was performed after T1 response was blocked more than 80%. Neuromuscular relaxation was measured by the first twitch of train-of-four (T1) response at the adductor pollicis after supramaximal stimulation of ulnar nerve at 2Hz every 12 sec. The onset (disappearance of T1) and duration of 5, 25, 50, 75% recovery time of T1 and recovery index (time for 25-75% recovery of T1) were recorded. RESULTS: Onset of block was not significantly different between the young and elderly. Recovery time of 5, 25, 50, 75% and recovery index were not prolonged in elderly compared with young adults. CONCLUSIONS: There were no significant differences between young and elderly adults in onest time, recovery time of 5, 25, 50, 75% and recovery index when atracurium is used in a single bolus dose. The results suggest that atracurium in elderly patients has similar onset and action duration compared with younger patients.
Adult ; Aged* ; Atracurium* ; Enflurane ; Humans ; Hydrolysis ; Intubation ; Nitrous Oxide ; Relaxation ; Ulnar Nerve ; Young Adult

The correlation between deoxyribonucleic acid (DNA) ploidy, pathological stage and prognosis was evaluated in 18 patients, who underwent nephrectomy and proved to be renal cell carcinoma. Of them, 10 (56%) cases showed a DNA diploid pattern and 8 (44% ) cases a DNA aneuploid one. The pathologic stage and DNA ploidy. revealed aneuploid tumors in 2(29%) of 7 patients with stage pT1-2N0M0(group 1). in 2 (33%) of 6 patients with stage pT3aN0M0 (group 2) and in 4 (80%) of 5 patients with stage pT3bN02M0.(group 3) respectively. The Mean follow up period was 3.3 years. The number of the survivals more than 2 years were 12(67%). comprising 8 of diploid tumors and 4 of aneuploid tumors, suggesting that patients with diploid tumor survived longer than those with aneuploid tumor. The survivals more than 2 years in relation to pathological stage were 6 (86%) or 7 patients with group 1, 5(83%) of 6 with group 2 and 1 (20%) of 5 with group 3, respectively. The S phase fraction showed no significant difference between diploid and aneuploid tumors, but the survivals more than 2 years had significantly lower S phase fraction than those less than 2 years. The results suggest that DNA ploidy correlates with pathologic stage and prognosis. and S phase fraction may influence the prognosis independently.
Aneuploidy ; Carcinoma, Renal Cell* ; Diploidy ; DNA* ; Follow-Up Studies ; Humans ; Nephrectomy ; Ploidies* ; Prognosis* ; S Phase

BACKGROUND: Unplanned extubation (UE) of patients requiring mechanical ventilation in an intensive care unit (ICU) is associated with poor outcomes for patients and organizations. This study was conducted to assess the clinical features of patients who experienced UE and to determine the risk factors affecting reintubation after UE in an ICU. METHODS: Among all adult patients admitted to the ICU in our institution who required mechanical ventilation between January 2011 and December 2013, those in whom UE was noted were included in the study. Data were categorized according to noninvasive or invasive management after UE. RESULTS: The rate of UE was 0.78% (the number of UEs per 100 days of mechanical ventilation). The incidence of self-extubation was 97.2%, while extubation was accidental in the remaining patients. Two cases of cardiac arrest combined with respiratory arrest after UE were noted. Of the 214 incidents, 54.7% required invasive management after UE. Long duration of mechanical ventilation (odds ratio [OR] 1.52; 95% confidence interval [CI] 1.32-1.75; p = 0.000) and high ICU mortality (OR 4.39; 95% CI 1.33-14.50; p = 0.015) showed the most significant association with invasive management after UE. In multivariate analysis, younger age (OR 0.96; 95% CI 0.93-0.99; p = 0.005), medical patients (OR 4.36; 95% CI 1.95-9.75; p = 0.000), use of sedative medication (OR 4.95; 95% CI 1.97-12.41; p = 0.001), large amount of secretion (OR 2.66; 95% CI 1.01-7.02; p = 0.049), and low PaO2/FiO2 ratio (OR 0.99; 95% CI 0.98-0.99; p = 0.000) were independent risk factors of invasive management after UE. CONCLUSIONS: To prevent unfavorable clinical outcomes, close attention and proper ventilatory support are required for patients with risk factors who require invasive management after UE.
Adult ; Heart Arrest ; Humans ; Incidence ; Intensive Care Units* ; Critical Care* ; Mortality ; Multivariate Analysis ; Respiration, Artificial ; Risk Factors