No abstract available.
Emergencies*

No abstract available.
Disulfiram*

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

AIM: Firstly to evaluate the changes of corneal sensation and its effect to dry eye syndrome after laser in situ keratomileusis (LASIK); secondly to evaluate the relation between the changes of corneal sensation and the laser ablation depth. ·METHODS: 30 patients (60 eyes) had bilateral LASIK with a superior-hinged flap. Every patient underwent preoperative and postoperative (after one week, one month and three months) evaluations, including corneal sensation, Schirmer's basic tear secretion test, tear breakup time (TBUT), corneal fluorescein stainting, and a questionnaire evaluating dry eye obtained from each patient.·RESULTS: Compared with preoperative level, after one week and one month, the difference of corneal sensation was very significant (P＜ 0.01); after three months, there was no statistical difference (P ＞ 0.05). After one week, there was no statistical difference (P ＞ 0.05) in the subjective dry eye symptoms, after one month, the difference was significant(P=0.025 ＜0.05) and after three months, the difference was very significant (P=0.001 ＜ 0.01). Compared with preoperative level, the basic tear secretion decreased significantly after one week and one month(P＜ 0.01), it did not return to the baseline level after three months (P ＜ 0.01). Tear breakup time decreased significantly after the surgery, and after three months, there was still statistical difference compared with preoperative level (P ＜ 0.01); with cornea fluorescence staining, we found corneal epithelial defect was most serious after one month after LASIK, and did not return to the baseline level after three months (P ＜ 0.01). Linear regression analysis and relevant were used to evaluate the relation between the changes of corneal sensation and the laser ablation depth (r=0.798, P ＜ 0.01). ·CONCLUSION: The central corneal sesation decreased noticeable after LASIK, and it recovered three months postoperatively, but the indicators of dry eye syndrome did not return to their preoperative levels following it. We have found that the decreasation of corneal sensation had positive correlation with the laser ablation depth.

No abstract available.
Animals ; Rats*

The prognosis of malignant ovarian tumor is poorer than that of borderline malignant ovarian tumor, Therefore an accurate diagnosis and estimation of the biologic behavior of the tumor are necessary for proper management of the patient. The histologic investigation of the tumor may provide information on the estimation of the malignant potential of tumor cells, but it may be a questionable method because of the subjective determination of tumor grade. Quantification of proliferative activity of tumor cells may play a role as an objective method to provide an estimation of the malignant potential of tumor cells. An evaluation of histologic findings was done on 84 cases of ovarian mucinous and serous tumors that were surgically resected and diagnosed during the period from January 1981 through July 1992. The proliferating cell nuclear antigen (PCN A) labelling index estimated from the immunohistochemical stain for PCN A and the Sphase fraction and porliferative index obtained from flow cytometric DN A analysis were assessed each other with histologic findings. The results are as follows: The presence of aneuploidy in malignant tumors was statistically significant as compared with benign tumors. The borderline malignant tumors showed no significant difference between the number of diploidy and aneuploidy. The PCNA labelling index, S-phase fraction and proliferative index tended to increase as the histologic grade of tumors went up. They were higher in malignant tumors than in others. The PCN A labelling index, S-phase fraction and proliferative index were higher in tumors with aneuploidy than in those with diploidy. In contrast to borderline malignant tumors, the PCNA labelling index in malignant tumors revealed a significant relation with the mitotic index. The S-phase fraction and proliferative index showed, in malignant tumors, a close correlation with the architectural grade and nucleolar grade, but not in borderline malignant tumors. Considering these results, the presence of aneuploidy, PCNA label.

The intercourse for mutual understanding between the doctor and the patient is an essential factor of successful medical treatment. The law should confine its duties to forming conditions where the remedial discourse can be held freely and peacefully. Under the Art. 16 of the medical law, however, the structure of free remedial discourse is distorted by asymmetrically distributing the rights and obligations between the doctor and the patient.; The doctor's responsibility to treat the patient ends as soon as the recipient decides to terminate it on his or her own volition. In the case of patients requiring immediate attention the doctor and the patient should discuss the matters of the medical, ethical and political aspects of the termination of treatment with religious men or women etc. If the above mentioned is properly carried out, any decision is fully legitimated regardless of the its content.
Female ; Human Rights ; Humans ; Jurisprudence ; Male ; Volition

It is well known that histologic grade and tumor stage are important prognostic factors, and that the monoclonal antibody to proliferating cell nuclear antigen(PCNA) can recognize S-phase cells. The PCNA index of 53 transitional cell carcinomas(TCCs) of the urinary bladder was studied to evaluate its prognostic validity. The PCNA indices of TCCs ranged from 38 to 92, whih were quite different from that of normal transitional epithelium(9.4). The PCNA indices were significantly higher in tumors of the higher histologic grade and/or tumor stage(correlation coefficient 0.64 and 0.43; P=0.00). The PCNA index was particularly valuable in discriminating the superficial TCCs from the deeply invasive TCCs(67.1+/-15.46 and 79.9+/-9.70; P=0.000). Among TCCs of the same tumor stage, the histologic grade affected the PCNA index. However, TCCs of the same histologic grade revealed similar PCNA indices regardless of tumor stage. These results indicate that the PCNA index is an objective and reliable prognostic factor in TCCs, which is superior to the conventional histologic grade.

We report herein a case of lymphomatoid papulosis in a 23-year-old female who had recurrent erythematous pinhead to pea sized papules and nodules on the both inner thighs and forearms for 4 years. Some lesions showed central hemorrhagic necrosis or scale formation. Individual lesions persisted for several months and showed spontaneous regression leaving pigmentation or depigmented atrophic scar. Histopathologically, there was marked cell infiltration, especially in the dermoepiderrnal junction and perivascular area. Infiltraled cells consisted of sorne ncutrophils and numerous atypical cells that had variable sized and irregular shaped nuclei. Electronmicroscopically, some atypical cells had cerebriform nuclei with marked peripheral condensation of chromatin and cytoplasm contained a few organelles, many polyribosomes and some dense bodies.
Chromatin ; Cicatrix ; Cytoplasm ; Female ; Forearm ; Humans ; Lymphomatoid Papulosis* ; Necrosis ; Organelles ; Peas ; Pigmentation ; Polyribosomes ; Thigh ; Young Adult

Giant cell tumor of tendon sheath(GCTTS) is a benign mesenchymal lesion composed of cytologically bland mononuclear cells admixed with multinucleated giant cells. Our report describes the clinical and pathologic features of a 36-year-old female's tumor with a two years history over the lateral side of the left little finger, Especially, we could observe the characteristic thre types of cells in an electromicroscopic study, histiocyte-like cells, fibroblast-like cells and multinucleated giant cells. In lmmunohistochemical studies, we demonstrated that the tumor cells of GCTTS exhibit a phenotype consistent with histiocyte differentiated to Langerhan's cell.
Adult ; Fingers ; Giant Cell Tumors* ; Giant Cells* ; Histiocytes ; Humans ; Phenotype ; Tendons*