PURPOSE: There have been numerous retrospective and uncontrolled study of laparoscopic appendectomy. Although most of these have concluded that the laparoscopic appendectomy is at least as good as open appendectomy, there has been considerable controversy as to whether laparoscopic appendectomy is superior. METHODS: We performed total 47 cases of laparoscopic appendectomy (LA) during one year from January 1997 to December 1997 and these were compared with 50 cases of open appendectomy (OA) in same period to assess the clinical usefulness. RESULTS: The sex, male to female ratio and severity of appendicitis were similar in both groups. The anesthetic time was longer in the LA group (P<0.05) but operative time was similar. Gas-passing time and diet-intake time in postoperative period were earlier in LA group (P<0.05). The LA group required less analgesics in postoperative period. In LA group, no case was converted to open appendectomy and overall complication rate was lower in LA group but this was not statistically significant. Among the postoperative complication, the wound infection rate was absolutely lower in LA group (P<0.05). The diagnostic rate for acute abdomen including acute appendicitis was superior in LA group, especially in reproductive women. The hospital stay was shorter in LA group (P<0.05) and hospital charges was not different in both group. CONCLUSION: Laparoscopic appendectomy offers considerable advantages over open appendectomy because this has ability to reduce postoperative complications and shorten recovery times and is useful for detecting the cause of acute abdomen other than acute appendicitis. So we expect this technique will be alternative operation or new standard operation in selected cases for suggestive acute appendicitis.
Abdomen, Acute ; Analgesics ; Appendectomy* ; Appendicitis ; Female ; Hospital Charges ; Humans ; Length of Stay ; Male ; Operative Time ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Wound Infection

OBJECTIVES: Physical exercise has become popular in recent years. It has been known that exercise is related to the development of heartburn, belching, regurgitation and chest pain. However there are few data concerning the effect of exercise on esophageal motor function and gastroesophageal reflux. We evaluated the effect of exercise intensity on esophageal motor activity and gastroesophageal reflux. METHODS: We studied healthy volunteers (15 males, age: 28+/-5 years, BW: 68+/-10kg) using a 24 hours ambulatory esophageal pressure, pH catheter and portable digital data recorder (Microdigitrapper 4Mb, Synetics Medical, Sweden). Subjects exercised on a treadmill (Marquette Case 15 Electronic INC) at 50% and 70% maximal heart rate for 30 min. Subjects rested 2 hours before exercise (base line) and for 30 min between exercise sessions. RESULTS: 1) Exercise of 50% maximal heart rate reduced total contraction, contraction duration, percentage of simultaneous contraction and repetitive contraction, (P<0.05) but increased percentage of contractions above 20mmHg amplitude (P<0.05). 2) Exercise of 70% maximal heart rate decreased total contraction, esophageal amplitude, contraction duration and percentage of peristaltic contraction, (P<0.05) but increased percentage of simultaneous contraction (P<0.05). 3) Gastroesophageal reflux was not change on both 50% maximal heart rate and 70% maximal heart rate exercise. CONCLUSION: More propulsive esophageal motility are induced following exercise of 50% maximal heart rate, but not 70% maximal heart rate.
Catheters ; Chest Pain ; Eructation ; Exercise ; Gastroesophageal Reflux* ; Healthy Volunteers ; Heart Rate ; Heartburn ; Humans ; Hydrogen-Ion Concentration ; Male ; Motor Activity ; Running*

No abstract available.
Rectal Prolapse*

No abstract available.
Adenocarcinoma* ; Carcinoma, Endometrioid*

Fourty three patients known to hnve cervical intraepithelial neoplasia were assigned to Papanicolaou smear in five different ways, i, e, A) cotion tipped wood applieator at the pasterior vaginal fronix and the ectocervix, B) cotton tipped wood applicator at the ectocervix and the endocervical canal, C) Cytohrush at the endocervical canal, D) Cervexbrusk and E) Cyto-spatula. At the completion of cytologic study, all the subjects were done colposcopically directed biopsy and/or ECC. To evaluate the false negative rates of the cytologic test, cervical cone biopsy or hysteectorny was performed on all the patient. The false negat,ive rates were 53.5% in A) 39.5% in B), 14,0% in C), l8.6% in D), 25.6% in E) and statistical differences occurect between each group, It was also found that bleedings were most frequently endountered in E) and the encocervical cells were most frequently appeared in C). With these results, it can he stated that the rate of negative encocervical cells in the srnear were correlated with the false negative rates of cervical cytology.
Biopsy ; Cervical Intraepithelial Neoplasia ; Cervix Uteri* ; Female ; Humans ; Papanicolaou Test ; Wood

No abstract available.
DiGeorge Syndrome*

OBJECTIVE: The purpose of this study was to compare the plasma amitriptyline and nortriptyline level between before and after fluoxetine addition with patients who were currently taking amitriptyline. METHOD: From the inpatient and outpatient unit of Soon Chun Hyang University Hospital, Chunan, fourteen subjects who were taking amitriptyline 25mg more than 1 week at least were given fluoxetine 20mg. Before and 2 weeks after fluoxetine addition the plasma level of amitriptyline and nortriptyline are analyzed simultaneously by High Performance Liquid Chromatography(HPLC) At the same times, HAM-D(Hamilton Rating Scale for Depression) score and the UKU(Uldvalg for Klinske Unders phi gelser) side effect scale were checked. RESULTS: After fluoxetine addition to the patients who were taking amitriptyline, the plasma level of amitriptyline, nortriptyline and sum of amitriptyline and nortriptyline had risen. The mean plasma amitriptyline level increased from 168.9+/-89.4ng/ml to 183.0+/-102.0ng/ml after fluoxetine addition(p=0.011) but the change was not statistically significant. The mean plasma nortriptyline level increased significantly from 114.3+/-70.2ng/ml to 168.0+/-86.2ng/ml after fluoxetine addition(p=0.011) In addition, the mean plasma level of total amitriptyline and nortriptyline increased significantly from 283.1+/-125.3ng/ml to 350.9+/-78.4ng/ml after fluoxetine addition(p=0.016) After fluoxetine addition, no significant change was noted in the UKU side effect scale score. CONCLUSION: As consequence of comparson of plasma amitriptyline and nortriptyline level before and after fluoxetine addition mean amitriptyline, nortriptyline and total plasma level was increased after fluoxetine addition. This suggests that coadministration of amitriptyline and fluoxetine may induce improvement of depressive symptom in depressive patients by way of increased plasma level of amitriptyline.
Amitriptyline* ; Chungcheongnam-do ; Depression ; Fluoxetine* ; Humans ; Inpatients ; Nortriptyline ; Outpatients ; Plasma*

OBJECTIVES: Early diagnosis of intrauterine growth retardation is important to ensure optimal monitoring and delivery with the introduction of real-time and Doppler ultrasound systems, a noninvasive method of measuring human fetal blood flow has become available. The aim of this study is to compare blood flow velocity waveforms at the fetal descending aorta and umbilical artery in normal and in patients with pregnancy induced hypertension. METHODS: Using a combination of linear array real-time and pulsed Doppler ultrasound, blood flow velocity measurements were carried out at the fetal descending aorta and umbilical artery in 35 normal pregnancies and 18 cases of pregnancy induced hypertensive patients. RESULTS: The mean systolic/diastolic ratio of umbilical artery and aorta was significantly higher in PIH patients than in normal pregnancies(3.8 +/- 0.81 versus 2.97 +/- 0.52, p<0.05) and to predict perinatal morbidity, umbilical velocimetry is more sensitive than that of descending thoracic aorta. CONCLUSION: This study suggests that umbilical artery velocimetry could be used as a marker to predict adverse perinatal outcome.
Aorta ; Aorta, Thoracic* ; Blood Flow Velocity ; Early Diagnosis ; Female ; Fetal Blood ; Fetal Growth Retardation ; Humans ; Hypertension, Pregnancy-Induced ; Pregnancy ; Rheology* ; Ultrasonography ; Umbilical Arteries

To identify significant prognostic factors in patients undergoing simple hysterectomy in the presence of invasive cervical cancer, the records of 45 patients who had taken such a procedure between 1993 and 1997 were reviewed. Overall relapse-free survival and 5-year survival rates were 91.1 and 92.1%, respectively. Factors found to be significantly related to survival were the retrospectively determined stage(p=0.0000), the presence of residual disease(p=0.0001), and cell type(p=0.0000). By multivariate analysis, factor emerging as significantly detrimental to survival was the cell type. The presence of residual disease was a marginally significant factor(p=0.067). The expectations for survival of patients with residual tumor mass and/or with adenocarcinoma after simple hysterectomy appear to be markedly worse than those with others, so radical reoperation should be considered in those patients.
Adenocarcinoma ; Humans ; Hysterectomy* ; Multivariate Analysis ; Neoplasm, Residual ; Reoperation ; Retrospective Studies ; Survival Rate ; Uterine Cervical Neoplasms*

The purpose of this study is to investigate the effect of lengthening in long bones on the articular carilage by observing the changes in articular cartilage, Fifty-seven rabbits of growing period were divided into four lengthening groups; 5%, 10%, 20%, and 30%. Lengthening by callotasis that was done on the left tibiae and right tibiae were used as control. After lengthening histopathological, histochemical and autoradiographic studies were done on the proximal and distal tibial articular cartilages. That following observations were made. 1. As compared with controls, statistically significant degenerative changes were noted in proximal and distal articular cartilages when the tibiae were lengthened 10% or more. 2. In the proximal joints, the changes were significant between 10% and 20% lenghtening groups, but not between the 20% and 30% lengthening groups. 3. In the distal joints, the changes were significant. Not only were there between 10% and 20% lengtening groups but also there were between 20% and 30% lengtening groups. 4.Degenerative changes were frequently found in the intermediate zone between the periphery and the center, where most of the weight is borne.5. Decrease in matrix content of degenerated articular cartilage was noted by histochemical studies using safranin-0 and Alcian-blue.6. Autoradiography with S04 was done to quantitate matrix content of articular cartilage, and the mean uptake ratio of the articular cartilage was slightly higher than others in the 30% lengthening group. This esuggest decreased matrix synthesis, but no statistical significance was found. Following conclusion were drawn from above observations. 1. In rabbits, tibial lengthening tended to cause microscopic degenerative changes, and the changes begun to appear when the tibiae were lengthened 10% or more. 2. When lengthened over 20%, the changes became more pronounced in the distal joint than in the proximal joint.
Autoradiography ; Bone Lengthening ; Cartilage, Articular ; Joints ; Leg ; Osteogenesis, Distraction ; Rabbits ; Tibia