OBJECTIVE: Peripartum emergency cesarean hysterectomy of 28 cases at our hospital for 10years were reviewed that the clinical indication, history, and annual incidence change. METHODS: A retrospective descriptive analysis from January, 1988 to December, 1997 was carried out. RESULTS: There were 28 cases of emergency cesarean hysterectomy identified during this period among total 24, 689 deliveries. The annual incidence of emergency cesarean hysterectomy was significantly declined statistically(p<0.005). Cesarean hysterectomy was performed in 20 of 6, 671 cesarean section(0.30%) and in 8 of 18, 018 vaginal deliveries(0.04%), so more frequently after cesarean section than vaginal delivery. The cesarean hysterectomy rate was more frequent in multiparous women(0, 22%) than in nulliparous women(0, 02%). The most common indication of cesarean hysterectomy was 13 cases of uterine atony(46%), followed by 5 cases uterine rupture(18%), 5 cases of placenta previa with placenta accreta(18%), 3 cases of placenta previa(11%), 2 cases of uterine myoma(7%). No significant difference in length of operating time, amount of blood loss and operative complications were found between total abdominal hysterectomy and subtotal hysterectomy. The all patient who had cesarean hysterectomy recieved from 1200ml to 15840ml of blood transfusion with a mean of 3673ml. In aspect of fetal outcome, 3 cases of FDIU(Fetal death in utero) in uterine rupture and 1 case of stillbirth in preterm were found. The maternal complications were wound disruption, DIC, wound hematoma, ureter injury, vaginal stump bleeding, UTI(Urinary tract infection) and retroperitoneal bleeding, CONCLUSION: We conclude that the incidence of emergency cesarean hysterectomy declined with prediction of antenatal risk factor, preparing of sufficient fresh blood, prophylactic antibiotics, vigorous uterotonics and close observation after delivery.
Anti-Bacterial Agents ; Blood Transfusion ; Cesarean Section ; Dacarbazine ; Emergencies* ; Female ; Hematoma ; Hemorrhage ; Humans ; Hysterectomy* ; Incidence ; Peripartum Period* ; Placenta ; Placenta Previa ; Pregnancy ; Retrospective Studies ; Risk Factors ; Stillbirth ; Ureter ; Uterine Rupture ; Wounds and Injuries

No abstract available.
Adenocarcinoma, Mucinous* ; Child* ; Colon* ; Humans ; Mucins*

Changes of power spectrum of R-R interval variabilty during recovery from N2O-O2 - halothane anesthesia have been studied in 20 patients. Power spectral analysis of R-R intervals during awake period and recovery period have been performed with newly developed R-R interval variability, we compared the power of each frequency range(low: 0.04-0.08 Hz, middle 0.10-0.15 Hz, high: above 0.3 Hz) between awake period and recovery period. There was no difference between awake period and recovery period in the power of low and high frequency ranges, but there was remarkable difference in power of midfrequency range. During awake period the power of midfrequency range changed with cyclic pattern, but there was no cyclic change during recovery period even after the regain of consciounss(30+/-3.2 min.). The power of midfrequency range during recovery period began to change with cyclic pattern only after 45 minutes. It is concluded that the power of midfrequency range is useful index of recovery from N2O-O2 -halothane anesthesia.
Anesthesia* ; Halothane ; Humans

Analysis of R-R interal variability is a useful method of obtaining many information about cardiovascular control mechanisms. Among the many methods of analyzing R-R variability, power spectral analysis(PSA) is said to be the most powerful and acurate tool. Although application of computer techniques in analysing R-R interval variability were introduced, as most of the studies on the R-R interval variability have been off-line and invasively, they were not suitable for practical use. So we prepared a program for non-invasive on-line perioperative assessment of R-R interval variability. We used Turbo C++(ver 1.0, Borland International, USA) and Turbo Assembler(ver 2.0, Borland International, USA) for programing. Data were collected by A/D converter(PCL 718,, Taiwan) by interrupt mode and transferred to TBM386 compatibie computer with VGA color monitor. By applying PSA to R-R interval variation, we can get an almost as confident information about the cardiovascular system as analysis of arterial waveform, In addition to this we can get data that requires very reduced momory size, and get them non-invasively. So analysing R- R interval variability may be the most suitable method for on-line continuous assessment of cardiac parameters.
Cardiovascular System

OBJECTIVE: To evaluate the role of C-reactive protein and fetal fibronectin for patients with preterm labor and intact mxmbranes. STUDY DESIGN: The study group was comprised of sixty patients who presented to the Taegu Fatima Hospital between 24-36 gestational weeks who had a diagnosis of preterm labor. The study group underwent assay of C-reactive protein in the matemal serum, and fetal fibronectin from the external os and posterior fomix of the vagina by means of polyester fiber swabs. The study group was categorized to four groups according to the results of CRP and fetal fibronectin, that is 28 cases of CRP(-)/fetal fibronectin(-); group I, 12 cases of CRP(+)/fetal fibronectin (-); groupII, 9 cases of CRP(-)/fetal fibronectin(+); groupIII, 11 cases of CRP(+)/fetal fibronectin(+): grouplV, and the controls were 12 women without preterm labor. Outcome measures were occurrence of preterm delivery, the admission-to-delivery interval, matemal age and parity, fetal body weight, 1min/5min Apgar score, perinatal morbidity and mortality etc. Statistical analyses were performed by means of ANOVA test and Dunnett's t-test. RESULTS: The prevalence of study group were group I 46.7%, group II 20%, group III 15% and group IV 18.3%. There were no significant difference of matemal age, parity and gestational weeks at admission between study group and control group, but in all study group the admission to delivery interval was significantly shorter than that of control group. Analysis indicated also no significant difference of maternal hemoglobin between study group and conuol group but white blood cell count of group II and IV were significantly higher than that of control group. In perinatal outcomes, the mean birth weight and 1 minute Apgar score of study group except group I were significantly lower than those of control group but 5minutes Apgar score was lower only in group IV compared with control group. Perinatal morbidity and mortality of study group were higher than those of control group except group I. This study group was designed to compare the diagnostic performance of cervical fibronectin and of the serum CRP levels. The sensitivity and specificity of fetal fibronectin as a test to predict of preterm labor were 80% and 90%, which were slightly higher than those of CRP(70%, 78%). CONCLUSION: Both positive cervicovaginal fetal fibronectin and positive C-reactive protein in women with preterm uterine contraction can help identify the pregnancies at risk and to select proper management protocol.
Apgar Score ; Birth Weight ; C-Reactive Protein ; Daegu ; Diagnosis ; Female ; Fetal Weight ; Fibronectins ; Humans ; Leukocyte Count ; Membranes* ; Mortality ; Obstetric Labor, Premature* ; Outcome Assessment (Health Care) ; Parity ; Polyesters ; Pregnancy ; Prevalence ; Sensitivity and Specificity ; Uterine Contraction ; Vagina

No abstract available.
Dislocations* ; Tendons*

Purpose: A giant macular hole with retinal detachment occurred in a patient who had undergone several surgical treatments for retinal detachment, macular hole, and complicated cataracts. Here we report a case of successful retinal attachment and macular hole closure for this patient after autologous retinal flap transplantation.Case summary: Recently, an 18-year-old female presented with a newly developed visual field disturbance in her left eye. She had been on medication for severe atopic dermatitis in the past and seven years ago underwent scleral buckling, pars plana vitrectomy, and complicated cataract surgery due to rhegmatogenous retinal detachment of the left eye. Five years ago, extensive internal limiting membrane peeling, intravitreal gas tamponade, and aftercataract removal were performed due to the development of a macular hole with retinal detachment of the left eye. Thereafter, although the retina was reattached, closure of the macular hole was not successful. Recently, a giant macular hole with a retinal detachment was detected in this patient accompanied by symptoms of visual disturbance. Autologous retinal flap transplantation and intravitreal silicone oil tamponade were performed. Two months after the operation, she underwent silicone oil removal. Successful closure of the macular hole and retinal reattachment were confirmed. Conclusions In a patient with a refractory giant macular hole with retinal detachment, the closure of the hole and retinal reattachment were successfully achieved after retinal flap transplantation, without viscoelastics or perfluorocarbon liquid.

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

No abstract available.
Granuloma* ; Intubation*