BACKGROUND: The laparoscopy requires carbon dioxide (CO2) insufflation and Trendelenburg position for operational convenience. However, the above circumstances affect the cardiopulmonary systems significantly and intraocular pressure (IOP) may be also influenced. METHODS: In 27 non-glaucoma patients right and left intraocular pressure (RIOP, LIOP) were measured 5 minutes after induction of general anesthesia (control value), 15 and 30 minutes after CO2 insufflation and endelenburg-lithotomy position. RESULTS: The control values of RIOP and LIOP were 11.3 4.7 mmHg and 11.5 4.7 mmHg respectively. At 15 minutes after CO2 insufflation and Trendelenburg-lithotomy position, they increased to 16.6 5.3 mmHg and 17.0 5.9 mmHg (p<0.05). At 30 minutes, 18.4 3.5 mmHg and 18.2 4.1 mmHg (p<0.05). CONCLUSION: CO2 insufflation and Trendelenburg-lithotomy position increase IOP significantly in non-glaucoma patients during laparoscopy.
Anesthesia, General ; Carbon Dioxide ; Head-Down Tilt ; Humans ; Insufflation* ; Intraocular Pressure* ; Laparoscopy*

No abstract available.
Cell Line* ; Gonadotropin-Releasing Hormone* ; Medroxyprogesterone Acetate* ; Medroxyprogesterone* ; Tamoxifen*

We present a case in which a patient with acute hemorrhagic gastritis demonstrated abnormal gastrointestinal accumulation of radiotracer during Tc-99m-methylene diphosphonate (MDP) skeletal scintigraphy. A hemorrhage gastritis was subsequsently demonstrated by endoscopy. The menchanism for the intestinal localization of Tc-99m-MDP in this patient is not clear, but we guess that the extravasated blood containing the radiopharmaceutical cannot recirculate and stays at the bleedings site, so we can see the intestinal activity.
Endoscopy ; Gastritis ; Hemorrhage* ; Humans ; Radionuclide Imaging* ; Technetium Tc 99m Medronate*

LMP (latent membrane protein)-1 protein is one of the Epstein-Barr viral proteins and it is the most crucial one for the transforming activity. It is known to show considerable variation in its nucleic acid sequence and some biologic difference is reported to be associated with the variation. Twenty four cases of the EBV-associated Hodgkin's disease cases were searched for the 30-bp deletion within the C terminal intracytoplasmic domain of LMP-1 oncogene, one of the well-known genetic variation, by PCR and Southern blot using selected sets of primers and probes. The strain of the virus was also determined with PCR. Each case was positive both on LMP-1 immunostaining and in situ hybridization for EBER (Epstein-Barr encoded RNA). Deletion within LMP-1 oncogene was identified in 22 cases (92%), of which 5 cases showed wild form as well as a deleted form of LMP-1 at the same specimens. In seven cases showing the non-deleted form, pure or mixed with a deleted form, the distribution of sex and age was similar to that of the deleted form-only-group, but there was a slight tendency for a higher stage at presentation (4 of the 7 cases presented with stage IV). Those seven cases comprised of 4 cases of nodular sclerosis (NS), 2 cases of mixed cellularity (MC) and a case of lymphocyte depletion subtype while there were 9 and 12 cases of NS and MC among all the examined cases, respectively. Two cases with both a deleted form and the non-deleted form of LMP-1 showed type I and II strain of the virus while all the others contained only type of the. In conclusion, the rate of deletion in LMP-1 oncogene in our series was higher than that reported in western countries and there was a slight tendency for higher stages in cases detecting mixed deleted and non-deleted forms of LMP-1 than in cases a of deleted from of LMP-1.
Blotting, Southern ; Genetic Variation ; Herpesvirus 4, Human ; Hodgkin Disease* ; In Situ Hybridization ; Korea* ; Lymphocyte Depletion ; Membranes ; Oncogenes* ; Polymerase Chain Reaction ; Sclerosis ; Viral Proteins

BACKGROUND & OBJECTIVES: Subacute combined degeneration (SCD) is a disease of spinal cord involving the posterior and lateral column due to vitamin B12 deficiency. The clinical and electrophysiologic findings of SCD are various. METHODS: From 1989 to 1996, 7 patients were diagnosed with SCD in our hospitals. The diagnosis was made by the neurologic and laboratory findings and electrophysiolgic studies such as nerve conduction studies(NCS) and evoked potential(EP). RESULT: Four patients received gastrectomy. Two had chronic atrophic, gastritis; one of them was assumed to have food-cobalamin malabsorrtion. The remaining one was a heavy drinker. The mean duration of neurologic symptoms was 35.7 months. The most common initial complaint was paresthesia (in 4) and impairment of cutaneous sensation was the most common neurologic sign At the time of diagnosis, 5 patients had myelopathy with was supported by EP in 3(60%). There were abnormal NCS findings in 5 f 6 patients with peripheral neuropathy. In one patient, there was no symptom and sign compatible with myelopathy but median nerve SEP showed bilateral central conduction delay. No one had visual symptoms but prolongation of P 100 was detected in 2 patients. Sural nerve biopsy was done in 2 case, which revealed chronic nonspecific neuropatby in one and chronic axonopathy in the other. Megaloblastic anemia was found in 4 cases and improved by cobalamin therapy in all the parents, in which the follow up hematologic data were available. There as a tendency that nonanemic patients had more severe neurologic symptoms than anemic ones. We could not find any relationship between the duration and severity of neurologic menifestations was best in the patients with the shortest duration of neurologic manifestations and hematologic feature festations. CONCLUSIONS: The authors suggest that early detection and treatment is very important for the improvement of symptoms in SCD.
Anemia, Megaloblastic ; Biopsy ; Diagnosis ; Follow-Up Studies ; Gastrectomy ; Gastritis ; Humans ; Median Nerve ; Neural Conduction ; Neurologic Manifestations ; Parents ; Paresthesia ; Peripheral Nervous System Diseases ; Sensation ; Spinal Cord ; Spinal Cord Diseases ; Subacute Combined Degeneration* ; Sural Nerve ; Vitamin B 12 ; Vitamin B 12 Deficiency

No abstract available.
Brain Stem* ; Hepatolenticular Degeneration*

OBJECTIVES: The analysis of heart rate variability (HRV) is a useful non-invasive tool to investigate the autonomic nerve function. Previous studies on the relationship between HRV and depression have been reported controversial results. Similarly, the correlation between the serum lipids and depression is debatable. The purpose of this study is to examine the relationship between heart rate variability, lipid profile and depression. METHODS: A total of 42 patients with major depressive disorder (MDD) and 32 age and sex-matched normal subjects who had no previous history of major medical and mental illnesses were recruited for this study. A structured-interview was used to assess the general characteristics and psychiatric illness. HRV measures were assessed by time-domain and frequency-domain analyses. Psychological symptoms were measured using the Hamilton rating scale for anxiety (HAM-A), Hamilton rating scale for depression (HAM-D). In addition, the evaluation for lipid profile was performed by blood test. RESULTS: In serum lipid profile test, MDD group showed higher cholesterol (197.68+/-42.94 mg/dL vs. 176.85+/-34.68 mg/dL, p=0.044), TG (139.45+/-92.54 mg/dL vs. 91.4+/-65.68 mg/dL, p=0.018), LDL (130.03+/-33.18 vs. 106.62+/-27.08, p=0.004) level than normal control group. In HRV time domain analyses, the standard deviation of the NN interval (SDNN) was decreased in MDD group than normal control group, but was not significant (32.82+/-14.33 ms vs. 40.36+/-21.40ms, p=0.078). ApEn (Approximate Entrophy) was significantly increased in MDD group than normal control group (1.13+/-0.11 vs. 0.91+/-0.18, p<0.001). ApEn was correlated with LDL level (r=0.277, p=0.028), HAM-D scores (r=0.534, p<0.001) and HAM-A scores (r=0.470, p<0.001). CONCLUSION: MDD patients showed increased ApEn, one of the HRV measurement. And this ApEn was correlated with LDL, HAM-D and HAM-A scores. In this study, the analysis of ApEn would be a useful test of MDD.
Anxiety ; Autonomic Pathways ; Cholesterol ; Depression ; Depressive Disorder, Major ; Heart ; Heart Rate ; Humans

CT from fortynine patients with 53 surgical disc explorations were reviewed and correlated with surgicalfindings. The results were as follows: 1. Frequent locations of HNP were in L4–5 (65%) and L5-S1(31%). The mostcommon type of HNP was paramedian type (71%). 2. Focal protrusion of the posterior margin of disc and obliterationof epidural fat pad were observed in all of cases (100%) and other common findings were indentation of epiduralsac in 46 cases(96%) and compression of nerve root sleeve in 33 cases(69%). 3. Cephalad and caudad extension ofproturded soft tissue density in the spinal canal was observed in 15 cases (31%) with variable degree. And morethan 6mm extension were provided to be extruded disc in 9 cases. 4. Vacuum phenomenon was demonstrated in 5cases(10%) and was accompained with bulging annulus. 5. Forty eight herniated nucleus(HNP) were confirmedsurgically in 44 patients. Misinterpretations were made in 4 instances(4 patients); 1 because of lumbar scoliosis,1 because of spondylolisthesis, and the other 2 because of calcified posterior longitudinal ligament and bulgingannulus. One case of true negative examination was central and foraminal stenosis in spinal CT. Thus, sensitivity,specificity and overall accuracy of lumbar spine CT in HNP were 92%, 100% and 92%, respectively.
Adipose Tissue ; Constriction, Pathologic ; Humans ; Longitudinal Ligaments ; Spinal Canal ; Spine ; Spondylolisthesis ; Vacuum

OBJECTIVES: The purpose of this study was to define the underserved emergency medical services (EMS) areas in Daejeon metropolitan city, as well as to identify their distinctive characteristics in public health perspectives. METHODS: An underserved EMS area was operationally defined as an area in which it is difficult to arrive at an emergency medical center within 30 minutes. Using a cost-weighted distance algorithm with a geographic information system (GIS), the underserved EMS area was calculated. The characteristics of the underserved areas were analyzed by the Chi-square test. The SPSS statistical software package was used to perform the statistical analysis. All statistical tests were two-sided, and a p-value<0.05 was considered statistically significant. RESULTS: Twelve administrative sectors ('Dong' in Korean) were included in the underserved areas, accounting for a population of approximately 8,100 citizens. The relationships between underserved EMS area and populations of agriculture, fishery, and forestry; citizens who are recipients of national basic livelihood security program; disabled; or aged 65 or older were statistically significant. CONCLUSION: It was found that 12 administrative sectors were included in the underserved EMS areas. Revealing underserved EMS areas using GIS analysis based on a cost-weighted distance algorithm of road data was an effective analytic method. However, as this study was confined to Daejeon City, South Korea, a nation-wide study should be performed to provide a more accurate conclusion.
Accounting ; Aged ; Agriculture ; Emergencies ; Emergency Medical Services ; Fisheries ; Geographic Information Systems ; Humans ; Public Health ; Republic of Korea

Cimetidine, an H-histamine receptor antagonist, has been advocated to have enhancing effect on delayed type hypersensitivity. However, some recent reports have caused controversial opinion regarding the effect of cimetidine on delayed type hypersensitivity assessed in vivo. In this study the effect of cimetidine at the various periods of contact sersitivity reaction (CSR) to DNCB was assessed in guinea pigs. Three groups of five guinea pigs were sensitized with DNCB in the nuchal region and challenged with DNCB in the back on 16th day after sensitization, Cimetidine, 300mg/3ml/kg, was injected intraperitoneally once a day for the duration of different periods. For the first group, cimetidine was injected during the first 10 days after sensitization to assess its effect on the preparative and recognition phase of the induction period of CSR, For the second group, cimetidine was injected from the 6th to the 16th day to evaluate the enhancing effect of cimetidine on CSR at the period when suppressor T-cells were considered to be active. For the third group, cimetidine was injected for the last 3 days before elicitation test to assess the effect of short term treatment of cimetidine on the established CSR to DNCB. For the elicitation, two different consentrations of DNCB were applied on the three sites along both sides of the spine in the back. Total means of the degree of CSR elicited by DNCB were significanly ircreased by cimetidine in the second and third groups (p<0.05). These enhancing effects of cimetidine on CSR were more prominent at the uppermost back than other sites, eliclted by 0.05% DNCB rather than 0.01% DNCB.
Animals ; Cimetidine* ; Dermatitis, Contact* ; Dinitrochlorobenzene ; Guinea Pigs* ; Guinea* ; Hypersensitivity ; Spine ; T-Lymphocytes