To assess the effect of postoperative pain control of upper abdominal surgery through lumbar epidural narcotic injection, the 3rd or 4th lumbar epidural puncture was done, and were injected 1 mg of morphine (Group I) or 10 mg of demerol (Group II) mixed with 10 ml of normal saline into the epidural space, after operation of the cholecystectomy in 10 patients and antrectomy and vagotomy, subtotal or total gastrectomy in 10 patients. Time interval of the postoperative analgesic effect between morphine and demerol groups were compared. The results of this study were as follows: 1. In the group I, average analgesic duration was 29.4 hours. 2. In the group II, average analgesic duration was 4.0 hours. It is concluded that postoperative pain control of upper abdominal surgery through the lumbar epidural narcotic injection was effective, and morphine injection was more effective than demerol.
Cholecystectomy ; Epidural Space ; Gastrectomy ; Humans ; Meperidine ; Morphine ; Narcotics* ; Pain, Postoperative ; Punctures ; Vagotomy

OBJECTIVE: The objective of this study is to evaluate the expressions, microvessel counts and angiogenic pathway of VEGF and PD-ECGF and proliferative activity of Ki-67 according to clinicopathologic feature of cervical tumor. METHODS: Two hundred three cervical specimens were evaluated; among these 20 were designated normal epithelium, 36 mild dysplasia, 28 moderate dysplasia, 36 severe dysplasia, 28 carcinoma in situ, 17 microinvasive carcinoma and 38 invasive cervical carcinoma (21 squamous cell carcinoma and 17 adenocarcinoma). Microvessel count was determined by immunohistochemical staining using anti-factor VIII-related monoclonal antibody. The expression of VEGF (vascular endothelial growth factor) and PD-ECGF (platelet-derived endothelial cell growth factor) were evaluated by immunohistochemical staining with anti-human VEGF monoclonal antibody and anti-dThdPase monoclonal antibody. The proliferative activity was examined using a Ki-67 equivalent monoclonal antibody (MIBl). RESULT: There was no statistical significance on microvessel count except invasive cancer comparing with mild dysplasia including normal tissue, but there was a little increase in microvessel counts according to severity of tumor. The intensity of VEGF and PD-ECGF expression was significantly correlated with severity of cervical tumor. And the microvessel density was significantly higher in the positive expression of VEGF and PD-ECGF than in the negative expression. The intensity of PD-ECGF expression in invasive adenocarcinoma was significantly lower in comparison with VEGF expression. The intensity of Ki-67 expression had no correlation with severity of cervical tumor and was significantly higher in moderate and severe dysplasia than in microinvasive and invasive carcinoma. Ki-67 expression had no statistical correlation with VEGF and PD-ECGF. CONCLUSION: The VEGF and PD-ECGF are important angiogenic factors and associated with progression of cervical tumor. The VEGF may be involved in the progressions of squamous cell carcinoma and adenocarcinoma, but the PD-ECGF may not be involved or be minimally involved in the progression of adenocareinoma. There seems to be a different angiogenic pathway pertaining to the histologic difference of cervical cancer. There was no difference of Ki-67 expression according to severity of cervical tumor.
Adenocarcinoma ; Angiogenesis Inducing Agents ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Endothelial Cells ; Epithelium ; Microvessels ; Thymidine Phosphorylase* ; Uterine Cervical Neoplasms ; Vascular Endothelial Growth Factor A*

Vecuronium bromide is a nondepolarizing neuromuscular blocking agent with minimal effect on the autonomic nervous system and little or no histamine release. Some investigators have found that as the dose of vecuronium increased from its ED the onset time is decreased. This study was designed to investigate the influences of a divided dose and single large dose on onset time of vecuronium in 40 ASA physical status l and 2 adult patients. The patients were divided into two groups: Gp. l; Priming dose(0.01 mg/kg) of vecuronium 4 minutes prior to intubating dose(0.14 mg/kg) Gp. 2; Single bolus intubating dose(0.15 mg/kg) of vecuronium followed immediately the induction agent. The results were as follows. l) After the priming dose administration, in the Gp. 2, 13 patients complained of side effcts. 2) The onset time (from the end of injection to l00% depression of the twitch tension) were 172.0+/-23.8 seconds in the Gp. I and 164.0+/-27.5 seconds in the Gp. 2. 3) Clinical duration of blockade (from the end of injection to first return of the second twitch of TOF) was 39,2+/-6.4 minutes in the Gp. l. In conclusion, we recommend the single large dose of vecuronium(0.15 mg/kg) for the endotracheal intubation in whom SCC is contraindicated.
Adult ; Autonomic Nervous System ; Depression ; Histamine Release ; Humans ; Intubation, Intratracheal* ; Neuromuscular Blockade ; Research Personnel ; Vecuronium Bromide*

OBJECTIVES: We studied peritoneal fluid and serum LDH levels to identify patients with ovarian carcinoma and differentiate them from patients with benign ovarian tumor or other gynecological tumors. METHODS: From July 1998 to May 1999, peritoneal fluid and serum LDH, serum CA-125 levels were measured in 95 patients: 11 with ovarian carcinoma, 2 with borderline ovarian tumor, 45 with benign ovarian tumor, 2 with endometrial carcinoma, 21 with CIS, 7 with cervical cancer and 7 with uterine myoma. RESULTS: Peritoneal fluid LDH and serum LDH and CA-125 levels in ovarian cancer patients were significantly higher than those in patients with benign ovarian tumor and other gynecological tumors(p<0.05). Peritoneal fluid LDH demonstrated higher sensitivity(100%) and greater diagnostic efficiency(86%) than serum LDH(73% and 84%, respectively) or serum CA-125.(82% and 83%, respectively) CONCLUSION: Peritoneal fluid LDH, compared to serum LDH and serum CA-125, presented the greatest diagnostic efficiency in discriminating ovarian cancer from benign ovarian tumor and, therefore, it may be efficient as a biochemical marker in diagnosis of ovarian cancer, even in early stages of the disease.
Ascitic Fluid* ; Biomarkers ; Diagnosis ; Endometrial Neoplasms ; Female ; Humans ; Lactic Acid* ; Leiomyoma ; Ovarian Neoplasms* ; Uterine Cervical Neoplasms

No abstract available.
Cesarean Section* ; Female ; Pregnancy

OBJECTIVE: Our purpose was to complete delivery during daytime through rapid and safe management with oral prostaglandin plus oxytocin, and to reduce the duration of induced labor, hospital stay and dispersion of human power. METHODS: Ninety pregnancies requiring induction of labor between December 1998 and July 1999 were analyzed prospectively. Patients were assigned to receive either oral PGE2 or oral PGE1. In one group, labor induction was performed with 0.5 mg of oral PGE2 (group 1, n=46), was orally taken every one hour since 06:00 AM to 09:00 AM and intravenous oxytocin infusion (The beginning dose was 2 mU/min, the dose increased by 2 mU/30 min) beginning at 09:00 AM, and in the other group (group 2, n=44), 100 microgram of PGE1 was orally taken at 11:00 PM the day before oxytocin infusion was commenced at 07:00 AM. If there was uterine contraction of more than 200 Montevideo units, intravenous oxytocin would not be given. RESULTS: The mean time (+/-standard deviation) to active phase labor (cervical dilatation more than 3 cm and uterine contraction more than 200 Montevideo units) with PGE2 group was 335.16+/-157.89 minutes versus 534.16+/-211.79 minutes with PGE1 group (P<0.001). The mean time from active phase to birth was 182.8+/-93 minutes in group 1 versus 236.4+/-88.8 minutes (P<0.001). These significances were due to the difference of time interval from taking prostaglandins to infusion of oxytocin between the two groups. The time zone of expected delivery was 13:28 PM to 15:48 PM and 10:22 AM to 13:18 PM (Confidence Interval 95%). The induction failure rates were 10.87% versus 9.09%. The induction failure rate was significantly different according to Bishop score (if <4, 15.3% versus if >or= 4, 0%) and the cesarean section rate was also (if < 4, 40.7% versus if >or= 4, 19.4%) in the two groups (P<0.05). There were no clinical or statistical differences in demographic data, clinical characteristics, maternal outcomes and complications, and neonatal outcomes. CONCLUSION: Both may be proper methods of inducing delivery during daytime and begun at outpatient office base.
Alprostadil ; Cesarean Section ; Dilatation ; Dinoprostone* ; Female ; Humans ; Labor, Induced ; Length of Stay ; Outpatients ; Oxytocin* ; Parturition ; Pregnancy ; Prospective Studies ; Prostaglandins ; Uterine Contraction

PURPOSE: It is to report the efficacy and safety of an argon laser photocoagulation which was the treatment modality for retinopathy of prematurity. METHODS: From March 1996 to December 1999, on 69 prethreshold retinopathy of prematurity, they were series of observations following periods of two to five days, one week, two weeks, four weeks, three months and one year time respectively. RESULTS: We noticed the regressions in 84 prethreshold retinopathy of prematurity cases as well. CONCLUSIONS: The report emphasized the advantages of the argon laser photocoagulation which reduce the risk from a general anesthesia by applying a topical anesthesia, and the safety of using laser technique of convenience to apply and minimize the tissue damages of the lesions. It also described the preferable consequent results following the early treatment with divided applications on the prethreshold cases.
Anesthesia ; Anesthesia, General ; Argon* ; Light Coagulation ; Ophthalmoscopes* ; Retinopathy of Prematurity*

Isometric tension was recorded in uterine arterial ring preparation contracted by potassium (60 mM) and norepinephrine(1.8 X 10(-7) M). With pretreatment of various concentrations of nifedipine(2.9 x 10(-9) ~2.9 X10(-7) M) and verapamil(2.2 X 10(-7) -2.2 X 10(-5) M), the relaxation was dose-dependent and inhibitory effects of both agents were more marked on the potassium than norepinephrine-evoked contraction. After immersion of the arterial preparation in calcium-free solution, the potassium-evoked contraction was decreased to 21+/-4.1%(mean+/-SEM) of the response in normal Krebs solution and norepinephrine-evoked contraction to 26+/-3.8%. The responses to both agents were completely restored when the calcium concentration was increased to 4.0 mM. Pretreated nifedipine(2.9 x 10(-7) M) in calcium-free solution depressed the potassium-evoked contraction to 7.3+/-1.6% and norepinephrine-evoked contraction to 12+/-3.7%. In addition of calcium(0-4.0mM), the potassium-evoked contraction increased to 30+/-4.6% and that by norepinephrine to 45+/-5.4%. Pretreated verapamil(2.2 X 10(-5) M) in calcium-free solution depressed the potassium-evoked contraction to 14+/-3.6% and norepinephrine-evoked contraction to 18+/-3.3%. In addition of calcium(0-4.0mM), the potassium-evoked contraction increased to 41+/-4.2% and that by norepinephrine to 57+/-4.7%. It was concluded that nifedipine and verapamil relaxed KC1 contracted ring in the presence of external calcium and relaxed norepinephrine contracted ring in both the presence and absence of external calcium. These findings suggest that calcium antagonists interfere with the release of calcium from intracellular sites as well as with the slow inward current of calcium.
Calcium ; Humans* ; Immersion ; Nifedipine* ; Norepinephrine ; Potassium ; Relaxation ; Uterine Artery* ; Verapamil*

OBJECTIVE: To evaluate the clinicopathologic features and clinical outcomes of adnexal tumors in pregnancy. METHODS: After review of charts of 51 patients managed at Kyungpook National University Hospital from January 1996 to June 2002, data including clinical findings, treatments and outcomes were analyzed. RESULTS: The mean age of pregnant women with adnexal tumors was 28.5 years old and the adnexal tumors were more common in nulliparous pregnant women (74.5%) than parous those. There were asymptomatic or no signs in 40 cases (78.4%), lower abdominal pain in 9 cases (17.6%), vaginal bleeding in 1 case (2.0%) and palpable mass by patient herself in 1 case (2.0%). The surgical treatments were performed at first trimester in 9 cases (19.1%), second trimester in 31 cases (66.0%) and third trimester in 7 cases (14.9%). Postoperative histopathologic diagnoses of adnexal tumors were 22 cases (43.1%) of benign cystic teratoma, 7 cases (13.8%) of functional cyst, 6 cases (11.8%) of serous cystadenoma, 4 cases (7.8%) of mucinous cystadenoma, 4 cases (7.8%) of endometrioma, 3 cases (5.9%) of parovarian cyst and 4 cases (7.8%) of malignancy including 2 cases of mucinous cystadenocarcinoma and 2 cases of mucinous tumor, borderline. The complication resulting from adnexal tumors was torsion of 6 cases (11.8%). The outcome of pregnancy was available in 30 cases, term delivery in 25 cases (83.3%), preterm delivery in 3 cases (10%) and spontaneous abortion in 2 cases (6.7%). CONCLUSION: Although the incidence of adnexal tumors with pregnancy is variable according to the reports, the detection rate is more and more increasing due to a widespread application of ultrasound. Thus, obstetricians must always consider adnexal tumors combined with pregnancy and try to minimize the complications of surgery during pregnancy to prevent adverse fetal outcome and maternal morbidity.
Abdominal Pain ; Abortion, Spontaneous ; Cystadenocarcinoma, Mucinous ; Cystadenoma, Mucinous ; Cystadenoma, Serous ; Diagnosis ; Endometriosis ; Female ; Gyeongsangbuk-do ; Humans ; Incidence ; Mucins ; Parovarian Cyst ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Pregnancy* ; Pregnant Women ; Teratoma ; Ultrasonography ; Uterine Hemorrhage

OBJECTIVE: To evaluate the clinicopathologic features and clinical outcomes of adnexal tumors in pregnancy. METHODS: After review of charts of 51 patients managed at Kyungpook National University Hospital from January 1996 to June 2002, data including clinical findings, treatments and outcomes were analyzed. RESULTS: The mean age of pregnant women with adnexal tumors was 28.5 years old and the adnexal tumors were more common in nulliparous pregnant women (74.5%) than parous those. There were asymptomatic or no signs in 40 cases (78.4%), lower abdominal pain in 9 cases (17.6%), vaginal bleeding in 1 case (2.0%) and palpable mass by patient herself in 1 case (2.0%). The surgical treatments were performed at first trimester in 9 cases (19.1%), second trimester in 31 cases (66.0%) and third trimester in 7 cases (14.9%). Postoperative histopathologic diagnoses of adnexal tumors were 22 cases (43.1%) of benign cystic teratoma, 7 cases (13.8%) of functional cyst, 6 cases (11.8%) of serous cystadenoma, 4 cases (7.8%) of mucinous cystadenoma, 4 cases (7.8%) of endometrioma, 3 cases (5.9%) of parovarian cyst and 4 cases (7.8%) of malignancy including 2 cases of mucinous cystadenocarcinoma and 2 cases of mucinous tumor, borderline. The complication resulting from adnexal tumors was torsion of 6 cases (11.8%). The outcome of pregnancy was available in 30 cases, term delivery in 25 cases (83.3%), preterm delivery in 3 cases (10%) and spontaneous abortion in 2 cases (6.7%). CONCLUSION: Although the incidence of adnexal tumors with pregnancy is variable according to the reports, the detection rate is more and more increasing due to a widespread application of ultrasound. Thus, obstetricians must always consider adnexal tumors combined with pregnancy and try to minimize the complications of surgery during pregnancy to prevent adverse fetal outcome and maternal morbidity.
Abdominal Pain ; Abortion, Spontaneous ; Cystadenocarcinoma, Mucinous ; Cystadenoma, Mucinous ; Cystadenoma, Serous ; Diagnosis ; Endometriosis ; Female ; Gyeongsangbuk-do ; Humans ; Incidence ; Mucins ; Parovarian Cyst ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Pregnancy* ; Pregnant Women ; Teratoma ; Ultrasonography ; Uterine Hemorrhage