No abstract available.
Ambulatory Care Facilities* ; Humans ; Outpatients* ; Pharynx*

The maternal and neonatal effects of 50% O2 -50% N2O alone and 50r% O2-5O% N2O combined with 0.5% halothane or 1% enflurane were studied in 37 parturients undergoing general anesthesia for cesarean section, All patients received thiopental and succinrlcholine for induction and were intubated and ventilated with a tidal volume of 10m1/kg and a rate of 107 breaths/min. ulltil the delivery. Two of 11(18%) patients given O2-N2O alone had recall; none in those patients receiving a potent inhalation agent had any recall. Blood loss was similar in 7tle two groups. There were no statistically significant differences between groups in induction-7odeliverr and uterine incision-t7-delivery intervals, the frequen-cies of Apgar score<7 at and 5 min., maternal and fetal blood 7as tensions, and acid-base balance. 1t is concluded that analgesic concentrations of halothane and enflurane can be safely added to 50% O2-5O% N2O to prevent maternal awareness during general anesthesia for cesarean section while maintaining normal maternal and neonatal conditions.
Acid-Base Equilibrium ; Anesthesia, General ; Cesarean Section* ; Enflurane* ; Female ; Fetal Blood ; Halothane* ; Humans ; Inhalation ; Pregnancy ; Thiopental ; Tidal Volume

The antinuclear antbody (ANA) test have been used to screen the patients with systemic lupus erythematosus (SLE) and other autoimmune diseases. We had retrospectively reviewed the 263 records of pediatric patients with doing ANA tests who admitted at Department of Pediatrics, Kyung Hee University Hospital, from January 1988 to May 1993. The following results were obtained. 1) The positive rate of ANA test in patients with connective tissue diseases is 16 out of 40(40%).In patients with SLE, the positive rate of ANA test is 9 out of 11 (82%). 2) The positive predictivity for SLE is 9 out 36 (25%). 3) The positive predictivity for connective tissue disease and possible immune disease is 28 out of 36 (78%). 4) The false positive rate is 8 0ut of 36 (22%), Thus, the pediatric patients with positive ANA test should be applicable for diagnosis with prudence. 5) The positive anti-dsDNA in patients with the positive ANA is shown in 4 cases and these patients are all SLE. In conclusion, the patients who had repeated positive ANA should be tested Anti-dsDNA antibody, and further clinical and diagnostic evaluation of other ANA associated diseases.
Autoimmune Diseases ; Connective Tissue Diseases ; Diagnosis ; Humans ; Immune System Diseases ; Lupus Erythematosus, Systemic ; Pediatrics ; Retrospective Studies

Nonsystemic vasculitic neuropathy (NSVN) is a localized vasculitis confined to the peripheral nerves. Absence of systemic manifestations frequently leads to mis- or under diagnosis without the aid of pathologic study. NSVN may present typically with multiple mononeuropathies or less commonly with a sensorimotor polyneuropathy. We report two cases of NSVN presenting with acute severe painful neuropathy. Sural nerve pathology showed unequivocal vasculitis. High dose corticosteroid therapy was effective in controlling the pain. NSVN should be considered as a treatable cause of acute painful neuropathy.
Acute Pain* ; Diagnosis ; Mononeuropathies ; Pathology ; Peripheral Nerves ; Polyneuropathies ; Sural Nerve ; Vasculitis

PURPOSE: To compare clinical and radiological results between standard insertion method and semiextended method which was designed to improve proximal fixation and alignment in proximal tibia fracture. MATERIALS AND METHODS: A retrospective review from May 2000 to February 2004, identified 24 extraarticular fractures in proximal tibia, initially treated with locked intramedullary nails at least 1 year follow up. There were 12 open injuries, 4 segmental, 3 butterfly fragments and 17 comminuted. Semiextended method was used in 10 fratures and standard insertion method which is cephalad to tibial tubercle in 14. Follow up clinical assessment consisted of review of associated injuries and complications and these two methods were compared by postoperative angulation and displacement in anteroposterior and lateral radiographs. Data were analysed by t-tests. RESULTS: In semiextended group, average angulation was 2.3 degrees in coronal and 2.8 degrees in sagittal plane and average displacement was 4.5 mm in coronal and 5.3 mm in sagittal. In ordinary group, average angulation was 5.1 degrees in coronal and 7.4 degrees in sagittal plane and average displacement was 6.1 mm in coronal and 5.3 mm in sagittal. In semiextended group, there were significant reduction in coronal angulation (p=0.006) and sagittal angulation (p=0.001), but there was no significant difference in coronal (p=0.344) and sagittal (p=0.99) displacement. Both groups showed anterior, valgus angulation and posterolateral displacement in most cases. There were 14 associated injuries and one patient developed nonunion and was treated by nail exchange with autogenous bone graft. CONCLUSION: Our retrospective analysis demonstrated that semiextended method is effective for reducing coronal and sagittal angulation, but is not helpful for reducing displacement in both planes.
Butterflies ; Follow-Up Studies ; Fracture Fixation, Intramedullary* ; Humans ; Retrospective Studies ; Tibia ; Tibial Fractures* ; Transplants

No abstract available.
Drug Therapy, Combination* ; Lymphoma, Non-Hodgkin*

No abstract available.
Korea* ; Lymphoma*

No abstract available.
Humans

We report a case of giant malignant gastrointestinal stromal tumor (GIST) accompanying an advanced gastric adenocarcinoma. A 73-year-old male patient was admitted to our hospital due to epigastric discomfort. In gastrofiberscopic examination, a localized Borrmann III gastric cancer at the lower body and antrum was noted. In endoscopic ultrasonographic examination, T3 hyperechoic advanced gastric cancer lesion and a relatively well-marginated heterogenous hypoechoic huge mass with a size of 10 cm were noted. In abdomen CT findings, localized wall thickening in the gastric antrum and the anterior wall, and a 11-cm-sized large heterogeneously enhancing mass in gastric body, posterior wall were noted. We did a radical subtotal gastrectomy, including a huge mass, with D2 lymph node dissection. Pathologic findings revealed double primary gastric neoplasms (synchronous occurrence of an adenocarcinoma and a huge GIST). Although closely juxtaposed, these two tumors had not merged and were separated by the thin rim of the muscularis propria.
Abdomen ; Adenocarcinoma ; Aged ; Gastrectomy ; Gastrointestinal Stromal Tumors* ; Humans ; Lymph Node Excision ; Male ; Pyloric Antrum ; Stomach Neoplasms* ; Stomach*

BACKGROUND : The prognosis for patienys with stage IV gastric cancer is very poor. However, recently, some studies have reported benefits from a gastric resection for metastatic gastric cancer. This clinical study was performed to evaluate the effectiveness of a noncurative gastrectomy in treating stage IV gastric cancer with hepatic metastasis, peritoneal seeding, or distant lymph-node metastasis. METHODS : A retrospective analysis of 114 gastric cancer patients who had undergone a gastric resection, in spite of distant metastasis, between May 1989 and March 1998 at the Department of Surgery, College of Medicine, University of Ulsan, was performed. RESULTS : The average age was 53 years old, and male-to-female ratio was 73 : 41. A total gastrectomy was performed in 48 cases and a distal gastrectomy in 66 cases. Lymph-node dissection was performed to D0, D1, and D2 in 42, 37, and 35 cases, respectively. Postoperative adjuvant chemotherapy was done, mainly by 5-FU and cisplatin. The complication rate was low. The median follow- up was 19 months. The overall average survival times of all patients was 25 months, and the average survival time of patients with hepatic metastasis, peritoneal seeding, and distant lymph-node metastasis, were 28 months, 21 months, and 34 months, respectively. However, there were no statistically significant differences between these survival times. There were six long-term survivors, more than 3 years. The causes of death, in descending order, were renal failure, intestinal obstruction due to peritoneal seeding, hepatic failure due to hepatic metastasis and pneumonia, and sepsis due to lung metastasis. CONCLUSIONS : An aggressive gastric resection for stage IV gastric cancer with hepatic or distant lymph-node metastasis and peritoneal seeding might be useful to lengthen the survival period. A prospective study is needed, especially one with an exact evaluation and analysis of the quality of life.
Cause of Death ; Chemotherapy, Adjuvant ; Cisplatin ; Fluorouracil ; Gastrectomy ; Humans ; Intestinal Obstruction ; Liver Failure ; Lung ; Lymph Nodes* ; Middle Aged ; Neoplasm Metastasis* ; Pneumonia ; Prognosis ; Quality of Life ; Renal Insufficiency ; Retrospective Studies ; Sepsis ; Stomach Neoplasms* ; Survivors ; Ulsan