No abstract available.
Pleasure*

No abstract available.
Fracture Fixation, Intramedullary*

BACKGROUND: Exogenously administered epinephrine under enflurane anesthesia was known to have mild myocardial sensitizing effect. And N2O activates the sympathetic nervous system mildly. We planed this study to confirm cadiovascular effects of clinically administered epinephrine for hemostasis under the enflurane-N2O anesthesia during tonsillectomy. METHODS: Eighty children scheduled to have tonsillectomy were selected randomly and divided into 2 groups as follows; Group E: 1:100,000 epinephrine 2ug/kg and Group EL: 1:100,000 epinephrine containing 1% lidocaine 2 g/kg. Blood pressure, heart rate, and the occurrence of arrhythmia were evaluated before injection, at injection, 1 min, 2 min, 3 min, 5 min and 10 min after injection and 1 min after operation start. RESULTS: In both groups, systolic and diastolic blood pressure and heart rate are increased. But there are no significant statistical differences in each group and between groups. One min after operation, there are significant increases in systolic and diastolic blood pressure and heart rate in both groups (p<0.05), but there is no significant difference between groups. CONCLUSION: Under the enflurane-N2O anesthesia of children, 1:100,000 epinephrine 2ug/kg used for hemostasis could be used comparatively safe without any significant hemodynamic changes. But because there is always the possibility of myocardial sensitization, careful observation is necessary during epinephrine injection under the enflurane-N2O anesthesia.
Anesthesia* ; Arrhythmias, Cardiac ; Blood Pressure ; Child ; Enflurane ; Epinephrine* ; Heart Rate ; Hemodynamics ; Hemostasis* ; Humans ; Lidocaine ; Sympathetic Nervous System ; Tonsillectomy*

No abstract available.
Colon* ; Rectum*

We herein report a case of therapy-resistant dermatomyositis treated with oral prednisolone and chlorambucil combination therapy. Concurrently, she showed cervical carcinoma in situ(CIS). Initially, we started to treat her with combination oral prednisolone, intramuscular methotrexate, hydroxychloroquin, and removal of cervical CIS. However, our patient failed to respond to these regimens. Thus, we had have another combination treatment of oral prednisolone and chlorambucil. After the treatment of this combination regimen, her recalcitrant dermatomyositis improved dramatically without recurrence. There were no significant adverse side effects with chlorambucil therapy.
Chlorambucil* ; Dermatomyositis* ; Humans ; Methotrexate ; Prednisolone ; Recurrence

No abstract available.
Neurilemmoma* ; Stomach*

BACKGROUND: The clinical and histopathological classification of erythema multiforme(EM) and Stevens-Johnson syndrome (SJS) are difficult due to a lack of clear-cut criteria. In recent studies, some authors suggested that erythema multiforme and Stevens-Johnson syndrome were clinically and histopathologically different disorders. OBJECTIVE: The purpose of this study was to review the clinicopathological characteristics of the EM and SJS and to suggest specific findings for differentiating between the two diseases. METHODS: Fifty four patients with EM and SJS diagnosed in the Department of Dermatology of Dong-San Hcepita1 from January 1987 through to December 1996 were studied retrospectively. RESULTS: The results were summarized as follows. l. In view of causal factors, 54 cases were classified as drug-induced (n=22, 41%), herpes-induced (n=16, 30%), tuberculosis (n= 2, 3%), pneumonia (n=l, 2%), unknown (n=13, 24%). 2. Fifty four cases were clinically classified as SJS (n= 29, 54%), EM minor (n=-15, 2S%) and EM major (n = 10, 18%). 3. Erythema multiforme was found to be more related to herpes (13 of 25 cases) than to drugs (3 of 25 cases), while SJS was more related to drugs (19 of 29 cases) than to herpes (3 of 29 cases). 4. Varying degrees of necroti changes of keratinocytes were found in all the cases. The severity of degree or extent of necrosis was higher in patients with SJS than EM. 5. In demial changes, EM showed differences from SJS by having a denser and deeper lymphocytic infiltrate, and increased amount of extravasated erythrocytes. CONCLUSION: Taken together, although our findings could not provide a defmite clue to determine whether EM and SJS are different distinet entities or not, this study may be useful to differentiate and to understand the pathogenesis of EM and SJS. A prospective large scaled study should be conducted to definitively characterize these entities.
Classification ; Dermatology ; Erythema Multiforme* ; Erythema* ; Erythrocytes ; Humans ; Keratinocytes ; Necrosis ; Pneumonia ; Retrospective Studies ; Stevens-Johnson Syndrome ; Tuberculosis

No abstract available.
Abdominal Cavity* ; Abscess* ; Atrial Natriuretic Factor* ; Drainage*

Nocodazole is an anticancer agent, well-known for its antimetastatic activity that acts on microtubules, microfilaments and extracellular matrix proteins. Hela, Hep G2, A549, L929, and NIH/3T3 cell lines were cultivated in alpha-MEM with 3microM or 30microM nocodazole. To investigate the mechanism of nocodazole preventing tumor cell metastasis, the influences of nocodazole on the amounts of glycoprotein, fibronectin, laminin and actin were investigated using PAS staining and PAP technique at light microscopic level. Two designed models ; coverglass and 3-day-old rat heart fragments models, were used in observing the invasiveness of cancer cells. Partitularly the three-dimensional model coculturing cell lines and heart fragment was used in evaluating the migration and/or proliferation or the invasiveness of cell around the fragment, and observed under inverted or bright field light microscope. The amount of glycoprotein of all cell-lines increased in cells of groups treated with nocedazole for 1, 2 and 3 day. The amounts of fibronectin usually increased in cells of groups treated with nocodazole for 1, 2 and 3 day. The amounts of laminin increased in cells of groups treated with nocodazole. The amounts of actin usually increased in cells of groups treated with nocodazole for 1, 2 and 3 days. With the prolonging of nocodazole-treatment time in two dimensional model using coverglass, the cells of control group except Hep G2 cells formed monolayer in cell-free zone according to migration or proliferation of many cells. But only a few cells of experimental groups migrated or proliferated into cell-free zone. In rat heart fragment model the cells of control group showed the invasiveness into the fragment but few or none of the cells from experimental groups attached around the fragment. Taken together, nocodazole increased the synthesis of fibronectin and laminin in cells in place of depolymerizing microtubules. Therefore, the amounts of extracellular matrix proteins in the extracellular space increased. And the increase amounts of actin connected to the extracellular matrix proteins through the integrin of plasma membrane seemed to strengthen cell attachment because of accordance between the orientation of actin and extracellular matrix proteins. Since it is important for cancer cells` metastasis to secrete various enzymes to pass through extracellular matrix proteins, it is expected more difficult for the cells to metastasize into other regions due to the increase of extracellular matrix proteins. As a result of confirmation of antiinvasive actions using two kinds of model, nocodazole seems to be a valuable anti-metastatic agent by supressing the cell motility and consequently, the invasiveness into the fragment. Nocodazole at concentration of 3microM will be probably anticipated antimetastatic activity reflecting that the effects of nocodazole between 3microM and 30microM groups had no differences.
Actin Cytoskeleton ; Actins ; Animals ; Cell Line* ; Cell Membrane ; Cell Movement ; Extracellular Matrix Proteins* ; Extracellular Matrix* ; Extracellular Space ; Fibronectins ; Glycoproteins ; Heart ; Hep G2 Cells ; Laminin ; Microtubules ; Neoplasm Metastasis ; Nocodazole* ; Rats

Numerous operations have been described to treat the recurrent anterior dislocation of the shoulder, but no one procedure was accepted as the choice of operation. We perforemed 6 Bristow procedures and 5 combined Bankart and Putti-Platt procedures and examined six shoulders by arthroscope from sep. 1989 to Sep. 1992, and we analysed the pathologic feature and the results of them. The average follow-up period was 2.2 years. 1. There were 8 males and 3 females and their average age was 33.7 years. The mean age in initial dislocation was 28 years. 2. The number of recurrent dislocation before operation was 17.9 times and the average duration of the disease was 5.7 years. 3. The pathologic lesions observed in intraoperative field were Hill-Sachs lesion (72.7%), Bankart lesion (90.9%), and the erosion of the glenoid rim (54.5%). On arthroscopic examination of 6 cases, Hill-Sachs lesion was found in 4 cases, Bankart lesion was seen in all of 6 cases, and the erosion of the glenoid rim was observed in 4 cases. 4. The average range of the limitation of external rotation was 17.3 and its significant difference was not observed between 2 operative groups. 5. By Rowes rating sheet, 4 cases of 5 combined Bankart and Putti-Platt operations were excellent and 1 case was good. 6. In conclusion, combined Bankart and Putt-Platt operation was considered as a good surgical procedure in the treatment of recurrent anterior dislocation of the shoulder.
Arthroscopes ; Dislocations ; Female ; Follow-Up Studies ; Humans ; Male ; Shoulder