Background: This study was aimed to compare the analgesic effect and side effects of morphine- bupivacaine mixture with those of fentanyl-bupivacaine mixture after Cesarean section. Methods: Eighty patients who were taken continuous epidural catheterization after Cesarean section were divided into two groups. In group 1 (N=40) the mixture of 1% lidocaine 10 ml and morphine 1mg was firstly injected via epidural catheter, and then two day infusor (Baxter(R)) which contained the mixture of 0.15% bupivacaine 100 ml and morphine 6mg was connected to epidural catheter. In group 2 (N=40) the mixture of 1% lidocaine 10 ml and fentanyl 100 mcg was firstly injected via epidural catheter, and then two day infusor (Baxter(R)) which contained the mixture of 0.15% bupivacaine 100 ml and fentanyl 850 mcg was connected to epidural catheter. Mean arterial pressure (MAP) and heart rate (HR) were checked preoperatively, and at post-injection 10, 20, 30 and 60 minutes. The visual analogue scale (VAS) was checked at postoperative 1/2, 1, 6, 12, 24 and 48 hours. The side effects of epidural analgesia were evaluated. Results: In group 2 MAP was significantly decreased at post-injection 20 minute. VAS was significantly increased at post-injection 1/2 and 1 hour in group 1. The most frequent side effect was pruritus in both groups. Conclusions: The first bolus injection of the mixture of 1% lidocaine 10 ml and fentanyl 100 mcg has more rapid analgegic effect than the mixture of 1% lidocaine 10 ml and morphine 2 mg, but because of shorter duration of action of fentanyl it seems to be better to increase the dosage of fentanyl or replace fentanyl by morphine for more effective epidural analgesia after Cesarean section.
Analgesia, Epidural ; Arterial Pressure ; Bupivacaine ; Catheterization ; Catheters ; Cesarean Section* ; Female ; Fentanyl ; Heart Rate ; Humans ; Infusion Pumps ; Lidocaine ; Morphine ; Pregnancy ; Pruritus

No abstract available.
Salivary Glands*

Our experience with recurrent dislocation of the patella on ten knees in eight patients seen at Seoul National University Hospital during the last 2 years and eight months is reported. Five were female and three male. The age ranged from seven to 27 years. In four of the patients the onset was attributable to a definite history of trauma, while in one patient the dislocation was considered due to developmental anomalies and in another it was clearly congenital Still another patient had a progressively short limb due to premature closure of the distal femoral epiphysis with accompanying flexion-valgus deformity of the knee, presumably caused by an unrecognized infection during early childhood One adolescent girl had bilateral knock knees. The knock knees were treated successfully by supracondylar osteotomy and one post-traumatic knee by classical Roux-Goldthwait procedure with equally excellent result, The rest were treated by Greens vastus medialis transfer with division of the iliotibial band or reefing of the medial joint capsule when necessary. In one knee dislocation recurred, probably due to avulsion of the transferred vastus, and two knees had residual subluxation and limitation of flexion. The results on the remaining seven knees were excellent.
Adolescent ; Congenital Abnormalities ; Dislocations ; Epiphyses ; Extremities ; Female ; Genu Valgum ; Humans ; Joint Capsule ; Knee Dislocation ; Knee ; Male ; Osteotomy ; Patella ; Quadriceps Muscle ; Seoul

The incidence of pediatric dermatoses shows a tendency to increase inspite of medical development and environmental improvement. Pediatric dermatoses must be regarded as separate disease entities because child skin differs from adult skin in its structures and functions. Also to be noted are the special, characteristics of the child skin during the growth period. 11,447 childhood patients who had visited the demantologic department of Soon Chun Hyang Hospital, from 1975 to 1980, were analysed. in order to compile the current statistics on the tendencies of pediatric skin dises in Korea. The results are summarized as follows; l. Among the 34, 472 outpatients, 11, 447 were pediatric patients, comprising 33. 2% of the total figure. 2. In order of frequency, the most common dermatoses were atopic dermatitis, contact dermatitis, impetigo contagiosum, molluscum contagiosum, dermatophytosis, scabies, folliculitis, urticaria, varicella and insect bite. 3. The majority of childhood derrnatitis(65.5%) were shown to develop in the preschool age group, with the peak incidence falling in the 0-3 year age group (41.4%) 4. In analysis of the male: female frequency ratio, the dermatoses which showed a greater male frequency ratio were atopic dermatitis, contact dermatitis, impetigo contagiosum, scabies, insect bite, urticaria and miliaria. The dermatoses in which the female ratio was greater were seborrheic dermatitis, acne and hemangioma.
Acne Vulgaris ; Adult ; Chickenpox ; Child ; Dermatitis, Atopic ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Female ; Folliculitis ; Hemangioma ; Humans ; Impetigo ; Incidence ; Insect Bites and Stings ; Korea ; Male ; Miliaria ; Molluscum Contagiosum ; Outpatients ; Scabies ; Skin ; Skin Diseases* ; Statistics as Topic* ; Tinea ; Urticaria

No abstract available.
Dental Enamel* ; Dental Porcelain*

Serum Immunoglobulin (Ig)A, IgG, IgM, levels were measured in 99 coal workers' pneumoconiosis (CWP) patients and 12 healthy coal workers and 9 non-miners to compare with each group by the radiological categories, its complications and working period in coal mine. Serum were measured by nephelometry. The findings were as follows: 1) Serum IgA levels were significantly different between three groups of CWP patient, healthy coal worker and non-miner (mean+/-standard deviation: 226.4+/-87.7, 221.3+/-45.1, 170.1+/-65.7 respectively). 2) There were no significant differences of Ig levels among radiological categories of CWP. 3) There were no significant differences of Ig levels among simple pneumoconiosis and its complicated disorders. 4) The three Ig levels were slightly increased in the group of mining years less than 20 years (IgA: r=0.1869, p<0.10 IgG: r=0.2902, p<0.05 IgM: r=0.2889, p<0.05).
Coal* ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins* ; Mining ; Nephelometry and Turbidimetry ; Pneumoconiosis*

A statistical comparison of pulmonary artery and pulmonary venous wedge pressure has been made by the correlation coefficient method in 24 children with various congenital heart disease. None of them had pulmonary hypertension above the normal range. During the systolic phase, pulmonary arterial pressure was 2.02+/-2.64mmHg greater than pulmonary venous wedge pressure with poor correlation(r=0.57). During the diastolic phase, pulmonary venous wedge pressure was 2.08+/-2.47mmHg greater than pulmonary aetery pressure with poor correlation(r=-.63). Mean pulmonary arterial pressure was 0.79+/-1.02mmHg greater than pulmonary venous wedge pressure with good correlation (r=0.96). Therefore, it is concluded that if pulmonary artery is not entered, a pulmonary vein wedge pressure is a useful indication of pulmonary artery mean pressure in selected cases of congenital heart disease.
Arterial Pressure ; Child ; Heart Defects, Congenital* ; Humans ; Hypertension, Pulmonary ; Pulmonary Artery* ; Pulmonary Veins ; Pulmonary Wedge Pressure* ; Reference Values

Patients with severe congestive heart failure due to rheumatic heart disease generally have both reduced cardiac output and increased pulmonary and systemic venous pressures. A study was therefore made of the use of vasodilator therapy with orally administered hydralazine, which acts on arteriolar resistance vessels and thus reduces afterload. 55 children aged from 4 years old to 15 year old were divided into two groups. Group I received oral hydralazine(4mg/kg/kay in 4 divided doses) in addition to digoxin therapy for mean duration of 10.5 months. Group II received oral digoxin only. The hemodynamic results using M-mode echocardiography, chest X-ray, and EKG between two groups were analyzed. 1) 4(78%) of 55 patients had only mitral valve involvement and another 12 patients had double valve involvement and all the patients belonged to functional class III or IV fo New York heart Association. 2) Left venticular end-diastolic dimensions and the height of R in V6 on EKG were not changed significantly in both groups. 3) Shortening fraction, LPEP/LVET, and RPEP/RVET were markedly improved in both groups, but the degree of improvement in group I was more significant than in group II. 4) 21(80%) of 26 patients in group I showed significant improvement in functional class(t=1.92, 0.05 Adolescent ; Cardiac Output ; Child* ; Child, Preschool ; Digoxin ; Echocardiography ; Electrocardiography ; Estrogens, Conjugated (USP)* ; Heart ; Heart Failure* ; Hemodynamics ; Humans ; Hydralazine ; Mitral Valve ; Rheumatic Heart Disease ; Thorax ; Venous Pressure

Anomalous development of the odonteid precess is an uncommon clinical occurence that can seriously impair the integrity af the atlantoaxial articulation. Absence of the odontoid process may be either congenital or acquired, but clinically the etiology is of little importance as the clinical signs and symptoms and the treatment are identical in both. We experienced a case of congenital absence of the odontoid process and good result was obtained from the posterior atlantoaxial fusion with hale-cast.
Odontoid Process

Of 29 scoliotic patients treated by Harrington and Dwyer instrumentation, fourteen patients were taken of preoperative cnrrection by halo-femoral skeletal traction for the last two years from June 1974 to June 1976 at the Department of Orthopedic Surgery, Seoul National University Hospital. The correctability of scoliosis by the use of halo-femoral traction was evaluated with roentgenogram study and the following result was obtained. 1. Of the 14 cases, five cases were male and eight were female, and they were between the age of 13 and 29. 2. The etiology of the 14 scoliosis was idiopathic in three, paralytic in eight, congenital in one, and associated with neurofibromatosis in two. 3. The average initial curve was 108 degress with the flexibility of 32.1% on side bending. 4. The average preoperative curve with halo-femoral traction for one week was 75. 1 (30.5% correction), and the end of two week was 68 (37% correction). 5. The average immediate postoperative curve was 58.5 (46.5% correction). 6. The result of traction in the different etiologic type showes no significant difference.
Female ; Humans ; Male ; Neurofibromatoses ; Orthopedics ; Pliability ; Scoliosis ; Seoul ; Traction