BACKGROUND: The analgesic properties of the nonsteroidal antiinflammatory drugs (NSAIDs) have been attributed to their effects on the peripheral synthesis of prostaglandins. Although the preoperative use of NSAIDs has been increasing because of concerns regarding the side effects of opioid analgesics but results of clinical preemptive analgesia studies remain inconclusive. So, we studied the efficacy of preemptive analgesic effects of tenoxicam, new NSAID, on postoperative continuous intravenous analgesia with morphine. METHODS: We studied 40 parturients, undergoing cesarean section, ASA class I or II, randomly divided into two groups. Tenoxicam group were injected tenoxicam 0.3 mg/kg and control group were injected normal saline 3 ml at ten min. before induction. For both groups morphine 0.1 mg/kg was administered as loading dose and 0.015 mg/kg/hr as maintenance dose. We examined verbal quantitative score (VQS) at postoperative 30 min, 1, 6, 12, 24 and 48 hr. Maternal satisfaction, side effects, hepatic and renal function also evaluated after pain control. RESULTS: The values of VQS showed no significant differences between two groups 30 min, 1 and 6hr after start of morphine infusion, but there was significant decrease in tenoxicam group compared to control group 12, 24 and 48 hr after start of morphine infusion (p<0.05). There was no significant difference in maternal satisfaction between two groups and also there were no significant differences in the overall incidences of side effects between two groups. CONCLUSIONS: Preoperative single injection of tenoxicam showed incomplete preemptive analgesic effects on postoperative pain control after cesarean section.
Analgesia* ; Analgesics, Opioid ; Anti-Inflammatory Agents, Non-Steroidal ; Cesarean Section* ; Female ; Incidence ; Morphine* ; Pain, Postoperative ; Pregnancy ; Prostaglandins

These days, the epidural administration. of morphine is commonly used for postoperative pain re lief because even small amount of morphine (3mg) is enough to have an effect on specific opiates receptors of the spinal canal. We report a prospective double blind study of the efficacy of a single epidural dose of morphine on pain after spinal decompression. Postoperative pain was assessed by a linear analogue pain score and by the additional require ment for systemic analgesics. The results obtained are as follows:l. In spinal decompression, the adminitration of epidural morphine is easy, effective and safe because the epidural space has been already exposured during operation. 2. After operation the epidural route of morphine administration will give pain relief for up to 12 hours excellently. 3. When epidural morphine is given at the time of operations, the use of systemic analgesics is much reduced. 4. The side effects of epidural morphine are much reduced due to the small amount of morphine required. This simple procedure is recommended as an effective and safe method of reducing postoperative pain.
Analgesia ; Analgesics ; Decompression ; Double-Blind Method ; Epidural Space ; Methods ; Morphine ; Pain, Postoperative ; Prospective Studies ; Spinal Canal

No abstract available.
Estrogens, Conjugated (USP)* ; Heart Failure* ; Humans ; Thyroid Function Tests* ; Thyroid Gland*

We experienced 150 cases of spontaneous intracerebral hematoma which were confirmed by CT scan in Gang Nam Sacred Heart Hospital from November 1980 to October 1982. The analysis is based on 110 patients with primary intracerebral hematoma on whom operation was performed in 44 cases and conservative treatment was done in 66 cases. The CT scan of brain allows the clinical diagnosis of intracerebral hematom, and size, location, extension, ventricular penetration and evolution of hemorrhage are accurately portrayed. The results of the treatment were affected by conscious level, location and volume of hematoma, ventricular penetration and blood pressure. The operative treatment was better than conservative management in followings : 1. semicomatose and drowsy mental state, 2. subcortical hemorrhage, 3. more than 20 cc in volume, 4. progressively deteriorating neurological function and consciousness. We have obtained the best results in operating cases between 4th and 7th day after the stroke.
Blood Pressure ; Brain ; Consciousness ; Diagnosis ; Heart ; Hematoma* ; Hemorrhage ; Humans ; Stroke ; Tomography, X-Ray Computed

We experienced 150 cases of spontaneous intracerebral hematoma which were confirmed by CT scan in Gang Nam Sacred Heart Hospital from November 1980 to October 1982. The analysis is based on 110 patients with primary intracerebral hematoma on whom operation was performed in 44 cases and conservative treatment was done in 66 cases. The CT scan of brain allows the clinical diagnosis of intracerebral hematom, and size, location, extension, ventricular penetration and evolution of hemorrhage are accurately portrayed. The results of the treatment were affected by conscious level, location and volume of hematoma, ventricular penetration and blood pressure. The operative treatment was better than conservative management in followings : 1. semicomatose and drowsy mental state, 2. subcortical hemorrhage, 3. more than 20 cc in volume, 4. progressively deteriorating neurological function and consciousness. We have obtained the best results in operating cases between 4th and 7th day after the stroke.
Blood Pressure ; Brain ; Consciousness ; Diagnosis ; Heart ; Hematoma* ; Hemorrhage ; Humans ; Stroke ; Tomography, X-Ray Computed

BACKGROUND/AIMS: It have been reported that operative mortality and morbidity rate rise significantly when emergency cholecystectomy is performed in critically ill patients with acute cholecystitis(AC), and many studies have also concluded that delayed or interval laparoscopic cholecystectomy(LC) in patients with AC demonstrated high conversion rate and complication rate compared with early LC. However, if the acutely inflamed gallbladder(GB) is decompressed by emergent percutaneous gallbladder drainage(PGBD), it may decrease the technical difficulty of LC allowing successful delayed LC or may decrease the wound complication of delayed open cholecystectomy, when the patient is in better condition. The purpose of this retrospective study was to assess the outcome of delayed cholecystectomy focused on LC following PGBD in patients with AC METHODS: A total of 181 patients with AC were divided into PGBD(n= 66) and non-PGBD group(n= 115), and each group were subdivided into PGBD-delayed LC(after 72 hours of admission, n= 32), PGBD-open cholecystectomy(n= 20), non-PGBD-early LC(within 72 hours of admission, n= 40), non- PGBD-delayed LC(n= 17), non PGBD-open cholecystectomy group(n= 58) and others. PGBD group had higher incidence of comorbidity compared with non-PGBD group. Outcomes of cholecystectomy was assessed by conversion rate and morbidity rate(chi2 test), LC time and hospital stay(median test) for LC, and morbidity for open cholecystectomy in PGBD group compared with those of non PGBD group. RESULTS: PGBD promptly relieved of symptom of AC in 94 % of patients and showed 3 % of technical failure and 4.5 % of complication rate. Compared with non PGBD-early and delayed LC group, the PGBD-delayed LC group showed longer LC time(median 110 min vs 82.5, p < 0.05, vs 95 min), a little lower conversion rate(12.5 % vs 22.5 % vs 17.6 %), similar morbidity rate(19% vs 17.5 % vs 29 %) and prolonged total hospital stay(median 12.5 days vs 7 days, p < 0.001, vs 10 days). In open cholecystectomy series, PGBD group showed lower morbidity rate compared with non PGBD group(5% vs 24 %, p < 0.05) CONCLUSION: Unlike to open cholecystectomy series, PGBD did not significantly improve the outcome of LC for AC as assessed by conversion and morbidity rate and hospital stay compared with non PGBD. Thus we can conclude that although PGBD is a safe and effective emergency procedure for AC, it should be limited to higher risk group such as elderly or critically ill patients and to acalculous cholecystitis.
Acalculous Cholecystitis ; Aged ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cholecystitis, Acute* ; Comorbidity ; Critical Illness ; Drainage* ; Emergencies ; Gallbladder* ; Humans ; Incidence ; Length of Stay ; Mortality ; Retrospective Studies ; Wounds and Injuries

The traumatic false aneurysm of the vertebral artery, as distinct from arteriovenous fistula, is rare condition. The aneurysm of the extracranial vertebral artery is most frequently related to penetrating or perforating injury, such as gunshot or stab injury, and it is not true aneurysm but false aneurysm. We expected a case of false aneurysm in 52 years old man who had taken penetrating neck trauma by sharp steel rod at work. The vertebral angiogram disclosed an aneurysmal shadow and occlusion of the vertebral artery at the level of the axis and successfully treated by clipping of the artery and resection of the aneurysmal mass.
Aneurysm ; Aneurysm, False* ; Arteries ; Arteriovenous Fistula ; Axis, Cervical Vertebra ; Humans ; Middle Aged ; Neck ; Steel ; Vertebral Artery*

Infantile hypertrophic pyloric stenosis (IHPS) a common childhood disorders characterized by nonbilious projectile vomiting, an olive shaped mass in the right upper quadrant of the abdomen and visible gastric peristaltic wave in the upper abdomen. Its etiology and pathogenesis are not clear but abnormal nerve distribution of the pylorus has been postulated2-6. We performed immunocytochemical staning to the pyloric muscle from 10 IHPS and 3 controls patients, utilizing specific monoclonal antibody to NCAM(neural cell adhesion molecule). In IHPS patients, the number of NCAM protein immunoreactive nerve fibers were less than that in normal subjects. Auerbach myenteric plexuse was well developed and interbundle nerve plexuse was present but nerve fibers supplying individual muscle cells in smooth muscle bundles were poorly developed. These results indicate reduction of innervation in smooth muscles in IHPS patients that possibly contributes to the pathogenesis of IHPS.
Abdomen ; Cell Adhesion ; Humans ; Muscle Cells ; Muscle, Smooth ; Myenteric Plexus ; Nerve Fibers ; Neural Cell Adhesion Molecules ; Olea ; Pyloric Stenosis, Hypertrophic* ; Pylorus* ; Vomiting

Sooty blotch and flyspeck (SBFS), a disease caused by a complex of fungi, results in substantial economic losses for commercial growers of sweet persimmon (Diospyros kaki L.) in Korea. However, many species causing SBFS in Korea have not been identified and sources of inoculum are uncertain. Based on mycological characteristics, pathogenicity, and molecular data, the causal fungi were identified as Dissoconium sp. and Zygophiala wisconsinensis. This is the first report of SBFS of sweet persimmon in Korea.
Diospyros ; Fungi ; Korea

Behcet disease is a multisystemic disorder characterized by a chronic relapsing triple symptom complex of recurrent oral ulceration, genital ulceration, and ocular inflammation. The onset of Behcet disease is rare in old age as is whole colon involvement. We recently saw a 78-year-old female patient examined to have intestinal Behcet disease with diffuse colon ulcers. She was admitted due to multiple oral ulcers, genital ulcers, low abdominal pain, and hematochezia. Colonoscopy showed multiple well-demarcated, large, deep, bleeding ulcers from the cecum into the descending colon. The patient was diagnosed with Behcet disease and treated with steroid, colchicine, and mesalazine. This paper describes a case of Behcet disease with unusual intestinal distribution.
Abdominal Pain ; Aged ; Behcet Syndrome ; Cecum ; Colchicine ; Colon ; Colon, Descending ; Colonoscopy ; Female ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Inflammation ; Mesalamine ; Oral Ulcer ; Ulcer