No abstract available.
Common Variable Immunodeficiency* ; Humans

Recently, the bcl-2 and p53 protein have been recognized as important factors that is contributed to programmed cell death. The objective of this study was to evaluate the prognostic significance of bcl-2 and p53 protein expression in uterine cervical carcinoma. The expression of bcl-2 and p53 in 59 cases of uterine cervical carcinoma (stage IB to IIB) were surgically treated from January 1993 to June 1994. The expression of bcl-2 and p53 was examined by immunohistochemical method using formalin fixed paraffin embedded tissue specimens. The 48 cases were squamous cell carcinoma and 11 cases were adenocarcinoma. The results were as follows: 1. The expression rate of bcl-2 protein was 28.8%(17/59) and there was no significant correlaltion between the expression of bcl-2 protein and the clinicopathologic parameters (histologic type, grade, FIGO stage, cervical invasion depth, lymph node metastasis, parametrial invasion, tumor size, neoadjuvant chemotherapy response, recurrence, survival). 2. The expression rate of p53 protein was 32.2%(19/59) and there was no significant correlation between expression of p53 protein and the clinicopathologic parameters. 3. There was significant correlation between and expression of bcl-2 and p53 protein (P 0.05). In conclusion, bcl-2 and p53 protein are thought to be possible factors in the carcinogenesis of uterine cervical carcinoma and correlate with progression of it. But further study will be required to clarify the role of bcl-2 and p53 in carcinogenesis of the uterine cervix.
Adenocarcinoma ; Carcinogenesis ; Carcinoma, Squamous Cell ; Cell Death ; Cervix Uteri ; Drug Therapy ; Female ; Formaldehyde ; Lymph Nodes ; Neoplasm Metastasis ; Paraffin ; Recurrence ; Uterine Cervical Neoplasms*

BACKGROUND: Ondansetron is a specific 5-hydroxytrypamine (HT3) receptor antagonist, sodium channel blocker and mu-opioid receptor agonist. Prophylactic intravenous administration of ondansetron has an antiemetic effect in general and epidural anesthesia. This study is designed to evaluate the antiemetic effect of intravenous ondansetron in patient-controlled epidural analgesia (PCEA) patients. METHODS: Sixty ASA physical status I-II patients undergoing elective cesarean section under epidural anesthesia using 0.75% ropivacaine and fentanyl 50microgram were received intravenous fentanyl 50microgram plus ondansetron 2 mg (group 2 mg: n = 20), 4 mg (group 4 mg: n = 20) or 8 mg (group 8 mg: n = 20) after delivery of baby. PCEA was started using 0.15% ropivacaine and 50microgram/ml butorphanol (total volume: 300 ml, 4 ml of bolus dose, and 10 min of lockout interval). The intraoperative and postoperative incidence and severity of nausea and vomiting were recorded using 4 point scale (0: none, 1: mild, 2: moderate, 3: severe) for postoperative 24 hours. RESULTS: There were no significantly lower incidence and severity of nausea and vomiting in group 8 mg (10%, 5%) than group 2 mg (25%, 10%), and group 4 mg (20%, 10%) during postoperative 24 hours. CONCLUSIONS: Prophylactic intravenous ondansetron 8 mg injection with PCEA drug has no superior antiemitic effect than 2 mg or 4 mg in cesarean section patients under PCEA without significant side effects.
Administration, Intravenous ; Analgesia, Epidural* ; Anesthesia, Epidural ; Antiemetics ; Butorphanol ; Cesarean Section* ; Female ; Fentanyl ; Humans ; Incidence ; Nausea ; Ondansetron* ; Postoperative Nausea and Vomiting* ; Pregnancy ; Sodium Channels ; Vomiting

BACKGROUND: We compared the dose requirement, analgesic effect and side effects of fentanyl with those of meperidine when administered by patient controlled analgesia(PCA) with ketorolac after total abdominal hysterectomy. METHODS: Patients received ketorolac(bolus dose 1.5 mg, lockout interval 10 min) with either fentanyl(bolus dose 5 mcg) or meperidine(bolus dose 5 mg) using PCA pump postoperatively. RESULTS: During 48hrs, patients receiving fentanyl used significantly more drug(51.2 mg of morphine) than those receiving meperidine(25.4 mg of morphine) when results were expressed as morphine(mg) equivalents using the putative potency ratios of 1:10:0.01(morphine:meperidine:fentanyl). There were no significant differences in incidences of side effects, but analgesic effect of fentanyl was superior to that of meperidine at 12 and 48 hours after operation. CONCLUSIONS: Although both fentanyl and meperidine were useful and safe drugs for PCA for postoperative pain control, combinations of meperidine and ketorolac provided more effective analgesia.
Analgesia ; Analgesia, Patient-Controlled* ; Analgesics ; Fentanyl* ; Humans ; Hysterectomy* ; Incidence ; Ketorolac ; Meperidine* ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis

Reviewing the results of the blood cultures performed at Yeungnam University Hospital during 4-year-period through January, 1, 1984 to December 31, 1987, the following results were obtained. 1) Out of 8083 blood specimens cultured microorganisms grew in 582 specimens with positivity rate of 7.20%. Polymicrobial bacteremia was found in 16 patients. 2) Among 582 positive specimens, Gram-positive cocci grew in 189 specimens, and Gram-negative bacilli, in 393 specimens. Clinically significant microorganisms consisted of 82 Staphylococcus aureus, and 20 Streptococcus species in Gram-positive cocci group, 80 Salmonella typhi, 72 Escherichia coli, 72 Salmonella paratyphi A in Enterobacteriaceae, and 46 Pseudomonas cepacia, and 16 Pseudomonas aeruginosa in glucose non-fermenting microorganisms. 3) Increasing incidence of Serratia, Acinetobacter and Pseudomonas species as major nosocomial infection source is noteworthy. They showed increased tendency from 6.3% of 1984 to 17.7% of 1987 of total positive blood cultures. 4) High isolation rate of Pseudomonas species and Aeromonas hydrophila was noted in summer, while Salmonella typhi showed high prevalence from May to September and in January. 5) In susceptibility tests of isolated organisms, staphylococcus aureus was sensitive to basic antimicrobial agents except for ampicillin. The glucose non-fermenting microorganisms showed high resistance to basic antimicrobial agents in 32.2%. In conclusion, considering the relatively higher incidence of growth of Staphylococcus epidermidis than ideal level indicates that sampling technique should be improved. Secondly, all the hospital staffs in cooperation with Hospital Infection Committee are desirable to pay efforts to decrease the nosocomial infection.
Acinetobacter ; Aeromonas hydrophila ; Ampicillin ; Anti-Infective Agents ; Bacteremia ; Burkholderia cepacia ; Cross Infection ; Enterobacteriaceae ; Escherichia coli ; Glucose ; Gram-Positive Cocci ; Humans ; Incidence ; Prevalence ; Pseudomonas ; Pseudomonas aeruginosa ; Salmonella paratyphi A ; Salmonella typhi ; Serratia ; Staphylococcus aureus ; Staphylococcus epidermidis ; Streptococcus

BACKGROUND: Propofol is a drug which has both sedative and anxiolytic properties which when given in IV form can provide a rapid onset of effects. However inter-individual dose requirement can vary widely, making titiration to effect essential. Patient-controlled sedation (PCA), which administers bolus doses of the sedative agent to the point at which the patient is satisfied have been found to be both effective and popular for patients undergoing surgery under loco-regional anethesia. The aim of this study was to compare the effectiveness and quality of target-controlled infusion (TCI) of propofol by the anesthesiologist (anesthesiologist-controlled sedation: ACS) versus PCS to achieve conscious sedation. METHODS: Sixty patients scheduled to undergo spinal anesthesia with 0.5% hyperbaric bupivacaine 12-18 mg or brachial plexus block with 1% lidocaine 40 ml were divided into 2 groups. In the ACS group (n = 30), the initial target concentration of propofol was 1.0 microgram/ml and the target concentration was adjusted in steps of 0.2 microgram/ml to maintain an Observer's Assesment of Alertness/Sedation (OAA/S) score of 3 with a TCI pump. In the PCS group (n = 30), a 20 mg bolus of propofol was delivered at each button without a lockout interval to the point at which a patient was satisfied with the level of sedation. Infusion rate, total dosage, duration of induction and recovery and recall of operative procedure were checked. BIS, EKG, heart rate, noninvasive anterial blood pressure, respiratory rate and SpO2 were recorded during the operation. RESULTS: The mean (range) infusion rate and total infusion dose were not significantly different with each group: ACS 38.5 (13.1-101.0) microgram/ml, 132 (80-241) mg/h and PCS 25.4 (21.3-80.1) microgram/ml, 118 (69-220) mg/h. Duration of induction was significantly extended in the PCS group (5.8 min) as compared with the ACS group (2.9 min)(P < 0.05). The intensity of amnesia related to blood propofol concentration was more improved in the ACS group and inadequate sedation and involuntary movement were occurred more frequently in the PCS group. CONCLUSIONS: PCS with propofol provided more effective sedation, but had more frequent delayedinduction time, inadequate sedation and incomplete amnesia than ACS.
Amnesia ; Anesthesia, Conduction* ; Anesthesia, Spinal ; Blood Pressure ; Brachial Plexus ; Bupivacaine ; Conscious Sedation ; Dyskinesias ; Electrocardiography ; Equidae ; Heart Rate ; Humans ; Lidocaine ; Propofol* ; Respiratory Rate ; Surgical Procedures, Operative

By means of a sensitive radioirnrnunoassay method,ferritin was assessed in the cerebrospinal fluid (CSF) of 50 hospitalized subjects to evaluate its potential value for the diagnosis of tuberculous rneningititis. The rnean ferritin value obtained in the controls was 4.29ng /rnl with ranging between 1.7 and7.4ng/rmL The differences of CSF ferritin content between controls and patients with aseptic rneningitis as well as other non-infectious neurologic disorder were not significant. But rnarked elevation ranging 14 and 88ng/rnl (rnean, 37.4ng/rnl) were observed in patients with tuberculous rneningitis. And the ratio of CSF ferritin to serum ferritin in paients with tuberculous rneningitis was elevated significantly rnore than those in other groups inculuding controls, patients with aseptic rneningitis and other non-infectious neurologic disorder. The level in the serurn and CSF were independent, but that in CSF correlated vrith its total protein content. Results of this study suggest rneasuring CSF ferritin level are a valuable adjunct in differentiating aseptic meningitis from uncomplicated tuberculous meningitis.
Cerebrospinal Fluid ; Diagnosis ; Ferritins* ; Humans ; Meningitis* ; Meningitis, Aseptic ; Nervous System Diseases ; Tuberculosis, Meningeal

BACKGROUND: The technique using target-controlled infusion (TCI) with propofol produces safe intraoperative sedation during regional anesthesia with rapid recovery and high patient satisfaction. The objective of this study was to define the blood propofol concentration necessary for conscious sedation in regional anesthesia patients according to age. METHODS: Sixty patients scheduled to undergo regional anesthesia were allocated into one of three groups according to age, such as group 1 (n = 20): 16 24 yr, group 2 (n = 20): 30 39 yr, group 3 (n = 20): 40 55 yr. Thirty minutes after performing regional anesthesia, TCI of propofol started at a target plasma level of 1 microgram/ml adjusted in steps of 0.2 microgram/ml to maintain a sedation level 3 on a 5-point sedation scale. RESULTS: The mean target concentration was 0.9 microgram/ml (group 1), 0.8 microgram/ml (group 2), 0.7 microgram/ml (group 3). The mean propofol consumption was 38.5 microgram/kg/min (group 1), 34.3 microgram/kg/min (group 2), and 30.8 microgram/kg/min (group 3). The recovery time was significantly delayed in group 3 (2.8 min) compared to group 1 (1.5 min) and group 2 (1.8 min). CONCLUSIONS: TCI of propofol within at 0.7 0.9 microgram/ml blood concentration range produces safe intraoperative sedation during regional anesthesia with rapid induction, rapid recovery and high patient satisfaction without severe complications in 16 55 yr old patients.
Anesthesia, Conduction* ; Conscious Sedation* ; Humans ; Patient Satisfaction ; Plasma ; Propofol*

BACKGROUND: Propofol has been found to be an ideal anesthetic for sedation during regional anesthesia with the advantage of rapid onset of action and recovery. Infusion of propofol by target-controlled infusion (TCI) has been shown to be effective in achieving conscious sedation. The purpose of this study was to define the optimal target concentration of propofol evaluated by bispectral index (BIS) which is necessary for conscious sedation in patients to achieve a local or regional blockade. METHODS: Sixty patients scheduled to undergo local or regional anesthesia were divided into 3 groups. 10 20 min after performing local anesthesia with 2% lidocaine 10 ml (group 1), spinal anesthesia with 0.5% hyperbaric bupivacaine 12 18 mg (group 2) or brachial plexus block with 1% lidocaine 40 ml (group 3), TCI of propofol was started at a target plasma level of 1 microgram/ml and the target concentration was adjusted in steps of 0.2 microgram/ml to maintain a sedation level comparable to an Observer's Assessment of Alertness/Sedation (OAA/S) score of 3. BIS, EKG, heart rate, noninvasive arterial blood pressure, respiratory rate and SpO2 were recorded during the operation. RESULTS: Group 1 had a significantly higher mean (range) target concentration [1.8 (0.9 2.8) microgram/ml] than group 2 [0.9 (0.2 2.4) microgram/ml] and group 3 [1.0 (0.2 2.6) microgram/ml]. A target concentration of 0.9 1.8 microgram/ml of propofol produced BIS 78.2 (group 1), 73.4 (group 2) and 75.4 (group 3). CONCLUSIONS: TCI of propofol with a 0.9 1.8 microgram/ml blood concentration produces safe sedation during locoregional anesthesia without severe complications.
Anesthesia ; Anesthesia, Conduction ; Anesthesia, Local ; Anesthesia, Spinal ; Arterial Pressure ; Brachial Plexus ; Bupivacaine ; Conscious Sedation* ; Electrocardiography ; Heart Rate ; Humans ; Lidocaine ; Plasma ; Propofol* ; Respiratory Rate

BACKGROUND: Desflurane provides satisfactory surgical anesthesia when used alone or in combination with N2O or fentanyl or both. The goals of this study were to determine the effect of alfentanil infusion in the presence of desflurane and nitrous oxide. METHODS: Sixty patients undergoing plastic surgery were anesthetized with desflurane, 50% nitrousoxide, and alfentanil (10mu g/kg loading dose followed by 0.25mu g/kg/min infusion [group 1], 0.25mu g/kg/min infusion [group 2], no infusion [group 3]). The minimum alveolar concentration of desflurane, induction and recovery time, and perioperative side effects according to charge of the alfentanil regimen were checked. RESULTS: Induction and recovery time were shorter in group 1 (20.2 min, 4.5 min) and group 2 (30.0 min, 4.2 min) than group 3 (48.1 min, 7.9 min) (P < 0.05). Minimum alveolar concentration of desflurane was lower in group 1 (3.6 vol%) and group 2 (3.7 vol%) than group 3 (6.7 vol%) (P < 0.05). Incidences of hypotension and bradycardia were significantly higher in group 1 than group 2 or 3 (P < 0.05). CONCLUSIONS: We recommend 0.25mu g/kg infusion without a loading dose of alfentanil combined with 3.7 vol% of desflurane and 50% N2O as the best combination dosage in plastic surgery to shorten the induction and recovery time without significant side effects.
Alfentanil* ; Anesthesia ; Bradycardia ; Fentanyl ; Humans ; Hypotension ; Incidence ; Nitrous Oxide ; Surgery, Plastic