BACKGROUND: Postintubational sore throat and hoarseness are usually mild symptoms but they are very common complaints among the patients after endotracheal general anesthesia. In addition, some might have severe discomfort and need invasive procedure to relieve these problems. We tried new method of endotracheal tube cuff filling with local anesthetics to reduce postoperative sore throat and hoarseness and evaluated the results. METHODS: Endotracheal cuff filling was done with air 5 ml in healthy 20 patients (ASA I-II, control group). And in another healthy (ASA I-II) 35 patients, the cuffs were filled with 4% lidocaine 3.5 ml and 8.4% sodium bicarbonate 1.5 ml mixture. After 24 hours following general anesthesia, patients were visited and asked whether there were sore throat or hoarseness, if any, how the degree was. RESULTS: In lidocaine-treated group, the incidence of postintubational sore throat was less compared to control group significantly. There was no difference in incidence of hoarseness between two groups. CONCLUSION: Endotracheal cuff filled with lidocaine and sodium bicarbonate mixture is suggested as an effective protective method that reduces the frequency of postintubational sore throat.
Anesthesia* ; Anesthesia, General ; Anesthetics, Local ; Hoarseness* ; Humans ; Incidence ; Lidocaine* ; Pharyngitis* ; Sodium Bicarbonate* ; Sodium*

BACKGROUND: In the cutaneou; neoplasms, especially melanocytic skin lesions, the degree of the nuclear atypia such as the hyp rchromatism, pleomorphism, and giantism is a very impor tant factor when determining the differntial diagnosis between the malignant. and the benign turnors and the prognosis. OBJECTIVE: So we measured and cornpared the nuclear atypia of the malignant melanoma, and acquired and congenital melanocytic nevi(AMN and CMN) using the computerized image analysis (IA). METHODS: Five micron sections were cut from each paraffin block. The sections were Feulgen-stained and image analysis was perforrned with an AIC image analysis system. In each case, 50 lymphocytes nuclei fnim the sarne specimen slide were measured as an internal diploid control. Each 100 cells of the MM, CMN and AMN were measured and are referred to in this report as the upper part and the lower part. The morphological parameters such as mean nuclear area, coefficient of variation(CV) of the nuclear area, roundness of the nucleus and CV of the roundness were measured. For the nuclear content, mean ploidy, CV of the mean ploidy ind 2c Deviation Index(2cI3I) were calculated and then the DNA histograms were produced. RESULTS: Nuclear area, CV of the nuclear area, mean ploidy, CV of the mean ploidy and 2cDI were found to be significantly reat.er for rnalignant melanoma than for CMN and AMN. The nuclear area of AMN is significantly lar ger than that of CMN and there were no significant differences between the uper and the lower parts of three melanocytic lesions in any of the measured parameters. CONCLUSION: The results of o ir study suggest that the IA of the melanocytic cells might reflect the biologic behavior rnore sensitively than do clinical or histologic criteria, therefore important information for differentiating thi benign and the malignant melanocytic lesions may be obtained by the DNA profile and morphomi try on Feulgen stained tissue specirnens using IA.
Diagnosis ; Diploidy ; DNA* ; Lymphocytes ; Melanoma ; Paraffin ; Ploidies* ; Prognosis ; Skin*

PURPOSE: Percutaneous needle aspiration biopsy under the imaging guidance in the diagnosis of intrathoracic diseases has become a standard practice. Core tissue obtained by automated gun biopsy(AGB) is believed to be more diagnostic than materials from fine needle aspiration(FNA) by many cytopathologists. The authors evauated the role of automated gun biopsy in localized pulmonary lesions with respect to the its accuracy and complications. MATERIALS AND METHODS: We performed 107 percutaneous biopsies in localized pulmonary lesions under fluoroscopic guidance among 107 patients:AGB using 18G or 20G was done in 81 patients, and both AGB and FNA was done in 26 patients. RESULTS: Biopsy samples sufficient for histologic diagnosis were obtained in 94(87.9%) of 107 patients, AG8 in 73(90.1%) of 81 patients and AGB and FNA in 21(80.8%) of 26 patients. 11 of 13 negative results were due to inadeguate specimen size for the histologic diagnosis or were composed of necrotic areas, and 2 of 13 negative results were obtained through nontarget tissue. 10 patients developed pneumothorax and 4 of them required chest tube insertion. Minimal hemoptysis was found in 3 patients. CONCLUSION: Percutaneous automated gun biopsy under fluoroscopic guidance was easy and simple method of obtaining specimens of good quality and quantity. It may be an useful procedure in the diagnosis of localized pulmonary lesions.
Biopsy* ; Biopsy, Needle ; Chest Tubes ; Diagnosis ; Hemoptysis ; Humans ; Needles ; Pneumothorax

PURPOSE: Percutaneous needle aspiration biopsy under the imaging guidance in the diagnosis of intrathoracic diseases has become a standard practice. Core tissue obtained by automated gun biopsy(AGB) is believed to be more diagnostic than materials from fine needle aspiration(FNA) by many cytopathologists. The authors evauated the role of automated gun biopsy in localized pulmonary lesions with respect to the its accuracy and complications. MATERIALS AND METHODS: We performed 107 percutaneous biopsies in localized pulmonary lesions under fluoroscopic guidance among 107 patients:AGB using 18G or 20G was done in 81 patients, and both AGB and FNA was done in 26 patients. RESULTS: Biopsy samples sufficient for histologic diagnosis were obtained in 94(87.9%) of 107 patients, AG8 in 73(90.1%) of 81 patients and AGB and FNA in 21(80.8%) of 26 patients. 11 of 13 negative results were due to inadeguate specimen size for the histologic diagnosis or were composed of necrotic areas, and 2 of 13 negative results were obtained through nontarget tissue. 10 patients developed pneumothorax and 4 of them required chest tube insertion. Minimal hemoptysis was found in 3 patients. CONCLUSION: Percutaneous automated gun biopsy under fluoroscopic guidance was easy and simple method of obtaining specimens of good quality and quantity. It may be an useful procedure in the diagnosis of localized pulmonary lesions.
Biopsy* ; Biopsy, Needle ; Chest Tubes ; Diagnosis ; Hemoptysis ; Humans ; Needles ; Pneumothorax

Purpose: To investigate the pattern of Symptom Assessment in Dry Eye (SANDE) questionnaire symptom scores in dry eye disease (DED) patients and to assess the relationships with several dry eye signs. Methods: The medical records of 173 patients with DED were analyzed retrospectively. Each patient’s SANDE score and history of autoimmune disease and ocular surgery were investigated, and Schirmer’s test, tear film breakup time (TBUT), ocular surface staining score (OSS), tear osmolarity, and tear MMP-9 test were assessed. The distribution of SANDE scores and relationships between the SANDE score and various dry eye signs were analyzed. The relationships between the SANDE scores of TBUT (< 5 / ≥ 5) and OSS (< 3 / ≥ 3) subgroups were compared. Results: The average SANDE score was 52.6 ± 28.1. The SANDE scores were significantly higher in OSS ≥ 3 than in OSS < 3 (79.1 ± 21.6 vs. 51.1 ± 27.6, p = 0.030), and TBUT ≥ 5 had marginally significantly lower SANDE scores than TBUT < 5 (47.2 ± 25.6 vs. 55.6 ± 29.0, p = 0.050). TBUT was significantly negatively (R = -0.151, p = 0.024) correlated with the SANDE score, while OSS was marginally significantly positively (R = 0.111, p = 0.073) correlated. As OSS increased, the SANDE scores tended to increase (p for trend = 0.008). Other dry eye signs were not associated with the SANDE score. Conclusions The DED symptom score from the SANDE questionnaire was related to TBUT and OSS, but there was still a discrepancy between the symptoms and signs of DED.

Retrocaval ureter is a congenital venous anomaly, in which the ureter passes behind and is compassed by inferior vena cava. We experienced a case of multiple urothelial cell carcinoma in retrocaval ureter in 68 years old male. He was treated with transurethral resection of bladder tumor and right nephroureterectomy with bladder cuff excision.
Aged ; Carcinoma, Transitional Cell ; Humans ; Male ; Retrocaval Ureter* ; Ureter ; Urinary Bladder ; Urinary Bladder Neoplasms ; Vena Cava, Inferior

OBJECTIVES: We investigated the factors related to the treatment outcome for substance abuse inpatients. METHODS: We reviewed the medical records of 97 patients who were discharged from the substance abuse treatment unit in Seoul National Mental Hospital. We then had follow-up telephone interview with 53 family memebers and/or patients of 97 patients. RESULTS: 1) Among 97 discharged patients, 59 patients were dropped out, 38 patients graduated successfully from the treatment program. The dropout group had shorter treatment period, were more often admitted involuntarily, had greater incidence of violence history and violated ward rules more often(p<.05). The main reasons for dropout were violation of rules(45.3%), escape during outdoor activities(3.7%), and refusal of return to the hospital(15.2%). 2) At the follow-up interview, 32 patients were abstaining from substances whereas 21 patients resumed use. The abuser group and more previous psychiatric admissions, more comorbid psychiatric disorders, and higher percentage of history of suicide attempts than the abstaining group(p<.05). 3) After the discharge from the hospital, 45% of patients showed to discontinue substance. Treatment graduates were more in recovery from substance abuse. The abstaining group had a higher percentage of employment than the abuser group(p<.05). CONCLUSION: The treatment outcome was more likely to be related with co-existing psychiatric problems such as previous psychiatric admission, comorbid psychiatric disorders, and history of suicide attempts. Therefore it is suggested that careful evaluation and appropriate treatment for such factors are needed for better treatment outcome. And psychiatric interview to enhance the motivation of patients is needed for completion of treatment.
Adult* ; Disulfiram ; Employment ; Follow-Up Studies ; Hospitals, Psychiatric ; Humans ; Incidence ; Inpatients ; Interviews as Topic ; Medical Records ; Motivation ; Patient Dropouts ; Seoul ; Substance-Related Disorders ; Suicide ; Treatment Outcome* ; United Nations ; Violence

BACKGROUND: The authors sought to determine whether a shallow needle approach to the axillary artery would improve complete sensory blocks of median, radial, and ulnar nerves as compared with a perpendicular approach when transarterial axillary block is performed using a scalp vein needle (23G, 3/4'). METHODS: Fifty-four patients were allocated equally to a perpendicular group (the PA group) or a shallow approach group (SA group). Sensory and motor scores were evaluated and compared in the two groups at 5-minute intervals for 20 minutes after block. The main outcome variables were rates of blockage of median, radial, and ulnar nerves. RESULTS: Excellent block rates (defined as completion of surgery using brachial plexus block alone) were obtained in both groups (SA group 77.8% vs. PA group 70.3%, P = 0.755). However, the rate of blockage of all three nerves was significantly higher in the SA group (74% vs. 40.7%, P = 0.013). Furthermore, the rate of complete sensory block of the radial nerve at 20 minutes was significantly greater in the SA group (85.2% vs. 59.3%, P = 0.033). CONCLUSIONS: A shallow needle approach to the axillary artery resulted in a significantly higher median, radial, and ulnar nerve block rate at 20 minutes after LA injection than a perpendicular approach.
Axillary Artery* ; Brachial Plexus Block* ; Brachial Plexus* ; Humans ; Needles* ; Radial Nerve ; Scalp ; Ulnar Nerve ; Veins

BACKGROUND: The authors sought to determine whether a shallow needle approach to the axillary artery would improve complete sensory blocks of median, radial, and ulnar nerves as compared with a perpendicular approach when transarterial axillary block is performed using a scalp vein needle (23G, 3/4'). METHODS: Fifty-four patients were allocated equally to a perpendicular group (the PA group) or a shallow approach group (SA group). Sensory and motor scores were evaluated and compared in the two groups at 5-minute intervals for 20 minutes after block. The main outcome variables were rates of blockage of median, radial, and ulnar nerves. RESULTS: Excellent block rates (defined as completion of surgery using brachial plexus block alone) were obtained in both groups (SA group 77.8% vs. PA group 70.3%, P = 0.755). However, the rate of blockage of all three nerves was significantly higher in the SA group (74% vs. 40.7%, P = 0.013). Furthermore, the rate of complete sensory block of the radial nerve at 20 minutes was significantly greater in the SA group (85.2% vs. 59.3%, P = 0.033). CONCLUSIONS: A shallow needle approach to the axillary artery resulted in a significantly higher median, radial, and ulnar nerve block rate at 20 minutes after LA injection than a perpendicular approach.
Axillary Artery* ; Brachial Plexus Block* ; Brachial Plexus* ; Humans ; Needles* ; Radial Nerve ; Scalp ; Ulnar Nerve ; Veins

PURPOSE: This study was performed to investigate whether rebamipide is useful in the treatment of male infertility due to oxidative damage. MATERIALS AND METHODS: 50 infertile males with elevated reactive oxygen species (ROS) in their semen were enrolled. All patients were given an oral daily dose of 900mg rebamipide for at least 3 months. The concentrations of rebamipide and ROS, and the levels of lipid peroxidation, sperm motility, vitality and fertilizing capacity were measured by a high-performance liquid chromatography (HPLC) fluorescent method, chemiluminescence, the thiobarbituric acid method, a computer assisted semen analyzer, eosin-nigrosin staining and hypo-osmotic swelling test, respectively. Additionally, the clinical outcomes, including pregnancy and delivery, were observed at the gynecology outpatient and IVF clinics. RESULTS: The rebamipide concentration in semen after medication was 220.77+/-327.84ng/ml (SD), with a large deviation, but this was higher than the level found in the serum, which was 126+/-76ng/ml (SD). The levels of seminal ROS and lipid peroxidation were significantly decreased according to the duration of treatment (p<0.05). The sperm vitality and fertilizing capacity were also significantly improved at 2-3 months post treatment (p<0.05). Out of the 41 cases with trial pregnancies, 20 (48.8%) became pregnant, consisting of childbirth, miscarriage or ongoing in 17, 2 and 1 case, respectively. Side effects were observed in only 1 case (2%) with self-limits. CONCLUSIONS: These results suggest that rebamipide is an effective free radical scavenger, which may be useful as an oral antioxidant in patients with male infertility due to oxidative damage caused by high tissue affinity to the male accessory organ, antioxidant effect and the improving effect of seminal parameters.
Abortion, Spontaneous ; Antioxidants ; Chromatography, Liquid ; Female ; Gynecology ; Humans ; Infertility, Male ; Lipid Peroxidation ; Luminescence ; Male ; Outpatients ; Oxidative Stress* ; Parturition ; Pregnancy ; Reactive Oxygen Species ; Semen ; Sperm Motility ; Spermatozoa