No abstract available.
Duodenum* ; Hematoma*

No abstract available.
Duodenum* ; Hematoma*

The brachial plexus block by interscalene approach is useful for any procedure on upper extremity, including the shoulder. Complications such as high epidural block, total spinal anesthesia, permanent neurologic damage, phrenic nerve block, cardiac arrest, pneumothorax and Horner's syndrome etc. were reported. Ipsilateral Horner' syndrome can be used for confirmation of the accompanying sympathetic block. We experienced a case of 35-year old male patient who developed ipsilateral Horner's syndrome following the injection of 40ml of 1% lidocaine with 1 : 200,000 epinephrine to brachial plexus by interscalene approach. This compication lasted for 10days after interscalene brachial plexus block.
Adult ; Anesthesia, Spinal ; Brachial Plexus* ; Epinephrine ; Heart Arrest ; Horner Syndrome* ; Humans ; Lidocaine ; Male ; Phrenic Nerve ; Pneumothorax ; Shoulder ; Upper Extremity

We examined the expressions of CD44 splice variants (v4/5, v6), alpha-smooth muscle actin, nm23 to evaluate their roles as prognostic factors in 70 cases of uterine cervical carcinoma (stage IB to IIB) who were surgically treated from January 1989 to June 1990 with a clinical follow-up of a minimum of 5 years. The expression was examined by an immunohistochemical method using archival formalin fixed paraffin embedded tissue. In the 70 cases, 61 cases were squamous cell carcinoma and 9 cases were adenocarcinoma. CD44v4/5, CD44v6, alpha-smooth muscle actin, and nm23 were detected in 41.4%, 70%, 100%, and 74.3% of tumor samples, respectively. CD44 splice variants and nm23 showed membrane and cytoplasmic staining of tumor cells, respectively. The expression of alpha-smooth muscle actin showed cytoplasmic staining confined to stromal cells and was classified into three grades by the extent in stromal cells: with less than 10% of stromal cells; 32.9%, 10-50% of stromal cells; 40.0%, more than 50%; 27.1%. These expressions were not correlated with histologic types, lymph node involvement, recurrence, and grades of tumor infiltrating lymphocyte (TIL). But CD44v4/5 had significantly inverse correlation with TIL (p=0.049). The expression of CD44v4/5 was significantly correlated with that of CD44v6 (p=0.05), and that of alpha-smooth muscle actin was inversely correlated with that of nm23 (p=0.049). In conclusion, in FIGO IB-IIB uterine cervical carcinoma CD44 variants, nm23, and SMA show high prevalence, however, with little prognostic significance assessed by recurrence and lymph node metastasis.
Actins* ; Adenocarcinoma ; Carcinoma, Squamous Cell ; Cytoplasm ; Follow-Up Studies ; Formaldehyde ; Lymph Nodes ; Lymphocytes ; Membranes ; Neoplasm Metastasis ; Paraffin ; Prevalence ; Recurrence ; Stromal Cells ; Uterine Cervical Neoplasms*

BACKGROUND: This study examined the efficacy of patient-controlled epidural analgesia (PCEA) for post-cesarean section pain control and compared the suitability of four different volumes of continuous background infusion (CBI). METHODS: Sixty patients were received 0.125% bupivacaine with 5 g/ml fentanyl by PCEA (2 ml of demand dose and 10 minutes of lockout interval) and CBI. Experimental groups were divided four groups according to the volumes of CBI; 1 ml/hr, 2 ml.hr, 3 ml/hr and 4 ml/hr of CBI during 48 hours postoperatively. RESULTS: Total amount of fentanyl and bupivacaine consumption was significantly higher in 1ml/hr of CBI group than 2 ml/hr of CBI group during first 24 hours, and in 4 ml/hr of CBI group than 1 ml/hr and 3 ml/hr of CBI group during second 24 hours. CBI/maximum hourly demand dose was 15~23%. There is no significant difference between the groups in pain score, side effects and patient's satisfaction. CONCLUSIONS: This study suggests that two or three ml/hr of CBI can provide the most effective postoperative analgesia and the optimal ratio of CBI/maximum hourly demand dose is about 20%.
Analgesia ; Analgesia, Epidural* ; Bupivacaine ; Fentanyl ; Humans

No abstract available.
Uterus*

BACKGROUND: Toluene diisocyanate (TDI) is the most prevalent agent to cause occupational asthma (OA) in Korea. The pathogenic mechanism of TDI-induced OA is still unclear. Involvement of both immunological and non-immunologicaI mechanisms have been suggested. OBJECTIVE: To evaluate a possible role of neutrophil in the development of TDI-asthma. OBJECT AND METHOD: Myeloperoxidase (MPO) as a neutrophil activation marker in both serum and induced sputum, and IL-8 in induced sputum were measured. Induced sputa and sera were collected from 15 TDI-induced OA patients (classified to group I) during TDI- bronchoprovocation test and were compared with those from 11 asthmatic subjects with negative TDI-bronchoprovocation test (group II). MPO levels were measured by radioimmunoassay, IL-8 levels, by enzyme linked immunosorbent assay and albumin levels, by nephelometry. Sputum MPO and IL-8 levels were presented as a ratio to albumin. RESULT: Serum MPO level tended to decrease during the TDI-bronchoprovocation test in two groups, but no statistical significance was reached (p>0.05). However, the ratios of MPO (the ratio of MPO level measured at 30 min to MPO level at baseline, and the ratio MPO level measured at 360 min to MPO baseline) in group I were significantly lower than group II (p=0.004, p=0.03 respectively). The IL-8/albumin and MPO/albumin levels in induced sputum from group I were significantly increased after the TDI-bronchprovocation test in comparison to the baseline value which was obtained before the bronchoprovocation test (p=0.0l, p=0.02 respectively). There was a significant correlation between the percent increase of IL-8/albumin and the MPO/albumin in induced sputum (r=0.89, p<0.05). CONCLUSION: These findings suggest a possible involvement of neutrophil in the development of bronchoconstiction after the TDI exposure, and IL-8 might contribute to neutrophil recruitment to airway mucosa. Further investigation will be needed to investigate mechanism of neutrophil activation in the pathogenesis af TDI-induced OA.
Asthma, Occupational* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-8 ; Korea ; Mucous Membrane ; Nephelometry and Turbidimetry ; Neutrophil Activation* ; Neutrophil Infiltration ; Neutrophils* ; Peroxidase ; Radioimmunoassay ; Sputum* ; Toluene 2,4-Diisocyanate

The incidence in women less than 35 years of age is increasing despite an overall decrease in newly diagnosed invasive cervieal cancer among all age groups. However the influence of young age on prognosis remains controversial. So 163 patients of invasive cervical cancer in women aged 35 or less treated from Jan. 1, 1984 to Dec. 31. 1993 at the Department of Obstetrics and Gynecology, Kosin Medical College, Pusan, Korea, were studied retrospectively. We obtained the following results; The 5-year survival rates by clinical stage were 88.7Y% in stage I b, 71.5% in stage IIa, 31.2% in stage IIb and O% in stage III or above. The lymph node metastasis rates by stage in RAH group, were 21.3% in stage I b and 31.8% in stage IIa. The lymph nodc metastasis rates by lesion size in RAH group, were 19.2% in 2cm below, 20.7% in 2-4cm and 40.0% in 4cm above. The 5-year survival rates in RAH group were 74,9% in lymph node positive group and 89.0% in lymph node negative group. The recurrenee rates by clinieal stage were 0% in stage Ia, 20.6% in stage I b, 22.2% in stage IIa, 50.0% in stage Ilb and 90.9% in stage III or above.
Busan ; Female ; Gynecology ; Humans ; Incidence ; Korea ; Lymph Nodes ; Neoplasm Metastasis ; Obstetrics ; Prognosis ; Retrospective Studies ; Survival Rate ; Uterine Cervical Neoplasms*

PURPOSE: We evaluated the effects of amitriptyline in patients with urinary frequency or pelvic pain syndrome and compared with propiverine hydrochloride (BUP-4(R)) and diazepam (Valium(R)). MATERIALS AND METHODS: One-hundred and sixty-eight patients with urinary frequency or pain were included and 38 out of 168 patients were lost to follow up. The patients with interstitial cystitis, UTI and neurogenic bladder were excluded. Amitriptyline group were instructed to take 25mg to 75mg of amitriptyline before bed. Propiverine hy drochloride and diazepam group were instructed to take 20mg, 4-6mg before bed, respectively. The clinical effects and side effects were evaluated after 4 weeks of medication. RESULTS: In the amitriptyline group, 73.1% in 78 patients with frequency, 68.3% in 60 pain, 65.6% in 32 nocturia, 53.8% in 26 weak urinary stream, 53.8% in 13 dysuria, 72.7% in 11 urgency showed symptom improvement. Urinary frequency and pain score were significantly decreased in the amitriptyline group. In the propiverine hydrochloride group, 66.7% in 21 patients with frequency, 38.8% in 18 pain showed symptom improvement. In the diazepam group, 37.5% in 24 patients with frequency, 31.3% in 16 pain showed symptom improvement. Side effects of amitriptyline had appeared in 24 (27.6%) out of 87 patients; 17 cases of dry mouth, 10 drowsiness, 2 agitation, 2 nausea, 1 constipation and 1 skin rash. CONCLUSIONS: Amitriptyline is useful in vague voiding symptoms especially in urinary frequency and chronic pelvic pain syndrome. It is equally effective in both men and women. Side effects are minimal and tolerable. A double-blind placebo-controlled trial is necessary for general acceptance in the future.
Amitriptyline* ; Constipation ; Cystitis, Interstitial ; Diazepam ; Dihydroergotamine ; Dysuria ; Exanthema ; Female ; Humans ; Lost to Follow-Up ; Male ; Mouth ; Nausea ; Nocturia ; Pelvic Pain* ; Rivers ; Sleep Stages ; Urinary Bladder, Neurogenic

No abstract available.
Humans ; Humans*