The purpose of this study is to demonstrate a new postoperative analgesic which minimize the physiological changes of patients. Recently, it has become popular to administer opioids to epidural space rather than intravenously or by intramuscular administration. However, the side effects of opioids have limited the usefulness of this procedure. We tried to find out a way of providing postoperative analgesia while minimizing the side effects of opioids. This study has tested the effects of administering a mixture of small doses of morphine, fentanyl and bupivacaine and epidural morphine alone. The data of this study has taken from 20 paturients who have scheduled for cesarean section. We have classified into two groups which consist of 10 paturients each. We have administered epidural morphine alone to the first group and a small doses of morphine-fentanyl-bupivacaine mixture to second group. We have evaluated analgesic effects by comparing both groups' pain scores of the operative day and of the first postoperative day and evaluated such side effects as the degree of itching, nausea, vomiting, dizziness and respiratory depression by asking to paturients. This study has found the followings: 1) Pain scores of the first group in the operative day and the first postoperative day are 1.2+/-0.4 and 0.4+/-0.5. The second group's pain scores are 0.2+/-0.4 and 0, and the second group's pain scores have significantly reduced (p<0.05). 2) Frequencies of such side effects as itching, nausea and vomiting are higher in the first group (8) than in the second group(4). In conclusion, small doses of morphine-fentanyl-bupivacaine mixture has demonstrated a more effective postoperative analgesia with minimum side effects in pain controlling after cesarean section than epidural morphine alone.
Analgesia* ; Analgesics, Opioid ; Bupivacaine ; Cesarean Section* ; Dizziness ; Epidural Space ; Female ; Fentanyl ; Humans ; Morphine* ; Nausea ; Pregnancy ; Pruritus ; Respiratory Insufficiency ; Vomiting

BACKGROUND: Pelviscopic techniques have rapidly increased in therapeutic procedures as well as diagnostic procedures because of the many benefits associated with much smaller incisions than traditional open techniques. But the deliberate pneumoperitoneum with carbon dioxide during pelviscopic surgery may cause some problems-hypercarbia, pneumomentum, subcutaneous or mediastinal emphysema, pneumothorax, hypoxemia, hypotension, cardiovascular collapse and cardiac dysrhythmia. METHOD: We observed the changes of blood pressure (systolic, mean, diastolic), pulse rate, PaCO2, PaO2, peak inspiratory airway pressure and expired tidal volume at 10 minute after induction of general anesthesia (control value), 30 minutes and 60 minutes after insufflation of CO2 and Trendelenburg position. RESULTS: The blood pressure, PaCO2 and peak inspiratory airway pressure were increased significantly than control values (p<0.05). The changes of pulse rate and expired tidal volume were not statistically significant in comparison to control values. The PaO2 was decreased significantly (p<0.05). CONCLUSION: To minimize the risk of CO2 retension and unstability of cardiovascular system during pelviscopy under the Trendelenburg position, we must monitor the vital signs and the arterial blood gas status continuously and carefully.
Anesthesia, General* ; Anoxia ; Arrhythmias, Cardiac ; Blood Pressure ; Carbon Dioxide ; Cardiovascular System ; Head-Down Tilt* ; Heart Rate ; Hypotension ; Insufflation* ; Mediastinal Emphysema ; Pneumoperitoneum ; Pneumothorax ; Tidal Volume ; Vital Signs

No abstract available.
Body Weight* ; Cholesterol*

No abstract available.
Humans ; Quality of Life* ; Renal Dialysis* ; Renal Insufficiency*

Intraductal variant of peripheral cholangiocarcinoma is extremely rare. This variant shows intraductal growth and intraluminal extension without any infiltrative growth. The mode of intraductal growth is not known. The prognosis of this variant is better than that of usual cholangiocarcinoma. We report three cases, one of which is associated with Clonorchis sinensis (CS) infection. The tumors were entirely confined within the dilated peripheral tributaries of the intrahepatic bile duct. Microscopically, the tumors were well to moderately well differentiated, with a papillary or a micropapillary growth pattern. Focal clear cytoplasmic change and mucin production were noted. The tumors showed intraductal spreading without any invasion to the liver parenchyme. Mucosal hyperplasia and dysplasia were noted in the adjacent ducts. The authors assume that intraductal cholangiocarcinoma is a distinct subtype, and persistent irritation, such as, CS infection may undergo a malignant transformation through mucosal dysplasia.
Bile Ducts, Intrahepatic ; Cholangiocarcinoma* ; Clonorchis sinensis ; Cytoplasm ; Hyperplasia ; Liver* ; Mucins ; Prognosis

No abstract available.
Child* ; Gastritis* ; Humans

PURPOSE: The purpose of this study was to compare the antioxidant level, serum cholesterol and skin beta-carotene, of female elderly who had been living more then 10 months in institutions which offered either vegetarian or nonvegetarian diet. METHODS: Total of 110 female elderly, 56 from institution serving vegetarian diet and 54 from nonvegetarian diet, were recruited from institutions located in S and N city in Korea. beta-carotene level was measured on their palm using Pharmanex Biophotonic Scanner and annual health evaluation data was utilized for the analysis of serum cholesterol. RESULTS: The subjects on a vegetarian diet had a significantly higher level of phosphorus, carotene, and folic acid. The elderly who were living in an institution offering a vegetarian diet had a lower level of serum cholesterol and higher level of skin beta-carotene, compared to those living in an institution offering a non-vegetarian diet. CONCLUSION: This study reveals that a vegetarian diet is beneficial in increasing skin beta-carotene level, decreasing serum total cholesterol level. The skin beta-carotene measurement appear valuable as a bio-marker of antioxidant intake. Further study on antioxidant food and effective serving strategy for elderly are recommended.
Aged ; beta Carotene ; Carotenoids ; Cholesterol ; Diet ; Diet, Vegetarian ; Female ; Folic Acid ; Humans ; Korea ; Phosphorus ; Skin

The purpose of this study was to investigate weight control attempts and related factors among 209 middle school female students in Daejeon. Variables examined were body satisfaction, beliefs regarding weight control, body image, nutrition knowledge, nutritional attitudes, dietary behavior and dietary intake. A cross-sectional survey was employed, and data was analyzed using t-test and chi-square teat (at alpha=0.05). The average height, weight, and body fat (%) of subjects were 160.2 cm, 52.4 kg, and 25.9%, respectively. Those who attempted weight control were 61.7% of the samples, suggesting that weight control was quite popular among adolescents. Students in the weight control attempt group were more satisfied with their body size (p<0.001), and showed more distorted body image than those in the no weight control attempt group (p<0.001). Most of beliefs regarding weight control were also different in the two groups. The attempt group believed more strongly in the advantages of weight control, and believed less strongly in the harmful effects or difficulties associated with weight control. Although there were no differences in nutrition knowledge in the two groups, nutritional attitudes were slightly more favorable in the attempt group (p<0.01). In contrast, eating behaviors, such as those related to caloric intake (p<0.001), body image (p<0.001), and specific situations (p<0.01) were more desirable in the no-attempt group than in the attempt group. In addition, dietary intake of the attempt group was less adequate than that of the no-attempt group for nutrients such as iron (p<0.01), vitamin A, thiamin, riboflavin, and vitamin C(p<0.05). This study suggests that adolescents who attempt control weight have a more distorted body image and inadequate diet and showed more undesirable eating behaviors. Students should be taught and practice desirable methods of weight control. Educational programs should also include strategies for changing beliefs regarding weight control, as well as modifying diets and eating behaviors.
Adipose Tissue ; Adolescent ; Body Image ; Body Size ; Cross-Sectional Studies ; Diet ; Energy Intake ; Feeding Behavior ; Female* ; Humans ; Iron ; Riboflavin ; Vitamin A ; Vitamins

A case of extrapulmonary silicosis involving abdominal lymph nodes in a 62-year-old man is presented. The patient underwent subtotal gastrectomy and regional lymph nodes dissection for gastric adenocarcinoma of clinical stage III. On gross examination, two separate gastric adenocarcinomas and multiple enlarged lymph nodes mimicking metastatic lesion were noted. Microscopic examination of the enlaged lymph nodes revealed characteristic sclerohyaline silicotic nodules without metastatic adenocarcinoma. Chest roentgenogram showed diffusely scattered multiple tiny nodular lesions in the entire lung fields, particularly the posterior side of both upper lung fields. He had worked in a mine for 18 years and had been exposed to silica for 5 of those years. We report incidentally found, unusual case of extrapulmonary silicosis.
Adenocarcinoma ; Gastrectomy ; Humans ; Lung ; Lymph Nodes ; Middle Aged ; Silicon Dioxide ; Silicosis* ; Thorax

Diabetes mellitus is the prevalent disease among older adults. The purpose of this study was to implement and evaluate the nutrition education program for diabetes mellitus patients aged 60 and over. The one group pretest and posttest design was employed to evaluate the program effectiveness. Nutrition education program for diabetes mellitus patients was carried out at the public healthy center in Guri city. The 38 out of 63 patients completed education program. They received four sessions of group education during four weeks. Nutrition education materials (booklet, leaflet) for older adults were provided to participants. Data about blood glucose, blood pressure, nutrition and diabetes mellitus knowledge, dietary behavior, dietary intake by 24-hour recalls were collected before and after nutrition education to evaluate the program effectiveness. All data were statistically analyzed using SAS package (ver.8.2) and significant difference was evaluated by chi-square-test, paired t-test and Wilcoxon signed rank test. Study results showed that blood pressure and blood glucose were slightly decreased after nutrition education but they did not reach statistical significance. There were positive changes in nutrition knowledge and dietary behavior. The total score of nutrition and diabetes knowledge increased significantly (p < 0.001), and the total score of dietary behavior was improved (p < 0.05) after nutrition education. Dietary intakes of most of nutrients examined were not significantly different between preand post-test. Based on study results, it appears that nutrition education program for the aged diabetes mellitus patients might effectively increase nutrition knowledge, dietary behavior and diet quality. This nutrition education program can be used at the public health centers or senior centers for the management of diabetes mellitus for older adults.
Adult ; Aged ; Blood Glucose ; Blood Pressure ; Diabetes Mellitus ; Diet ; Humans ; Phenothiazines ; Program Evaluation ; Public Health