BACKGROUND: Various kinds of methods had been tried to reduce pain on injection of propofol. In this study, the effect of lidocaine pretreatment and that of temperature controlled injections were compared and evaluated its clinical utility. METHODS: One hundred and twenty patients were randomly allocated into 4 groups after permission. Room temperature propofol was used as induction agent in group P,. In group C, cooling (4 degrees C) propofol was used and warming propofol (37 degrees C) in group H. And room temperature propofol following lidocaine (1 mg/kg) was used in group L. Injection dosage of propofol was 2 mg/kg and injection speed was 2 ml/sec in all groups. In each patients, pain score and visual analog scale were measured and tested by ANOVA or Kruskal-Wallis test. RESULTS: There were no statistical significant difference in pain score among the 4 groups. But in visual analog scale analysis, group L markedly reduced values than the other groups by statistically significant manner (in Duncan grouping). CONCLUSION: The alleviating effect of lidocaine pretreatment on painful injection was better than that of changing temperature of propofol itself. More over effectiveness, in view of simplicity, we recommend lidocaine pretreatment.
Humans ; Lidocaine ; Propofol* ; Visual Analog Scale

No abstract available.
Hydronephrosis*

No abstract available.
Amniotic Fluid* ; Female ; Humans ; Infant* ; Prospective Studies*

Management of the small lower ureteral stone has been attempted by either transurethral manipulation or expectant therapy. To date, however, the choice of proper method has depended mostly on clinician's preference, and the effectiveness of the transurethral stone manipulation has remained controversial. Herein we evaluated the effectiveness of the transurethral stone manipulation, using with the Dormia dislodger, in 37 patients with lower ureteral stone less than 10mm in greatest diameter. The results are summarized as follows. 1. The overall success rate was 68% (25 of 37 patients); Immediate delivery of the stone was observed in 16 of 37 patients. In another 5 patients the stone was removed at the time when the indwelled ureteral catheter was taken out. In the remaining 4 patients the stone passed spontaneously within a week following the procedure. 2. Higher success rate was observed in smaller stone; 79% in less than 4 mm, 58% in 46 mm, and 33% in 610 mm in it's greatest diameter, respectively. 3. The morbidity rate was 8.1% (3 of 37 patients); In one patient a broken basket was retained in the ureter, which was removed at the time of ureterolithotomy. In another patient a ureteral stricture requiring periodic dilation was complicated. And in the other patient persistent hematuria was observed, which was relieved by conservative management. These results suggest that transurethral manipulation might have to be initially applied to unremittingly painful patients with small lower ureteral stone.
Constriction, Pathologic ; Hematuria ; Humans ; Methods ; Ureter* ; Urinary Catheters

No abstract available.
Urinary Tract Infections* ; Urinary Tract*

No abstract available.
Fever* ; Humans ; Infant, Newborn*

BACKGROUND: The pathogenesis of atopic dermatitis is still unknown, but house dust mites are thought to be playing an impor tant role in the development of skin lesions. Atopic dermatitis shows an immediate react,ion to mite allergens in skin prick test, postive IgE-FAST for mite antigens, and higer serum levels of mite-specific IgG4, IgE and IgE immune complexes. This immediate antigen-IgE-initiated reaction, however, is not clinically and histologically relevant to typical skin lesion, eczematization. OBJECTIVE: We tried to show that atopic skin lesions can clinically be induced by the type 1V hypersensitivity to house dust mites and evaluate the histological features of the eczematous skin lesions. METHODS: We investigated patch test reaction to Dermatophagoides farinae and the changes of expression of intercellular adhesion molecule 1(ICAM 1), vascular cellular adhesion molecule 1(VCAM 1), and E selectin on vascular endothelial cells in skin biopsies obtained from positive patch sites. RESULTS: Positive rate is 41%. The patch test has a good correlation with asthma predisposition. In the positive reaction sites, the expression of ICAM 1 is markedly increased, and those of VCAM 1 and E selectin are induced on the vascular endothelial cells. CONCLUSION: D. farinae patch testing represents a diagnostic method besides prick testing in mite induced eczematous dermatitis but better standardization is necessary. D. farinae can activate the endothelial cells and enhance the expression of adhesion molecules, so allergic contact sensitivity to mite allergen is playing an important role in the pathogenesis of atopic dermatitis.
Allergens ; Antigen-Antibody Complex ; Asthma ; Biopsy ; Cell Adhesion Molecules* ; Cell Adhesion* ; Dermatitis, Atopic* ; Dermatitis, Contact ; Dermatophagoides farinae* ; E-Selectin ; Eczema ; Endothelial Cells ; Humans ; Hypersensitivity ; Immunoglobulin E ; Immunoglobulin G ; Mites ; Patch Tests* ; Pyroglyphidae* ; Skin

Uric acid, pure or admixed, calculous disease during childhood is uncommon. We recently encountered a case of multiple calcium-uric acid urolithiasis in a l7-month-old male patient presented with anuria owing to bilateral complete obstruction of the ureteropelvic junction in which acute renal failure developed following emergency removal of the stones.
Acute Kidney Injury ; Anuria ; Child* ; Emergencies ; Humans ; Male ; Uric Acid ; Urolithiasis*

A retrospecive clinical observation was done on 325 cases of hypertension admitted to Department of internal Medicine of Seoul Red Cross Hospital from January, 1979 to December, 1982. The following results have been obtained. 1) The observed patients were 157 males and 168 females, and the prevalence rate of malignant hypertension among 325 hypertensions was 16 cases (4.9 percent). Among 16 cases of malignant hypertension 9 cases were male and 7 cases were female. Most frequently in 50, 60 and 40 years of age in this order each sex. 2) The average admitted dates are 7 days. 27 cases (8.3percent) were readmitted above 2 times after one discharged. 3) The most freqeuntly observed duration of Known hypertension 37.9 percent was 6-10 years and the next frequently observed duration 37.4 percent was 3-5 years. 4) The highest percentage of malignant hypertension had systolic blood pressure between 190-209mmHg and diastolic blood pressure between 150-169mmHg. 5) The highest percentage of seasonal number was spring (31.1 percent) and the next autumn, summer, winter in this order and the prevalence rates of hypertention are increased average 1.9% of each year. 6) The 78.5 percent of the patients were found that their blood pressure were abnormaly high when they were examined with related symptoms on admission, and they major symptorms were headache and dizziness. 7) The physical examination on admission, tachycardia (56percent), tachypnea (15.1percent), semicoma to coma (12.9 percent) in this order. 8) The status of treatment in hypertension on admission was as follows; imtermittent treatment 54.5 percent, no treatment 31 percent and continuous treatment 14.5 percent in this order. 9) In the chest X-ray on admission, the most frequent finding was cardiomegaly, and normal finding was the next frequency. The pulmonary Tbc was noted in 12.6 percent. 10) According to the degree of fundoscopic abnormality by K-W classification stage III was 68.8 percent and stage IV was 31.2 percent. 11) Electrocardiogram abnormalities were 44.9 percent, and 87.5 percent of malignant hypertension revealed electrocardiographic abnormalities and left ventricle hypertrophy was observed in 70.5 percent. 12) Hypercholesterolemia 78 percent, Hypernatremia 69.8 percent, Hypokalemia 22.8 percent, serum chloride 34.5 percent (<95m Eg/l), BUN 53.8 percent (>20mg/dl) and creatinine 45.8 percent (>3mg/dl) on admission. 13) Proteinuria was observed in 87.5 percent of malignant hypertension. 14) Marked improved for clinically was 24 percent and mortality rate was 5.2 percent, most common cause of death are cardiovascular accident (64.7percent) and renal failure (23.5percent).
Blood Pressure ; Cardiomegaly ; Cause of Death ; Classification ; Coma ; Creatinine ; Dizziness ; Electrocardiography ; Female ; Headache ; Heart Ventricles ; Humans ; Hypercholesterolemia ; Hypernatremia ; Hypertension ; Hypertension, Malignant ; Hypertrophy ; Hypokalemia ; Internal Medicine ; Male ; Mortality ; Physical Examination ; Prevalence ; Proteinuria ; Red Cross ; Renal Insufficiency ; Seasons ; Seoul ; Tachycardia ; Tachypnea ; Thorax

BACKGROUND: Recently, using propofol as intravenous anesthetic agent is increasing. And it is known that propofol has little effects on liver function even after long operation such as plastic surgery. But its effect on liver functon after hepatobilliary operation which may damage liver was not studied. Thus, authors carried out this study to evaluate the effect of propofol on liver function by comparing with enflurane in the patients who had laparoscopic cholecystectomy. METHODS: Patients's anesthesia records and hospital charts from January 1994 to June 1996 were anlaysed retrospectively. Three hundred and thirty three patients who had normal liver function preoperatively and had no complications during and after operation were selected. They were divided into two groups ; propofol group (n=191) and enflurane group (n=142). The preoperative values of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP) were compared with those of 1 and 3 days after operation. RESULTS: One day after operation, both propofol and enflurane group showed significant increase in AST and ALT (p<0.05) and decrease in ALP (p<0.05). But there was no difference between two groups. CONCLUSION: Concerned to liver function, propofol is as useful as enflurane to the patients who scheduled for laparoscopic cholecystectomy.
Alanine Transaminase ; Alkaline Phosphatase ; Anesthesia* ; Aspartate Aminotransferases ; Cholecystectomy, Laparoscopic* ; Enflurane* ; Humans ; Liver* ; Propofol* ; Retrospective Studies ; Surgery, Plastic