Backgronud : Postoperative pain control became anesthesiologist's familiar yield, so many anesthesiologists are very interested in opioid and local anesthetic's characterestics and there cardiovascular effects. It's important which anesthetic has the best pain killing and the least cardiovascular effect. We used epidural opioid and local anesthetics and intravenous opioid to investigate their pain killing and cardiovascular effects. METHODS: We studied 50 patients undergoing gastrectomy. An epidural catheter was placed via the T8-9 or L1-2 interspace. Epidural fentanyl group (Ep-F) received fentanyl 2 microgram/kg in 10ml saline, epidural bupivacaine group (Ep-B), 10 ml 0.25% bupivacaine, and epidural lidocaine group (Ep-L), 10 ml 1.5% lidocaine, epidurally; intravenous fentanyl group (IV-F) received fentanyl, 2 microgram/kg. 50% of the original dose was repeated every hour until the operation ended. Control group was given nothing before general anesthesia. Cardiovascular data was compared between those before and those at 1hour after skin incision. The time interval between end of the operation and the time of first analgesic requirement and the total number of intramuscular analgesic requirements during the first 48hours postoperatively were compared. RESULTS: Urinary output during surgery was significantly larger in group Ep-F. Group Ep-L developed more frequent episodes of hypotension. Group Ep-F, group IV-F and control group required higher enflurane concentrations. CONCLUSIONS: Group Ep-F was accompanied less hypotension and postoperative analgesic requirements were reduced.
Anesthesia, General* ; Anesthetics, Local ; Bupivacaine* ; Catheters ; Enflurane ; Fentanyl* ; Gastrectomy* ; Homicide ; Humans ; Hypotension ; Lidocaine* ; Pain, Postoperative ; Skin

A retrospective quality assurance study of intraoperative consultation (frozen section) was carried out to assess the accuracy and to determine the reasons of discordance. Of 14,977 surgical pathology cases accessioned over a 6-month period in Asan Medical Center, frozen sections were done on 1,270 (8.5%) patients and 2,392 frozen sections (1.88 frozen sections/case) were performed. Discordance was noted in 106 cases (4.4%) and diagnosis was deferred in 26 cases (1.1%). All deferred cases were reviewed with the result of 53.8% justified and 46.2% unjustified. The discordant cases were divided into three categories as to their clinical significances: category A (no affect on patient care) 61.3%, B (minimal affect) 9.4%, and C (major affect) 29.2%. Of 31 category C cases, 7 cases were false positive and 24 cases were false negative. Misinterpretation (70.8%) was the leading cause of discordance, followed by sampling error (15.1%), failure to identify lesion (8.5%), and technical problem (5.7%). More than one-third (35.8%) of all discordances were of central nervous system cases. Total central nervous system cases were 403 (16.8%) with a significantly higher disordance rate (9.8%) and deferral rate (2.5%) in comparison to the other cases with 3.4% discordance rate and 0.8% deferral rate. There were 43 colorectal cancer cases of intraoperative consultation for adequacy of resectional margins. The surgical margins were between 0.4 cm and 28 cm (mean: 6.7 cm) away from the tumor and there was no tumor-positive case. The study indicates surgical pathology should 1) promote interpretative skills in cases involving minute fragments of neurosurgical cases, 2) defer the diagnosis and ask for more tissue on inadequate or inappropriate specimens and 3) give only gross opinions without unnecessary frozen section procedures in the event of simple, clear-cut cases.
Abscess ; Anti-Bacterial Agents ; Biopsy ; Central Nervous System ; Chungcheongnam-do ; Colitis, Ulcerative ; Colorectal Neoplasms ; Diagnosis ; Diagnosis, Differential ; Endoscopy ; Enterocolitis, Pseudomembranous* ; Frozen Sections* ; Humans ; Mucous Membrane ; Necrosis ; Pathology ; Pathology, Surgical ; Retrospective Studies ; Selection Bias

Malignant mixed miillerian tumor (MMMT) was one of the rare uterine sarcoma. This tumor is composed of sarcoma and carcinoma. Primary MMMT in the peritoneum is among the rarest sites for MMMT. MMMT is highly malignant and the prognosis is grave due to frequent recurrence and metastasis. In the world literature, only 22 cases with primary MMMT of the peritoneum have been reported and most of these were single report. We report one case of primary MMMT in the peritoneum with a brief review.
Neoplasm Metastasis ; Peritoneum* ; Prognosis ; Recurrence ; Sarcoma

A clinical study was conducted to compare effectiveness of IV Globulin with that of steriod in childhood acute ITP. We carried out an experiment to 36 patients of acute ITP who recovered over 50.000/mm(3) of platelet count and not to recur in 6 months. Study group consist of 10 children who were treated with steriod only (Group A), 13 children who were treated with IV Globulin (0.4g/kg/d, 5 days, Group B), and 13 children combined with steroid (Group C) Study period was from January 1988 to December 1992, folllowing results were obtained. 1) There were no significant difference in sex ratio. age distribution, pretreatment hemoglobin level, platelet count and prolonged bleeding time among study groups. 2) The days which platelet count reached to 50.000/mm(3), 100,000/mm(3) were 3.7 days (Group A), 2.1 days (Group B), and 2.3 days (Group C), respectively (p<0.05). 3) Complete response rates within 4 weeks did not show significant difference (90% in Group A, 84.6% in Group B, 92.3% in Group C), the complete response rate within 1 week were significantly different among three group (44.4% in Group A, 90.9% in Group B, 83.3% in Group C)(p<0.05). In conclusion, it is more desirable for early treatment of a childhood ITP because IV Globulin is easy to normalize platelet count in a short time.
Age Distribution ; Bleeding Time ; Child ; Humans ; Platelet Count ; Sex Ratio

PURPOSE: The purpose of this study is to examine how well patients who had hip arthroplasty comply with medical regimens given to them after the operation. METHOD: The subjects of the study were patients who had arthroplasty at P Hospital between April 1. 2001 and August 30, 2002. 20 patients of the subjects experienced complications after the operation and the other 20 did not. Data from a survey using the qustionnaire were statistically analyzed in terms of real number, percentage point, mean and standard deviation by using chi2test. t-test and ANOVA. RESULT: 1) the surveyed patients were significantly different in the compliance of medical regimen among them according to their education background as one of the subjects general characteristics. 2) It was found that the group of complication was higher in the compliance of medical regimen than that of non-complication. The two groups showed statistically significant difference with each other in the degree of compliance with therapeutic instructions than the experimental group in terms of the maintenance of abduction after the operation, training instructions on step-by-step basis, urination cotrol on bed, accurate use of crutch, compliance with medication, balance among medical treatment, training, leisure, rest and nutrition. instructions by physicians, nurses and physical therapists, use of low armchairs and toilet bowels and no bending of the body forward, and use of a non-operated leg in case of go upstairs or downstairs. CONCLUSION: It seems necessary to develop systematic and sessional education programs for improving the compliance of medical regimen. ultimately reducing complications following hip arthroplasty.
Arthroplasty* ; Compliance ; Education ; Hip* ; Humans ; Leg ; Leisure Activities ; Patient Compliance* ; Physical Therapists ; Urination

No abstract available.
Chlorambucil* ; Nephrotic Syndrome*

No abstract available.
Animals* ; Fever* ; Hantaan virus*

PURPOSE: This survey was done to describe parenting self-efficacy and beliefs in corporal punishment as they are related to child abuse. Also demographic variables that influence child abuse were investigated. METHOD: A cross-sectional study was conducted during the second week of April 2002. The 160 participants were parents of students in five elementary schools in the J area of Korea. They replied to a structured questionnaire, and 129 replies were included in the final analysis. The WIN SPSS program was used for the analysis. RESULT: Parenting self-efficacy, beliefs in corporal punishment and child abuse showed no significant differences according to gender of the children. Child abuse by parents has significantly negative correlation with parenting self-efficacy (r=-.369, p=.000), socioeconomic states of family(r=-.290, p=.001), educational level of mother(r=-.211, p=.027), educational level of father(r=-.342, p=.000), parent's age(r=-.200, p=.028). Stepwise multiple regression showed that parenting self-efficacy and beliefs in corporal punishment significantly influence child abuse in Korean parents. CONCLUSION: As parenting self-efficacy explained 49.7% of child abuse, it is the most important variable for preventing child abuse. Belief in corporal punishment was the second most important variable in preventing child abuse. These two variables explained 53.3% of variance in child abuse by parents.
Child Abuse ; Child* ; Cross-Sectional Studies ; Humans ; Korea* ; Parenting* ; Parents* ; Punishment* ; Child Health ; Surveys and Questionnaires

No abstract available.
Hantaan virus* ; Hemorrhagic Fever with Renal Syndrome* ; Prevalence*

PURPOSE: This study was done to identify menstrual discomfort and dietary habits, and factors related to the menstrual discomforts. METHOD: Participants were 320 female middle school students in G city. The Menstrual Discomfort Questionaire(MDQ) and dietary habit lists were used as tools. RESULTS: Factors related to MDQ were found to be the VAS scores (r=.361, p=.002), a mount of menstrual bleeding (r=.131, p=.019), height (r=.134, p=.016), adequacy of meal time (t=7.19, p=.008), consumption of milk & milk products (F=3.20, p=.042) and, hot, salty & irritant foods (F=8.01, p=.000), eating more than 3 kinds of side-dishes with each meal (F=8.32, p=.000), and various protein foods (F=5.15, p=.006). In stepwise regression, 4 variables (VAS scores, height, hot, salty & irritant foods, more than 3 kinds of side-dishes with each meal) explained 20.3% of the variance in the total MDQ scores. CONCLUSION: Reduction of hot, salty & irritant foods and having more than 3 side-dishes with each meal would be effective in menstrual discomfort management. As well, good and, balanced dietary habits should be encouraged for early adolescent girls. To keep up with the ideal dietary habits, nutritional education & counseling should be continued. In a further study, a replication study with larger samples and more specified nutritional assessment are recommended.
Adolescent* ; Counseling ; Eating ; Education ; Female ; Food Habits* ; Hemorrhage ; Humans ; Meals ; Milk ; Nutrition Assessment ; Child Health