BACKGROUND: The initiation of treatment seems to be important in provoking preemptive analgesia and to provide excellent postoperative pain control. To verify the effectiveness of postoperative analgesia and preemptive effects, pre-incisional and post-incisional epidural infusion of morphine and bupivacaine mixture were compared. METHODS: Patients scheduled for elective upper abdominal surgery were divided into 2 groups. Each group received 2 mg of morphine in 10 ml of 0.25% bupivacaine as a bolus followed by 0.1 mg/ml/hr of morphine infusion in 0.125% bupivacaine epidurally. In post-incisional group, the epidural injection of mixture was started 15 minutes after skin incision and in pre-incisional group, the epidural infusion of mixture was started 15 minutes before skin incision. Each groups were evaluated in visual analogue scales (VAS) for pain, pain scores in movement, and total administered doses in postoperative 1, 2, 4, 8, 24, 48, and 72 hours and compared with each others. RESULTS: There were no differences between pre-incisional and post-incisional start of continuous epidural mixture infusion of morphine and bupivacaine in VAS for pain, pain scores at movement, and total amount of infused doses for 72 hours postoperatively. Also, there were no differences in the incidence of complications and satisfactions of patients between two groups. CONCLUSIONS: The continuous epidural mixture infusion of morphine 0.1 mg/ml/hr in 0.125% bupivacaine following a bolus dose of 2 mg morphine in 0.25% 10 ml bupivacaine has no difference in postoperative analgesic effect whether it starts after or before surgical incision.
Analgesia ; Bupivacaine ; Humans ; Incidence ; Injections, Epidural ; Morphine* ; Pain, Postoperative ; Skin ; Weights and Measures

OBJECTIVE: To evaluate the cytohistologic correlation and the clinical significance among patients with atypical squamous cells of undetermined significance(ASCUS), low-grade squamous intraepithelial lesion(LSIL), and high-grade squamous intraepithelial lesion(HSIL) identified on cervical Pap smear screening. MATERIALS AND METHODS: Pathologic reports of patients who have underwent cervical Pap smear screening at Korea university Ansan hospital from January 1997 to December 1998 were evaluated. Cytologic diagnosis was classified by the Bethesda System (TBS). Among these patients, the patients whose histologic diagnosis was established by cervical punch biopsy, LEEP, conization, and hysterectomy were targetted. Cytohistologic correlation were analysed in ASCUS, LSIL, and HSIL respectively. RESULTS: During 2 year period (1997-1998), total 3587 Pap smears were taken. The median rate of abnormal cytology was 7.2%, with 4.6% of ASCUS, 0.8% of LSIL, 1.3% of HSIL, and 0.5% of squamous cell carcinoma. The median ratio of ASCUS versus SIL was 2.2. Smears with ASCUS showed 46.9% with chronic cervicitis, 40.6% with LSIL(35.9% with koilocytotic atypia, 4.7% with mild dysplasia), 10.9% with HISL, and 1.6% with invasve squamous cell carcinoma on biopsy. Smears with LSIL showed 38.1% with LSIL(9.5% with koilocytotic atypia, 28.6% with mild dysplasia), and 28.6% with HSIL on biopsy. Smears with HSIL showed 27.8% with LSIL, 63.9% with HSIL, and 8.3% with invasive squamous cell carcinoma on biopsy. CONCLUSIONS: Smears with ASCUS showed 53.1% with SIL and cancer on biopsy. But most of theses cases revealed koilocytotic atypia rather than dysplasia, so conservative management such as repeated Pap smear is desirable. On the other hand, because smears with LSIL showed dysplasia rather than koilocytotic atypia on biopsy, more active management such as colposcopic directed biopsy is required.
Biopsy ; Carcinoma, Squamous Cell ; Conization ; Diagnosis ; Gyeonggi-do ; Hand ; Humans ; Hysterectomy ; Korea ; Mass Screening ; Uterine Cervicitis

No abstract available.
Animals ; Dogs* ; Lactic Acid*

No abstract available.
DNA, Recombinant* ; Hepatitis B Vaccines* ; Hepatitis B* ; Hepatitis* ; Yeasts*

No abstract available.
Enzyme-Linked Immunosorbent Assay*

No abstract available.
Enzyme-Linked Immunosorbent Assay*

No abstract available.
Enzyme-Linked Immunosorbent Assay*

No abstract available.
Animals ; Calcium Channels* ; Calcium* ; Rats*

No abstract available.
Catheterization* ; Catheters* ; Hemothorax* ; Subclavian Vein*

The occurrence of fistulous tract between the thoracic subarachnoid space and the pleural cavity due to injury is uncommon. The one was developed after traffic accident and treated by surgical repair of the fistula : The other was post-operative complication of costotransversectomy for T2 sympathectomy. The complication was realized by the surgeon who was aware of the small leakage of cerebrospinal fluid from the dura propria of the T2 nerve root at the time of surgery. Intermittent pleural punctures for drainage and semisitting position were followed by spontaneous closure of the fistula. These cases were reported so that the uncommon condition might be added to the differential diagnosis of pleural effusion.
Accidents, Traffic ; Cerebrospinal Fluid ; Diagnosis, Differential ; Drainage ; Fistula* ; Pleural Cavity ; Pleural Effusion ; Punctures ; Subarachnoid Space ; Sympathectomy