OBJECTIVES: To evaluate the effect of parity & delivery method on female fecal incontinence. METHOD: Based on 213 cases of 4 different delivery method and 40 cases of one non-delivery group, a retrospective analysis of the prevalence of female fecal incontinence, between January 1996 and December 1998, was done. With delivery mode, 4 different groups were: first vaginal delivery group , two or more vaginal deliveries group, first cesarean section group, and first vaginal delivery followed by cesarean section group. All subjects were examined by questionaire or phone about the experience of fecal incontinence after delivery. In cases of fecal incontinence , we reviewed the obstetric complications with medical records. RESULT: There was no fecal incontinence in the non-delivery group. The incidence of fecal incontinence in the two or more vaginal delivery group(11.7%, 9/77) and the first vaginal delivery followed by cesarean section group(18.1%, 8/44) was higher than the first vaginal delivery group(6.8%, 3/44), and the first cesarean section group(2.1%, 1/48)(P<0.05). The obstetric complications in fecal incontinence cases were: a prolonged second stage, anal sphincter laceration, vacuum extraction, a large baby etc. CONCLUSION: Fecal incontinence was significantly correlated with the number of vaginal deliveries and obstetric complications during delivery. Fecal incontinence after the first vaginal delivery or vaginal delivery followed by cesarean section are very important factors in choosing the next delivery method.
Cesarean Section ; Fecal Incontinence* ; Female* ; Humans ; Incidence ; Lacerations ; Medical Records ; Parity* ; Pregnancy ; Prevalence ; Psychosexual Development ; Retrospective Studies ; Vacuum

Dermoid cysts of the posterior fossa are benign, mostly midline, congenital brain neopasm, usually located above or behind the vermis or adjacent meninges2)18)20), Dermoid lesions are slow growing and may become quite large before producing signs and symptoms12). We have recently experienced a case of dermoid which arised in cerebellar hemisphere. A 32-year old woman who had a history of chronic headache at morining was visited in our department and she was also complained of a egg-sized plapable mass which was growing nature, non-tender, soft, and movable on the right occipital area. On admission, there were no specific localizing and lateralizing neurological abnormalities. Unenhanced CT scan shows hypodense mass in the left cerebellar hemisphere and cystic mass at the right occipital scalp(Fig. 1. A). T1-weighted MR image shows hypointense mass in the left cerebellar hemisphere(Fig. 2. A). The Carotid angiography shows non-specific findings. Paramedian suboccipital approach was performed and mass was removed from the lleft cerebellar hemisphere. The cystic scalp mass was removed totally from the left cerebellar hemisphere. The cystic scalp mass was removed totally from the right occipital area. Diagnosis of dermoid cyst was confirmed pathologically by the specimens obtained from two different sites, left cerebellar hemisphere and right occipital ccalp.
Adult ; Angiography ; Brain ; Dermoid Cyst* ; Diagnosis ; Female ; Headache Disorders ; Humans ; Scalp ; Tomography, X-Ray Computed

Meigs' syndrome is defined as a hydrothorax with ascites and a pelvic tumor, both of which resolve on removal of the tumor. Pseudo-Meigs' syndrome is a variant not possessing the original tumor cell types described by Meigs. Both these syndromes should be considered in otherwise healthy women who present with either new or recurrent hydrothorax and ascites. Pseudo-Meigs' syndrome occurs with the clinical triad of (1)ascites, (2)pleural effusion and (3)Brenner tumors, struma ovarii, benign thecomas, extreme ovarian edema, uterine leiomyomas or other benign pelvic tumors. A case of Pseudo-Meigs' syndrome associated with Brenner tumor is presented with a brief review of literatures.
Ascites ; Brenner Tumor ; Edema ; Female ; Humans ; Hydrothorax ; Leiomyoma ; Meigs Syndrome ; Struma Ovarii ; Thecoma

Background: The highly lipid soluble opioid, fentanyl, has a rapid onset and short duration of action. The present study was designed to examine the analgesic efficacy and side effects of the combination of fentanyl with morphine in patients using intravenous PCA. Methods: Patients were randomly assigned to receive one of three PCA regimens: M4 group (40 mg morphine+90 mg ketorolac+1.5 mg dorperidol), M2F2 group (20 mg morphine+200 ug fentanyl+90 mg ketorolac+1.5 mg dorperidol), or M2F4 group (20 mg morphine+400 ug fentanyl+90 mg ketorolac+1.5 mg dorperidol). All patients were given initial loading dose of 0.1 mg/kg morphine plus 1 mg droperidol at the end of surgery. Pain score, side effects, and overall satisfaction were assessed at 30 min, 1 hr, 8 hr, 24 hr, and 48 hr postoperatively. Results: The pain score was significantly higher in the M2F2 group than in the M4 group and M2F4 group during 1 hr and 8 hr postoperatively. The total opioid consumption was significantly greater in the M2F4 group than in the M4 group. Patient satisfaction was better in the M2F4 than other two groups. There were no differences in the overall incidence of side effects among three groups. Conclusions: The present results suggest that the combination of fentanyl with morphine for intravenous patient-controlled analgesia is a useful method, and the double dose of fentanyl in comparison with the equipotent morphine dose is recommended in the early postoperative period.
Analgesia, Patient-Controlled* ; Droperidol ; Fentanyl* ; Humans ; Incidence ; Morphine* ; Passive Cutaneous Anaphylaxis ; Patient Satisfaction ; Postoperative Period

BACKGROUND: For pediatric anesthesia we frequently use rocuronium bromide, which is often associated with a localized withdrawal of the arm or generalized movements, that may cause harm to the patient. Lidocaine is said to be one of the better agents and reduce the incidence of movement associated with rocuronium injection in adults. The purpose of this study was to compare the effects on movement associated with rocuronium injection according to the method of lidocaine administration in children. METHODS: Two hundreds and four pediatric patients undergoing general anesthesia were randomly assigned to one of six groups (each group n = 34). Fifty seconds after the injection of thiopental sodium 5 mg/kg, the SM group was given mixture of rocuronium bromide 0.6 mg/kg and normal saline 0.05 ml/kg (same amount of 2% lidocaine 1 mg/kg) for 5-10 seconds. The LM 1.0 and LM 2.0 groups were given a mixture of rocuronium bromide 0.6 mg/kg and 2% lidocaine 1 mg/kg or 2 mg/kg, respectively. The LS 1.0, LS 1.5 and the LS 2.0 groups were given 2% lidocaine 1.0 mg/kg, 1.5 mg/kg, and 2.0 mg/kg respectively, 50 seconds after the injection of thiopental sodium, and rocuronium was given 5 seconds after the administration of lidocaine. Withdrawal movements after the injection of rocuronium were investigated. RESULTS: All of the SM group showed withdrawal movement and the LM 2.0, LS 1.0, LS 1.5, and LS 2.0 groups showed less withdrawal movement than the SM group. And the LS 1.0, LS 1.5, and LS 2.0 groups showed less movement than the LM 1.0 group. LS 2.0 group showed less withdrawal movement than LM 2.0 group. CONCLUSIONS: The sequential administration of lidocaine and rocuronium produced a better result than the administration of a mixture in terms of reducing withdrawal movement on rocuronium injection.
Adult ; Anesthesia ; Anesthesia, General ; Arm ; Child* ; Humans ; Incidence ; Lidocaine* ; Neuromuscular Blockade ; Thiopental

OBJECTIVE: The objective of this study was to determine the relationship between the fetal doppler flow velocimetry and birth weight in low risk pregnancy population. METHODS: From December 1995 to May 1996, We prospectively performed doppler study in 254 uncomplicated, term pregnant women, who visited Pohang Hospital, Dongguk University. Using pulsed color doppler, we measured umbilical artery RI, middle cerebral artery RI and middle cerebral-umbilical artery RI ratio within one week before delivery. RESULTS: The result was that low birth weight group (below 2500gm) had very significant lationship with umbilical artery RI(P<0.01), middle cerebral artery RI(P<0.05) and middle cerebral-umbilical artery RI ratio(P<0.05), but there was no significant relationship in these blood flow indices between normal birth weight group (2501gm- 3999gm) and macrosomia group (above 4000gm). CONCLUSIONS: We concluded that application of doppler ultrasonopaphy in the assessment of fetal weight is somewhat helpful for identification of low birth weight, not for macrosomia.
Arteries ; Birth Weight ; Female ; Fetal Weight* ; Gyeongsangbuk-do ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Middle Cerebral Artery ; Pregnancy ; Pregnant Women ; Prospective Studies ; Rheology ; Ultrasonography* ; Umbilical Arteries

Papillary eccrine adenoma, first described by Rulon and Helwig in 1977, is a rare benign adnexal neoplastn. It is usually present as a solitary dermal nodule on the distal extremities. It has characteristic histopathological findings, consisting of dilated ducts that contain eosinophilic secretions and are associated with intralummal papillations. On the basis of histological and histochemical studies it is believed to be an adnexal neoplasm of possible eccrine differentiation. We report two recent cases of papillary eccrine adenomas occuring in two young male patients without subjective symptoms who had firm dermal nodules on the extremities.
Adenoma* ; Eosinophils ; Extremities ; Humans ; Male

Background: We hypothesized that intravenous lidocaine mixed with propofol may have an influence on anesthesia induction and hemodynamic responses to propofol induction and endotracheal intubation as well as propofol-induced pain on injection. Methods: Seventy-five patients were allocated to group L1 (2% lidocaine 1.5 mg/kg, n=25), group L2 (2% lidocaine 2 mg/kg, n=25) or group C (normal saline 0.05 mL/kg, n=25) according to the lidocaine dosage mixed with propofol 2 mg/kg. The pain on injection was scored as none, mild, moderate, and severe. The site of pain and recall of pain were also recorded. Loss of verbal response was observed during induction. Mean arterial blood pressure (MAP) and heart rate (HR) were recorded before anesthetic induction (baseline value), immediately before and after endotracheal intubation, and every min until 5 min thereafter. Results: Ninety-two percent of patients reported pain upon injection in group C, whereas 8% of the patients in group L1 and no patient in group L2. Loss of verbal response before injection of total dose of propofol was observed in 44% in group L2, 36% in group L1 and 28% in group C. Lowered MAP caused by propofol increased significantly after endotracheal intubation in all three groups (p<0.05). HR increased immediately and 1 min after endotracheal intubation in all three groups (p<0.05). Conclusions: Our results indicate that intravenous lidocaine 1.5 mg/kg or 2 mg/kg mixed with propofol 2 mg/kg significantly reduces the incidence and the degree of pain, but does not affect anesthesia induction and hemodynamic responses to propofol and tracheal intubation.
Anesthesia ; Arterial Pressure ; Heart Rate ; Hemodynamics* ; Humans ; Incidence ; Intubation* ; Intubation, Intratracheal ; Lidocaine* ; Propofol*

Marchiafava-Bignami disease (MBD) is characterized by cerebral white matter lesions associated with chronic alcoholism. Premortem diagnosis of MBD is usually based on history and clinical manifestations. We report a case of acute MBD in which diffusion-weighted MRI (DWI) showed high signal intensities along the white matter including the corpus callosum. DWI may be useful in premortem diagnosis of acute MBD.
Alcoholism ; Corpus Callosum ; Diffusion ; Diffusion Magnetic Resonance Imaging ; Humans ; Leukoencephalopathies ; Marchiafava-Bignami Disease

OBJECTIVE; This study was conducted to evaluate the effect of pregnancy on the activities of oxygen hee radical generating and scavenging system in the female rats. MATERIAL & METHOD; Rats weighing 200-220 gm were grouped to non-pregnant, 2nd trimester and 3rd trimester of pregnancy. The experiment was carried out following overnight fasting. Animals were anesthetized by administration of pentothal sodium, and blood was drawn via abdominal aorta. After exsanguination, the liver, kidney, heart, lung, with or without placenta tissues were excised immediately. The excised tissue was frozen in liquid nitrogen rapidly, and stored in liquid nitrogen for analysis. RESULTS; The gain in body weight was higher in pregnant rats than in normal rats. Lipid peroxidation was not significantly different among all groups in the liver, kidney, heart, lung, and placenta tissue. Xanthine oxidase activity of the kidney in the 3rd trimester of pregnancy was lower than that of non-pregnant rats. Superoxide dismutase activity of the liver was significantly decreased in the 2nd and 3rd trimester of pegnancy compared with that of non-pregnant rats, and that of lung was also decreased than that of non-pregnant rats. Catalase activity of the kidney was decreased in the 2nd and 3rd trimester of pregnancy compared with that of non-pregnant rats. Glutathione content of the liver was markedly decreased in the 2nd and 3rd trimester of pregnancy compared with that of non-pregnant rats. CONCLUSION; In conclusion, these results suggest that oxygen free radical will not increase in the liver, kidney, heart, lung, and placenta during normal pregnancy, but in the cases of overproduction of oxygen free radical, the liver, kidney, and lung will have me chance of tissue damage because of decreased activity of some anti-oxidant enzymes and/or decreased amount of anti-oxidant materials.
Animals ; Aorta, Abdominal ; Body Weight ; Catalase ; Exsanguination ; Fasting ; Female ; Glutathione ; Heart ; Humans ; Kidney ; Lipid Peroxidation ; Liver ; Lung ; Nitrogen ; Oxygen* ; Placenta ; Pregnancy ; Rats ; Sodium ; Superoxide Dismutase ; Thiopental ; Xanthine Oxidase