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*

Cerebral ischemia is a complex and mutifactorial process. Animal models of cerebral ischemia have been widely used to make clear the pathophysiology of the ischemic brain injury and to test the therapies against cerebral ischemia. Many animal ischemia models have been developed in numerous species and in various forms of cerebral ischemia, namely global and focal, complete and incomplete, and permanent and transient. In global cerebral ischemia, selective cell vulnerability to ischemia is a most important factor. Neurons appear to be more susceptible to hyoxia and ischemia as compared with other components, such as glial cells and vessels. In global cerebral ischemia models, the global cerebro-circulatory arrest model by occluding the inominate, the left subclavian and both mammary arteries, the bilateral carotid occlusion with systemic hypotension model in rats, the 4 vessel occlusion model in rats, and the bilateral carotid occlusion model were decribed in here. On the other hand, the main issue in the focal cerebral ischemia is a concept of ischemic thresholds of cerebral blood flow. The so-called "zone of ischemic penumbra" is of particular interest as a zone of nonfunctioning but still viable tissue that may recover its function if blood flow can be restored. As the focal cerebral ischemia model, the middle cerebral artery occlusion model in cats and rats and the embolic stroke model were discussed in here.
Animals* ; Brain Injuries ; Brain Ischemia* ; Cats ; Hand ; Hypotension ; Infarction, Middle Cerebral Artery ; Ischemia ; Mammary Arteries ; Models, Animal* ; Neuroglia ; Neurons ; Rats ; Stroke