No abstract available.
Tinnitus*

BACKGROUND: Continuous epidural morphine administration (CEM) is a common method to treat the pain of terminal cancer patients, but this could produce many side effects/ such as pruritus, nausea, vomiting, constipation and urinary retention. The purpose of this study was to determine the optimal epidural butorphanol dosage to prevent side effects of CEM in terminal cancer patients. METHODS: Thirty terminal cancer patients were randomly assigned to one of three groups. After insertion of epidural catheter, morphine 2 mg and butorphanol 1 mg were injected epidurally for a loading dose and a 2 Day Infusor (2 ml/hr)(Home Pump(R) , I-Flow, Lake Forest, USA) containing morphine 8 mg with butorphanol 2 mg (B2 group, n = 10), 4 mg (B4 group, n = 10) or 6 mg (B6 group, n = 10) mixed with 5% D/W (total 100 ml) was connected. Severity of pain, nausea and vomiting, and pruritus were evaluated using VAS score at 1, 6, 12, 24, 36 and 48 hr after epidural infusion. RESULTS: Severity of pain, nausea and vomiting, and pruritus were significantly decreased in the B6 group as comparable to the other two groups (p < 0.05). CONCLUSIONS: The addition of butorphanol 3 mg to morphine 4 mg in CEM in terminal cancer patients reduced nausea, vomiting and pruritus and improved the pain control effect.
Butorphanol* ; Catheters ; Constipation ; Humans ; Infusion Pumps ; Lakes ; Morphine* ; Nausea ; Pruritus ; Urinary Retention ; Vomiting

Pyogenic osteomyelitis is a frequent and difficult disease in treatment in orthopedic surgery. The various manifestation of the disease related to the causative organisms, the sites of involvement, the pathogenesis and the clinical course tend to give a bad prognosis after treatment. This study consists of three hundred and twenty four cases of pyogenic osteomyelitis which are studied at the Department of Orthopedic Surgery, Yonsei University hospital for 7 years and 8 months from January 1973 to August 1979. The results are as follows: 1. The frequency of the disease was highest in 1977 but not significant. 2. Femur and tibia were most frequently involved. (65.4%). 3. Age distribution showed the highest incidence between 6 and 15 years of age. (60.6%) Sex ratio was 2(M):1(F) 4. The causative organism was mostly Staphylococcus. (80.5%) The coagulase(+) Staphylococcus showed the highest sensitivity to cefamezine (88.8%) and the highest resistance to penicillin. (89.7%) 5. The treatment had been carried out case by case with variable methods. Author considered the best method of treatment was early decompression and massive antibiotic therapy in acute osteomyelitis, and saucerization with closed irrigation system in chronic osteomyelitis.
Age Distribution ; Cefazolin ; Decompression ; Femur ; Incidence ; Methods ; Orthopedics ; Osteomyelitis ; Penicillins ; Prognosis ; Sex Ratio ; Staphylococcus ; Tibia

BACKGROUND/AIMS: This study was to evaluate the frequency and the course of the adverse effects of AZA/6-MP in Korean patients with inflammatory bowel disease (IBD). METHODS: Medical records of the patients with IBD treated with AZA/6-MP at Severance hospital from June 1996 to September 2006 were retrospectively analyzed. RESULTS: A total of 133 patients were studied. Male to female ratio was 1.3:1. The mean age was 31.7+/-10.9 year. Adverse effects included leukopenia occurred in 75 cases (56.4%), nausea/vomiting in 32 cases (24.1%), arthralgia in 6 cases (4.5%), hepatitis in 6 cases (4.5%), skin rash in 4 cases (3.0%), herpes zoster in 3 cases (2.3%), and headache in 1 case (0.8%). Most of leucopenia (58.7%) developed within 3 months after maximal tolerated dose of AZA/6-MP and nausea/vomiting frequently occurred within 3 months after start of AZA/6-MP treatment. Thirty-eight patients (28.6%) required the discontinuation of medication due to adverse effects. CONCLUSIONS: Leukopenia was the most common adverse effect of AZA/6-MP treatment. Leukopenia and nausea/vomiting developed frequently in the early period of treatment of AZA/6-MP in patients with IBD. AZA/6-MP should be used cautiously to scrutinize bone marrow suppression.
6-Mercaptopurine/*adverse effects/therapeutic use ; Adolescent ; Adult ; Azathioprine/*adverse effects/therapeutic use ; Behcet Syndrome/drug therapy/etiology ; Cohort Studies ; Drug Therapy, Combination ; Female ; Humans ; Immunosuppressive Agents/*adverse effects/therapeutic use ; Inflammatory Bowel Diseases/*drug therapy/etiology ; Leukopenia/chemically induced ; Male ; Middle Aged ; Retrospective Studies ; Time Factors

Thyroid anomaly are rare embryological condition. The failure of the development of one lobe leading to unilateral agenesis is the rarest of all the thyroid anomalies, The cause of unilateral agenesis is unknown. Thyroid hemiagenes is common in females (3: 1) with the left lobe being absent. The common disease in the remaining lobe is a benign adenoma, a multinodular goiter, hyperthyroidism, chronic thyroiditis, and rarely carcinoma. The most common pathology involved in thyroid hemiagenesis is hyperthyroidism. This report the case of a 57-year-old woman with a right thyroid hemiagenesis.
Adenoma ; Female ; Goiter ; Humans ; Hyperthyroidism ; Middle Aged ; Pathology ; Thyroid Gland* ; Thyroiditis

BACKGROUND: The concept of preemptive analgesia has been suggested recently as another technique in the treatment of postoperative pain. This study was undertaken to determine whether preoperative blockade of nociceptive input with operative bupivacaine would exert a preemptive effect on postoperative analgesia. METHODS: 40 patients undergoing hysterectomy with general anesthesia were allocated randomly to receive either 0.25% bupivacaine 40ml infiltrated into the proposed wound line 10min before incision or no infiltration. Patient-controlled analgesia fentanyl and ketorolac were administered to both groups during first 48 postoperative hours. RESULTS: Pain scores and cumulative fentanyl and ketorolac consumption dosage at 12, 24, 36, 48 hours after surgery was similar in both groups. CONCLUSIONS: We concluded that preincisional infiltration with bupivacaine had no advantage in reducing postoperative analgesic requirements or pain scores after hysterectomy.
Analgesia ; Analgesia, Patient-Controlled ; Anesthesia, General ; Anesthetics ; Bupivacaine ; Fentanyl ; Humans ; Hysterectomy* ; Ketorolac ; Pain Measurement ; Pain, Postoperative ; Wounds and Injuries

The c-erbB-2 oncogene encodes a 185,00 dalton transmembrane glycoportein with tyrosine kinase activity, and the aberrant overexpression of which has been implicated in the indution of a malignat phenotype. Overexpression of the c-erbB-2 has been found in many human adenocarcinomas, especially mammarian and ovarian carcinomas, and that is associated with poor prognosis. We used an enzyme-linked immunosorbent assay(ELISA) to explore the relationship between c-erbB-2 oncoprotein and prognostic factors of endmetrial cancer and analyzed the tissued form the 24patients with endometiral cancer and 10 control cases. patinens with endometrial cancer were found to bave 20% of c-erbB-2 oncoprotein overexpression rate and signficiantly higher c-erbB-2 median oncoprotein expression than conterolC-erbB-2 oncoprotein overexpression showed no statistically significant association with known prognostic factors including stage, grade, histologic cell type, myometrial invasion and lymph node metastases, although the c-erbB-2 oncoprotein overexpression rate was increased by stage, and was higher in lymph node metastatic group than in confined to the uterus goup. High c-erbB-2 oncoprotein overexpression was correlated with absence of estrogen receptor (Rs=-0.46, p=0.047) and progestreone receptor (Rs=-0.57, p=0.045), further studies are needed to determine the significance of the c-erbB-2 everexpression in endometrial cancer.
Adenocarcinoma ; Endometrial Neoplasms* ; Estrogens ; Female ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Oncogenes ; Phenotype ; Prognosis ; Protein-Tyrosine Kinases ; Uterus

The c-erbB-2 oncogene encodes a 185,00 dalton transmembrane glycoportein with tyrosine kinase activity, and the aberrant overexpression of which has been implicated in the indution of a malignat phenotype. Overexpression of the c-erbB-2 has been found in many human adenocarcinomas, especially mammarian and ovarian carcinomas, and that is associated with poor prognosis. We used an enzyme-linked immunosorbent assay(ELISA) to explore the relationship between c-erbB-2 oncoprotein and prognostic factors of endmetrial cancer and analyzed the tissued form the 24patients with endometiral cancer and 10 control cases. patinens with endometrial cancer were found to bave 20% of c-erbB-2 oncoprotein overexpression rate and signficiantly higher c-erbB-2 median oncoprotein expression than conterolC-erbB-2 oncoprotein overexpression showed no statistically significant association with known prognostic factors including stage, grade, histologic cell type, myometrial invasion and lymph node metastases, although the c-erbB-2 oncoprotein overexpression rate was increased by stage, and was higher in lymph node metastatic group than in confined to the uterus goup. High c-erbB-2 oncoprotein overexpression was correlated with absence of estrogen receptor (Rs=-0.46, p=0.047) and progestreone receptor (Rs=-0.57, p=0.045), further studies are needed to determine the significance of the c-erbB-2 everexpression in endometrial cancer.
Adenocarcinoma ; Endometrial Neoplasms* ; Estrogens ; Female ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Oncogenes ; Phenotype ; Prognosis ; Protein-Tyrosine Kinases ; Uterus

BACKGROUND/AIMS: The aim of this study was to determine the actual practice patterns of clinicians caring for Korean patients with inflammatory bowel diseases (IBDs). METHODS: Questionnaires, including te indications and doses of 5-aminosalicylic acid (5-ASA), corticosteroids, or azathioprine/6-mercaptopurine (AZA/6-MP), assessment of response, the surveillance method, and the interval for adverse effects, were distributed during the 2008 KASID annual lecture. Thirty questionnaires were collected. RESULTS: Most of the responders (93.3%) were board-certified with sub-specialty training in gastroenterology. For active diseases, 43.3% of the responders escalated the dose of 5-ASA from conventional to maximal doses. Of the patients in disease remission, 36.7% were maintained on the conventional or a reduced dose for a fixed period of time. Corticosteroids were prescribed by dose-base (20/30 [66.7%]). In most cases, the starting dose was 40 mg/d (15/19 [78.9%]), and tapered within a 1 (43.3%) or 2 week interval (40.0%). There were various definitions of corticosteroid-refractoriness and -dependency among the responders. Most of the responders initiated AZA at 50 mg/d; 68.4% of the patients increased the dose by 25 mg and 55.6% of the patients increased the dose within a 4-week interval. For monitoring adverse events, such as leukopenia, 63.3% of the patients checked a complete blood count for 2 weeks in the 1st month of therapy. CONCLUSIONS: There were various patterns of practice in the treatment of Korean IBD patients, especially in terms of the prescribing patterns of drugs and assessment of response, which suggests that standard therapeutic guidelines of IBD should be established in Korea.
Adrenal Cortex Hormones ; Aminosalicylic Acids ; Azathioprine ; Blood Cell Count ; Gastroenterology ; Glucocorticoids ; Humans ; Inflammatory Bowel Diseases ; Korea ; Leukopenia ; Mesalamine ; Physician's Practice Patterns ; Surveys and Questionnaires

PURPOSE: The TNM classification for carcinoma of the colon and the rectum provides more detail than other staging systems. This study was performed to evaluate the effectiveness of AJCC staging system (5th ed., 1997) for the colorectal cancer in predicting prognosis. METHODS: We analyzed a data base of 1,233 colorectal cancer patients (M:F=673:560) who underwent surgery in Asan Medical Center during July 1989-December 1996. Survival analysis was performed between the stages and the subgroups in same stage by using Kaplan-Meier method and log rank test. Borderline subgroup comparison between the stages was performed, also. Significance was assigned to a P value of <0.05. RESULTS: Mean age of the patients was 57 (19-90) years old. Median follow-up period was 42 (6-129) months. The number of patients in each stage were 0: 15, I: 152, II: 390, III: 465, IV: 199. The 5 year overall & disease free survival rates of each stage were 100%, 100% (in stage 0), 96.4%, 93.6% (in stage I), 82.7%, 82.2% (in stage II), 59.9%, 55.3% (in stage III), and 7.3%, 24.9% (in stage IV), respectively (P=0.000). Subgroup analysis in stage I (T1N0 vs. T2N0) and II (T3N0 vs. T4N0) revealed no differences. However, in stage III, N1 (n=246) group showed better survival than N2 (n=219) group (70.3%, 65.5% vs. 49.2%, 44.6%: P=0.000). Borderline survival analysis between stage I and II (T2N0 vs. T3N0) was significantly different (96.6%, 95.7% vs 82.7%, 82.3%: P=0.006). However, between stage II and III (T4N0 vs. T1N1), appropriate analysis was impossible due to small number of cases. CONCLUSIONS: AJCC staging system for colorectal cancer was reliable and effective in predicting prognosis. However, substages are needed in stage III.
Chungcheongnam-do ; Classification ; Colon ; Colorectal Neoplasms* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Prognosis ; Rectum