BACKGROUND: We observed fentanyl known as centrally-acting antitussive agents provoke a cough response in some patients at induction of anesthesia. This may be of clinical importance. METHOD: 121 patients (ASA class I) were assigned randomly to 4 groups. Each group was given different doses of fentanyll Group 1 (n=30); 0.5ug/kg, Group 2 (n=30); 1ug/kg, Group 3 (n=33); 2ug/kg, Group 4 (n=28); 4 g/kgl, within 1 second through a peripheral venous cannula before induction of anesthesia. All patients were observed carefully in order to detect a cough response and any side effects. RESULT: The incidences of FCR (Fentanyl Cough Response) were 0% in Group 1, 10.0% in Group 2, 30.3% in Group 3, and 39.3% in Group 4. The ED50 of FCR was 4.25ug/kg. The mean onset-time from the end of fentanyl administration to the beginning of coughing was 12.5 seconds. FCR was decreased with aging, but not affected by weight, height, or smoking. Other serious side effects were not accompanied. CONCLUSION: Fentanyl can evoke the pulmonary chemoreflex dose-dependently and the ED50 was 4.25 g/kg.
Aging ; Anesthesia ; Antitussive Agents ; Catheters* ; Cough* ; Fentanyl* ; Humans ; Incidence ; Reflex* ; Smoke ; Smoking

PURPOSE: The purpose of this study is to assess the clinical utility of multiplanar reformation images of helical CT in the evaluation of pancreatic diseases. MATERIALS AND METHODS: Helical CT scans of the pancreas were obtained in 30 patients with pancreatic diseases. Helical CT was performed with 5mm collimation at 5mm/sec table speed during rapid injection of intravenous contrast agent using power injector. After scanning, helical volume data were reconstructed at 2mm interval and then multiplanar reformation of the pancreas and adjacent structures was done. In both prospective reconstructed axial images and multiplanar reformation images, detection of pancreatic lesion, extent of lesion, and vascular and bile ductal changes were analyzed with a grading system of 1,2, 3. RESULTS: The mean grade of detection of pancreatic lesions was 2.37 in the prospective axial image and 2.83 in multiplanar reformation image, extent of diseases was 2.40 in prospective axial image and 2.97 in multiplanar reformation image, and vascular and bile ductal changes was 2.00 in the prospective axial image and 2.97 in multiplanar reformation image. All the differences were statistically significant (P<0.0001). CONCLUSION: Multiplanar reformation images of helical CT are useful in the evaluation of pancreatic diseases and especially in the demonstratibn of complex anatomic relationships between the pancreas and surrounding structures.
Bile Ducts ; Humans ; Pancreas ; Pancreatic Diseases* ; Prospective Studies ; Tomography, Spiral Computed*

No abstract available.
Child* ; Humans ; Kidney Failure, Chronic*

BACKGROUND: The purpose of this study is followings: First, to find out similarity in anesthesiology related terminology in Korea, China and Japan. Second, to clarify the use of Chinese character in making anesthetic terminology in Korea. Third, in attempt to explore the criteria in making terminology. METHODS: 335 terms were selected in anesthetic terminology book and allocated to English term. RESULTS: 44 terms(13%) were same in Chinese character among three countries, 144 terms(43%) were different in each other, 141 terms (42%) were same between two countries (Korea-China 9, Korea-Japan 130 and China-Japan 2). CONCLUSIONS: Only small terms were same in three countries and nearly half of terms were different. Most of same terms in two countries came from Korea-Japan. It seemed that three countries had their own terms in anesthesiology. Making terminology with Chinese character were not believed to be the best and only way. Moreover, it was suspicious using Chinese character as communicating tool among three countries. Creative efforts with our own native language for better terminology in this field were expected.
Anesthesiology* ; Asian Continental Ancestry Group ; China* ; Humans ; Japan* ; Korea* ; Publications

Peritonitis is a major complication of continuous ambulatory peritoneal dialysis and it remains the leading cause of patient droupout. VRE is a very serious pathogen because it is difficult to eradicate due to very limited effective antibiotics and because there is a possibility of transfer of this resistance to other gram-positive organisms including Staphylo-coccus aureus. We experienced a case of CAPD peritonitis by VRE, which was treated with high dose ampicillin and streptomycin without removal of CAPD catheter. We report our experience of CAPD peritonitis caused by VRE and review the literature.
Ampicillin ; Anti-Bacterial Agents ; Catheters ; Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Streptomycin ; Vancomycin*

From June 1990 to December 1998, 792 kidney transplantations were performed at Asan Medical Center. 436 cases(55M) were from living-related donors, 139 cases(17.6%) were from living-unrelated donors and 217 cases(27.4%) were from cadaveric donors. The results of the trasnplantation were analyzed according to the various factors known to influence the outcome of transplantation. In living transplants, the overall patients survival rate was 98.2% at 1 year and 95.8% at 5 years, the corres-ponding allograft survival rate was 96.9 and 86.1N. In cadaveric transplants, the overall patients survival rate was 94.3% at 1 year and 94.3% at 5 years, the corresponding allograft survival rate was was 90.296 and 84.8%. In living transplants, donor age(>50yrs), recipient age(>50yrs), ABO compatability, pretrans-plant blood transfusion, diabetic history had no effect on allograft survival rate. But HLA DR cornpa-tability, serum creatinine(2.5mg/dL) at discharge and rejection history had effect on allograft survival(p<0.05). In living-related transplants, 5 year allograft survival rate was 100% at HLA identical group and 86% at HLA haplomatched group. But the statistical significance was not found(p=0.052). In cadaveric transplants, donor age(>50yrs), recipient age(>50yrs), ABO compatability, HLA DR match, diabetic history, pretransplant transfusion had no effect on allograft survival. But serum creatinine at discharge(>2.5mg/dL) and posttransplant rejection had effect on allograft survival.
Allografts ; Blood Transfusion ; Cadaver ; Chungcheongnam-do* ; Creatinine ; Humans ; Kidney Transplantation ; Survival Rate ; Tissue Donors

Gliomas, the most common primary tumors of the human central nervous system, are usually malignant and virtually incurable. They can be classified according to their cellular differentiation:astrocytoma, oligodendroglioma, and ependymoma. The majority of these brain tumors are astrocytomas, which typically progress through three histopathologically defined stages with the passage of time:one premalignant stage, low-grade astrocytoma, and two malignant stages, anaplastic astrocytoma and glioblastoma multiforme. Recent studies on the molecular mechanisms of carcinogensis have demonstrated a possible role for two classes of genes in neoplastic transformation:tumor suppressor genes and oncogenes. Tumor suppressor genes are wild-type alleles of genes that are believed to function normally in the cell to suppress cellular proliferation. Inactivation of both copies of suppressor gene may contribute to neoplastic transformation by removing a normal constraint to cell growth. The well characterised suppressor genes are RB gene and p53 gene. Gliomas, like most other cancers, are associated with several genetic changes, including oncogenes and suppressor genes. In an attempt to further our knowledge of tumor suppressor genes contributing glioma development and progression, restriction fragment length polymorphism(RFLP) analysis was done to determine loss of heterozygosity(LOH) on chromosome 10. 13q(RBI), 17p, and 22q containing putative tumor suppressor genes in 36 cases of human gliomas with various malignancy grades. And to detect p53 gene mutations at exon 5, 6, and 7 in 23 cases of malignant gliomas, polymerase chain reaction-single strand conformation polymorphisms(PCR-SSCP) analysis was performed. Loss of heterozygosity for loci on chromosome 10 were found in four of 5(60%) informative cases of glioblastoma multiforme and one of 2(50%) cases of anaplastic astrocytomas. Loss of heterozygosity on chromosome 17p was found in eight of 17(47%) informative cases of malignant gliomas, including 2 cases of anaplastic oligodendroglioma. There was no allelic loss of chromosome 10 and 17 in benign gliomas. Deletions on RBI locus were seen in six of 10(60%) informative cases of glioblastoma multiforme and two of 5(40%) informative cases of low-grade astrocytomas, suggesting that RBI gene may have a role associated with the early events in tumorigenesis. In PCR-SSCP analysis, six of 23(26%) cases of malignant gliomas, including one case of anaplastic oligodendroglioma, showed mobility shifts on exon 5 or 7 of p53 gene which suggest point mutations of this gene. There was no LOH at IGLC2 locus on chromosome 22. On the basis of the data presented here, it is possible to associate certain molecular abnormalities with gliomas of increasing grades of malignancy, deletion of RB gene, loss of heterozygosity on chromosome 17p, p53 gene mutation, and loss of allele on chromosome 10.
Alleles ; Astrocytoma ; Brain Neoplasms ; Brain* ; Carcinogenesis ; Cell Proliferation ; Central Nervous System ; Chromosomes, Human, Pair 10* ; Chromosomes, Human, Pair 22 ; Ependymoma ; Exons ; Genes, p53* ; Genes, Retinoblastoma ; Genes, Suppressor ; Genes, Tumor Suppressor ; Glioblastoma ; Glioma* ; Humans* ; Loss of Heterozygosity* ; Oligodendroglioma ; Oncogenes ; Point Mutation ; Polymorphism, Restriction Fragment Length

Gliomas, the most common primary tumors of the human central nervous system, are usually malignant and virtually incurable. They can be classified according to their cellular differentiation:astrocytoma, oligodendroglioma, and ependymoma. The majority of these brain tumors are astrocytomas, which typically progress through three histopathologically defined stages with the passage of time:one premalignant stage, low-grade astrocytoma, and two malignant stages, anaplastic astrocytoma and glioblastoma multiforme. Recent studies on the molecular mechanisms of carcinogensis have demonstrated a possible role for two classes of genes in neoplastic transformation:tumor suppressor genes and oncogenes. Tumor suppressor genes are wild-type alleles of genes that are believed to function normally in the cell to suppress cellular proliferation. Inactivation of both copies of suppressor gene may contribute to neoplastic transformation by removing a normal constraint to cell growth. The well characterised suppressor genes are RB gene and p53 gene. Gliomas, like most other cancers, are associated with several genetic changes, including oncogenes and suppressor genes. In an attempt to further our knowledge of tumor suppressor genes contributing glioma development and progression, restriction fragment length polymorphism(RFLP) analysis was done to determine loss of heterozygosity(LOH) on chromosome 10. 13q(RBI), 17p, and 22q containing putative tumor suppressor genes in 36 cases of human gliomas with various malignancy grades. And to detect p53 gene mutations at exon 5, 6, and 7 in 23 cases of malignant gliomas, polymerase chain reaction-single strand conformation polymorphisms(PCR-SSCP) analysis was performed. Loss of heterozygosity for loci on chromosome 10 were found in four of 5(60%) informative cases of glioblastoma multiforme and one of 2(50%) cases of anaplastic astrocytomas. Loss of heterozygosity on chromosome 17p was found in eight of 17(47%) informative cases of malignant gliomas, including 2 cases of anaplastic oligodendroglioma. There was no allelic loss of chromosome 10 and 17 in benign gliomas. Deletions on RBI locus were seen in six of 10(60%) informative cases of glioblastoma multiforme and two of 5(40%) informative cases of low-grade astrocytomas, suggesting that RBI gene may have a role associated with the early events in tumorigenesis. In PCR-SSCP analysis, six of 23(26%) cases of malignant gliomas, including one case of anaplastic oligodendroglioma, showed mobility shifts on exon 5 or 7 of p53 gene which suggest point mutations of this gene. There was no LOH at IGLC2 locus on chromosome 22. On the basis of the data presented here, it is possible to associate certain molecular abnormalities with gliomas of increasing grades of malignancy, deletion of RB gene, loss of heterozygosity on chromosome 17p, p53 gene mutation, and loss of allele on chromosome 10.
Alleles ; Astrocytoma ; Brain Neoplasms ; Brain* ; Carcinogenesis ; Cell Proliferation ; Central Nervous System ; Chromosomes, Human, Pair 10* ; Chromosomes, Human, Pair 22 ; Ependymoma ; Exons ; Genes, p53* ; Genes, Retinoblastoma ; Genes, Suppressor ; Genes, Tumor Suppressor ; Glioblastoma ; Glioma* ; Humans* ; Loss of Heterozygosity* ; Oligodendroglioma ; Oncogenes ; Point Mutation ; Polymorphism, Restriction Fragment Length

The purpose of this study was to examine the effects of anti-sperm antibody (ASA) on the fertilization processes using conventional IVF and ICSI procedure in human and hamster oocytes. In human IVF, we have observed restricted fertilization with sperm testing positive for ASA. (23~90% IgA, 60-97 % IgG). However, if ICSI was perform in the next IVF cycle with the same patients, we could successfully fertilize the oocytes (37%; p<0.001), thus achieving pregnancy and delivery. When the sperm were cocultured in medium containing ASA, there were binding of ASA to sperm surface. In addition, the mean rate of the acrosomal reaction in an in vitro acrosome reaction test was lower for Ab-bound sperm (43.5%) than for Ab-free sperm group (51.3%, p<0.05). We used human sperm and hamster oocytes to confirm the negative effects of the ASA on fertilization. The sperm and/or oocytes have been expose to medium containing ASA before IVF and ICSI. In this experiment, the ASA was bound to the oocyte and sperm surface. The following results were obtain by using various combinations of ASA free or ASA bound sperm with ASA free or ASA bound oocytes for IVF. When ASA free sperm were inseminate with ASA free and ASA bound hamster oocytes, the fertilization rates are 89.6% and 74.3% respectively. However, when ASA bound human sperm were use the results were 62.5% and 55.6% respectively. These shows the fertilization rate was significantly decreased in both ASA bound and ASA free oocytes when using ASA bound sperm. No difference found when ASA are present on the oocyte surface. When the hamster oocytes was treated by ICSI with ASA free or ASA bound human spermatozoa, no significant difference was found. These results showed that ICSI is the most promising method for couples who fertilization was not possible by conventional IVF because of ASA.
Acrosome Reaction ; Animals ; Antibodies* ; Cricetinae ; Family Characteristics ; Fertilization ; Humans ; Immunoglobulin A ; Oocytes ; Pregnancy ; Sperm Injections, Intracytoplasmic* ; Spermatozoa

PURPOSE: To investigate the results of surgical treatment of the symptomatic accessory navicular in adolescent. MATERIALS AND METHODS: 11 patients who were 11~16 years old with symptomatic accessory navicular were identified between 2001 and 2009. Six cases were diagnosed after trauma and 8 cases were diagnosed by accident with painful bony protrusion on medial aspect of foot. In cases after at least 3 months of ineffective conservative treatment, patients were treated by resection of accessory navicular and reattachment of tibialis posterior tendon to the apex of the medial longitudinal arch using periosteum and ligamentous soft tissue without transposition of its course. And then short leg cast was applied for correction of the flat foot (if it is combined) which was molded into the longitudinal arch with the talonavicular joint released and foot inverted during about 6 weeks. RESULTS: All were type II accessory navicular without tibialis posterior tendon lesions. In most cases pain was improved, results were excellent in seven and good in four. Calcaneal pitch angle and talus-first metatarsal angle was improved about 4.64degrees and 5.79degrees in average. CONCLUSION: Symptomatic accessory navicular in adolescent might not be associated with the tibialis posterior tendon lesions. The surgical treatment composed of excision of the accessory navicular with simple replication of the tibialis posterior tendon without altering its course led to good results in most cases. The procedure has a low rate of complications. And it is easy to be performed with a good satisfaction.
Adolescent ; Flatfoot ; Foot ; Fungi ; Humans ; Joints ; Leg ; Ligaments ; Metatarsal Bones ; Periosteum ; Tendons