No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

BACKGROUND: Induction of anesthesia with propofol commonly associated with reduction in systemic arterial pressure, especially in elderly and high risk patients. This reduction is influenced by the dose and rate of propofol injection. The aim of this study was to examine the effect of different injection rate of propofol on vital signs, dose requirement and induction time during induction period. METHODS: Unpremedicated one hundred and twenty ASA physical status I and II patients aged 20~60 years scheduled for elective surgery were randomly allocated into one of four (150, 300, 600, 1200 ml/hr) groups according to speed of injection of propofol during induction period. Loss of verbal contact was taken as the end-point of induction. Vital signs, SpO2, dose requirement of propofol and induction time were checked. RESULTS: As the injection rate of propofol became slower, there were significant reduction in induction dose and increase in induction time (p<0.05). For example, induction dose and time were 1.82 mg/kg, 223 +/- 58 sec in 150 ml/hr group and 3.14 mg/kg, 50 +/- 11 sec in 1200 ml/hr group, respectively. Also, decrease in systolic and diastolic pressure were less marked at lower injection rates. CONCLUSIONS: Slower injection of propofol produces less vital sign changes and dose requirement for the induction of anesthesia.
Aged ; Anesthesia* ; Arterial Pressure ; Blood Pressure ; Humans ; Propofol* ; Vital Signs*

No abstract available.
Leiomyoma*

The authors have analysed 39 rheumatoid wrists in 25 rheumatoid patients, who underwent vsrious surgeries including arthroscopic and open synovectomy, partial and total arthrodesis and total wrist arthroplasty at the department of orthopaedic surgery, St. Mary's Hospital from November 1985 to April 1988, and the effect of eaeh surgery on the wrist function and proper time of operation are discussed. The results were as follows; 1. The patients who were classified as a classical rheumatoid arthritis according to the ARA criteria were four males and twenty-one females, with a mean age of 43 yesrs, and the functional capacity of the patients before operation was graded in III for twenty-threeand in IV for two patients. 2. Out of 25 patients (39 wrists), 14 patients are in bilateral and II patients in unilateral involvement. The synovectomy in 13 wrists, arthrodesis in 24 wrists and total joint replacement in 2 wrists were performed and followed them for average 17 months after operation. 3. The synovectomy were done for 13 wrists in grade II and III according to the classification of rheumstoid arthritis by radiology(3). There were two cases of recurrence in the cases of synovectomy, but not in replacement and arthrodesis. 4. The arthrodesis of wrist was performed for 24 wrists-bilateral arthrodesis in 3 patient (6 wrists) and unilateral fusion in 18 patients. For 4 cases out of 24 cases of wrist arthrodesis, the second and third carpo-metacsrpal joints were fused simultaneously. 5. Protek total wrist arthroplasty was done in 2 cases snd followed them for more than9 months with relatively good clinical results. Finally, it is our beliefs for rheumatoid wrists that surgery is often indicated to control the various wrist problems, early synovectomy is strongly indicated, and partial wrist fusion has proven to be effective in patients with moderate destruction, deformity and pain, but the total wrist arthrodesis and arthroplasty is still in controversy. The proper surgery for rheumatoid wrist should be determined by the clinical severity of disease and radiological changes of wrist.
Arthritis ; Arthritis, Rheumatoid ; Arthrodesis ; Arthroplasty ; Classification ; Congenital Abnormalities ; Female ; Humans ; Joints ; Male ; Recurrence ; Wrist

Varying types of polyps could occur in the vermiform appendix. However, it is very unusual. Collins found 57 cases (0.08%) of benign mucosal polyps in the 71,000 cases of appendectomy specimens. There has been no reported case of appendiceal polyp in the literature in Korea. The authors experienced two cases of polyp in the vermiform appendix. The first case was a 51 year-old male patient who received a left hemicolectomy due to colonic polyposis. The second case was a 71 year-old male patient who was treated by appendectomy under the clinical diagnosis of acute appendicitis. The microscopic type of both cases were hyperplastic polyp.
Male ; Humans

No abstract available.
Brain* ; Child* ; Humans ; Magnetic Resonance Imaging*

BACKGROUND: The aim of the present study was to evaluate the effect of sevoflurane with or without nitrous oxide compared with propofol on the incidence of postoperative nausea and vomiting after gynecologic laparoscopy. METHODS: One hundred and forty patients of ASA status I or II, undergoing gynecologic laparoscopy were studied. Patients were allocated randomly to one of four groups: (I) GROUP 1 (n = 35): Anesthesia was induced and maintained with propofol using a computer controlled infusion system in combination with 60% nitrous oxide in oxygen. (II) GROUP 2 (n = 35): Anesthesia was induced and maintained with sevoflurane in combination with 60% nitrous oxide in oxygen. (III) GROUP 3 (n = 35): Anesthesia was induced with sevoflurane with 100% oxygen and maintained with sevoflurane in combination with 60% medical air in oxygen. (IV) GROUP 4 (n = 35): Anesthesia was induced with propofol 2 mg/kg intravenously and maintained with sevoflurane in combination with 60% nitrous oxide in oxygen. The incidence of postoperative nausea and vomiting and requests for antiemetic rescue medication were assessed 2 and 24 hours after surgery. RESULTS: In group 1 (compared with groups 2, 3, and 4), the incidences of postoperative nausea and vomiting (9% compared with 31%, 29%, and 37%) within the first 2 hours after surgery, were significantly lower. However, there were no statistical differences among the four groups in the 2 to 24 hours after surgery with respect to the incidences of postoperative nausea and vomiting. Conclusion: For gynecologic laparoscopy, the use of propofol for induction and maintenance is more effective at preventing postoperative nausea and vomiting than sevoflurane with or without nitrous oxide within the first 2 hours of surgery, This study found no statistically significant difference between the postoperative incidence of nausea and vomiting, whether 60% N2O or medical air was used with sevoflurane.
Anesthesia ; Humans ; Incidence ; Laparoscopy* ; Nausea ; Nitrous Oxide ; Oxygen ; Postoperative Nausea and Vomiting* ; Propofol ; Vomiting

BACKGROUND: In Korea, methicillin-resistant Staphylococcus aureus (MRSA) is the most common nosocomial pathogen, which is particularly prevalent in ICU. We performed this study to investigate the modes of transmission of MRSA and the role of nasal carriage of11RSA to subsequent MRSA infections in medical ICU. METHODS: All patients admitted to the medical lCU during 10 months were studied prospectively. Nasal swabs were done in all patients within 24 hours of admission and weekly thereafter. For patients who developed MRSA infections, additional cultures were done before start of antibiotics. Surveillance cultures of nostril, hands of health care workers and environment were done once at the end of the study. Bacterial typing was performed with pulsed-field gel electrophoresis (PFGE) using Smal. RESULTS: Among 138 patients enrolled, 24 patients (17.4 %) were nasal colonizers, and 9 patients (6.5%) were already infected with MRSA prior to admission. New nasal colonization among patients, in whom follow up nasal cultures were done at the interval of 3 days or more, developed at 36.2 % (21/58 patients). New infections of MRSA in patients who were admitted for more than 3 days, developed at 11.7 % (13/111 patients). Patients in isolation room were infected with MRSA less frequently (P <0.05). No other risk factors for nasal colonization of MRSA or MRSA infections were found. There were no significant differences between nasal colonizers and non-colonizers in the incidence of MRSA infections. PFGE analysis of MRSA isolates from patients showed several major patterns, which were similar in both MRSA isolates obtained prior to admission and those acquired after admission. PFGE patterns of MRSA isolates from health care workers and environment were different from those of patients. CONCLUSION: Patients who were infected or colonized with MRSA seemed to be a major source for transmission of MRSA in medical ICU. In medical lCU, where MRSA were prevalent, nasal colonization was not related to the increased incidence of MRSA infections.
Anti-Bacterial Agents ; Bacterial Typing Techniques ; Colon ; Cross Infection ; Delivery of Health Care ; Electrophoresis, Gel, Pulsed-Field ; Follow-Up Studies ; Hand ; Humans ; Incidence ; Intensive Care Units ; Korea ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Prospective Studies ; Risk Factors ; Staphylococcus aureus

A 1q21.1 microdeletion is an extremely rare chromosomal abnormality that results in phenotypic diversity and incomplete penetrance. Patients with a 1q21.1 microdeletion exhibit neurological-psychiatric problems, microcephaly, epilepsy, facial dysmorphism, cataract, and thrombocytopenia absent radius syndrome. We reported a neonate with confirmed intrauterine growth restriction (IUGR), micrognathia, glossoptosis, upper airway obstruction, facial dysmorphism, and eye abnormality at birth as well as developmental delay at the age of 1 year. These clinical manifestations, except for the IUGR and upper airway obstruction, in the neonate indicated a 1q21.1 microdeletion. Here, we report a rare case of a 1q21.1 microdeletion obtained via paternal inheritance in a newborn with upper airway obstruction caused by glossoptosis and tracheal stenosis.
Airway Obstruction* ; Cataract ; Chromosome Aberrations ; Chromosome Deletion ; Epilepsy ; Eye Abnormalities ; Fetal Growth Retardation ; Glossoptosis ; Humans ; Infant, Newborn* ; Microarray Analysis ; Microcephaly ; Micrognathism ; Parturition ; Penetrance ; Radius ; Thrombocytopenia ; Tracheal Stenosis ; Wills

The Mental foramen is the exit of the mandibular canal through which the mental nerve pass. The location of the mental foramen, an anthropologically valuable structure, is not only influenced by factors such as tooth attrition, age, loss of teeth, and alveolar bone resorption but also race, diet and geographical position. This study was undertaken to clarify the anthropological characteristics of the location of the mental foramina in the mandibles of the selected Korean population. Forty four mandibles (23 males and 21 females with average age of 66.5 years obtained from the collection of the department of anatomy and cell biology of Hanyang medical college were studied. The apparent position of mental foramen in relation to the mandibular teeth and the true position of mental foramen in relation to the body of the mandible were measured. The obtained results were as follows: In 89% of 35 mandibular sides the mental foramen was located around the second premolar, the most commonly between the second premolar and the first molar, which belongs to type V according to Wang et al. (1986). The distances from the alveolar bone crest across the mental foramen to the lower border of the mandible was 27.4+/-2.4 mm. The mean distances from mental foramen to the alveolar crest and lower border were 12.1+/-2.3 and 13.1+/-2.0 mm, respectively. The mean position of mental foramen was 4.08 on the line between the second premolar and the first molar. The mental foramen of selected Korean population was located more posterioly when compared with many previous reports from various races. The results of this study would be useful to clarify the anthropological position of the mental foramen in Korean.
Anthropology ; Bicuspid ; Bone Resorption ; Continental Population Groups ; Diet ; Female ; Humans ; Male ; Mandible ; Molar ; Tooth ; Tooth Attrition