BACKGROUND: Intravenous patient controlled analgesia (IV-PCA) is a very popular and relatively safe technique due to its innate negative feedback mechanism. Morphine, the most commonly used analgesic, however, has its own drawbacks due to troublesome side effects. Narcotic agonist-antagonists are known to have ceiling effects not only to their analgesic potency, but also to their side effects. The authors studied the efficacy and incidence of side effects of Butorphanol IV-PCA for postoperative analgesia and compared these to morphine. METHODS: 38 ASA class I or II patients, undergoing gynecological surgery were randomly assigned into two groups, respectively Butorphanol and Morphine and examined hemodynamic changes, overall pain relief, patients satisfaction and the frequency of side effects. After general anesthesia, each patient randomly received loading dose of butorphanol or morphine in the recovery room and discharged to the floor with the PCA module. Upon arrival, individual patient was evaluated at predetermined time interval for 24 hours. RESULTS: The percentage of patient satisfaction was very high in both groups. The incidence of nausea was less in butorphanol group. The incidence of other side effects was statistically insignificant. CONCLUSIONS: Butorphanol has less incidence of side effects and comparable level of analgesia when compared to morphine. We conclude that butorphanol may be considered as a part of routine IV-PCA regimen, in postoperative pain management.
Analgesia ; Analgesia, Patient-Controlled* ; Anesthesia, General ; Butorphanol* ; Female ; Gynecologic Surgical Procedures* ; Hemodynamics ; Humans ; Incidence ; Morphine* ; Nausea ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Patient Satisfaction ; Recovery Room

No abstract available.
Thrombasthenia*

Background: Conventional laryngoscopy with Macintosh blade requires a movement of the head, neck and cervical spine. The Bullard laryngoscope is an anatomically shaped, potentially eliminating the need for cervical spine extension. Bullard and Macintosh laryngoscopes were compared by measuring the degree of cervical spine extension by radiological measurement. Methods: Eighteen patients requiring endotracheal intubation were studied. Anesthesia was induced in neutral head position followed by laryngoscopy. Each patients was intubated two times by Macintosh and Bullard laryngoscope in random order. Radiographic evaluation was performed to determine the degree of cervical spine extension on four occasions; before induction, during facial mask ventilation, and during Bullard and Macintosh laryngoscopy. Results: The extension of cervical spine was significantly less following Bullard laryngoscopy than Macintosh laryngoscopy for best view (p<0.05). Conclusions: The Bullard laryngoscope can be used with less cervical spine extension than Macintosh laryngoscope. It may be useful in patients in whom cervical spine movement is limited or undesirable.
Anesthesia ; Head ; Humans ; Intubation, Intratracheal ; Laryngoscopes ; Laryngoscopy* ; Masks ; Neck ; Spine* ; Ventilation

PURPOSE: The purpose of this study was to examine the effects of exercise intervention, including dumbbell(weight lifting), walking, and yoga, on the body composition, physiologic factors, body image, and perceived health in the community-dwelling women. METHOD: This study utilized pretest-posttest design with three types of exercise interventions. The types of exercise intervention included dumbbell, walking, and yoga. RESULTS: A total of 136 subjects were included: 49 for dumbbell, 67 for walking, and 20 for yoga. As measures of body composition, BMI, body weight, and body fat rate were significantly improved only after dumbbell intervention(p<.01). Systolic blood pressures were significantly decreased in the groups of dumbbell and walking. Diastolic blood pressure was significantly declined only in the walking group. Vital capacities and body image were improved in all groups(p<.01). However, total cholesterol levels were not improved in all groups(p>.05) and none of the measures for perceived health state were not significantly changed in all groups(p>.05). CONCLUSION: From the findings of this study, it was demonstrated that the effects of exercise interventions were differentiated by their types and variables to be affected. Therefore, future studies that apply the tailored exercise intervention to each age-categorical group are needed.
Adipose Tissue ; Blood Pressure ; Body Composition ; Body Image ; Body Weight ; Cholesterol ; Female ; Humans ; Vital Capacity ; Walking* ; Yoga* ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to examine the effects of exercise intervention, including dumbbell(weight lifting), walking, and yoga, on the body composition, physiologic factors, body image, and perceived health in the community-dwelling women. METHOD: This study utilized pretest-posttest design with three types of exercise interventions. The types of exercise intervention included dumbbell, walking, and yoga. RESULTS: A total of 136 subjects were included: 49 for dumbbell, 67 for walking, and 20 for yoga. As measures of body composition, BMI, body weight, and body fat rate were significantly improved only after dumbbell intervention(p<.01). Systolic blood pressures were significantly decreased in the groups of dumbbell and walking. Diastolic blood pressure was significantly declined only in the walking group. Vital capacities and body image were improved in all groups(p<.01). However, total cholesterol levels were not improved in all groups(p>.05) and none of the measures for perceived health state were not significantly changed in all groups(p>.05). CONCLUSION: From the findings of this study, it was demonstrated that the effects of exercise interventions were differentiated by their types and variables to be affected. Therefore, future studies that apply the tailored exercise intervention to each age-categorical group are needed.
Adipose Tissue ; Blood Pressure ; Body Composition ; Body Image ; Body Weight ; Cholesterol ; Female ; Humans ; Vital Capacity ; Walking* ; Yoga* ; Surveys and Questionnaires

Carcinosarcoma of the salivary gland is an extremely rare tumor that is composed of both malignant epithelial and mesenchymal components. Diagnosing carcinosarcoma with fine-needle aspiration cytology is challenging because of its overlapping cytomorphologic characteristics with other high-grade malignant salivary gland tumors. Among the many features, including pleomorphic oncocytoid epithelial components, necrotic background, and mitoses, recognizing the singly scattered atypical spindle cells is most essential in carcinosarcoma. We present a case of a 66-year-old male patient with characteristic features of carcinosarcoma, who was successfully treated by wide local excision and subsequent radiation therapy.
Aged ; Biopsy, Fine-Needle ; Carcinosarcoma ; Humans ; Male ; Mitosis ; Salivary Glands

Gastritis cystica profunda (GCP) is a rare disease which is mainly observed at the site of gastroenterostomy. However, it may occur in the stomach without a previous history of surgery. Under histologic examination GCP shows hyperplastic and cystic dilatation of the pseudopyloric glands with submucosal invasion. GCP with sessile polypoid pro-trusion is most commonly found but, submucosal tumors, giant gastric mucosal folds and pedunculated forms are occasionally found. We present the case of GCP showing a large sized polyp (3 2.5 2.5 cm) with a long pendulous pedicle that had developed in the fundus of the stomach without previous surgical history. Endoscopic polypectomy was performed for confirmation.
Dilatation ; Gastritis* ; Gastroenterostomy ; Polyps ; Rare Diseases ; Stomach

BACKGROUND/AIMS: This study was undertaken to perform a cross-cultural adaptation of the Behcet's Disease Current Activity Form (BDCAF, version 2006) questionnaire to the Korean language and to evaluate its reliability and validity in a population of Korean patients with Behcet's disease (BD). METHODS: A cross-cultural study was conducted among patients with BD who attended our rheumatology clinic between November 2012 and March 2013. There were 11 males and 35 females in the group. The mean age of the participants was 48.5 years and the mean disease duration was 6.4 years. The first BDCAF questionnaire was completed on arrival and the second assessment was performed 20 minutes later by a different physician. The test-retest reliability was analyzed by computing kappa statistics. Kappa scores of > 0.6 indicated a good agreement. To assess the validity, we compared the total BDCAF score with the patient's/clinician's perception of disease activity and the Korean version of the Behcet's Disease Quality of Life (BDQOL). RESULTS: For the test-retest reliability, good agreements were achieved on items such as headache, oral/genital ulceration, erythema, skin pustules, arthralgia, nausea/vomiting/abdominal pain, and diarrhea with altered/frank blood per rectum. Moderate agreement was observed for eye and nervous system involvement. We achieved a fair agreement for arthritis and major vessel involvement. Significant correlations were obtained between the total BDCAF score with the BDQOL and the patient's/clinician's perception of disease activity p < 0.05). CONCLUSIONS: The Korean version of the BDCAF is a reliable and valid instrument for measuring current disease activity in Korean BD patients.
Adult ; Asian Continental Ancestry Group/psychology ; Behcet Syndrome/*diagnosis/physiopathology/psychology ; Comprehension ; Cultural Characteristics ; Female ; Humans ; Language ; Male ; Middle Aged ; Observer Variation ; Predictive Value of Tests ; Reproducibility of Results ; Republic of Korea/epidemiology ; Severity of Illness Index ; *Surveys and Questionnaires

BACKGROUND: Although degree of motor blockade during high thoracic spinal anesthesia is difficult to determine, pulmonary function may reflect the level of motor blockade. So we checked pulmonary function during spinal anesthesia with two different local anesthetic agents. METHODS: 50 patients, ASA PS 1-2, were randomly divided into two groups. After basal pulmonary function test (FVC: forced vital capacity, FEV1: forced expiratory volume in one second, PEFR: peak expiratory flow rate, PEP: peak expiratory pressure, PIP: peak inspiratory pressure.), the patients received spinal anesthesia with either 0.5% hyperbaric bupivacaine or 0.5% hyperbaric tetracaine. Thirty minutes after injection, level of sensory blockade was checked by pinprick test and pulmonary function test was performed. RESULTS: Almost all the values of pulmonary function reduced after spinal anesthesia, but the degrees of reduction were not differ in two groups except PEP, which reduced more profoundly in tetracaine group than bupivacaine group. CONCLUSIONS: It is more desirable that we use bupivacaine rather than tetracaine as spinal anesthetic agent in the patient with poor pulmonary function.
Anesthesia, Spinal* ; Anesthetics ; Bupivacaine* ; Forced Expiratory Volume ; Humans ; Peak Expiratory Flow Rate ; Respiratory Function Tests ; Tetracaine* ; Vital Capacity

Necrotizing fasciitis (NF) is an uncommon, life-threatening infection of the subcutaneous tissue and superficial fascia. The clinical course of NF is rapid and progressive, and it is often fatal despite the appropriate therapy. The prognosis of NF depends on a timely diagnosis and then proper treatment. At onset it may not be possible to clearly distinguish NF from minor soft-tissue infections. Although infection are common due to the use of steroids and immunosuppressive agents in patients with systemic lupus erythematous (SLE), it is interesting that NF has rarely been reported with SLE. Here, we present two cases of NF with SLE.
Fasciitis, Necrotizing ; Humans ; Immunosuppressive Agents ; Prognosis ; Steroids ; Subcutaneous Tissue