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

PURPOSE: Gonadotropin-releasing hormone agonist (GnRHa) is known for improving final adult height in patients with central precocious puberty (CPP). This study aimed to investigate the age of menarche and near adult height in girls with CPP who had been treated with GnRHa. METHODS: In this retrospective study, we reviewed the medical records of 71 Korean girls with CPP who had started menarche or reached over 13 years of bone age after long-term GnRHa treatment. We estimated near adult height using the Bayley-Pinneau method and identified the age of menarche in girls with CPP. RESULTS: Mean chronological and bone age at menarche were 11.9+/-0.7 and 12.8+/-0.4 years, respectively. The period between menarche and the end of treatment was 14.0+/-5.6 months. Posttreatment near adult height was 163.8+/-4.7 cm, which was significantly greater than pretreatment predicted adult height (158.7+/-4.1 cm). CONCLUSION: GnRHa treatment in girls with CPP could improve final adult height and made the age of menarche close to that of the general population.
Adult* ; Female ; Gonadotropin-Releasing Hormone* ; Humans ; Medical Records ; Menarche* ; Puberty, Precocious* ; Retrospective Studies

No abstract available.
Cisplatin ; Paclitaxel ; Radiodermatitis

Neuromyelitis optica (NMO) is an idiopathic inflammatory demyelinating disease, characterized by optic neuritis and myelitis. NMO is a very uncommon and serious neurologic manifestation of systemic lupus erythematous (SLE). We report a 28-year-old man with NMO as neuropsychiatric manifestation of SLE. He was diagnosed as lupus nephritis at 16-year-old. He had optic neuritis at three years and seven months ago. Oral prednisolone was tapered off according to the improved eye symptoms. Two months later, he visited rheumatology clinics for urinary disturbance and paresthesia on both feet. A spinal magnetic resonance imaging revealed increased signal intensity in T2-weighted images from second to sixth cervical level and from eleventh to twelfth thoracic level. We diagnosed neuromyelitis optica and treated with intravenous cyclophosphamide therapy monthly for three times. He was discharged without any neurological deficits and has been followed up.
Adolescent ; Adult ; Cyclophosphamide ; Demyelinating Diseases ; Foot ; Humans ; Lupus Nephritis ; Magnetic Resonance Imaging ; Myelitis ; Neurologic Manifestations ; Neuromyelitis Optica* ; Optic Neuritis ; Paresthesia ; Prednisolone ; Rheumatology