BACKGROUND: Induction of anesthesia with a high dose of fentanyl and vecuronium decreases the heart rate and blood pressure. This study was designed to evaluate the effect of preinduction atropine on these hemodynamic changes in patients undergoing coronary artery bypass graft surgery (CABG). METHODS: Forty-one patients who underwent CABG were randomly divided into two groups. After insertion of a radial artery cannula and a Swan-Ganz catheter, normal saline 1 ml (control group, n = 20) or atropine 0.5 mg (atropine group, n = 21) was injected intravenously 1 min before the induction of anesthesia. Anesthesia was induced with a first dose of fentanyl (5-8 microgram/kg) and vecuronium (0.12 mg/kg) and a second dose of fentanyl (5-10 microgram/kg). The patient was then intubated. Hemodynamic variables were measured before the induction of anesthesia, 1 min after the administration of each drug during the induction of anesthesia and 5, 10, and 30 min after the intubation. RESULTS: There was no significant differences between the two groups in terms of demographic data except that the number of patients with diabetes mellitus was greater in the control group than in the atropine group. The number of patients treated for hypotension or bradycardia during the induction of anesthesia was greater in the control group than in the atropine group, but this was not statistically significant. Heart rates significantly decreased in the control group but were maintained in the atropine group without any significant tachycardia. Blood pressure significantly decreased in both groups. CONCLUSIONS: Intravenous injection of atropine before anesthetic induction in patients undergoing CABG attenuates the decrease in heart rate resulting from anesthetic induction with high dose fentanyl and vecuronium. However, it didn't prevent the decrease in blood pressure nor did it reduce the incidence of treatment for hypotension.
Anesthesia ; Atropine* ; Blood Pressure ; Bradycardia ; Catheters ; Coronary Artery Bypass* ; Coronary Vessels* ; Diabetes Mellitus ; Fentanyl* ; Heart Rate ; Hemodynamics* ; Humans ; Hypotension ; Incidence ; Injections, Intravenous ; Intubation ; Radial Artery ; Tachycardia ; Transplants ; Vecuronium Bromide*

No abstract available.
Electrocoagulation* ; Laparoscopy*

No abstract available.
Sterilization, Tubal*

We report a rescently experienced case with atypical radiologic manifestation of solid and papillary epithelial neoplasm of the pancreas in a 37 years old female patient. The tumor had heavy calcification on its capsule wall and septa. Instead of the usual encapsulated lesion with partly solid and partly cystic-hemorrhagic components, the lesion consisted of numerous fine cavitations containing air without fluid component except focal abscess fluid.
Abscess ; Female ; Humans ; Neoplasms, Glandular and Epithelial* ; Pancreas* ; Pancrelipase*

No abstract available.
Copper* ; Female ; Humans ; Intrauterine Devices*

The accuracy of Kato's self smear Kit was studied in screening a relatively unselected population group for cervical cancer. Routine cervicovaginal smears taken periodically would be the ideal method but would be unrealistic in view of the physician's time involved when considered on a large population scale. Three hundred patients were randomly selected at the Out Patient Clinic of Yonsei Medical Center and 26 cases grossly of cervical cancer were included in this group. We have here summarized the results briefly as follows. 1. Among 300 women examined in our OPD, 256 (85.3%) were classified as Pap. Class I or II, 9(0.3%) as a 'Defferred' group (Class II, Repeat), 18(6%) as Class III and 17(5.7%) as Class IV or V. 2. Fifteen of the total cases had insufficient material for evaluation (poor quality) and the major causes of the poor smears were vaginal douche within 24 hours, technical problems and cell degeneration. 3. The rate of agreement between the Self Smear Kit and cervicovaginal smear was as follows: a. The rate of complete agreement was 93.2% (280/300) b. The rate of complete or partial agreement was 96.7% (290/300). 4. The diagnostic accuracy of the Self Smear Kit was as follows: a. If we assumed the 'Deferred' group to be detection failures for uterine cancer, the diagnostic accuracy would be 82.4%. b. If we assumed the 'Deferred' group to be detection successes, the diagnostic accuracy would be 94.1%. 5. The quality of self smears was superior when taken by an aid nurse rather than by the patient herself. 6. Optimal time for good preservation with the Self Smear Kit prior to pap. stain under the following temperatures was proven experimentally to be as follows; a. At 5 degrees C: 3 days after smear b. At 15 degrees C: 3 days after smear c. At 30 degrees C: 2 days after smear
Adult ; Cervix Neoplasms/prevention & control* ; Female ; Human ; Mass Screening/methods* ; Middle Age ; Vaginal Smears/instrumentation ; Vaginal Smears/methods*

Estriol excreation was studied in 216 normal and 61 pathologic pregnancies. The 95% fiducial limits of the normal excretion of estriol, within which 95% out of 100 future determinations in normal pregnancies are expected to fall, were established. The estriol curve in normal pregnancy in this study agrees well in its general shape with those presented by previous investigators who used different chemical methods of determination. The estriol values in pathologic pregnancies with preeclampsia. intrauterine fetal death and antepartum hemorrage have been analyzed. The clinical significance of estriol determinations during pregnancy was discussed.
Estriol/urine* ; Female ; Fetal Death/urine ; Human ; Pre-Eclampsia/urine ; Pregnancy* ; Pregnancy Complications/urine* ; Uterine Hemorrhage/urine

Carbon monoxide gas is found in the atmosphere whenever society has become industrialized. In addition to the fact that Korea has become industrialized, bituminous coal is used to heat homes here, in heating systems that, if not very carefully maintained, leak this gas, resulting in a number of deaths and near deaths each winter. It has only rarely been reported by investigators that genetic damage may be done transplacentally to a human fetus by a pregnant woman's being poisoned by CO. We explored this by evaluating the damage done to the mouse fetus through an in vivo experiment, using micronucleus and sister chromatid exchange (SCE) tests. Mice were mated and pregnant ones divided into a group that received acute exposures on 3 different days, a group that received chronic exposure, and a control group. In the meantime in the control group the incidence of both micronuclei and SCE was less on the maternal side, in both the acute and chronic exposure groups, whereas the incidences of both micronuclei and SCE were more on the maternal side. However, the incidence on the fetal side was not far behind. Increasing, the dosage of carbon monoxide with gestational age increased the incidence of both micronuclei and SCE in the mother and fetus alike.
Animal ; Carbon Monoxide/toxicity* ; Cell Nucleus/drug effects* ; Female ; Fetus/drug effects* ; Maternal-Fetal Exchange ; Mice ; Mice, Inbred ICR ; Mutagens* ; Pregnancy ; Sister Chromatid Exchange/drug effects*

The aim of this study is to evaluate pituitary-ovarian function at different postpartum periods during the lactational amenorrhea in order to understand the mechanism by which puerperal lactation is associated with a protracted period of amenorrhea and natural infertility. Ninety four lactating women and 119 lactating women with menstruation, aged between 21 and 38 years, volunteered for this study. The pituitary was relatively insensitive to LH-RH during the first 3 weeks following delivery. The recovery of FSH responsiveness to LH-RH occurred earlier than that of LH. Normal FSH response resumed in the 2nd week while the LH response, although not normal, started at the 3rd week postpartum. Pituitary responsiveness after the 5th week postpartum was similar to that occurring in normally menstruating women, except that FSH response was exagerated. Serum prolactin levels were elevated above 160 ng/ml until the 5th week postpartum and decreased to 84.2 ng/ml in the 6th week postpartum. It appears that at least one reason for anovulation during the first four weeks following delivery is the relative insensitivity of the pituitary to hypothalamic stimulation. Prolactin does not seem to modulate pituitary responsiveness to LH-RH. In order to clarify hormonal profiles during the lactational amenorrhea beyond the 5th week puerperium, serum levels of LH, FSH, prolactin, estradiol and progesterone were determined during different postpartum periods. Serum FSH and LH levels during 1-10 months postpartum were similar to basal levels seen during the normal menstrual cycle. Serum estradiol concentrations throughout 1-10 months postpartum, however, were significantly decreased as compared with the levels during the follicular phase of the normal menstrual cycle. Serum prolactin levels were elevated throughout 1-10 months postpartum in lactating amenorrhic women but decreased as the postpartum period lengthened. As compared with lactating amenorrhic women, lactating women with resumed menstruation showed a decrease in prolactin levels from 89.20 ng/ml to 51.39 ng/ml at 1-3 months, from 75.08 ng/ml to 49.99 ng/ml at 4-6 months, and from 54.73 ng/ml to 28.74ng/ml at 7-10 months postpartum. These results suggest that the apparent anovulation seen beyond 5th week postpartum during lactation was not due to pituitary insensitivity to LH-RH. Rather, prolactindependent mechanism interfering with cyclic activity may be operative during long term lactation.
Amenorrhea/etiology* ; Female ; Gonadorelin/pharmacology ; Gonadotropins, Pituitary/secretion ; Human ; Lactation* ; Ovary/physiology* ; Pituitary Gland/physiology* ; Pregnancy ; Prolactin/physiology ; Puerperium*

An anastomosis stricture with a total obstruction is rare and treatment options are variable. We describe our experience with a combination of a single port transanal laparoscopic approach and intraoperative colonoscopic balloon dilatation. The patient was a 48-year-old man with rectal cancer. A laparoscopic single port lower anterior resection and diverting ileostomy were performed followed by a colon study and ileostomy takedown. The colon study and sigmoidoscopy revealed total obstruction of the rectum at the anastomosis level. We employed a transanal approach using a single port to correct this. We located the anastomosis stricture site and generated a lumen using a dissector and electocautery method to insert the balloon device. Colonoscopic balloon dilatation was subsequently successful. The patient was discharged with no postoperative complications. A laparoscopic single port transanal approach with an intraoperative colonoscopic balloon dilatation is a viable alternative approach to treating an anastomosis stricture of the rectum.