No abstract available.
Child* ; Humans ; Humerus*

The present study was performed to compare maternal and perinatal outcomes in triplet and twin pregnancies with the result of ART(Assisted Reproductive Technology). Each pregnancy of 18 triplet pregnancies with 18 weeks or more was matched for maternal age, EDC(estimated date of confinement), parity, history of preterm delivery, indication of ART with two sets of twin pregnancies. Triplet pregnancies had a significantly shorter gestational age at delivery than twin pregnancies(30.4 versus 34.6 weeks), and a significantly lower mean birth weight(1,514 versus 2,286g). The mean hospital stay was significantly longer in triplets(22.3 versus 10.1 days). The incidences of 5 min Apgar score less than 7, neonatal deaths were significantly more often in triplets than twins; 18(33.3%) vs 6(8.3%), 15(27.8%) vs 7(9.72%), respectively. There were significant differences in the incidence of neonatal complications such as respiratory distress syndrome; 14(25.9%) vs 7(9.72%), ventilatory support; 18(33.3%) vs 5(6.9%), neonatal seizure; 9(16.7%) vs 0, btween the two groups. However, there were no significant differences between the groups in maternal complications or neonatal morbidity such as congenital malformations or hyperbilirubinemia, intraventricular hemorrhage, or bronchopulmonary dysplasia. We suggest that counseling patient regarding the anticipated perinatal outcomes of triplet pregnancies with the result of ART should be conducted with our data.
Apgar Score ; Bronchopulmonary Dysplasia ; Counseling ; Female ; Gestational Age ; Hemorrhage ; Humans ; Hyperbilirubinemia ; Incidence ; Infant, Newborn ; Length of Stay ; Maternal Age ; Parity ; Parturition ; Pregnancy ; Pregnancy, Triplet ; Pregnancy, Twin* ; Reproductive Techniques, Assisted* ; Seizures ; Triplets*

BACKGROUND: The present study was undertaken to determine the clinical effect of hyperbaric 0.5% bupivacaine spinal anesthesia compared with the 0.5% plain bupivacaine anesthesia for lower extremity operation. METHODS: We evaluated the clinical effects in 40 patients having orthopedic surgery of the lower extremities during spinal anesthesia using 15 mg of bupivacaine 0.5% in 8% dextrose (group I) or 15 mg of bupivacaine 0.5% plain (group II). The drugs were administrated in a randomized fashion. We measured the maximal sensory block level according to pinprick test, the time to maximal sensory block, the regression time, the duration of sensory block, the time to complete motor block and the duration of complete motor block. RESULTS: The mean maximal sensory block level was higher in group II (T6) than in group I (T7). The regression time, the duration of sensory block and the duration of complete motor block was significantly longer in group II than in group I. CONCLUSIONS: In conclusion, both the hyperbaric and the plain 0.5% bupivacaine spinal anesthesia are equally suitable for lower extremity operation.
Anesthesia ; Anesthesia, Spinal* ; Anesthetics ; Bupivacaine* ; Glucose ; Humans ; Lower Extremity* ; Orthopedics

BACKGROUND: It has been reported that two common vasodilators, nitroglycerin (NTG) and sodium nitroprusside (SNP), inhibit regional HPV and decrease arterial oxygenation as a result. The purpose of the present study was, therefore, to determine the comparative effect of NTG and SNP on HPV in a rabbit model of isolated lung perfusion with exclusion of the influential factors on HPV. METHODS: In adult white rabbits (n=20), lungs were isolated and perfused with the constant pulmonary blood flow. The acid-base status and temperature of perfusate was also constantly maintained. Thirty minutes later, baseline hypoxic pressor response (HPR) was measured as the difference of pulmonary artery pressure (PAP) between a period of 95% hyperoxic gas inhalation and that of 3% hypoxic gas inhalation. ED50 of NTG and SNP was calculated from the hypoxic pressor response measured in the same way, according to changes of doses (0.5, 1.0, 2.0, and 5.0 microgram/kg). RESULTS: Both NTG and SNP significantly decreased the baseline PAP in the doses of 1.0 microgram/kg and above, and also decreased the HPR in a dose-related manner. ED50 of SNP was significantly lower than that of NTG. CONCLUSIONS: NTG and SNP dilated directly the pulmonary vasculature and inhibited HPV in a dose- related manner. SNP had a greater inhibiting effect on HPV than NTG.
Adult ; Humans ; Inhalation ; Lung* ; Nitroglycerin* ; Nitroprusside* ; Oxygen ; Perfusion ; Pulmonary Artery ; Rabbits ; Vasoconstriction* ; Vasodilator Agents

BACKGROUND: The purpose of this study was to compare the effects of ondansetron and granisetron on the prevention of postoperative nausea and vomiting (PONV) in gynecologic patients. METHODS: In a randomized placebo-controlled study, 200 gynecologic patients were divided into 5 groups. Each patient received one of 5 medications: placebo (saline 3 ml), ondansetron 4 mg (O4), ondansetron 8 mg (O8), granisetron 1.5 mg (G1.5) and granisetron 3 mg (G3). They were administered intravenously immediately before the induction of anesthesia. A standardized inhalation anesthesia and a postoperative intravenous patient-controlled analgesia were applied. Twenty four hours after anesthesia, the incidence and severity of PONV and other adverse effects were assessed. RESULTS: The incidence of PONV was 88%, 83%, 75%, 70% and 60% in the placebo, O4, O8, G1.5 and G3 groups, respectively, which showed significantly lower value in the G3 group than in the placebo and O4 groups (P< 0.05). The severity of PONV was also significantly lower in the G3 group than in the placebo group (P < 0.05). CONCLUSIONS: In this study, granisetron 3 mg showed a better prophylactic effect in the mitigation of PONV in gynecologic patients then a placebo or ondansetron 4 mg.
Analgesia, Patient-Controlled ; Anesthesia ; Anesthesia, Inhalation ; Female ; Granisetron* ; Gynecologic Surgical Procedures* ; Humans ; Incidence ; Ondansetron* ; Postoperative Nausea and Vomiting*

No abstract available.
Antibodies* ; Chungcheongnam-do* ; Diagnosis* ; Immunoglobulin G* ; Immunoglobulin M* ; Orientia tsutsugamushi* ; Rickettsia* ; Scrub Typhus*

No abstract available.
Antibodies* ; Chungcheongnam-do* ; Diagnosis* ; Immunoglobulin G* ; Immunoglobulin M* ; Orientia tsutsugamushi* ; Rickettsia* ; Scrub Typhus*

Fetal bilateral renal agenesis is a lethal congenital anomaly. An early and reliable prenatal diagnosis is extremely important as it may offer options for pregnancy termination as early as possible. The criteria for the ultrasonographic diagnosis of bilateral renal agenesis are severe oligohydramnios, nonvisualization of the bladder, and the empty renal fossa. However, severe oligohydramnios makes it difficult to diagnose the disease because of poor sonographic resolution. We present two cases of bilateral renal agenesis, one is diagnosed by ultrasonography after amnioinfusion at 24 weeks gestation, the other is diagnosed postnatally after term delivery.
Diagnosis ; Female ; Oligohydramnios ; Pregnancy ; Prenatal Diagnosis ; Ultrasonography ; Urinary Bladder

No abstract available.

Marjolin's ulcer is a malignant degeneration of cicatrical tissue, especially in chronic burn scar. Since the first description by Jean Nicholas Marjolin(1828), many studies for Marjolin's ulcer have been performed and reported. From 1985 to 1997, we experienced 20 cases in 14 patients diagnosed as Marjolin's ulcer clinically, and we analysed malignant transformation rate, induction period of Marjolin's ulcer and prevention of Marjolin's ulcer, etc. The results are summarized as follows. 1) The sex distribution was predominant in male(64.3%). 2) The most common cause of injury was flame burn(78.6%). 3) The mean age at the time of diagnosis was 45.6 years and the average lag period was 20.6 years. 4) The pathologic types of Marjolin's ulcer were squamous cell carcinoma(57.2%), followed by dyspasia(28.6%), acnthosis and hyperkeratosis(14.2%). 5) The locations of ulcers were frequently on the lower extremity(42.9%), followed by upper extremity(35.7%) and trunk (21.4%). 6) The lymph node involvements were 3 patients out of the 8 patients who were confirmed as squamous cell carcinoma. 7) The modalities of treatment were skin graft (18 cases, 12 patients), myocutaneous flap(1 case, 1 patient), fasciocutaneous flap(1 case, 1 patient).
Burns ; Carcinoma, Squamous Cell ; Cicatrix ; Diagnosis ; Humans ; Lymph Nodes ; Sex Distribution ; Skin ; Transplants ; Ulcer*