This study was undertken to estimate the induction time, hemodynamic responses and local venous complications after intravenous administration of the midazolam, the water-soluble benzodiazepine derivative, comparing with those of the thipental, as an induction agent. Sixty ASA Class I or II surgical patients were divided into two groups: I and II, and were given 5 mg/kg thiopental sodium and 0.15 mg/kg midazolam hydrochloride, respectively. The results obtained were as follows; 1) The induction timeQoss of palpebral reflex) of the group II(88.7+/-41.8 seconds)was longer than those of the group I (19.5+/-3.7 seeonds). 2) The magnitude of fall in the systolic blood presure, 1 and 2 minute after intravenous administration of the induction agents observed in the group II was smaller than those observed in the group I compared with the pre-induction valuea But other parameters did not change significantly compsred with the pre-induction values in both groups. 3) In five patients of the group I, they complained of pain on the injection, but no patient of the group II complained of it. There was no statistically significant difference in the incidence of the postoperative local venous complications on the injection sites such as thrombosis or phlebitis between both groups.
Administration, Intravenous ; Benzodiazepines ; Hemodynamics ; Humans ; Incidence ; Midazolam* ; Phlebitis ; Thiopental* ; Thrombosis

This study was undertken to estimate the induction time, hemodynamic responses and local venous complications after intravenous administration of the midazolam, the water-soluble benzodiazepine derivative, comparing with those of the thipental, as an induction agent. Sixty ASA Class I or II surgical patients were divided into two groups: I and II, and were given 5 mg/kg thiopental sodium and 0.15 mg/kg midazolam hydrochloride, respectively. The results obtained were as follows; 1) The induction timeQoss of palpebral reflex) of the group II(88.7+/-41.8 seconds)was longer than those of the group I (19.5+/-3.7 seeonds). 2) The magnitude of fall in the systolic blood presure, 1 and 2 minute after intravenous administration of the induction agents observed in the group II was smaller than those observed in the group I compared with the pre-induction valuea But other parameters did not change significantly compsred with the pre-induction values in both groups. 3) In five patients of the group I, they complained of pain on the injection, but no patient of the group II complained of it. There was no statistically significant difference in the incidence of the postoperative local venous complications on the injection sites such as thrombosis or phlebitis between both groups.
Administration, Intravenous ; Benzodiazepines ; Hemodynamics ; Humans ; Incidence ; Midazolam* ; Phlebitis ; Thiopental* ; Thrombosis

Multiple gastric caner, now considered to be a sort of multiple primary cancer by Moertel's classification, is a special type of cancer in which two or more tumor lesions arise independently from the stomach. Although its incidence is rare and it has never been reported in Korea yet, the report of multiple gastric cancer is increasing with lengthened life survival and improved diagnostic method. We recently experienced two cases of triple gastric cancer, the one in 53-years-old male who had well differentiated adenocarcinoma(EGC IIb+c) on antrum, poorly differentiated adenocarcinoma on cardia and moderately differentiated adenocarcinoma on mid-body, and the other in 65-years-old female who had two poorly differentiated adenocarcinoma on cardia and anterior wall of low body and moderately differentiated adenocarcinoma (EGCIIc) on posterior wall of low body. Triple gastric cancer is rare, so we reported 2 cases of triple gastric cancer.
Adenocarcinoma ; Cardia ; Classification ; Female ; Humans ; Incidence ; Korea ; Male ; Stomach ; Stomach Neoplasms*

BACKGROUND: The dipstick methodology is the most fundamental urinalysis but interfered by many factors. We evaluated the effect of semen contamination on the urine dipsticks. METHODS: Thirty-two specimens for semen analysis were enrolled. After semen was directly applied on urine dipsticks, residual samples were diluted in pooled normal urine. Urine dipsticks were performed at each dilution titer. Seminal plasma separated by centrifugation of semen were also tested in the same manner. RESULTS: All semen showed positive results for blood, protein and leukocytes. The intensities of reaction for blood and leukocytes were correlated with sperm concentration. The negative conversion of blood and protein occurred at 1:100, and that of leukocytes occurred at 1:50. Seminal plasma showed nearly the same findings. CONCLUSIONS: Semen contamination of urine may cause false positive reaction especially for blood and protein on the urine dipsticks. It should therefore be considered when assessing unexplained, transient hematuria or proteinuria.
Centrifugation ; False Positive Reactions ; Hematuria ; Leukocytes ; Proteinuria ; Semen Analysis ; Semen* ; Spermatozoa ; Urinalysis

This paper describes the basic date measurements for total body irradiation with 6 Mv photon beam including compensators designs. The technique uses bilateral opposing field with tissue compensators for the head, neck, lungs, and legs from the hip to toes. In vivo dosimetry was carried out for determining absorbed dose at various regions in 7 patients using diode detectors (MULTIDOSE, Model 9310, MULTIDATA Co., USA). As a results, the dose uniformity of+/-3.5%(generally, within+/-10%) can be achieved with our total body irradiation technique.
Head ; Hip ; Humans ; Leg ; Lung ; Neck ; Toes ; Whole-Body Irradiation*

PURPOSE: To assess the patterns of myelodysplastic syndrome(MDS) and aplastic anemia(AA) on MRI of the spinal bone marrow and to find the differential points between the two groups. MATERIALS AND METHODS: Fourteen patients with MDS(n=7) and AA(n=7) were studied using magnetic resonance imaging. Sagittal images from the lower thoracic and lumbar vertebral marrow were evaluated on Tl-weighted and STIR images. Five distinct patterns of signal intensity of the Tl-weighted and STIR images were classified. T1 and T2 relaxation times and T1 marrow/fat signal intensity ratio were measured and analyzed (t-test). The cellularity of bone marrow was evaluated on histologic slides. RESULTS: MDS showed homogeneously low signal intensity on T1WI and high signal intensity on STIR image, indicating hypercellular marrow, whereas AA showed relative high signal intensity on T1WI and low signal intensity on STIR image, representing fatty marrow. T1 and T2 relaxation time(T1 for MDS=750.26msec +/- 177.50, T1 for AA= 413.21 msec +/- 167.39 (p<0.000), T2 for MDS=91.86 msec +/- 14.16, T2 for AA=81.44msec +/- 15.31 (p< 0.001) and T1 marrow/fat signal intensity ratio(0.22 +/- 0.048 in MDS, 0.30 +/- 0.083 in AA(p<0.000)) revealed statistically significant difference between the two groups. CONCLUSION: Although the marrow aspiration and needle biopsy are mandatory in hematologic disease for diagnosis, there are limited in assessing the change of total marrow mass. Therefore MRI of bone marrow might be useful in distinguishing MDS from AA because of its ability of representation of total marrow mass.
Anemia, Aplastic* ; Biopsy, Needle ; Bone Marrow ; Diagnosis ; Diagnosis, Differential* ; Hematologic Diseases ; Humans ; Magnetic Resonance Imaging* ; Myelodysplastic Syndromes* ; Relaxation

PURPOSE: To assess the patterns of myelodysplastic syndrome(MDS) and aplastic anemia(AA) on MRI of the spinal bone marrow and to find the differential points between the two groups. MATERIALS AND METHODS: Fourteen patients with MDS(n=7) and AA(n=7) were studied using magnetic resonance imaging. Sagittal images from the lower thoracic and lumbar vertebral marrow were evaluated on Tl-weighted and STIR images. Five distinct patterns of signal intensity of the Tl-weighted and STIR images were classified. T1 and T2 relaxation times and T1 marrow/fat signal intensity ratio were measured and analyzed (t-test). The cellularity of bone marrow was evaluated on histologic slides. RESULTS: MDS showed homogeneously low signal intensity on T1WI and high signal intensity on STIR image, indicating hypercellular marrow, whereas AA showed relative high signal intensity on T1WI and low signal intensity on STIR image, representing fatty marrow. T1 and T2 relaxation time(T1 for MDS=750.26msec +/- 177.50, T1 for AA= 413.21 msec +/- 167.39 (p<0.000), T2 for MDS=91.86 msec +/- 14.16, T2 for AA=81.44msec +/- 15.31 (p< 0.001) and T1 marrow/fat signal intensity ratio(0.22 +/- 0.048 in MDS, 0.30 +/- 0.083 in AA(p<0.000)) revealed statistically significant difference between the two groups. CONCLUSION: Although the marrow aspiration and needle biopsy are mandatory in hematologic disease for diagnosis, there are limited in assessing the change of total marrow mass. Therefore MRI of bone marrow might be useful in distinguishing MDS from AA because of its ability of representation of total marrow mass.
Anemia, Aplastic* ; Biopsy, Needle ; Bone Marrow ; Diagnosis ; Diagnosis, Differential* ; Hematologic Diseases ; Humans ; Magnetic Resonance Imaging* ; Myelodysplastic Syndromes* ; Relaxation

No abstract available.
Erythromycin* ; Gastric Emptying* ; Gastroparesis*

Between July 1987 and December 1992, we treated 22 patients with chromic myelogenous leukemia; 14 in the chronic phase and 8 with more advanced disease. All were received with allogeneic bone marrow transplantation from HLA-identical sibling donors after a total body irradiation (TBI) cyclophosphamide conditioning regimen. Patients were non-randomly assigned to either 1200 cGy/6fractions/3days (6 patients) or 1320 cGy/8 fractions/4days (16 patients) by dose of TBI. Of the 22 patients, 8 were prepared with cyclophosphamide alone, 14 were conditioned with additional adriamycin or daunorubicin. To prevent graft versus host disease, cyclosporine was given either alone or in conjunction with methotrexate. The actuarial survival and leukemic-free survival at four years were 58.5% and 41.2%, respectively, and the relapse rate was 36% among 22 patients. There was a statistically significant difference in survival between the patients in chronic phase and more advanced phase (76% vs 33%, p=0.05). The relapse rate of patients receiving splenectomy was higher than that of patients receiving splenic irradiation (50% vs 0%, p=0.04). We conclude that the probability of cure is highest if transplantation is performed while the patient remains in the chronic phase.
Bone Marrow Transplantation* ; Bone Marrow* ; Cyclophosphamide ; Cyclosporine ; Daunorubicin ; Doxorubicin ; Graft vs Host Disease ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Leukemia, Myeloid ; Methotrexate ; Recurrence ; Siblings ; Splenectomy ; Tissue Donors ; Whole-Body Irradiation*

PURPOSE: To characterize the magnetic resonance (MR) imaging features of myelofibrosis and compare them with bone marrow biopsy findings. MATERIALS AND METHODS: The authors retrospectively reviewed sagittal T1-and T2 weighted and short tau inversion recovery (STIR) images of the thoracolumbar spine of six patients (five males and one female, mean age 46) with biopsy-proven myelofibrosis. Marrow signal intensity of the thoracolumbar spine was classified with respect to those of muscle and fat, based on the consensus of two radiologists after visual inspection. These MR features were compared with the degree of fibrosis and marrow cellularity, as determined by bone marrow biopsy. RESULTS: In all patients, marrow signal intensity of the thoracolumbar spine was reduced onT1 and T2 weighted images (invariably low on T1 weighted images, low (2/6) to intermediate (4/6) on T2 weighted images). On STIR images, marrow signal intensity was variable (high (3/6) or low (3/6)), and this correlated with degree of fibrosis, not with marrow cellularity. The signal intensity of marrow with mild to moderate fibrosis was high on STIR images, while that of marrow with marked fibrosis was low. CONCLUSION: MR imaging features of myelofibrosis were characterized as low on T1 weighted images and low to intermediate on T2 weighted images. In addition, the signal intensity of STIR imaging correlated with degree of fibrosis.
Biopsy* ; Bone Marrow* ; Consensus ; Female ; Fibrosis ; Humans ; Magnetic Resonance Imaging ; Male ; Primary Myelofibrosis* ; Retrospective Studies ; Spine