Background: The continuous brachial plexus block brings about the prolongation of surgical anesthesia, postoperative pain relief, and sympathectomy. Methods: The twenty-five patients scheduled for upper extremity operations had been taken the continuous axillary brachial plexus block procedure to relief postoperative pain and, to get the sympathetic block effect. We used local anesthetics less than maximum recommended dose, 0.125% bupivacaine continuously infused at 4 ml/hour via catheter. We adopted the faces pain rating scale to evaluate postoperative pain degree. The faces pain rating scale composed of six faces, based upon the degree of pain. The patients has been asked to choose these rating scale according to their painfulness three times a day for five days. Results: Clinically, we have found the effective decrease in the degree of pain. Systemic toxic reactions, hematoma and infection sign at injected site were not found. Conclusion: The pain of upper extremity after operation was controlled by continuous infusion of 0.125% bupivacaine, 4 ml/hr, usually.
Anesthesia ; Anesthetics, Local ; Brachial Plexus* ; Bupivacaine ; Catheters ; Hematoma ; Humans ; Pain, Postoperative ; Sympathectomy ; Upper Extremity*

Dermatomyositis* ; Skin*

The complement system is known to be involved in the pathogenesis of the skin lesions in pernphigus vulgaris, bullous pemphigoid, dermatitis herpetiformis, epidermolysis bullosa acquisita, and systemic lupus erythematosus. Authors examined the skin specimens of each disease cases, who did not show any evidence of complement deficiency, to determine the deposition of complement components(C4, C3, Chb-9) and their inhibitors(C4bp, Factor H, S-protein) by modified direct immunofluorescence. We also looked at the staining pattern and localization, for further insights of their pathobiologic contributions in each disease. The findings of deposits of complement components up to C9, as well as inhibitor proteins at the primary histopathologic sites, in the majority of those cases, may indicate that the complement system, to certain extent, involves the inflamrnatory reactions in these diseases. The co-localization of C5b-9 and S-protein could be regarded as the consequence of in situ formation of SC5b-9 complexs or as the result of non-lytic adsorbed complexes of fluid phase SC5b-9. The pathologic role of the complement seems to depend mostly on the complement-fixing biologic property and the amount of the tissue bound immune complexes, which are often heterogeneous to different diseases and among different patients.
Antigen-Antibody Complex ; Complement Factor H ; Complement Membrane Attack Complex ; Complement System Proteins* ; Dermatitis Herpetiformis ; Epidermolysis Bullosa Acquisita ; Fluorescent Antibody Technique, Direct ; Humans ; Lupus Erythematosus, Systemic ; Pemphigoid, Bullous ; Skin ; Skin Diseases*

Pathological laughing and crying(PLC) is a condition that is characterized by episodic, brief, contextually inappropriate, uncontrollable outbursts of laughing and/or crying. It can be observed in patients with various neurological disorders. PLC often causes distress in interpersonal functioning and activities for patients and their families. PLC can be recognized easily with proper understanding of the condition and its nature. Also it generally shows good response to various pharmacological treatments. This review aims to encourage the diagnosis and treatment of PLC by providing definition and clinical presentation of PLC, analysis of its pathophysiology and various current treatment options.
Crying* ; Diagnosis ; Humans ; Nervous System Diseases

The purpose of this study w-s to predict the respose to the chincap therapy from the initial cephalometric measurements and to obtain the indication of chincap therapy. 40 patients selected for this study were classified into two groups by the occlusal stability after completion of permanent dentition and the iiu4n ovement of facial profile, after chincap therapy. One was g response group which consisted of 25 children and the other was poor response group with 15 patients. Various measurements of the craniofacial structure in the initial lateral cephalogram were calculated and analyzed by t-test and discriminant analysis. The results were, as follows 1. Good response group had more horizontal growth pattern in initial stage of treatment, and the contributing measurements were Bjork sum, anterior-posterior facial height ratio, gonial angle, lower gonial angle and occlusal plane to AB plane angle. 2. The critical points and predictive values of the influential skeletal measurements were calculated. 3. The discriminant function was obtained from three. major influential measurements; Bjork sum, gonial angle and occliml plane to AB plane angle, and this function could discreminate correctly in 85% of this samples.
Child ; Dental Occlusion ; Dentition, Permanent ; Humans

PURPOSE: The purpose of this study was to describe the clinical characteristics of neonatal urinary tract infection (UTI) caused by Klebsiella pneumoniae and non- Klebsiella pneumoniae UTI. METHODS: We compared clinical characteristics of 84 neonatal patients with UTI caused by Klebsiella pneumoniae who were hospitalized at the Department of Pediatricsat Han Dong University, Sunlin Hospital during the period between May, 1994 and August, 1998. The cases were divided into two groups depending upon causative organisms' Klebsiella pneumoniae UTI vs non-Klebsiella pneumoniae UTI, and the clinical characteristics of these groups were compared. RESULTS: Escherichia coli was the most common bacterial pathogen causing neonatal UTI, followed by Klebsiella pneumoniae. There was no significant difference in the sex distribution of Klebsiella pneumoniae UTI, but non-Klebsiella pneumoniae UTI showed male predominence. There were no significant differences in the incidences of hematologic, urologic, radiologic findings and perinatal complications in between these 2 groups. CONCLUSION: Klebsiella pneumoniae is the second most common pathogen causing neonatal UTI. There were no specific differences in the laboratory, symptomatologic, and radiologic findings in these two groups.
Escherichia coli ; Humans ; Incidence ; Klebsiella pneumoniae* ; Klebsiella* ; Male ; Pneumonia ; Sex Distribution ; Urinary Tract Infections* ; Urinary Tract*

The abnormalities in Hypothalamic-pituitary-adrenal(HPA) axis are associated with many psychiatric symptoms including depression. We present a report of a 71 year old man who was admitted to the psychiatric department presenting symptoms of headache, avolition, loss of energy, psychomotor retardation, poor appetite, insomnia, anxiety resulting from adrenal insufficiency and hypopituitarism. Hypothyroidism and electrolyte disturbance were managed and headache, insomnia, anxiety, GI symptoms were improved. But he remained in anergic state. After discharge, he was readmitted to infection department with high fever and drowsy mentality. Adrenal insufficiency was recognized and he was treated with corticosteroid replacement therapy. Finally his diagnosis was made as panhypopituitarism and overall symptoms were resolved. In this case, we showed how the atypical symptoms resulting from hypopituitarism develop and progress. Hypothyroidism, adrenal insufficiency, and growth hormone deficiency resulting secondarily from panhypopituitarism were associated with various nonspecific symptoms such as loss of energy, fatigue, insomnia, weight loss, decreased appetite etc. In clinical situation, differential diagnosis with depression is needed when clinicians were met a patient with these nonspecific symptoms. It is important that laboratory tests and differential diagnosis with endocrine diseases should be conducted, especially in geriatric patients with nonspecific symptoms like anergia, fatigue, poor appetite and so on.
Adrenal Insufficiency ; Anxiety ; Appetite ; Axis ; Depression ; Diagnosis, Differential ; Endocrine System Diseases ; Fatigue ; Fever ; Growth Hormone ; Headache ; Humans ; Hypopituitarism ; Hypothyroidism ; Sleep Initiation and Maintenance Disorders ; Weight Loss

No abstract available.
Dyskeratosis Congenita*

BACKGROUND: Epidurally administered clonidine represents an approach to control the pain after cesarean section that produces analgesia by an alpha 2-adrenergic mechanism and may provide postoperative analgesia without nausea, pruritus, and respiratory depression associated with systemic or intraspinal opioid administration. This study was undertaken to evaluate the analgesic effect according to the dose of appropriate bolus and the combination of epidural morphine and clonidine after cesarean section. METHOD: Forty five women, ASA physical status 1 or 2, scheduled for elective cesarean section were randomly assigned to receive epidural administration for postoperative pain control. Group A (n=15) received 1 mg morphine and 75 g clonidine bolus followed by 4 mg morphine and 150 g clonidine. Group B received 2 mg morphine and 75 g clonidine bolus followed by 4 mg morphine and 300 g clonidine. Group C received 3 mg morphine and 75 g clonidine bolus followed by 4 mg morphine and 450 g clonidine. Each combination of drug was injected at Bromage scale 1 after surgery. RESULTS: All groups showed relatively stable hemodynamic status. Analgesic effect was significantly better in Group B and C than Group A (p<0.05). Sedative effect was not a problem in all groups. The incidence of side effects in Group C was more than Group B, which than Group A, but almost cases did not require treatment. CONCLUSION: 2 mg morphine and 75 g clonidine bolus followed by 4 mg morphine and 300 g clonidine with excellent analgesic effect and less side effects is considered as adequate dose in postoperative pain control after cesarean section with epidural anesthesia.
Analgesia ; Anesthesia, Epidural* ; Cesarean Section* ; Clonidine* ; Female ; Hemodynamics ; Humans ; Hypnotics and Sedatives ; Incidence ; Morphine* ; Nausea ; Pain, Postoperative ; Pregnancy ; Pruritus ; Respiratory Insufficiency

The digital workflow of optical impressions by the intraoral scanner and CADCAM manufacture of dental prostheses is actively developing. The complex process of traditional impression taking, definite cast fabrication, wax pattern making, and casting has been shortened, and the number of patient’s visits can also be reduced. Advances in intraoral scanner technology have increased the precision and accuracy of optical impression, and its indication is progressively widened toward the long span fixed dental prosthesis. This case report describes the long span implant case, and the operator fully utilized digital workflow such as computer-guided implant surgical template and CAD-CAM produced restoration after the digital impression. The provisional restoration and customized abutments were prepared with the optical impression taken on the same day of implant surgery. Moreover, the final prosthesis was fabricated with the digital scan while utilizing the same customized abutment from the provisional restoration. During the data acquisition step, stl data of customized abutments, previously scanned at the time of provisional restoration delivery, were imported and automatically aligned with digital impression data using an ‘A.I. abutment matching algorithm’ the intraoral scanner software. By using this algorithm, it was possible to obtain the subgingival margin without the gingival retraction or abutment removal. Using the digital intraoral scanner’s advanced functions, the operator could shorten the total treatment time. So that both the patient and the clinician could experience convenient and effective treatment, and it was possible to manufacture a prosthesis with predictability.