No abstract available.
Drug-Related Side Effects and Adverse Reactions* ; Humans ; Physicians, Family*

No abstract available.
Acanthoma*

To evaluate the effect of Morphine during spinal anesthesia with alpha-adrenergic agonist, we used 0.18 mg of epinephrine, 90 ug of clonidine and 0.3 mg of morphine with 12 mg of T-cain respectively and compared hemodynamic and analgesic effects of each drug. Eighty patients were divided into four groups as follows; Group I (n=20); T-cain with clonidine, Group II (n=20); T-cain with epinephrine, Group III (n=20); T-cain with clonidine and morphine, and Group IV (n=20); T-cain with epinephrine and morphine. The results were as follows; 1) The onset time of analgesia and the time reached to the highest level of sensory loss were most rapid in the epinephrine and morphine group. 2) The duration of analgesia was significantly prolonged in the group of epinephrine and morphine than the group of epinephrine and clonidine. 3) It was more likely complicated in the morphine groups than others but there was no significance. 4) Although the heart rate was gradually decreased over 60 min. after anesthesia, there was no significance between the groups. 5) Systolic and diastolic blood pressure were decreased mainly over 30~45 min. after anesthesia, but there was no significance. In conclusion, epinephrine can be sustituted for clonidine because analgesic duration was not significantly changed, and the duration of analgesia was prolonged by morphine.
Adrenergic alpha-Agonists ; Analgesia ; Anesthesia ; Anesthesia, Spinal* ; Blood Pressure ; Clonidine* ; Epinephrine* ; Heart Rate ; Hemodynamics ; Humans ; Morphine*

Expander procedure is a newly developed extraocular muscle weakening technique which has several advantages such as good control of resection margin, easy reoperation, rare postoperative muscular paresis. For the study of usability of Gore-Tex(R) as a muscle expander, fifteen rabbits received expander procedure with Gore-Tex(R) in right eye and silicone retinal band in left eye. At postoperative 1, 3, 5, 7, 12 weeks, histopathologic examination was performed. There was no significant difference in inflammatory reaction in both groups. Inflammatory reaction decreased with time in both groups. In Gore-Tex(R) expander group, muscle regeneration from cut end was observed at the 3rd postoperative week and fibroblast ingrowth into the expander was observed at the 5th postoperative week. These findings were more prominent with time. Adhesion of expander to underlying sclera was not observed in both groups. It is concluded that expander procedure using Gore-Tex(R) will be a new and useful surgical method for the extraocular muscle weakening procedure.
Fibroblasts ; Paresis ; Rabbits ; Regeneration ; Reoperation ; Retinaldehyde ; Sclera ; Silicones

IgA nephropathy can occur rarely as a complication of D-penicillamine treatment, but it is exact pathogenesis remains unclear. If a patients has gross or microscopic hematuria during D-penicillamine treatment, D-penicillamine induced IgA nephropathy should be suspected as a cause of hematuria. In those cases, renal biopsy should be taken for diagnosis and proper management. We experienced a case of IgA nephropathy confirmed by renal biopsy in a 39-years-old female patient with scleroderma during D-penicillamine therapy and report this case with a review of literature.
Biopsy ; Diagnosis ; Female ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoglobulin A* ; Penicillamine*

No abstract available.
Down Syndrome*

OBJECTIVE: This study aims the electrophysiological documentation of possible neurological abnormalities in diabetic patients with or without neuropathy symptoms. METHOD: Forty five diabetic patients, 15 male and 30 female, were included in this study. They were divided into symptomatic and asymptomatic groups and received various electrophysiologic studies including a nerve conduction study, F-wave study and median and tibial SSEP study. The clinical parameters were the clinical symptom and sign of neuropathy, disease duration, complications, HbA1c, and fasting blood sugar. Statistical significances of the parameters were observed between symptomatic and asymptomatic groups. RESULTS: The most sensitive electrophysiologic parameter was the tibial SSEP. For the documentation of diabetic neuropathy, the electrophysiologic study of posterior tibial, median, superficial peroneal and sural nerves were most useful. F-wave study did not reflect the early involvement of proximal nerve segment in diabetic patients. CONCLUSION: Multimodal neurophysiological approaches including a tibial SSEP study rather than the conventional nerve conduction studies can depict a broader and more complete map of the possible abnormalities of diabetic neuropathy.
Blood Glucose ; Diabetic Neuropathies ; Evoked Potentials, Somatosensory* ; Fasting ; Female ; Humans ; Male ; Neural Conduction* ; Sural Nerve

Purpose: : This study aimed to identify the effects of a multifaceted pediatric delirium education program for pediatric intensive care unit (PICU) nurses on their delirium knowledge, confidence in delirium nursing, and delirium evaluation accuracy. Methods: : This study used a one-group pretest-posttest design. The participants were 50 nurses in two units of the PICU at S General Hospital in Seoul. All participants took a 1-hour lecture with case-based practice for the first two weeks, and received feedback as they applied the program to clinical practice over the next two weeks. Test measures were completed before and after the four week intervention period for all participants. The delirium evaluation accuracy was measured using the Korean version of the Cornell Assessment of Pediatric Delirium. Data were analyzed using the chi-square and paired t-tests. Results: : After the Pediatric Delirium Education Program, nurses’ delirium knowledge (x2 =11.65, p =.001), confidence in delirium nursing (t=9.71, p＜.001), and delirium evaluation accuracy (t=6.07, p＜.001) improved significantly. Conclusions : Pediatric delirium education programs for PICU nurses were effective. For active application of the program in clinical practice in the future, various cases of childhood delirium and specific strategies for each subject must be developed. To achieve this, long-term intervention and research for multiple organizations are required.

Hepatoid thymic carcinoma is an extremely rare subtype of primary thymus tumor resembling “pure” hepatoid adenocarcinomas with hepatocyte paraffin 1 (Hep-Par-1) expression. A 53-year-old man presented with voice change and a neck mass. Multiple masses involving the thyroid, cervical and mediastinal lymph nodes, and lung were detected on computed tomography. Papillary thyroid carcinoma was confirmed by biopsy, and the patient underwent neoadjuvant chemoradiation therapy. However, the anterior mediastinal mass was enlarged after the treatment whereas the multiple masses in the thyroid and neck decreased in size. Microscopically, polygonal tumor cells formed solid sheets or trabeculae resembling hepatocytes and infiltrated remnant thymus. The tumor cells showed immunopositivity for cytokeratin 7, cytokeratin 19, and Hep-Par-1 and negativity for α-fetoprotein. Possibilities of germ cell tumor, squamous cell carcinoma, and metastasis of thyroid papillary carcinoma were excluded by immunohistochemistry. This report on the new subtype of thymic carcinoma is the third in English literature thus far.

Hepatoid thymic carcinoma is an extremely rare subtype of primary thymus tumor resembling “pure” hepatoid adenocarcinomas with hepatocyte paraffin 1 (Hep-Par-1) expression. A 53-year-old man presented with voice change and a neck mass. Multiple masses involving the thyroid, cervical and mediastinal lymph nodes, and lung were detected on computed tomography. Papillary thyroid carcinoma was confirmed by biopsy, and the patient underwent neoadjuvant chemoradiation therapy. However, the anterior mediastinal mass was enlarged after the treatment whereas the multiple masses in the thyroid and neck decreased in size. Microscopically, polygonal tumor cells formed solid sheets or trabeculae resembling hepatocytes and infiltrated remnant thymus. The tumor cells showed immunopositivity for cytokeratin 7, cytokeratin 19, and Hep-Par-1 and negativity for α-fetoprotein. Possibilities of germ cell tumor, squamous cell carcinoma, and metastasis of thyroid papillary carcinoma were excluded by immunohistochemistry. This report on the new subtype of thymic carcinoma is the third in English literature thus far.