BACKGROUND: Intrathecal morphine provides good pain relief after anorectal surgery, but often associated with unpleasant side effects. Ondansetron, a selective 5-hydroxytryptamine3 (5-HT3) receptor antagonist, have been introduced for the prevention and treatment of emesis after chemotherapy in cancer patients and after general anesthesia. METHODS: Thus we studied the effect of ondansetron on the postoperative analgesic and side effects of spinal morphine in 60 patiens. The patients were given subarachnoid injection of 0.5% tetracaine 5 mg mixed with morphine 0.3 mg and positioned to jack-knife after fixation of anesthetic level. Either simple 5% dextrose solution 1000 ml or dextrose solution 1000 ml mixed with ondansetron 8 mg was injected intravenously in a rate of 100 ml/hr. The visual analog scale (VAS) of pain and incidence and severity of postoperative nausea, vomiting, pruritus and urinary retention were evaluated at 12 hour, 24 hour and 48 hour after injection of spinal morphine. RESULTS: The number of patients who became nauseated or vomited did not differ significantly between groups. Also, the VAS and the incidence and severity of other side effects such as pruritus and urinary retention did not differ significantly between groups. CONCLUSION: Ondansetron administered intravenously, did not prevent side effects of intrathecal morphine.
Analgesics ; Anesthesia, General ; Drug Therapy ; Glucose ; Humans ; Incidence ; Morphine* ; Ondansetron* ; Postoperative Nausea and Vomiting ; Pruritus ; Serotonin ; Tetracaine ; Urinary Retention ; Visual Analog Scale ; Vomiting

No abstract available.
Migraine Disorders*

Vibrio cholerae strain other than O1 and O139 (Vibrio cholerae non-O1/O139) are associated with sporadic diarrhea and have often been reported in association with extraintestinal infections. We report a case of peritonitis by V. cholerae non-O1/O139 in 43-year-old male who was diagnosed cirrhosis. He, was complained of abdominal distension and fever without history of consumption of raw sea food and exposure to sea water. Gram negative bacilli were cultured from his peritoneal fluid and identified as V. cholerae sero group O14.
Adult ; Ascitic Fluid ; Cholera ; Diarrhea ; Fever ; Fibrosis ; Humans ; Male ; Peritonitis* ; Seafood ; Seawater ; Vibrio cholerae* ; Vibrio*

Vibrio cholerae strain other than O1 and O139 (Vibrio cholerae non-O1/O139) are associated with sporadic diarrhea and have often been reported in association with extraintestinal infections. We report a case of peritonitis by V. cholerae non-O1/O139 in 43-year-old male who was diagnosed cirrhosis. He, was complained of abdominal distension and fever without history of consumption of raw sea food and exposure to sea water. Gram negative bacilli were cultured from his peritoneal fluid and identified as V. cholerae sero group O14.
Adult ; Ascitic Fluid ; Cholera ; Diarrhea ; Fever ; Fibrosis ; Humans ; Male ; Peritonitis* ; Seafood ; Seawater ; Vibrio cholerae* ; Vibrio*

BACKGROUND: Androgenetic alopecia is a common, genetically predisposed condition among men and women, which commences at any age after puberty. It may significantly affect a variety of psychological and social experiences and the individual's quality of life(QOL). OBJECTIVE: The purpose of this study was to investigate the impact of androgenetic alopecia on patient's illness behavior and quality of life. METHODS: A total of 192 male patients with androgenetic alopecia were enrolled and interviewed with structured questionnaire which contained 26 items including personal information, social, psychological questions and the patients' knowledge of androgenetic alopecia. RESULTS: 1. The mean age of the patients was 27 years old. The proportion of patients under 30 years old was 79.7%. 2. The mean age of onset in the patients was 24 years old. 3. Using the Norwood's classification, the proportion of type IIIa, type III, type IIIvertex and female pattern was 76.1%. And that of type I and II was 16.1%. 4. The 177 patients (92.2%) showed dissatisfaction about their hair states and 116 patients (60.5%) made efforts to conceal and compensate for their alopecia. The peer teasing about their condition was reported by 134 patients (69.8%). 5. Most unmarried patients (89.3%) thought that hair loss would erode their chances for romance. 6. Only 33 patients (17.2%) had experiences of professional treatments. CONCLUSION: This study confirms that androgenetic alopecia has significant impact on the overall QOL of patients.
Adolescent ; Adult ; Age of Onset ; Alopecia* ; Classification ; Cytochrome P-450 CYP1A1 ; Female ; Hair ; Humans ; Illness Behavior* ; Male ; Puberty ; Quality of Life* ; Single Person ; Young Adult ; Surveys and Questionnaires

PURPOSE: Surgeons perform either symmetrical lateral rectus recession or monocular recession of the lateral rectus and resection of the medial rectus (recession/resection procedure) in order to correct simulated divergence excess intermittent exotropia, X(T). We compared the results of these two procedures using surgical outcomes. METHODS: A total of 49 patients with simulated divergence excess X(T) were included in this study; among these 49, 32 underwent symmetrical lateral rectus recession and 17 underwent recession/resection procedure. Surgery was defined successful when the horizontal angle of deviation was within 8 prism diopters or less at distance and near at the last follow-up. RESULTS: The rate of success at the time of final follow-up was 68.8% in those who underwent symmetrical lateral rectus recession and 70.6% in those who underwent recession/resection procedure, showing no statistically significant difference between the two groups (p>0.05). Furthermore, there were also no significant differences in the undercorrection, overcorrection rates and the decrease in the deviation at distance and near between the two surgical procedures (p>0.05). CONCLUSIONS: No difference was present between the two methods examined in this study; thus, either of the two methods would be suitable for the correction of simulated divergence excess X(T).
Exotropia* ; Follow-Up Studies ; Humans

No abstract available.
Scrub Typhus*

A pulmonary artery catheter (PAC) is a useful monitoring device for measuring pulmonary artery pressure, pulmonary capillary wedge pressure and cardiac output, but its insertion brings about many complications including pulmonary artery rupture, infarction, thrombosis and infection. This case concerns the knotting of a PAC in a 27 year-old female patient who had undergone cardiac transplantation due to dilated cardiomyopathy. The PAC was inserted via the right subclavian vein to the pulmonary artery and withdrawn to the superior vena cava before heart was removed. After the weaning of the cardiopulmonary bypass (CPB), we tried to reinsert the PAC, which was neither advanced nor withdrawn. Postoperative chest x-ray revealed that the PAC appeared to be knotted in the subclavian vein. Two days later, we loosened the knot of the PAC and removed it via femoral and bracheal cineangiography techniques guided by fluoroscopy without any complications. In this case, we thought the knotting of the PAC occurred at insertion due to severe tricuspid regurgitation, and its size was reduced at withdrawal before the CPB and wedging to the subclavian vein. Knotting of PAC is very rare and unpredictable, but once it or other complications of the PAC is suspected, we recommend that the manipulation of the PAC should be stopped and x-ray should be checked.
Adult ; Cardiac Output ; Cardiomyopathy, Dilated ; Cardiopulmonary Bypass ; Catheters* ; Cineangiography ; Female ; Fluoroscopy ; Heart ; Heart Transplantation* ; Humans ; Infarction ; Pulmonary Artery* ; Pulmonary Wedge Pressure ; Rupture ; Subclavian Vein ; Thorax ; Thrombosis ; Tricuspid Valve Insufficiency ; Vena Cava, Superior ; Weaning

BACKGROUND: The arterial to end-tidal carbon dioxide tension difference(Pa-ETCO2) can be increased in patients with congenital heart disease(CHD) and, therefore, end-tidal carbon dioxide tension(PETCO2) does not accurately approximates arterial carbon dioxide tension(PaCO2). The purpose of this study was to evaluate the stability of the Pa-ETCO2 in pediatric patients with congenital heart disease undergoing open heart surgery. METHODS: Forty three children with CHD were studied: twenty two were acyanotic and twenty one were cyanotic. Simultaneous PETCO2 and PaCO2 measurements, as well as pulse rate, blood pressure, pH and arterial oxygen tension(PaO2) were obtained for each patient during four intraoperative events: (1) after induction of anesthesia and before sternotomy, (2) after sternotomy and before cardiopulmonary bypass(CPB), (3) after weaning of CPB, and (4) after closure of sternotomy. RESULTS: The PETCO2 of cyanotic group were lower than that of acyanotic group throughout operation period, and did not change significantly after CPB. Cyanotic children demonstrated a greater Pa-ETCO2 difference before CPB as compared with acyanotic group. In acyanotic group, Pa-ETCO2 difference increased significantly after CPB(P <0.05), whereas it remained unchanged in cyanotic group. CONCLUSIONS: Since cyanotic children had higher Pa-ETCO2 differences intraoperatively and acyanotic children showed an increase in Pa-ETCO2 after CPB, the PETCO2 cannot be the alternative value to estimate reliably the PaCO2 during open heart surgery of pediatric CHD.
Anesthesia ; Blood Pressure ; Carbon Dioxide ; Child ; Heart Defects, Congenital ; Heart Diseases* ; Heart Rate ; Heart* ; Humans ; Hydrogen-Ion Concentration ; Oxygen ; Sternotomy ; Thoracic Surgery* ; Weaning

BACKGROUND: In both infants and children, increased hormonal and metabolic responses to open heart surgery may be directly related to postoperative complications. Anesthestic management including regional anesthesia can substantially attenuate a perioperative stress response and targeted therapy may improve the outcome. In this study, our objectives were to quantify the extent of pain control, and to evaluate the safety and efficacy of caudal morphine or meperidine. METHODS: Seventy-five pediatric patients undergoing a open heart surgery were randomly assigned to three groups according to receiving morphine (group M, n = 25), or meperidine (group D, n = 25) caudally, and a control group (group C). Caudal morphine 30ng/kg with 0.15% bupivacaine 1 ml/kg or meperidine 2 mg/kg with 0.15% bupivacaine 1 ml/kg was injected after anesthetic induction. Pain score and side effects were evaluated immediate postoperatively, 12, 24, and 48 hr postoperatively in the intensive care unit and consciousness recovery and extubation time were checked. RESULTS: Patients in the groups M and D had significantly lower pain scores than the group C. Recovery and extubation time were shorter in the groups M and D. Incidence of nausea and vomiting was significantly higher in the group M than in the groups D and C. CONCLUSIONS: Caudal morphine and meperidine reduced postoperative pain and facilitated extubation.
Anesthesia, Conduction ; Bupivacaine* ; Child ; Consciousness ; Heart* ; Humans ; Incidence ; Infant ; Intensive Care Units ; Meperidine* ; Morphine* ; Nausea ; Pain, Postoperative ; Postoperative Complications ; Thoracic Surgery* ; Vomiting