Squamous cell carcinoma of the skin arises mostly in the head and neck regions, less frequently in the rest of the body, and rarely in the palms and soles. We report a case of a 6S-year-old man who had had time-sequential development of multiple squamous cell carcinomas on his palms and soles for the past 12 years. These lesions were, in order of time, ulcerative nodules, ulcerative hyperkeratotic papules, hyperkeratotic plaques, maceratied plaques, dark discolored patchs, and hyperkeratotic papules. They were treated by total excision and cryotherpy apart from the last squatnous cell carcinoma in 1994.
Carcinoma, Squamous Cell* ; Head ; Neck ; Skin ; Ulcer

No Abstract Available.
Myxoma*

BACKGROUND AND OBJECTIVES: The study was designed to investigate the changes in the expression of hypoxia inducible factor-1alpha (HIF-1alpha) according to time after being exposed to noise trauma and find out the effect of HIF-1 alpha in the prevention of noiseinduced hearing loss by pre-treatment with cobalt chloride (CoCl2). SUBJECTS AND METHOD: BALB/c hybrid mice with 25 dB HL or less ABR were used in this study. In the study group, subjects were exposed to 120 dB SPL broad white band noise for 3 hours per day for 3 days. The changes in their hearing were documented before and after 1, 2, 3, 4, and 9 days of the first noise exposure. CoCl2 was injected into the peritoneum 2 hours prior to each noise exposure to see the effect of induced HIF-1alpha on noise-induced hearing loss. For the control, injection with distilled water was performed and hearing thresholds were measured in the same manner. Cochlea from each group was obtained in order to observe the morphological changes in the inner ear and the expression of the HIF-1alpha using immunohistochemial staining and immuno-fluorescein staining along with quantification of the hair cell loss. RESULTS: Mice exposed to the noise for 3 days, showed permanent threshold shift and the expression of HIF-1alpha was increased. When HIF-1alpha was induced by pre-treatment of CoCl2 prior to the noise exposure, however, hearing recovery was observed to some degree. And hair cell survival rate was also higher when treated with CoCl2 compared to the distilled water treated group. CONCLUSION: When pre-treated with CoCl2, inducing HIF-1alpha before the noise trauma, it allowed for a less stereocilia loss in the hair cells in the organ of Corti. HIF-1alpha may play an important role in the prevention of noise-induced hearing loss.
Animals ; Anoxia ; Cell Survival ; Cobalt ; Cochlea ; Ear, Inner ; Hair ; Hearing ; Hearing Loss ; Hearing Loss, Noise-Induced* ; Hypoxia-Inducible Factor 1 ; Mice ; Noise ; Organ of Corti ; Peritoneum ; Stereocilia ; Water

No abstract available.
Humans* ; Placenta* ; Pregnancy*

BACKGROUND: The reversal of neuromuscular blocker might be accelerated if the anticholinesterase was administered in divided doses. This study has been conducted to evaluate the correct ratio of divided doses of neostigmine for the rapid recovery in the rabbits after pancuronium when the profound relaxation(PTC=0) was confirmed. METHODS: Rabbits(n=60) were randomly allocated to 6 groups. After pancuronium 0.2 mg/kg intravenously, spontaneous recovery was evaluated in group 1. When the profound relaxation(PTC=O) was confirmed at 5 min. after pancuronium, neostigmine 50 ug/kg was injected as a bolus in group 2. At that time, neostigmine was given at 10 ug/kg followed by 40 ug/kg 3 min. later in group 3. At that time, neostigmine was given at 20 ug/kg followed by 30 ug/kg 3 min. later in group 4. At that time, neostigmine was given at 30 ug/kg followed by 20 ug/kg 3 min. later in group 5. At that time, neostigmine was given at 40 ug/kg followed by 10 ug/kg 3 min. later in group 6. RESULTS: The mean time from injection of pancuronium to 95% recovery was 99.3 min. in group 1, 59.8 min. in group 2, 53.2 min. in group 3, 51.5 min. in group 4, 50.8 min. in group 5 and 41.1 min. in group 6. The recovery index was significantly reduced in group 6(p<0.05). CONCLUSIONS: We conclude that the recovery time is reduced when neostigmine is administered in divided doses: a larger priming dose followed by a smaller bolus at profound relaxation.
Muscle Relaxation* ; Neostigmine* ; Neuromuscular Blockade ; Pancuronium* ; Pharmacokinetics ; Rabbits* ; Relaxation

BACKGROUND: The addition of bupivacaine to lipid soluble opioids have improved analgesia and can reduce opioid related side effects in the epidural analgesia. The use of the combination of bupivacaine and lipid soluble opioid fentanyl is gaining in popularity after surgery. But recent work has produced conflicting results, and the ideal combination of local anesthetics and opioid for Patient Controlled Epidural Analgesia (PCEA) is unknown. We have compared the efficacy and the safety of 0.1% bupivacaine and 0.2% bupivacaine combined with fentanyl 5 microgram/ml for PCEA. METHODS: Forty women undergoing lower abdominal gynecological surgery under general anesthesia were assigned to receive an epidural initial bolus of 0.1% (0.1% group) or 0.2% bupivacaine (0.2% group) combined with 5 microgram/ml fentanyl mixture 10 ml, followed by a PCEA with 2 ml/hr continuous background infusion and demand-dose of 2 ml in prospective, random, double blind fashion. Resting and coughing visual analogue scale (VAS) for pain, infusion rates of the mixture, and side effects were recorded at 4, 8, 24, 48 hr postoperatively, and satisfaction were noted after 48 hr. RESULTS: No differences in resting and coughing VAS scores, hypotension, nausea, itching sensation, and somnolence were observed between the two groups. The mean infusion rates of mixtures during the first 4 hr were higher in the 0.1% group (3.3 1.3 ml/hr) than the 0.2% group (2.5 0.6 ml/hr) (p<0.05). The incidence and the degree of sensory and motor block were higher in the 0.2% group (p<0.05). CONCLUSIONS: Both groups provided sufficient postoperative analgesia and satisfaction with some side effects. The high incidence and degree of sensory and motor block were resulted in the 0.2% group, which is not optimal for early ambulation. To search for more titrated bupivacaine concentration between 0.1% and 0.2%, loading doses or appropriate epidural puncture level having reduced demand dose and decreased side effects, further studies are expected.
Analgesia ; Analgesia, Epidural* ; Analgesics, Opioid ; Anesthesia, General ; Anesthetics, Local ; Bupivacaine* ; Cough ; Early Ambulation ; Female ; Fentanyl* ; Gynecologic Surgical Procedures ; Humans ; Hypotension ; Incidence ; Nausea ; Prospective Studies ; Pruritus ; Punctures ; Sensation

The incidence of airway difficulty in the general surgical population varies greatly depending on the degree of airway difficulty. Much of the anesthesia related morbidity attributable to managing a difficult airway comes from an interurruption of gas exchange (hypoxia and hypercarbia) which may cause cardiovascular instability and brain damage. Most airway catastrophes ocurrs when possible difficulty with the airway was not recognized. Although fiberoptic intubation is reliable method in patients with difficult airways, there are many cases of difficulty in visualizing the structure of the larynx with conventional fiberoptic technique due to copious secretion, swelling and hemorrhage in the pharyngeal cavity. Recently, we experienced a success in difficult tracheal intubation with LMA in the 27 year old male patient diagnosed ankylosing spondylitis. We hope that using a #4 LMA as a conduit for 6.0 mm cuffed endotracheal tube with the aid of fiberscope attached to the video camera system would be an alternative method for difficult intubation.
Adult ; Anesthesia ; Anesthesia, General* ; Blood Pressure* ; Brain ; Clonidine* ; Epinephrine ; Heart Rate* ; Heart* ; Hemodynamics ; Hemorrhage ; Hope ; Humans ; Incidence ; Intubation* ; Larynx ; Male ; Norepinephrine ; Plasma* ; Skin ; Spondylitis, Ankylosing ; Succinylcholine ; Thiopental

BACKGROUND: The purpose of this study is to investigate the frequency of and errors in citation of references in articles from the Korean Journal of Anesthesiology (KJA) from the first application of the present contribution rules (1996) to 1998 and to suggest a clue to improve the quality of our journal. METHODS: All references cited from KJA were reviewed using a computerized searching system. If any differences are found during the review, we compare it with the original article. Errors on the contribution rules were examined according to the instructions for the authors revised in 1995. RESULTS: Overall 74% of the articles had more than one reference cited from KJA. The average number of the references cited from KJA per article was 1.73. In such references, citation errors were found in 48% of articles published in 1996, 44% in 1997, and 43% in 1998. The percentages of general errors and errors involving the contribution rules were 62% and 38%, respectively. Common general errors were found in titles (164 cases), pages (102 cases), and name (60 cases). Those involving the contribution rules found in the notation of name (120 cases), pages (54 cases), and inadequate notation of the number of issue (49 cases). CONCLUSIONS: Despite numerous efforts, the incidence of citation errors was still high when the articles of KJA were cited as references. Improvement in the quality of our journal will be possible only by rigid adherence to contribution rules, thorough review of the articles, and a lucid explanation of contribution rules.
Anesthesiology* ; Incidence

BACKGORUND: Capacitive calcium entry involves the influx of Ca2+ across the sarcolemma in response to the depletion of intracellular Ca2+ stores. Presently, little is known about the nature of the intracellular Ca2+ store (s) in pulmonary arterial smooth muscle cells (PASMCs), even though the unique contractile response of this tissue to hypoxia may at least partially involve the intracellular release of Ca2+ . The authors aimed to investigate the effects of nicardipine on capacitative calcium entry. METHODS: isolated pulmonary smooth muscle cells were obtained from enzymatically treated canine pulmonary artery. Currents were recorded at room temperature using the dialyzed whole cell recording technique. The protocol used to deplete intracellular Ca2+ stores and to monitor the development of the store-operated Ca2+ currents, involved cells being were voltage-clamped at 0 mv to inactivate any voltage-dependent calcium currents, which were recorded in response to a 200 ms voltage step from 120 to 40 mV in 20 mV increments. RESULTS: Simultaneous depletion of intracellular Ca2+ leads to linear store-operated Ca2+ current (iSOC) reversal near 0 mV. Nicardipine does not affect iSOC. CONCLUSiONS: in canine PASMCs, the depletion of intracellular Ca2+ stores leads to the activation of iSOC, which is not inhibited by nicardipine, a voltage-dependent Ca2+ channel (VDCC) blocker, indicating that VDCC blocked by nicardipine does not contribute to CCE in canine PASMCs.
Anoxia ; Calcium Channels ; Calcium* ; Muscle, Smooth* ; Myocytes, Smooth Muscle* ; Nicardipine* ; Patch-Clamp Techniques ; Pulmonary Artery ; Sarcolemma

Myotonic dystrophy is a multisystemic disorder inherited as an autosomal dominant trait. The characteristic clinical features include the presence of myotonia, atrophy of the muscles of the face and the sternocleidomastoids and numerous nonmusclar manifestations such as cataracts, frontal baldness, gonadal dysfunctions and cardiac abnormalities. We experienced one case of myotonic dystrophy with prolonged atrial flutter in 30-year-old male who was admitted because of palpitation. We present this case with reviewing literatures.
Adult ; Alopecia ; Atrial Flutter* ; Atrophy ; Cataract ; Gonads ; Humans ; Male ; Muscles ; Myotonia ; Myotonic Dystrophy*