BACKGROUND: The purpose of this study was to compare the effects of ondansetron and granisetron on the prevention of postoperative nausea and vomiting (PONV) in gynecologic patients. METHODS: In a randomized placebo-controlled study, 200 gynecologic patients were divided into 5 groups. Each patient received one of 5 medications: placebo (saline 3 ml), ondansetron 4 mg (O4), ondansetron 8 mg (O8), granisetron 1.5 mg (G1.5) and granisetron 3 mg (G3). They were administered intravenously immediately before the induction of anesthesia. A standardized inhalation anesthesia and a postoperative intravenous patient-controlled analgesia were applied. Twenty four hours after anesthesia, the incidence and severity of PONV and other adverse effects were assessed. RESULTS: The incidence of PONV was 88%, 83%, 75%, 70% and 60% in the placebo, O4, O8, G1.5 and G3 groups, respectively, which showed significantly lower value in the G3 group than in the placebo and O4 groups (P< 0.05). The severity of PONV was also significantly lower in the G3 group than in the placebo group (P < 0.05). CONCLUSIONS: In this study, granisetron 3 mg showed a better prophylactic effect in the mitigation of PONV in gynecologic patients then a placebo or ondansetron 4 mg.
Analgesia, Patient-Controlled ; Anesthesia ; Anesthesia, Inhalation ; Female ; Granisetron* ; Gynecologic Surgical Procedures* ; Humans ; Incidence ; Ondansetron* ; Postoperative Nausea and Vomiting*

The 56-kilodalton protein genes of Orientia tsutsugamushi TA678, TA686, TA716, TA763 strains were amplified by PCR. The amplified products were sequenced and cloned into pIH821 vector. The recombinant proteins were expressed in Escherichia coli as fusion proteins with maltose binding protein. The recombinant proteins were purified and used for the sensitization of sheep RBCs and the reactivity of the recombinant 56-kDa proteins of Orientia tsutsugamushi TA 678, TA686, TA716 strains were analyzed with 40 sera from scrub typhus patients in Korea, 40 sera from scrub typhus in Thailand, Malaysia and Philippines. The 56-kDa protein coding DNA sequence of Orientia tsutsugamushi TA678, TA686, TA716 show 70 to 88% homology with other known strains and four variable regions are also observed. 39 of 40 sera from scrub typhus patients in Korea showed the strongest reactivity to the recombinant protein of Boryong strain and one sera showed the strongest reactivity to the recombinant protein of Gilliam strain. 14 of 40 sera from patients in Thailand, Malaysia and Philippines showed the strongest reactivity to the recombinant protein of TA686 strain and 12 sera showed the strongest reactivity to the recombinant protein of TA716 strain. No serum from patients in Thailand, Malaysia and Philippines showed the strongest reactivity to the recombinant protein of Boryong strain.
Asian Continental Ancestry Group* ; Base Sequence ; Chungcheongnam-do ; Clinical Coding ; Clone Cells ; Cloning, Molecular* ; Escherichia coli ; Hemagglutination Tests* ; Hemagglutination* ; Humans ; Korea ; Malaysia ; Maltose-Binding Proteins ; Orientia tsutsugamushi* ; Philippines ; Polymerase Chain Reaction ; Recombinant Proteins ; Scrub Typhus ; Sheep ; Thailand

Marjolin's ulcer is a malignant degeneration of cicatrical tissue, especially in chronic burn scar. Since the first description by Jean Nicholas Marjolin(1828), many studies for Marjolin's ulcer have been performed and reported. From 1985 to 1997, we experienced 20 cases in 14 patients diagnosed as Marjolin's ulcer clinically, and we analysed malignant transformation rate, induction period of Marjolin's ulcer and prevention of Marjolin's ulcer, etc. The results are summarized as follows. 1) The sex distribution was predominant in male(64.3%). 2) The most common cause of injury was flame burn(78.6%). 3) The mean age at the time of diagnosis was 45.6 years and the average lag period was 20.6 years. 4) The pathologic types of Marjolin's ulcer were squamous cell carcinoma(57.2%), followed by dyspasia(28.6%), acnthosis and hyperkeratosis(14.2%). 5) The locations of ulcers were frequently on the lower extremity(42.9%), followed by upper extremity(35.7%) and trunk (21.4%). 6) The lymph node involvements were 3 patients out of the 8 patients who were confirmed as squamous cell carcinoma. 7) The modalities of treatment were skin graft (18 cases, 12 patients), myocutaneous flap(1 case, 1 patient), fasciocutaneous flap(1 case, 1 patient).
Burns ; Carcinoma, Squamous Cell ; Cicatrix ; Diagnosis ; Humans ; Lymph Nodes ; Sex Distribution ; Skin ; Transplants ; Ulcer*

This paper reports a patient with Moyamoya disease who developed a psychotic disorder following a stroke. A 47-year-old female with Moyamoya disease without a psychiatric history experienced persecutory delusion and auditory hallucinations after eight months of intracranial hemorrhage in the right temporal lobe. The adult was managed with low-dose antipsychotics, risperidone. A brief Psychiatric Rating Scale was performed weekly after hospitalization, and psychotic symptoms eventually were under control after three weeks following the initiation of psychotropic medication. This case suggests that low-dose antipsychotics would be effective in patients with psychosis newly developed from a stroke secondary to Moyamoya disease.

No abstract available in English.
Carcinoma, Squamous Cell ; Clinical Study ; Epithelial Cells ; Wounds and Injuries

Usually the histologic response of muscle to the ischemia range from mild, reversible change to extensive necrosis and fibrosis in the case of anterior tibial compartment syndrome. But dystmphic calcification in the late stages is very rare condition.Only three cases were previously reported by Gallie and Broder et al in the literature. We are reporting six cases of dystrophic calcification following anterior tibial compartment syndrome in late stages. Onsets of dystrophic calcifications after original injuries ranged from twelve years to thirty-two years. Two out of six cases revealed painless maas in the anterior tibial compartment and remaining four cases revealed painful aases. At surgery, tooth-paste like, calcified material was evacuated in one of five operated cases and yellowish grey, brittle materials were evacuated in the remaining four cases.
Compartment Syndromes ; Fibrosis ; Ischemia ; Leg ; Necrosis

There are many procedures for treatment of injuries of acromioclavicular separation, but still controversies concerning the best management of these injuries. From March 1981 to August 1984 at Masan Korea Hospital, twelve cases were treated by technique of modified Phemister method, two cases by Dewar and Barrington method, two cases by Stewart method, one case by Neviaser method, three cases by skillful neglect method and two cases by shoulder harness immobilization. The following results were obtained. 1. These injuries were more prevalent in male and more in right side. 2. The most common cause of injuries was traffic accident and followed by falling from the height. 3. Three cases were grade 2 and nineteen cases grade 3 by Allman's classification. 4. We treated these injuries by operative method in seventeen cases and non-operative method in five cases. 5. There were good functional results of treatment in operative method. 6. There were two cases of superficial wound infection, two cases of migration of K-wire and one case of recurrence of deformity in operative method, and two cases of shoulder stiffness and 2 cases of recurrence of deformity in non-operative method.
Accidental Falls ; Accidents, Traffic ; Acromioclavicular Joint ; Classification ; Congenital Abnormalities ; Humans ; Immobilization ; Korea ; Male ; Methods ; Recurrence ; Shoulder ; Wound Infection

In the past, arthrodesjs was a widely used procedure but in recent times, with the development of replacement arthroplasty, decreased in tuberculosis and polio. etc, it is not commonly used by orthopedic surgeons. However, for those in the young age group, people employed in hard labor and patients with acute inflammatory disease, arthrodesis is through to be more appropriate than replacement arthroplasty. From January 1980 to December 1985, 20 cases of arthrodesis of the knee joint were carried out. The results were follows.; 1. Methods of arthrodesis used were Charnley compression arthrodesis in 10 cases, Hoffman compression arthrodesis in 2 cases, cross pinning in 3 cases and and cross pinning with patella graft in 5 cases. 2. Bone union was seen in all 12 cases of compression arthrodesis at an average of 21.3 weeks while bone union was seen in 7 out of 8 cases of non-compression arthrodesis at an average 25 weeks. 3. Among the 20 cases, complication were pseudoarthrthrosis in one case, pin tract infection in 2 cases and skin necrosis in 5 cases. 4. Inconclusion of the above results, bone union was carried out in 19 cases out of total 20 cases, and compression arthrodesis showed faster bone union at an average of 3.7 weeks earlier than non-compression arthrodesis.
Arthrodesis ; Arthroplasty, Replacement ; Humans ; Knee Joint ; Knee ; Necrosis ; Orthopedics ; Patella ; Poliomyelitis ; Skin ; Surgeons ; Transplants ; Tuberculosis

The method of ankle arthrodesis is variable but compression arthrodesis has been widely used because of better results than non-compression arthrodesis. Twenty-one cases of ankle arthrodesis were carried out at department of orthopaedic surgery of Korea Veterans Hospital from January 1980 to June 1986, and were analysed clinically. The results obtained were as follows; l. Among 11 cases of compression arthrodesis, Charnleys method was done in 8 cases and Monofixateur in 3 cases. 2. Among 10 cases of non-compression arthrodesis, Chuinard-Peterson method was done in 7 cases and anterior 'sliding graft in 3 cases. 3. The average duration of immobilization after ankle arthrodesis was 11.7 weeks, and average 4.2 weeks were less needed in the compression arthrodesis than non-compression arthrodesis. 4. The postoperative complications were developed in 8 cases (38%): wound infection in 4 cases,skin necrosis in 3 cases and incisional neuroma in 1 case. 5. Bony union was obtained in 20 cases(95.2%) out of 21 cases at average 15.7 weeks, and in the non-compression arthrodesis and in the cnmpression arthrodesis, respectively, 90% at 17.7 weeks and 100% at 13.9 weeks.
Ankle Joint ; Ankle ; Arthrodesis ; Hospitals, Veterans ; Immobilization ; Korea ; Methods ; Necrosis ; Neuroma ; Postoperative Complications ; Transplants ; Wound Infection

During the rehabilitation period, traumatic fracture of the lower extremity in chronic spinal cord injured patients may be occur frequently. In the past, conservative treatment with pillow or plaster splinting was advocated by many clinician, but its treatment is still controversial. This paper presents our experience with fracture of 20 patients(5.7%) of total 350 patients who had spinal cord injuries from Jan. 1980 to Mar. 1987 at Korea Veterans Hospital. The results were as follow. 1. The incidence of fracture was not related to age, sex, type and duration of spinal cord injury. 2. The most common cause of fracture was insignificant trauma(94%). 3. The distribution of fracture was in the following order of frequency;supracondyle of femur (20%), shaft of femur (20%), shaft of tibis (16%). 4. The methods of treatment-Twenty cases were treated by conservative treatment and eleven cases were treated by operative treatment in following order; paster splint with well padded; 9 cases (20%), pillow splint; 4 eases (13%), plate and screw; 3 cases (10%). 5. Total 11 cases of complications were 8 cases in conservative treatment and 3 cases in operative treatment. 6. The duration of bone union was average 10 weeks in nonoperative treatment and average 10.2 weeks in operative treatment. Treatment should strive to achieve fracture healing with minimal danger to the patient and should cause little or no interfrence with patient's daily routine.
Femur ; Fracture Healing ; Fractures, Bone ; Hospitals, Veterans ; Humans ; Incidence ; Korea ; Lower Extremity ; Rehabilitation ; Spinal Cord Injuries ; Spinal Cord ; Splints