OBJECTIVE: To assess the effect of fentanyl and midazolam on in vitro fertilization rate and early embryo development in a mouse IVF model. METHODS: Mouse oocytes were exposed in vitro to fentanyl at a concentration of 0(control), 50, 250, 500, 1000, 5000 pg/ml, and midazolam, 0(control), 2.5, 12.5, 25, 50, 250 ng/ml for 30 minutes, washed and inseminated. Thereafter fertilization was assessed. And subsequent in vitro development to the blastocyst stage was monitored daily. RESULTS: Where fertilization occurred, subsequent embryo cleavage and development up to the blastocyst stage was affected significantly by the presence of fentanyl and midazolam solution in the medium(i.e., 14% to 31%, 10% to 35%), in comparison with control group( 60%, 62%). CONCLUSION: It can be concluded from these experiments that even a brief exposure of cumulus enclosed oocytes to a low concentration of fentanyl, midazolam is deleterious to subsequent cleavage.
Anesthetics ; Animals ; Blastocyst ; Embryonic Development ; Embryonic Structures* ; Female ; Fentanyl* ; Fertilization ; Fertilization in Vitro* ; Mice* ; Midazolam* ; Oocytes ; Pregnancy

No abstract available.
Constriction, Pathologic* ; Humans ; Infant, Newborn* ; Pulmonary Artery* ; Systolic Murmurs*

OBJECTIVES: The aim of this study was to evaluate the psychological characteristics of the patients with bruxism by Minnesota Multiphase Personality Inventory(MMPI). METHODS: MMPI was administered to 87 patients(46 bruxism group and 41 control group) who had visited a local dental clinic from January to August 1998. RESULTS: The bruxism group had a higher score than control group in Masculinity-Femininity(Mf) scale. There were no differences between bruxism group and control group on the distribution of Depression(D), Psychopatic Deviate(Pd), Paranoia(Pa), Psychasthenia(Pt) scales. The bruxism group with the family history showed higher score than the bruxism group without family history in Pd scale. Male bruxism group had a higher score than female bruxism group in Defensiveness(K) scale and female bruxism group had higher score than male bruxism group in Pa scale. The bruxism group of clenching type had higher score than the bruxism group of mixed type in Social Introversion(Si) scale. There were no differences in MMPI score between those who had and did not have symptoms such as masticatory musle pain, neck pain and headache. CONCLUSION: It is concluded that individualized approach may be effective to the evaluation of psychological disturbances which might be related to sex, family history and, type of bruxism, while we did not find significant differences in personality charateristics between the bruxism and control groups.
Bruxism* ; Dental Clinics ; Female ; Headache ; Humans ; Male ; Minnesota ; MMPI* ; Neck Pain ; Weights and Measures

No abstract available.
Humans ; Methacholine Chloride* ; Rhinitis*

With the introduction of cyclosporine, heart transplantation has become a widely accepted treatment for patients with end-stage heart failure. Number of operation increased steadily during recent 6 years with many postoperative follow up cases. A number of survivors are now presenting for non-cardiac surgery. Cardiac transplanted patients present anesthesiologists with challenging problems related to the infection in immunosuppressed patients, rejection phenomena, denervated heart pathophysiology with altered hemodynamic function of their own and under circumstances of stress and drug therapies. We experienced 2 cases of general anesthesia for noncardiac surgery in heart transplanted patients without important hemodynamic changes. Preoperative evaluation including heart status, rejection, immunosuppressive drug therapy and its complications is mandatory. These patients present few problems during anesthesia if adequate hydration, aseptic technique, selection of proper vasoactive drugs are provided.
Anesthesia* ; Anesthesia, General ; Cyclosporine ; Drug Therapy ; Follow-Up Studies ; Heart Failure ; Heart Transplantation ; Heart* ; Hemodynamics ; Humans ; Survivors

PURPOSE: This study was conducted to estabilish the prevalence, clinical features and relationship between ECG findings and echocardiographic findings of Wolff-Parkinsion-White(WPW) syndrome in asymptomatic preschool children. METHODS: An electrocardiographic screening study was performed on 77,824 preschool children in Jeonbuk province from April, 1999 to August, 2001. Patients with WPW syndrome underwent echocardiographic study. RESULTS: Twenty three patients with WPW syndrome were discovered by electrocardiographic screening of preschool children. The prevalence rate was 2.9 per 10,000 preschool children and there was no significant sexual difference. Two patients had a history of symptoms related to tachyarrythmia. According to the ECG classification of Rosenbaum et al., five patients were type A and 18 were type B. Utilizing the criteria of Gallagher et al, right anterior, 12 patients; right anteiror paraseptal, four patients; left anteiror, three patients. Nineteen of 23 patients underwent echocardiographic study. Four of five patients with type A WPW syndrome had abnormal early systolic anterior motion of left ventricular posterior wall. Twelve of 14 patients with type B had abnormal interventricular septal motion characterized by early sytolic posterior motion immediately after inscription of the delta wave. CONCLUSION: The prevalence rate of preschool children in Jeonbuk province was 2.9/10,000. By the classification according to the electrocardiographic findings, the accessory pathway location was dominant right side than left side. In the echocardiographic study, type A WPW syndrome showed abnormal left ventricular posterior wall motion and type B WPW showed abnormal interventricular septal motion.
Child, Preschool* ; Classification ; Echocardiography* ; Electrocardiography* ; Humans ; Jeollabuk-do ; Mass Screening ; Prevalence ; Wolff-Parkinson-White Syndrome*

BACKGROUND: Facial diplegia has diverse etiologies, including viral and bacterial infections such as diphtheria, syphilis and Lyme disease, and also protozoal infection in very rarely cases. CASE REPORT: A 20-year-old male patient was admitted to our hospital due to bilateral weakness of the upper and lower facial muscles. Examination revealed that the patient had a facial diplegia of the peripheral type. A peripheral blood smear demonstrated the presence of the asexual trophozoite stage of Plasmodium vivax with ring-form trophozoites, which led to a diagnosis of malaria. A serum work-up revealed increased IgG titers of antibodies to myelin-associated glycoprotein and ganglioside GD1b. The patient was administered antimalarial treatment, 1 week after which he showed signs of recovery. To our knowledge, this is the first case of facial diplegia after malaria infection, providing evidence that the mechanism underlying the condition is related to immune-mediated disease. CONCLUSIONS: Facial diplegia can manifest after P. vivax infection.
Antibodies ; Bacterial Infections ; Diphtheria ; Facial Muscles ; Humans ; Immunoglobulin G ; Lyme Disease ; Malaria ; Malaria, Vivax ; Male ; Myelin-Associated Glycoprotein ; Plasmodium ; Plasmodium vivax ; Syphilis ; Trophozoites ; Young Adult

PURPOSE: The purpose of this study was to evaluate the ultrasonographic and CT findings of various diseases that affect the intraparotid lymph node. MATERIALS AND METHODS: The subjects were 32 patients having various diseases involving the intraparotid lymph node. The final confirmed diagnoses were nonspecified benign inflammatory lymphadenopathy (n=20), metastasis (n=5), tuberculous lymphadenitis (n=4), and lymphoma (n=3). For the nonspecified benign inflammatory lymphadenopathy, there were multiple lesions in five patients and bilateral lesions in two patients, and a total of 26 lesions were included in this study. The pathologic proof of the diagnosis was made for 4 of 26 lesions, and by ultrasound follow-up on 22 of 26 lesions. All the patients underwent ultrasound. Color Doppler imaging was also performed in 19 patients and contrast-enhanced CT was also performed in 8 patients. All cases with metastasis, tuberculous lymphadenitis and lymphoma were pathologically confirmed and these patients were all examined with contrast-enhanced CT. RESULTS: For the nonspecified benign inflammatory lymphadenopathy, all the lesions were seen at the superficial lobe. All twenty six lesions were observed as well-defined ovoid or round hypoechoic nodules with posterior sonic enhancement on ultrasonography. A central echogenic hilum was seen in 12 of 26 inflammatory lymphadenopathies (46%), and a central hilar vascularity was noted in 13 of 19 inflammatory lymphadenopathies (68%) on color Doppler imaging. Contrast-enhanced CT showed well-defined nodules with homogeneous enhancement in most lesions. In 3 lesions, a central low density hilum was seen within a lymph node. In 12 cases with metastasis, tuberculous lymphadenitis and lymphoma, there were multiple lesions in 6 cases. CT revealed intraparotid masses with or without central necrosis and the associated multiple lymph node enlargements in the ipsilateral neck region, and their appearances were similar to that of parotid mass. CONCLUSION: Nonspecified benign inflammatory lymphadenopathy involving intraparotid lymph nodes often demonstrated characteristic ultrasonographic findings, including a central echogenic hilum on gray scale US and central hypervascularity on color Doppler ultrasonography. In the metastasic lesions, the tuberculous lymphadenitis and the lymphomas, the multiplicity of lesions and the associated enlarged lymph nodes in the ipsilateral neck region could be helpful in the differential diagnosis.
Diagnosis ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Lymph Nodes ; Lymphatic Diseases* ; Lymphoma ; Neck ; Necrosis ; Neoplasm Metastasis ; Tomography, X-Ray Computed ; Tuberculosis, Lymph Node ; Ultrasonography ; Ultrasonography, Doppler, Color

Hypertrophic neuropathy is a non-specific consequence of repeated demyelination and remyelination, encountered in a wide range of inherited and acquired disorders. We report an 11-year-old boy with HMSN III, a kind of hypertrophic neuropathy, with clinical, electrophysiologic and pathologic data. The electrophysiologic studies show complete conduction block in the upper and lower extremities with severe abnormal spontaneous activities. The pathologic findings of sural nerve reveal prominent hypomyelination, onion bulb formation, and severe endoneurial collagenization. Complete conduction block with the preservation of fair to good grade muscle strength is an unusual finding in hypertrophic neuropathy and other peripheral neuropathies, in general.
Case Report ; Child ; Hereditary Motor and Sensory Neuropathies/pathology/*physiopathology ; Human ; Hypertrophy ; Male ; *Neural Conduction

A 43-year-old female patient with a left L5 radiculopathy was referred to our pain clinic for an epidural steroid injection. An epidural puncture was done at the L4-5 intervertebral space with the loss of resistance technique using air. There was no CSF leaKage during the procedure. After 6 ml of air was injected, she complained of a sudden severe headache, nausea, tinnitus, and mild hearing difficulty. The headache was localized at the left temporal and suboccipital area and the nature of it was constant, squeezing, and non-throbbing. Neurological examination was normal except a mild sensory change on the right face and right hemibody. A brain CT disclosed sudural and subarachnoid pneumocephalus. Twenty-four hours after the event, she was discharged without any specific complaints. To avoid pneumocephalus during epidural puncture, saline instead of air is highly recommended. If physicians use air, a small volume should be used and careful evaluation of the patients condition during injection despite no CSF leaKage should be done.
Adult ; Brain ; Catheterization* ; Catheters* ; Female ; Headache ; Hearing ; Humans ; Nausea ; Neurologic Examination ; Pain Clinics ; Pneumocephalus* ; Punctures ; Radiculopathy ; Tinnitus