Intrathecal injection of a small amount of morphine was used to provide obstetric analgesia in 20 primiparous women in labor. When the cervix was 3~4cm dilated approximately, 0.25mg or 0.5mg of morphine was injected intrathecally in each patient. In all parturients, labor pains were completery relieved after 10~60 min and analgesia lasted 8 to 15 hours. The vital signs of all parturients after intrathecal morphine injection were stable. The analgesia was well achieved but there was no alteration of motor power or pinprick sensation. The maternal side effects such as itching, nausea, vomiting, somnolence and urinary retention occured in a high proportion of parturients, but severity of these side effects were mild in most cases. Urinary retention was most severe side effect in our cases. All newborns were scored as having 8~10 on Apgar scores at 1 min after birth.
Analgesia ; Analgesia, Obstetrical* ; Cervix Uteri ; Female ; Humans ; Infant, Newborn ; Injections, Spinal ; Labor Pain ; Morphine* ; Nausea ; Parturition ; Pregnancy ; Pruritus ; Sensation ; Urinary Retention ; Vital Signs ; Vomiting

BACKGROUND: Histological analysis of tuberculosis shows a spectrum of findings, from well formed granulmatous inflammation with few bacilli in patient with normal immune response to M. tuberculosis to poorly formed granulomatous inflammation with many bacilli in patient with defective immune response. To evaluate the degree of immune response to M. tuberculosis, we studied the histologic features, including the presence of acid fast bacilli(AFB) in lymph node of patients with cervical tuberculous lymphadenitis, and compared them with clinical characteristics. METHODS: We reviewed the histologic features of 33 cases of cervical tuberculous lymphadenitis and processed the excised nodes for auramine-rhodamine staining to detect AFB. The AFB positivity in tissue was compared with the histologic features(degree of granuloma formation, presence of caseation necrosis, presence of neutrophilic infiltration) and clinical characteristics (lymph node size, duration of symptom, presence of local symptom or radiologic evidence of pulmonary tuberculosis). RESULTS: 1) The mean age at diagnosis was 42.4 years, and male to female ratio was 1 : 45. 2) Histologically, all cases showed well formed granuloma and variable degrees of caseation necrosis, and 39% of the cases showed neutrophilic infiltration in the granulomatous inflammation. 3) AFB were confirmed in 52% of the cases, and they were found extracellularly and at the periphery of caseation necrosis. 4) There was no association between AFB Positivity and histological features or clinical characteristics. CONCLUSION: Cervical tuberculous lymphadenitis showed well formed granulomatous inflammation with caseation necrosis, and there was no association between AFB positivity in the tissue and histological or clinical characteristics.
Diagnosis ; Female ; Granuloma ; Humans ; Inflammation ; Lymph Nodes ; Lymphadenitis ; Male ; Necrosis ; Neutrophils ; Tuberculosis ; Tuberculosis, Lymph Node*

Epidemiological data of Bordetella pertussis infection among adolescents and adults are limited in Korea. Patients (> or = 11 yr of age) with a bothersome cough for less than 30 days were enrolled during a 1-yr period at 22 hospitals in Korea. Nasopharyngeal swabs were collected for polymerase chain reaction (PCR) and for bacteriologic culture. In total, 490 patients were finally enrolled, and 34 (6.9%) patients tested positive for B. pertussis; cough duration (14.0 days [7.0-21.0 days]) and age distribution were diverse. The incidence was the highest in secondary referral hospitals, compared to primary care clinics or tertiary referral hospitals (24/226 [10.6%] vs. 3/88 [3.4%] vs. 7/176 [4.0%], P = 0.012), and the peak incidence was observed in February and August (15.8% and 15.9%), with no confirmed cases between March and June. In the multivariate analysis, post-tussive vomiting was significantly associated with pertussis (odds ratio, 2.508; 95% confidence interval, 1.146-5.486) and secondary referral hospital showed a borderline significance. In conclusion, using a PCR-based method, 6.9% of adolescent and adult patients with an acute cough illness had pertussis infection in an outpatient setting. However, hospital levels and seasonal trends must be taken into account to develop a better strategy for controlling pertussis.
Adolescent ; Adult ; Bordetella pertussis/*genetics ; Child ; DNA, Bacterial/*analysis ; Demography ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; *Polymerase Chain Reaction ; Republic of Korea/epidemiology ; Seasons ; Vomiting/etiology ; Whooping Cough/*epidemiology/microbiology/pathology ; Young Adult