No abstract available.
Humans ; Purpura, Thrombocytopenic, Idiopathic* ; Splenectomy*

No abstract available.
Animals ; Lymphocyte Subsets* ; Lymphocytes* ; Rats*

Morphine anesthesia for cardiac surgery became very popular since Lowenstein at al. reported that 1.5~3.0mg/kg of morphine administered intravenously during ventilating with 100% oxygen did not alter cardiovascular dynamics in patients without heart disease and improved them in patients with aortic valve disease. However, morphine anesthesia soon appeared to cause significant disadvantages and many problems such as intraoperative awareness, histamine reactions marked increases in intraoperative blood pressure and prolonges postoperative respiratory depression. This study was primarily undertaken to evaluate the effects of intraspinal morphine anesthesia and compare them with the problems resulting from intravenous morphine anesthesia. We had 25 patients scheduled for open heart surgery. They were anesthetized mainly by intraspinal morphine and intravenous tranquilizers. Spinal tapping using Whitacre pencil point needle was performed in a sitting position at a level between L2-L4 and spinal fluid was drawn and mixed with morphine by a 10cc syringe and was administered rapidly with barbotage 3 times. Then the patient was given pentothal and anectin, and was intubated, followed by intravenous administration of Ativan or valium. The patient's respiration was controlled with 100% oxygen throughout the entire surgery. 1) The dosages of intraspinal morphine ranged between 6~10mg which was bridfly calculated by 0.1mg/kg with some variation according to heights and patients conditions. 2) Activan or valium was administered intravenously to eliminate intraoperative awareness. Ativan was preferred to valium for valve surgery. 3) Cardiovascular dynamics appeared stable throughout the intraoperative, recovery and ICUcare periods. 4) Respiratory depression seemed to be most serious between 12~16hour after intraspinal injection of morphine. Therfore this technique is recommended only in patients who need a controlled respiration for more than 12 hours because respiratory arrest occurs more commonly at that hour. 5) Respiratory care in the ICU was very effective satisfactory without any further medication for synchronisation between patient and respiratior becauses of the length of respiratory depression. 6) Somnolence lasts 24~36hours with no inadvertent reactions. 7) Well documented complications such as respiratory depression, pruritis and urinary retention were not problems in patients for open heart surgery. 8) The anesthesia induced by intraspinal morphine injection was satisfactory in anesthesia practice for open heart surgery. Therefore, we have called this procedure which has not been reported yet intraspinal morphine anesthesia.
Administration, Intravenous ; Anesthesia* ; Aortic Valve ; Blood Pressure ; Diazepam ; Heart Diseases ; Heart* ; Histamine ; Humans ; Injections, Spinal ; Intraoperative Awareness ; Lorazepam ; Morphine* ; Needles ; Oxygen ; Pruritus ; Respiration ; Respiratory Insufficiency ; Spinal Puncture ; Syringes ; Thiopental ; Thoracic Surgery* ; Urinary Retention

Rapid administration of solution containing dextrose results in marked hyperglycemia and osmotic diuresis. Jeon reported blood sugar of 200 to 465mg per 100ml. in patients receiving 10ml per hour of 5% dextrose in 1/3 saline and the urine output went up to 340ml per hour. This study was undertatken to evaluate Elitol asto changes of blood sugar concentrations when it was administered rapidly. Elitol is a maltose contained in a balanced salt solution shich has a different effect in the blood sugar level from a gulcose contained solution. 40 patients were chosen at random and divided into 3 groups i.e. one group 5% dextrose in water(D5/W), the second group 5% dextrose in lactated ringer's solution(D5/LR) and the third group the Elitol solution. Patient's blood was drawn on the operating table prior to starting I.V. infusion for the measurement of blood sugar in various conditions of N.P.O. Intravenous fluid was administered at 10ml/kg/hour while anesthesia was induced and maintained with an endotracheal tube in place. The blood samples were taken after one hour, 2 hours and 3 hours from the time the LV. infusion started. In the group of 5% dextrose in water, the value of blood sugar was 82+/-mg% at NPO2 205+/-36mg% at 1 hour, 273+/-49mg% at 2 hours, and 316+/-63mg% at 3 hours. The blood sugar values increased markedly. In the group of 5% dextrose in lactate Ringer's solution the values of blood sugar were 99+/-16mg% at NPO, 255+/-49mg% at 1 hour, 285+/-54mg% at 2 hours and 292+/-78mg% at 3hours. The values of blood sugar increased significantly and were very similar to the 1st group. In the group of Elitol, the values of blood sugar were 92+/-12mg% at NPO, 126+/-21mg% at 1 hour, 131+/-24mg% at 2 hours and 128+/-23mg% at 3hours. The increase of blood sugar levels were insignificant which is entirely different from the change of blood sugar in the above groups. Accordingly we came to the conclusion that rapid infusion of Elitol solution affects the blood sugar levels insignificantly compared to the dextrose containing solutions which increase the blood sugar levels greatly.
Anesthesia ; Blood Glucose* ; Diuresis ; Glucose ; Humans ; Hyperglycemia ; Lactic Acid ; Maltose ; Operating Tables ; Water

This study was undertaken to estimate the effects of the induction agents on the bioparameters such as changes in blood pressure, pulse rate, Apgar score, patients movement, fetal arterial and venous blood gas analysis, memory and emergence reactions. 116 parturients undergoing cesarian section were divided into two groups: ketamine group and thiopental group, and were given 1.2 mg/kg ketamine in ketamine group and 4 mg/kg thiopental sodium in thiopental group as an induction agent respectively. The results were as follows; I) Blood pressure increased in both groups, but ketamine group less increased than thiopental group statistically. Pulse rate did not increased in skin incision in ketamine group statistically. 2) The patient's movement were 5 case(9%) in ketamine group and 17 cases(29%) in thiopental group. 3) There was not significant difference in fetal arterial and venous blood gas analysis. 4) In Apgar score, ketamine group is better than thiopental group. 5) There was no psychologic side reactions in both groups. 6) Postoperative recalling of intraoperative awareness occured in seven patients(12%) only in the thiopental group.
Apgar Score ; Blood Gas Analysis ; Blood Pressure ; Cesarean Section ; Female ; Heart Rate ; Humans ; Intraoperative Awareness ; Ketamine* ; Memory ; Pregnancy ; Skin ; Thiopental*

Cutaneous focal mucinosis is a rare disease which usually manifests itself as a single asymptomatic papule or nodule, but vesicular presentati:on has only rarely been reported. This condition is one of many mucinoses, including localized lichen myxedematosus, acral persistent papular mucinosis, alopecia mucinosa, follieular mucinosis, and myxoid cysts which present with localized cutaneous lesions. We report a rare vesicular form of cutaneous focal mucinosis in a 42-year-old caucasian male who showed a slowly growing, 0.5 cm-sized, asymptomatic vesicle of one-week duration on his right knee. A histopathological examination revealed a localized accumulation of amorphous basophilic material which was positive on colloidal iron staining at pH 2.5. However, it was negative at pH 0.4 in an alcian blue stain, and negative on colloidal iron staining after treatment with hyaluronidase. The amorphous material was judged to be hyaluronic acid from the results of the above special stains. Proliferation of fibroblasts was also observed. Electron microscopy showed well-develuped endoplasmic reticulum and secretory vesicles in the fibroblasts. The lesion could not be completely removed even after two succesive wide excisions.
Adult ; Alcian Blue ; Basophils ; Colloids ; Coloring Agents ; Endoplasmic Reticulum ; Fibroblasts ; Ganglion Cysts ; Humans ; Hyaluronic Acid ; Hyaluronoglucosaminidase ; Hydrogen-Ion Concentration ; Iron ; Knee ; Male ; Microscopy, Electron ; Mucinoses* ; Mucinosis, Follicular ; Rare Diseases ; Scleromyxedema ; Secretory Vesicles

Chronic prostatitis has various symptoms and many problems in management. Recently a lipidosterolic extract of Serenoa Repens, Permixon has been reported to reveal potential antiandrogenic and anti inflammatory activities on prostate. Then we used Permixon on chronic prostatitis and following results were obtained. Permixon is administered orally in dose of 160mg., b.i.d. for 60 days in 31 cases of chronic prostatitis in 1st group, Permixon 160mg, with Cipro-floxacin 500mg, b.i.d. in 35 cases in 2nd group and Placebo 2 tablets, b.i.d. in 30 cases in 3rd group. In 1st group 36 cases(77.4%) were improved, 29 cases(82.8%) in 2nd group and 7 cases (23.3 %) of 3rd group were improved. Permixon is an effective drug in chronic prostatitis and there was no changes in laboratory findings and negligible side effects were noticed
Prostate ; Prostatitis* ; Serenoa* ; Tablets

Central vanous pressure is an extremely useful parameter in the effective monitoring of a patient who is seriously ill. Central venous pressure may be defined as a dynamic measurement of the ability of the right heart and the placement of the catheter in either the right atrium or the superior cava is considered satisfactory. The purpose for this study is to evaluate CVP values according to the placement of the catheter in clinical practice because we have used a short anglocath instead of a long intracath for the measurement of CVP. Ten patients were catheterized with a 20cm in tracathin the right subclavian vein by a supraclavicular approach. AS a control group CVP was measured at 13cm from the puncture site to the tip of catheter which was estimated to be in the right atrium. In the second group, CVP was measured at 8cm which goes the innominate vein and in the fourth group, measured at 5cm which locates in the subclavian vein. Mean values of venous pressures in each location are as follows: The right atrium(13cm from the puncture site): 8.68cm H2O. THe superior vena cava (10cm from the puncture site): 8.69cm H2o/ The innominate vein(8cm from the puncture site): 8.64cm H2O. The subclavian vein (5cm from the puncture site):8.68cm H2O. As a result of this study, we came to the conclusion that the CVP values in all four groups(right atrium, superior vena cava, innominate vein, subclavian vein) are almost the same, so that we can use a short angiocath with no problems for the measurements of CVP which is anchored in the innominate vein or the subclavian vein.
Brachiocephalic Veins ; Catheters* ; Central Venous Pressure ; Heart ; Heart Atria ; Humans ; Punctures ; Subclavian Vein ; Vena Cava, Superior ; Venous Pressure

The complications of herpes zoster ophthalmicus vary greatly among different patients. The major portion of the complications fall under four types; (1) keratitis, (2) iridocyclitis, (3) muscular palsies, and (4) optic neuritis. We have experienced a case of herpes zoster ophthalmicus complicated by abducens palsy, sectorial paralysis of iris sphincter, iritis, and transient increase of intraocular pressure. The case was reviewed and the pathogenesis of the complications were discus sed.
Herpes Zoster Ophthalmicus* ; Herpes Zoster* ; Humans ; Intraocular Pressure ; Iridocyclitis ; Iris ; Iritis ; Keratitis ; Optic Neuritis ; Paralysis*

The laparoscopic cholecystectomy has been rapidly accepted as the standard treatment for gallbladder stones because its minimally invasive nature offers a significant advantage over an open cholecystectomy in terms of postoperative morbidity & recovery. The endoscopic sphinterotomy has become the primary treatment for common bile duct stones, yielding a duct clearance rate of approximately 90%. The laparoscopic cholecystectomy combined with the preoperative endoscopic sphinterotomy is becoming more widely employed as a therapeutic option for the management of gallbladder stones & common bile-duct stones. The authors retrospectively analyzed 71 patients who had been treated by an open cholecystectomy and a common bile-duct exploration (group A) and 35 patients who had been treated by a laparoscopic cholecystectomy plus endoscopic sphinterotomy (group B) at the Department of Surgery, Jungang Gil Hospital, from March 1993 to January 1996. The diagnotic procedures performed were ultrasonography ERC and DISIDA scan, and abdominal computed tomography. Intraoperative cholangiograms were successfully performed in 59 cases from group A and in 5 cases from group B. Successful duct clearance was achieved in 87.3% of the group A cases and in 87.5% of the group B cases. The operation time, the postoperative hospital stay, and postoperative complications were significantly lower for group B than for group A. The major postoperative complication was wound pain & infection for both groups. We conclude that in comparison with group A, group B appeared to have a similar clearance rate, a much lower morbidity, a shorter hospital stay, an earlier return to working fitness, and a better cosmetic result.
Cholecystectomy ; Cholecystectomy, Laparoscopic ; Choledocholithiasis* ; Cholelithiasis* ; Common Bile Duct ; Gallbladder ; Humans ; Length of Stay ; Postoperative Complications ; Retrospective Studies ; Return to Work ; Ultrasonography ; Wounds and Injuries