Since the time when the lumbar discogram was used as the clinical diagnostic method for the first time in 1952, many problems have been pointed out to this method, and moreover, in presentday tendencies for the diagnostic method, the lumbar discogram is carried on even useless by majority. One of the important reasons is that so many studies for the lumbar discograms have reported so many false positive lumbar discograms at the high ratio. Hower we found a certain usefulness of the lumbar discogram incidental to the operation. The purposes of our operative lumbar discogram are those; 1) to observe the radiological configuration of the lumbar discogram. 2) to measure the amount of the the dye injected into normal and abnormal lumbar discs, especially in our Koreans. 3) for confirmation of the diagnosis when the myelographic finding is suspicious. 4) for confirmation of the Ievel especially when the number of the possible lesion is more than one. We investigated and analyzed the 35 lumbar discograms of 26 patients and compiled the statistics.
Diagnosis ; Humans ; Methods

Before beginning the extracorporeal circulation, perfusionists should supply oxygen into the oxygenator and establish blood flow through the blood line of the heart-lung machine. But these manipulation can induce severe hypocarbic state of priming solutions due to wash out of CO2 gas in the solution. This study was carried out to examine the relationship of blood gas changes between hypocarbic priming solutions and body circulation in 15 patients undergoing open heart surgery with extracorporeal circulation. PaCO₂, pH, buffer base and PaO2 were measured from priming solutions before and 15 minutes after the extracorporeal circulation. The results were as follows; 1) Before the extracorporeal circulation, mean PaCO₂ level was 12.1±7.8 mmHg in the priming solution. However, 15 minutes after extracorporeal circulation, the PaCO₂ level was maintained at 35.7±5.7 mmHg. 2) pH in the priming solution was variable from 6.93 to 7.99 (mean 7.45±0.29), but after 15 minutes it was ranged from 7.28 to 7.42 (mean 7.35±0.05). 3) Mean buffer base level in the priming solution was 7.9±3.5 mmol/l. but after 15 minutes, it was 19.6±1.2 mmol/l. 4) Mean PaO₂ level in the priming solution was 667.1±45.6 mmHg, but after 15 minutes, it was 280.7±131.7 mmHg.
Extracorporeal Circulation* ; Heart* ; Heart-Lung Machine ; Humans ; Hydrogen-Ion Concentration ; Oxygen ; Oxygenators ; Thoracic Surgery*

In the beginning of anesthetic training, one of the clinical practices that anesthetists have to learn is manually controlled ventilator techniques. The popularity of manually controlled ventilatory techniques has been gradually decreased with increased use for anesthetic ventilators. However it is important and basic for the anesthetists to master manually controlled ventilator techniques skillfully. Recently, we analyzed the arterial blood gas in 30 cases before and during general anesthesia, and studied the effects of the manually controlled ventilation on the pulmonary gas exchange. The results were as follow; 1) Mean value of PaCO₂ during the manually controlled ventilation, 29.9±2.0 mmHg was decreased statistically comparing with that of PaCO₂ before the anesthesia, 39.8±2.8 mmHg. 2) Mean values of pH and HCO₃⁻ during the manually controlled ventilation were 7.48±0.03, 22.2±2.4 mEq/1, respectively and values before the anesthesia were 7.41±0.02, 25.2±1.8 mEq/1, respectively. 3) Mean value of PaO₂ and O₂ saturation during the manually controlled ventilation were 270.0±28.8 mmHg, 99.6±0.2%, respectively and values before the anesthesia were 92.5±4.0 mmHg, 96.9±1.0%, respectively. These results indicates that manually controlled ventilation at our department of anesthesiology produced mild hyperventilatory state. However these were no significant changes in cerebral blood flow and other biochemical parameters.
Anesthesia ; Anesthesia, General* ; Anesthesiology ; Cerebrovascular Circulation ; Hydrogen-Ion Concentration ; Pulmonary Gas Exchange ; Ventilation* ; Ventilators, Mechanical

BACKGROUND: It is a routine practice that High Frequency Jet Ventilation (HFJV) is applied through a 14~16 gauge (about 12 French (Fr.)) angiocath. The 14 Fr. suction catheter which is similar to angiocath in its internal diameter is commonly available in the operating room. We evaluated the suction catheter as a carrier of HFJV in point of ventilation, oxygenation and operating field during HFJV at microlaryngeal endoscopic surgery (MES). METHODS: Fifteen adult patients undergoing HFJV via 14 Fr. suction catheter during MES were studied. Time-based arterial blood gas analyses were done before and after HFJV. The movement of operating field was examined using laryngoscopic examination by surgeon and anesthesiologist. We also evaluated complications such as abdominal distension, barotrauma and so on. RESULTS: The mean arterial oxygen tension was maintained above 250 mmHg all the time during HFJV. The mean carbon dioxide tension was less than 51 mmHg. There were no remarkable catheter movement and complications. CONCLUSION: The 14 Fr. suction catheter is a good replacement of angiocath. It provided good operating field, ventilation and oxygenation without complications.
Adult ; Barotrauma ; Blood Gas Analysis ; Carbon Dioxide ; Catheters* ; High-Frequency Jet Ventilation* ; Humans ; Operating Rooms ; Oxygen ; Suction* ; Ventilation

Two cases of vitiligo-type hypomelanosis followed by the local application of Benoquin ointment for the treatment for the treatment of melasma are reported. These two cases of hypomelanosis are unwanted and unintended side effects probably caused by the application of monobenzyl ethers of hydrcquinone (monobenzone). Monobenzone blocks the enzyme tyrosinase and thereby prevents the conversion of tyrosine to dihydroxyphenylanine, a precursor of melanin, and since this does not destroy melanocyte or facilitate the loss of melanin. The skin contact with the material will not occur, repigmentation will slow but eventuaIly complete.
Ether ; Ethers ; Hypopigmentation* ; Melanins ; Melanocytes ; Melanosis ; Monophenol Monooxygenase ; Skin ; Tyrosine ; Vitiligo*

Penicillamine is a component of the penicillin molecule which was identified in the urine of patients with chronic liver disease who were receiving penicillin for the treament of intercurrent infections. Walshe demostrated its effectiveness as copper chelating agent and introduced it into the treatment of Wilson's disease. In addition, it has been shown to be effective in treatment of cystinuria, heavy metal poisoning, and rheumatoid arthritis. Levamisole is a three-ringed molecule which has been used as broad-spectrum antihelminthic drug. Levamisole is capable of T cell immune enhancer and has variable effects on antibody production, Since immune enhancer may affect multiple cell types, either directly or indirectly, and may operate on the adenylcyclase-cAMP-prostaglandin system, the results of treatment may be complex. Levamisole has been shown to be effective in rheumatoid arthritis by several study. We analysed the 29 rheumatoid arthritis patients who were treated at Deartment of Orthopedic Surgery, Chung Ang University Hospital from June, 1978 to June, 1982; among them 17 recieving penicillamine and 12 recieving levamisole. The results were as follows: 1. There were statistically significant improvement in ESR. But there were decrease in mean WBC and platelet counts in patients recieving penicillamine or levamisole. Hemoglobin was not affected. 2. Side effects led to withdrawal of treatment in 8(47%) patients in the penicillamine group and 5(42%) in the levamisole group. 3. In 17 patients having penicillamine treatment, one patient had complete remission(8%).
Antibody Formation ; Arthritis ; Arthritis, Rheumatoid ; Copper ; Cystinuria ; Hepatolenticular Degeneration ; Humans ; Levamisole ; Liver Diseases ; Orthopedics ; Penicillamine ; Penicillins ; Platelet Count ; Poisoning

No abstract available.
Endometrial Neoplasms* ; Female ; Ovary*

Association of the hepatoid and choriocarcinomatous components in adenocarcinoma of the stomach is extremely unusual and raises a possibility of new approach understand the histogenesis of gastric hepatoid adenocarcinoma. This paper describes a Borrmann type III adenocarcinoma of the stomach with both choriocarcinomatous and hepatoid components in composite tumor pattern in a 50-year-old man. Tubular arrangement of differentiated embryonalcarcinoma was encountered in choricarcinomatous and hepatoid areas, which showed strong immunoreactivity to beta-HCG and AFP, respectively. The findings suggest that gastric adenocarcinoma may have a potential of differentiation toward embryonal carcinoma. from which both choriocarcinoma and hepatoid variant of gastric adenocarcinoma may develop by retrodifferentiation.
Adenocarcinoma

No abstract available.
Dacarbazine* ; Disseminated Intravascular Coagulation

The nail has been considered to be the best human model to evaluate the general body state at all ages. The present study was disigned to measure the nail growth rate and to define the correlation of them with other values of nail size. The subjects were 373 males and 812 females whose ages from R months to 79 years. The results were as follows: 1. The linear elongation of the nails were most rapid in the 14 to 15 year-old age group. It decreased steadily as the subjects got older and olr1er. 2. Sex differences in the nail growth rate were not statistically significant. R. Where were no statistically significant differences in the linear growth rate of nails between right and left hands. 4. The middle finger nail grew more quickly than others, while the thumb and little finger nails grew more slowly. 5. Linear growth of nails were not significantly correlated to the thickness and length of nails and the length of lunulae.
Adolescent ; Female ; Fingers ; Hand ; Humans ; Male ; Sex Characteristics ; Thumb