BACKGROUND: The afferent and efferent pathways of fentanyl cough response (FCR) and central organization are poorly understood at present. The aim of this study was to investigate the pretreatment effects of morphine, propofol, atropine, and midazolam on FCR. METHOD: The 120 healthy patients were randomly assigned to six equal pretreatment groups. They received 2ug/kg fentanyl rapidly through a peripheral venous catheter. The patients in each group were pretreated before the time necessary for peak plasma levels with different drugs as follows: group 1, no premedication; group 2, morphine 0.05 mg/kg iv; group 3, morphine 0.05 mg/kg iv naloxone 0.01mg/kg iv; group 4, propofol 0.5 mg/kg iv; group 5, atropine 0.01 mg/kg iv; group 6, midazolam 0.05 mg/kg iv. The patients were observed for any coughing or side effects, including oxygen desaturation, bronchoconstriction, chest wall rigidity and seizure. RESULT: 40% of patients in group 1 (control) had a cough response to fentanyl. Group 2 (morphine) and group 3 (morphine naloxone) showed a reduced FCR of 10%. The incidence of coughing was 60% of the patients in group 4 (propofol), 30% in group 5 (atropine), and 40% in group 6 (midazolam). These were not statistically significant. CONCLUSION: FCR is not altered by pretreatment with propofol, atropine, or midazolam, but morphine inhibits cough response and this antitussive effect was not antagonized by naloxone.
Atropine* ; Bronchoconstriction ; Catheters ; Cough* ; Efferent Pathways ; Fentanyl* ; Humans ; Incidence ; Midazolam* ; Morphine* ; Naloxone ; Oxygen ; Plasma ; Premedication ; Propofol* ; Seizures ; Thoracic Wall

PURPOSE: While conventional hemorrhoidectomy is notorious for postoperative pain, stapled hemorrhoidopexy has been reported less painful because it has no anal wound. However, the safety of stapled hemorrhoidopexy is not established completely yet. Therefore, the purpose of this study is to evaluate the safety of stapled hemorrhoidopexy through analyzing the postoperative complications. METHODS: The author analyzed the complications of 63 patients treated with stapled hemorrhoidopexy by reviewing the medical records. All of the operations were performed by one surgeon. RESULTS: There were 39 men and 24 women with a mean age of 47.7 years. The majority of cases were carried out under spinal anesthesia except 4 cases of general anesthesia. The combined operations were performed in 16 cases (25.4%) including skin tag excision, external hemorrhoid excision, and polypectomy. The postoperative complications were 2 cases (3.2%) of rectal stenosis, 1 case (1.6%) of thrombosis, 1 case (1.6%) of abscess, and 1 case (1.6%) of late bleeding. Three patients were needed to rehospitalized and reoperation was needed in 1 case of thrombosis. One case of rectal stenosis was treated easily by manual dilatation. However, the other rectal stenosis was treated by Hega dilatation. CONCLUSION: Complications after stapled hemorrhoidopexy may be different from complications after conventional hemorrhoidectomy. However, most of the complications after stapled hemorrhoidopexy can be avoided by respecting the rectal wall anatomy during the procedure. Therefore, in terms of postoperative complications, the stapled hemorrhoidopexy may be a safe procedure.
Abscess ; Anesthesia, General ; Anesthesia, Spinal ; Constriction, Pathologic ; Dilatation ; Female ; Hemorrhage ; Hemorrhoidectomy ; Hemorrhoids ; Humans ; Male ; Medical Records ; Pain, Postoperative ; Postoperative Complications ; Reoperation ; Skin ; Thrombosis ; Wounds and Injuries

Real-time ultrasonogram was performed in 31 Pt. with CHPS, who was admitted at the pediatric department of Wonkwang University hospital from January 1991 to June 1993. Those who had positive results of pyloric volume for diagnosis of CHPS and were confirmed by surgery. The results were at follows: 1) The average ultrasonographic measurements of pyloric muscle thickness, pyloric diameter, pyloric length were 4.9+/-1.09mm, 14.42+/-2.69mm, 19.17+/-2.37mm, and pyloric volume was 3.26+/-1.39ml. 2) The diagnostic reliabilities with the ultrasonographic measurements of muscle thickness (>4mm), pyloric diameter (>12mm) and pyloric length (>15mm) by Stunden's criteria in 31 cases were compared, which were not significant difference among them. 3) In ultrasonographic measurements of 31 cases for diagnosis of CHPS, positive results with 3 parameters were 80.6% and with 2 parameters and double tract signs were 87.1%. So. we conclude pyloric volume greater than 1.4ml was the most reliable parameter, which was satisfied 100% with diagnosis of CHPS.
Diagnosis* ; Pyloric Stenosis, Hypertrophic* ; Ultrasonography

No abstract available.
Rectal Neoplasms

No abstract available.
Acetylcholinesterase* ; Aluminum* ; Animals ; Brain* ; Choline O-Acetyltransferase* ; Choline* ; Rats*

We reviewed 28 pts. with testicular tumors admitted to the department of urology, Catholic medical college during last 12 yrs. The results are summarized as follows; 1. Age distribution ranged from 4 months to 59 years old, showing the highest incidence below 10 yrs old (39%). 2. There were 28 cases of testis tumor, and all cases were germ cell tumors which consisted of 9 cases of seminoma, 10 cases of teratoma, 5 cases of embryonal carcinoma, 2 cases of teratocarcinoma. 1 case of seminoma and embryonal carcinoma, and 1 case of choriocarcinoma and seminoma. 3. Serum HCG and AFP were evaluated in 13 cases. All seminoma and teratoma, 1 case of seminoma and embryonal ca. ranged within normal limit. But, among 4 cases of embryonal ca. 2 had elevated serum HCG, and 3 had elevated serum AFP. 1 case of teratocarcinoma and 1 case of seminoma and teratoma had elevated serum AFP and HCG. 4 The clinical stage was A in 21, B in 6, C in 3. 5. Radical orchiectomy was done in all cases, and retroperitoneal lymph node dissection was given for 9 cases. Radiation therapy and chemotherapy with PVB regimen were performed in 10 and 3 cases. 6. On 12 cases follow up study was made. Of them 3 (1 of teratocarcinoma, 1 of embryonal carcinoma, 1 of seminoma and embryonal carcinoma) in stage C were died at 3.3 yrs, 1.2 yrs and 15 days after orchiectomy. And 1 case(teratocarcinoma) in stage A were died at 1.5 yrs. after orchiectomy due to pulmonary metastasis. Remaining 8 cases are alive without evidence of relapse for mean follow up 39.7 months.
Age Distribution ; Carcinoma, Embryonal ; Choriocarcinoma ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Incidence ; Lymph Node Excision ; Middle Aged ; Neoplasm Metastasis ; Neoplasms, Germ Cell and Embryonal ; Orchiectomy ; Pregnancy ; Recurrence ; Seminoma ; Teratocarcinoma ; Teratoma ; Testicular Neoplasms ; Testis ; Urology

V.parahaemolyticus or V.alginolyticus infections are usually associated with consumption of raw or undercooked shellfish, contaminated food, and exposure of wounds to warm seawater. V.parahaemolyticus causes gastroenteritis(the most common syndrome), wound infections, and septicemia. V alginolyticus occasionally causes extraintestinal infections in humans. so far, the authors have not found the report of V.parahaemolyticus and V.alginolyticus isolation from a patient. So, we report a case of concurrent isolation of V.parahaemolyticus and V.alginolyticus from a patient who had a history of intestinal diarrhea and vomiting.
Diarrhea ; Humans ; Seawater ; Sepsis ; Shellfish ; Vibrio alginolyticus* ; Vibrio parahaemolyticus* ; Vibrio* ; Vomiting ; Wound Infection ; Wounds and Injuries

V.parahaemolyticus or V.alginolyticus infections are usually associated with consumption of raw or undercooked shellfish, contaminated food, and exposure of wounds to warm seawater. V.parahaemolyticus causes gastroenteritis(the most common syndrome), wound infections, and septicemia. V alginolyticus occasionally causes extraintestinal infections in humans. so far, the authors have not found the report of V.parahaemolyticus and V.alginolyticus isolation from a patient. So, we report a case of concurrent isolation of V.parahaemolyticus and V.alginolyticus from a patient who had a history of intestinal diarrhea and vomiting.
Diarrhea ; Humans ; Seawater ; Sepsis ; Shellfish ; Vibrio alginolyticus* ; Vibrio parahaemolyticus* ; Vibrio* ; Vomiting ; Wound Infection ; Wounds and Injuries

BACKGROUND: We observed fentanyl known as centrally-acting antitussive agents provoke a cough response in some patients at induction of anesthesia. This may be of clinical importance. METHOD: 121 patients (ASA class I) were assigned randomly to 4 groups. Each group was given different doses of fentanyll Group 1 (n=30); 0.5ug/kg, Group 2 (n=30); 1ug/kg, Group 3 (n=33); 2ug/kg, Group 4 (n=28); 4 g/kgl, within 1 second through a peripheral venous cannula before induction of anesthesia. All patients were observed carefully in order to detect a cough response and any side effects. RESULT: The incidences of FCR (Fentanyl Cough Response) were 0% in Group 1, 10.0% in Group 2, 30.3% in Group 3, and 39.3% in Group 4. The ED50 of FCR was 4.25ug/kg. The mean onset-time from the end of fentanyl administration to the beginning of coughing was 12.5 seconds. FCR was decreased with aging, but not affected by weight, height, or smoking. Other serious side effects were not accompanied. CONCLUSION: Fentanyl can evoke the pulmonary chemoreflex dose-dependently and the ED50 was 4.25 g/kg.
Aging ; Anesthesia ; Antitussive Agents ; Catheters* ; Cough* ; Fentanyl* ; Humans ; Incidence ; Reflex* ; Smoke ; Smoking

No abstract available.
Neurofibromatoses* ; Pseudarthrosis* ; Ulna*