BACKGROUND: We postulated that loss of epidural negative pressure might affect on the sensory blockade level of spinal anesthesia. METHODS: Thirty nine patients were involved in our study; group 1, spinal anesthsia with 23G spinal needle (n=20): group 2, spinal anesthesia with 27G spinal needle through the 18G Weiss epidural needle (n=19). Sensory blockade level was checked by pinprick test at 5, 10, 15, 20, 25, 30, 40, 60 and 90 minutes after spinal anesthesia. RESULTS: There was no difference of sensory blockade level between group 1 and 2. CONCLUSION: From above result, there was no evidence of loss of epidural negative pressure affecting on the spinal sensory blockade level.
Anesthesia, Spinal* ; Humans ; Needles

No abstract available.
Leg*

Collagen is the major component of scar tissue. Considerable progress of fibroblast growth kinetics and of collagen synthesis has been achieved in the past decade. We have been interested in fibroblasts activities as they are expressed by cells cultured in collagen substrate. This study is to examine the effects of collagen substrate and peptide growth factors In culture medium on DNA and protein synthesis of human dermal fibroblasts. Collagen, interleukin-1(IL-1) and transforming growth factor-beta(TGF-beta) were added to fibroblast culture media according to the designed experiment model and DNA and protein synthesis were measured by [3H]-thymidine, [3H]-leucine, and [3H]-proline incorporation method. The morphological features of fibroblasts were observed by light microscope. The results were as follows ; 1) There were significant decreases of DNA and protein synthesis of cultured fibroblasts in the presence of collagen substrate compared with those in Control groups(p<0.01). 2) DNA and protein synthesis were decreased as dose dependant manner of collagen density in culture media. 3) Morphological features of fibroblasts became less stellate and flat, more spindle-like in the presence of collagen. 4) In responsiveness to IL-1, collagen non-treated groups responded to IL-1 but collagen treated groups were unresponsive to IL-1 (P<0.05). 5) Cells In collagen non-treated groups responded to TGF-beta as dose-related manner(P<0.01). Collagen treated groups desponded to TGF-beta but did not show TGF-beta dose-dependant relationship. In Conclusion, collagen substrate in the culture medium could lower the DNA and protein synthesis of fibroblasts. Cells in collagen substrate were unresponsive or less responsive to peptide growth factors than those in non-collagen substrate.
Cicatrix ; Collagen* ; Culture Media ; DNA* ; Fibroblasts* ; Humans ; Intercellular Signaling Peptides and Proteins ; Interleukin-1 ; Kinetics ; Transforming Growth Factor beta

To ten male volunteers, 25 to 35 years old and without any known disease, physiological saline solution (placebo) 1 ml, morphine 10mg, and Remeflin 16 mg were administered intramuscularly. Effects of tbese agents upon ventilation at rest and respiratory response to carbon dioxide rebreathing were studied. The results are as follows: 1) Morphine significantly decreased respiratory rate, minute volume, and Pao2 and increased Paco2 without significantly affecting either tidal volume or arterial pH. 2) In morphine-induced respiratory depression, Remeflin improved ventilation by significantly increasing tidal volume and minute volume with resultant increase in Pao2 and decrease in Paco2, Remeflin did not significantly alter respiratory rate and arterial pH 3) Morphine displaced respiratory response curve to carbon dioxide obtained with placebo 7 torr to the right and Remeflin 6 torr to the left. No changes in slope of the curves were observed. 4) It is concluded that Remeflin stimlulatea respiration by directly acting upon the respiratory center.
Adult ; Carbon Dioxide ; Humans ; Hydrogen-Ion Concentration ; Male ; Morphine ; Respiration ; Respiratory Center ; Respiratory Insufficiency ; Respiratory Rate ; Sodium Chloride ; Tidal Volume ; Ventilation ; Volunteers

Pulmonic autograft replacement of the aortic valve (Ross procedure) has been to have potential for growth in children, no complication of antiocagulation, and enhanced durability. Therefore, Ross operation is indicated in the young, in patients with an active life style, and when anticoagulation is contraindicated. However, late autograft valve has occurrd more frequently in patients with significant size discrepancy between the pulmonay valve annulus and the aortic valve annulus. In order to resolve this problem, we performed aortic annuloplasty with Duran ring for more accurate and strong reinforcement. We report a case using the Duran ring as a method of aortic annuloplasty during Ross procedure.
Aortic Valve ; Autografts ; Child ; Humans ; Life Style

A 46-year-old woman presented with multiple purpuric skin rashes together with splenomegaly and thrombocytopenia. The resected spleen weighed 720 gm, and contained multiple, discrete, dark red, bulging nodules throughout the entire splenic parenchyma. Microscopically, the nodules revealed various range of endothelial cell proliferation which included cavernous vasculature, anastomosing vascular channels, papillary intravascular growth and solid pattern. Intrasinusoidal sequestration of platelets along with extramedullary hematopoiesis was present in the neoplastic vascular spacws. Neither exposure to thorotrast nor vinyl chloride was nonfirmed. Ultrastructurally, the tumor cells demonstrated a row of pinocytotic vesicles, occasional intercellular junctional structures, and the paucity/absence of filamentous structures or Weibel-Palade bodies supports origin of sinus lining type cells. After splenectomy, the thrombocyte count returned to normal. We conclude this is the first case of primary splenic angiosarcoma with Kasabach-Merritt syndrome in Korean literature.
Female ; Humans

PURPOSE: To describe the high-resolution CT findings of varicella-zoster pneumonia. MATERIALS AND METHODS: Seven adult patients with clinically and serologically diagnosed varicella-zoster pneumonia underwent HRCT scanning. One had undergone a kidney transplant, and the others were immunocompetent. The HRCT findings were retrospectively analyzed by two radiologists in terms of the presence of a nodule, pneumonic consolidation, ground-glass attenuation and pleural effusion, and with regard to the number, size and distribution of nodules. RESULTS: HRCT findings of varicella pneumonia included nodule (n=7), consolidation (n=3), diffuse groundglass attenuation (n=1) and pleural effusion (n=1). Nodules were mostly 2-10 mm in size, and multiple (n=6), and zonal predominancy was not apparent. One case in which HRCT demonstrated diffuse groundglass opacity and slight bilateral pleural effusion involved a patient in whom complications of acute respiratory distress syndrome occured. CONCLUSION: When HRCT demonstrates the presence of nodules 2-10 mm in size multiple nodules, or nodule surrounded by ground-glass attenuation, or the coalescence of nodules and consolidation is observed in adults with chickenpox, the varicella-zoster pneumonia should be included in the differential diagnosis.
Adult ; Chickenpox ; Diagnosis, Differential ; Fluconazole ; Humans ; Kidney ; Pleural Effusion ; Pneumonia* ; Respiratory Distress Syndrome, Adult ; Retrospective Studies

There are considerable discrepacies between clinical symptoms and imaging diagnosis in the localization of the responsible radiculopathy. The purposes of this study are to analyzed the dynamic alteration of contrast filling of the spinal nerve sleeves during positional changes and to determine how the abnormalities of nerve sleeves no lateral bending A-P views correlate with sciatica. The criteria indicationg the root abnormality in functional myelography were (1) bad filling of ipsilateral root to sciatica and (2) good filling of contralateral root compared with those in neutral A-P view. Of total 77 patients, 67 had radiculopathy and 10 had no radiculopathy. In 23 (34.3%) of 67 patients with radiculopathy and 6 (60%) of 10 patients with no radiculopathy, their clinical symptoms well correlated with conventional myelographic findings. However, in 35 (52.2%) of 67 patients with radiculopathy and 6(60%) of 10 patients with no radiculopathy, their symptoms well correlated with functional myelographic findings. This study suggests that the functional myelogaphy using both lateral bending A-P views can be used as a complementary tool in the evaluation of the radiculopathy.
Diagnosis ; Humans ; Myelography* ; Radiculopathy* ; Sciatica ; Spinal Nerves

This is the evaluation report of clinical competence of undergraduate medical students in Plastic Surgery field using OSCE(Objective Structured Clinical Examination) executed in three years. OSCE comprises of assessment of subject, choice of clinical stations sampling, identification of components of clinical competence to be evaluated, the level of performance required, development of specification table, editing of OSCE presentation page and assessment of practicability and results exploitation. About fifty students were examined annually. Seven station stimuli with simulated patient participation were carried out. The mean OSCE score was 82.3+/-6.19. The reliability of the total station was 0.72. The examination shows a positive response to the OSCE. Our experience shows OSCE's feasibility for Plastic Surgery during the initial course of education. Referring to our experiences, the Korean Society of Plastic and Reconstructive Surgeons (KPRS) applied the OSCE test for Korean Plastic Surgery Board Certification.
Certification ; Clinical Competence* ; Education ; Evaluation Studies as Topic ; Humans ; Patient Participation ; Students, Medical ; Surgery, Plastic*

Independent Component Analysis (ICA) is a signal processing algorithm to separate independent sources from unknown mixed signals and can be applied to separate artifacts and independent neural sources from EEG recordings. This study was designed to extract individual components of eyeball movements from scalp EEG. Digital EEG signals were recorded using the international 10-20 system during eye closure, eye opening, and blinking. 18 EEG tracings using bipolar montage were analyzed by ICA algorithm into 18 independent components. Each of the components was reviewed, selected, and reconstructed into an original montage. Among 18 components, two components which were thought to represent eyeball movements were obtained. Each of the components was inversely projected into the original bipolar montage. This inverse projection showed separated vertical and horizontal eyeball movements components. These results suggest that the ICA analysis of EEG can separate vertical and horizontal eyeball movements and may be applied to separate other EEG artifacts and source signals from unknown mixed sources recordings of EEG.
Artifacts ; Blinking ; Electroencephalography ; Scalp