Gastric bezoars are large masses or concretions, composed with plant fiber, hair and miscellaneous foreign bodies, found in the stomach and occur usually as sequele of gastric surgery. We experienced 2 cases of fat bezoars which developed after drinking of melted beef fst. They had postprandial epigastric fullness and pain, those were relieved on supine and left recumbent position. Upper gastrointestinal series showed a large movable mass in the stomach in hoth cases. On gastrofibercopic examination, a large egg sized white bezoar was cordirmed in both cases and a gastrie ulcer at antrum associated in one case. In attempt to removal of the bezoars, we tried to break them, but failed because of its character. The patients were treated with pancreatic lipase containg digestives, Pancreon-F and Azintal. From one day after this treatment, symptoms were completely relieved. Five days later, we confirmed disappearance of bezoars by gastrofiberscopy. and upper gastrointestinal barium
Barium ; Bezoars* ; Drinking ; Foreign Bodies ; Hair ; Humans ; Lipase* ; Ovum ; Plants ; Stomach ; Ulcer

In an attempt to evaluate the efficacy ef cimetidine in treatment of erosive gastritis, a praspective study wras done in 9 cases of heworrhagie gastritia, 4 cases yunctiform gastritis, 9 caees verrueous gastritia, and 9 caseis mixed type, Four hundred mg of cimetidine was given in the morning and at bedtime for 3 weeks. Evaluation ef the efficacy was assessed by clinical syinptoms acoring and by endoscopic findings of erosion before treatment, on the 8th day, on the 15th day, and on the 22th day of treatment in all patients. The results were as follows; 1) Clinical sytnptoms in patients with erosive gastritis were epigastric discamfortness(83. 9%), heart burn(80. 0%), indigestion(77, 6%), hunger pain(74.2%), belching(71.0%), anotexla (48.4%) and nausea(45.5%). There was no differenees of symptoms among the type of erosion. 2) Percent decrease in clinical eyxeptoms were; 45% on the 8th day, 68% on the 15th day, 81% on the 22th day of treatment. Ciinical symptoms in patients with punetiform gastritis lasted longer than other typea. 3) Disappearance of the gastric mucossl erosion was seen in 8 cases of hemorrhagic gastritis, 6 case of mixed type, 5 cases of verruceous gastritis, 2 cases of punctiform gastritis, and overall 21 Cases(67.7%) on the 22th day of treatment, endoscopieally. Faur eases af punctiform gastritis were transformed into verrueous gastritis during the treatment. 4) Disappearance of the erosion was observed more frequently in the mueosa of oxyntic area than that of antrum. This study suggests that cimetidine appears to be effective for relief of elinical symptoms in patients with erosive gastritis, and for treatment of hemorrhagic gastritis and erosions in the mucosa of oxyntic area,
Cimetidine* ; Gastritis* ; Heart ; Humans ; Hunger ; Mucous Membrane

Dysphagia is commonly observed in stroke patients. The precise locations of lesion and its effect that produce swallowing disorder remain to be determined. Unilateral hemispheric lesion as well as bilateral lesions and brainstem, which has nucleus for lower cranial nerves and neurons in swallowing centers, is also associated with dysphagia. Though the reported incidence of dysphagia is different among studies because of evaluation methods, up to half of acute stroke patients are affected by dysphagia, where its presence has been associated with risk of complications, such as pneumonia, malnutrition, dehydration etc. These complications are also related with prolonged hospital stay and poor functional outcome. Most of the dysphagic patients will make a functional recovery and return to pre-stroke diet patterns after acute period but about twenty percent of patient would have significant problems in swallowing even after 6 months according to previous studies. This suggests that intensive management and serial follow up evaluation as well as early screening of dysphagia is one of the important treatment strategies in the management of stroke.

BACKGROUND: House dust mites have been reported to play an aportant role in the pathogenesis of atopic dermatitis(AD). In fact a high positive rate for house dust mites in the skin prick test was observed in patients of AD. However, it is quite difficult to determine the clinical relevance of positive immediate hypersensitivity to mite antigen by clarical history alone because AD patients are nearly always exposed to these antigens in their daily lives. OBJECTIVE: The aim of this study was to elucidate the clinical. singficance of a positive immediate hypersensitivity reaction by observing the proliferative respons of peripheral blood mononuclear cells(PBMC) to mite antigen in the AD. METHODS: The proliferative response of PBMC separated from Dermatopkagoides farinae(Df) positive AD patients to Df antigen was compared with that from Df negative normal controls, Df positive normal controls and Df negative AD patients. RESULTS: PBMC from Df positive AD patients showed signinc not proliferation in response to Df antigen evaluated by comparing stimulation indices(SI) among different experiment groups. CONCLUSION: Significant correlation between responses of PBMC and immediate hypersensitivity of skin to Df antigen in AD was found, and it was suggested the Df may be a real aggravating factor in the Df positiv AD patients. SI may be used as ar objective criteria to select patients for hyposensitization therapy after doing a skin test.
Dermatitis, Atopic* ; Desensitization, Immunologic ; Humans ; Hypersensitivity, Immediate* ; Mites* ; Pyroglyphidae ; Skin Tests ; Skin*

BACKGROUND: Autonomic reflex dysfunction in patients with diabetes is associated with unstable cardiovascular response in perioperative period. In this study we wanted to investigate the extent to which the intraoperative cardiovascular responses depend on the degree of autonomic dysfunction. METHODS: The influence of diabetic autonomic neuropathy upon the behavior of the circulatory system was investigated in 35 patients who had undergone ophthalmological surgery. A standardized test combination was used to study the patient's cardiovascular refractory reactions. The patients were then divided into a control group, non-diabetics without autonomic neuropathy (n = 18), and an experimental group, diabetics with autonomic neuropathy (n = 17). The anesthetic and surgical procedures (vitrectomy) were standardized and always identical. RESULTS: During the induction of anesthesia, patients in the experimental group didn't experience changes in mean arterial blood pressure and heart rate as compared to patients in control group. During the maintenance of anesthesia, there were significant decreases in mean arterial blood pressure and heart rate in the experimental group, but in the state of emergence of anesthesia, there were no significant differences in either group. CONCLUSION: Autonomic neuropathy represents a perioperative risk factor, especially during induction and maintenance of anesthesia. I therefore recommend an autonomic nervous function test for evaluation of diabetic autonomic neuropathy in preoperative anesthesiological examination.
Anesthesia ; Anesthesia, General* ; Arterial Pressure ; Diabetic Neuropathies* ; Heart Rate ; Humans ; Perioperative Period ; Reflex ; Risk Factors

The antihypertensive effect of clonidine was evaluated in 129 patients with essential hypertension of mild to moderate severity with a dosage of one tablet(0.075mg) a day for 71 patients of Group I and two tablets a day for 58 patients of Group II. The results were as follows : 1) Of 71 patients of Group I, 34 patients(47.9%)showed good antihypertensive effect(greater than 15 mmHg drop in mean diastolic pressure) and 11 patients(15.5%) showed fair effect(10-14 mmHg drop in mean diastolic pressure). 2) Of 58 patients of Group II, 39 patients(67.2%) showed good effect and 7 patients(12.1%) showed fair effect. 3) The side effect observed was transient and tolerable dry mouth, which developed in 5.6% of Group I patients and 13.6% of Group II patients.
Clonidine* ; Humans ; Hypertension ; Mouth ; Tablets

Over 26 kinds of tablets and capsules, such as Tetracycline, Quinidine and Potassium preparations were reported to cause esopbageal ulcerations, eharacterized in various size, shape and number, ind sually in mid-esophagus, Recently authors experienced 10 cases of drug-induced esophageal ulcerations due to antibiotics and antiinflammatory agents such as Tetracycline, Aspirin, etc. Four cases were men and six were women. Four cases were in third dades, three in fourth cleeades, two in fifth decades and one in sixth decades. Presenting symptoras were odynophagia(4/10), dysphagia(3/10), substernal pain(7/10) and epigastric pain(3/10). Endoscopic examination of the esophgus showed single or multiple, small and shallow ulcers on the mid-esophgeal mucosa at the level of 30cm from the ineisor in eight cases, one Iarge and deep ulcer at the level of 40cm from incisor in one patient and one amall, shallow and one large, deep ulcers at the same time. in one patient The shape of alcers were various from a round to a large horseshoe shaped one. The clinical course was mild without complications. It was suggested that drug-induced esophsgeal ulcers with antibiotics and antiinflammatory agents could be found frequently and they had benign and mild clinicalc ourse,
Anti-Bacterial Agents ; Anti-Inflammatory Agents ; Aspirin ; Capsules ; Female ; Humans ; Incisor ; Male ; Mucous Membrane ; Potassium ; Quinidine ; Tablets ; Tetracycline ; Ulcer*

A 69-year-old male patient with previous history of traumatic brain injury 5 months ago was admitted to the Department of Neuropsychiatry because of aggressive behavior and delusional features. After starting on 2 mg of risperidone per day, his delusion, anxiety, and aggressive behavior gradually improved. Two weeks later, he was given 10 mg of donepezil per day for his mild cognitive impairment. After 6 weeks of admission in the Department of Neuropsychiatry, he showed parkinsonian features including difficulty in walking, decreased arm swing during walking, narrowed step width, scooped posture, bradykinesia, tremor, and sleep disorder. To rule out the primary Parkinsonism, dopamine transporter imaging technique [18F]fluoropropyl-carbomethoxy-iodopropyl-nor-beta-tropane positron emission tomography-computed tomography (18F]FP(IT PET-CT)) was performed, and dopamine transporter activity was not decreased. We considered that his parkinsonian features were associated with the combination of risperidone and donepezil. Both drugs were stopped and symptoms rapidly disappeared in several days.
Anxiety ; Arm ; Brain Injuries ; Delusions ; Dopamine Plasma Membrane Transport Proteins ; Electrons ; Humans ; Hypokinesia ; Indans ; Male ; Mild Cognitive Impairment ; Neuropsychiatry ; Parkinson Disease ; Parkinsonian Disorders ; Piperidines ; Posture ; Risperidone ; Tremor ; Walking

BACKGROUND: An adequate uteroplacental and fetal blood flow during labor and cesarean delivery is of prime importance for fetal well-being and neonatal outcome. METHODS: Using the vascular smooth muscle of the human isolated umbilical arteries, this study was performed to see whether commonly used local anesthetics (bupivacaine, lidocaine and 2-chloroprocaine) and opioids (morphine,fentanyl and meperidine) could induce contracion or relaxation of these resting and precontracted vessels. Rings from human umbilical arteries were prepared by microdissection. The vessel rings were mounted in tissue baths for an isometric recording of the contractile activity. For resting muscles, the reactivity to drugs is expressed as a percentage of a maximal KCl-induced contraction, and for precontracted muscle, it is expressed as a percentage of a submaximal KCl-induced contraction. RESULTS: Bupivacaine, lidocaine and 2-chloroprocaine all induced contractions. Bupivacaine showed a maximal contraction (46.7 +/- 10.5%) at concentrations of 43 micrometer, lidocaine 19.7 +/- 4.8% at 0.11 mM. and 2-chloroprocaine showed 14.6 +/- 2.9% at 0.65 mM. Morphine, fentanyl and meperidine all induced contractions. Morphine showed a maximal contraction (19.6 +/- 7.1%) at a concentration of 10 4 M, meperidine at 17.2 +/- 8.4% at 3 x 10 5 M, and fentanyl at 1.7 +/- 2.0% at 3 x 10(-6)M. When umbilical arteries were induced to contract with a submaximal concentration of KCl, bupivacaine and lidocaine showed an ability to increase the magnitude of the sustained contraction, but 2-chloroprocaine showed a relaxation of the sustained contraction. Morphine, fentanyl and meperidine showed no change in the sustained contraction. CONCLUSIONS: This study demonstrates these local anesthetics and opioids as vasoactive on human umbilical arteries. If applicable in vivo, these drugs might have some influence on umbilical vessel tone and thus might reduce umbilical blood flow.
Analgesics, Opioid* ; Anesthetics, Local* ; Baths ; Bupivacaine ; Fentanyl ; Fetal Blood ; Humans* ; Lidocaine ; Meperidine ; Microdissection ; Morphine ; Muscle, Smooth, Vascular ; Muscles ; Relaxation ; Umbilical Arteries*

BACKGROUND: The relationship between the NO and its vasodilatory effect of propofol has been a somewhat controversial matter. And, the effects of propofol has not been evaluated in septic condition whether it is solely due to its increased iNOS activity. METHODS: First experiment is to study that the vasodilatory effect of propofol could be caused by NO. Isolated aortic rings with or without endothelium were contracted phenylephrine (10(-9)-10(-5)M) cumulatevely after porpofol (10(-5)M) administration. The effects of L-NAME (3 x 10(-4)M) and methylene blue (10(-5)M) on contractile responses for phenylephrine were evaluated. Second experiment is to study the effect of propofol on septic vesseles. the no LPS (lypopolysaccaride) and LPS treated rings with or without endothelium were contracted phenylephrine (10(-9)-10(-5)M) cumulatevely after porpofol (10(-5)M) administration. The development of sepsis was confirmed by iNOS expression using RT-PCR. RESULTS: All the aortic rings showed decreased response on phenylephrine contractile response with propofol administration. These responses were significantly less in denuded ones than in ones with intact endothelium. The endothelium dependent relaxation of propofol was inhibited by pretreatment with L-NAME and methylene blue in rat aortic rings having intact endothelium. All the aortic rings incubated with LPS showed decreased phenylephrine contractile response. The addition of propofol produced significantly more decrease in contractile response in LPS incubated rings in a greater than additive effect. The LPS induced hyporesponsiveness to phenylephrine was reversed by addition of cycloheximide. However, with the addition of propofol to LPS treated rings, complete reversal of this hyporesponsiveness to phenylephrine, failed to occur by addition of cycloheximide. CONCLUSIONS: 1) The vasodilatory effect of propofol seems to be mediatede by EDRF/NO, 2) The vasodilatory effect of propofol is increased in septic vesseles. Moreover, the inability of nitric oxide synthase inhibitior to reverse this response completely suggest that increased induction of iNOS may not be a sole responsible factor for this finding.
Animals ; Arteries* ; Cycloheximide ; Endothelium ; Methylene Blue ; NG-Nitroarginine Methyl Ester ; Nitric Oxide Synthase ; Phenylephrine ; Propofol* ; Rats* ; Relaxation ; Sepsis