BACKGROUND: Peripheral nerve injury may produce a syndrome consisting of spontaneous pain, allodynia and hyperpathia. Cholinesterase inhibitors are known to have an antinociceptive effect in hot plate and tail flick tests and to be mediated by spinal muscarinic system. The purpose of the current study was to determine the effect of intrathecally (i.t.) administered edrophonium and neostigmine on the touch-evoked allodynia and to identify the antagonism of antiallodynia in a rat model of neuropathic pain. METHODS: Sprague Dawley rats were prepared with tight ligation of left L5/L6 spinal nerves with 6~0 black silk and chronic lumbar intrathecal catheters. After obtaining the baseline hindpaw withdrawal scores, edrophonium (3~100ug) or neostigmine (0.3~10ug) was administered intrathecally. Tactile allodynia was measured using von Frey filaments and allodynic threshold was calculated by updown method. Motor dysfunction was assessed by observing righting/stepping reflex responses and abnormal weight bearing. To examine the reversal of antiallod ynia, muscarinic receptor antagonist atropine (10ug) or nicotinic receptor antagonist mecamylamine (10ug) was injected intrathecally 5 min. prior to injection of edrophonium or neostigmine. RESULTS: I.t. edrophonium and i.t. neostigmine produced a dose dependent antagonism of allodynic state but had moderate to severe effect on motor weakness at doses of 3 and 10 g of neostigmine. Pretreatment with i.t. atropine yielded a complete antagonism of antiallodynia in both drugs, but i.t. mecamylamine did not significantly reverse incresed allodynic threshold. CONCLUSIONS: These experiments suggest that i.t. edrophonium or i.t. neostigmine produces a dose dependent antagonism on touch-evoked allodynia at the spinal level and this antagonism is likely due to spinal muscarinic system.
Atropine ; Catheters ; Cholinesterase Inhibitors ; Edrophonium* ; Hyperalgesia ; Ligation ; Mecamylamine ; Models, Animal ; Neostigmine* ; Neuralgia* ; Peripheral Nerve Injuries ; Rats, Sprague-Dawley ; Receptors, Muscarinic ; Receptors, Nicotinic ; Reflex ; Silk ; Spinal Nerves ; Weight-Bearing

Bee sting therapy is said to have been practised since the age of ancient Egypt. Some people believe in the benefit of apitherapy for articular inflammation, hematoma, sciatica, hay fever, etc. However, honeybee has several venoms that may induce various clinical and histopathological findings. We report a case of foreign-body granuloma after honeybee acupuncture for polyarthralgia. To our knowledge, this is the first report of foreign-body granuloma developing at an acupunctured site in English literature.
Acupuncture* ; Apitherapy ; Arthralgia ; Bees ; Bites and Stings ; Egypt ; Granuloma, Foreign-Body* ; Hematoma ; Inflammation ; Rhinitis, Allergic, Seasonal ; Sciatica ; Venoms

Choledochal cyst of the common bile duct is usually considered to be large cystic dilatation that extends from the wall of the common bile duct. Choledochal cyst is a very rare cond.ition in adult, These cysts are commonly distinctive in childran under the age of ten. Even in this age group they are considered rare. The classicajl triad of a choledochal cyst inclule pain, jaundice and a palpable right upper quadrant mass. This triad was found in only 21~63% and the most common finding is jaundice. Diagnoais of choledochal cyst usually is made during laparotomy, In nonjaundiced patients, oral cholangiogram and/or intravenous cholangiogram may yield the diagnosis. In jaundiced patiente where the diagnosis may be more difficult to make, one may consider doing ERCP and/or percutaneous transhepatic cholangiogram. The percutaneous transhepatic cholangiogram seems to be very helpful in diagnosing jaundiced patients. It is being used more and more in recent years but this method is not without complication. With advent of ERCP, visualization of the biliary tree has become a simple procedure when performed by expert endoscopists. To our knowlege, no previous case of choledochal cyst diagnosed by ERCP has been reported. yet in our country This paper reports 4 cases of choledochal cyst diagnosed by ERCP.
Adult ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde* ; Choledochal Cyst ; Common Bile Duct ; Diagnosis ; Dilatation ; Humans ; Jaundice ; Laparotomy

No abstract available.

No abstract available.
Cell Line* ; Gonadotropin-Releasing Hormone* ; Medroxyprogesterone Acetate* ; Medroxyprogesterone* ; Tamoxifen*

Postcholecystectomy syndrome is the persistence or recurrence of symytom complex following cholecystectomy, The majority of the patients have mild symptoms. However, the cause of recurrent symptoms is often obscure and as a consequence, a plan of management is difficult to formulate. Recently ERCP has proved to be increasingly helpful in the investigation of postcholecystectomy patients. The purpose of this study was to test the effectiveness of the ERCP in the evaluation of patients with postcbiolecystectomy syndrorae. The results are as follows 1) 102 postcholecystectomy patients were studied by endoscopic retrograde cholangiopancreatography and successful cannulation with demonstration of at least one duct was achieved in 49 of 50 jaundiced patients and in 49 of 52 non-jaundiced patients. The overall success rate was 96. 1%. 2) The results of ERCP were normal in 26 patients(26.5%) and abnormal in 72 patients (73.5%), Only 3 of 50 jaundiced patients were normal, but 23 of 52 non-jaundiced patients showed no abnormal findings. 3) The most common abnormality was biliary stone in common bile duct and intrahepatic duct which were present in 51 patients(50%). Cholangitis without stone was next common finding which was in 13 patients(13%). Of the remaining patients have air biligram, 2 CBD stricture, 1 CBD aseariasis & 1 chronic pancreatitis. 4) Time lapse between onset of symptoms and cholecystectomy was variable. 31 patients were studied less than 2 years after cholecystectomy. 18 of these patients had jaundice and 13 had no jaundice. Within 2 years afte chklecystectomy, the biliary stone was most common finding which were present in 14 out of 31 patients.
Catheterization ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholangitis ; Cholecystectomy ; Common Bile Duct ; Constriction, Pathologic ; Humans ; Jaundice ; Pancreatitis, Chronic ; Postcholecystectomy Syndrome ; Recurrence

A 29-year-old Korean woman visited the Department of Surgery in MizMedi Hospital with a palpable itching mass on the right breast that had existed for the past 7 months. She had no history to eat either frogs or snakes, but had the history of drinking impure water. Sonography revealed a serpiginous hypoechoic tubular structure associated with partial fat necrosis in breast parenchymal layer and subcutaneous fat layer. It also revealed oval cystic lesions. At operation, an ivory white opaque ribbon-like worm that measured 16.5 cm in length and 0.5 cm in width was extracted. Anti-sparganum specific serum IgG level in the patient's serum (absorbance = 0.71), measured by ELISA, was found to be significantly higher than those of normal controls (cut off point = 0.21). Sonography and ELISA appear to be helpful to diagnose sparganosis. Breast sparganosis is rarely found throughout the world.
Adult ; Animals ; Antibodies, Helminth/blood ; Breast/*parasitology ; Breast Diseases/diagnosis/*parasitology ; Enzyme-Linked Immunosorbent Assay ; Female ; Human ; Immunoglobulin G/blood ; Sparganosis/diagnosis/*parasitology ; Sparganum/immunology/isolation & purification ; Ultrasonography, Mammary

No Abstract Available.
Mucinoses*

Primary cancer af the duodenum is rare. An extensive experience with fiberoptic eaophag-ogastro-duodenoscopy in our institution has indicated that duodenal cancer may be more frequent thsn suspeeted and readily diagnesed by this modality, With this in mied, clinical, pathological, diagnostic and therapeetie aspects of the 26 patients with primary duodenal cancer which had been endoscopically diugnosed were reviewed. The results obtained were as follows: 1) Ages ranged from 16 to 75, with the mean of 55.2 years. Seventeen patients were men and nine patients women being l. 9:1 of male-female ratio. 2) Hndoscoyic findings were 46. 1 percent ulcerative anld 34. 8 per cent ulcerative-infiltrative, 3) The diatribution within the duodenum was 50 per cent suprapapillary, 42. 4 per cent peri- papillary aecl 7. 6 per cent infrapapillary. 4) The twenty-three patients had adenocarcinoma, two patients leiomyosarcoma and 1 patient lymphoma. 5) Twenty patients were confirmed by duodenoseopic biipsies and six patients by operations. 6) The mast common presenting mmyliiints were abdominal pain, chronic blood lais leading anemia, jaundice, anorexia, indigestion, weight lass and palpable abdominal mass. 7) Of the 26 patients, eight patients underwent attempted curative resection, six patients underwent palliative bypasa procedures or exploratory laparotomy.
Abdominal Pain ; Adenocarcinoma ; Anemia ; Anorexia ; Diagnosis* ; Duodenal Neoplasms ; Duodenum ; Dyspepsia ; Female ; Humans ; Jaundice ; Laparotomy ; Leiomyosarcoma ; Lymphoma ; Male ; Ulcer

BACKGROUND: There are two kinds of mechanism for laser therapy according to selectie photothermolysis. Selective photothermolysis means that a chromophore can be selectively dei, stroyed with a laser of n appropriate wavelength and of a short pulse duration that is shortor than the thermal relaxation time of the chromophore. It is supposed that the side effects of the continuous wave laser, in which selective photothermolysis does not exist occur more often than when a pulsed wave laser is used. OBJECTIVE: We compar.d the side effects of flashlamp-pumped pulsed tunable dye laser(SPTL), whose treatment is baseal on selective photothermolysis, with those of copper vapor laser(CVL , which is a quasi-continuous thermal laser. METHODS: The laser cl arts of 498 patients with SPTL treatment and 485 patients with CVL, treatment in Asan Medical Center from 1989 to 1994 were examined, retrospectively. RESULTS: 1) Among 498 patients, with SPTL treatment, we observed various side effects in 47(9.4%). The incidences of individial side effects are as follows, hyperpigmentation in 6.2%(31), vesicl formation in 1.6% (8), surface texture change in 0.8% (4), Hypopigmentation in 0.6% (3), scar format,ion in 0.2% (1). 2) After CVL treatment, side effects occurred in 30(6.2%) among 485 patient.. Hyperpigmentation in 3.1%(15), vesicle formation in 2.5%(12), surface texture change in 0.2%(1), hypopigmentation in 0.2%(1), and scar formation in 0.1%(1) were observed. CONCLUSION: The total incidence of side effect.s after CVL treatment is not statistically different, from that after SPTL treatment, which contradicts the previous theory.
Chungcheongnam-do ; Cicatrix ; Copper* ; Humans ; Hyperpigmentation ; Hypopigmentation ; Incidence ; Laser Therapy ; Lasers, Dye* ; Lasers, Gas* ; Relaxation ; Retrospective Studies