Local anesthetics produce pain during infiltration into skin. The relationship between local anesthetic-induced pain and pH of the local anesthetic solution has not been fully investigated. Commercial preparation of local anesthetics are prepared as acidic solutions of the salts to promote solubility and stability. And the acidity of local anesthetic solition may be related with the pain during infiltration of the solutione. So, we tried to neutralize the lidocaine hydrochloride solution which is one of the most frequently used local anesthetic agent. Sodium bicarbonate was used for neutralization. Sodium bicarbonate was mixed with lidocaine hydrochloride until the resulting pH of the solution become 7.4 which is identical to the acidity of body fluid. To identify the effect of neutralized lidocaine solution, we had a course of double blind test to 6 volunteers. Both forearm of each volunteer were injected with neutralized lidocaine and plain one and the degree of pain was estimated by each volunteers. According to subjective description by the volinteers, everyone felt neutralized lidocaine injection site was less painful than plain lidocaine. We concluded that we could reduce pain from infiltration of lidocaine hydrochloride by neutralization of the anesthetic solution with sodium bicarbonate.
Anesthetics, Local ; Body Fluids ; Forearm ; Hydrogen-Ion Concentration ; Lidocaine* ; Salts ; Skin ; Sodium Bicarbonate ; Solubility ; Volunteers

Tailgut cyst is a rare congenital anomaly arising in the retrorectal space. Malignancy arising from the tailgut cyst is very rare. We experienced a case of adenocarcinoma arising from the tailgut cyst. The findings of this rare tumor are bony destruction of the sacrum on plain radiograph, a cystic mass on ultrasound, a low attenuation mass with calcification and enhancement on CT, and a multiseptated cystic mass containing solid component on MRI.
Adenocarcinoma* ; Magnetic Resonance Imaging ; Sacrum ; Ultrasonography

Since the invasiveness and metastatic potential of the carcinoma and the proliferation of the tumor cells are the decisional factors in determining the prognosis of carcinoma, it has been a principal area of study to foresee these factors in early stage of the disease process. The purpose of the study was to propose a method to precisely determine the prognosis of tumor. The investigation was performed, using laminin, type IV collagen, and Ki-67 antibody, to reveal the invasiveness and proliferation of the squamous cell carcinoma which is the most prevalent cancer in the area of oral and maxillofacial complex. Frozen tissue sections, 6-8mum in thickness, were prepared from the surgical excision of fresh squamous cell carcinoma for the experimental group. The control group was composed of sections from the normal oral mucosa of the contralateral side. Following incubation in an appropriate primary antibody including laminin, type IV collagen and Ki-67, LSAB method was employed and the tissue sections were treated with DAB for light microscopic immurlohistochemistry. Semiquantitative analysis of the basement membrane was composed of five different positivity of laminin and type IV collagen according to the intensity of the staining. Mean number of Ki-67 positive cells per 2000 total cells in one slide were calculated along with the standard deviation. The obtained results were as follows : 1. In the basement membrane of normal oral mucosa, antibodies against laminin and type IV collagen showed regular thickened, continuous line. Positive reaction was also detected in the vascular walls. Ki-67 labelling index was 4.10+/- 0.80%, and the positive cells were distributed mainly in the basal and parabasal cell layers. 2. In basement membrane of the proliferating tumor adjacent to carcinoma, antibodies against laminin and type IV collagen showed irregular thin, discontinuous line. Ki-67 labelling index was 18.95+/-4.67%, and the parabasal cell layer exhibited increased number of positive cells. 3. In the basement membrane of the main proliferating tumor, antibodies against laminin and type IV collagen showed almost indistinct interrupted line and/or almost indistinct line. Ki-67 labelling index was 31.56+/-5.51%, and the parabasal and spinous cell layer indicated increased cell positivity. 4. Invasive islands showed almost negative reaction to the antibody against type IV collagen, and almost indistinct line of the laminin antibody was observed. Based upon these findings, the loss of laminin and type IV collagen and the Ki-67 labelling index were the highest in the basement membrane of invasive islands. Therefore, it is thought that invasive islands were more deeply involved, than main proliferating tumor, in the invasiveness and proliferation of tumor, and the more the invasiveness of the tumor, the more the cell proliferative activity.
Antibodies ; Basement Membrane ; Carcinoma, Squamous Cell* ; Collagen Type IV* ; Islands ; Laminin* ; Mouth Mucosa ; Prognosis

Wernickes encephalopathy is an illness characterized by mental disturbance, paralysis of eye movements and ataxia of gait. The specific factor for most, if not all, of these symptoms is a deficiency of thiamine. Wemicke's encephalopathy mostly occurs in developing countries when the patient is in a state such as nutritionally deprived state, anorexia nervosa, stomach cancer, long duration of parenteral nutrition. Wernickes encephalopathy was recognized as a complication of hyperemesis of pregnancy in 1914. Unfortunately, cases continue to occur. We present here a case of Wernickes encephalopathy in a 36-year-old pregnant woman. We discuss the clinical picture, histopathology, radiology, therapeutic management and prognosis with review of the literature.
Adult ; Anorexia Nervosa ; Developing Countries ; Eye Movements ; Female ; Gait Ataxia ; Humans ; Hyperemesis Gravidarum* ; Hyperthyroidism* ; Paralysis ; Parenteral Nutrition ; Pregnancy ; Pregnant Women ; Prognosis ; Radiation Oncology ; Stomach Neoplasms ; Thiamine ; Wernicke Encephalopathy*

Recent development in thepolymerase chain reaction (PCR) has brought an extraordinary opportunity for the rapid detection of M. tuberculosis in clinical specimens for the diagnosis of tuberculosis. Pneumoconiosis is a sort of pulmonary fibrosis consequent to inhalation of the respirable dust. The association between pulmonary tuberculosis and pneumoconiosis is well recognized. There is a 10-fold increase in the tuberculosis risk among the workers who have pneumoconiosis demonstrated by chest roentgenogram. The physicians managing the patients with pneumoconiosis have to maintain a high index of suspicion for the development of mycobacterial infection, since the diagnosis of tuberculosis is often difficult. Mycobacterium tuberculosis is a very slow growing organism and acid-fast bacillus (AFB) staining frequently shows false negative results, and therefore PCR would be a very rapid, easy and sensitive diagnostic method for the diagnosis of Mycobacterium tuberculosis in pneumoconiotic patients. To compare the PCR method with the conventional methods in diagnosing Mycobacterium tuberculosis in sputum, we used the sputa of 115 pneumoconiosis patients in Munkyeong Cheil Hospital. Of 32 pulmonary tuberculosis in the pneumoconiosis patients, 29 were PCR positive and were higher than 28, 20 positive by culture and AFB stain. Overall sensitivity, specificity, and which were 90.6, 91.5 % respectively for the PCR assay, 87.5, 100 % for the culture method ; 62.5, 98.7 % for the AFB stain. The PCR assay is a rapid, efficient, sensitive method which can detect M. tuberculosis directly in pneumoconiosis patients, and further study should be followed for the development of the easier method.
Bacillus ; Diagnosis* ; Dust ; Humans ; Inhalation ; Mycobacterium tuberculosis ; Pneumoconiosis ; Polymerase Chain Reaction* ; Pulmonary Fibrosis ; Sensitivity and Specificity ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary*

No abstract available.
Abdominal Wall*

No abstract available.
Breast* ; Female ; Humans ; Mammaplasty* ; Mastectomy* ; Superficial Back Muscles*

One hundred fifty-seven patients wha underwent radical hysterectomy and pelvic lymphadenectomy for FIGO stage IB and IIA carcinoma of the cervix between February l975 and May 1987 were retros-pectively analysed to identify specific risk factors associsted with treatment failures. Prognostic factors inciuded clinical stage, histologic cell type, degree of differentiation, size of primary tumor, depth of stromal invasian, lymph-vaseular space invasion, and lymph node metastasis. Treatment results were evaluated according to the recurrence rate and 2-year absolute recurrence-free survival(NED) rate by the prognostie faetors and treatment modalities. Patients with lymph node me tases had a significantly higher incidence of bulky primary(-> 4cm), depth of stromal invasion(> 60% thickness), and lymph-vascular invasion(P<0.005). There was significant difference in the recurrence rate and 2-year, NED rate between cervical carcinoma stage IB and I1A(P <0.005). The pat,ients who had bulky primary tum~or(>4cm) and/or depth of stromal invasion (>60% thickness) had a higher recurrence and lower 2-year NKD rate(P<0.025, P<0.005), Unfortunately, it was not possible to demonstrate that these detrimentel effects could be overeorne by postoperetive radiation. When adjoined for these risk group, traditionally reported poor prognostic factors such as nodal metatasis, cell type and differentiation, lyrnphi-vascular mvasion assume less importance in our studies. In this study, prognosis is most inf1ueneed by clinical stage, depth of stromal invasion, and size of primary tumor,
Cervix Uteri* ; Female ; Humans ; Hysterectomy ; Incidence ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Risk Factors ; Treatment Failure*

No Abstract Available.
Receptors, Cytoplasmic and Nuclear*

No abstract available.
Collagen* ; Heparin* ; Mesangial Cells*