BACKGROUND: We prospectively evaluated the incidence and possible factors causing intramuscular injection during lumbar sympathetic ganglion block and compared the multiple needle technique to the single technique to obtain a profound and complete block effect. METHODS: Among 83 patients, 58 patients (group A, n = 27, multiple needle technique and group B, n = 31, single needle technique) were reevaluated for the changes of skin temperature (Ts) and mean segment of longitudinal contrast spread. After injecting the contrast agent, the incidence of psoas muscle injection and the change of Ts was compared between two groups. RESULTS: The incidence of psoas muscle injection was 21.3% (46/216) and it was associated with the level of injection (L2) significantly (chi-square = 14.773, P = 0.001). DT(post) (postblock temperature difference between ipsilateral and contralateral great toe, 4.6 +/- 2.8degrees C, 1.8 +/- 1.6degrees C, P < 0.001 for group A and B) and DT(net) (DT(post) - DT(pre), 3.9 +/- 2.7degrees C, 1.5 +/- 1.5degrees C, P < 0.001 for group A and B) was significantly higher in group A. The mean segment of longitudinal contrast spread was 8.1 +/- 0.9 for group A and 3.2 +/- 1.6 for group B (P < 0.001). CONCLUSIONS: The LSGB at the L2 level showed the lowest incidence of psoas muscle injection of contrast. Multiple needle approach showed more significant increase of DT(net) and DT(post).
Ganglia, Sympathetic ; Humans ; Incidence ; Injections, Intramuscular ; Needles ; Prospective Studies ; Psoas Muscles ; Skin Temperature ; Toes

Permanant ileostomy is necessary in the case of a total proctocolectomy for a cancerous change in the distal rectum due to ulcerative colitis or familial adenomatous polyposis coli, but the fecal content after a conventional ileostomy is usually liquid or semiliquid. Sometimes, this resultes in dehydration and some nutrient loss. Nahm-gun Oh has designed an antiperistaltic ileostomy for formed stool evacuation. About a 25 cm length of the most distal ileum is cut, this segment is reversed, and then the antiperistaltic ileostomy is performed. The authors have performed antiperistaltic ileostomies in 6 cases of familial adenomatous polyposis or ulcerative colitis with a cancerous change in the low rectum. During the past 5 years and 7 months at the Department of Surgery, Pusan National University Hospital, we found that the profuse ileostomy discharge of the conventional ileostomy was decreased in the antiperistaltic ileostomy group, and that the antiperistaltic ileostomy discharge had a liquid component which was markedly decreased compared to that of the conventional ileostomy discharge. In addition, the antiperistaltic ileostomy discharge appeared to be much more solid and less voluminous. In conclusion, the antiperistaltic ileostomy should be considered for creating the effect of a reservoir by producing intestinal stasis proximal to the segment. The antiperistaltic ileostomy is effective in reducing the daily amount of ileostomy discharge and is convenient for stoma care due to the diminished water content in the discharge.
Adenomatous Polyposis Coli ; Busan ; Colitis, Ulcerative ; Dehydration ; Ileostomy* ; Ileum ; Rectum

No abstract available.
Animals ; Rats ; Tooth

Cerebellar degeneration is a group of diseases that manifests as progressive ataxia, that finally led to death without specific treatment. We report here two patients with cerebellar degeneration, who had shown an improvement and less progressive course, which is associated with panax ginseng intake. Patient 1 was a 60-year-old woman with multisystem atrophy (MSA) type C with 5 year history of ginseng ingestion. Patient 2 was a 54-year-old woman with spinocerebellar ataxia (SCA) type 6, who had a history of ginseng intake for 30 months. Both the patients showed atrophic change in the cerebellum by brain magnetic resonance imaging. Cerebellar functions had been semi-quantified by International Cooperative Ataxia Rating Scale (ICARS) and monitored before and after the ginseng ingestion every 6 to 12 months. In Patient 1 with MSA type C, ICARS had improved from 21 to 17.5 ± 1.8 in the following 5 years. In Patient 2 with SCA, ICARS also showed an improvement from 22 to 6.0 ± 1.0 over 30 months. However, when she stopped taking ginseng, it progressed up to 13 points in two years. These observations provide a potential disease-modifying effect of ginseng on patients with cerebellar degeneration.
Cerebellar Ataxia ; Cerebellar Diseases

A polymerase chain reaction (PCR) method for detection of the pathogenic Yersinia pestis from other Yersinia spp. was developed. Five Y. pestis strains, ninety-two other Yersinia species and twenty-four Enterobacteriaceae strains were collected in Korea and from other countries. Oligonucleotide primers were designed from pathogenic gene of antiphagocytic protein capsule gene (fra 1) and plasminogen activator gene (pla). The 428 bp DNA fragment was amplified from five Y. pestis which contained the fra I gene. No product was amplified from other Yersinia species and other strains of the Enterobacteriaceae. The 439 bp DNA fragment was amplified from three K pestis which contained the pla gene. No product was amplified from two Y. pestis, other Yersinia species and other strains of the Enterobacteriaceae. These showed that the designed primers were specific for detection of Y. pestis among other Yersinia species and Enterobacteriaceae strains. Amplification was successful whether the template was derived from purified DNA or from aliquots of boiled bacterial suspension. The detection limits were 100 pg of DNA and 100 colony forming units (CFU) for fra I and 100 pg DNA and 10 CFU for pla, respectively. Our results prove that the PCR method using specific primers for Y. pestis is a rapid and convenient procedure for routine clinical detection and identification of Y. pestis.
DNA ; DNA Primers ; Enterobacteriaceae ; Korea ; Limit of Detection ; Plasminogen Activators ; Polymerase Chain Reaction* ; Stem Cells ; Yersinia pestis* ; Yersinia*

OBJECTIVE: This study was designed to evaluate whether maternal serum human chorionic gonadotropin(hCG) level measured during second trimester could be used as a predictor of pregnancy-induced hypertension. METHODS: Between March 1996 and November l997, 505 pregnant women undergoing second trimester(14-22 weeks of amenorrhea) triple marker screening for neural tube defect and Down syndrome who delivered at our institution were reviewed. All samples were assayed in the same laboratory and medical records were reviewed about medical and obstetrical history. RESULTS: Maternal serum human chorionic gonadotropin level(multiples of the median, MoM) was significantly higher in the pregnancy-induced hypertension group than in the control group. With the use of 2. l multiples of the median as a cutoff value, the sensitivity of human chorionic gonadotropin as a screening marker for development of pregnancy-induced hypertension was 38.7%, the specificity was 95.9%, positive predictive value was 38.7% and negative predictive value was 95.9%. Conlusion: We suggest that second trimester maternal serum human chorionic gonadotropin levels can be used clinically as an early predictive marker for pregnancy-induced hypertension.
Chorion ; Chorionic Gonadotropin* ; Down Syndrome ; Female ; Humans ; Humans* ; Hypertension* ; Hypertension, Pregnancy-Induced ; Mass Screening ; Medical Records ; Neural Tube Defects ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy* ; Pregnant Women ; Sensitivity and Specificity

Cholera enterotoxin (CT) is a major virulence determinant of Vibrio cholerae 01. CI' is known to be the major virulence factor of Vibrio cholerae 01 and in accordance with the recent report showing which V. cholerae non-01 has ctx gene, we performed the molecular genetic study for the detection of ctx gene related to the production of CT at the subject Vibrio spp. except for V. cholerae non-01 and V. cholerae non-01 stock cultured in the laboratory of microbiology, College of Medicine, Pusan National University and the Vibrio spp. isolated from the marine products of Pusan General Fish Market and the sea water, and then its results are as follows: 1. PCR for the detection of ctx gene at the subject of V. cholerae 01:61H-151 having the ctx gene of which the denaturation is 1 rninute at 95'C, annealing to 1min, 30 sec at 60'C, the extension to be 1min. 30 sec at 72'C and 30 or 40 cycles. ctx gene was detected from 4 strains of V. cholera non-01 derived from the environment isolates. 2. Adjusting the quantity of chromosomal DNA used as template DNA to be from 0.1 pg to 1 ng, in order to know the PCR conditions for the effective search of ctx gene, and the detection limit of the system was 10 pg of chromosomal DNA. 3. The broth culture was used for template DNA, ctx gene of 302 bp was detected from 4 V. cholerae non-01, as in the case of chromosomal DNA, and the cell number was possible to be detected to 3 * 10.4. We attempted the confirmation of ctx gene through Southern blot hybridization, labeling with P and then it was confirmed only from 4 V. cholerae non-01 as like PCR results. 5. As the result of the sensitivity of PCR and Southern blot hybridization, it was shown to be possible which 10 pg was detected in case of chromosomal DNA and in case of cultured broth, the cell number was detected until 10 at PCR and Southern blot hybridization, and thus it was examed which its sensitivity was same.
Blotting, Southern ; Busan ; Cell Count ; Cholera Toxin* ; Cholera* ; DNA* ; Enterotoxins ; Limit of Detection ; Molecular Biology ; Operon* ; Polymerase Chain Reaction* ; Seawater ; Vibrio cholerae* ; Vibrio* ; Virulence

No abstract available.
Cholecystectomy*

Trichost.asis Spinulosa consists of several fasciles of reta ned vellus hairs in the hyperkeratotic sebaceous follicles, resulting in a dark slightly raied horny follicular spines, resembling comedones on the trunk and face. The condition is relatively common, particulary among the age, but is usually overlooked on routine skin examination as the patient is rarely aware of it.. We report 6 cases of trichostasis spinulosa, which showed numerous asymptomatic tiny black comedo-like dots on their backs. We obtained the follicular material by tweezer, which consised of several vellus hairs surrounded by a keratinous plug. Histologic examination was done in 3 patients, one of whom showed a rarely reproted double follicle and double papilla. With scanning electron microscopy, we observed multiple vellu hairs embedded in a keratotic plug, emerging from a hair follicle opening.
Hair ; Hair Follicle ; Humans ; Microscopy, Electron, Scanning ; Skin ; Spine

No abstract available.
Hemodynamics* ; Hypertension, Pulmonary*