BACKGROUND: It has been shown that L-type calcium channel blockers increase the muscle relaxation effects of non-depolarizing neuromuscular blocking agents whereas the potentiated neuromuscular blocking effects by L-type calcium channel blocker are resistant to reversal by neostigmine. The aims of this study were 1) to see whether the pretreatment of L-type calcium channel blocker, such as verapamil, aggravates the pipecuronium-induced muscle relaxation, 2) if so, to see whether these effects are reversed by anticholinesterase, such as neostigmine and edrophonium or potassium channel blocker, such as 4-aminopyridine. METHODS: The rat-phrenic nerve-hemidiaphragms (n=60) were prepared. Twenty microgram of pipecuronium was administered to all organ bath. All samples were divided into two groups according to the administration of 10uM of verapamil i.e. verapamil pretreated, non-pretreated group. The amounts of administered pipecuronium were gradually increased by 4ug until the force of twitch decreased to 10% of control value in both groups. Each group was subdivided into three groups according to the administration of 0.75 M of neostigmine, 12.4 uM of edrophonium or 40uM of 4-aminopyridine. RESULTS: The dose of pipecuronium required for the decrease of contractile force to 10% of control value was less in verapamil pretreated group than in non-pretreated group. And, the decrease of contractile force in both groups was more effectively reversed by 4-aminopyridine than neostigmine and edrophonium. CONCLUSIONS: Verapamil potentiates the pipecuronium-induced neuromuscular blockade and 4-aminopyridine is more effective to reverse verapamil pretreated, pipecuronium induced neuromuscular blockade.
4-Aminopyridine* ; Baths ; Calcium Channels, L-Type ; Edrophonium* ; Muscle Relaxation ; Neostigmine* ; Neuromuscular Blockade* ; Neuromuscular Blocking Agents ; Pipecuronium* ; Potassium Channels ; Verapamil*

According to photothermolysis, the FPDL(flashlamp-pumped pulsed dye laser) treatment theoretically causes no epidermal damage, however, we have observed blister, crust and scars in clinical experiences, and we have also found that FPDL has limited effect on adults, specially, thick-skinned Asian people with rich melanin pigment. In order to explain these effects, we took biopsies and made a histologic observation and analyzed the results statistically. The biopsies were taken from 15 patients who received first treatment and stained with H&E and NBTC(nitroblue tetrazolium chloride). We measured epidermal melanin content, epidermal damage, vessel wall coagulation depth, RBC coagulation depth, mean vessel diameter and evaluated clinical results at post-treatment 6 weeks. The vessel diameter and darkness of lesion color were increased with ages. Complete vessel coagulation was restricted to small vessels. With increasing epidermal melanin content, epidermal damage increased accordingly. The clinincal results were enhanced with increasing coagulation depth of vessel walls, and deteriorated with increasing epidermal melanin content. The clinical result was not significantly correlated with RBC-coagulation depth or energy used. We observed that melanin pigments have an adverse effect on clinical results. The FPDL treatment can be a choice of treatment to children with light colored lesion, but has a limitation to Asian adults with rich melanin pigment. Therefore, repetitive treatment is necessary for improvement of clinical results.
Adult ; Asian Continental Ancestry Group ; Biopsy ; Blister ; Child ; Cicatrix ; Darkness ; Humans ; Lasers, Dye* ; Melanins

In case of severe blepharoptosis, frontalis muscle suspension with fascia or frontalis transfer has been popular for decades, but these static procedures have some disadvantages such as lagophthalmos, lid lag and remnant ptosis. Twenty-six patients with severe blepharoptosis who underwent frontalis suspension, frontalis transfer, or levator resection at Yonsei University Severance Hospital from 1980 to 1988 were studied. The follow-up period of patients ranged from 10 to 18 years with a mean of 12 years. Surveys and clinical results were obtained, In our review of postoperative complications, lagophthalmos persisted in sleep and even in forced eye closure in most patients 2 to 6 months after operation. But no recurrence was noted. In conclusion, undercorrection of ptosis is more desirable than overcorrection. As well levator resection can be considered in selected cases to prevent complications.
Blepharoptosis* ; Fascia ; Follow-Up Studies* ; Humans ; Postoperative Complications ; Recurrence

We present a case of multiple trichoepithelioma associated with milia. A 12-year-old girl developed symmetrically distributed, numerous, skin-colored papules on her face, some of which were studded with milia-like whitish materials. Histopathological findings of these lesions revealed the typical findings of trichoepitheliomas with overlying milia in the upper dermis.
Child ; Dermis ; Female ; Humans

Lateral osteotomy has been chosen as a part of rhinoplasty for modification of the nasal bony vault, alteration of the base width of the lateral walls, establishment of a new profile line of the nasal dorsum and lateral profile line, and closure of the open roof. Various methods of lateral osteotomy may be employed, however Orientals have characteristically broad and flat noses Compared to caucasians and for an esthetically satisfactory result, it is important to correct both in rhinoplasty. In this study, the authors performed their devised method of lateral osteotomy in 12 patients for the correction of broad, flat nasal dorsum and deviated noses. The operations could be broadly categorized into two groups: 1) short lateral osteotomy in which the lateral osteotomy line was incomplete and short, extending to the infraorbital rim; and 2) green-stick transverse osteotomy which was induced by in-siturotation fracture by osteotomy and, if considered necessary, augmentation rhinoplasty and nasal tip plasty were also performed simultaneously. Our nasal osteotomy has limited mobilization, where as the previous method has total mobilization, and it has the advantages of repositioning the broad and deviated nose in a preferable direction and shape, as well as the capability of narrowing the preferable area selectively. Especially if there is a necessity to correct both broad and flat noses such as in Orientals, our osteotomy methods have a synergistic effect in esthetic outcome when performed with augmentation rhinoplasty with a silastic implant. There were no complications such as relapse or air-way obstruction during the 4.5-month follow-up period. However, a long-term follow-up period is needed to evaluate the complications considering the physiologic aspect of the nose.
Follow-Up Studies ; Humans ; Nose ; Osteotomy* ; Recurrence ; Rhinoplasty*

No abstract available.
Folliculitis ; Herpes Zoster ; Herpesvirus 3, Human

Cutis verticis gyrata(CVG) is an unusual conformation of the scap characterized by the presence of folds and furrows due to thickening of the corium and the subutlneous tissue. In sccordance with etiological factor and associated findings, CVG occurs as primarary disease or secondary to a variety of local or systemic diseases. Cerebriform intradermal nevus(CIN) is a cause of CVG that can usually be recognized clinically and for a certainty histologically. We report two cases of CVG due to CIN. Not only did they have CVG due to CIN on the scalp, but also they had associated congenital nevi on the face and whole boispy, respectively.
Dermis ; Nevus ; Nevus, Intradermal* ; Scalp

No abstract available.
Cytomegalovirus* ; DNA* ; Humans* ; Polymerase Chain Reaction*

OBJECTIVE: To analyze the relationship between the degree of expression of E-cadherin and presence of high risk prognostic factors (lymph node metastasis or parametrium involvement), clinical stages and pathologic types in invasive cervical cancer. METHODS: An immunohistochemical technique has been applied to formalin-fixed, paraffin- embedded samples from 20 radical hysterectomy without risk factors and 16 radical hysterectomy with risk factors. The degree of expressions of E-cadherin immunostaining was compared with the International Federation of Gynecology and Obstetrics (FIGO) stage, presence of high risk prognostic factors, and pathologic types. RESULTS: The difference of the degree of expression of E-cadherin was not statistically significant between high-risk group (lymph node metastasis or parametrium invasion) and non-risk group. The difference of the degree of expression of E-cadherin was not statistically significant according to clinical stages and variable pathologic types either. CONCLUSIONS: These results suggest that the degree of the expression of E-cadherin has no relationship with known high risk prognostic factors, clinical stages and pathologic types in invasive cervical cancer.
Cadherins* ; Gynecology ; Humans ; Hysterectomy* ; Neoplasm Metastasis ; Obstetrics ; Risk Factors ; Uterine Cervical Neoplasms*

BACKGROUND: Adult with congenital heart disease represents a new category of specialized cardiovascular interest that requires the cooperation of a number of medical and surgical disciplines, and also requires the interactions among traditional departmental jurisdiction. Uninterrupted, long-term continuity care is essential if the concerns inherent in this new and increasing patient population are to be addressed. The purpose of this study was to analyze the clinical characteristics of congenital heart disease in adolescents and adults. METHODS: Between October 1994 and July 1996, retrospective follow-up records and registry chart of 229 consecutive patients with congenital heart disease for over 16 years in GUCH (grown-up congenital heart) clinic were reviewed by a physician and a nurse specialist. RESULTS: There were 126 female and 103 male GUCH patients with the mean age of 34+/-14.6 years old. Among the 229 patients, there were 179 natural survivors, those without cardiac repair, and 50 postoperative survivors. Congenital heart defects were 167 shunt legions, 17 obstructive and valvular legions, 14 tetralogy of Fallot, 15 complex congenital heart anomalies and 16 others. Among the 179 natural survivors; 122 (68%) required heart surgery or continuous medical surveillance, and among the 50 surgically repaired survivors; 37 (74%) required reoperation for residual heart defects, constant medical treatment or consultation from other medical divisions. The reasons for the hospital vistis were:cardiac operation or cardiac diagnosis in 128 (56%) patients, symptomatic heart conditions in 43 (19%), routine heart examinations since childhood in 31 (14%) and others in 27 (11%). Also, the patient compliances were higher in the GUCH clinic than the traditional departmental jurisdiction (p<0.001). CONCLUSIONS: To achieve continuing care for the patients with congenital heart disease in adolescents and adults, it is important to develope a specialized clinic addressing the specific needs of the congenital heart disease in adolescents and adults.
Adolescent* ; Adult* ; Diagnosis ; Female ; Follow-Up Studies ; Heart ; Heart Defects, Congenital* ; Humans ; Male ; Reoperation ; Retrospective Studies ; Specialization ; Survivors ; Tetralogy of Fallot ; Thoracic Surgery