No abstract available.
Echocardiography* ; Heart Defects, Congenital* ; Hypertension*

Forty eight female Sprague-Dawley rats received a subcutaneous implant containing 12.5 mg estradiol ant the age of 3 weeks. Three rats were killed in 1, 2, 3, 4, 6 weeks and in every month during 2~12 months after implantation, and the breasts were examined by light microscope. In all rats, enlargement of terminal end buds was obseved in 1~2 weeks, maximum development of hyperplastic alveolar nodules in 3 weeks, and marked dilatation and secretion of alveoli or ducts in 1~12 months after implantation. Ductal epithelial hyperplasia was observed in 27 rats and carcinomas developed in 23 rats in 2~12 months after implantation. It was thought that the changes induced by estradiol are more similar to the human breast lesions, compared with changes induced by chemical carcinogens such as dimethylbenzanthracene(DMBA), because breast carcinomas developed in close relationship with ductal epithelial hyperplasia in both estradiol-treated rats and humans, but not in DMBA-treated rats.
Female ; Humans ; Rats ; Animals ; Carcinogens

No abstract available.
Laurence-Moon Syndrome*

No abstract available.
Laurence-Moon Syndrome*

Arytenoid subluxation or recurrent laryngeal nerve paralysis may result from injury to the larynx following endotracheal intubation or blunt laryngeal trauma. Early diagnosis is important for appropriate treatment and better prognosis. A 62-years-old man was admitted for cholecystectomy. He was intubated without any difficulty and nasogastric tube was inserted with the help of laryngoscope and Magill forcep before surgery. He had a weak voice and hoarseness after atraumatic extubation and those symptoms did not improve even 2 days after. Indirect laryngoscopy, videolaryngotelescopy, electromyography(EMG) and computed tomographic findings revealed anterior, inferior subluxation of left cricoarytenoid cartilage associated with left thyroarytenoid muscle denervation and resultant unilateral vocal cord palsy. Conservative treatment for 40 days after the operation and follow-up examination was done. The voice quality was improved and indirect laryngoscopy examination showed that right vocal cord crossed midline in a attempt to meet its paralyzed counterpart on phonation.
Anesthesia, General* ; Cartilage ; Cholecystectomy ; Denervation ; Early Diagnosis ; Follow-Up Studies ; Hoarseness ; Intubation, Intratracheal ; Laryngeal Muscles ; Laryngoscopes ; Laryngoscopy ; Larynx ; Paralysis* ; Phonation ; Prognosis ; Recurrent Laryngeal Nerve* ; Surgical Instruments ; Vocal Cord Paralysis ; Vocal Cords ; Voice ; Voice Quality

Nevus lipomatosus cutaneous superficialis(NLCS) is a rare nevoiri anomaly characterized by ectopic adipose tissue in the dermis without predilection. In this disease two clinical types are distinguished: The classic type consists of asymptomatic linear or zosteriform coliection of soft, flesh colored to yellowish, papules or nodules that often coalesce into plaque. It is usually located in the pelvic girdle and lumbar area but has been repeted on the abdomen, thorax, thigh, and scalp. The solitary form usually appears later in life and can occur at any site. There is no sexurl irredilection or hereditary trend. There are no assoeiated abnor malities. The authors experienced three cases of typical NLCS including thia silitary type that had several solitary nodules irregularly. The first case was a 24-year-old female which has had multiple, flesh to dark brown-colored, confluent nodules over the left upper thigh for 5-years. The second case is the solitary type that a 56-year-old female has had discrete bean sized to what sized nodules on the right buttock for 13-years. The third case was a 23-year-old female who had soft, yellowish skin colored, cerebriform tumor on the right buttock for 10-yesrs. Diagnos was confirmed by clinical and histopathologic findings.
Abdomen ; Adipose Tissue ; Buttocks ; Dermis ; Female ; Humans ; Middle Aged ; Nevus* ; Scalp ; Skin ; Thigh ; Thorax ; Young Adult

We have experienced three cases of extrarnsmmary Pagets disease. The first case was a 77-year-old female who showed 8x10cm sized, erythematous plaque on the suprspubic area of one year's duration. The second case was a 60-year-old male who showed erythematous, oozing, crusted, well circumscribed patches on the right scrotum and the pubic area of 8 years' duration. Third case was a 79-year-old male who showed erythernstous to gray, eczemstoid plaques with marginal elevation on the right side of the scrotum, penile root and pubic area of 3 years duration. On histologic exarnination, the third case showed swest gland adenocarcinoma in the dermis.
Adenocarcinoma ; Aged ; Dermis ; Female ; Humans ; Male ; Middle Aged ; Paget Disease, Extramammary* ; Scrotum

BACKGROUND: Propofol and ketamine had been used for anesthesia induction and for total intravenous anesthesia. The nature of any hypnotic interactions occurring between propofol and ketamine are unknown. A comparison of maternal and neonatal effects among propofol-ketamine combination, ketamine and propofol were studied when used for anesthesia induction in Cesarean section. METHODS: Forty five patients in ASA class I or II scheduled for Cesarean section randomly assigned to either propofol 2 mg/kg (n=15), ketamine 1 mg/kg (n=15) or propofol 1 mg/kg - ketamine 0.5 mg/kg combination group (n=15) as an induction agent. Maternal systolic and diastolic blood pressure, heart rate, Apgar score and umbilical blood gas analysis were measured. RESULTS: Before intubation, systolic and diastolic pressure were decreased in propofol group but increased in ketamine and propofol-ketamine combination group. Heart rate were increased in all three groups. But there were no significant differences among three groups (p<0.05). After intubation, there were significant increase in systolic, diastolic pressure and heart rate in three groups but no significant differences among three groups (p<0.05). And there was no significant neonatal depression as assessed by Apgar scores and blood gas analyses. CONCLUSIONS: Propofol-ketamine combination was found to be similar to propofol or ketamine only in the effects on the mother and neonate. But propofol-ketamine gained more stable hemodynamic change than propofol or ketamine before intubation. Therefore propofol-ketamine appears to be a suitable alternatives to propofol or ketamine as an induction agent for anesthesia in Cesarean section.
Anesthesia ; Anesthesia, Intravenous ; Apgar Score ; Blood Gas Analysis ; Blood Pressure ; Cesarean Section* ; Depression ; Female ; Heart Rate ; Hemodynamics ; Humans ; Infant, Newborn ; Intubation ; Ketamine* ; Mothers ; Pregnancy ; Propofol*

The incidence of diabetes mellitus is in increasing tendency because of expension of medical care, economic development and increasing of the population of the aged person recently. The diabetic foot is one of serious complication of diabetes. With the advancement of the method of treatment of diabetes the other acute metabolic complications are decreased, but the development of diabetic gangrene encounteres at any age of adult life with increasing of incidence according to the duration of diabetes. The most of them requires operation, and its treatment is difficult frequently because of high incidence of wound problem in healing. So it is important to educate and prevent for lowering its incidence. From January 1978 to December 1984, 38 patients with diabetic foot were treated and analysed at Department of Orthopaedic Surgery of Presbyterian Medical Center. The results obtained are as follow. 1. The average of annual incidence of diabetic gangrene was 2.85%. There was increasing tendency of incidence to 1981, thereafter decreasing tendency. 2. 71% of patients with gangrene were in over-50 year age group. 3.72% of patients were in duration of diabetes more than 5 years. 4.79% of patiens were in inadequate treatment before admisson. 5. There was no relationship between fasting blood sugar level and development of gangrence. 6. The most common site of the lesion was big toe. 7. The most common predisposing fector was local pressure (39%), then minor trauma, and burn injury. 8. The primary wound healing rate was 53% after operation. 9. There was no relationship between the lowest palpable artery and primary wound healing. 10. The most common combined complication of diabetes was retinopathy (47%), then neuropathy and hypertension. 11. The rate of bacterial infection was 66%, and the most common organism was staphylococcus aureus (36%).
Adult ; Arteries ; Bacterial Infections ; Blood Glucose ; Burns ; Clinical Study ; Diabetes Mellitus ; Diabetic Foot ; Economic Development ; Fasting ; Gangrene ; Hallux ; Humans ; Hypertension ; Incidence ; Methods ; Protestantism ; Staphylococcus aureus ; Wound Healing ; Wounds and Injuries

BACKGROUND: Sufficient accumulations of local anesthetics in the extrapleural space promotes effective access to several intercostal nerves and, consequently, analgesia. The total volume of leakage of these anesthetics from the space can depend on the technique of extrapleural catheter insertion which is chosen. METHODS: Twenty patients due for thoracotomy were randomly selected to be provided with postoperative pain relief by an extrapleural approach. Before the thoracic cavity was closed, appropriate spaces between parietal pleura and intercostal muscle were made with surgical dilators under direct vision. An epidural catheter was introduced at a longitudinal lie in a cephalad direction, before the thoracic cavity was closed. Bupivacaine 0.25%, with 1 : 200,000 epinephrine was injected in a 10 ml dose about 20 minutes before the end of anesthesia, and infused at a rate of 0.88 mg/kg/hour for 1 hour, 0.35 mg/kg/hour for 23 hours and 0.3 mg/kg/hour for the second day postoperatively. RESULTS: The degree of analgesia with coughing and deep breathing was satisfactory to patients and thoracic surgeons. The average numbers of analgesic dermatomes obtained by pinprick tests, VAS, and Prince Henry pain scores were 5.2 0.5, 2.0 0.5 cm and 1.6 0.6, respectively. Changes in mean arterial pressure were insignificant, and heart rate increased at the postoperative hours of 1, 4 and 8 (P value < 0.05). FVC and FEV1 were restored to levels up to 67.2 and 71.0% of their preoperative values at the postoperative hour of 48. CONCLUSIONS: These results suggest that the technique of a catheter introduced at a longitudinal lie in a cephalad direction was effective and clinically useful for pain relief following thoracotomy regardless of some leakage of bupivacaine.
Analgesia ; Anesthesia ; Anesthetics ; Anesthetics, Local ; Arterial Pressure ; Bupivacaine ; Catheters* ; Cough ; Epinephrine ; Heart Rate ; Humans ; Intercostal Muscles ; Intercostal Nerves ; Pain Management* ; Pain, Postoperative ; Pleura ; Respiration ; Thoracic Cavity ; Thoracotomy*