Epiblepharon is a commonly encountered congenital anomaly in Asian infants and children. It causes symptoms of ocular irritation and inferior punctate corneal epithelial erosion. Surgical correction may be needed if ocular irritation symptom and corneal pathology persist with age. A series of 185 lower eyelid epiblepharon in 98 Korean children underwent lower eyelid crease reforming technique. Surgical treatment included excision of redundant skin and pretarsal orbicularis muscle with lid everting suture by anastomosis of the subcutaneous tissue and inferior tarsal border including capsulopalpebral fascia. With a minimum follow-up of 12 months, a total of 37 [20%]eyelids developed recurrence of cilia touch, and then 9 [4.8%]eye-lids needed further surgery.
Asian Continental Ancestry Group ; Child ; Cilia ; Eyelids* ; Fascia ; Follow-Up Studies ; Humans ; Infant ; Pathology ; Recurrence ; Skin ; Subcutaneous Tissue ; Sutures

No abstract available.
Leiomyoma*

The simultaneous administration of two or more drugs may result in interactions that increase or decrease the intended effects of one or both drugs. These interactions are often the result of induced alterations in the metabolism of the drugs. A wide variety of unrelated chemical agents are also capable of enhancing the activity of drug-metabolizing enzymea in the smooth-surfaced endoplasmic reticulum of the liver, and this accelerated metabolism alters the duration and intensity of action of a variety of pharmacological agents. Phenobarbital is a well known drug which promotes the metabolism of durgs in the liver. Some volatile or intravenous anesthetics were reported that enhance hepatic microspmal metabolism for themselves or for other drugs. Of these, Chang and Glazko (1974) reported that ketamine pretreatment did not influence the demethylation rate of drug metabolism and the liver weight in rats. However many opposite opinions have been expressed that ketamine enhanced mierosomal drug metabolism. Marietta et al (1975 and 1976) reported that the demethylating enzyme fraction of the ketamine-pretreated group was double of that of the control group in vitro. Thus we have made a study to evaluate the enhancement of drug metabolism induced by ketamine hydrochloride. Our experimental mice were divided into 4 groups, preteated with saline, phenobarbital, ketamine or carbon tetracbloride for 3 days. On the 1 st, 3 rd, 5th, 7th and 14th day after the pretreatment, we selected 10 mice randomly in each group, and hexobarbital(100mg/kg) was administered intraperitonealy. Then we evaluated the sleeping time, liver weight and microscopic findings of liver tissue. The results are as follows: 1) On the 1 st, 3 rd and 5th day after the pretreatment, the duration of hexobarbital induced hypnosis was significantly shorter in the ketamine-pretreated group than that in the control group, but not as long as that in the phenobarbital-pretreated group. 2) There was no remarkable change of the liver weight in the ketamine pretreated group. On the 1st and 3rd day after the pretreatment, liver weight was significanty increased in the phenobarbital and carbon tetrachloride pretreated groups. 3). Microscopic findings of liver showed no remarkable change in the ketamine-pretreated group, but there were significant cholestasis and hydrophic degeneration in the phenobarbital-and carbon tetrachloride-pretreated group respectively. In conclusion, it may be indicated that ketamine enhances hepatic microsomal drug metabolism because of shortening of the duration of hexobarbital-induced hypnosis.
Anesthetics, Intravenous ; Animals ; Carbon ; Carbon Tetrachloride ; Cholestasis ; Endoplasmic Reticulum ; Hexobarbital ; Hypnosis* ; In Vitro Techniques ; Ketamine ; Liver ; Metabolism ; Mice ; Phenobarbital ; Rats

In the late 1950, Greifenstein and associates have studied the properties of phenylcyelohexylamine derivatives and reported that these chemicals produced amnesia, analgesia, catatonia and catalepsy. Phencyclidine was the first of these drugs used in clinical anesthesia, but convulsive movement as well as excitatory behavior discouraged the use of the agent in human beings. Continued research for a more suitable derivative of phencyclidine with similar analgesic action, but shorter duratoin and lesser psychotomimetic action led McCarthy and Chen to investigate the pharmacologic properties of a large series of compounds. One of these, 2-ochlorophenylcyclohexylamine, was shown to have some advantages. Ketamine hydrochloride, chemically related to both phencyclidine and cyclohexylamine, proved to be more satisfactory for clinical anesthesia. Clinical investigations were begun in 1965 by Dominos group who first termed it dissociative anesthesia. As noted by Pender, the clinical signs of anesthesia with ketamine are completely different from those seen with conventional intravenous agents and gaseous compounds. Ketamine acts rapidly on intravenous or intramuscular administration to produce a state chracterized by catalepsy, analgesia and amnesia. It is devoid of sedation, hypnotic or convulsive properties. Normal pharyngeal-laryngeal reflexes are maintained and skeletal tone remains normal or increased. Since the introduction of ketamine by Domino's group, numerous reports have appeared to explain various aspects of the cardiovascular response(increased cardiac output, hypertention, little or no change in peripheral resistance) and respiratory response. However there are few reports on the effect of ketamine on intestinal motility. Thus we have made a study to observe the effect of ketamine on the intestinal motility of chickens. Strips of isolated muscle, 1 cm long, from adult fowl weighing l.2-1.5 kg and isolated smooth muscle of a patient with stomach cancer, were suspended in a muscle chamber containing Tyrode's solution into which was bubbled oxygen gas. The solution was. kept constant at 38 degrees C and contraction of the preparations was recorded on a polygraph. After being washed several times with fresh solution, the muscle strips attained constant motility and tonus. Ketamine and other drugs were added in various concentrations to the chamber. The results are as follows: 1) Ketamine did not exert any effect on human intestinal motility. It relaxed fowl intestinal muscle strips and potentiated the effect of epinephrine, norepinephrine, and isoproterenol. 2) The relaxing effects of ketamine on fowl intestinal muscle strips were not abolished by adrenergic blocking agents. 3) Ketamine demonstrated anticholinergic effect on the intestinal motility of the human and fowl. From the above results, it may be concluded that ketamine exerts a anticholinergic effect and depressant effect on intestinal motility of fowl without relation to adrenergic receptors.
Adrenergic Antagonists ; Adult ; Amnesia ; Analgesia ; Anesthesia ; Cardiac Output ; Catalepsy ; Catatonia ; Chickens* ; Cyclohexylamines ; Epinephrine ; Gastrointestinal Motility* ; Humans ; Isoproterenol ; Ketamine* ; Muscle, Smooth ; Norepinephrine ; Oxygen ; Phencyclidine ; Receptors, Adrenergic ; Reflex ; Stomach Neoplasms

Discrete subvalvular aortic stenosis is a relatively uncommon cause of the left ventricular outflow obstruction, requiring early intervention. Conventional transthoracic echocardiography may fail in some patients due to insufficient imaging quality. In particular, in patients with a discrete fibrous membrane close to the aortic valve without narrowing of the left ventricular outflow tract, the echocardiographic detection of the membrane may be difficult. Transesophageal echocardiography allows a clear visualization of the aortic valve and the left ventricular outflow tract in virtually all patients, it can be performed rapidly with almost no risk, and it may therfore be helpful in establishing the diagnosis of discrete subaortic stenosis, in particular in patients where the conventional transthoracic approach fails. We have experienced two cases of discrete subaortic stenosis. One case of them was combined with hypertrophic obstructive cardiomyopathy in this report we discussed the utility of multiplane transesophageal echocardiography in patients with discrete subvalvular aortic stenosis.
Aortic Stenosis, Subvalvular* ; Aortic Valve ; Cardiomyopathy, Hypertrophic ; Diagnosis ; Discrete Subaortic Stenosis ; Early Intervention (Education) ; Echocardiography* ; Echocardiography, Transesophageal ; Humans ; Membranes ; Ventricular Outflow Obstruction

OBJECTIVE: The aim this study was to investigate possible mechanisms behind olanzapine-associated weight gain. METHOD: Thirteen psychiatric inpatients (all meeting DSM-IV criteria for schizophrenia or schizophreniform disorder) receiving olanzapine in Soonchunhyang university Chun-an hospital were studied. Body weight, plasma leptin, insulin and fasting glucose levels were measured five-times over 6 weeks. Body mass index (BMI) was calculated. RESULT: At the end of sixth week, body weight, BMI, plasma leptin, insulin and fasting glucose levels were significantly increased from baseline. Both insulin and leptin plasma levels were significantly increased from baseline at the end of the sixth week of treatment. Both body weight and BMI were significantly increased from baseline at the end of the first week, the fourth week and sixth week, respectively. Fasting glucose was significantly increased from baseline at the end of the fourth week and sixth week, respectively. Between baseline and sixth week, the body weight, BMI, plasma leptin and fasting glucose levels were significantly correlated to insulin level. There was a tendency toward a correlation between BMI and leptin level, whereas no correlation was found between body weight and leptin. CONCLUSION: Olanzapine treatment was associated with weight gain and elevated level of leptin, insulin and fasting glucose. Elevated insulin levels and hyperleptinemia may be mechanisms behind olanzapine-induced weight gain.
Body Mass Index* ; Body Weight* ; Diagnostic and Statistical Manual of Mental Disorders ; Fasting* ; Glucose* ; Humans ; Inpatients ; Insulin* ; Leptin* ; Plasma* ; Schizophrenia ; Weight Gain

It is well known that local anesthetics, which block impulses in peripheral nerve fibers have marked effects on the central nervous system. The drugs, when given in small, subconvulsive doses, produce sedation, central analgesic action, and anticonvulsive effects. When subconvulsive doses of the local anesthetic, lidocaine, was administered to animals, there was marked depression of motor activity and probably this depression was due, at least in part, to sedation(Wagman et al, 1967). Local anesthetics are administered in combination with one another to produce rapid onset and prolonged duration of anesthesia. However the combined administration of large doses of multiple durgs generally is considered an important cause of local anesthetic toxicity. Some authors have said that combined administration of local anesthetics in animals showed that systemic toxicity was additive, but others not. So, the present study was undertaken to evaluate the effect of two combined local anesthetics on the motor activity by way of the effects of combined 2 local anesthetics on the central nervous system. As experimental animals, 460 mice, weighing about 20gm, were used. Subconvulsive doses of lidocaine 25mg/kg, 50 mg/kg, tetracaine 7.5mg/kg, 15 mg/kg, lidocaine 25mg/kg combined with tetracaine 7.5mg/kg and lidocaine 25mg/kg combined with bupivacaine 7.5mg/kg were administered. The motor activity was measured with a "Selective Activity Meter". The results are summarized as follows: 1) The group of mice treated with lidocaine showed markedly inhibited motor activity in comparison with the control group and the inhibitory action of lidocaine 25mg/kg and 50mg/kg was similar. 2) In the group treated with tetracaine there was marked inhibition of motor activity throughout the experiment and the inhibitory action of tetracaine 15mg/kg was more marked than 7.5mg/kg. The group treated with lidocaine 25mg/kg was more inhibited than the group with tetracaine 7.5mg/kg and less inhibited than the group with bupivacaine 7.5mg/kg. 3) In the group treated with bupivacaine there was strong inhibition of motor activity throughout the experiment and the inhibitory action of the group with bupivacaine 7.5mg/kg was less than the group with bupivacaine 15mg/kg. Inhibition in the group treated with bupivacaine 7.5mg/kg was shown to be more intense than any of the other drugs used in this test. The group treated with tetracaine 15mg/kg was more inhibited than the group with lidocaine 50mg/kg and less inhibited than the group with bupivacaine 15mg/kg. 4) The group treated with a combination of lidocaine 25mg/kg and tetracaine 7.5mg/kg was more inhibited in comparison with control and each treated group, but this increase of inhibition over each treated group was small. 5) The group treated with a combination of lidocaine 25mg/kg and bupivacaine 7.5mg/kg was more inhibited than the control and each treated group, but the increase of inhibition over each treated group was small. From the results described above, it may be concluded that local anesthetics depress the central nervous system and bupivacaine depresses the central nervous system more than lidocaine and tetracaine. Combined treatment does not show a synergistic effect on the motor activity.
Anesthesia ; Anesthetics, Local ; Animals ; Bupivacaine ; Central Nervous System ; Depression ; Lidocaine ; Mice* ; Motor Activity* ; Peripheral Nerves ; Tetracaine

There is too many pathological test compared to the number of pathology doctor in Korea. To solve this problem, there is a solution that establish more department of pathology, but it's not easy because of the amount of costs and other environmental constraints. In this circumstance, when special doctors whose fields are not pathology need external consulting, they go to pathology doctor and ask them personally. It wastes unexpectable time and cost. The improved system of these inefficient procedure in pathological consulting is "The Web Based Consultation System in Pathology". In this system, when a pathological consulting is needed, the doctors can send and receive the informations with web based platform. It's digitalized procedure of existing pathological consulting and made it possible to accomplish efficient consulting. Moreover the Pathology Database which generated in this system makes more systematic and continuous information administrate and practical use of that information.
Humans ; Korea ; Pathology*

Primary gastric lymphorna represents one to 7% of all gastric cancer and is the most common type of extranodal lymphoma. In attempt to evaluate the endoscopic characteristics, we analysed clinical and endoscopic findings in 35 patients with primary gastric lymphoma between January 1980 and August 1994 at the Yonsei Medical Center. The results were as follows: 1) The mean age of patients was 47.1 years with male to female ratio of 1.5: l. 2) Gastroscopy was performed in all 35 patienits, which revealed polypoid lesion in one case(2.9%), ulcerative lesion in 15 cases(42.9%), ulcero-infiltrative lesion in 6 cases(17.1%) and diffuse infiltrative lesion in 2 cases(5.7%). Gastric lymphoma was suggested in 6 cases, advanced gastric cancer in 21 cases, early gastric cancer in 5 cases and benign gastric ulcer in 3 cases. Pathologic diagnosis of biopsy specimens were gastric lymphoma in 24 cases, adenocarcinoma in 5 cases and chronic superficial gastritis in one case. 3) The characteristics of the endoscopic findings in gastric lymphoma were intractable or recurrent ulcer in 10 cases, thickened and mounded ulcer margin in 9 cases, multiple ulcers in 9 cases, giant rugae in 7 cases and polypoid or depressed lesion with central ulceration in 4 cases. In conclusion, recognition of specific endoscopic findings such as intractable or recurrent ulcer, volcano-like ulcer, multiple ulcers, giant rugae and combined lesion, the possibility of a lymphoma should be considered and vigorous biopsy attempts should be carried out. Then if the first microscopic report does not suggest this diagnosis, a second investigation including jumbo biopsies, perhaps by diathermy, should be undertaken.
Adenocarcinoma ; Biopsy ; Diagnosis* ; Diathermy ; Female ; Gastritis ; Gastroscopy ; Humans ; Lymphoma ; Male ; Stomach Neoplasms ; Stomach Ulcer ; Ulcer

This study is intended to the diagnostic accuracy and reproducibility rate according to the input devices and the video signals, potential technical problems of the telepathology system and possible physical and psychological impacts. Web based in telepathology system had been developed and in use, but their functional capability and diagnostic accuracy are considered to be inferior to those of conventional optical microscope. We devised a telepathology system using our existing microscope equipped with CCD camera unit that has no restriction of network speed. Total 55 histopathologic cases from various organs were selected. Three pathologists are involved in making diagnoses. The resulting diagnostic accuracies were 1CCD camera with composite video signal was 86.2%, 3CCD camera with composite video signal was 93.1% and 3CCD camera with component video signal was 95.0%. The 3CCD camera with component video signal resulted 95.0% diagnostic accuracy and was superior to 1CCD and 3CCD camera with composite video signal. At this time of problems were not noted in the monitor quality.
Diagnosis ; Telepathology*