No abstract available.
Spine*

BACKGROUND: Epidurally administered clonidine represents an approach to control the pain after cesarean section that produces analgesia by an alpha 2-adrenergic mechanism and may provide postoperative analgesia without nausea, pruritus, and respiratory depression associated with systemic or intraspinal opioid administration. This study was undertaken to evaluate the analgesic effect according to the dose of appropriate bolus and the combination of epidural morphine and clonidine after cesarean section. METHOD: Forty five women, ASA physical status 1 or 2, scheduled for elective cesarean section were randomly assigned to receive epidural administration for postoperative pain control. Group A (n=15) received 1 mg morphine and 75 g clonidine bolus followed by 4 mg morphine and 150 g clonidine. Group B received 2 mg morphine and 75 g clonidine bolus followed by 4 mg morphine and 300 g clonidine. Group C received 3 mg morphine and 75 g clonidine bolus followed by 4 mg morphine and 450 g clonidine. Each combination of drug was injected at Bromage scale 1 after surgery. RESULTS: All groups showed relatively stable hemodynamic status. Analgesic effect was significantly better in Group B and C than Group A (p<0.05). Sedative effect was not a problem in all groups. The incidence of side effects in Group C was more than Group B, which than Group A, but almost cases did not require treatment. CONCLUSION: 2 mg morphine and 75 g clonidine bolus followed by 4 mg morphine and 300 g clonidine with excellent analgesic effect and less side effects is considered as adequate dose in postoperative pain control after cesarean section with epidural anesthesia.
Analgesia ; Anesthesia, Epidural* ; Cesarean Section* ; Clonidine* ; Female ; Hemodynamics ; Humans ; Hypnotics and Sedatives ; Incidence ; Morphine* ; Nausea ; Pain, Postoperative ; Pregnancy ; Pruritus ; Respiratory Insufficiency

Fisting is an uncommon sexual activity, and death due to fisting is very rare. In the present report, we describe a case of a woman who died from fisting by her male partner. A 38-year-old woman went to a motel with a man after consuming alcohol, and there they kissed each other. As desired by woman, the man inserted his fingers into her vagina and anus, and later inserted his fist and forearm into her vagina and anus. After 20-30 minutes of fisting, the woman became unconscious and died. The autopsy confirmed the presence of perineal and vaginal lacerations with massive internal pelvic soft tissue injury with uterine artery rupture. A partial tear was noted at the rectosigmoid junction. The cause of death was hypovolemic shock due to uterine artery rupture. Following court trials, the assailant was sentenced to 4 years of imprisonment for the felony of inflicting bodily injury resulting in death.
Anal Canal ; Autopsy ; Cause of Death ; Female ; Fingers ; Forearm ; Humans ; Lacerations ; Male ; Rupture ; Sexual Behavior ; Shock ; Soft Tissue Injuries ; Unconscious (Psychology) ; Uterine Artery ; Vagina

No abstract available.
Candidiasis* ; Humans ; Infant, Newborn ; Infant, Premature*

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

29 isoniazid (INH) resistant isolated strains and INH sensitive reference strain (H37Rv) of Mycobacterium tuberculosis were analysed by polymerase chain reaction-single strand conformational polymorphism (PCR-SSCP) and NciI restriction mapping for the detection of mutations in katG gene and inhA gene. The katG gene was divided into 3 parts (Akat, Bkat, Ckat; each part is about 800 bp) and amplified, inhA gene was amplified as a whole. Each of the amplified 800 bp DNA was digested into small fragments of less than 400 bp with restriction enzymes for the direct PCR-SSCP analysis. Firstly, 10 strains were analysed. All the 10 isolates showed clearly distinct SSCP patterns in Bkat from that of the reference strain, but only two isolates showed distinct SSCP patterns in Akat, and no isolated strain showed any distinct SSCP patterns in Ckat. 10 isolates also showed distinct SSCP patterns in inhA. NciI restriction mapping of Bkat showed mutation in codon 463 in 7 strains among 10 isolated strains. With these results an early detection strategy for the INH resistant M. tuberculosis was applied to the rest of 19 isolated INH resistant strains. Firstly, isolates were screened by Ncsl mapping in Bkat, and 13 strains showed mutations in codon 463. Secondly, the rest of 6 INH resistant isolates were analysed by PCR-SSCP with restriction enzyme digestion (PCR-SSCP-RE) in Bkat, and all the strains showed distinct SSCP patterns from that of the INH sensitive reference strain. This proved our strategy as effective and economic and time saving method in early detection of INH resistant M. tuberculosis.
Codon ; Diagnosis* ; Digestion ; DNA ; Isoniazid* ; Korea* ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymorphism, Single-Stranded Conformational ; Restriction Mapping ; Tuberculosis

In vivo and in vitro culture of rat tumor chondrocytes is a good culture model for physiologic, pathologic and biochemical studies of tumor chondrocytes. Human tumor chondrocyte culture is another method, but it is difficult to maintain a cell line and in vivo culture. So called, Swarm Rat Chondrosarcoma, which wss developed spontaneously in a Spra-gue-Dawley rat and maintained by Dr. R. Swarm, can be cultured in vivo and in vitro at the same time. It is easy to maintain Swarm Rat Chondrosarcoma and is said that there are nearly no notable changes in cellular characteristics during consecutive cultures. In this study, in order to establish the basic culture method of rat tumor chondrocytes, the inoculated tumor mass were studied with swarm rat chondrosarcoma cell line which had been preserved at Orthopedic Research Laboratory of the Msssachusetts General Hospital. In vivo culture, injection of digested 1×10(6) cells, 1×10(7) cells and direct inoculation of tumor of mass were done at each 10 Sprague-Dawley rats group and examination was done at postinoculation 2, 3, 4, 5, 6, 7 and 8 weeks. In vitro culture, 1×10(6)/ml, 2×10(6)/ml and 4×10(6)/ml concentration cell suspensions were plated at 96-well-plate and observed at 2, 3, 4 and S days with inverted microscope. The results of this study are as follows. 1. In vivo culture, the best result was observed at direct inoculation of tumor fragments among 1×10(6) cells, 1×10(7) cells and direct tumor fragments inoculation. 2. The ideal time of obtaining tumor mass growing in rsts is between 4 to 6 weeks after inoculation. 3. In vitro culture, the proper cell density in 96-well-plate was 1 x 10(6)/ml among 1×10(6)/ml, 2×10(6)/ml snd 4 × 10(6)/ml.
Animals ; Cell Count ; Cell Line ; Chondrocytes ; Chondrosarcoma ; Hospitals, General ; Humans ; In Vitro Techniques ; Methods ; Orthopedics ; Rats ; Rats, Sprague-Dawley ; Suspensions

No abstract available.

No abstract available.
Knee Joint* ; Knee*

We analyzed ninety one fractures of femoral neck treated with surgery and followed for more than 2 years at Seoul National University from January 1977 to June 1983. Of these, 45(49%) were treated with internal fixation(compression hip screw or Knowles' pinning), 26(29%) with primary endoprosthesis, 20(22%) with total hip replacement arthroplasty. The criteria for internal fixation were fresh fracture that could be reduced satisfactorily and the age of the patient were under 65 years. The criteria for endoprosthesis were displaced subcapital or transcervical type or severe osteoporosis with intact acetabular cartilage. The criteria for total hip replacement arthroplasty were neglected fractured patients with significant medical problems, including cardiovascular, pulmonary, and renal disease, that posed significant risks for a second operation, and patients who had previous hip disease such as degenerative arthritis or rheumatoid arthritis. Following results were obtained. 1. In our series, the most frequent occurrence of femoral neck fractures was in the 7th decade(34 %), and the most common cause was fall down(72.6%). 2. In fresh fractures less than 3 weeks after injury, transcervical type (73%) according to anatomical classification and Garden's type III(44%) according to displacement were the most common type, respectively. 3. After internal fixation, 11% of avascular necrosis and 9% of non-union occurred. After endoprosthesis, 4% of acetabular protrusion, 8% of loosening and 12% of loosening and 12% of painful hip occurred. After total hip replacement arthroplasty, 10% of dislocation and 10% of loosening occurred. 4. Functional end results of excellent 56%, good 22%, fair 6% and poor 16% in internal fixation group, excellent 31%, good 38%, fair 12% and poor 19% in endoperosthesis group, and excellent 45%, good 30%, fair 10% and poor 15% in total hip replacement arthroplasty group were obtained.
Acetabulum ; Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Cartilage ; Classification ; Clinical Study ; Dislocations ; Femoral Neck Fractures ; Femur Neck ; Hip ; Humans ; Necrosis ; Osteoarthritis ; Osteoporosis ; Seoul