This study is designed to compare the effectiveness of single-bolus lidocaine, fentanyl and esmolol at the time of postintubation to blunt the hemodynamic intubation response in hypertensive patients. Sixty mildly hypertensive patients, scheduled for elective surgery, were randomly assigned in a double blind to receive a preintubation dose : in the firat group(Group A),20 patients received 1.5mg/kg lidocaine ; in the second group(Group B), another 20 patients received 3 ug/kg fentanyl; and in the third group(Group C), another 20 patients received 100mg esmolol. Within the above mentioned framework, this study obtained the following results : Systolic arterial pressure (SAP), heart rste (HR) and rate-pressure product (RPP) all significantly increased 1 minute after intubation. Fentanyl was more effective in protecting sgainst increase in SAP than lidocaine, which proves to be significant as shown in P<0.05. The statistical result, however, did not show the effectiveness of fentanyl signifieantly differed from that of esmolol in this respect. Esmolol preloading was significantly more effective in blunting hesrt rate than any other drugs. On the other hand, preloading of esmolol or fentanyl was significantly more effective in blunting rate-pressure product thsn lidocaine,which turned out to be P <0.05. Given these results, the present study concludes that esmolol preloading provides a reliable protection against increases in both heart rate and systolic srterial pressure accompanying laryngoscopy and intubation in hypertensive patients.
Arterial Pressure ; Fentanyl* ; Hand ; Heart ; Heart Rate ; Hemodynamics ; Humans ; Intubation ; Intubation, Intratracheal* ; Laryngoscopy ; Lidocaine*

BACGROUND: Recently, transfusion by component blood products instead of whole blood has gradually increased. And also filtered and/or irradiated blood products for the prevention of GVHD and other transfusion reaction has been used. To probe trends of recent transfusion, we analysed the use of blood components from 1989 through 1996 in Chonnam University Hospital. METHODS: We reviewed blood bank records from 1989 through 1996 in Chonnam University Hospital. RESULTS: 1. Total numbers of transfused blood units from 1989 to 1996 were 369,326 and the rate of component transfusion increased from 24.5% (1989) to 99.6% (1996) in Chonnam University Hospital. 2. Total numbers of transfused whole bloods were 5,569 units (24.5%) in 1989, then declined to 327 units (0.5%) in 1996. 3. Transfusion of PRC increased from 9,325 units (41.1%) in 1989 to 24,368 units (35.8%) in 1996, and also FFP from 7,371 units (32.4%) in 1989 to 15,546 units (22.9%) in 1996. 4. Use of platelet concentrates increased 16.4-fold from 2,223 units (2.5%) in 1989 to 36,531 units (46.8%) in 1996. 5. In 1996, percentage of filtered and irradiated blood products was 32.3% from cellular blood products. 6. With the use of the advanced blood seperator, hemapheresis showed slight increase annually. CONCLUSION: This paper will provide the basis of blood supply in Chonnam University Hospital and blood center.
Blood Banks ; Blood Group Incompatibility ; Blood Platelets ; Jeollanam-do*

The purpose of this study was to prevent the dilutional effect of excessive absorption of irrigating solution by using furosemide intraoperatively during transurethral resection of the prostate. Thirty patients, classified as ASA ps 2 or 3, were selected randomly and divided them into two groups as follows: Group l(N=15); Not-administrated furosemide(control group) Group 2(N=15); Administrated furosemide(Experimental group) All patients were premedicated with hydroxyzine(1 mg/kg, IM) and were performed continuous epidural anesthesia with 2/ lidocaine(1-1.5 mg/segment). 5% D-sorbitols were used for irrigating solution, and Hartmans solutions were given for maintenance fluid. And fixed the irrigating container to 60 cm in height from symphysis pubis. With the starting of operation, 20 mg furosemide was administrated to experimental group. The blood samples for serum Na+, K+, glucose and BUN were obtained at preoperation, 10 min, 20 min, 30 min after the stating of operation and immediate postoperative period, and serum osmolality and effective osmolality were calculated. The results were as follows: l) The values of sodium concentration of control group were decreased significantly at 10 min, 20 min, 30 min after the starting of operation and immediate postoperative period as compared with the preoperative value(p<0.05). But those of experimental group were not changed significantly. 2) The values of serum osmolality and effective osmolality were decreased significantly at 30 min after the starting of operation and immediate postoperative period as compared with the preoperative value(p<0.05). But those of experimenta1 group were not changed significantly. These results show that the dilutional effect of excessive absorption of irrigating solution might be prevented by using furosemide intraopertively. So we would like to recommend the use of furosemide during TURP, especially in patients with congestive heart failure or renal failure.
Absorption ; Anesthesia, Epidural ; Electrolytes* ; Furosemide* ; Glucose ; Heart Failure ; Humans ; Osmolar Concentration* ; Postoperative Period ; Prostate* ; Renal Insufficiency ; Sodium ; Transurethral Resection of Prostate

PURPOSE: Steatocystoma multiplex is a rare benign disease that occurred multiply on whole body surface. Many physicians have tried managing steatocystoma in variable methods. However it is hard to define the optimal way to cure steatocystoma. We performed both aspiration and excisional method to study the usefulness of both methods. METHODS: A 28-year-old woman has asymptomatic multiple subcutaneous nodules on whole body. Most lesions were aspirated with 26-guage needled 3cc syringe but large and purulent three nodules were excised. RESULTS: We diagnosed the lesion histologically as steatocystoma multiplex. Aspirated wound healed without scar, excised wound remained scar but esthetically acceptable. Axillary lesion contained so clustered type cysts that was difficult to aspirate whole cyst. Thus additional excisional method was needed. CONCLUSION: There are many practical methods to cure steatocystoma. However, there is no appropriate method to cure it. Therefore we should select different therapeutic method according to anatomical location and cyst size. Especially at subcutaneous fat-rich lesion like axilla and abdomen, it is better to excise the clustered cyst than to aspirate.
Abdomen ; Adult ; Axilla ; Cicatrix ; Female ; Humans ; Steatocystoma Multiplex ; Syringes

In 1960 Martin and his associates described another type of tumor of the stomach derived from the smooth muscle, which they named myoid tumor in a study of six patients. In 1962 Stout applied the term "lelomyoblastoma" to this interesting entity in a report of a collected series of 69 patients. Tumor cells are round or polygonal epithelioid cells, which contain perinuclear vacuole or clear zone. A 58 year-old female was admitted to this hospital because of epigastric discomfort for three months. At Upper gastrointestinal series and gastrofiberscope, a round hemispherical submucosal tumor was noted at posterior wall near the lesser curvature of gastric antrum. After subtotal gastrectomy, the submucosal tumor was diagnosed as leiomyoblastoma. Because leiomyoblastoma are rare and easily misdiagnosed as leiomyoma or leiomyosarcoma, careful histologic study is recommended.
Epithelioid Cells ; Female ; Gastrectomy ; Humans ; Leiomyoma ; Leiomyoma, Epithelioid* ; Leiomyosarcoma ; Middle Aged ; Muscle, Smooth ; Pyloric Antrum ; Stomach* ; Vacuoles

BACKGROUND AND OBJECTIVES: Hyperhomocyt(e)inemia is known to be one of independent risk factors for the ischemic heart diseases recently, but the role of hyperhomocysteinemia in restenosis after coronary intervention is unclear. The relationship between plasma homocysteine level and restenosis after coronary intervention was evaluated in Korean patients. MATERIALS AND METHOD: Eighty three patients underwent successful percutaneous coronary intervention (PCI) and follow-up coronary angiography were divided into two groups according to restenosis, and the level of plasma homocysteine was compared between groups with restenosis (n=5, M:F=7:8, 60.6+/-13.5 years) and without restenosis (n=8, M:F=0:8, 60.3+/-12.8 years). RESULTS: The clinical manifestation, atherosclerosis risk factors except for hypertension, and coronary angiographic findings were not significantly different in patients with or without restenosis(P=S). The value of homocysteine was 9.3+/-3.1 micromol/L in 35 patients with restenosis and 8.4+/-2.5 micromol/L in 48 patients without restenosis(P=S). All of 8 patients whose values of plasma homocysteine were more than 13 micromol/L, had angiographic restenosis. Plasma homocysteine was not an independent risk factor of restenosis by means of logistic regression analysis. CONCLUSION: Plasma homocysteine is not a potential risk factor of restenosis after percutaneous coronary intervention.
Atherosclerosis ; Coronary Angiography ; Follow-Up Studies ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Hypertension ; Logistic Models ; Myocardial Ischemia ; Percutaneous Coronary Intervention* ; Plasma ; Risk Factors

BACKGROUND: The incidence of candidemia in paediatric patients has increased over the last decade. We analysed the clinical characteristics of pediatric patients with candidemia over a 3-year period in Chonnam National University Hospital. METHODS: The medical records of 28 patients with candidemia diagnosed between 1996 and 1998 were retrospectively reviewed. Clinical characteristics including underlying illness, risk factors, therapy and outcome were assessed in relation to causing Candida species. RESULTS: The causing agents were mainly non-C. albicans species (24/28 cases, 81.5%). Underlying illnesses of patients were malignancy (n=12), surgical diseases (n=4), prematurity (n=2), and other medical illnesses of (n=10). Studies on clinical status at positive culture revealed antibiotic exposure (28/28, 100%), placement of central venous catheter (CVC, 16/28, 57.1%), use of total parenteral nutrition (15/28, 53.6%), and chemotherapy (14/28, 50%). Twenty patients were treated with amphotericin B and/or fluconazole and 15 patients'CVCs were removed. Overall mortality due to candidemia was 25%(7/28). CONCLUSIONS: These data show that most of pediatric candidemia cases are caused by non-C. albicans species and associated with a relatively lower mortality rate
Amphotericin B ; Candida ; Candidemia* ; Central Venous Catheters ; Drug Therapy ; Fluconazole ; Humans ; Incidence ; Jeollanam-do ; Medical Records ; Mortality ; Parenteral Nutrition, Total ; Retrospective Studies ; Risk Factors

PURPOSE: Radiation-induced chromosomal damage and apoptosis were compared in human lymphocytes. MATERIALS AND METHODS: Peripheral lymphocytes from 10 normal volunteers (6 males, 4 females, age range 23~41 years) were irradiated by gamma rays from a cell irradiator. Doses of irradiation were 0 (control), 0.18, 2, 5, 10, 20 and 25 Gy. Irradiated lymphocytes were examined by metaphase analysis for chromosomal aberrations and by flow cytometry for apoptosis. RESULTS of both studies were compared according to dose. RESULTS: Number of dicentric and ring chromosomes (D+R) was 0.5+/-0.53 at baseline, which was significantly increased after radiation according to the dose. The fraction of cells showing annexin V-fluore-scein isothiocyanate uptake was 0.55+/-0.39%, which increased to 3.58+/-1.85% by 2 Gy irradiation, and then decreased. The fraction of cells showing propidium iodide (PI) uptake was 0.52+/-0.12%, which significantly increased according to dose (upto 15.64+/-5.99% by 20 Gy irradiation). D+R and PI uptake were well correlated (r=0.84, p<0.001). CONCLUSION: Radiation-induced chromosomal aberration was correlated to nuclear uptake of PI, a marker of late apoptosis.
Apoptosis* ; Chromosome Aberrations* ; Female ; Flow Cytometry ; Gamma Rays ; Healthy Volunteers ; Humans* ; Lymphocytes* ; Male ; Metaphase* ; Propidium ; Radiation Injuries ; Ring Chromosomes

OBJECTIVE: Aplastic anemia is a rare but serious complication of viral hepatitis. Both aplastic anemia and viral hepatitis are more common in Korea than in the Western countries. It is necessary to study about the relationship between them. METHODS: Twenty-three patients with aplastic anemia visiting Chonnam University Hospital from 1995 to 1996 were studied for positivity of hepatitis B virus (HBV) and hepatitis C virus (HCV) to investigate the association of hepatitis virus infection with aplastic anemia. The surface antigen of HBV (HBsAg) and anti-HCV in sera were tested by EIA(enzyme immunoassay), and the presence of HBV-DNA and HCV-RNA in both sera and bone marrow cells was examined by the polymerase chain reaction (PCR). RESULTS: The positivities of HBsAg and anti-HCV in 23 patients with aplastic anemia were 4.3% (1 patient) and 8.7% (2 patients), respectively. The positivity of HBsAg is similar to that of HBsAg in general population of Korea. The positivity of anti-HCV is higher than that of anti-HCV in general population of Korea. One patient had HBV DNA and 3 patients had HCV RNA in their sera. All of the 3 hepatitis C viremic patients received 11 to 15 units of blood products in the past. None of the patients showed the evidence of recent viral hepatitis infection. HBV DNA and HCV RNA were not detected by the PCR in bone marrow cells in any of the patients. CONCLUSION: This study suggests that the HBV or HCV might not be a causative agent of aplastic anemia. The higher positivity of anti-HCV in the patients might be due to passive transmission of HCV after transfusion of blood products.
Anemia, Aplastic* ; Antigens, Surface ; Bone Marrow Cells ; DNA ; Hepacivirus* ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B* ; Hepatitis C* ; Hepatitis Viruses ; Hepatitis* ; Humans ; Jeollanam-do ; Korea ; Polymerase Chain Reaction ; RNA

BACKGROUND: There have been several studies aimed at determining the presence of the B(3) specific alleles in Korean B(3) blood donors. However, in these samples, only consensus exons 6 and 7 have been detected. Therefore, this study analyzed the complete exons (1~7) and flanking intronic region of the ABO gene sequence in B(3) donors. METHODS: A total of 12 B(3) blood donors collected at the Gwangju-Chonnam Red Cross Blood Center were identified using standard tube techniques. The genomic DNA was isolated from the peripheral blood and of exons 1~7 including flanking intronic regions were sequenced and an allele specific polymerase chain reaction (AS-PCR) was performed. RESULTS: Complete exon and flanking intronic analysis of the ABO alleles revealed the consensus B101 allele along with either the O01 or O02 allele in 11 out of the 12 donors. The remaining 1 donor had the Bw03/O01 genotype. CONCLUSION: No B(3) specific novel alleles were found in most Korean B(3) donors, and the genetic basis of B(3) blood group could not be explained.
Alleles ; Blood Donors* ; Consensus ; DNA ; Exons* ; Genotype ; Humans ; Introns* ; Polymerase Chain Reaction ; Red Cross ; Tissue Donors