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*

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

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*

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

This is pilot study to evaluate the relationship of physical fitness with age, body fat, work pattern and life style among 20-9 aged male workers (n=417). Physical fitness was measured by maximum oxygen uptake, forced vital capacity, 1 second forced expiratory volume, grip strength, back strength, sit ups and trunk flexion. Life style was self-reported on a questionnaire about regular exercise, smoking, alcohol consumption, coffee consumption, degree of stress, and percent of body fat measured by bioelectrical impedance fat meter. Age was significantly and negatively related to physical fitness except grip strength. Obesity was next to most significant factor for physical fitness, it was associated with maximum oxygen uptake, grip strength, back strength, trunk flexion. Regular exercise was associated with maximum oxygen uptake. Others was insignificantly related to physical fitness. Performance of physical fitness test was significantly correlated with age, obesity and regular exercise.
Adipose Tissue* ; Alcohol Drinking ; Coffee ; Electric Impedance ; Forced Expiratory Volume ; Hand Strength ; Humans ; Life Style* ; Male* ; Obesity ; Oxygen ; Physical Fitness* ; Pilot Projects ; Questionnaires ; Smoke ; Smoking ; Vital Capacity

BACKGROUND: Hepatitis C virus (HCV) is a major agent of transfusion-associated non-A, non-B hepatitis. The best method for prevention of HCV infection through transfusion is blood donor screening using reliable diagnostic tools. Enzyme immunoassays (EIA) for detection of HCV antibody were developed, but it required equipment and time consuming. In emergency situation such as massive bleeding, HCV screening of blood donor needs more simple, rapid and reliable method. Recently, for rapid detection of HCV antibody, Genedia HCV Rapid assay was developed. To evaluate the usefulness of this assay, comparative studies with third generation anti- HCV EIA and two HCV confirmatory tests (Genedia HCV Confirm 4.0 and Chiron RIBA HCV 3.0 SIA) were performed. METHODS: A total of 156 sera (106 positive and 50 negative), screened by second generation IMx anti-HCV assay (Abbott 2.0; Abbott Laboratories, U.S.A.), were examined with Genedia HCV Rapid (Green Cross, Korea) and Genedia HCV ELISA 3.0 (Green Cross, Korea). The discrepant sera between Genedia HCV Rapid and Genedia HCV ELISA 3.0 were confirmed by both Genedia HCV Confirm 4.0 and Chiron RIBA HCV 3.0 SIA. RESULTS: The concordance rates of Abbott 2.0 vs Genedia HCV Rapid, Abbott 2.0 vs Genedia HCV ELISA 3.0, and Genedia HCV Rapid vs Genedia HCV ELISA 3.0 were 88.4%, 89.7%, and 96.1%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of Genedia HCV Rapid for Genedia HCV Confirm 4.0 were 97.7%, 100%, 98.9%, and 97.0%, respectively, and for Chiron RIBA HCV 3.0 SIA 97.8%, 98.5%, 98.9%, and 97.0%, respectively. Of discrepant 6 sera between Genedia HCV Rapid and Genedia HCV ELISA 3.0, 2 were positive by Genedia HCV Confirm 4.0, and 3 positive by Chiron RIBA HCV 3.0 SIA. However, 14 negative sera by both Genedia HCV rapid and Genedia HCV ELISA 3.0, which were all positive by Abbott 2.0, were all negative by two confirmatory tests. CONCLUSIONS: These data show that Genedia HCV Rapid could be used in emergency blood donor screening for HCV antibody detection.
Blood Donors ; Emergencies ; Enzyme-Linked Immunosorbent Assay ; Hemorrhage ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans ; Immunoenzyme Techniques ; Mass Screening ; Sensitivity and Specificity