BACKGROUND: Tracheal intubation for general anesthesia often leads to trauma of the airway mucosa, resulting in postoperative sore throat and hoarseness. Numerous studies have investigated the factors as contributing causes, but the influence of method of anesthesia induction and time for extubation of the endotracheal tube has not been systematically examined. The aim of this study was to establish the effects of the methods of anesthesia induction and timing of extubation on postoperative sore throat and hoarseness. METHODS: Eighty patients with ASA physical status 1 or 2 were randomly divided into four groups. Group 1 patients (n=20) recieved succinylcholine 1.0 mg/kg for intubation and early extubated ; group 2 patients (n=20) recieved succinylcholine 1.0 mg/kg for intubation and lately extubated ; group 3 patients (n=20) recieved pancuronium 0.1 mg/kg for intubation and early extubated ; group 4 patients (n=20) recieved pancuronium 0.1 mg/kg for intubation and lately extubated. All patients were interviewed 6, 24, 48, and 72 hrs after operation by an anesthesiologist in a double-blind manner. RESULTS: The incidence of sore throat at postoperative 6 and 24 hrs were decreased in group 3 compaired with group 1, 2, and 4 (p<0.05), respectively. The severity of sore throat at postoperative 6 hrs were decreased in group 3 compared with group 1, 2 and 4 (p<0.05), and that of postoperative 24 hrs were decreased in group 3 compared with group 1 and 2 (p<0.05), respectively. The severity of hoarseness at postoperative 6 hrs were decreased in group 3 compared with group 2 (p<0.05). CONCLUSIONS: We suggest that postoperative sore throat and hoarseness may be developed more when extubation was perfomed lately than early. Therefore, early extubation provide advantage in terms of reducing sore throat and hoarseness in limited cases of anesthesia.
Anesthesia* ; Anesthesia, General ; Hoarseness* ; Humans ; Incidence ; Intubation ; Mucous Membrane ; Pancuronium ; Pharyngitis* ; Succinylcholine

There are some reports showing that an experience of long-enduring pain causes a change in the pain transmission system, suggesting a plastic nature of the nociceptive system. However, most of the studies concerning the analgesic effect of peripheral nerve stimulation dealt with normal animal or human subjects. So, the present study was undertaken to investigate the effect of peripheral nerve stimulation on the dorsal horn cell activity using a tonic pain model, which was made by producing a cutaneous inflammation. The main results are summarized as follows. 1) The evoked activity by electrical or natural stimulation as well as spontaneous activity was enhanced, and the receptive field size was also expanded by the inflammation. 2) Peripheral nerve conditioning stimulation reduced the C-response of the dorsal horn cell in the normal and inflamed group, and the degree of inhibition between the two groups showed no significant difference. 3) Inhibition of the C-response of the dorsal horn cells by peripheral conditioning stimulation was completely reversed by naloxone in the inflamed group whereas there was a partial block in the normal group.
*Analgesia ; Animal ; Cats ; Dermatitis/*physiopathology ; *Electric Stimulation Therapy ; Endorphins/physiology ; Female ; Genes, fos ; Male ; Naloxone/pharmacology ; Nerve Fibers/physiology ; Peripheral Nerves/*physiology ; Support, Non-U.S. Gov't

We report a case of tufted folliculitis which developed in a 33-year-old woman. Tufted folliculitis is a rare condition, characterized by a peculiar tufting of hair within areas of scarring alopecia. Histologically, it is characterized by a superficial folliculitis that involves several follicles opening into a common ostium from which multiple hairs come out. Some pathogenetic mechanisms have been proposed to explain the development of tufted folliculitis, but exact mechanism has not been found. Up to now, about 22 reports have been reported, and most of them were cases of westerners is has been reported only once in Korea. So, we report herein a Korean woman with tufted folliculitis of scalp.
Adult ; Alopecia ; Cicatrix ; Female ; Folliculitis* ; Hair ; Humans ; Korea ; Scalp

Kaposi's sarcoma was first descrided by Kaposi in 1872 as an idiopathic multiple hemorrhagic sarcoma. Its clinical features revealed to be erythematous red or purple macule started out, and developing into palpable dome-shaped nodules. Etiology is not defined to detail at present. Kaposi's sarcoma is classified to 4 categories; Classical, African, Epidemic and Transplant type. Epidemic or AIDS categories is found approximately 20 % of all AIDS and has strong predilection for head and neck region. The first case of Kaposi's sarcoma observed in patients with kidney transplants was reported in 1969. Kaposi's sarcoma now accounts for 5% of all tumors associated with transplanted patients and alteration of the immunosuppression may have played a key role in these recipients. The most common site of Kaposi's sarcoma in transplanted patients are extremities but rare in head and neck area. We report a case of Kaposi's sarcoma on the hard palate in the kidney transplantation patient.
Extremities ; Head ; Humans ; Immunosuppression ; Kidney ; Kidney Transplantation ; Mouth* ; Neck ; Palate, Hard ; Sarcoma ; Sarcoma, Kaposi*

No abstract available.
Amnion* ; Hydrocortisone* ; Pregnancy*

PURPOSE: To assess the diagnostic efficacy of macular and peripapillary retinal thickness measurements for the staging of diabetic retinopathy (DR) and the prediction of disease progression. METHODS: In this prospective study, 149 diabetic patients (149 eyes) and 50 non-diabetic control subjects were included. Baseline optical coherence tomography was employed to measure retinal thickness in the macula (horizontal, vertical, and central) and the peripapillary zone (superior, inferior, nasal, and concentric to the optic disc). Seven baseline parameters were correlated with the DR stages identified by fluorescein angiography. Baseline retinal thickness was compared between groups of patients requiring panretinal photocoagulation (PRP) within 6 months (PRP group) and patients not requiring PRP (No-PRP group). RESULTS: Macular and peripapillary retinal thicknesses in diabetic subjects were significantly greater than that in normal controls (p<0.05). All retinal thickness parameters, and particularly peripapillary circular scans, tended to increase with increasing DR severity (p<0.05). The baseline thicknesses of the peripapillary circular scans were greater in the PRP group than in the no-PRP group (p<0.05). CONCLUSIONS: Peripapillary retinal thickness may prove to be a useful criterion for DR severity and may also serve as an indicator of disease progression.
Aged ; Diabetic Retinopathy/*diagnosis/surgery ; Disease Progression ; Female ; Fluorescein Angiography ; Humans ; Light Coagulation ; Male ; Middle Aged ; Optic Disk ; Prospective Studies ; Retina/*pathology/surgery ; *Severity of Illness Index ; *Tomography, Optical Coherence

This paper presents the result and statistical analysis of the experiment, in which selective anterior or posterior rhizotomy were carried out under microscopic surgery. The materials used for the experiment were 48 young rabbits, and they were divided into four groups. The group I, which was used as control, was subjected to lower dorsal bilateral laminectomies with dural incision, the group II to laminectomies with three right posterior rhizotomies, the group III to laminectomies with three right anterior rhizotomies, and the group IV to laminectomies with three right anterior and posterior rhizotomies. Scoliosis was induced in group Il, Ill and IV. There was no significant statistical difference in the degrees of curvatures among these three groups. The convexity of the curvature faced to the side of the divided roots. In group III and IV, scoliotic curvatures were obvious within two weeks, but there were no considerable changes thereafter. In group Il, the curves progressed slowly up to the 12th week. They were statistically significant at the 4th week and increased continuously thereafter. The histological findings in the group III and IV showed denervation atrophy of the paravertebral muscles at the apex of the curvature, but there was little or no muscle atrophy in the group I and II. We came to a conclusion from the experimental results that scoliosis may be induced not only by anterior root paralysis but also by selective posterior root paralysis.
Atrophy ; Denervation ; Laminectomy ; Muscles ; Muscular Atrophy ; Paralysis ; Rabbits ; Rhizotomy ; Scoliosis

This review of upper cervical spine injuries includes 51 patients admitted to Korea University Hospital, Seoul during the period 1 Jan. 1990 to 31 Dec. 1994. The incidence of upper cervical injury was 13.6% in the 375 spine injury cases and 31.7% in the 161 cervical spine injuries. The most common type of injury was odontoid fracture, ie. 16 cases or 31.3%. The male-to-female ratio was 2.6:1 and the 4th decade showed peak incidence. 33 cases(64.7%) of the injuries were caused by traffic accidents. The chief complaints on admission were neck pain with limited range of motion in 39 cases(76.5%), motor weakness in 3 cases(5.9%), and sensory disturbance in 2 cases(3.9%). Operative treatment was performed in 23 patients resulted in neurologic improvement in 22 Cases(95.7%) and 28 patients were managed by conservative treatment with 25 cases(89.3%) of neurologic improvement. Mortality rate of the upper cervical spine injury was 3.9%. The above represents our experience with 51 patients suffering from upper cervical injuries. Management and follow-up guidelines are also reviewed.
Accidents, Traffic ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Mortality ; Neck Pain ; Range of Motion, Articular ; Seoul ; Spine*

Spontaneous intracerebral hemorrhage(ICH) is one of the most common neurosurgical disorders associated with high morbidity and mortality. However, the treatment of the disease remains controversial. While aggressive removal of the blood clot is advocated by some, supportive care without clot removal is recommended by others. This dichotomy in therapeutic approaches undoubtedly derives from a poor understanding of the pathophysiological mechanisms that result in brain injury following intracerebral hematoma. Thus, effective animal model of intracerebral hematoma is necessary so that the injury mechanisms can be identified and the specific therapy developed. In an attempt to establish the highly reliable and reproducible experimental model of intracerebral hematoma, various amount(sham. 25microliter, 50microliter and 100microliter) of autologous blood was injected stereotactically into the left basal ganglia of the anesthetized rats. 16 Sprague-Dawley rats were divided into 4 groups. The sham operation and injections of 25microliter, 50microliter and 100microliter of autologous arterial blood were performed on each group. The animals were assessed for the size and pattern of the hematoma and the neurological outcome at 24 hours after the formation of intracerebral hematomas. The 25microliter-injection group showed the more reproducible size and shape of the hematoma confined to the basal ganglia with better neurological outcome, Additionally, the perihematomal ischemic zone was observed after intracardiac perfusion with 2% 2,3,5-triphenyltetrazolium chloride(TTC). Another 18 rats were assessed for the histopathological changes during the hyperacute stage of the intracerebral hematoma with Hematoxylin-Eosin staining. Finally another 24 rats were divided into 6 groups and injected with 25microliter of blood. They underwent intravenous infusion of Evans blue and were sacrificed at 1, 3, 6, 12, 24 and 72 hours after the formation intracerebral hematomas. The Evans blue extra asation was noted around the needle tract and hematoma that meant disruption of the blood-brain barrier. Significant increment of the water content with resultant brain edema was noted on the ipsilateral brain 6-12 hours after the formation of the intracerebral hematoma.
Animals ; Basal Ganglia ; Blood-Brain Barrier ; Brain ; Brain Edema ; Brain Injuries ; Evans Blue ; Hematoma* ; Infusions, Intravenous ; Models, Animal ; Models, Theoretical* ; Mortality ; Needles ; Perfusion ; Rats* ; Rats, Sprague-Dawley

The content of meconium in amniotic fluid(AF) is important for assessing the risk of several perinatal problems such as asphyxia, meconium aspiration syndrome and various perinatal infections. This estimate is usually performed subjectively by visual inspection. The purpose of this study is to develop the objective method for quantitative measurement of meconium content in AF. Absorption spectra and meconium-crit of the solutions with various concentrations of meconium were measured. EfFects of filtration and blood contamination on the measurement of meconium content were also estimated by the same methods. Optical densities(OD) were correlated with concentrations of meconium in the whole range of scanned wavelengths. A specific peak of meconium was not available but the highest OD around 410 nm was shown. OD were linearly related to the concentrations of meconium. Meconium-crits were also well-correlated with the concentrations of meconium. Filtration of AF as well as blood contamination in AF severely affected the measurement of meconium content in AF. From the results of this study, both the spectrophotometric method and meconium-crit couid be objective methods for measuring meconium content. Both methods had merits and shortcomings. Filtration and blood contamination should be avoided for the measurement of meconium content in AF. We hope that both or either one of the two methods will be clinically used.
Absorption ; Amniotic Fluid* ; Asphyxia ; Female ; Filtration ; Hope ; Infant, Newborn ; Meconium Aspiration Syndrome ; Meconium*