BACKGROUND: Although a laparoscopic cholecystectomy results in less pain than an open cholecystectomy, it is not a pain-free procedure. A controversy exists over the effectiveness and clinical value of intraperitoneal local anesthetics for treating pain after a laparoscopic cholecystectomy. We investigated the effects of intraperitoneal lidocaine on pain after a laparoscopic cholecystectomy. METHODS: Forty patients were randomly assigned to receive 200 ml saline containing 200 mg lidocaine or the same volume of saline instilled under the right hemidiaphragm and cholecystectomy site at the end of surgery. Intensity of abdominal and shoulder pain were assessed 0, 1, 6, 12, 24 and 48 hours after surgery and recorded on a visual analog scale (VAS) and verbal rating scale (VRS). RESULTS: The abdominal pain scores (VAS and VRS) were significantly lower in the lidocaine group than the control group at 0 - 24 hours after surgery (P < 0.05). The shoulder pain scores and incidence were significantly lower in the lidocaine group than the control group at 6 - 12 hours after surgery. In the lidocaine group, the incidence of epigastric and right flank pain were significantly lower than the control group. CONCLUSIONS: Intraperitoneal instillation of lidocaine significantly reduces shoulder and abdominal pain for 24 hours after a laparoscopic cholecystectomy.
Abdominal Pain ; Anesthetics, Local ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Flank Pain ; Humans ; Incidence ; Lidocaine* ; Pain, Postoperative ; Shoulder Pain* ; Shoulder* ; Visual Analog Scale

Respiratory distress syndrome(RDS) in the newborn infants is a problem of great importance, not only to the obstetrician and pediatrician but also to the anesthesiologist. RDS is a frequent result of premature birth and occasionally occurs in full term infants. The need for estimation of fetal maturity by amniocentesis is especially indicated when early termination of pregnancy is required in cases of diabetes, Rh sensitization, hypertensive, poor obstetrical history and onset of premature labor, when the decision to attempt to stop labor must be made. A Foam-stability test was performed on 54 samples of amniotic fluid to assess its practical value as a rapid method of confirming adequate surface activity in the neonatal lung. The results of the test were compared with the lecithin-sphingomyelin ratio, gestational age, birth weight and clinical RDS. The results obtained were as follows: 1) Of the 46 cases with the foam test positive, none of the new born infants developed clinical RDS and their mean L/S ration was 3.6+/-0.2. 2) All of the newborn infants with the foam test negative developed clinical RDS and their mean L/S ration was 1.5+/-0.2. 3) In 5 cases with an intermediate test, one who had L/S ration 2.0 showed mild and transient clinical RDS. 4) These results suggest that the foam test is a reliable index of neonatal lung maturity and high predictive value for RDS, when applied to uncontaminated amniotic fluid.
Amniocentesis ; Amniotic Fluid ; Birth Weight ; Female ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Lung* ; Obstetric Labor, Premature ; Pregnancy ; Premature Birth ; Rh Isoimmunization

No abstract available.
Echocardiography* ; Heart Valves* ; Humans

We present an unusual case in which a patient was diagnosed with the preeclampsia associated with a partial hydatidiform mole and bilateral theca-lutein cysts. The patient newly developed proteinuric hypertension at 16 weeks' gestation. Ultrasound findings showed small multiple cystic spaces in the placenta and a live singleton fetus. Triploid 69, XXX was confirmed at karyotype analysis. Intrauterine fetal death was found at 18 weeks' gestation and termination of pregnancy was performed, and a partial hydatidiform mole was confirmed at pathologic examination. Torsion of bilateral theca-lutein cysts was developed at postpartum one week. Detorsion and aspiration of the bilateral theca-lutein cysts were performed under the laparoscopy.
Female ; Fetal Death ; Fetus ; Humans ; Hydatidiform Mole ; Hypertension ; Karyotype ; Laparoscopy ; Placenta ; Postpartum Period ; Pre-Eclampsia ; Pregnancy ; Triploidy

The purpose of this study was to evaluate the effects of repeated fasting and refeeding on lipid metabolism. Thirty male ICR mice, aged 6 weeks, were fed an AIN-93 control diet during the experimental period. The mice were divided into 5 groups: Non fasting group (ad libitum-fed, NF), fasting for 3 days (F), fasting for 3 days and then refeeding for 4 days repeated once (FRF1), fasting for 3 days and then refeeding for 4 days repeated twice (FRF2), and fasting for 3 days and then refeeding for 4 days repeated three times (FRF3). Rates of body weight gain, epididymal fat weight, and serum TG were significantly decreased in the F, FRF1, FRF2, and FRF3 groups, compared to the NF group. LDL-cholesterol was significantly higher in the FRF3 group than the NF and F groups, but HDL-cholesterol and HDL/TC were significantly lower in the FRF3 group than in the NF and F groups. Serum total carnitine was significantly lower in the FRF1, FRF2, FRF3 groups than the NF and F groups. However, rates of serum and hepatic acyl-carnitine concentration were significantly lower in FRF1, FRF2, and FRF3 than in NF and F. Repeated fasting-refeeding resulted in visible reductions of body weight and fat mass, but it caused ill-effects with lipid and carnitine metabolism in the body.
Adipose Tissue ; Aged ; Animals ; Body Weight ; Carnitine ; Diet ; Fasting ; Humans ; Lipid Metabolism ; Male ; Mice ; Mice, Inbred ICR ; Obesity

The surgical closure of VSD in patient with severe pulmonary hypertension has been considered a difficult problem for surgeons, because sudden hemodynamic change after closure of the defect could bring on high perioperative mortality. Recently, it was reported that UVP (unidirectional valve patch), which allows some blood to flow from right to left in case of acute right heart failure, is effective in improving the postoperative hemodynamics after closing septal defects. This 42-year old woman had suffered from VSD for 20 years and recently complained of worsening exertional dyspnea for three months, and was diagnosed of a large VSD (2.0 cm in diameter) with severe pulmonary hypertension (116/38 mm Hg), equal to systemic arterial pressure. We could successfully close VSD with severe pulmonary hypertension using one UVP and the other UVP for the creative ASD to be prepared against possible acute right heart failure. She was discharged on the fourteenth postoperative day and has been well for twelve months with spontanenous closure of UVP patch at the ninth postopeative month.
Adult ; Arterial Pressure ; Dyspnea ; Female ; Heart Failure ; Heart Septal Defects ; Heart Septal Defects, Ventricular* ; Hemodynamics ; Humans ; Hypertension, Pulmonary* ; Mortality

We performed thoracoscopic resection for diagnosis in a 41 year-old-female presenting with multiple pulmonary nodules in both lung fields, which was detected incidentally on routine chest x-ray and followed by additional exmaminations including chest CT scan and percutaneous needle aspiration biopsy under the presumptive diagnosis of metastatic cancer. During thoracoscopy, the result of the frozen section analysis of multiple masses revealed strong evidence of leiomyoma. In her past medical history, she had undergone myomectomy, and hysterectomy, 7 years ago and 10 years ago, respectively. Based on permanent, special staining of specimen, estrogen receptor assay and review of past specimen of uterine myoma, the final diagnosis was benign metastasizing leiomyomata from uterine myoma, the report was very uncommon in Korean and English literatures. The patient has been followed up for 2 years without special therapy, such as hormonal therapy.
Biopsy, Needle ; Diagnosis ; Estrogens ; Frozen Sections ; Humans ; Hysterectomy ; Leiomyoma* ; Lung Neoplasms ; Lung* ; Multiple Pulmonary Nodules ; Needles ; Thoracoscopy ; Thorax ; Tomography, X-Ray Computed

Pyothorax-associated lymphoma is a distinct type of malignant lymphoma composed of lymphocytes, mostly of a B-cell nature. It occurs in patients with a long history of pyothorax and is strongly associated with Epstein-Barr virus infection. We experienced a case of pyothorax-associated lymphoma in a 66-year-old male. The patient had chronic pyothorax after tuberculous pleurisy was treated about 37 years earlier and was hospitalized for a recently occurring chest wall mass. A core needle biopsy of the chest wall mass led to a diagnosis of diffuse large B-cell lymphoma. Pyothorax-associated lymphoma is rare in Korea, but should be considered in patients with chronic pyothorax and a recently occurring pleural mass.
Aged ; B-Lymphocytes ; Biopsy, Large-Core Needle ; Empyema ; Empyema, Pleural ; Herpesvirus 4, Human ; Humans ; Korea ; Lymphocytes ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Primary Effusion ; Male ; Thoracic Wall ; Tuberculosis, Pleural

Pyothorax-associated lymphoma is a distinct type of malignant lymphoma composed of lymphocytes, mostly of a B-cell nature. It occurs in patients with a long history of pyothorax and is strongly associated with Epstein-Barr virus infection. We experienced a case of pyothorax-associated lymphoma in a 66-year-old male. The patient had chronic pyothorax after tuberculous pleurisy was treated about 37 years earlier and was hospitalized for a recently occurring chest wall mass. A core needle biopsy of the chest wall mass led to a diagnosis of diffuse large B-cell lymphoma. Pyothorax-associated lymphoma is rare in Korea, but should be considered in patients with chronic pyothorax and a recently occurring pleural mass.
Aged ; B-Lymphocytes ; Biopsy, Large-Core Needle ; Empyema ; Empyema, Pleural ; Herpesvirus 4, Human ; Humans ; Korea ; Lymphocytes ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Primary Effusion ; Male ; Thoracic Wall ; Tuberculosis, Pleural

The most common recurrent cytogenetic abnormalities in T-lymphoblastic leukemia (T-acute lymphoblastic leukemia [T-ALL]) involve T-cell receptor (TCR) loci and a variety of partner genes, including HOX11, HOX11L2, MYC, and TAL1. In this report, we present a rare case involving simultaneous translocation of the TCR alpha/delta loci with different partner loci (Xq22 and 12p13); this resulted in a poor prognosis. Chromosomal analysis showed 46,Y,t(X;14)(q22;q11.2),t(12;14)(p13;q11.2) and FISH analysis by using a T-cell receptor alpha delta DNA probe, Split Signal (DakoCytomation, Denmark), showed translocations at the same TCR alpha/delta locus on both chromosomes. FISH with 2 bacterial artificial chromosome clones showed break apart signal, which suggests involvement of the IRS4 gene. To our knowledge, this is the first report of T-ALL in which both TCR alpha/delta loci were translocated with different partner loci, and 1 of the partner loci, Xq22, was a rare translocation partner locus that included IRS4 gene.
Adult ; Chromosomes, Human, Pair 12 ; Chromosomes, Human, Pair 14 ; Chromosomes, Human, X ; Genetic Loci ; Humans ; Insulin Receptor Substrate Proteins/genetics ; Karyotyping ; Male ; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma/*genetics/pathology ; Receptors, Antigen, T-Cell/*genetics ; *Translocation, Genetic