No abstract available.
Adenocarcinoma*

BACKGROUND: Epinephrine used in surgery to provide hemostasis may elicit ventricular arrhythmias. A desirable anesthetic would not sensitize the myocardium to exogenously administered epinephrine. So the effect of sevoflurane, which was introduced to clinical anesthesia recently, on cardiac arrhythmias induced by the infusion of epinephrine was compared with those of halothane which was already known to epinephrine-induced arrhythmia in the 14 mongrel dogs. METHODS: The authors compared the arrhythmogenicity (three or more premature ventricular contractions, PVCs)of intravenously administered epinephrine in 14 mongrel dogs who were randomly assigned to receive sevoflurane (1.7 vol%) or halothane (0.75 vol%) anesthesia equipotently. The arrhythmogenic doses of epinephrine determined in this comparative study were expressed by both infusion rates of epinephrine during sevoflurane and halothane anesthesia. RESULTS: The mean values of the arrythmogenic infusion rates of epinephrine were 27.1 7.6 g/kg for sevoflurane and 2.7 0.8 g/kg for halothane. CONCLUSIONS: We concluded that the arrythmogenic doses of epinephrine during sevoflurane were significantly higher than those during halothane anesthesia.
Anesthesia* ; Animals ; Arrhythmias, Cardiac ; Dogs* ; Epinephrine* ; Halothane* ; Hemostasis ; Myocardium ; Ventricular Premature Complexes

Congenital tuberculosis is an infection that is established in the fetus by hematogenous spread or by the aspiration or inhalation of infected amniotic fluid either before or during labor. The diagnosis can be confirmed only if both the tuberculous nature of the lesion and the antenatal origin of the infection can be proved. The authors analysed roentgen findings of two cases of pulmonary tuberculosis, thought to be congenital; 1. Diffuse distribution of nodular densities and some confluent densities were seen in the entire lungs in the inital film.The pulmonary markings were decreased in some degree. 2. Air bronchogram was noted. 3. Hepatosplenomegaly was associated.
Amniotic Fluid ; Diagnosis ; Female ; Fetus ; Inhalation ; Lung ; Tuberculosis ; Tuberculosis, Pulmonary

Palisaded neutrophilic and granulomatous dermatitis (PNGD) is an uncommon skin eruption associated with immune-mediated connective tissue diseases such as rheumatoid arthritis, lupus erythematosus, and Behcet's disease. This condition is also described as Winkelmann's granuloma, linear subcutaneous bands, rheumatoid papules, rheumatoid neutrophilic dermatitis, interstitial granulomatous dermatitis with cutaneous cords and arthritis, or Churg-Strauss disease. PNGD shows variable clinical manifestations and is characterized histopathologically by step pattern of early leukocytoclastic vasculititis, progressing to form palisaded granulomatous inflammation, and surrounding zones of necrobiosis in the later stages. We report a 66-year-old woman with multiple skin nodules, who had concomitant rheumatoid arthritis. Histopathologic findings revealed palisaded neutrophilic and granulomatous dermatitis.
Aged ; Arthritis ; Arthritis, Rheumatoid ; Connective Tissue Diseases ; Dermatitis ; Female ; Granuloma ; Humans ; Inflammation ; Necrobiotic Disorders ; Neutrophils ; Skin

Background: The highly lipid soluble opioid, fentanyl, has a rapid onset and short duration of action. The present study was designed to examine the analgesic efficacy and side effects of the combination of fentanyl with morphine in patients using intravenous PCA. Methods: Patients were randomly assigned to receive one of three PCA regimens: M4 group (40 mg morphine+90 mg ketorolac+1.5 mg dorperidol), M2F2 group (20 mg morphine+200 ug fentanyl+90 mg ketorolac+1.5 mg dorperidol), or M2F4 group (20 mg morphine+400 ug fentanyl+90 mg ketorolac+1.5 mg dorperidol). All patients were given initial loading dose of 0.1 mg/kg morphine plus 1 mg droperidol at the end of surgery. Pain score, side effects, and overall satisfaction were assessed at 30 min, 1 hr, 8 hr, 24 hr, and 48 hr postoperatively. Results: The pain score was significantly higher in the M2F2 group than in the M4 group and M2F4 group during 1 hr and 8 hr postoperatively. The total opioid consumption was significantly greater in the M2F4 group than in the M4 group. Patient satisfaction was better in the M2F4 than other two groups. There were no differences in the overall incidence of side effects among three groups. Conclusions: The present results suggest that the combination of fentanyl with morphine for intravenous patient-controlled analgesia is a useful method, and the double dose of fentanyl in comparison with the equipotent morphine dose is recommended in the early postoperative period.
Analgesia, Patient-Controlled* ; Droperidol ; Fentanyl* ; Humans ; Incidence ; Morphine* ; Passive Cutaneous Anaphylaxis ; Patient Satisfaction ; Postoperative Period

Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon dermal angioproliferating tumor, characterized by red to brown papules or nodules on the head and neck, though also occurring in the mouth, trunk, extremities and inguinal area. The palm is a very unusual site for ALHE, and there have been very few cases reported globally thus far. ALHE can be pruritic and painful and histopathologic findings show vascular proliferation with infiltration of eosinophils and lymphocytes in the dermis. Plump endothelial cells protrude into the lumen. We report a case of ALHE occurring at an unusual site, the right palm, in a 62-year-old man, who had suffered from a solitary pinkish-colored, central depressed round hyperkeratotic plaque on his palm for 4 years. On the basis of clinical and histopathologic data, a diagnosis of ALHE was made. To our knowledge, this is the first report of ALHE on the palm in Korean dermatologic literature.
Angiolymphoid Hyperplasia with Eosinophilia ; Dermis ; Endothelial Cells ; Eosinophils ; Extremities ; Head ; Humans ; Lymphocytes ; Middle Aged ; Mouth ; Neck

PURPOSE: The aim of this study was to investigate attitudes toward death according to personality types and to suggest the need to develop related hospice programs. METHODS: Personality types were identified by the Korean version of the Myers-Briggs Type Indicator (MBTI) Form G. A questionnaire with 26 five-point Likert items was used to survey participants' attitudes toward death. RESULTS: The ESFP personality type was most common (20%) among available 100 participants. Significant differences were observed in the attitudes towards death preparation according to personality type s. Participants with personality preference types E, T and J showed positive attitudes (P<0.05) toward death, but no significant differences were shown based on the SN index. CONCLUSION: The attitudes toward death differed by personality types. Therefore, this study points to the need to develop diverse hospice programs based on the personality types.
Hospice Care ; Personality Inventory ; Surveys and Questionnaires

No abstract available.
Cerebrospinal Fluid Rhinorrhea ; Meningitis, Bacterial ; Rhinoplasty

BACKGROUND: Galectin-1 (Gal-1) is a member of the galectin family of proteins, which are carbohydrate-binding proteins with an affinity for beta-galactosides. Gal-1 is differentially expressed by various normal and pathological tissues and it performs polyvalent, wide-ranging biological activities. A Gal-1 expression or over-expression in tumors and/or in the tissue surrounding them must be considered as a sign of malignant tumor progression that is often related to tumor metastasis. Although Gal-1 also plays important roles for tumorigenesis and tumor progression, the expression of Gal-1 in melanocytic nevus, dysplastic nevus and malgant melanoma has not yet been investigated. OBJECTIVE: We wanted to investigate and compare the expression of Gal-1 in melanocytic nevus, dysplastic nevusand malignant melanoma. METHODS: The paraffin-embedded specimens of 9 cases of malignant melanoma (MM), 6 cases of dysplastic nevus (DN) and 6 cases of intradermal nevus (IN) were subjected to immunohistochemical staining for Gal-1. RESULTS: The percentage of positive cells for Gal-1 in the MM was significantly higher than that of the DN and IN (p<0.01). The staining intensity of the positive cells for Gal-1 was the highest also in the MM. Meanwhile Gal-1 was more strongly expressed in highly atypical (more pleomorphic, more atypical mitoses) areas of the melanoma tissues. But there was no significant difference between the DN and IN for the expression of Gal-1. LIMITATION: This study is restricted to a small number of patients. CONCLUSION: The present study suggests that Gal-1 is more strongly expressed in malignant melanoma than in melanocytic nevus and dysplastic nevus. Interestingly, Gal-1 was more strongly expressed in the highly atypical portions of the melanoma tissue. Gal-1 might well contribute to the tumorigenesis and malignancy of melanocytes.
Benzamides ; Cell Transformation, Neoplastic ; Dysplastic Nevus Syndrome ; Galectin 1 ; Galectins ; Humans ; Melanoma ; Neoplasm Metastasis ; Nevus, Intradermal ; Nevus, Pigmented ; Proteins ; Tyrosine

Since the first report by Berberich and Hirsch in 1923, conventional angiography had been playing essential roles in diagnosis and treatment in the field of Orthopedic Surgery. Angiography is still the most definitive method for evaluating arterial disease, and is also an invaluable aid in the diagnosis of certain abnormalities which characteristically alter the normal vascular pattern. But the clinical use of conventional angiography as a routine diagnostic study has been limited by the risk associated with arterial catheterization cost, and poor patient acceptance. With improvement of radionuclide angiography and development of the methods for the identification and amplification of signals from small quantities of intravascular administered iodinated contrast agent and their combination with image subtraction (so called digital subtraction angiography, DSA), we have partially substituted the DSA and Radionuclide angiography for conventional angiography in diagnosis and post-operative evaluation of orthopedic patients. We have analyzed and compared the 197 cases who had taken conventional angiography from August, 1981 to July, 1985, and 16 cases who had taken radionuclide angiography from January, 1983 to July, 1985, and 21 cases who had taken DSA from October, 1983 to July, 1985 in Department of Orthopedic Surgery, Seoul National University Hospital. The results were as follow: 1. Conventional angiography is the most reliable and most widely used method in diagnosis of peri pheral arterial disease and evaluating the distribution of peripheral circulation of patient who need arterial reconstruction. But the clinical use of the angiography has been limited by the risk of complications. 2. DSA is simple, relatively non-invasive and can be done in out-patient basis. DSA is particulary useful and can replace the conventional angiography in post-operative assessment of peripheral vascular reconstruction, in the assessment of blunt and penetrating peripheral arterial trauma, and in the evaluation of peripheral aneurysm and vascular malformation. 3. Radionuclide angiography is also simple, and has no morbidity and useful in the patients who may be allergic to the contrast medium. Radionuclide angiography is useful in the evaluation of obstruction of major artery, deep vein thrombosis, and in repeated post-operative evaluation of arterial reconstruction.
Aneurysm ; Angiography ; Angiography, Digital Subtraction ; Arteries ; Catheterization ; Catheters ; Diagnosis ; Extremities ; Humans ; Methods ; Orthopedics ; Outpatients ; Radionuclide Angiography ; Seoul ; Vascular Malformations ; Venous Thrombosis