The results of ABO blood typing in 64-year-old patient with chronic renal and heart failure were positive with anti-B, delayed and weak positive with anti-A in the slide method for the cell typing, mixed-field agglutiniation by light microscopy in the tube method for the cell typing, and also was negative in anti-A, lectin and positive in anti-H, therefore blood typing of this patient was confirmed to A3B.
Blood Grouping and Crossmatching ; Heart Failure ; Humans ; Microscopy ; Middle Aged

We report computed tomography (CT) and magnetic resonance (MR) findings of a patient with polyostotic Paget disease and multicentric giant cell tumor (GCT). Brain CT scan showed widening of diploic space, cortical thickening and enhancing soft tissue mass in occiput with underlying calvarial destruction. Ill-defined soft tissue masses were also detected in maxillary sinus and buttock with underlying bony destruction on CT. MR image showed multifocal nodules in wide diploic space with low signal intensity on T1 -weighted image and bright signal intensity on T2-weighted image. Mass in occiput showed homogeneous hypointensity to bone marrow on T1-weighted image and homogeneous iso- intensity on T2-weighted image. Multiple nodules in diploic space and occipital mass showed contrast enhancement following administration of Gd-DTPA. Biopsy was performed at scal p, maxillary sinus and buttock, and histologic analysis revealed GCT.
Biopsy ; Bone Marrow ; Brain ; Buttocks ; Gadolinium DTPA ; Giant Cell Tumors* ; Giant Cells* ; Humans ; Maxillary Sinus ; Tomography, X-Ray Computed

For anesthesia of sixty children undergoing elective tonsillectomy, we randomly assigned the patients as 2 groups, intravenous propofol for induction and 6-12 mg/kg/hr propofol infusion with 66% nitrous oxide for maintenance(propofol group) or intravenous 4 mg/kg thiopental for induction and inhalation of enflurane with 66% nitrous oxide for maintenance(enflurane group). We compared the effects of two groups for induction time, hemodynamic change, recovery time, and side effects. The results were as follows. 1) Time for loss of eyelid reflex was significantly shorter in enflurane group than in propofol group(P <0.05). 2) Heart rate was increased significantly in both groups at 1 min after intubation, 1 min after operation, 5min after end of operation(P< 0.05). But there were no significant differences between groups. 3) Systolic and diastolic arterial pressure were increased significantly in both groups at 1 min after intubation(P<0.05). But there were no siginificant differences between groups. 4) The recovery time was shorter siginificantly in propofol group than in enflurane group(P< 0.05), and recovery scores according to modified Steward coma scale were higher in propofol group than in enflurane group until 25 min after end of anesthesia(P< 0.05). 5) Pain on injection at induction was siginificantly more frequent in propofol group than in enflurane group(P< 0.05), and excitatory effect during emergence was significantly more frequent in enflurane group than in propofol group(P< 0.05).
Anesthesia ; Arterial Pressure ; Child* ; Coma ; Enflurane* ; Eyelids ; Heart Rate ; Hemodynamics ; Humans ; Inhalation ; Intubation ; Nitrous Oxide ; Propofol* ; Reflex ; Thiopental ; Tonsillectomy*

PURPOSE: We sought to determine how the initial concentration of triamcinolone acetonide injected intravitreally might influence the clearance and residual period of the intravitreal triamcinolone acetonide. METHODS: Sixty-four eyes of 32 rabbits were divided into 4 groups. Each group was injected with 5, 10, 15, or 20 mg/0.1 ml of triamcinolone acetonide intravitreally. At 1, 7, 14, and 28 days after intravitreal injection, four eyes were obtained from each group by sacrificing two rabbits. The vitreous bodies were obtained and prepared for HPLC analysis. The concentrations of triamcinolone acetonide were quantitated by HPLC with fluorescence detector. We compared the data using the logarithmic regression coefficients of each line. RESULTS: The elimination half-lives of the intravitreal triamcinolone acetonide were 3.23 days, 3.73 days, 4.11 days, and 4.98 days at the initial injection doses of 5, 10, 15, and 20 mg per 0.1 ml, respectively. Compared to the 5 mg initial dose, the clearance rate of the intravitreal triamcinolone acetonide was decreased 1.15 times, 1.27 times and 1.55 times at 10 mg, 15 mg, and 20 mg of the initial dose, respectively. CONCLUSIONS: The residual duration of intravitreal triamcinolone acetonide was prolonged as the initial concentration of intravitreal injection increased. Furthermore, the clearance rate decreased as the injection dose is increased. This shows that higher injection doses of triamcinolone acetonide induce not only an increased intravitreal concentration, but also prolonged the duration of effectiveness.
Chromatography, High Pressure Liquid ; Fluorescence ; Intravitreal Injections ; Rabbits ; Triamcinolone Acetonide ; Triamcinolone* ; Vitreous Body

Spinal and epidural anesthesia were performed with a 26 gauge, long spinal needle through a 17 gauge Tuohy needle in thirty patients undergoing elective Caesarian section. To study the effects of subarachnoid local anesthetic solution, the thirty patients were classified into 3 groups on the anesthetics used respectively; a group treated with 0,5% hyperbaric tetracaine 10 mg alone (group I), a group treated 0.5% hyperbaric tetracaine 10 mg and fentanyl 10 mg (group II), a group treated 0.5% hyperbaric tetracaine 10 mg, fentanyl 10 ug and epinephrine 0.3 mg (group III). Each group contained 10 patients. The results were as follows. 1) Onset time of analgesia to T10 sensory level was significantly longer in group IlI than in remained groups and that to T4 sensory level was significantly shorter in group II than in other groups (p<0.05). 2) The time recovered from motor and sensory block was significantly longer in group III than in other groups (p<0.05). 3) The time requiring fentanyl from postoperative pain was significantly longer in group III than in other groups (p<0.05). 4) Complications after postoperative pain block were as follows; delayed awakening (3 cases), itching (3 cases), and one was nausea and vomiting. However serious complications such as respiratory depression did not occurred. In summary, We can concluded that use of needle-through-needle method of anesthesia for elective Caesarian section has benifits not only of spinal anesthesia but also of facilitating postoperative pain block.
Analgesia ; Anesthesia ; Anesthesia, Conduction* ; Anesthesia, Epidural ; Anesthesia, Spinal ; Anesthetics ; Epinephrine ; Fentanyl ; Humans ; Nausea ; Needles ; Pain, Postoperative ; Pruritus ; Respiratory Insufficiency ; Tetracaine ; Vomiting

In a placebo-controlled trial, we have studied the vasodilator properties of bolus dose of nitroglycerin, isosorbide dinitrate and chlorpromazine in 38 patients during cardiopulmonary bypass with a constant pump flow. Mean arterial pressure and blood volume of the venous reservoir were recorded for 10 min after drug administration to detect changes in arteriolar resistance and venous capacitance, respectively. Nitroglycerin, 2.5 ug/kg, decreased arterial pressure, but the effect lasted for 3 minutes. Chlorpromazine, 0.1 mg/kg, decreased arterial pressure for 9 minutes. Isosorbide dinitrate, 20 ug/kg, had no significant change on arterial pressure. The venous capacitance-increasing effects of nitroglycerin and chlorpromazine were significant for 4 minutes after the bolus. Thereafter the effect of nitroglycerin began to decline, while that of chlorpromazine significantly continued. Isosorbide dinitrate had no significant change on venous reservoir level. The SVR reduction effects of nitroglycerin was significant for 3 minutes, chlorpromazine decreased SVR for over 10 minutes. In conclusion chlorpromazine effect on arterial pressure and venous capacitance was more potent and longer than nitroglycerin and isosorbide dinitrate. Nitroglycerin and chlorpromazine effect on preload and afterload were significant after bolus dose.
Arterial Pressure ; Blood Volume ; Cardiopulmonary Bypass ; Chlorpromazine* ; Humans ; Isosorbide Dinitrate* ; Isosorbide* ; Nitroglycerin* ; Vascular Access Devices

Spinal anesthesia has been safely and reliably performed in minor pediatric surgery. Preterm infants are more likely to develop respiratory or cardiovascular complications after general anesthesia than full tern infants. This regional anesthesia may offer special advantages for surgical procedures such as inguinal hernia repair in former premature infants with a history of apnea and bradycardia of prematurity. Spinal anesthesia was done in sixty seven infants and children under 15 years of age, who were to undergo minor abdominal and lower extremity orthopedic procedure. In all cases 0.25 mg/kg of 0.5% hyberbaric tetracaine was injected into subarachnoid space. Age-related 4 groups (0~1, 1~6, 6~12, 12~15 years-old) were divided. The depth of lumbar puncture, sensory block, hemodynamic changes, status of sedation, duration of anesthesia, complication following spinal anesthesia were observed. The results were as follows; 1) Lumbar puncture was successed in 66 cases(98.5%), but failed in 1 case(1.5%). 2) The highest correlation in depth of lumbar puncture was with body-surface area(y=1.19+2.06x, r=0.956, p<0.001). 3) The mean height of sensory block in all age-related groups was similar between T(5) to T(6) skin dermatome. 4) Chidren less than 6 years of age showed a little changes in blood pressure and heart rate following spinal anesthesia. But children more than 6 years of age had widely varible decreases in blood pressure and heart rate, and recieved ephedrine(4 cases) or atropine(2 cases). 6) 55 cases(82.1%) required sedation with midazolam or propofol, 8 cases(10.6%) required general anesthesia to complete operative procedure. 7) The time needed to regain motor funtion increased with age (y=1.04+/-O.llx, r=0.952, p<0.001). 8) Preoperative complications were bloody tap (5 cases), hypotension (14 cases), bradycardia (6 cases), nausea or vomiting (4 cases), insufficient analgesia (2 cases), and failed tap (1 case). Postoperative complication was nonspecific postdural puncture headache (1 case). From the above results, it was suggested that spinal anesthesia without use of potent inhalational anesthetics in minor pediatric surgery is one of useful method under meticulous monitoring and observation.
Analgesia ; Anesthesia ; Anesthesia, Conduction ; Anesthesia, General ; Anesthesia, Spinal* ; Anesthetics ; Animals ; Apnea ; Blood Pressure ; Bradycardia ; Charadriiformes ; Child ; Heart Rate ; Hemodynamics ; Hernia, Inguinal ; Humans ; Hypotension ; Infant ; Infant, Newborn ; Infant, Premature ; Lower Extremity ; Midazolam ; Nausea ; Orthopedic Procedures ; Post-Dural Puncture Headache ; Postoperative Complications ; Propofol ; Skin ; Spinal Puncture ; Subarachnoid Space ; Surgical Procedures, Operative ; Tetracaine ; Vomiting

PURPOSE: Mutation of the p53 tumor suppressor gene is the most common genetic defect in all human tumors. Because of the widespread mutations and polymorphism in the p53 gene, the conventional screening methods cannot distinguish between polymorphisms or functionally silent mutations and inactivating mutations. It is well known that plasmids can be generated by homologous recombination in vivo in the yeast by cotransforming the PCR product with a linearized yeast expression vector encoding part of a gene and a selectable marker gene. The aim of this study is to develop more easy and reliable method for functional assay of p53 mutation. MATERIALS AND METHODS: We constructed a gap vector which can reliably and conveniently be used to screen p53 mutations in a simple yeast growth assay. The gap vector was constructed as follows: About 100 bp DNA fragments containing parts of N- and C- terminal portion of p53 were cloned into XbaI/SmaI and HindIII/XhoI sites of yeast expressing vector, respectively. The gap vector was obtained by double cutting with SmaI and HindIII followed by gel elution. Yeast was transformed with the reporter vector containing three tandem copies of the consensus p53 binding site by lithium acetate-mediated method. RT-PCR amplification of p53 transcripts from cell lines or tumor tissues was carried out. To investigate whether p53 gene is mutated or not, yeast containing reporter gene was cotransformed with PCR product and linearized gap vector, plated on SD medium minus histidine, and incubated for 3 days. The colonies on selective media were isolated and characterized. RESULTS: The tumor tissues examined were one hepatocellular carcinoma, three breast cancers, two stomach cancers and two colon cancers. One hepatocellular carcinoma tissue had mutation in both alleles of the p53 gene, and 7 cancer tissues had heterozygous mutations in the p53 gene. The result of functional assay was well correlated with mutational analysis by sequencing. CONCLUSION: p53 functional assay system might be easy and reliable method for functional screening of p53 on tumor tissues and this might be used for screening of other mutated gene. This technique, FASAY, requires only a few steps, can be automated readily and should permit screening for germline or somatic heterozygous mutations in any gene whose function can be monitored in yeast.
Alleles ; Binding Sites ; Breast ; Carcinoma, Hepatocellular ; Cell Line ; Clone Cells ; Colonic Neoplasms ; Consensus ; DNA ; Genes, p53 ; Genes, Reporter ; Genes, Tumor Suppressor ; Genes, vif ; Histidine ; Homologous Recombination ; Humans ; Lithium ; Mass Screening ; Plasmids ; Polymerase Chain Reaction ; Stomach Neoplasms ; Yeasts*

PURPOSE: We report a case of endogenous endophthalmitis caused by Klebsiella pneumoniae, accompanied by orbital cellulitis and necrotizing scleral perforation secondary to liver abscess. METHODS: A fifty three year old woman patient who had received treatment for uveitis in local ophthalmic clinic for five days was referred to this ophthalmologic department in consultation for uncontrolled ocular pain and eyelid swelling accompanied by proptosis. Ten days before admission, she had already received antibiotic medication at internal medicine clinic for abdominal pain and fever. Since her ocular pain along with exophthalmos and eyelid swelling got worse, she received a whole body examination including blood culture, urine test, chest and abdominal radiologic examination to find out infectious focus. In addition, ultrasonography, computed tomography and aqueous culture for ophthalmic examination were performed. Then she was treated with antibiotic medication via systemic and topical route. RESULTS: The Klebsiella pneumoniae was cultured from vitreous in endogenous endophthalmitis accompanied by orbital cellulitis and necrotizing scleral perforation. Although the inflammation was improved with antibiotic medication, she lost her vision. CONCLUSIONS: From the fact that scleral perforation can be complicated by endogenous bacterial endophthalmitis, it is strongly urged that systemic work up such as radiologic examination and blood test be carried out with caution to detect infectious diseases.
Abdominal Pain ; Communicable Diseases ; Endophthalmitis* ; Exophthalmos ; Eyelids ; Female ; Fever ; Hematologic Tests ; Humans ; Inflammation ; Internal Medicine ; Klebsiella pneumoniae ; Klebsiella* ; Liver Abscess ; Orbital Cellulitis ; Thorax ; Ultrasonography ; Uveitis

BACKGROUND: Intrathecal or epidural neostigmine has a postoperative analgesic effect. In this study we evaluated the effects of epidural neostigmine on postoperative analgesia and stress responses after gastrectomy. METHODS: Eighty, ASA physical status 1 or 2, patients scheduled for gastrectomy were randomly assigned to one (n = 20) of four groups. Patients received 5 ml of 0.25% bupivacaine with either saline (N0 group), neostigmine 5microgram/kg (N5 group), neostigmine 10microgram/kg (N10 group), neostigmine 15microgram/kg (N15 group) epidurally 30 minutes before operation. All patients received identical general anesthesia. Patient-controlled epidural analgesia (PCEA) was provided by bupivacaine (0.05%) and fentanyl (4 microgram/ml) for postoperative analgesia. RESULTS: The N10 and N15 groups showed reduced 24-h PCEA consumptions compared with the N0 and N5 groups (P < 0.05). No differences in visual analog pain scores at rest or during movement were observed between the groups. The concentrations of plasma cortisol, epinephrine, norepinephrine and glucose did not differ among the four groups, and their incidences of postoperative adverse effects were similar. CONCLUSIONS: Epidural neostigmine 10 and 15microgram/kg in bupivacaine produced a postoperative analgesic effect, but did not suppress stress responses after gastrectomy
Analgesia* ; Analgesia, Epidural ; Anesthesia, General ; Bupivacaine ; Epinephrine ; Fentanyl ; Gastrectomy* ; Glucose ; Humans ; Hydrocortisone ; Incidence ; Neostigmine* ; Norepinephrine ; Plasma