Although there are many peri-operative measures to reduce core temperature loss during operation, rapid drop has been experienced in the first sixty minutes following induction of general anesthesia. Recently, preoperative warming has been emphasized to prevent inadvertant hypothermia during operation. The purpose of this study is to find the effect of preoperative warming on reducing rectal temperature drop in surgical patients. With informed consent, 46 female adult patients, scheduled for total abdominal hysterectomy or salpingo-oophorectomy in the Seoul National University Hospital from September 3, 1996 to September 19, 1996 were divided into two groups. The variables of age and body surface were matched between the two groups as possible. Among them, 24 patients were preparatively covered up to the shoulders with a forced-air warming blanket(WARM TOUCHTM). set between 36-40degrees C for prewarming, and the other 22 patients(control group)were not before the induction of anesthesia. Rectal temperature was measured by mercury thermometer for rectum after admission to the operating room and by rectal probe which was inserted in the rectum just before the induction during the operation. The rectal temperature was monitored and recorded at every fifteen minutes for the first sixty minutes after the induction and each step during the surgery(intubation, surgical draping, peritoneum opening, one hour and the end of the operation) Collected data were analyzed by means of t-test, Repeated Measures Analysis of Variance with PC-SAS. The results of this study are as following. (1) There was no significant difference between the two groups in age, weight, height, room temperature, basal rectal temperature, operation time. (2) Temperature gradient of the rectal temperature in the warming group was less steeper than that in the control roup during the first sixty minutes after general anesthesia. (3) The rectal temperature measured at every fifteen minutes for the first sixty minutes and the end of surgery after the general anesthesia showed the difference between the two groups during surgery. (4) There was no rectal temperature difference during the intubation, however there was significant temperature difference between the two groups from draping to the end of surgery. In conclusion, prewarming of the surgical patient before induction resulted in increased the skin temperature and heat content, which relieved the dangerous core temperature drop which is potential to be provoked within one hour after induction of the surgical patients and kept the rectal temperature higher than that of the control group during surgery. The suggestions from this study shown below : First, further study is needed to find the preventive effect of the core temperature drop in the first sixth minutes after anesthetic induction by preoperative warming for gastrorectal, thoracic surgery patients who man have the core temperature drop during the operation. Second, in other to keep patient normothermia during the surgery, it needs to study whether using pre-and peri-operative warming can prevent hypothermia or not. Finally, the study of the peroperative warming effect on surgical patients' relaxation and thermal discomfort before the operation is needed because most patients in the case group said to have felt thermal comfort ; 'comfortable' and 'good'.
Adult ; Anesthesia ; Anesthesia, General ; Female ; Hot Temperature ; Humans ; Hypothermia ; Hysterectomy ; Informed Consent ; Intubation ; Operating Rooms ; Peritoneum ; Rectum ; Relaxation ; Seoul ; Shoulder ; Skin Temperature ; Thermometers ; Thoracic Surgery

PURPOSE: To evaluate the surface anatomy of the central sulcus(CS), precentral gyrus(PrCG) and postcentral gyrus(PoCG) on the basis of sulci pattern on MR images. MATERIALS AND METHODS: The MR images were obtained in the plane 10 degree angled to the orbitomeatal line. The MR images of 120 subjects(6 months to 79 years) with normal anatomy were analyzed and another four subjects with known space occupying lesions were also reviewed. RESULTS: The identification of gyri was feasible on the axial T1WI from anterior to posterior and from upper to lower images. The STS demonstrated symmetric pattern on both sides in 84 of 120 cases (70%), including two cases of prominent STS pattern. The asymmetric pattern was seen in 36 of 120 cases (30%):14 of 120 cases (12%) on the right and 22 of 120 cases (18%) on the left at 4.5 cm above the level of the splenium of corpus callosum. The PrCG and PoCG and CS were identified well in all cases with the use 'of the sulci pattern. CONCLUSION: The identification of the gyri on the basis of the cerebral sulci pattern on MR images is useful and important when locating the space occupying lesion of the brain.
Brain ; Corpus Callosum ; Magnetic Resonance Imaging*

No abstract available.
Dermatitis, Seborrheic* ; Humans

PURPOSE: To investigate the visual prognosis, the interval, and the rate of development of after-cataract following cataract surgery in atopic dermatitis. METHODS: Twenty eyes of 13 patients diagnosed as cataract associated with atopic dermatitis were operated between January, 1994 and January, 2000. Visual acuity, postoperative inflammatory reaction, the interval, and the rate of development of after-cataract were investigated and compared with the cataract cases without atopic dermatitis. RESULTS: The average preoperative best corrected visual acuity of 20 eyes was 0.23+/-0.22. The average postoperative best corrected visual acuity at 1, 2, 7, and 12 months after surgery were 0.78+/-0.23, 0.83+/-0.16, 0.78+/-0.23, 0.83+/-0.26, respectively. These values showed no significant difference compared to the postoperative visual acuity of the cataract cases without atopic dermatitis. Aqueous flares measured with laser flare meter were 15.09+/-9.20, 11.15+/-4.68, and 7.38+/-0.75 photon counts/millisecond at 10 days, 1, and 2 months after surgery, which did not seem to influence the final visual acuity and the development of after-cataract (p>0.05). Among the 20 eyes, 66.67% finally developed after-cataract and the average time interval of the development of after-cataract was 11.25+/-4.22 months. CONCLUSIONS: Visual prognosis following cataract surgery in atopic dermatitis is good, while after-cataract seems to develop more frequently and earlier compared to the cases without atopic dermatitis.
Aqueous Humor ; Cataract* ; Dermatitis, Atopic* ; Humans ; Prognosis* ; Visual Acuity

We studied three patients in whom otorrhea occurred without bacterial infection following ventilation tube (VT) insertion. These patients took oral steroids since the conventional therapy was not effective; however, the oral steroids produced temporal effect since sticky otorrhea occurred when the oral steroids were stopped. We collected ear discharge from each patient and consulted the pathologist about histopathologic findings of it. We identified the predominant eosinophilic infiltration at specimen. We tried to relate this type of otitis media with eosinophilic otitis media (EOM) and treated the patients with intratympanic steroid injection.
Bacterial Infections ; Dexamethasone ; Ear ; Eosinophils ; Humans ; Middle Ear Ventilation ; Otitis ; Otitis Media ; Polymethacrylic Acids ; Steroids ; Ventilation

A randomised trial was conducted in 13 patients to assess the circulatory response to endotracheal intubation. None of the patient suffered from heart or lung disease, all were premedicated with lorazepam 0.4 mg/kg, glycopyrrolate 0. 004 mg/kg intramuscularly 30-60 min. beforehand. Patients received vecuronium 0.01mg/kg intravenously for precrurarization and 2 min. later 6 patients received lidocaine 2 mg/kg intravenously and 7 patients received saline 1 ml/20 kg intravenously. Blood pressure and pulse rate were measured repeatedly by an automatic recording device (Datascope 2100A) and cardiac output was measured by noninvasive cardiac output monitor with suprasternal doppler ultrasound. After laryngoscopy and intubation, systolic arterial pressure increased 19.7% mean arterial pressure 18.8% from baseline values in lidocaine group (p<0.05), and systolic arterial pressure increased 21.4% mean artereal pressure 19.8% from baseline values in saline group (p<0. 05). Pulse rate increased 30.9% from baseline values in lidocaine group (p<0.05) and 32.5% from baseline in saline group (p<0.05). But there was no intergroup difference in systolic arterial pressure, mean arterial pressure and pulse rate. Diastolic pressure of both group did not increase significantly and did not show intergroup difference. Cardiac output increased 35.3% from baseline values in lidocaine group (p<0.05). We concluded that lidocaine 2 mg/kg infusion intravenously 2 min prior to laryngoscopy and intubation does not prevent hemodynamic reaction evoked by endotracheal intubation.
Arterial Pressure ; Blood Pressure ; Cardiac Output ; Glycopyrrolate ; Heart ; Heart Rate ; Hemodynamics ; Humans ; Intubation* ; Intubation, Intratracheal ; Laryngoscopy ; Lidocaine* ; Lorazepam ; Lung Diseases ; Ultrasonography ; Vecuronium Bromide

14-3-3 proteins are cytoplasmic proteins of about 29 kDa and have a minimum of seven isoforms. This protein is important in signal transduction with the ability of binding with phosphoserine of many signalling proteins. We expressed 14-3-3 protein tagged with 6 histidine residues in E. coli and purified the protein by nickel affinity chromatography. Using this purified protein as an antigen, we made rabbit antisera and mouse monoclonal antibodies to 14-3-3 zeta isoform. We subcloned cDNA of 14-3-3 zeta isoform derived from HeLa cell lamda gt 11 library into an E. coli expression vector which is designed to express heterologous protein with N- terminal 6 hidtidine tag. BALB/c mice were immunized with purified 14-3-3 protein and the hybridoma clones which produce monoclonal antibodies angainst 14-3-3 protein were selected. These monoclonal antibodies reacted with the recombinant protein expressed in E. coli as well as the 29-kDa native protein in various cell lines. However, they did not immunoprecipitate 14-3-3 protein. The monoclonal antibodies produced in this study can be valuable tools for the identification of the 14-3-3 in signal transduction study.
14-3-3 Proteins ; Animals ; Antibodies, Monoclonal ; Cell Line ; Chromatography, Affinity ; Clone Cells ; Cytoplasm ; DNA, Complementary ; Escherichia coli* ; Escherichia* ; HeLa Cells ; Histidine ; Humans* ; Hybridomas ; Immune Sera ; Mice ; Nickel ; Phosphoserine ; Protein Isoforms ; Signal Transduction ; Staphylococcal Protein A

No abstract available.
Cell Line* ; Humans*

Membranous lipodystrophy is a peculiar type of fat necrosis, present in patients with various types of skin diseases. It is charaeterized by the presence of microcysts and macrocysts lined by amorphous eosinophilic material with a crenelated arabesque appearance and microgranules in the subcutis with massive fat necrosis. The eosinophilic lining and microgranules stain positively with periodic acid-Schiff, are resistant to diastase, and also stain with Sudan black B. We report three cases of subcutanous membranous lipodystrophy in patients with erythema induratum, posttraumatic panniculitis and morphea with typical clinical and histopathologic findings.
Amylases ; Eosinophils ; Erythema Induratum ; Fat Necrosis ; Humans ; Lipodystrophy* ; Panniculitis ; Scleroderma, Localized ; Skin Diseases ; Sudan

BACKGROUND: More than 200 million people suffer from malaria worldwide. In Korea this infectious disease had been on a decreasing trend since 1930s and was considered to be eradicated from 1985. However, since 1993 when a case of malaria was reported, its incidence is progressively increased. Recent efforts have been focused on the development of vaccine against the infective sporozoite stage of Plasmodium vivax. It has been found that sporozoites are complicated with genetic variation within the circumsporozoite gene and phenotypic heterogeneity in the protein it encodes. So, we investigated the distribution of circumsporozoite gene of Plasmodium vivax in Korea. METHODS: Polymerase chain reactions (PCR) were performed on samples confirmed with microscopic examination for P. vivax and negative samples with clinical and microscopic examination. The amplified products were analyzed by dot hybridization with oligonucleotide probes VK210 and VK247 which are respectively complementary to the predominant and variant strains of the circumsporozoite gene of P. vivax. RESULTS: The incidence of isolation in VK210 and VK247 strains were 96.3%, respectively and individuals who were infected with both strains were 92.7%. Compared to the microscopic examination, the results of PCR showed 82% in sensitivity, 100% in specificity. CONCLUSIONS: The present study suggests that a single-epitope vaccine based on either one circumsporozoite domain is unlikely to be protective because both VK210 and VK247 strains of P. vivax were found widely in Korea. The PCR method appears not to be feasible as a screening, but suitable as a confirmatory test for the identification of Plasmodium species.
Communicable Diseases ; Genetic Variation ; Genotype* ; Incidence ; Korea* ; Malaria ; Mass Screening ; Oligonucleotide Probes ; Plasmodium vivax* ; Plasmodium* ; Polymerase Chain Reaction ; Population Characteristics ; Sensitivity and Specificity ; Sporozoites