BACKGROUND: The use of caudal morphine for postoperative analgesia has been increased in popularity since 1981. The purpose of this study was to compare the effect of analgesia and incidence of side effects of a mepivacaine-morphine mixture with mepivacaine alone. METHODS: Forty patients were randomly divided into two groups. In group 1, caudal block was performed with 1% mepivacaine 1 ml/kg alone. In group 2, caudal block was performed with 1% mepivacaine 1ml/kg-morphine 0.03 mg/kg mixture. Postoperative five-point pain scores and side effects were measured. RESULTS: There were no significant differences in sedation dose, incidence of side effects and supplemental analgesics. Pain scores were significantly lower at postoperative 2 and 3 hours in mepivacaine-morphine mixture group. CONCLUSIONS: Caudal epidural mepivacaine-morphine (0.03 mg/kg) mixture is effective in children for control of postoperative pain without significant side effects.
Analgesia* ; Analgesics ; Child* ; Humans ; Incidence ; Mepivacaine ; Morphine* ; Pain, Postoperative

PURPOSE: We designed this study to identify and suggest the reasonable timing of adjuvant radiotherapy in the treatment of uterine carcinosarcoma according to the surgical intent and patterns of progression. MATERIALS AND METHODS: We retrospectively analyzed a total of 50 carcinosarcoma patients diagnosed between 1995 and 2010. Among these 50 patients, 32 underwent curative surgery and 13 underwent maximal tumor debulking surgery. The remaining five patients underwent biopsy only. Twenty-six patients received chemotherapy, and 15 patients received adjuvant radiotherapy. RESULTS: The median follow-up period was 17.3 months. Curative resection (p < 0.001) and stage (p < 0.001) were statistically significant factors affecting survival. During follow-up, 30 patients showed progression. Among these, eight patients (16.0%) had loco-regional progression only. The patients who had received adjuvant radiotherapy did not show loco-regional progression, and radiotherapy was a significant negative risk factor for loco-regional progression (p = 0.01). The time to loco-regional progression was much earlier for non-curative than curative resection (range, 0.7 to 7.6 months vs. 7.5 to 39.0 months). CONCLUSION: Adjuvant radiotherapy in the treatment of carcinosarcoma might be related to a low loco-regional progression rate. Radiotherapy should be considered in non-curatively resected patients as soon as possible.
Biopsy ; Carcinosarcoma ; Follow-Up Studies ; Humans ; Radiotherapy, Adjuvant ; Retrospective Studies ; Risk Factors

No abstract available.
Endometriosis* ; Female ; Gonadotropin-Releasing Hormone*

Abrupt increase in the size of cervico-mediastinal tumor due to infection or spontaneous hemorrhage into cyst can induce severe tracheal compression and therefore sudden death. A 5 year old boy, who had a history of URI, had an enlarging cystic hygroma on the right side of the neck and anterior mediastinum. Under diagnosis of the cervico-mediastinal cystic hygroma, surgical removal was scheduled. After induction of anesthesia, intubation was done without any difficulty. A few minutes later, signs of partial airway obstruction were appeared. And within a very short period, total airway occlusion occurred. The tracheal tube was removed and manual ventilation was performed with positive airway pressure, but ineffective. We attempted to puncture cricothyroid membrane with 14 Gauge needle in order to ventilate manually. As soon as we puncture cricothyroid membrane, straw-colored fluid, not air, gushed out through a needle. After aspiration of about 200ml of cystic fluid, the obstructive signs disappeared and the patency of the airway was maintained. Intraoperatively, no more airway problems occured and vital signs were stable. And postoperatively, patient had no specific complications and discharged on the 7th day after operation.
Airway Obstruction* ; Anesthesia ; Child, Preschool ; Death, Sudden ; Diagnosis ; Hemorrhage ; Humans ; Intubation ; Intubation, Intratracheal* ; Lymphangioma, Cystic* ; Male ; Mediastinum ; Membranes ; Neck ; Needles ; Punctures ; Ventilation ; Vital Signs

Objectives: This study was to evaluate whether Ham's F-10 used in assisted reproductive technology (ART) could be replaced with newly-introduced Medicult or Human Tubal Fluid (HTF) media, and the rate of embryo development could be enhanced by cumulus cell coculture. METHODS: Ham's F-10, Medicult, and HTF media supplemented with 0.4% bovine serum albumin (BSA) were used. Two-cell embryos were obtained from oviducts of mated F1 hybrid female mice superovulated by pregnant mare serum gonadotropin (PMSG) and human chorionic gonadotropin (hCG). Cumulus cells for coculture were obtained from oviducts of ICR female mice superovulated by PMSG and hCG. Two-cell embryos were cultured in Ham's F-10, Medicult, and HTF media respectively to observe and compare the rate of embryo development. In addition, two-cell embryos were cultured in these three media for 24, 48, 72, 96 hrs with or without cumulus cell, and rates of embryo development were investigated and compared. RESULTS: As for the rate of embryo development to hatched blastocyst after 96 hrs culture, HTF (87.5%) and Ham's F-10 (85%) were significantly higher than Medicult (70.5%). The beneficial effect of embryo development by cumulus cell coculture on two-cell mouse embryo among these three media was enhanced significantly in Medicult (control 88.5% versus coculture 98.5%) by 24 hrs, and was not enhanced statistical significantly but slightly elevated in Ham's F-10 (86.5% versus 95.5%) and HTF (91.3% versus 96.9%) by 48 hrs, but rates of embryo development were similar between control and coculture group in all three media by 96 hrs. Significant differences were not shown in three media, but HTF showed generally high tendency of the enhancing effect of embryo development and the beneficial effect of embryo development by coculture. CONCLUSIONS: As a result of culturing two-cell embryos in three media for 96 hrs, generally HTF and Ham's F-10 showed higher rate of embryo development than Medicult. As for the beneficial effect of coculture, Medicult only showed early transient significant improvement of embryo development. Considering that coculture effect of good quality media may be not so great, Ham's F-10 and HTF are more stable media than Medicult. Accordingly, HTF may be considered to be a medium to replace with Ham's F-10, however, the present study suggest that Medicult or HTF is not able to replace with Ham's F-10 in ART.
Animals ; Blastocyst ; Chorionic Gonadotropin ; Coculture Techniques* ; Culture Media* ; Cumulus Cells* ; Embryonic Development* ; Embryonic Structures* ; Female ; Gonadotropins ; Humans* ; Mice* ; Oviducts ; Pregnancy ; Reproductive Techniques, Assisted ; Serum Albumin, Bovine

Bone materials diggd up from the Haemi nameless martyrdom holy place burial sites were severely broken into fragments of various size, clay matrix filled the bone marrow cavities, grass roots were spreaded into the periosteum and the fragments were very soft enough to be flaken. To make permanent specimens, bony fragments impregnated within unsaturated polyester resin with catalyzer MEKP, promotor 8% cobalt octoate, and UV absorber. Permanent specimens were so very transparent that all the macroscopic structures can be observed, and they were hard enough not to be broken or cracked. This method of preserving bony fragments is considered to be used in archaeologic preservation and in making teaching materials of various human organs or tissues.
Bone Marrow ; Burial* ; Cobalt ; Humans ; Methods ; Periosteum ; Poaceae ; Polyesters ; Teaching Materials

No abstract available.
Cicatrix* ; Herpes Zoster* ; Histiocytoma, Benign Fibrous*

The importance of the donor-to-recipient body surface area ratio or the calculated donor kidney-weight to recipient body-weight ratio is still matter of controversy in clinical renal transplantation(Tx). To assess the value of the true kidney weight(KW in gms) to the recipient body-weight(BW in kg) ratio in living donor renal Tx, the records of 165 adult living donor renal transplants were reviewed. All patients received uniform cyclosporine and steroid immunosuppression. Five patients were excluded because of early graft loss. In the remaining 160 patients, full information including KW, BW, degree of HLA matching, demographics of recipient and donor, acute rejection(AR) episodes, serum creatinine(Scr) at post-Tx 1 month and 1 year, 24 hours urinary excretion of protein at post-Tx 1 year and finally outcome of graft were available. Patients with KW/BW< OR =3.5 have significantly(p=0.007) higher Scr at post-Tx 1 month and 1 year. The 24 hours urinary excretion of protein in this group was in excess of that for the patients with KW/BW>3.5, but this difference was not statistically significant. These findings were still true even if we eliminated the effect of acute rejection episodes. In 96 patients that never experienced acute rejection, we could demonstrate the significant impact of KW/BW on the Scr. In conclusion, if the Scr at post-Tx 1 year is a major determinant of the long-term graft outcome, the important role of KW/BW ratio is must considered in the selection of a potential living donor.
Adult ; Allografts* ; Body Surface Area ; Cyclosporine ; Demography ; Humans ; Immunosuppression ; Kidney ; Living Donors* ; Tissue Donors ; Transplants

The importance of the donor-to-recipient body surface area ratio or the calculated donor kidney-weight to recipient body-weight ratio is still matter of controversy in clinical renal transplantation(Tx). To assess the value of the true kidney weight(KW in gms) to the recipient body-weight(BW in kg) ratio in living donor renal Tx, the records of 165 adult living donor renal transplants were reviewed. All patients received uniform cyclosporine and steroid immunosuppression. Five patients were excluded because of early graft loss. In the remaining 160 patients, full information including KW, BW, degree of HLA matching, demographics of recipient and donor, acute rejection(AR) episodes, serum creatinine(Scr) at post-Tx 1 month and 1 year, 24 hours urinary excretion of protein at post-Tx 1 year and finally outcome of graft were available. Patients with KW/BW< OR =3.5 have significantly(p=0.007) higher Scr at post-Tx 1 month and 1 year. The 24 hours urinary excretion of protein in this group was in excess of that for the patients with KW/BW>3.5, but this difference was not statistically significant. These findings were still true even if we eliminated the effect of acute rejection episodes. In 96 patients that never experienced acute rejection, we could demonstrate the significant impact of KW/BW on the Scr. In conclusion, if the Scr at post-Tx 1 year is a major determinant of the long-term graft outcome, the important role of KW/BW ratio is must considered in the selection of a potential living donor.
Adult ; Allografts* ; Body Surface Area ; Cyclosporine ; Demography ; Humans ; Immunosuppression ; Kidney ; Living Donors* ; Tissue Donors ; Transplants

Recently a new formulation of CsA, based on microemulsion technology, has been developed and became available. This improved galenic technology allows more predictable and consistent absorption, thus minimizing inter-patient and intra-patient variability and permitting more predictable whole blood CsA concentration. The objectives of this study are to assess 1) long-term safety and tolerability in renal transplant patients when switched from conventional CsA(Con-CsA) to microemulsion CsA(Me-CsA), 2) the ability of Me-CsA to maintain CsA blood trough levels in the predefined therapeutic window, and 3) the long-term side effects of Me-CsA. A total number of 965 renal transplant patients had been surveyed. These patients had to have variable graft function under Con-CsA based immunosuppression and at least 1 month passed since their last graft. After a one month run-in phase, Con-CsA was converted to Me-CsA patients on a 1:1 dose level basis. The clinical status such as graft dysfunction, graft and patient survival, medical illness and side effects were monitored. The clinical laboratory studies such as CBC, BUN, creatinine, serum electrolyte, liver function test, blood cyclosporine trough level and 24hr urinary excretion of protein were monitored every 3 or 6 months for 1 year. The results of our research are as following; 1) During conversion period from Con-CsA to Me-CsA, there was no episode of Me-CsA related side effects and admission cases. 2) There were statistical differences in mean CsA blood level during Con-CsA period, but no significant distinctions were noted during Me-CsA period. 3) Daily dosages of the Con-CsA were statistically variable between one month interval periods, but the Me-CsA daily dosages were statistically stable between 3,6,9, and 12 months after the conversion. 4) Serum creatinine level did not change significantly by the conversion.
Absorption ; Allografts* ; Creatinine ; Cyclosporine* ; Follow-Up Studies* ; Humans ; Immunosuppression ; Liver Function Tests ; Transplants