No abstract available.
Animals ; Liver* ; Rats*

BACKGROUND: One of the main disadvantages of caudal block is the long latent period before a satisfactory blockade is obtained. Many investigators have used various preparations of local anesthetic solutions to improve the speed of onset. This study was performed to evaluate the effectiveness of prewarming of lidocaine HCl for caudal block. METHODS: Fifty healthy young patients (ASA I) were allocated into two groups, A and B. In group A, the local anesthetic solution were injected at room temperature (25 degrees C), while in group B, they were injected at 37oC. All the caudal block were performed using 2% lidocaine HCl 20 ml with fentanyl 100ug and epinephrine 1:200,000. The onset time was defined as the period from completion of injection until the patient first noticed loss of sensation to pin-prick on perianal region. Assessment of sensory loss was made at 15 seconds interval. We have compared the onset of sensory blockade between groups. The duration of analgesia and any significant side effects were also recorded. RESULTS: The onset of sensory blockade was significantly faster in group B (3.5 +/- 0.5 minutes) than group A (6.2 +/- 0.9 minutes). The duration of analgesia were not significantly changed between groups. Side effects of urinary retention, pruritus and nausea were noted between both groups but the difference was not significant. CONCLUSIONS: We have found that the onset time was 44% faster with warm lidocaine-fentanyl mixture (37 degrees C) than with the room temperature (25 degrees C). The improved clinical usefulness was achieved with no increase in side effects. The technique is a safe and effective method to reduce the latency of onset.
Analgesia ; Epinephrine ; Fentanyl ; Humans ; Lidocaine ; Nausea ; Pruritus ; Research Personnel ; Sensation ; Urinary Retention

No abstract available.

No abstract available.
Hirschsprung Disease*

The clinical investigation was performed regarding cutaneous manifestations in 495 patients with thyroid disorders who had visited Pusan National University Hospital from January, 1979 to April, 1984. The results of this study were as follows: I. Of the 495 patients with thyroid disorders, 417 patients(84. 2%) showed various cutaneous manifestations. Among the cutaneous manifestations presented in the 176 patients with hyperthyroidism, hyperhidrosis was the most common(24. 2%), followed by pruritus (42. O%), chronic urticaria(29, 5%), bronze appearance(21. 6%), sparsity of hair (20. 5%), soft and friable nail(17. 6%). 3. Among the cutaneous manifestations presented in the 57 patients with hypothyroidism, pruritus was the most common(26. 3%), followed by sparsity of hair (21. 1%,), chronic urticaria(19. 3%), soft and friable nail(14. 0%). 4. In patients with Graves disease, cutaneous manifestations were more frequently observed than those of other thyroid disorders. 5, Autoimmune thyroid disorders such as Graves' di ease and Hashimotos thyroiditis were rarely associated with vitiligo(only 2 cases) and alopecia areata(only 1 case).
Alopecia ; Busan ; Graves Disease ; Hair ; Humans ; Hyperhidrosis ; Hyperthyroidism ; Hypothyroidism ; Pruritus ; Thyroid Gland* ; Thyroiditis

Keratosis punctata of palmar creases has been considered an uncommon variant of keratosis punctata, which itself is considered rare condition. Clinically our case, 32-year-old seaman, shows cup-shaped depression of the epidermis of varying size, from 1-3mrn in diameter, limited to the large flexor creases of the palms and digit. The histologic features are hyperkeratotic and slight acanthotic central epidermal depression without parakeratosis and loss of granular layer. A sparse mononuclear infilterate are seen arround the capillaries in the dermal papillas. No relationship to arsenical agents, syphilis, or genetic factors can be ascertained by history.
Adult ; Capillaries ; Depression ; Epidermis ; Humans ; Keratosis* ; Parakeratosis ; Syphilis

Partial lipodystrophy is an uncommon disorder primarily affecting women, with onset usually in childhood, characterized by slowly progressive, symrnetrical loss of aubcutaneous fat from the upper half of the body. We present a case of partial lipodystrophy in a 43-year-old woman with multiple depressed lesion on the face and reticulated atrophic lesions on the upper trunk and u]pper extremities. Typically, her face was the first part of the body so affected, giving it a characteristic cadeverous appearance, and gradu ally spreaded to the upper half of t2e body. Sirnultaneously, there was an accumulation of fat over the lower part of the body. She was generally otherwise well, although there had been an association with hyperpigmentation, hirsutism, arthralgia, thyroid disoraer, and low serum CR(45mg/dl), Riopsy specimens of iace and back showed lack of subcutaneous fat, but in the other section of the face showed hydropic degeneration of basal cells and inflammatory infiltrate in the dermis.
Adult ; Arthralgia ; Dermis ; Extremities ; Female ; Hirsutism ; Humans ; Hyperpigmentation ; Lipodystrophy* ; Subcutaneous Fat ; Thyroid Gland

No abstract available.
Lung*

BACKGROUND: The prevalence of pulmonary tuberculosis among the elderly is increasing in Korea and in the developed countries due to the increased elderly population and their predispositions to chronic disease, poverty and decreased immunity. To define the characteristics of pulmonary tuberculosis in the elderly, we evaluated the clinical spectrum of pulmonary tuberculosis. METHODS: We analyzed 92 patients retrospectively that were diagnosed as active pulmonary tuberculosis over the age of 65. The analysis involved patient's profiles, clinical manifestations, coexisting diseases, diagnostic methods, anti-TB medications and their side effects, and treatment outcomes. RESULTS: The results were as follows:- 1) The ratio of male to female was 2.1:1(62:30 cases) 2) Chief complaints were a cough (47.8%),dyspnea(40.2%), sputum(38.0%), chest pain(12.0%), anorexia(10.9%), and fever(9.8%). 3) 38(41.3%) of cases had a past history of pulmonary tuberculosis. 4) The coexisting diseases were:-COPD, 25 cases(27.2%);pneumonia, 17 cases(18.5%);DM, 13 cases(14.1%);and malignancy, 10 cases(10.9%). 5) The positivity of Mantoux test(5 TU, PPD-S) was 82.7%. 6) Pulmonary tuberculosis was diagnosed using the following methods : sputum AFB (Acid Fast Bacillus) smear 42.4%, sputum TB(M.Tuberculosis) culture 15.2%, sputum TB PCR (Polymerase Chain Reaction) 10.9%, bronchial washing AFB smear 2.1%, chest radiology only 25.0%. 7) Locations of radiologic lesions were RULF, 50 cases;RLLF, 50 cases, mostly, then LLLF;26 cases were leastly involved. 8) The coexisting tuberculosis were endobronchial TB(8.7%), TB pleurisy(7.6%) miliary TB(5.4%), intestinal TB(2.2%), renal TB(1.1%) 9) The proportion of treatment regimen with 1st line drug and 2nd line drug were 92.3% and 7.6%, respectively. 10) The outcome of treatment were as follows:cured 31.5%, expired 13.0%, no return 47.8%, follow-up now 7.6%. CONCLUSION: The pulmonary tuberculosis in the elderly has atypical patterns with chronic coexisting diseases. Therefore, the possibility of pulmonary tuberculosis should be considered in elderly patients with pulmonary symptoms.
Aged* ; Chronic Disease ; Cough ; Developed Countries ; Female ; Follow-Up Studies ; Humans ; Korea ; Male ; Polymerase Chain Reaction ; Poverty ; Prevalence ; Retrospective Studies ; Sputum ; Thorax ; Tuberculosis* ; Tuberculosis, Pulmonary

PURPOSE: To obtain magnetization transfer ratio(MTR) of the annulus fibrosus and nucleus pulposus and to assess the feasibility of utilizing the changes of these MTRs as an early indicator of disk degeneration. MATERIALS AND METHODS: MR images of lumbar spine with magnetization transfer(MT) technique in 42 patients were obtained. spin echo techniques (600/14) with same TR/TE with 1KHz off-resonance saturation were employed in 1.0T MR system. MTRs were calculated in two regions, anterior annulus fibrosus and nucleus pulposus, and the results were compared between the normal and degenerative disks, from grade I to IV, on T2-weighted images. RESULTS: MTRs of the nucleus pulposus were 17.6% in the normal disks, and 26.7%, 28.4%, 29.1%, 29.7% in degenerative disks, from grade I to IV, respectively, with a significant difference(P<0.05). On the other hand, MTRs in the annulus fibrosus were 30.2% in the normal disks and 31.5%, 33.2%, 32.1% and 35.6% in degenerative disks, from grade I to IV, respectively, without significant difference. CONCLUSION: Since MTRs are significantly higher in degenerative nucleus pulposus than those of the normal disks, increased MTRs in the nucleus pulposus can be used as an early sign of the degeneration of the nucleus pulposus.
Hand ; Humans ; Intervertebral Disc Degeneration* ; Magnetic Resonance Imaging* ; Spine