Background: This study was aimed to compare the analgesic effect and side effects of morphine- bupivacaine mixture with those of fentanyl-bupivacaine mixture after Cesarean section. Methods: Eighty patients who were taken continuous epidural catheterization after Cesarean section were divided into two groups. In group 1 (N=40) the mixture of 1% lidocaine 10 ml and morphine 1mg was firstly injected via epidural catheter, and then two day infusor (Baxter(R)) which contained the mixture of 0.15% bupivacaine 100 ml and morphine 6mg was connected to epidural catheter. In group 2 (N=40) the mixture of 1% lidocaine 10 ml and fentanyl 100 mcg was firstly injected via epidural catheter, and then two day infusor (Baxter(R)) which contained the mixture of 0.15% bupivacaine 100 ml and fentanyl 850 mcg was connected to epidural catheter. Mean arterial pressure (MAP) and heart rate (HR) were checked preoperatively, and at post-injection 10, 20, 30 and 60 minutes. The visual analogue scale (VAS) was checked at postoperative 1/2, 1, 6, 12, 24 and 48 hours. The side effects of epidural analgesia were evaluated. Results: In group 2 MAP was significantly decreased at post-injection 20 minute. VAS was significantly increased at post-injection 1/2 and 1 hour in group 1. The most frequent side effect was pruritus in both groups. Conclusions: The first bolus injection of the mixture of 1% lidocaine 10 ml and fentanyl 100 mcg has more rapid analgegic effect than the mixture of 1% lidocaine 10 ml and morphine 2 mg, but because of shorter duration of action of fentanyl it seems to be better to increase the dosage of fentanyl or replace fentanyl by morphine for more effective epidural analgesia after Cesarean section.
Analgesia, Epidural ; Arterial Pressure ; Bupivacaine ; Catheterization ; Catheters ; Cesarean Section* ; Female ; Fentanyl ; Heart Rate ; Humans ; Infusion Pumps ; Lidocaine ; Morphine ; Pregnancy ; Pruritus

No abstract available.
Arrhythmias, Cardiac* ; Arteries* ; Child* ; Humans

Hidradenitis suppurativa is a rare disease which represents a chronic suppurative and scarring process, affecting the apocrine glands due to persistent bacterial infection and apocrine dysfunction. We have experienced a case of hidradenitis suppurativa, 22-year-old female which involved both axillary region. Diagnosis was established by clinical characteristicsymptoms, histopathological findings and bacteriological examinations.
Apocrine Glands ; Bacterial Infections ; Cicatrix ; Diagnosis ; Female ; Hidradenitis Suppurativa* ; Hidradenitis* ; Humans ; Rare Diseases ; Young Adult

The Graf system has supposed advantages with its flexible nature, as compared with rigid fixation. But there have been no reports about effects in the adjacent motion segment after soft stabilization. The purpose of this study was to evaluate the radiologic changes occuring in the adjacent segments of the Graf system and to assess its ability stabilizing the lumbar spine. A retrospective review of radiographs and medical records was undertaken in 32 cases who had been treated with the Graf system in degenerative lumbar spinal disorders. The average age at operation was 52.5 years and the average follow up period was 49.6 months. The results of this study were as follows: clinical assesments based on the Kirkaldy-Willis criteria revealed excellent in 13 cases (40.6%), good in 16 cases (50%), fair in 2 cases (6.3%) and poor in 1 case (3.1%). Radiologically we analysed the adjacent segments in 25 cases except the cases which did not have the correspondence between the clinical findings and the radiological findings, and the fixated segments in 32 cases. The acceleration of degenerative changes were found in the above adjacent segments in 11 cases (44%) and in the below adjacent segments in 5 cases (27.7%). Also, those changes were found in the fixated segments with discectomy in 19 cases (50%) and in the fixated segments without discectomy in 9 cases (37.5%). In conclusion, we think that the Graf system in a lumbar region may biomechanically influence the adjacent segments. The mechanical effects of the device could be changed by the polyester bands which were followed for a longer period of time in the fixated segments. Therefore, randomized prospective studies comparing the Graf system to other treatement methods could provide clear indications for lumbar spinal disorders.
Acceleration ; Diskectomy ; Equidae ; Follow-Up Studies ; Lumbosacral Region ; Medical Records ; Polyesters ; Retrospective Studies ; Spine

Maffuccis syndrome was first reported by Maffucci, an Italian, in 1881. It is manifested by unilateral multiple hemangiomas and enchondromas. It is congenital but is not hereditary. We encountered a case of this rare syndrome, with which bleeding tendency was combined. All who have multiple hemangioma on his unilateral side of the body should be checked with bone X-rays to rule out this syndrome. This syndrome is noted for transformation to malignant tumors. When there is pain or enlargenent of the tumor without any significant trauma, biopsy is in order. There can develop bleeding tendency due to microangiopathic coagulopathy which is associated with throm-bocytopenia and hypofibrinogenemia.
Biopsy ; Chondroma ; Hemangioma ; Hemorrhage

No abstract available.

Collagen is the major structural protein in the human body, especially in connective tissues. There are more than 13 types of collagen. Among them, type II collagen is a main component of articular cartilage structure. Altered immunological conditions against type II collagen may be closely related to the pathologic conditions of joint, especially arthritis. Since 1977, animal model for collageninduced arthritis(CIA) has been developed and used in the investigation of arthritis. In those animals, high titers of anti-type II collagen antibody were noticed. Pathologic findings were similar to rheumatoid arthritis of human, which suggested that rheumatoid arthritis might be one of the autoimmune diseases. There had been many reports about elevation of serum and synovial level of anti-type II collagen antibody in rheumatoid arthritis patients. But majority of them did not discriminate the antibody titers according to the type of immunoglobulin(i.e. IgG, IgM). And the question whether the elevated antibody titers are cause or effect of the arthritis is still in controversy. In this study, the serum levels of anti-type II collagen antibody were determined in 82 persons(35 degenerative arthritis patients, 24 rheumatoid arthritis patients and 22 normal controls without any joint problem) via ELISA method. In each person the serum IgG, IgM and IgG+M+A antibody levels against bovine type IIcollagen and chicken typeII collagen were determined individually. Statistical evaluation of these data among degenerative arthritis group, rheumatoid arthritis group and normal control group was performed. The results were as follows; 1. Degenerative arthritis group revealed significant elevation of anti-type II collagen antibody(IgG, IgG+M+A) compared to normal control(p < 0.05). 2. Rheumatoid arthritis group showed significant elvation of IgM and IgG+M+A compared to normal control. 3. Between degenerative arthritis and rheumatoid arthritis group, no sigificant difference was noticed. 4. Rheumatoid arthritis group showed significant increase of IgM antibody level compared to normal control. 5. Female rheumatoid arthritis group showed significant increase of IgM level compared to female degenerative arthritis group. These findings suggested that the elevation of anti-type II collagen antibody titer is not specific for rheumatoid arthritis and related with general pathologies destroying articular cartilage. And it is suggested that anti-type II collagen antibody associated with rheumatoid arthritis is mainly IgM proportion, especially in female patients. So further investigation of anti-type II collagen antibody associated with rheumatoid arthritis is needed to target IgM antibody.
Animals ; Arthritis ; Arthritis, Rheumatoid ; Autoimmune Diseases ; Cartilage, Articular ; Chickens ; Collagen ; Collagen Type II ; Connective Tissue ; Enzyme-Linked Immunosorbent Assay ; Female ; Human Body ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Joints ; Methods ; Models, Animal ; Osteoarthritis ; Pathology

This mycological and cultural investigation was made in 86 cases of onychomycosis diagnosed on positive KOH wet mount at Chosun University Hospital from October, 1989 to February, 1990. The results were as follows : l. The ratio of male to female was 1.2:1. According to Zaiass classificat.ion, distal subungual onychomycosis (DSO) was the most predominant type(79 cases) and others, in decreasing frequency, were superficial white onychomycosis (SWO) (Fcases), total dyst,rophic onychomycosis (TDO) (1 cases, and proximal subungual onychomycosis (PSO) was not. found. 2. In DSO, isolat,ed fungi were T. mentagrophyte(31 cases), "i'. rubrum(23 c
Female ; Fungi ; Humans ; Male ; Mycology* ; Onychomycosis*

CTLA-4 (=CD152), a T cell activation antigen, has been known to be homologous to CD28 in its molecular and genomic structure. Both of these two molecules are sharing their counterreceptors, B7 (CDSO) and B7-2 (CD86) and are known to play a crucial role in T cell activation. In previous our study it was reported that there are 2 forms of CTLA-4 antigen in activated human T cells, 30 kD membrane-bound form and 34 kD cytosolic-sequestered form and the former was less than 5 % of total of this antigen induced. Aims of this study are to confirm previous finding by using flow cytometry and to characterize the cytoplasmic form of human CTLA-4 by using ultrafiltration and immunoprecipitation techniques. In PHA stimulated peripheral blood lymphocyte surface expression of CTLA-4 was less than 2.1% of any of CD4+, CD8+ and CD56+ subsets. And the 34 kD form of CTLA-4 was detected in CDS+ subset only. This discrepancy confirms that 34 kD antigen is the cytoplasmic form of human CTLA-4. In ultrafiltration and subsequent Western blot analysis study this 34 kD antigen was detected in >100 kD fraction only. And in non-reducing condition this antigen formed high molecular weght complex (MW > 350 kD). In immunoprecipitation study using anti-peptide A antibody it was found that this high molecular weight complex consists of the 34 kD cytoplasmic form of CTLA-4 and previously unknown 54 kD antigen and 46 kD antigen at 1:1:8-10 ratio. And none of these 3 molecules were identified in membrane fraction of activated human T cell. The result of this study implies that CTLA-4 molecule induced upon T cell activation mainly sequestered in cytoplasrn and another signal is necessary to target this antigen on the activated T cell surface.
Antigens, CD27 ; Blotting, Western ; CTLA-4 Antigen ; Cytoplasm* ; Flow Cytometry ; Humans* ; Immunoprecipitation ; Lymphocytes ; Membranes ; Molecular Weight ; T-Lymphocytes ; Ultrafiltration

Patients with severe congestive heart failure due to rheumatic heart disease generally have both reduced cardiac output and increased pulmonary and systemic venous pressures. A study was therefore made of the use of vasodilator therapy with orally administered hydralazine, which acts on arteriolar resistance vessels and thus reduces afterload. 55 children aged from 4 years old to 15 year old were divided into two groups. Group I received oral hydralazine(4mg/kg/kay in 4 divided doses) in addition to digoxin therapy for mean duration of 10.5 months. Group II received oral digoxin only. The hemodynamic results using M-mode echocardiography, chest X-ray, and EKG between two groups were analyzed. 1) 4(78%) of 55 patients had only mitral valve involvement and another 12 patients had double valve involvement and all the patients belonged to functional class III or IV fo New York heart Association. 2) Left venticular end-diastolic dimensions and the height of R in V6 on EKG were not changed significantly in both groups. 3) Shortening fraction, LPEP/LVET, and RPEP/RVET were markedly improved in both groups, but the degree of improvement in group I was more significant than in group II. 4) 21(80%) of 26 patients in group I showed significant improvement in functional class(t=1.92, 0.05 Adolescent ; Cardiac Output ; Child* ; Child, Preschool ; Digoxin ; Echocardiography ; Electrocardiography ; Estrogens, Conjugated (USP)* ; Heart ; Heart Failure* ; Hemodynamics ; Humans ; Hydralazine ; Mitral Valve ; Rheumatic Heart Disease ; Thorax ; Venous Pressure