Internal hernia is an unusual cause of the intestinal obstruction. The advances of CT make the diagnosis more easier than in the past. We report one case of internal hernia with herniation of the ileum into the lesser omenturn. The diagnosis could be made when abdominal radiographs showed fixed clustering of the small bowel loops in upper abdomen medial to the stomach. CT and ultrasound showed characteristic interposition of the ileum between the left hepatic lobe and the stomach.
Abdomen ; Diagnosis ; Hernia* ; Ileum ; Intestinal Obstruction ; Stomach ; Ultrasonography

No abstract available.
Bacteria* ; Ulsan*

No abstract available.
Enzyme-Linked Immunosorbent Assay*

No abstract available.
Enzyme-Linked Immunosorbent Assay*

No abstract available.
Enzyme-Linked Immunosorbent Assay*

Postoperative pain control is one of the main concern for the anesthesiologist. Intermittent narcotic injections caused inadequate pain relief in many patients. Periodic injections could improve analgesia with increased incidence of undesirable side effects including respiratory depression, nausea, vomiting, and urinary retenion. Balanced analgesia may lessen these complications without reducing analgesic effect. I assessed the effect of balanced analgesia using morphine, ketorolac and droperidol. Each 20 gynecological patients were allocated to one of four groups Morphine(initial bolus 2mg followed by 48mg continousi.v. for 2 days) or ketorolac(initial bolus 30mg, follwed by 120mg continousi.v. for 2 days) was continously injected in group 1 and group 2, respectively. In group 3, half doses of morphine and ketorolac in group 1, 2 was used in combinstion. 5mg of droperidol was added to group 3 drugs in group 4. There were no significant changes in blood pressure and heart rate in all groups. Onset time of analgesic effect was faster in morphine containing groups 1, and 4, and the effect was better in all three morphine containing group 1, 3 and 4 than ketorolac group 2. Untoward effects were least in ketorolac group 2. Droperidol could prevent nausea and vomiting, however led to increased incidence of somnolence. It could be concluded that balanced analgesia with morphine, ketorolac and droperidol with fine titration would be better than intravenous morphine or ketorolac alone.
Analgesia* ; Blood Pressure ; Droperidol* ; Heart Rate ; Humans ; Incidence ; Ketorolac* ; Morphine* ; Nausea ; Pain, Postoperative* ; Respiratory Insufficiency ; Vomiting

A 27-year-old woman developed Wemicke's encephalopathy in the 16th week of her first pregnaney. She had thyroid storm and abnormal liver function. Her thyrotoxic symptom and abncemal liver function was recovered after medication of antithyroid drug, steroid, hepatotonic drug and administration of thiamine(fursulthiamin), but the fetus was lost, Thereafter her thyroid function returned to normal and euthyroid state was maintained without medication of antithyroid drug, but her neurological defect was remained. We suggest that severe hyperemesis gravidarum is a possible risk factor of the thyroid storm and Wemicke's encephalopathy in patients with hyperthyroidism, and consider the check of the thyroid function. The need for parenteral thiamine supplementation and medication of antithyroid drug is warranted in patients with severe hyperemesis gravidarum which lasts longer than 3 weeks and abnormal thyroid function.
Adult ; Female ; Fetus ; Humans ; Hyperemesis Gravidarum* ; Hyperthyroidism ; Liver* ; Pregnancy ; Risk Factors ; Thiamine ; Thyroid Crisis* ; Thyroid Gland* ; Wernicke Encephalopathy*

Pleomorphic (undifferentated) carcinoma is a rare histologic type of carcinomas of the gallbladder and an atypical carcinoid is thought to be an intermediated type between carcinoid tumor and small cell carcinoma. Dense core "neurosecretory" granules can be found in the above mentioned tumors. We experienced a case of a double tumor of the gallbladder in a 51-year old male patient. Grossly, a large solid mass, about 5.0 cm in diameter, was found in the fundic portion and the neck portion also had a small 1.5 cm-sized polypoid mass. Microscopically, these lesions had features of pleomorphic carcinoma and atypical carcinoid, respectively. Immunohistochemically, they manifested reactivity for neuron specific enolase. Ultrastructural study revealed neurosecretory granules in the cytoplasms of tumor cells of the fundic and neck masses. Although light microscopic features of these tumor masses are quite different, we consider that these tumors represent a spectrum of neuroendocrine differentiation.
Male ; Humans

College and university foodservice dietitians have to be competent for playing a role as the future food service executive as well as the present foodservice administrator in the promising foodservice industry field. The study conducted a survey to examine training needs corresponding to educational contents for the purpose of helping them acquire a new knowledge related to self-development and duty through educational training. The results of this study suggested that training needs were differed by general characteristics of dietitians, operational characteristics of food services, and training subjects. A future study should develop systematic training strategies for dietitians.
Administrative Personnel ; Food Services ; Humans ; Nutritionists*

BACKGROUND: Clonidine, which is known to have analgesic and sedative properties, has recently been shown to be an effective preanesthetic medication in humans. The drug may cause side effects, including bradycardia and hypotension. This study was conducted to evaluate the ability of intravenous atropine to increase the heart rate (HR) in awake adults receiving clonidine preanesthetic medication. METHODS: We studied HR responses to intravenous atropine in 45 patients assigned randomly to either a control group, who received no medication (group 1, n=15), or clonidine groups, who received oral clonidine of 2~2.5 mcg/kg (group 2, n=15), or 4.5~5 mcg/kg (group 3, n=15) 90 min before scheduled induction of anesthesia. When HR and blood pressure had been confirmed to be stable in operating room, all patients received incremental doses of atropine, 2.5, 2.5 and 5 mcg/kg at 2-min intervals. The HR and mean arterial pressure were recorded at 1-min intervals. RESULTS: Before atropine injection, the HR decreased significantly (P<0.05) in group 3. The increases in HR in response to a cumulative dose of atropine 10 mcg/kg were 21+/-8, 17+/-7 and 7+/-5 beats/min (mean+/-SD) in group 1, 2 and 3, respectively (P<0.05). The positive chronotropic response to intravenous atropine was attenuated significantly only in group 3 (P<0.01). CONCLUSIONS: It was concluded that oral clonidine of 4.5~5 mcg/kg decreased HR significantly, and blunted the increase in HR after intravenous atropine in awake adults although oral clonidine of 2~2.5 mcg/kg did not.
Adult* ; Anesthesia ; Arterial Pressure ; Atropine* ; Blood Pressure ; Bradycardia ; Clonidine* ; Heart Rate* ; Heart* ; Humans ; Hypotension ; Operating Rooms ; Preanesthetic Medication