No abstract available.
Humans ; Peptic Ulcer*

BACKGROUND: Induction of anesthesia with propofol commonly associated with reduction in systemic arterial pressure, especially in elderly and high risk patients. This reduction is influenced by the dose and rate of propofol injection. The aim of this study was to examine the effect of different injection rate of propofol on vital signs, dose requirement and induction time during induction period. METHODS: Unpremedicated one hundred and twenty ASA physical status I and II patients aged 20~60 years scheduled for elective surgery were randomly allocated into one of four (150, 300, 600, 1200 ml/hr) groups according to speed of injection of propofol during induction period. Loss of verbal contact was taken as the end-point of induction. Vital signs, SpO2, dose requirement of propofol and induction time were checked. RESULTS: As the injection rate of propofol became slower, there were significant reduction in induction dose and increase in induction time (p<0.05). For example, induction dose and time were 1.82 mg/kg, 223 +/- 58 sec in 150 ml/hr group and 3.14 mg/kg, 50 +/- 11 sec in 1200 ml/hr group, respectively. Also, decrease in systolic and diastolic pressure were less marked at lower injection rates. CONCLUSIONS: Slower injection of propofol produces less vital sign changes and dose requirement for the induction of anesthesia.
Aged ; Anesthesia* ; Arterial Pressure ; Blood Pressure ; Humans ; Propofol* ; Vital Signs*

No abstract available.
Elbow*

BACKGROUND: Morphine for the intravenous patient controlled analgesia (IV-PCA) provides effective postoperative pain control, but it has side effects such as itching, nausea and vomiting. Meanwhile, butorphanol, a synthetic potent agonist-antagonist narcotic with low incidence of adverse side effects and minimal addiction, produce adequate analgesia for postoperative pain. The purpose of this study was to compare the suitability of butorphanol combining with or without morphine with that of morphine in terms of relieving postoperative pain and incidence of side effects. METHODS: Sixty ASA physical status I or II female patients undergoing total abdominal hysterectomy were randomly allocated into one of three groups according to type of drug used (n=20 for each group). The groups were divided to group M (morphine 100 mg), group M B (morphine 50 mg+butorphanol 10 mg) and group B (butorphanol 20 mg). Drugs for each group mixed with 90 ml of normal saline (total amount: 100 ml) for infusion. Loading dose, PCA dose, lockout interval, mode of infusion was 0.05 ml/kg, 0.02 ml/kg, 8 minute, and PCA only, respectively. In each group, visual analog scale (VAS), pain score, sedation score, degree of satisfaction, total amount of drug used, history of attempt/injetion and incidence of side effects were checked. RESULTS: There were no significant differences in analgesic effects and degree of satisfaction among three groups, but incidence of side effects (especially pruritis) were less in group M+B and B compared with group M (p<0.05). CONCLUSIONS: Butorphanol showed comparable postoperative pain relief and marked less side effects compared with morphine. Butorphanol was considered as a useful drug for postoperative pain relief using IV-PCA.
Analgesia ; Analgesia, Patient-Controlled* ; Analgesics ; Butorphanol* ; Female ; Humans ; Hysterectomy ; Incidence ; Morphine* ; Nausea ; Pain, Postoperative* ; Passive Cutaneous Anaphylaxis ; Pruritus ; Visual Analog Scale ; Vomiting

No abstract available.
Myocardial Infarction*

Patau syndrome is trisomy 13, one of the abnormalities of chromosomal structure and, is relatively common with Down syndrome and Edward syndrome. Also it is associated with intrauterine growth retardation, holoprosencephaly, cyclopia, cleft lip, cleft palate, ventricular septal defect, atrial septal defect, extremity abnormalities, and renal malformations. Because early death is typical with 50% of infants with trisomy 13 dying within 1 month and only 18% surviving more than 1 year, prevention through genetic counseling may be important for subsequent pregnancy. We present one case of trisomy 13 with abnormal ultrasound finding of holoprosencephaly, cyclopia, micrognathia, ventricular septal defect, atrial septal defect, and intrauterine growth retardation. And confirmed chromosomally with pregnancy termination.
Cleft Lip ; Cleft Palate ; Down Syndrome ; Extremities ; Female ; Fetal Growth Retardation ; Genetic Counseling ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Holoprosencephaly ; Humans ; Infant ; Pregnancy ; Pregnancy Trimester, Second* ; Trisomy ; Ultrasonography

Pars plana vitrectomy with encircling scleral buckling was performed for 30 eyes of 30 patients with complicated retinal disorders, and the changes of axial length, refractive power, and corneal curvature were analyzed. Significant axial length elongations were observed after encircling procedures. Mean elongation was 0.93+/-0.48mm after 3 months and 0.91+/-0.54mm after 6 months. These spherical equivalent of refraction showed myopic shift of -2.26+/-1.51 diopters(D) after 3 months and -2.19+/-1.39D after 6 months. These changes seem to be less prominent in the eyes with preoperative axial length of 24.50mm or longer(0.68+/-0.46mm after 3 months, 0.60+/-0.49mm after 6 months) than in the eyes with axial length of 24.49mm or shorter(1.18+/-0.35mm 1.23+/-0.38mm). Slight increase in astigmatism was observed, 0.80+/-1.35D after 3 months and 0.64+/-1.01D after 6 months. The mean keratometric readings showed no significant changes, 0.00+/-0.95D after 3 months and 0.26+/-0.95D after 6 months. The result of this study may give an important information when combined procedure of encircling scleral buckling and IOL implantation be planned.
Astigmatism ; Humans ; Reading ; Retinaldehyde ; Scleral Buckling* ; Vitrectomy

BACKGROUND: Ethyl crbmate(EC) has been identified at low microgram quantities in various fermented beverages, destiled products and tobacco smoke. EC has long been known as a carcinogen. Oxidation of the ethyl group of EC is followed by dehydration to yield the carcinogen vinyl carbamate (VC). This is further oxidized to vinyl carbamate epoxide(VCO). VC and VCO proved to be much more carcirogenic than EC. OBJECT: The objective of this study is to compare the potency of carcinogenic ability and histologic changes in skin tumors induced by EC, VC, or VCO. METHODS: In this exeriment, the tumor induction was performed by painting the mouse skin once a week for five weeks with EC, VC and VCO solution, and then 12-0-tetradecanoyl-phorbol-13-acetate(TP2) was treated in the same manner twice a week for 35 weeks. We biopsied the skin at B 0, 15, 25, 30 and 35 weeks and stained the specimens with hematoxylineosin. RESULTS: The time period for the first appearance of papilloma was 6 weeks in the VC-TPA and VCO-TPA group, but, 15 weeks in the EC TPA group. The average number of papilloma showed a statistically sign.ficant difference after 15 weeks between the EC-TPA, VC-TPA and VCO-TPA group. The occurrence of keratoacanthoma and squamous cell carcinoma was 16 and 21 weeks respectively. Histologic changes, such as epidermal layers, pseudohorncysts, degree of hyperkeratosis, hypergranulosis, dysplasia and dyskeratotic cells were more prominent in the papil loma than in the non-papilloma lesion. Dermal changes disclosed similiar findings, that is, increased dermal thicknes, proliferation of vessels and hair follicles, and fibrosis of the dermis. Squamous cell carcinomis and keratoacanthomas were produced only in the VCO-TPA group. CONCLUSION: From the above results it is concluded that VC and VCO have a more potent carcinogenic potential than EC. Various skin tumors, such as papilloma, keratoacanthoma or squamous cell carcinoma were prorduced by the above carcinogens.
Animals ; Beverages ; Carcinogens ; Carcinoma, Squamous Cell ; Dehydration ; Dermis ; Fibrosis ; Hair Follicle ; Keratoacanthoma ; Loma ; Mice ; Paint ; Paintings ; Papilloma ; Skin* ; Smoke ; Tobacco ; Urethane*

Idiopathic thrombocytopenic purpura is an uncommon illness but most common form of thrombocytopema in pregnancy. Corticosteroids, splenectomy, immunosuppressive drugs, and immunoglobulin therapy have been recommended for manaaement. The optimal method of delivery is controversial. We have experienced a case of idiopathic thrombocytopenic purpura diagnosed previously and managed with corticosteroid and vincrstine, which was followed by pregnancy, vaginal delivery and postpiirtum splenectomy.
Adrenal Cortex Hormones ; Immunization, Passive ; Pregnancy* ; Purpura, Thrombocytopenic, Idiopathic* ; Splenectomy

Papillary eccrine adenoma is a rare sweat gland tumor with a characteristic histopathological appearance and has a benign clinical course. Five cases were reported in Korea since a report by Song et al. in 1988. We report a case of papillary eccrine adenoma in a 38-year-old male who had a firm, dark brown nodule on the medial surface of the left thigh. Microscopically, the tumor was composed of multiple dilated ducts lined by two or more layers of epithelial cells and the luminal cells showed papillary projections into the lumen in some tubules. Immunoperoxidase staining was positive for CEA, S-100, and EMA. We excised the lesion completely and no evidence of recurrence was observed for 6 months.
Adenoma* ; Adult ; Epithelial Cells ; Humans ; Korea ; Male ; Music ; Phenobarbital ; Recurrence ; Sweat Glands ; Thigh