Postoperative pain control is very important not only for the relief of pain. but in the prevention of respiratory acidosis, pulmonary complications, emotional disturbances and sleeping disturbances etc. Jn spite of its significance there are a few studies on postoperative pain control in medical literature. Techniques have been developed for postoperative pain control since the 19 century, for example analgesics, inhalational agents, regional block, hypnosis and accupuncture. However none of these techniques was satisfactory because of various complications. The intermittent intramuscular injection of narcotics (e.g. meperidine) has been used most widely pto the present. There have been many complications, induding addiction, from this method. Our study was done in the recovery room with intramuscular injections of Thalamonal to fully awake patients, with 20 cases each having operation done in the upper abdomen, lower abdomen, and in other sites. We evaluated the results for the requirement of meperidine after the adminstration of Thalamonal. This was compared with the control group. There were 85% of cases that did not require the injection of meperidine. One case was complicated by hypotension, but this patient was improved with routine management for , hypotension. Other complications were not found.
Abdomen ; Acidosis, Respiratory ; Affective Symptoms ; Analgesics ; Humans ; Hypnosis ; Hypotension ; Injections, Intramuscular* ; Meperidine ; Narcotics ; Pain, Postoperative* ; Recovery Room

Urachal anomalies are very rare. Since Cabrolius' report of patent urachus in 1550, only 315 cases have been collected in the literature. Failure of the urachal lumen to close and completely obliterate causes one of several anomalies. These have been classified into four distinct entities by Blichert-Tott and Neilsen, Who also tabulated the incidence of each variant in the 315 reported cases : patent urachus , 48 per cent ; urachal cyst , 31 percent ; urachal sinus or alternating sinus, 18 per cent , and vesicourachal diverticulum, per cent . A brief discussion of embryology, symptoms , histopathology , diagnosis and treatment is made and a case of congenital patent urachus is reported here at Korea General Hospital.
Diagnosis ; Diverticulum ; Embryology ; Hospitals, General ; Incidence ; Korea ; Urachal Cyst ; Urachus*

In capacitive heating device, which considered efficient for deep heating, parallel arrangement of the electrodes is a serious limiting factor in heating for eccentrically located lesions because it causes overheating of the exposed ipsilateral skin surface, the heating pattern is also frequently inappropriate, arid the arrangement tends to be unstable due to the patient's gravity. Therefore we attempted an angular arrangement of the electordes to achieve more homogenous and efficient heating for such lesions. In phantom study, both the thermal profile and thermogram established the heating pattern in this unusual angular arrangement of the electrodes at 60degree, 90degree and 120degree angles, respectively. An angular arrangement was also clinically applied to 3 patients. The patients' tolerance was good without significant complication and the thermal distribution was satisfactory. In conclusion, this unusual arrangement of electrodes appears to be promising in the clinical application to the eccentrically located lesions.
Electrodes* ; Gravitation ; Heating* ; Hot Temperature* ; Humans ; Skin

Combined hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC) is sometimes found in resected livers, however, cases with double cancer of HCC and CC are very rare. As well, the rarity of CC arising in von Meyenburg complexes (VMCs) is appreciated. We report the case of a 74-year-old man found to have intrahepatic double cancer composed of well-differentiated HCC and CC which exhibited a histologic progression from VMCs to adenomatous lesions and CC. To our knowledge, this is the first case report published in the literature of a double HCC and CC associated with multiple VMCs. The pathogenesis and previous associated reports of these lesions are discussed.
Aged ; Bile Ducts, Intrahepatic/abnormalities* ; Carcinoma, Hepatocellular/pathology* ; Carcinoma, Hepatocellular/etiology ; Case Report ; Cholangiocarcinoma/pathology* ; Cholangiocarcinoma/etiology ; HumanLiver Neoplasms/pathology* ; Liver Neoplasms/etiology ; Male ; Neoplasms, Multiple Primary/pathology* ; Neoplasms, Multiple Primary/etiology

Intraductal papillary mucinous tumor of the pancreas is characterized by intraductal papillary proliferation of mucin-producing epithelial cells with or without excessive mucin secretion. According to the degree of epithelial dysplasia, intraductal papillary mucinous tumor is classified into adenoma, borderline tumor, and carcinoma. We recently experienced a case of fine needle aspiration cytology of the intraductal papillary mucinous adenoma in a 69-year-old male. The fine needle aspiration cytology yielded flat sheets of columnar, mucin containing epithelial cells in the background of dense mucin containing degenerated cellular material and histiocytes.
Adenoma ; Aged ; Biopsy, Fine-Needle* ; Epithelial Cells ; Histiocytes ; Humans ; Male ; Mucins* ; Pancreas*

No abstract available.
Leukemia, Myelogenous, Chronic, BCR-ABL Positive*

BACKGROUND: Since March 1, 1989, a new health care system has been introduced. But the departments of ENT, ophthalmology, dermatology and PMR (rehabilitation medicine) in tertiary health care hospitals were exempted from the new system and were allowed to see patients directly. Thereafter, the Ministry of Health revised the National Health Insurance regulation, and required the above departments to see patients only with referral. This study was done to analyze whether the revision has contributed to providing adequate specialized medical services and to know what role family physicians can assume under revision by analyzing the referred patients. METHODS: From November 1998 to June 2000 and from July 2000 to February 2002, both 20 months, we reviewed the charts of 331 patients who were referred from family medicine department of KHMC (Kyung Hee Medical Center) to the above four departments and analysis has done. RESULTS: During both periods, the number of cases increased from 94 to 237, and the patients group had no significant difference in age and sex. Reviewing the number of referred cases, before revision, cases were concentrated to the department of ENT and to PMR. After revision, cases were evenly distributed in three departments. except for PMR. Reviewing referral contents, the three departments except for dermatology showed no significant difference. CONCLUSION: The sum of cases increased by 2.5 times, but the three departments except for dermatology showed no significant difference in referral and diagnosis content. In dermatology, the majority of the patients wanted a referral with the objective of obtaining a referral paper. Therefore, we can consider that the revision didnot contribute to specialized medical services. But after revision, referral cases to ophthalmology and dermatology increased by 4 and 6 times. We recommend that family physicians know and experience more about these.
Delivery of Health Care* ; Dermatology ; Diagnosis ; Humans ; National Health Programs ; Ophthalmology ; Physicians, Family ; Referral and Consultation* ; Tertiary Care Centers*

PURPOSE: The purpose of the study was to investigate fatigue, depression and sleep in young adult and middle-aged. METHOD: The convenient sample consisted of 415 subjects from 20 to 59 years old. Data were collected using a self-report questionnaire from July to October, 2001. The VAS-F and CES-D were utilized to measure the level of fatigue and depression. Sleep duration and sleep satisfaction were measured based on the subject's self-report. RESULT: The result of the study revealed that the level of fatigue and depression was higher among young adult than middle-aged. Considering age and gender, the level of fatigue and depression was higher among young adult women and middle-aged men. Depression and sleep satisfaction influenced on the fatigue. CONCLUSION: Health care providers need to concern about fatigue and depression in young adult women and middle-aged men. Especially, more concern and intervention programs are needed for young adult women and middle-aged men.

Granular cell tumor is a rare and usually benign tumor that occasionally involves the breast. The physical examination, the mammographic and ultrasonographic findings and the pathologic findings are often suggestive of carcinoma. We report here a rare case of granular cell tumor of the breast that mimicked carcinoma on the mammography, ultrasonography and MR imaging.
Breast* ; Granular Cell Tumor* ; Magnetic Resonance Imaging ; Mammography ; Physical Examination ; Ultrasonography

Inflammatory myofibroblastic tumor or inflammatory pseudotumor is characterized by spindle cell proliferation with inflammatory cell infiltration, predominantly plasma cells and lymphocytes. We have experienced a case of inflammatory myofibroblastic tumor of the mesentery in a 57-year-old male patient with intermittent abdominal pain. On computer tomography, a well demarcated mass was seen in the mesenteric side of the ascending colon. Right hemicolectomy was performed under the impression of the metastatic tumor of lymph nodes. Grossly, a rather well-circumscribed gray white mass was noted in the mesentery of the ascending colon. Microscopically, the lesion consisted of plump spindle cells and accompanying inflammatory cellular infiltrates. The spindle cells were positive for vimentin.
Abdominal Pain ; Cell Proliferation ; Colon, Ascending ; Granuloma, Plasma Cell ; Humans ; Lymph Nodes ; Lymphocytes ; Male ; Mesentery* ; Middle Aged ; Myofibroblasts* ; Plasma Cells ; Vimentin