No abstract available.
Diarrhea* ; Humans ; Infant*

BACKGROUND: Intravenous patient controlled analgesia (IV-PCA) is a very popular and relatively safe technique due to its innate negative feedback mechanism. Morphine, the most commonly used analgesic, however, has its own drawbacks due to troublesome side effects. Narcotic agonist-antagonists are known to have ceiling effects not only to their analgesic potency, but also to their side effects. The authors studied the efficacy and incidence of side effects of Butorphanol IV-PCA for postoperative analgesia and compared these to morphine. METHODS: 38 ASA class I or II patients, undergoing gynecological surgery were randomly assigned into two groups, respectively Butorphanol and Morphine and examined hemodynamic changes, overall pain relief, patients satisfaction and the frequency of side effects. After general anesthesia, each patient randomly received loading dose of butorphanol or morphine in the recovery room and discharged to the floor with the PCA module. Upon arrival, individual patient was evaluated at predetermined time interval for 24 hours. RESULTS: The percentage of patient satisfaction was very high in both groups. The incidence of nausea was less in butorphanol group. The incidence of other side effects was statistically insignificant. CONCLUSIONS: Butorphanol has less incidence of side effects and comparable level of analgesia when compared to morphine. We conclude that butorphanol may be considered as a part of routine IV-PCA regimen, in postoperative pain management.
Analgesia ; Analgesia, Patient-Controlled* ; Anesthesia, General ; Butorphanol* ; Female ; Gynecologic Surgical Procedures* ; Hemodynamics ; Humans ; Incidence ; Morphine* ; Nausea ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Patient Satisfaction ; Recovery Room

Congenital onychodysplasia of the index fingers(COIF) is a rare condition of the nails, characterized by the following : (1) congenital occurrence, (2) unilateral or bilateral index finger involvement, (3) variability in nail appearance such as anonychia, micronychia, and polyonychia, (4) possible hereditary involvement, and (5) frequently associated bone anomalies. A 7-week-old male baby with an atrial septal defect presented with micronychia of the left index finger. Roentgenogram of both hands revealed a bone defect of the left 2nd distal phalanx. To our knowledge, distal phalangeal bone defect has not been previously described in this disease. We report a case of COIF with atrial septal defect.
Fingers* ; Hand ; Heart Septal Defects, Atrial ; Humans ; Male

Background: Conventional laryngoscopy with Macintosh blade requires a movement of the head, neck and cervical spine. The Bullard laryngoscope is an anatomically shaped, potentially eliminating the need for cervical spine extension. Bullard and Macintosh laryngoscopes were compared by measuring the degree of cervical spine extension by radiological measurement. Methods: Eighteen patients requiring endotracheal intubation were studied. Anesthesia was induced in neutral head position followed by laryngoscopy. Each patients was intubated two times by Macintosh and Bullard laryngoscope in random order. Radiographic evaluation was performed to determine the degree of cervical spine extension on four occasions; before induction, during facial mask ventilation, and during Bullard and Macintosh laryngoscopy. Results: The extension of cervical spine was significantly less following Bullard laryngoscopy than Macintosh laryngoscopy for best view (p<0.05). Conclusions: The Bullard laryngoscope can be used with less cervical spine extension than Macintosh laryngoscope. It may be useful in patients in whom cervical spine movement is limited or undesirable.
Anesthesia ; Head ; Humans ; Intubation, Intratracheal ; Laryngoscopes ; Laryngoscopy* ; Masks ; Neck ; Spine* ; Ventilation

BACKGROUND: Inducible heat shock protein 70s (iHSP70) are expressed by stressful stimuli that result in protein denaturation, and are thought to assist in the maintenance of cellular integrity and viability. In addition, iHSP70 is known to be a sensitive marker of neuronal injury. To my best knowledge, no previous studies have been documented on iHSP70 induction by nociceptive impulse transmission through peripheral nerves not by direct neural damage. The purpose of this study was to examine the hypothesis that iHSP70 can be expressed in the nervous system, which is related to the dental nociceptive pathway, by tooth pulp inflammation. METHODS: The pulp of rat mandibular molars was exposed. Animals were sacrificed at 1, 4, and 7 days after pulpal exposure, and the pulps were evaluated histologically. Also, iHSP70 levels were examined in the Gasserian ganglion (GG) and the trigeminal sensory nucleus (TSN). RESULTS: At 4 days after pulpal exposure, iHSP70 was significantly more expressed in the ipsilateral GG than in the contralateral GG. In the histological study, inflammation was found in the entire pulp tissue at 4 days. There were no significant differences in iHSP70 levels between the ipsilateral TSN and the contralateral TSN. Also, there were no significant differences in iHSP70 expression of GG and TSN between both sides at 1 and 7 days after pulpal exposure. CONCLUSIONS: These results suggest that iHSP70 can be expressed in the GG at 4 days after pulpal exposure by nociceptive impulses due to pulpal inflammation.
Animals ; Heat-Shock Proteins* ; Hot Temperature* ; HSP70 Heat-Shock Proteins* ; Inflammation ; Molar ; Nervous System ; Neurons ; Peripheral Nerves ; Protein Denaturation ; Rats* ; Tooth ; Trigeminal Ganglion

No abstract available.

BACKGROUND: Maligant pleural effusions are common and significant problems in patient with advanced malignancies. In comparison with traditional sclerosing agent, intrapleural chemotherapy has a potential advantage of treating the underlying malignancy in addition to providing local control of th effusion. This study evaluated efficacy of intrapleural chemotherapy with cisplatin and cytarabine in the management of malignant pleural effusion from lung cancer and others. METHODS: 29 patients with pathology-proven malignant pleural effusion were prospectively analyzed to estimate the effect of intrapleural chemotherapy. A single dose of cisplatin 100mg/m plus cytarabine 1200mg/m in the 250ml normal saline were instilled into the pleural space via a chest tube and drained 4 hours later. Patients were evaluated for toxicity and response at 24hours, 1st, 2nd, 3rd week, and monthly interval. No recurrence of the effusion was considered a complete response(CR). Partial responses (PR) was defined as a 75% or greater decrease in the amount of effusion on serial chest radiographs. RESULTS: The overall response rate(CR plus PR) was 93.1% (27 of 29 patients). The median length of response was 7.5 months. Among 17 patients who were assessable until they died, 14 patients(82%) maintained complete response at the last follow-up. One patient experienced reversible grade 4 myelosuppression, 3 patients had grade 3 nausea & vomiting. 2 patients had empyema, and 2 patients had wound infection. CONCLUSIONS: The outcome of this trial indicated that the intrapleural chemotherapy with cisplatin and cytarabine with little treatment related mortality and morbidity.
Chest Tubes ; Cisplatin* ; Cytarabine* ; Drug Therapy* ; Empyema ; Follow-Up Studies ; Humans ; Lung Neoplasms ; Mortality ; Nausea ; Pleural Effusion ; Pleural Effusion, Malignant* ; Prospective Studies ; Radiography, Thoracic ; Recurrence ; Vomiting ; Wound Infection

Sclerotic fibroma is a rare skin neoplasm that can occur seen sporadically or in association with Cowden's disease. Clinically, it presents as asymptomatic flesh-colored or pinkish slow-growing papules or nodules with a wide anatomical distribution. We report a rare case of pedunculated type of sclerotic fibroma resembling soft fibroma, which has not been reported in Korea.
Fibroma ; Hamartoma Syndrome, Multiple ; Korea ; Skin Neoplasms

During the recent epidemic period (1995~1996), seven strains of rubella virus were isolated in Korea. To analyze phylogenetic relationship between seven Korean strains and rubella virus strains from other different geographical areas, structural genes (E1, E2 and C) of Korean strains were enzymatically amplified and automatically sequenced. The sequence similarities of the E1, E2 and C genes of the cosmopolitan types were 95.8~98.1%, 92.6~99.2% and 96.4~99.3% based on 1,441, 122 and 139 nucleotides and 96.9~98.5%, 90~100% and 97.8~100% based on 480, 40 and 46 amino acids compared to the sequences of strain RA27/3, respectively. In contrast, the sequence similarities of the E1, E2 and C genes of the Asian types were 91.5~92.1%, 83.6~88.5% and 91.4% based on nucleotides ad 96.9~97.7%, 85.5% and 97.8% based on amino acids compared to the sequences of strain RA27/3. respectively. However, immunodominent epitopes of the E1 gene of the cosmopolitan and Asian types were well conserved, and the growth patterns in cell culture and immunofluorescent antibody titers in cross-reaction test showed no differences between two different types. In phylogenetic analysis based on nucleotide sequences of each gene regions, the comopolitan and Asian types formed tow distinct phylogenetic lineages. These data showed two distinct genotypes of rubella viruses cocirculated in Korea, but no significant differences in the antigenicity of two different rubella virus strains were found.
Amino Acids ; Asian Continental Ancestry Group ; Base Sequence ; Cell Culture Techniques ; Epitopes ; Genotype ; Humans ; Korea ; Nucleotides ; Rubella virus* ; Rubella* ; Sequence Analysis*

It has been commonly noted that male patients have worse prognosis in adult polycystic kidney disease, IgA nephropathy, and membranous nephropathy. Several animal experiments were performed to clarify the mechanisms by which male gender confers a more adverse renal prognosis. Obese Zucker rats are characterized by severe obesity, insulin resistance, extremely high serum insulin level, high cholesterol level and spontaneous glomerular sclerosis. The aim of current study was to investigate whether there was a gender difference in 1) mean arterial pressure and renal function 2) glomerular volume by renal perfusion 3) glomerular hemodynamic factors including glomerular blood flow, glomerular pressure, renal vascular resistance, ultrafiltration coefficient by micropuncture techniques in obese male and female Zucker rats. There was no difference in blood glucose, serum insulin level, mean arterial pressure and glomerular sclerosis rate between male and female Zucker rats. Male Zucker rats had slightly higher glomerular filtration rate, kidney weight, single nephron glomerular filtration rate, glomerular capillary hydraulic pressure which was statistically insignificant. These findings suggest that gender difference in hemodynamic factors does not play a role in the progression of renal disease in obese Zucker rats.
Animal Experimentation ; Animals ; Arterial Pressure ; Blood Glucose ; Capillaries ; Cholesterol ; Female ; Glomerular Filtration Rate ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranous ; Hemodynamics* ; Humans ; Insulin ; Insulin Resistance ; Kidney ; Male ; Nephrons ; Obesity, Morbid ; Perfusion ; Polycystic Kidney, Autosomal Dominant ; Prognosis ; Punctures ; Rats* ; Rats, Zucker ; Sclerosis ; Ultrafiltration ; Vascular Resistance