Background: Bupivacaine was introduced to be a long-acting spinal anesthetic agent. It has been argued about whether the addition of epinephrine prolongs the bupivacaine action or not. The aim of this present investigation was to find out the effect of additional epinephrine on spinal anesthesia with bupivacaine. Methods: 47 patients undergoing an operation on lower extremity were randomly allocated to 2 groups. All patients were anesthetized by subarachnoid block with 0.5% bupivacaine in 8% glucose, which was mixed with 0.2 ml of normal saline in group non-E (n=24) and 0.2 ml of 1:1,000 epinephrine in group E (n=23). We evaluated blood pressure and heart rate, the sensory and motor blockade and voiding time after spinal anesthesia. Results: The systolic blood pressure (SBP) at 8 and 10 min after anesthesia were lower in group non-E than in group E (p<0.05). The trend of decreasing diastolic blood pressure was similar in both groups. The heart rate(HR) at 2 min after anesthesia was lower in group non-E than in group E (p<0.05). The sensory block in T10 was produced faster in group non-E (7 min) than in group E (11 min)(p<0.05). And the maximal sensory block level and its reaching time was T7 and 14 min in group non-E, and T8 and 17 min in group E (p=0.12, p=0.11). Two segment regression time was 124 min in group non-E, and 184 min in group E (p=011). The onset time of motor block to Bromage scale 3 was 12 min in group non-E and 16 min in group E (p=0.06). The recovery time from complete motor block to Bromage scale 1 after maximal motor block was 263 min in group non-E, and 278 min in group E. The time at which patients voided after anesthesia was 469 min in group non-E, and 466 min in group E. Three patients urinated by using a urinary catheter in each group. Conclusions: The addition of epinephrine to bupivacaine for spinal anesthesia can slow the decrease in SBP and increase the HR at early stage of anesthesia, and slow the sensory block.
Anesthesia ; Anesthesia, Spinal* ; Blood Pressure ; Bupivacaine* ; Epinephrine* ; Glucose ; Heart ; Heart Rate ; Humans ; Lower Extremity ; Urinary Catheters

Intracompartmental pressure of leg was measured by the slit catheter technique in one hundred fifty compartments of one hundred cases; fifty were from healthy young male adults, the others were from tibial fractured patients during three years from March 1983 to Fobruary 1986. The results were as follows; 1. Slit-catheter technique was found as a accurate method for continuous pressure monitoring. 2. The range of normal pressure was from zero to six millimeters of mercury(1.45mmHg±0.85). 3. Tissue pressure was 0–15mmHg(4.03mmHg±1.83) in unaffected side of fractured patients, 4–35mmHg(14.65mmHg±2.05) in affected side of fractured patients.
Adult ; Catheters ; Clinical Study ; Humans ; Leg ; Male ; Methods

The knee joint is one of the most susceptable joint to ligamentous injury. For good results, it is very important to make an early diagnosis and to give prompt management. The aim of treatment is to restore the ligaments to their previous anatomic position and tension. The authors reviewed 420 cases of ligamentous injuries in 400 patients who were admitted and managed for 6 years from March, 1981 to February, 1987. The results were as follows : 1. The athletic injury was the most commcn cause of injury(55%), and fall-down was next(26%). 2. The most common ruptured individual ligament was the medial collateral ligament. Combined ligament rupture was more common in medial collateral ligament and anterior cruciate ligament. 3. The ruptured sites of the individual ligament were found to be the following ; a) the medial collateral ligament was ruptured most frequently at the femoral attachment(43%), with the superficial layer ruptured in the midsubstance and the deep layer at the femoral attachment; b) the lateral collateral ligament torn at the fibular attachment(51%); c) the anterior cruciate ligament torn at the femoral attachment(39%); d) the posterior cruciate ligament torn at the femoral attachment(64%). 4. Many ligamentous injuries were associated with fracture(44%) and tear of meniscus- (42%). 5. In stress-radiogram, the significance of ligament injuries was present in more than 10 and 10 mm. 6. Excellent and good results were obtained in 94% by non-surgical treatment and in 92% by surgical treatment. 7. Early surgical repair of the ligament within 2 weeks after injury, gave much better result than later repairs.
Anterior Cruciate Ligament ; Athletic Injuries ; Clinical Study ; Collateral Ligaments ; Early Diagnosis ; Humans ; Joints ; Knee Joint ; Knee ; Lateral Ligament, Ankle ; Ligaments ; Posterior Cruciate Ligament ; Rupture ; Tears

No abstract available.
Neurons*

BACKGROUND AND AIMS: When acute gastric anisakiasis is clinically suspected, endoscopic removal of larva is the only definite treatment method. However, there has been little known for endoscopic findings of gastric anisakiasis. METHODS: In 39 patients with gastric anisakiasis, the ingested species of marine products and clinical findings were investigated. The form of larvae, the mucosal changes of the insertion site, close and distant area were also analysed during endoscopic examination. RESULTS: Twelve patients (30.8%) ate raw Astroconger myriaster solely, and the most frequent mucosal insertion site of larvae was around the greater curvature of the body (59.5%). Endoscopic findings of erosion (33.3%), hemorrhagic erosion (33.3%) and redness of the mucosa (11.9%) were observed at the insertion site. The adjacent mucosal changes were edema and fold enlargement. All patients were treated medically. CONCLUSIONS: When acute gastric anisakiasis is suspected, the careful endoscopic examination of larva was necessary for confirmatory diagnosis and definite treatment of the disease.
Anisakiasis* ; Diagnosis ; Edema ; Humans ; Incheon* ; Larva ; Mucous Membrane

No abstract available.
Korea* ; Lung Neoplasms* ; Lung*

No abstract available.
Sarcoma*

BACKGROUND: One of the most, probable pathogenesis of vitiliga is autoimmune. Systemic cor tico st,eroids suppress immunity and may arrest the progression of vitiligo and lead to repigmentation. OBJECTIVE: We have assessed the clinical effect of a oral small oral dose of corticosteroid to minimize side effects in vitiligo patients. METHODS: Thirty four patients(9;male, 25;female) with vitiligo were evaluated in this study. The patients took 7.5mg-20mg prednisolone initially for 2 months and then the dosage was tapered to half of the initial dosiat the 3rd month and half of dose of 3rd month for the last 4th month. We compared the effcct of treatment of vitiligo before and aft.er the study by photographs. and side efferts were issessed at. 1, 2, 3 and 4 month. RESULTS: The arrest of the progression of vitiligo was noticed in 79% of patients and repigmentation was noticed in 59% of patients which is statistically significant. The effect, of treatment according to extent, duiation, type, and site of vitiligo were not statistically significant. The side effects of treatment were minimal and did not affect the course of treatment. CONCLUSION: Small doses of iral corticosteroids are effective without any significant side effects in preventing progression and loiiduce repigmentation of active spreading vitiligo and generalized type of vitiligo that is difficult to treat with topical corticosteroids.
Adrenal Cortex Hormones* ; Humans ; Prednisolone ; Vitiligo*

No abstract available.
Ambulatory Care Facilities* ; Humans ; Outpatients* ; Pharynx*

No abstract available.
Humans ; Pneumothorax*