The Fig. 5A was given incorrectly.

The purpose of this study is to demonstrate a new postoperative analgesic which minimize the physiological changes of patients. Recently, it has become popular to administer opioids to epidural space rather than intravenously or by intramuscular administration. However, the side effects of opioids have limited the usefulness of this procedure. We tried to find out a way of providing postoperative analgesia while minimizing the side effects of opioids. This study has tested the effects of administering a mixture of small doses of morphine, fentanyl and bupivacaine and epidural morphine alone. The data of this study has taken from 20 paturients who have scheduled for cesarean section. We have classified into two groups which consist of 10 paturients each. We have administered epidural morphine alone to the first group and a small doses of morphine-fentanyl-bupivacaine mixture to second group. We have evaluated analgesic effects by comparing both groups' pain scores of the operative day and of the first postoperative day and evaluated such side effects as the degree of itching, nausea, vomiting, dizziness and respiratory depression by asking to paturients. This study has found the followings: 1) Pain scores of the first group in the operative day and the first postoperative day are 1.2+/-0.4 and 0.4+/-0.5. The second group's pain scores are 0.2+/-0.4 and 0, and the second group's pain scores have significantly reduced (p<0.05). 2) Frequencies of such side effects as itching, nausea and vomiting are higher in the first group (8) than in the second group(4). In conclusion, small doses of morphine-fentanyl-bupivacaine mixture has demonstrated a more effective postoperative analgesia with minimum side effects in pain controlling after cesarean section than epidural morphine alone.
Analgesia* ; Analgesics, Opioid ; Bupivacaine ; Cesarean Section* ; Dizziness ; Epidural Space ; Female ; Fentanyl ; Humans ; Morphine* ; Nausea ; Pregnancy ; Pruritus ; Respiratory Insufficiency ; Vomiting

The study conducted from May to September in 1994 to investigate applicability of the Hearing Handicap Inventory for the Elderly-Screening version(HHIE-S) in parallel with the puretone audiometer to the initial screening test of noise-induced hearing loss(NIHL) in some noise-exposed workers. Subjects were selected by systemic sampling that took every fifth person from 6,700 workers taking the annual occupational health examination by the department of Health Maintenance of Dongsan Hospital Keimyung University in Taegu. The authors administered the pure-tone audiometric test and self-reported questionnaire of HHIE-S including items of sociodemographic and job-related variables concurrently. The final subjects analysed were 1,019(488 males and 531 females) excluding fourteen persons who had many missing values in their questionnaires. The reliability coefficients of HHIE-S scale by Cronbach's alpha were 0.84. In the univariate analysis of hearing handicap measured by the HHIE-S, work duration, military service and the hearing threshold loss at 1kHz and 4kHz was the only selected variable explaining the hearing handicap in males and hearing threshold loss at 1kHz and 4kHz, age, and work duration were selected in females. In ROC curves for HHIE-S scores against NIHL as gold standard which was defined by the follow-up audiogram as more than 30dB of the average of 0.5/1/2kHz and 50dB at 4kHz, the optimal cutoff for the parallel HHIE-S appeared to be 8. The results suggest that HHIE-S appeared to have some reliability and validity in this data and might be used in screening NIHL in parallel with pure-tone audiometer in noise-exposed workers.
Daegu ; Female ; Follow-Up Studies ; Hearing ; Hearing Loss, Noise-Induced* ; Humans ; Male ; Mass Screening* ; Military Personnel ; Occupational Health ; Surveys and Questionnaires ; Reproducibility of Results ; ROC Curve

Hepatic fibrosis was induced in Sprague-Dawley rate to evaluate the ultrastructural changes of fat-storing cells (Ito cells). For experimental induction of liver fibrosis, the rats were administered intraperitoneally with 0.5 ml of 50% Ccl4 solution per Kg body weight, twice weekly for 12 weeks. The rats were sacrificed every week. The liver tissues were examined under light and electron microscopes. And the immunohistochemical study of desmin was also performed. The results were summarized as follows: Light microscopic findings: The cellular infiltrations was inflammatory cells and Kupffer cells developed from 1 week after Ccl4 injection, and were the most severe in 4 weeks. The strong immunoreactivity for desmin was also evident in 4 weeks. The centrilobular necrosis and fibrosis developed from 2 weeks after injection, and the necrosis persisted until 8 weeks. The progress of fibrosis was accompanied by decreases in cellular infiltration and reactivity for desmin, and increased gradual nodular formation was also observed. The cirrhosis was developed after 10 weeks. Electron microscopic findings: An increase in number of fat-storing cells was observed from 1 week after injection. Transitional cells characterized by a depletion of lipid droplets and a hypertrophy of the rER appeared after 2 weeks. The number of transitional cells with abundant collagen fibers in the extracellular spaces increased in 4 weeks. With progression of fibrosis the number of fat-strong cells decreased and proliferating fibroblasts with dilated rER were observed. According to these results it was revealed that there was an apparent transition from fatstrong cells to transitional cells and to fibroblasts. These cells had a few similar characteristics and may belong to the same cell population. Thus it was suggested that fatstrong cells might play an important role in hepatic fibrosis.
Animals ; Body Weight ; Collagen ; Desmin ; Extracellular Space ; Fibroblasts ; Fibrosis* ; Hypertrophy ; Kupffer Cells ; Lipid Droplets ; Liver ; Liver Cirrhosis ; Necrosis ; Rats ; Rats, Sprague-Dawley

It has suggested that a significant proportion of intraepithelial lesion of the cervix may be related to the influence of human papillomaviurs (HPV). Its etiological relation with cervical intraepithelial neoplasia (CIN) and cervical squamous cell carcinoma has recently been proposed. The 131 cases of CIN and 6 condyloma acuminata were stained by immunoperoxidase technique for HPV anigen. The results are as follows: The 18 cases (13.1%) exhibited positive staining, localized in nuclei of koilocytotic cells confined to superficial and intermediate layer of epithelium. HPV antigen was found in 1 case (16.7) of 6 condyloma acuminata, 4 cases (12.5%) of 32 mild dysplasia, 3 cases (13.6%) of 22 moderate dysplasia, 2 cases (14.3%) of 14 severe dysplasia and 8 cases (12.7%) of 63 carcinoma in situ. In the positive cases of mild and moderate dysplasia, HPV antigen was localized directly within the lesion, while those cases of severe dysplaia and carcinoma in situ contained positive cells in areas of mild or moderate dysplasia adjacent to the lesion. Of three distinct morphologic patterns, flat type was most common and papillary type was least. Histologically condylomatous lesions were present in 67 cases (51.1%) out of 131 cases of CIN. The histological and cytological feature encountered most frequently was koilocytotic arypia. Other main histological features are bi- or multinucleation, exocytosis of inflammatory cells, acanthosis, mitotic figures, dyskeratosis and epithelial pearl. On the cervical smear, the evidence of condyloma was proved in 50.0%. Cytologically in the condyloma with high degree of CIN, the nuclear atypia was so prominent that the differentiation from dysplasia or carcinoma in situ was very difficult, although the chromatin appeared somewhat smudged. The mean age of 18 cases was 42.4 years which is older than previous study. The results of this study provide common association with HPV and CIN and add great weight to the suggestion that the infection with HPV plays an important part in genesis of cervical cancer.
Humans

A monoclonal antibody to PCNA, which can be used on routinely processed tissue, was applied to 25 cases of gastric adenomas and 64 cases of gastric adenocarcinomas in order to diffentiate adenoma and adenocarcinoma and also to evaluate the prognostic value in adenocarcinoma. The results were summerized as follows: The PCNA labelling index was 29.14+/-12.77% in control, 44.09+/-17.11% in adenoma and 80.15+/-10. 69 in adenocarcinoma, resulting in significant increase in adenocarcinoma compared to adenoma. In adenocarcinoma, no significant correlation was observed between PCNA labelling index and histologic grade, and there -was increased tendency of PCNA labelling index in proportion to depth of invasion without statistical significance. The PCNA index was significantly increased in advanced adenocarcinoma compared to early gastric carcinoma, and also in positive nodal metastasis group than in negative group. From above results, the PCNA stain will be able to provide a helpful method for the differential diagnosis between gastric adenoma and adenocarcinoma, and could be a useful prognostic factor in adenocarcinoma if other factors are considered together.
Adenocarcinoma* ; Adenoma* ; Diagnosis, Differential ; Neoplasm Metastasis ; Proliferating Cell Nuclear Antigen* ; Stomach

Regardless of the any cause leg ulcers are painful and inconvenient to patients and present clinical and economic problems due to their chronicity. Conventional skin grafts, cultured allogenic epidermis, and cultured autologous epidermis have been used for the treatment of leg ulcers. In a twenty-year-old woman with leg ulcers, autologous pure epidermal sheets were obtained from the lower chest by means of suction blisters and grafted to the leg ulcers. All lesions were healed completely in 20 days after grafting. The donor sites showed slight postinflammatory hyperpigmentations without scars. The autologous epidermal graft using suction blisters appears to be a useful method for the treatment of leg ulcers, with no immunologic rejection, no need for cultivation and anesthesia, no desiccation, and no scars on the donor sites.
Anesthesia ; Blister* ; Cicatrix ; Desiccation ; Epidermis ; Female ; Humans ; Leg Ulcer* ; Leg* ; Methods ; Skin ; Suction* ; Thorax ; Tissue Donors ; Transplants*

We report a case of drug eruption and liver damage due to diaminodiphenyl suIfone(DDS) ingestion in a 17-year-old female. This patient had taken DDS for 20 days, 100mg-200mg daily to treat an unknown skin disease. Thereafter, she had generalized erythematous eruption on whole body, icteric sclera and fever. Liver function test showed abnormality (SGOT 514 unit, SGPT 710 unit, alkarine phosphotase 4. 3 B.U., total biIirubin 7. Oml/dl, direct bilirubin 4. 8mg/dl). The adverse reactiions to DDS are gastrointestinal intolerance, hemolytic, anemia, methemoglobinemia, agranulocytoais, hepatitis, neuritis, psychosis and a skin rash described as a fixed drug eruption, erythema multiforme, exfoliative dermatitis and toxic epidermal necrolysis. In Korea, DDS has been used for the treatment of skin diseases of various types for a long time without prescription, especially in rural areas. This trend is a significant sociomediical problem in Korea.
Adolescent ; Alanine Transaminase ; Anemia ; Bilirubin ; Dermatitis, Exfoliative ; Drug Eruptions* ; Eating ; Erythema Multiforme ; Exanthema ; Female ; Fever ; Hepatitis ; Humans ; Korea ; Liver Function Tests ; Liver* ; Methemoglobinemia ; Neuritis ; Prescriptions ; Psychotic Disorders ; Sclera ; Skin Diseases ; Stevens-Johnson Syndrome

BACKGROUND: The diagnosis of tuberculosis has been based on the detection of tubercle bacilli by acid-fast stain of smear or cultures, and recently the serologic diagnosis of tuberculosis has been provided a means of sensitive and specific detection of Mycobacterium tuberculosis. We evaluated the utility of enzyme immunoassay using determiner Tuberculosis Glicolipids(TBGL) antibody kit(Kyowa Medex Co. Ltd, Japan) to detect anti-TBGL antibody for diagnosis of pulmonary tuberculosis. METHODS: Anti-TBGL antibody assay was performed to the form 44 patients with active pulmonary tuberculosis(17 patients with smear positive, 7 patients with only culture positive, 20 patients with clinically active tuberculosis) and 80 controls (30 healthy controls, 24 patients with non-tuberculous respiratory diseases, 26 patients with inactive tuberculosis). We compared the sensitivity and specificity of anti-TBGL antibody with culture and AFB stain. RESULTS: Anti-TBGL antibodies were detected in 16 of 17(94%) smear positive patients, 4 of 7 patients with only culture positive and 16 of 20(80%) smear negative patients who had been clinically diagnosed as active pulmonary tuberculosis. Nine(35%) out of 26 patients with inactive tuberculosis, one(4%) out of 24 patients with non-tuberculous respiratory diseases and no one of healthy control had a positive antibody response. Overall sensitivity, specificity of the anti-TBGL antibody assay were 82%, 88%, respectively and sensitivities and specificities of culture and AFB smear 64%, 97%, and 49%, 100%, respectively. Anti-TBGL antibody titers in patients with active tuberculosis were significantly higher than control grup(P<0.05). Conclusions : The anti-TBGL antibody assay was sensitive, rapid and convenient. This assay will be useful as a tool for the diagnosis of tuberculosis in combination with other conventional methods.
Antibodies ; Antibody Formation ; Diagnosis* ; Humans ; Immunoenzyme Techniques* ; Mycobacterium tuberculosis ; Sensitivity and Specificity ; Tuberculosis ; Tuberculosis, Pulmonary*

The several Chinese herbs such as Soon-Ki-Hwal-Hyul-Tang, Bo-Yang-Hwan-O-Tang, Seong-Hyang-Jeong-Ki-San, So-Hap-Hyang-Won and O-Yak-Soon-Ki-San were extracted with water and then lyophilized. For identification of the effect of extracted herbs, they were medicated to 103 patients of cerebrovascular accident for 4 week. They were hospitalized in D-Oriental Medical Hospital from April to August in 1999. The herbs were extracted with water and lyophilized and then, used as samples. The medical history of each patient was detected and analyzed from their medical records. The results were as follows: 1) Each sample (Soon-Ki-Hwal-Hyul-Tang, Bo-Yang-Hwan-O-Tang, Seong-Hyang-Jeong-Ki-San, and O-Yak-Soon-Ki-San) was statistically significant differences of systolic blood pressure(t=4.22, P=0.0004: t=3.44, P=0.0028: t=2.11. P=0.0463: t=3.23, P=0.0052). The statistically significant difference of diastolic blood pressure showed by medicated with Soon-Ki-Hwal-Hyal-Tang, Seong-HyangJeong-Ki-San, and O-Yak-Soon-ki-San(t=2.13, P= 0.0459: t=2.68, P=0.0136: t=3.12, P=0.0066). 2) The statistically significant difference of the arm/leg-ROM showed by medicated with Soon-Ki-Hwal-Hyul-Tang, Bo-Yang-Hwan-O Tang, So-Hap-Hyang-Won(t =4. 74/4. 95, P=0.0002/0.0001: t=2.25/2.44, P=0.0368/0.0248: t=585/6.76, P=0.0001/0.0001). 3) In the verbal disorder, Soon-Ki-Hwal-Hyul-Tang, Bo-Yang-Hwan-O-Tang had statistically significant differences(t=4.50, P=0.0002: t=3.32, P=0.0036) 4) In the conscious disorder, Soon-Ki-HwalHyul-Tang, Bo-Yang-Hwan-O-Tang, Seong-Hyang =-Jeong-Kj-San, and So-Hap-Hyang-Won had statistical1y significant differences(t =6.32, P = 0,0001: t=8.32, P=0.000l: t=3.74, P=0.0012: t=5.14, P=0.0001). 5) Bovine aortic endothelial cell (BAEC) were cultured in DMEM treating 0.01mg/ml. and 0.1mg/ml of each lyophilized samples for 24 hours, In BAECs were treated by 5 kinds of samples, the effect of So-Hyap-Hyang-Won induced syncytium of adjacent endothelial cells. It may induce the recovering of the damaged blood vessels in cerebrovascular accidental patient by angiogensis of endothelial cells. Therefore, it suggests that the medication of So-Hap-Hyang-Won will help to nursing care for cerebrovascular accidental patients.
Asian Continental Ancestry Group ; Blood Pressure ; Blood Vessels ; Endothelial Cells ; Giant Cells ; Humans ; Medical Records ; Nursing Care ; Stroke* ; Water