OBJECTIVES: The differentiation of tuberculous effusion from the other causes of exudative pleural effusion remained difficult even with aids of biochemical analyses and pleural biopsy. As the pathophysiology of tuberculous pleural effusion is an enhanced cell mediated immunity, Adenosine deaminase(ADA) and various cytokines including Inteferon-γ, tumor necrosis factor alpha(TNF-α) are considered as useful diagnostic tools in differentiating exudative pleural effusion The author would like to demonstrate the diagnostic usefulness of TNF-α in the differentiation of exudative pleural effusion, and compared the discriminating ability of TNF-α with ADA. METHODS: Pleural fluids obtained from 80 patients (tuberculous : 39, malignant : 31, parapneumonic : 10) with exudate pleural effusions were processed for cell counts and biochemical analysis including ADA and TNF-α RESULTS: Tuberculous pleural fluid showed higher levee of ADA and TNF-α, 48.7α 32.7U/L and 184.1±214.2pg/mL than that of non-tuberculous effusion 26.0α41.3U/L and 44.1α114.2pg/mL, respectively (ADA, TNF-α : p<0.05, p<0.01). Receiver operating characteristics(ROC) curves were generated for ADA and TNF-α, and the best cut-off value for adenosine deaminase and TNF-α were considered as 30U/L and 15pg/ml, respectively. Comparing the area under the ROC curves, there was no significant difference between ADA and TNF-α CONCLUSION: For the differential diagnosis of tuberculous pleural effusion from the other causes of exudative pleural effusions, TNF-α as well as ADA was considered as useful diagnostic method. However adding TNF-α to ADA has no further diagnotic benefit than ADA alone.
Adenosine ; Adenosine Deaminase ; Biopsy ; Cell Count ; Cytokines ; Diagnosis, Differential ; Exudates and Transudates ; Humans ; Immunity, Cellular ; Pleural Effusion* ; ROC Curve ; Tuberculosis ; Tumor Necrosis Factor-alpha*

BACKGROUND: Diclofenac is a nonsteroidal anti-inflammatory drug widely used as adjuvant for postoperative pain management using intravenous Patient Controlled Analgesia (PCA). The analgesic and hemostatic effects of diclofenac were measured in 80 paturients after Cesarean section. METHODS: Eighty parturients were randomly allocated to four groups and each group had 20 women. The parturients were given loading dose of meperidine in D group and morphine in M group and then postoperative pain was controlled with PCA device for up to 48 hours after Cesarean section when the parturients awoke and complained pain. The parturients received intramuscular diclofenac 75 mg followed by loading dose of meperidine in DV group and morphine in MV group. Diclofenac was repeated every 12 hours. We evaluated the effects of diclofenac on postoperative opioid requirement, numerical rating score of pain and hemostasis at 48 hours after operation. RESULT: Diclofenac decreased almost 50% of opioid requirement and pain score lowered significantly at 12, 24 hours in DV group and at 12 hours in MV group. But there was no difference in laboratory data including hemoglobin, hematocrit, platelet count and bleeding time among the groups. CONCLUSION: We concluded that diclofenac is effective and safe adjuvant for postoperative pain management without hemostatic abnormality. But it is necessary to try further evaluation of hemostatic effect of diclofenac.
Analgesia, Patient-Controlled ; Bleeding Time ; Cesarean Section* ; Diclofenac* ; Female ; Hematocrit ; Hemostasis ; Humans ; Meperidine ; Morphine ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis* ; Platelet Count ; Pregnancy

BACKGROUND: The development of techniques and improvement of diagnostic facilities have led to the increased use of pacemakers in cardiac patients. So, anesthesiologists should have paid more attention to the patients with pacemakers, and they also need the full knowledge of wide varieties of pacemakers currently used for a safety of these patients. The purpose of this study is the assessment of fifteen pacemaker patients undergoing surgery. METHODS: This study was done in 15 cardiac patients with pacemaker who underwent noncardiac operations. We evaluated symptom, ECG rhythm, underlying cardiac disease before pacemaker implantation and the type of implanted pacemaker. The type and duration of operations, together with anesthetic techniques were also assessed. RESULTS: The pre-pacemaker symptoms were intermittent dizziness, palpitation, syncope, and general weakness. The underlying cardiac diseases were complete A-V block, sick sinus syndrome and bifascicular block. The types of implanted pacemakers were VVIR (n=14) and DDD (n=1). The kinds of anesthetic techniques were general anesthesia (N2O-O2-enflurane; n=10, N2O-O2-fentanyl; n=1), and continuous epidural block (n=3) or continuous spinal block (n=1) combined with general anesthesia (N2O-O2). CONCLUSIONS: We should evaluate the patient with pacemakers preoperatively for underlying cardiac disease and implanted pacemaker. Thereafter, we have to choose the safe anesthetic technique.
Anesthesia, General ; Dichlorodiphenyldichloroethane ; Dizziness ; Electrocardiography ; Heart Diseases ; Humans ; Sick Sinus Syndrome ; Syncope

OBJECTIVE: The purpose of this study is to measure plantar foot pressure and to make comparison of plantar foot pressure between measurements with and without ballet shoes. METHOD: Sixty six feet of healthy ballerinas were evaluated by Footscan plate and Foot scan Pro 4.5 program to analyze plantar foot pressure. We measured plantar foot pressure with and without ballet shoes respectively. The foot was divided into 7 different points on the basis of each metatarsal bone head, 1st toe, and heel. Also total plantar foot pressure was measured. RESULTS: There were no difference in plantar foot pressure between with and without ballet shoes. The highest pressure point of plantar foot in all subjects is the heel with ballet shoes and the great toe without ballet shoes. And the highest pressure point of plantar foot in skilled ballerinas is the great toe with and without ballet shoes. Also the highest pressure point of plantar foot in unskilled ballerinas is the heel with ballet shoes and the second metatarsal head without ballet shoes. CONCLUSION: We concluded that the ballerinas may need the protective ballet shoes.
Foot* ; Head ; Heel ; Metatarsal Bones ; Shoes* ; Toes ; Walking*

"Acknowledgements" section should be inserted in this article.

Hemifacial microsomia (HFM) is the most common craniofacial anomaly after cleft lip and cleft palate; this deformity primarily involves the facial skeleton and ear, with either underdevelopment or absence of both components. In patients with HFM, the management of the asymmetries requires a series of treatment phases that focus on their interception and correction, such as distraction osteogenesis or functional appliance treatment during growth and presurgical orthodontic treatment followed by mandibular and maxillary surgery. Satisfactory results were obtained in a 9-year-old girl with HFM who was treated with distraction osteogenesis. At the age of 19, genioplasty and mandible body augmentation with a porous polyethylene implant (PPE, Medpor(R), Porex) was sequentially performed for the functional and esthetic reconstruction of the face. We report a case of HFM with a review of the literature.
Child ; Cleft Lip ; Cleft Palate ; Congenital Abnormalities ; Ear ; Female ; Follow-Up Studies* ; Genioplasty ; Goldenhar Syndrome* ; Humans ; Mandible ; Osteogenesis, Distraction ; Polyethylene ; Skeleton

In the present study, the antinociceptive profiles of hop extract were characterized in ICR mice. Hop extract administered orally (from 25 to 100 mg/kg) showed an antinociceptive effect in a dose-dependent manner as measured in the acetic acid-induced writhing test. Antinociceptive action of hop extract was maintained at least for 60 min. Moreover, cumulative response time of nociceptive behaviors induced with intraplantar formalin injection was reduced by hop extract treatment during the 2nd phases. Furthermore, the cumulative nociceptive response time for intrathecal injection of substance P (0.7 microg) or glutamate (20 microg) was diminished by hop extract. Intraperitoneal pretreatment with naloxone (an opioid receptor antagonist) attenuated antinociceptive effect induced by hop extract in the writhing test. However, methysergide (a 5-HT serotonergic receptor antagonist) or yohimbine (an alpha2-adrenergic receptor antagonist) did not affect antinociception induced by hop extract in the writhing test. Our results suggest that hop extract shows an antinociceptive property in various pain models. Furthermore, the antinociceptive effect of hop extract may be mediated by opioidergic receptors, but not serotonergic and alpha2-adrenergic receptors.
Animals ; Formaldehyde ; Glutamic Acid ; Humulus ; Injections, Spinal ; Methysergide ; Mice ; Mice, Inbred ICR ; Naloxone ; Reaction Time ; Receptors, Opioid ; Serotonin ; Substance P ; Yohimbine