BACKGROUND: As undergoing general anesthesia for Cesarean Section, we usually maintain a light anesthesia until delivery. It provokes the high incidence of waketulness for the mothers. We surveyed the incidence of maternal wakefulness when thiopental was used as an induction agent. METHODS: Forty pregnant women (ASA class I or II) at term who underwent general anesthesia and cesarean section received thiopental, 4mg/kg. As the 'isolated forearm technique', a pressure cuff was inflated to isolate one arm from the the effects of succinylcholine so that wakefulness during anesthesia could be assessed by asking the patient to move her hand. To assess wakefulness,the patient was commanded to squeeze the investigator's hand a specified number of times. If the patient promptly squeezed the investigator's hand the appropriate number of times, the command was repeated but a different number of times specified. Only if the patient responded correctly both times, then we noted as a positive response. This test was repeated at 1 minute intervals beginning 1 minute after thiopental injection through the delivery. RESULTS: Five of the forty patients (12.5%) showed wakefulness. Twenty nine of the forty patients showed 'reaching movements'. One patient showed both wakefulness and 'reaching movements'. CONCLUSIONS: When we undergo general anesthesia for Cesarean Section, especially using thiopental as an induction agent, we should consider the maternal wakefulness seriously.
Anesthesia ; Anesthesia, General ; Anesthesia, Obstetrical ; Arm ; Cesarean Section* ; Female ; Forearm* ; Hand ; Humans ; Incidence ; Mothers ; Pregnancy ; Pregnant Women ; Succinylcholine ; Thiopental ; Wakefulness*

Cutaneous manifestations of sarcoidosis are highly variable and can be devided into the specific lesions which reveal noncaseating granuloma and the nonspecific lesio is which are referred to as cutaneous changes. Among speciific lesions, annular lesions may be foimied from coalescing papular lesions that may clear centrally and elevate peripherally. We report a case of sarcoidosis with multiple annular lesions on the face in a 33-year-old female who had systemic involvements in the intrathoracic organs and eyes. The main histopathologir. findings were well-demarcated islands of epitheloid cells with a few giant cells in the dermis. In addition, a slight admixfure of lymphoid cells was present at the margins of the epitheloid cell granulomas. Complete regression of t!he skin lesions was obtained with systemic cortiocosteroid therapy and no recurrence has been found for 2 1/2years.
Adult ; Dermis ; Female ; Giant Cells ; Granuloma ; Humans ; Islands ; Lymphocytes ; Recurrence ; Sarcoidosis* ; Skin

There had been a continuous evolution of lymphoma classification and recently a Revised European-American Lymphoma Classification was proposed by the International Lymphoma Study Group. This new classification often requires information on immunophenotypic and molecular biologic markers in addition to the usual histologic findings. Recent advances in the production of commercially available monoclonal antibodies reactive on formalin-fixed paraffin-embedded tissues provide us a great help to classify the non-Hodgkin's lymphoma. We have analyzed 31 low grade B-cell lymphomas by the schemes proposed by the International Lymphoma Study Group using antibodies to CD3, CD5, CD20, CD23, CD43, cyclin D1, and bcl-2 protein, and have analyzed the immunophenotypic features. Among 31 low grade B-cell lymphomas, 8 small lymphocytic lymphomas, 5 mantle cell lymphomas, 7 follicle center lymphomas (2 grade I, 3 grade II, and 2 grade III), and 11 marginal zone B-cell lymphomas (all of which were extranodal) were identified. Among 8 small lymphocytic lymphomas, 5 cases were positive for CD5; 6 cases were positive for CD23; 7 cases were positive for CD43; all 8 cases were negative for cyclin D1; and 7 cases were positive for bcl-2. Among 5 mantle cell lymphomas, 4 cases were positive for CD5 and CD43; all five cases were negative for CD23; 4 cases were positive for cyclin D1 and bcl-2. All 7 follicle center lymphomas were negative for CD5, CD43 and cyclin D1 and 2 cases were positive for CD23; and 6 cases were positive for bcl-2. All marginal zone B-cell lymphomas were negative for CD5, CD23 and cyclin D1; 3 cases were positive for CD43 and 9 cases were positive for bcl-2. Diagnostic utility for CD5 antigen detection on paraffin embedded tissue has a limitation due to weak antigen expression in tumor cells of B-cell lymphomas; however, still be useful in differentiating small lymphocytic lymphoma and mantle cell lymphoma from other B-cell lymphomas when applied in conjunction with CD43. CD23, CD43, and cyclin D1 appear to be of great help in differentiating subgroups of low grade B-cell lymphomas. Bcl-2, as known, is found to be useful to rule out reactive follicular hyperplasia.
Antibodies ; Antibodies, Monoclonal ; Antigens, CD5 ; B-Lymphocytes* ; Biomarkers ; Classification ; Cyclin D1 ; Hyperplasia ; Immunohistochemistry* ; Leukemia, Lymphocytic, Chronic, B-Cell ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Mantle-Cell ; Lymphoma, Non-Hodgkin ; Paraffin*

PURPOSE: To analyze the characteristies of traumatic brainstem injury by CT and MR MATERIALS AND METHODS: CT and MR studies of 10 patients with traumatic brainstem lesion in MR were retrospectively reviewed, particularly attended to location, signal intensity and associated lesions. RESULTS: CT failed to depict 8 of 10 brainstem lesions. All lesions were detected in MR images with T2-weighted images showing higher detection rate (n=10) (100%) than Tl-weighted images (n=3) (30%) or CT (n=2) (20%). The brainstem lesions located in the dorsolateral aspects of the rostral brainstem(mid brain and upper pons)in 7 (70%) cases, in ventral aspects of rostral brain in 2 (20%) cases and in median portion of pons in 1 (10%) case. Corpus callosal (n=5), Iobar white matter(n=5) diffuse axonal injury, and 2 hemorrhagic lesions in basal ganglia were the associated findings. CONCLUSION: MR imaging is more helpful than CT in the detection of brainstem injury, especially T2 weighted images. Primary brainstem lesions were typically located in the dorsolateral aspect of rostral brainstem(midbrain and upper pons). Corpus callosum and white matter lesions were frequently associated.
Basal Ganglia ; Brain ; Brain Stem* ; Corpus Callosum ; Diffuse Axonal Injury ; Humans ; Magnetic Resonance Imaging ; Pons ; Retrospective Studies

Kaposi's sarcoma is a neoplasm of multifocal origin which manifest primarily as vascular nodules in the skin and other organs. We report a case of Kaposis sarcoma of classic type in a 17-year-old boy, who had a 4 x 5cm sized, dusky erythematous plaque with multiple spots of acupuncture on the left foot for 1 year. Histopathologic examination showed dilated, bizarre-shaped vessels, ndothelial cell proliferation, and spindle cell formation with vascular slits throughout the dermis. He was treated with 3000 rads of radiation(300 rad per day for l0 successive days). Six months after radiotherapy, gross findings were much improved and histopathologic findings showed only fibrosismc hemosiderin deposits in the dermis.
Acupuncture ; Adolescent ; Cell Proliferation ; Dermis ; Foot ; Hemosiderin ; Humans ; Male ; Radiotherapy* ; Sarcoma, Kaposi* ; Skin

No abstract available.
Angiography ; Arterial Occlusive Diseases ; Lower Extremity

No abstract available.
Adenocarcinoma, Papillary* ; Thyroid Gland*

In the summer of 1969 from July through October, authors carried out a study of susceptibility in adult female bed bug(Cimex lectularius) in order to ascertain any development of resistance to insecticides in Korea. The test to DDT and Dieldrin was performed in laboratory by the continuous exposure of residues method, with standard impregnated paper used for adult mosqitoes. Some results so far obtained can be summarised as follows: LC(50) were 2.839% in DDT and 0.167% in Dieldrin. The resistance has been arisen 2.4-2.9 times in DDT and 1.6-2.4 times in Dieldrin as compared with London laboratory strain, but they were susceptible 1.4 times in DDT and 180 times in Dieldrin as compared to Israel resistance strain.
parasitology-arthropodology-bed bug-Cimex lectularius ; prevention ; chemotherapy ; resistance ; DDT ; dieldrin

Chronic hypertension causes pathologic changes within the tunica media, termed lipohyalinosis. The most prominent changes were seen at bifurcation point within the vessels and middle and distal portion of the vessels. The role of microaneursyms in spontaneous intracerebral hemorrhage (ICH) secondary to hypertension is not well understood. A cerebral amyloid angiopathy is associated with fibrinoid necrosis and affects the small to medium sized vessels and it may account for a higher percentage of spontaneous ICH in the elderly. Neurologic dysfunction secondary to ICH is caused by initial hemorrhage with its associated mass effect, and tissue destruction with hematoma enlargement. Consequently, the further deterioration may be due to cerebral edema. The exact role of CBF changes is not unproved in the pathogenesis of neuronal injury. However, much has been learned about the mechanisms involved the brain edema formation after ICH. A number of components of blood are capable of inducing brain injury and brain edema formation. The hematoma exerts its effects not only by mechanical but also by chemical influences.
Aged ; Brain Edema ; Brain Injuries ; Cerebral Amyloid Angiopathy ; Cerebral Hemorrhage* ; Hematoma ; Hemorrhage ; Humans ; Hypertension ; Necrosis ; Neurologic Manifestations ; Neurons ; Tunica Media

Intraoperative monitoring has been a valuable part in the cerebral aneurysm surgery. Insight into the nervous system and the relationship of the aneurysm to the adjacent structure during the surgery provide critical information to the surgeon allowing reversal or avoidance of neural insults and the complete clipping of the aneurysm. The goal of cerebral aneurysm surgery is to eliminate the risk of hemorrhage but not disrupt the surrounding vascular and neural structures. Several techniques including microvascular doppler ultrasonography, monitoring cerebral blood flow, evoked potentials, intraoperative angiography, endoscope assisted aneurysm surgery and neuronavigator system are used for the surveillance in the aneurysm surgery. The abnormal findings in these procedures can change surgical management during the surgery such as removal or readjustment of temporary or permanent clips and a decrease in brain retraction or manipulation. The additional feedback provided by intraoperative monitoring promises to improve the safety and efficacy of aneurysm surgery.
Aneurysm ; Angiography ; Brain ; Endoscopes ; Evoked Potentials ; Hemorrhage ; Intracranial Aneurysm* ; Monitoring, Intraoperative ; Nervous System ; Ultrasonography, Doppler