The intravenous administration of midazolam is widely used as sedative premedication for upper gastrointestinal endoscopy. We performed a study to evaluate the effectiveness and safety of midazoiam as premedication for upper gastrointestinal endoscopy. Between June 1995 and October 1995, 112 patients of diagnostic esophago-gastroduodenoseopy were enrolled in the study. The patients were recieved a bolus midazolam 0.~03mg/kg or placebo, followed by typical anesthesia. The blood pressure, pulse and oximeter values were monitored. The systolic blood pressure and heart rate were increased during endoscopy in compared with before premedication, and normalized immediately. There was no significant change of arterial oxygen saturation. Midazolam induced amnesia completely in 49.2% and partially in 27.2%, and all patients were recovered completely in 1 hour. The tolerance score is higher in the midazolam group as compared with the placebo group(p<0.05), and midazolam group would accept the same sedation for repeated endoscopies(p<0.01). We conclude that midazolam has beneficial effects as premedication for upper gastrointastinal endoscopy without significant altteration in cardiopulmonary parameters. This suggest that midazolam may be used more frequently as premedication, especially in the cases of repeated endoscopy.
Administration, Intravenous ; Amnesia ; Anesthesia ; Blood Pressure ; Endoscopy ; Endoscopy, Digestive System ; Endoscopy, Gastrointestinal* ; Heart Rate ; Humans ; Midazolam* ; Oxygen ; Premedication*

We report a case of B-cell chronic lymphocytic leukemia (CLL) with trisomy 12 detected by FISH using chromosome 12 alpha-satellite Probe (Oncor , USA) in uncultured interphase cells. Chromosome studies did not produce an analyzable metaphase by standard short term culture and revealed only normal female karyotype by B cell mitogen (phorbol 12-myristate 13-acetate) stimulated 96 hr culture. The patient, a 59-year-old female, did not have hepatomegaly, splenomegaly, lymphadenopathy and any other symptoms. The peripheral blood of the patient showed marked lymphocytosis (WBC : 28,300/microL, Lymphocyte: 80%) and the diagnosis by immunophenotyping was B cell CLL:CD5, CDl9, CD2O, SmIg, HLA-DR positive.
Chromosomes, Human, Pair 12 ; Diagnosis ; Female ; Fluorescence* ; Hepatomegaly ; HLA-DR Antigens ; Humans ; Immunophenotyping ; In Situ Hybridization* ; Interphase ; Karyotype ; Leukemia, Lymphocytic, Chronic, B-Cell* ; Lymphatic Diseases ; Lymphocytes ; Lymphocytosis ; Metaphase ; Middle Aged ; Splenomegaly ; Trisomy*

We report a case of B-cell chronic lymphocytic leukemia (CLL) with trisomy 12 detected by FISH using chromosome 12 alpha-satellite Probe (Oncor , USA) in uncultured interphase cells. Chromosome studies did not produce an analyzable metaphase by standard short term culture and revealed only normal female karyotype by B cell mitogen (phorbol 12-myristate 13-acetate) stimulated 96 hr culture. The patient, a 59-year-old female, did not have hepatomegaly, splenomegaly, lymphadenopathy and any other symptoms. The peripheral blood of the patient showed marked lymphocytosis (WBC : 28,300/microL, Lymphocyte: 80%) and the diagnosis by immunophenotyping was B cell CLL:CD5, CDl9, CD2O, SmIg, HLA-DR positive.
Chromosomes, Human, Pair 12 ; Diagnosis ; Female ; Fluorescence* ; Hepatomegaly ; HLA-DR Antigens ; Humans ; Immunophenotyping ; In Situ Hybridization* ; Interphase ; Karyotype ; Leukemia, Lymphocytic, Chronic, B-Cell* ; Lymphatic Diseases ; Lymphocytes ; Lymphocytosis ; Metaphase ; Middle Aged ; Splenomegaly ; Trisomy*

BACKGROUND: Fanconi's anemia (FA) is an autosomal recessive disease characterized by aplastic anemia, pre-malignancy, congenital malformations and chromosome breakage syndromes. As up to 30% of patients have no detectable congenital anomalies, the modern diagnosis of FA rests on chromosomal breakage of patient's cells induced by chemical clastogens such as diepoxybutane (DEB) or mitomycin-C (MMC). METHODS: We have done chromosome breakage test to differentiate FA from 11 aplastic anemia, three Diamond-Blackfan syndrome, three myelodysplastic syndrome, one acute leukemia with congenital anomaly and three siblings of FA. The peripheral blood lymphocytes from each individual were co-cultured in phytohemagglutinin-containing medium by the three methods, i.e., DEB treated, MMC treated and un-treated. RESULTS: Five cases were found to have increased chromosomal breakages to DEB and MMC, confirming diagnosis of FA. Other 21 cases showed no increased chromosomal breakages. No overlap was found between FA group and others (P<0.01). In one FA, there was no increased spontaneous breakage, but increased breakage to DEB and MMC. Of five FA, one case showed no congenital anomalies. CONCLUSIONS: Chromosme breakage test was shown to be simple, reliable and useful in ascertaining the diagnosis of FA.
Anemia, Aplastic ; Chromosome Breakage* ; Diagnosis* ; Fanconi Anemia* ; Humans ; Leukemia ; Lymphocytes ; Mitomycin ; Mutagens ; Myelodysplastic Syndromes ; Siblings

PURPOSE: To determine the presence of cruciate ligament tears following avulsion injuries involving the ACL and PCL, and to correlate the findings with those of surgery. MATERIALS AND METHODS: Between March 1997 and May 2002, avulsion injury involving the ACL or PCL was diagnosed in 19 patients. Ten of these [8 males and 2 females aged 10-51 (avergae, 27.7) years] were included in this study. We assessed the presence of cruciate ligament tears at MR imaging, correlating the findings with those of surgery. Associated intra-articular injuries, treatment methods and follow-up results were also evaluated. RESULTS: Among Seven patients with ACL avulsion injury, this was assessed at MR imaging as complete tear (n=1), partial tear (n=5), or intact (n=1), while all MR images of PCL avulsion injury (n=3) showed that this was partial tear. All imaging findings corresponded with the surgical findings. In four patients there was associated knee injury involving, respectively, tears of the medial meniscus, lateral meniscus, PCL and MCL, and popliteal ligament. CONCLUSION: Our findings showed that with one exception, patients with avulsion injury of the ACL or PCL had suffered either a partial or complete tear. MR imaging may be useful in the diagnosis of tears of the cruciate ligament which have not been noticed at surgery or arthroscopy in avulsion injuries involving the ACL and PCL.
Arthroscopy ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Knee Injuries ; Knee* ; Ligaments* ; Magnetic Resonance Imaging* ; Male ; Menisci, Tibial ; Spine*

No abstract available.

In our previous study, we observed that hydrosalpingeal fluid (HSF) adversely effect mouswe embryo development and hatching. The aim of this study was to evaluate the effect of HSF as assessed by the blastocyst development rate (BDR) and by cell counting in vitro HSF was collected from nine patients undergoing salpingoneostomy to correct hydrosalpinx. Two-cell embryos were obtained from superovulated ICR mice. T6 medium and T6+/-0.4% bovine serum albumin were used as control media. T6 medium containing 10% or 50% HSF and 100% HSF from each patient were used as test media. Nine to 15 embryos were cultured in microdrops prepared from each of these media. To assess the total cell number within each blastocyst, the blastocysts were fixed and stained with Hoechst 33342 to facilitate cell counting. The mean BDR in two control media were 88.89% and 85.40%. The mean BDR in media containing 10%, 50%, 100% HSF were 85.87%, 89.58% and 75.57%, respectively (*: p<0.05). The overall mean cell count (+/-SEM) in control media were 87.6+/-9.65 and 90.12+/-11.38. The BDR was affected adversely only by 100% HSF and not in media containing 10% or 50% HSF. Mean cell counts were decreased significantly only in blastocysts cultured 100% HSF (63.8+/-13.66; p<0.01) but not in blastocysts cultured in 10% or 50% HSF (91.3+/-12.44 and 82.9+/-18.27, respectively). Thus, it is concluded that HSF has no embyotoxic effect but has a mildly negatively effect on embryonic growth and development.
Animals ; Blastocyst ; Cell Count ; Embryonic Development ; Embryonic Structures* ; Female ; Growth and Development ; Humans* ; Mice* ; Mice, Inbred ICR ; Pregnancy ; Serum Albumin, Bovine

PURPOSE: Wernicke's syndrome, which is characterized by nystagmus, abducent and conjugate gaze palsies, ataxia, mental confusion, and amnesia, is caused by a deficiency in levels of thiamine and is observed mainly in persons who abuse alcohol. Recognized predisposing conditions other than alcoholism include chronic dietary deprivation(imbalanced diet, prolonged intravenous feeding.) and impaired absorption or intake of dietary nutrients. METHODS: We have experienced a 31-year-old female presented 15 weeks into pregnancy who complained of icteric skin color, diplopia, and gait disturbance after prolonged vomiting for 2 months. Neurologic examination demonstrated obtunded sensations, nystagmus and ataxia of gait. EEG showed a mild degree of slowly diffuse activity. The neurological signs pointed to a diagnosis of Wernicke's encephalopathy. RESULTS: We report a case of Wernicke's syndrome induced by hyperemesis gravidarum with the review of literature.
Absorption ; Adult ; Alcoholism ; Amnesia ; Ataxia ; Diagnosis ; Diet ; Diplopia ; Electroencephalography ; Female ; Gait ; Gait Ataxia ; Humans ; Hyperemesis Gravidarum* ; Neurologic Examination ; Paralysis ; Pregnancy ; Sensation ; Skin ; Thiamine ; Thiamine Deficiency ; Vomiting ; Wernicke Encephalopathy*

PURPOSE: To investigate the effect of a nasal cavity abnormality on the success rate of endonasal dacryocystorhinostomy (DCR). METHODS: Two hundred seventy eyes of 230 patients who had undergone endonasal DCR from February 2003 to July 2004 were retrospectively analyzed. The patients were classified into three groups after all were preoperatively examined by an otolaryngologist. Group A consisted of patients who had no nasal cavity abnormality; Group B, patients who had a nasal cavity abnormality and who received treatment; and Group C, patients with a nasal cavity abnormality but who received no treatment. RESULTS: The success rate of endonasal DCR were 83.9% in Group A, 87.5% in Group B, and 79.2% in Group C, with no statistical significance among the three groups (p>0.05). CONCLUSIONS: The presence of a nasal cavity abnormality did not affect the success rate of endonasal DCR.
Dacryocystorhinostomy* ; Humans ; Nasal Cavity* ; Retrospective Studies

Verapamil overdose results in cardiac arrhythmia including the complete A-V block, and hypotension due to decreased peripheral resistance and decreased myocardial contractility. However, sustained-release verapamil overdose frequently has atypical presentations, such as delayed and prolonged course of toxic signs and symptoms. Although several cases of sustained-release verapamil overdose have been reported worldwidely, the specific treatment modalities and prognostic indicators for verapamil overdose have not been well-defined. Recently, we experienced a case of sustained-release verapamil overdose in 30-year-old female. 10 hours after verapamil ingestion she presented in severe bradycardia and hypotensive shock state. Initial EKG showed the complete AV block and her systolic blood pressure was below 60 mmHg. Temporary cardiac pacemaker was performed and she was treated with activated charcoal, glucagon, amrinone, and several sympathomimetics, and 48 hours after admission, she was fully recovered.
Adult ; Amrinone ; Arrhythmias, Cardiac ; Atrioventricular Block ; Blood Pressure ; Bradycardia ; Charcoal ; Eating ; Electrocardiography ; Female ; Glucagon ; Humans ; Hypotension ; Shock ; Sympathomimetics ; Vascular Resistance ; Verapamil*