No abstract available.

Phenol-glycerine subarachnoid blocks were performed in 5 patients, who had intractable perianal pain from postoperative rectal cancer. An initial diagnostic subarachoid block with 0. 25 ml of 0.5% tetracaine in 10% glucose through L 5-S 1 was performed with the patient in a sitting position tilted about 15 degree to the affected side. After evaluation of the test block, the following day a therapeutic block was undertaken by injecting 0. 15-0. 2 ml of 10% phenol-glycerine. Excellent relief occurred in all cases and in one of them the repeated block for recurrent pain was done and 5 months after the first block. One case required of successive blocks 3 times during 8 days with the old phenol glycerine solution over 1 year. Life duration ranged from days to more than 12 months after the blocks. As to complication, dysuria developed temporarily in 3 cases. The one-sided saddle block with 10% phenol glycerine for perianal cancer pain is remarkably safe as well as effective and should be employed more frequently.
Dysuria ; Glucose ; Glycerol ; Humans ; Phenol ; Rectal Neoplasms ; Tetracaine

Balanced anesthesia with the potent opioid analgesics for cesarean section is preferential technique than N2O-O2 with single inhalation anesthetics due to avoid the decreased uterine muscle tone or vigorous postpartum blood loss. The 60 patients were randomly assigned to study the two group so that 30 patients were administered Buprenorphine(B group) or fentanyl(F group) anesthesia. The hemodynamic responses and recovery characteristics of the two groups were compared with each other. The patients who received the analgesics for postoperative pain control were observed. The results were as follows ; 1) The systolic and diastolic blood pressure at 10 min after injection of fentanyl was significantly lower than preinduction time. 2) The diastolic pressure at 10 minute after injection of buprenorphine was significantly lower than pre-induction. 3) There was no difference between the two patient groups in the blood pressure, the heart rate. 4) postoperative recall was 1 patients in the F group and 3 patients in B group. 5) The 24 patients were injected analgesics. Among them 10 patients(33.3%) were in the B group and 16 patients(53.3%) were in the F group. The authors conclude that balanced anesthesia with buprenorphine is a practical altemative technique to fentanyl for cesarean section patients.
Analgesics ; Analgesics, Opioid ; Anesthesia ; Anesthetics, Inhalation ; Animals ; Balanced Anesthesia* ; Blood Pressure ; Buprenorphine ; Cesarean Section* ; Female ; Fentanyl ; Heart Rate ; Hemodynamics ; Humans ; Mice ; Myometrium ; Pain, Postoperative ; Postpartum Period ; Pregnancy

Surgety is a potent stimulus for the neurohormonal axis and it is important to know the influence of specific anesthetic procedures on those host responses. The purpose of this study was to compare the effect of total intravenous anesthesia of propofol with those of inhalation anesthesia on circulating cortisol concentration and hemodynamic responses during pre-induction (Tl), bolus injection of induction doses (T2), post-intubation (T3), skin incision (T4), after 30 minutes skin incision (T5) and in the recovery room after reversal of anesthesia and extubation (T6). Sixty patients of ASA class 1 or 2 schedule to undergo general anesthesia were allocated randomly to two groups. Group E was induced with pentotal sodium (5 mg/kg) and maintained with O2/N2O and 1.5-2 Vol/% enflurane, group P was induced with propofol (2 mg/kg) and maintained with O2/N2O and continuous infusion of propofol (initial rate is 10 mg/kg/hr for 10 minutes and then 8 mg/kg/hr). The results were as follows; 1) The changes of the plasma cortisol level, there were statistically difference between the E group and the P group in the skin incision and 30min. after (P<0.06). 2) The plasma cortisol level in the propofol group was significantly increased than eontrol value only 30 min. after reversal and extubation. 3) The plasma cortisol level in the enflurane group was continuously increased from post- intubation until the end of the experiment. 4) There were no significant difference in hemodynamic changes between the enflurane group and the propofol group.In condusion, total intravenous anesthesia of propofol have no suppressive cortisol production during sutgical stress.
Anesthesia ; Anesthesia, General* ; Anesthesia, Inhalation ; Anesthesia, Intravenous ; Appointments and Schedules ; Axis, Cervical Vertebra ; Enflurane* ; Hemodynamics* ; Humans ; Hydrocortisone* ; Intubation ; Plasma ; Propofol* ; Recovery Room ; Skin ; Sodium

Surgety is a potent stimulus for the neurohormonal axis and it is important to know the influence of specific anesthetic procedures on those host responses. The purpose of this study was to compare the effect of total intravenous anesthesia of propofol with those of inhalation anesthesia on circulating cortisol concentration and hemodynamic responses during pre-induction (Tl), bolus injection of induction doses (T2), post-intubation (T3), skin incision (T4), after 30 minutes skin incision (T5) and in the recovery room after reversal of anesthesia and extubation (T6). Sixty patients of ASA class 1 or 2 schedule to undergo general anesthesia were allocated randomly to two groups. Group E was induced with pentotal sodium (5 mg/kg) and maintained with O2/N2O and 1.5-2 Vol/% enflurane, group P was induced with propofol (2 mg/kg) and maintained with O2/N2O and continuous infusion of propofol (initial rate is 10 mg/kg/hr for 10 minutes and then 8 mg/kg/hr). The results were as follows; 1) The changes of the plasma cortisol level, there were statistically difference between the E group and the P group in the skin incision and 30min. after (P<0.06). 2) The plasma cortisol level in the propofol group was significantly increased than eontrol value only 30 min. after reversal and extubation. 3) The plasma cortisol level in the enflurane group was continuously increased from post- intubation until the end of the experiment. 4) There were no significant difference in hemodynamic changes between the enflurane group and the propofol group.In condusion, total intravenous anesthesia of propofol have no suppressive cortisol production during sutgical stress.
Anesthesia ; Anesthesia, General* ; Anesthesia, Inhalation ; Anesthesia, Intravenous ; Appointments and Schedules ; Axis, Cervical Vertebra ; Enflurane* ; Hemodynamics* ; Humans ; Hydrocortisone* ; Intubation ; Plasma ; Propofol* ; Recovery Room ; Skin ; Sodium

OBJECTIVE: Preterm labor and delivery is probably the largest problem in modern perinatology. The early diagnosis of preterm labor is crucial for prevention of preterm birth. To predict the onset of preterm labor, we examined the diagnostic performance of serial cervical assessment by transvaginal sonography. METHODS: In this prospective study, we performed transvaginal sonography at approximately 30 and 34 weeks of gestation in women with singleton pregnancies. Cervical parameters evaluated included endocervical length, the presence of funneling, funnel length and funnel width. We then assessed the relation between cervical parameters and the risk of spontaneous preterm labor. RESULTS: We examined 258 women at approximately 30 weeks of gestation and 247 of these women again at approximately 34 weeks. Spontaneous preterm labor occurred in 9 of women examined at 30 weeks(Group 1) and in 13 at 34 weeks(Group 2). The endocervical length was normally distributed at 30 and 34 weeks(mean +/-SD, 38.26+/-6.82mm and 35.63+/-7.35mm, respectively). The endocervical length decreased significantly from 30weeks to 34 weeks(p=0.0001). Both groups showed significantly shorter endocervical length(p <0.05) and groupl more presence of funneling than group of term pregnancy(p<0.05). Receiver-operator characteristic curve and multiple logistic regression analyses indicated that endocervical length <-30mm at 30 weeks and <-25mm at 34 showed highest diagnostic index in predicting the onset of preterm labor(p=0.0001). Conclusions: Serial transvaginal ultrasound assessment of endocervical length during early third trimester is a useful predictor of preterm labor and delivery in low-risk patients.
Early Diagnosis ; Female ; Humans ; Logistic Models ; Obstetric Labor, Premature* ; Perinatology ; Pregnancy ; Pregnancy Trimester, Third ; Premature Birth ; Prospective Studies ; Ultrasonography

BACKGROUND: Under normal conditions, cerebral blood flow is regulated as cerebral perfusion pressure changes (autoregulation). Inflammatory conditions like bacterial meiningitis result in a loss of cerebral autoregulation several hours after exposure to bacterial endotoxin. Endotoxin appears to produce effects via the production of reactive oxygen species, such as the superoxide anion. METHODS: Cerebral blood flow (CBF) was measured by hydrogen clearance in anesthetized rats 30 minutes after intravenous endotoxin 5 mg/kg or normal saline (control). Mean arterial pressure was reduced from 100 mmHg to 80 mmHg and 60 mmHg by hemorragic hypotension, and cerebral blood flow was measured at each pressure. RESULTS: In the control group, CBF did not change when arterial pressure was reduced to 80 mmHg (113.9 ml vs 111.9 ml), but declined significantly at 60 mmHg (113.9 ml vs 88.4 ml). In the group treated with endotoxin, both a reduction of mean arterial pressure to 80 mmHg (129.8 ml vs 101.8 ml) and 60 mmHg (129.8 ml vs 78.4 ml) caused a significant reduction in CBF, indicating that autoregualtion had been abolished. CONCLUSIONS: The results of this study indicate that within minutes of endotoxin exposure, CBF markedly increased, and that the autoregualtion of CBF was inhibited.
Animals ; Arterial Pressure ; Homeostasis* ; Hydrogen ; Hypotension ; Meningitis ; Perfusion ; Rats ; Reactive Oxygen Species ; Superoxides

BACKGROUND: Chlamydia trachomatis is most common sexually transmitted pathogen in the world, and a common cause of urethritis and cervicitis. Also it is common cause of preterm premature rupture of membranes and premature labor in pregnant women, and pneumonitis and conjunctivitis in neonate. A rapid and sensitive polymerase chain reaction(PCR)-based assay for detection of C. trachomatis is recently introduced. OBJECTIVES: We studied to determine whether a PCR assay is useful to detect Chlamydial infection in pregnant women. We also studied to compare its prevalence rate according to maternal age, trimester and parity, respectively. Study Design: Specimens were collected from 149 pregnant women by transcervical swab or endocervical lavage. If a specific band was detected in PCR assay, we considered as Chlamydial infection. RESULTS: In general, the positive bands were detected in the 45 of 149 pregnant women(30.2%). The positive bands were detected the 6 of 55(10.9%), 16 of 49(32.7%), and 23 of 45(51.1%) pregnant women in each trimester, respectively. Therefore, there was significantly increased according to the gestational age(p<0.05). However, there were not significantly different according to maternal age and parity(p> 0.05). CONCLUSION: We concluded that the PCR assay is a fast and useful test for the detection of C. trachomatis in transcevical cells from the pregnant women. This study suggested that Chlamydial infection seems to be increased according to the gestational age.
Chlamydia trachomatis* ; Chlamydia* ; Conjunctivitis ; Diagnosis* ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Maternal Age ; Membranes ; Obstetric Labor, Premature ; Parity ; Pneumonia ; Polymerase Chain Reaction* ; Pregnancy ; Pregnant Women* ; Prevalence ; Rupture ; Therapeutic Irrigation ; Urethritis ; Uterine Cervicitis

No abstract available.
Hepatocyte Growth Factor* ; Hepatocytes* ; Placenta* ; Pre-Eclampsia*

OBJECTIVES: As automobile part manufacturing is characterized by high speed and high repetition, observation methods which are usually utilized for static posture are inappropriate to evaluate musculoskeleatal risk factors. This study quantified the risk factors of musculoskeletal disorders on the forearm and suggested exposure limits by estimating the risk factors using surface electromyography (EMG) and electrogoniometer. METHODS: Ten percent of the total workers at 3 automobile part manufacturing factories were randomly selected, and 99 male workers were recruited as study subjects. The study was conducted during May 2003 to September 2004. The workers were equipped with electrogoniometers on the wrist and the elbow, surface EMGs on the skin of the flexor digitorum superficialis (FDS) and extensor carpi radialis (ECR) muscles, and the heart beat recorder during work as indicators of joint movement, local muscle tension and physical work load, respectively. RESULTS: After controlling for age, body mass index and job stress, wrist flexion maximum angle, FDS relative activity (RA) and ECR RA were significantly associated with forearm musculoskeletal symptoms. The odds ratios of the forearm were 5.0(95% CI: 1.1-22.7), 14.0(95% CI: 1.5-128.8) and 7.3(95% CI: 1.1-49.4) for wrist flexion maximum angle more than 76 degrees, FDS RA more than 2.8%, and ECR RA more than 3.5%, respectively. CONCLUSIONS: Joint angle and focal muscle activity were associated with forearm musculoskeletal symptoms. To reduce forearm musculoskeletal symptoms among automobile part manufacturers, the wrist flexion angle, and FDS and ECR activity need to be reduced below the guidelines recommended in this study.
Automobiles* ; Body Mass Index ; Elbow ; Electromyography* ; Forearm ; Heart ; Humans ; Joints ; Male ; Muscle Tonus ; Muscles ; Odds Ratio ; Posture ; Risk Factors* ; Skin ; Wrist