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

BACKGROUND: It is difficult to manage the symptoms of neuropathic pain, especially alloynia. The mechanism of the induction and maintenance of mechanical allodynia has been extensively researched for several decades. N-methyl-D-aspartate (NMDA) receptor antagonists are known to reduce mechanical allodynia. Recently, the role of prostaglandins in spinal nociceptive processing has been the focus of attention. Therefore, the present study was designed to investigate the effect of a combination of ketamine, a non-competitive NMDA antagonist, and of ketorolac, non-selective cyclooxygenase (COX) inhibitor on mechanical allodynia. METHODS: Male SD rats were prepared by tightly ligating the left L5 and L6 spinal nerves. All rats developed mechanical allodynia 7 days after surgery. N group (control, n = 6) received 5 ml of 0.9% normal saline intraperitoneally. K group (n = 6) received ketamine 1 mg/kg. T group received ketorolac 30 mg/kg, and KT group received ketamine 1 mg/kg and ketorolac 30 mg/kg simultaneously. Paw withdrawal thresholds to von Frey hairs were measured before and at 15 min, 30 min, 60 min and 120 min after drug administration. RESULTS: Normal saline and ketamine 1 mg/kg did not increase the paw withdrawal threshold from baseline. Ketorolac 30 mg/kg increased the paw withdrawal threshold only at 120 min after intraperitoneal injection. However, the co-administration of ketamine 1 mg/kg and ketorolac 30 mg/kg increased the paw withdrawal threshold significantly from baseline for 120 min. CONCLUSIONS: Intraperitoneal injection of ketamine and ketorolac attenuated the mechanical allodynia developed by spinal nerve ligation. Therefore, we suggest that combination of ketamine and ketorolac might be useful for the management of neuropathic pain.
Animals ; Hair ; Humans ; Hyperalgesia* ; Injections, Intraperitoneal* ; Ketamine* ; Ketorolac* ; Ligation* ; Male ; N-Methylaspartate ; Neuralgia ; Prostaglandin-Endoperoxide Synthases ; Prostaglandins ; Rats* ; Spinal Nerves*

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

Shwachman-Diamond syndrome (SDS) is a rare genetic disorder of unknown pathogenesis involving exocrine pancreatic insufficiency and hematological and skeletal abnormalities. About 25% of patients develop hematopoietic malignancies. We report on a case of acute myeloid leukemia (M2) in a 21-year-old woman affected by SDS. She was treated with conventional chemotherapy (idarubicin plus cytarabine) and reached complete remission of leukemia. After induction chemotherapy, she underwent allogeneic bone marrow transplantation (BMT). The BMT preparative regimen consisted of total body irradation (TBI) followed by cyclophosphamide. Cyclosporin A and short term methotrexate were used for graft-versus-host disease prophylaxis. After a follow-up of 12 months, she is alive leukemia free off any immunosuppressive agent. Although experience in this field is scarce, we speculate that bone marrow failure in SDS is an indication for BMT which is the only curative trentment option.
Adult ; *Bone Marrow Transplantation ; Case Report ; *Cell Transformation, Neoplastic ; Female ; Human ; Leukemia, Myelocytic, Acute/*pathology/*therapy ; Myelodysplastic Syndromes/*complications/*therapy ; Pancreatic Insufficiency/complications/therapy ; Syndrome ; Transplantation, Homologous

OBJECTIVES: The purpose of this study is to analyze the previously unreported effect of fetal sex on the fetal heart rate and to measure its magnitude in relation to the effects of other independent clinical variables. METHODS: Three hundred and seventeen pregnant women who were able to provide electronic fetal heart rate monitoring were evaluated. On the basis of fetal sex after birth, 167 pregnant women who delivered male neonate were for males group and 146 examples who delivered female neonate were for female group. We analyzed fetal heart rate data using the Catholic Computer Assisted Obstetric Diagnosis System(CCAOD). RESULTS: Female fetuses had significantly faster basal heart rate(140.51+/-12.43bpm) than male fetuses(137.64+/-13.68 bpm).(P=0.007) Percent acceleration time(PAT) increased significantly for males(6.10+/-4.00bpm), comparing to females(4.90+/-3.34bpm).(P=0.001) Also percent deceleration time(PDT) was significantly higher in male fetuses(7.50+/-8.70bpm) than female fetuses(6.18+/-7.70bpm).(P=0.039) But there was no differences in standard deviation(SD)(8.84+/-10.11bpm, 8.11+/-3.56bpm), long term variation(LTV)(80.38+/-62.79msec, 73.65+/-54.60msec), and short term variation(STV)(14.06+/-9.79msec, 13.33+/-12.32msec) between male and female fetuses. CONCLUSION: The fetal heart rate of female fetuses differ from that of male fetuses. Computerized linear analysis and nonlinear analysis of antepartum fetal heart rate will need to take into account the multiple factors that influence the fetal heart rate to identify precisely which pattern predict clinical outcome.
Acceleration ; Deceleration ; Diagnosis ; Female ; Fetal Heart* ; Fetus ; Heart ; Heart Rate, Fetal* ; Humans ; Infant, Newborn ; Male ; Parturition ; Pregnancy ; Pregnant Women

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