No abstract available.
Hemorrhoids*

No abstract available.
Bone Plates* ; Spine*

BACKGROUND: Induction of anesthesia with propofol commonly associated with reduction in systemic arterial pressure, especially in elderly and high risk patients. This reduction is influenced by the dose and rate of propofol injection. The aim of this study was to examine the effect of different injection rate of propofol on vital signs, dose requirement and induction time during induction period. METHODS: Unpremedicated one hundred and twenty ASA physical status I and II patients aged 20~60 years scheduled for elective surgery were randomly allocated into one of four (150, 300, 600, 1200 ml/hr) groups according to speed of injection of propofol during induction period. Loss of verbal contact was taken as the end-point of induction. Vital signs, SpO2, dose requirement of propofol and induction time were checked. RESULTS: As the injection rate of propofol became slower, there were significant reduction in induction dose and increase in induction time (p<0.05). For example, induction dose and time were 1.82 mg/kg, 223 +/- 58 sec in 150 ml/hr group and 3.14 mg/kg, 50 +/- 11 sec in 1200 ml/hr group, respectively. Also, decrease in systolic and diastolic pressure were less marked at lower injection rates. CONCLUSIONS: Slower injection of propofol produces less vital sign changes and dose requirement for the induction of anesthesia.
Aged ; Anesthesia* ; Arterial Pressure ; Blood Pressure ; Humans ; Propofol* ; Vital Signs*

Broncho-gastric fistula caused by benign gastric ulcer perforation after esophagectomy is very rare. In general anesthesia of a patient with broncho-gastric fistula, in spite of hyperventilation, leakage of the anesthetic gases through fistula may make the patient hypercapneic, and positive pressure ventilation may increase the risk of the pulmanary aspiration by the regurgitation of gastric fluid by stomach distension. For that reason, in this patient, denitrogenation was performed during patient's voluntary respiration with 100% oxygen for 5 minutes, and induction was performed without positive pressure ventilation, and one lung ventilation was carried out. Hypoxemia was followed by one lung ventilation because his pulmonary function was moderate obstructive type and his lung was damaged by aspiration of gastric fluid via broncho-gastric fistula. A low level of continuous positive airway pressure (CPAP) has no significant hemodynamic effect and can maintain the patency of nonventilated lung, so hypoxemia induced by one lung ventilation may be reduced. Thus we carried out one lung ventilation with CPAP (10 cmH2O) in nonventilated lung and blocked broncho-gastric fistula with a bronchial blocker for prevention of both regurgitation of gastric fluid and leakage of anesthetic gases. One lung anesthesia was performed without any problem in this case.
Anesthesia ; Anesthesia, General* ; Anesthetics, Inhalation ; Anoxia ; Continuous Positive Airway Pressure ; Esophagectomy ; Fistula* ; Hemodynamics ; Humans ; Hyperventilation ; Lung ; One-Lung Ventilation ; Oxygen ; Positive-Pressure Respiration ; Respiration ; Stomach ; Stomach Ulcer

46,XX male is a rare abnormality of sex determination with an incidence of 1 in 20,000 male neonates. The clinical manifestations of 46,XX males are usually hypogonadism, gynecomastia, azoospermia, and hyalinations of seminiferous tubules, with altered hormonal levels at puberty. Less frequently, some sexual ambiguities are found, always with sterility owing to reduced testicular development. The origin of male phenotype in 46,XX male could be the results of at least three different mechanisms:translocations of Y sequence, including the SRY gene, to an X chromosome or to an autosome(about 90% of cases); a mutation in a yet unknown X-linked or autosomal gene in the testis-determinating pathway, and cryptic Y chromosome mosacism. We experienced a case of SRY-positive 46,XX male in a 21-year-old man with small testes. (J Korean Soc Pediatr Endocrinol 2003;8:184-188)
Adolescent ; Azoospermia ; Genes, sry ; Gynecomastia ; Humans ; Hyalin ; Hypogonadism ; Incidence ; Infant, Newborn ; Infertility ; Male* ; Phenotype ; Puberty ; Seminiferous Tubules ; Testis ; X Chromosome ; Y Chromosome ; Young Adult

46,XX male is a rare abnormality of sex determination with an incidence of 1 in 20,000 male neonates. The clinical manifestations of 46,XX males are usually hypogonadism, gynecomastia, azoospermia, and hyalinations of seminiferous tubules, with altered hormonal levels at puberty. Less frequently, some sexual ambiguities are found, always with sterility owing to reduced testicular development. The origin of male phenotype in 46,XX male could be the results of at least three different mechanisms:translocations of Y sequence, including the SRY gene, to an X chromosome or to an autosome(about 90% of cases); a mutation in a yet unknown X-linked or autosomal gene in the testis-determinating pathway, and cryptic Y chromosome mosacism. We experienced a case of SRY-positive 46,XX male in a 21-year-old man with small testes. (J Korean Soc Pediatr Endocrinol 2003;8:184-188)
Adolescent ; Azoospermia ; Genes, sry ; Gynecomastia ; Humans ; Hyalin ; Hypogonadism ; Incidence ; Infant, Newborn ; Infertility ; Male* ; Phenotype ; Puberty ; Seminiferous Tubules ; Testis ; X Chromosome ; Y Chromosome ; Young Adult

No abstract available.
Humans ; T-Lymphocyte Subsets*

Angioedma is a group of disorders with multifactorial etiology but a similar clinical expression, is characterized by swelling of subcutaneous or submucosal tissue. Systemic lupus erythematosus(SLE) is a chronic multi-systemtic disease characterized by inflammation and tissue damage resulting from deposition of auto-antibodies and immune complex. We experienced a case of angioedema which was the first manifestation of SLE in 24-year-old female patient. She had suffered from severe facial edema and multiple lymphadenopathy for six months and she also had pleural effusion, positive anti-nuclear and anti-DNA antibody test. Marked decrease of C3 and C4 levels was noted with normal antigenic level, and activity of Cl esterase inhibitor. The angioedema was not improved with anti-hitamine agents and instead disappeared with use of corticosteroid and non-steroidal anti-inflammatory drugs. Complement levels normalized after corticosteroid treament. We report a case of SLE which initial manifestation was angioedema.
Angioedema ; Antigen-Antibody Complex ; Complement System Proteins ; Edema ; Female ; Humans ; Inflammation ; Lupus Erythematosus, Systemic* ; Lymphatic Diseases ; Pleural Effusion ; Young Adult

We report a case of subcutaneous panniculitic T-cell lymphoma (SPTCL) which occurred in a 10-year-old Korean girl. Her disease presented as multiple erythematous subcutaneous nodules on the right cheek, left chest, abdomen, left flank, both calves, and left shin with systemic symptoms. She had a protracted course of multiple erythematous subcutaneous nodules for 2 months often with spiking fever. Histopathologic findings for the subcutaneous nodules revealed lobular panniculitis-like findings composed of atypical small, bland lymphocytes and histiocytes. Characteristically, atypical lymphocytes rimmed individual fat cells in a lace-like pattern and some histiocytes occasionally phagocytosed WBCs. Bone marrow findings revealed increased phagocytic histiocytes with engulfed hematopoietic cell. The immunophenotypic studies showed CD45RO (UCHLl)+, CD20-, CD4-, CD8+ and CD56+ (focal), lysozyme+, CD45 (LCA)+ and EBV-. She received three cycles of high-dose cyclophosphamide, adriamycin, vincristine, prednisolone (CHOP) and methotrexate, intrathecal methotrexate and one cycle of fludarabine, mitoxantrone and dexamethasone (FND) chemotherapy. She died of acute renal failure during multiple chemotherapy.
Abdomen ; Acute Kidney Injury ; Adipocytes ; Bone Marrow ; Cheek ; Child* ; Cyclophosphamide ; Dexamethasone ; Doxorubicin ; Drug Therapy ; Female ; Fever ; Glycogen Storage Disease Type VI ; Histiocytes ; Humans ; Lymphocytes ; Lymphoma, T-Cell* ; Lymphoma, T-Cell, Cutaneous ; Methotrexate ; Mitoxantrone ; Prednisolone ; T-Lymphocytes* ; Thorax ; Vincristine

Antimetabolites, 5-fluorouracil(5-FU) and mitomycin-C(MMC), are used to promote the success rate of the glaucoma filtration surgery(GFS). The authors observed and compared the duration of bleb formation and complications by slit-lamp biomicroscopy, and the inhibition of fibroblast proliferation and of fibrosis by light microscopy following GFS in 4 group rabbits. One hundred and twenty rabbits comprised in this study were divided into four groups; the first control group(I) was the balanced salt solution soaked group(BSS) during GFS, the second(II) was the 5-FU subconjunctival injected group(5-FU SC) after GFS, the third(III) was the 5-FU soaked group(5-FU) during GFS, and the fourth(IV) was the MMC soaked group(MMC) during GFS. For the maintenance of bleb formation, MMC, 5-FU SC, 5-FU and BSS group showed 0%, 26.7%, 16.7%, 100% at the 1 month after GFS, and 0%, 0%, 0%, 73.3% at the 2 months after GFS, respectively, which suggested that MMC group lasted longest. The inhibition of fibrosis and fibroblast proliferation became higher in the order of MMC, 5-FU, 5-FU SC, BSS group at 2 weeks after the surgery. At 3 months after GFS, there was no conspicuous statistic difference(P>0.05) between 5-FU SC and 5-FU group, but some differences(P<0.001) in the rest groups. From these results, we concluded that antimetabolites such as 5-FU and MMC could be used effectively in cases of poor prognosis of GFS. However, the dosage and application method of antimetabolites should be considered very carefully and further research will be necessary to find out the optimal dosage with minimum toxicity.
Antimetabolites ; Blister ; Fibroblasts ; Fibrosis ; Filtering Surgery* ; Filtration* ; Fluorouracil* ; Glaucoma* ; Microscopy ; Mitomycin* ; Prognosis ; Rabbits*