Incarceration of the gravid uterus is a rare but serious complication of pregnancy. Reported is the case of a gravid 2, para 0, abortus 1 with known uterine subserosal myoma(5.3 x5.5cm sized) 26-year-old woman presented with acute dysuria and urinary retention. The patient was 14 weeks and 3 days pregnant and presented several week history of urinary frequency and sensation of incomplete bladder emptying. Examination revealed a retroflexed uterus with cervical opening pointing toward the anterior abdominal wall. An ultrasound revealed a thin, elongated maternal bladder and a uterus incarcerated between the sacral promontary and the pubis. The incarceration was successfully reduced by tenaculum traction of the cervical posterior lip without surgical intervention and had a normal infant of appropriate weight at term.
Abdominal Wall ; Adult ; Dysuria ; Female ; Humans ; Infant ; Leiomyoma ; Lip ; Myoma* ; Pregnancy ; Sensation ; Traction ; Ultrasonography ; Urinary Bladder ; Urinary Retention ; Uterine Retroversion ; Uterus*

No abstract available.
Child* ; Humans ; Nephrosis, Lipoid* ; Rifampin*

BACKGROUND: The effects of a newly synthesized potassium channel opener, KR-30816((-)(nitro-2-hydroxymethyl-2-methy-2H-1-benzopyran-4-y1)pyridine oxide) on the action potential of papillary muscles of guinea pigs and the ATP-sensitive potassium channel current(IKATP) of single ventricular muscle cells of rats were examined to make clear its action mechanism of the KATPchannel. METHODS: We used the conventional microelectrode and the excised inside-out patch configuration. RESULTS: KR-30816 caused a shortening of the action potential duration in dose-dependent manner, which was inhibited by glibenclamide(3microM). Before run-down of the K+channel, KR-30816 activated the cardiac ATP-sensitive K+ channel only in the presence of ATP and shifted the dose-response relation curve between [ATP]i and the channel activity to the right in parallel. After run-down of the KATP channel, KR-30816 did not after the channel opening either in the absence or in the presence of UDP. CONCLUSION: These results suggest that KR-30816 antagonizes the inhibitory effect of ATP on the KATPchannel in a competitive manner, thereby enhancing the channel openings.
Action Potentials ; Adenosine Triphosphate ; Animals ; Guinea Pigs ; Heart ; Microelectrodes ; Muscle Cells ; Papillary Muscles ; Potassium Channels* ; Potassium* ; Rats ; Uridine Diphosphate

BACKGROUND: Beat-to-beat heart rate variability (HRV) is caused by the fluctuating balance of sympathetic and parasympathetic tone. Analysis of heart rate variations may provide important clinical information and the influence of anesthesia on the autonomic nervous system. METHODS: We studied 18 ASA I female patients undergoing propofol-O2-N2O anesthesia for transabdominal hysterectomy and analyzed the HRV using power spectral analysis (PSA) at preinduction period, 2~5 minutes after induction, and 30~33 minutes after skin incision. RESULTS: The powers in all frequency bands decreased, but the decrease in low+middle frequency power was less than that in high frequency power during 2~5 minutes after induction. At 30~33 minutes after skin incision, all frequency bands and ratio of low middle/high frequency power spectra recovered and were not significantly different from those of before induction. CONCLUSIONS: Propofol-N2O-O2 anesthesia depress autonomic nervous system with relative preservation of sympathetic components. However autonomic nervous system and sympathetic/parasympathetic balance during operation recovered to the pre-anesthetic pattern, probably due to surgical stimuli and stress.
Anesthesia* ; Anesthetics ; Autonomic Nervous System ; Female ; Heart Rate* ; Heart* ; Humans ; Hysterectomy ; Skin

No abstract available.

Computed body tomography has become useful in the diagnosis of pancreatic disease. It was found to be are liable, often specific, and noninvasive method for detecting pancreatitis and extra-pancreatic extension of the pathology. Of eight hundred and seventy-two cases studied for abdominal pathology with EMI-CT 5005 whole body scanner form Oct. 1977 to August 1980, 21 cases were confirmed to be pancreatitis clinically or operatively. The authors reviewed the CT findings of the above cases and the results were as follows; 1. Among twenty-one cases, the acute pancreatitis was 12 cases and the chronic pancreatitis was 9 cases. The sex ratio as 17 males to females. 2. In acute pancreatitis, diffuse enlargement of pancreas (11/12), focal enlargement (1/12), loss of peripancreatic fat plane (9/12), thickening of anterior of pararenal fascia (6/12), and smooth margin ofpancreas (5/12) were observed. 3. In chronic pancreatitis, parenchymal atrophy (7/9), normal size (2/9), loss of peripancreatic fat plane (3/9), thickening of anterior pararenal fascia (1/9), calcification (1/9), smooth margin (2/9), and serrated margin (6/9) were observed. 4. The complications were associated with 7 cases of acute pancreatitis and 1 case of chronic pancreatitis; pseudocyst (6), abscess (2), and fat necrosis (3), The sites of the pseudocyst were lesser sac (2), anterior pararenal space (2), posterior pararenal space (1), subhepatic region (1), greater omentum (1), and intrapancreatic region (2). All of them were associated with acute pancreatitis except one in chronic pancreatitis.
Abscess ; Atrophy ; Diagnosis ; Fascia ; Fat Necrosis ; Female ; Humans ; Male ; Methods ; Omentum ; Pancreas ; Pancreatic Diseases ; Pancreatitis ; Pancreatitis, Chronic ; Pathology ; Peritoneal Cavity ; Sex Ratio

Hip and knee replacement arthroplasty is one of the important causes of pulmonary embolism, of which the incidence was reported to be from 2 to 16% But, there are no reports about the incidence of pulmonary embolism after these operations in Korea. The authors' intention was to study the incidence and clinical manifestations of pulmonary embolism after hip and knee surgery. Lung perfusion scans and inhalation scans were done preoperatively and 7 days postoperatively for 139 hip or knee replacement arthrosplasty patients in Asan Medical Center. We studied 62 cases of avascular necrosis of the femoral head, 33 cases of femur neck fractures, 45 cases of degenerative arthritis of the hip and knee joints and 17 cases of other diseases. In this study, hip replacement arthroplasties were done in 114 cases, knee replacement arthrosplasties in 25 cases. On preoperative lung scan, high or intermediate probability findings of pulmonary embolism were shown in 18 cases and all of them were asymptomatic. 139 cases showed normal or low probability on preoperative lung scan, of which 5 cases were changed to high probability and 7 cases to intermediate probability on postoperative lung scan. Four of the 7 intermediate probability cases were confirmed to be pulmonary embolism on pulmonary angiography. Of these 9 cases, hip replacement arthroplasties were done in 6 cases and knee replacement arthroplasties in 3 cases. There were 5 cases of osteoarthritis of hip and knee, 3 cases of avascular necrosis of femoral head and 1 case of femoral neck fracture. We concluded that preoperative and postoperative incidences of pulmonary embolism in Korea were similar to those in western countires. Most of the pulmonary embolism patients were asymptomatic and so lung perfusion scans and inhalation scans were helpful in the early diagnosis of pulmonary embolism.
Angiography ; Arthroplasty, Replacement, Hip ; Arthroplasty, Replacement, Knee ; Chungcheongnam-do ; Early Diagnosis ; Femoral Neck Fractures ; Head ; Hip ; Humans ; Incidence ; Inhalation ; Intention ; Knee Joint ; Knee ; Korea ; Lung ; Necrosis ; Osteoarthritis ; Osteoarthritis, Hip ; Perfusion ; Pulmonary Embolism

PURPOSE: To report a complete excision of a large superior orbital retrobulbar cavernous hemangioma using supraorbital craniotomy through the suprabrow approach combined with superior orbital wall removal. CASE SUMMARY: A 31-year-old woman presented to our clinic with left exophthalmos beginning one month earlier. Visual acuities and intraocular pressures of both eyes were normal and there was no diplopia and no limitation in ocular movement. On exophthalmometry, the right eye was 15 mm and the left eye was 18 mm. CT and MRI demonstrated a superior orbital retrobulbar mass of 2.0x2.6x2.0 cm in size, and the mass displaced the superior rectus and levator palpebrae muscles. After six months, a neurosurgeon attempted a classic supraorbital craniotomy but failed. Fourteen months later, the authors completely excised the tumor through superior orbital wall removal. The tumor was confirmed as a cavernous hemangioma after histopathologic study. CONCLUSIONS: The authors succeeded in complete excision of a superior orbital retrobulbar cavernous hemangioma using supraorbital craniotomy through a suprabrow approach combined with superior orbital wall removal.
Adult ; Caves ; Craniotomy ; Diplopia ; Exophthalmos ; Eye ; Female ; Hemangioma, Cavernous ; Humans ; Intraocular Pressure ; Muscles ; Orbit ; Visual Acuity

Eleven cases of juvenile diabetes mellitus who were admitted Seoul National University Hospital from Jan., 1969 to Aug., 1978 were aha1yzed. The mean age of onset was 7 and female to male ratio was 8 to 3 with female preponderance. Four had family history of diabetes, although none had diabetic sibling. Polyuria and polydipsia were noted in all cases as initial symptoms, and symptoms of weight loss (6 cases), disturbances in consciousness (5), generalized weakness (5), anorexia (4) and enuresis (3) were noted in the order of frequency. Leucocytosis was noted in 5 cases, but only 2 among the 4 who had infection revealed leucocytosis, The mean blood glucose level was 320 mg% and serum osmolality was 293 mOsm/L. There was no significant difference in the level of blood sugar and serum osmolality according to the consciousness status. Eight episodes of ketoacidosis occured in 5 cases. Three episodes developed due to discontinuance of insulin and three episodes accompanied infection. The mean blood glucose level was 495 mg% and serum osmolality was 300 mOsm/L in ketoacidosis. The consciousness cleared in average 20 hours and ketonuria disappeared in average 26 hours after the administration of insulin (average 5 units/kg of body weight). At discharge, the average dose of insulin needed was 1.2 U/kg/d. Six patients were followed from 6 months to 6 years. Two developed pulmomary tuberculosis during the period of follow up.
Age of Onset ; Anorexia ; Blood Glucose ; Consciousness ; Diabetes Mellitus* ; Enuresis ; Female ; Follow-Up Studies ; Humans ; Insulin ; Ketosis ; Male ; Osmolar Concentration ; Polydipsia ; Polyuria ; Seoul ; Siblings ; Tuberculosis ; Weight Loss

No abstract available.
Cataract* ; Nephrotic Syndrome*