No abstract available.
Fever* ; Mucous Membrane* ; Tongue*

No abstract available.
Laryngectomy* ; Rehabilitation* ; Voice*

No abstract available.

Syphilis was known to be generalized disease and it had been decreased until 1960's. But, it has been increased again recently. The author analysed the 22 cases of congenital syphilis which were treated at department of orthopaedic surgery at Ewha Womans University Hospital from Jan. 1979 to July 1983 and the following results were obtained. 1. There were no significant changes of the number of patient by years. 2. Common symptom and sign were hepatosplenomegaly(84%), fever(62%) and skin changes(50%), and pseudoparalysis was observed in one case. 3. Radiologic bone changes were observed in 11 cases (50%) and the following results were obtained: a. Below the two week old, there was relatively low incidence of bone change with 22%. b. There was high incidence of bone change in prematurity with 75%. c. Common features of bone changes were periosteal reaction, osteochondritis and metaphysitis (91%). Pathologic fracture was observed. in one case. 4. Although we have observed the bone changes only in 50% of cases, all the other reports has reported more than 80% and we thought that radiologic bone change would aid the diagnosis of congenital syphilis.
Clinical Study ; Diagnosis ; Female ; Fractures, Spontaneous ; Humans ; Incidence ; Osteochondritis ; Skin ; Syphilis ; Syphilis, Congenital

A 41 year-old male underwent resection of a pheochromocytoma under general anesthesia. The patient was treated with phenoxybenzamine for 14 days preoperatively and premedicated with triflupromazine, diazepam, pethidine and hydroxyzine in combination. Following induction of anesthesia with intravenous morphine, thiopental sodium and alcuronium, endotracheal intubation was performed. As soon as intubation, tachycardia(143/min) and hypertension(170/100 mmHg) developed, but were controlled by intravenous injection of propranolol. Anesthesia was maintained with nitrous oxide, oxygen and enflurane, and alcuronium. Blood pressure during manupulation of tumor mass was 160/100 mmHg without arrhythmia but gradually was controlled to the range of 120-130/80-85 mmHg after intravenous infuaion of nitroglycerine at the rate of 0.5-2 ug/kg/min. After removal of the tumor mass, the blood pressure dropped to 100/70 mmHg. Blood pressure was controlled by I.V. low molecular weight dextran, and Hartmanns solution, but a vasoconstrictive agent was not needed. There was no marked tachycardia or arrhythmia during anesthesia. The importance of preoperative preparation, premedication, selection of anesthetics and nitroglycerne for controling the episodic hemodynamic pressure response is discussed.
Adult ; Alcuronium ; Anesthesia ; Anesthesia, General ; Anesthetics ; Arrhythmias, Cardiac ; Blood Pressure ; Dextrans ; Diazepam ; Enflurane ; Hemodynamics ; Humans ; Hydroxyzine ; Injections, Intravenous ; Intubation ; Intubation, Intratracheal ; Male ; Meperidine ; Molecular Weight ; Morphine ; Nitroglycerin* ; Nitrous Oxide ; Oxygen ; Phenoxybenzamine ; Pheochromocytoma* ; Premedication ; Propranolol ; Tachycardia ; Thiopental ; Triflupromazine

The anatomical variations and shapes of the hymen with congenital anomalies of the external genitalia were investigated prospectively during the routine physical examination of 1,500 female infants born between March, 1992, and July, 1992, at the Taegu Fatima Hospital. All underwent a very careful inspection of external genitalia within the first 24 hours of life, and their external genitalia were photographed for confirmation. Abundant hymenal tissue that appeared redundant was observed in nearly all neonates. The annular hymen (89.1%) was the most common type. Of the annular hymens, 91.9% had a central orifice and the remainder had a ventral orifice. External ridges, intravaginal ridges, and clefts were the most frequent anatomical variations, representing 71.5%, 50.7%, and 40.5%, respectively. Congenital anomalies of the external genitalia were detected in 20 patients (1.4%). The anomalies were one case of imperforate hymen, one case of Skene's duct cyst, sixteen cases of hymenal cyst, and two cases of hymenal polyp. Imperforate hymen was incised and drained, and Skene's duct cyst was successfully treated with needle aspiration. Of 16 hymenal cysts, seven with a stalk were excised and the others without a stalk were managed with needle aspiration. Hymenal polyp, a larger form of tag with polypoid shape, was excised. All procedures were performed at the nursery without anesthesia. All the patients so treated were compeletely asymptomatic and had normal genitalia at follow-up. In conclusion, routine physical examination of the female newborn infant should include a careful inspection of the external genitalia with the knowledge of shapes and anatomical variations of the hymen. Longitudinal studies are necessary to understand developmental changes and the effects of estrogens.
Anesthesia ; Daegu ; Estrogens ; Female ; Female* ; Follow-Up Studies ; Genitalia* ; Humans ; Hymen* ; Infant ; Infant, Newborn* ; Longitudinal Studies ; Needles ; Nurseries ; Physical Examination ; Polyps ; Prospective Studies

BACKGROUND: Routine management of postoperative pain have been changed as a result of technological advances in drug delivery systems. The purpose of this study was to compare the effect of continuous epidural analgesia(CEA) system and intravenous patient controlled analgesia (IV-PCA) system for pain relief after cesarean delivery. METHODS: Sixty adult women were randomly assigned to receive analgesics either IV-PCA or CEA after cesarean delivery with general anesthesia for operation. IV-PCA group was received 30 mg intramuscular injection of ketorolac after awakening, followed by IV-PCA. PCA unit was filled with 60 ml; mixed with morphine 10 mg, fentanyl 1000 microgram, ketorolac 180 mg, and normal saline. It had a flow rate of 0.5 ml/hr and lockout interval was 15minutes. CEA group was received a bolus of epidural morphine 3mg and 8ml of 0.25% bupivacaine before the end of operation, followed by CEA. CEA unit was filled with 100 ml; mixed with morphine 4 mg, fentanyl 500 microgram, 0.5% bupivacaine 20 ml, and normal saline. It had a flow rate of 2ml/hr. The degree of analgesia was subjectively evaluated by a visual analogue scale(VAS). Patients were evaluated 0, 1, 2, 6, 12, 24, and 48hours after operation for pain relief, sedation, nausea, vomiting, pruritus, and respiratory rate. RESULTS: VAS pain score were significantly lower in CEA group than IV-PCA group at 0(8.0+/-1.4 vs 3.9+/-0.7), 1(4.4+/-1.3 vs 3.3+/-0.9) and 2hours(3.9+/-1.2 vs 3.3+/-0.8)(p<0.05). There were no apparent cases of respiratory depression and motor weakness of lower extrimity. Nausea or vomiting occurred in 7 patients(23%) of IV-PCA group, and occurred in 3 patients(10%) of CEA group. Pruritus occurred in 6 patients(20%) of IV-PCA group, and occurred in 11 patients (37%) of CEA group. Sedation occurred in 9 patients(30%) of IV-PCA group. Conculsions: We conclude that the CEA with small dose of morphine, fentanyl and bupivacaine is an easy and effective method for pain control after cesarean delivery.
Adult ; Analgesia ; Analgesia, Epidural* ; Analgesia, Patient-Controlled* ; Analgesics ; Anesthesia, General ; Bupivacaine ; Drug Delivery Systems ; Female ; Fentanyl ; Humans ; Injections, Intramuscular ; Ketorolac ; Morphine ; Nausea ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Pruritus ; Respiratory Insufficiency ; Respiratory Rate ; Vomiting

BACKGROUND: The antinociceptive effect and the potency of systemically administered morphine (micro-agonist), nalbuphine (agonist-antagonist), and ketorolac (cyclooxygenase inhibitor) was examined in rats using the formalin test. METHODS: Male Sprague-Dawley rats (250~300 g) received intraperitoneal injection of either saline or 3 doses of each test drug (0.3, 1.0, 3.0 mg/kg of morphine, 0.3, 1.0, 3.0 mg/kg of nalbuphine, and 10, 30, 100 mg/kg of ketorolac) 30 minutes prior to formalin injection. 50 microliter of 10% formalin was injected into the dorsal surface of the right hindpaw after 1 minute of 4% halothane induction. The construction of the dose-response curves and the determination of doses producing 50% maximum possible effect (ED50) were computed. RESULTS: Intraperitoneal injection of morphine, nalbuphine and ketorolac resulted in the significant, dose-dependent supression of both phases, but nalbuphine has a ceiling effect at high dose for analgesia at the phase I of the formalin test. The rank order of relative potency in rats to the formalin test was nalbuphine (1.16)>morphine (1)>>ketorolac (0.1) in phase I, morphine (1)>nalbuphine (0.61)>>ketorolac (0.02) in phase IIa, and morphine (1)>nalbuphine (0.57)>>ketorolac (0.03) in phase IIb. CONCLUSION: Comparing the systemic analgesic potency, nalbuphine and ketorolac will be needed in dosages 1.5 and 50 times that of morphine, respectively. These results suggest that ketorolac is not good enough as a single analgesic drug in preemptive analgesia for major surgery.
Analgesia ; Animals ; Formaldehyde* ; Halothane ; Humans ; Injections, Intraperitoneal ; Ketorolac* ; Male ; Morphine* ; Nalbuphine* ; Pain Measurement* ; Rats* ; Rats, Sprague-Dawley

PURPOSE: Recently, in an experiment using animals, radiation therapy using a laser or Tending Diancibo Pu (TDP) has been shown to be effective in treating scars on the skin by increasing the production of fibroblast cell and collagen and by accelerating the process of epithelization. The purpose of this study is to examine the effectiveness of TDP radiation therapy in treating human burn injuries in terms of the frequency of treatment, the timing of eschar separation, and the duration of treatment. METHODS: In the treatment group, the burn area of the patients was first sterilized with saline solution and potadin solution and covered with one vaseline gauze. Then, the burn area was radiated every other day by using TDP for 20 minutes at distance of 20-25 cm, at radiant plate temperature of 250-280oC. In the cases of control group, the burn area of the patients was first sterilized with saline solution and potadin solution and covered with one vaseline gauze. Then, the area was covered with one burn gauze and bandaged. The treatment was conducted every other day. RESULTS: In cases of superficial second degree burn injuries, the difference between the treatment and the control groups was 1.34 in terms of the frequency of treatment. In the cases of both superficial and deep second degree burns, the differences between the treatment and the control groups were 3.47 in terms of the frequency of treatment, 0.63 weeks in terms of the timing of eschar separation, and 6.03 days in terms of the duration of treatment. All these differences were statistically significant. CONCLUSION: From the experiment, it can be concluded that TDP radiation therapy is more effective in treating human burn injuries than conventional treatment in terms of the of the frequency of treatment, the timing of eschar separation, and the duration of treatment.
Animals ; Burns* ; Cicatrix ; Collagen ; Fibroblasts ; Humans ; Petrolatum ; Skin ; Sodium Chloride

No abstract available.
Congenital Hypothyroidism* ; Diagnosis* ; Prognosis*