In order to assess the effects of diazepam and meperidine as premedication for upper gastrointestinal endoscopy, eighty eight patients undergone an elective upper gastrointestinal endoscopy were studied. Studied patients were divided into two groups; one group was premedicated with buscopan and stropine(group I), and the other group was premedicated with diazepam and meperidien (group II). The results obtained were summarized as follows; 1) 83.0% of the group II (44/53) did not eomplain any discomfort by the procedure, but only 23.9% (8/35) of the group I showed no discopmort. The difference between two groups is statiatieally significant (p<0.005). 2) In 41 patients with previous experience of endoscopy, 22 patients from 27 of the graup Il(81.5%) did not feel any discomfort but it wes only 3 patients among 14 of the group I (21.4%) who did not feel discomfart (p<0,005). 3) In 47 patients without previous experience of endoscopy, 23 patients from 26 of the group II (88. 5%) did not show discomfort but it way only 5 patients among 21 of the group I (23.7%) (p<0.005). 4) In the patients with previous experience of endoscopy, 21 patients among 27 of the group II (77. 8%) felt better than that of the previous experience but it was only 3 patients among 14 of the group I (21.4%) (p<0.005). From the above results, we would emphasize that it is more effective to use diazepam and, meperidien as premendication for the gastrointestinal endoscopic procedure since it removes pstients apprehension rendering them a good cooperation with very minimal side effects,
Butylscopolammonium Bromide ; Diazepam ; Endoscopy ; Endoscopy, Gastrointestinal ; Humans ; Meperidine ; Premedication*

Breast feeding is one of many factors that have been associated with the development of lower respiratory tract illnesses. To assess the relation between breast feeding and subsequent experience of lower respiratory tract illness, we performed this study, retrospectively, on 366 infants who had been admitted to the pediatric ward, St. Francisco General Hospital, or had been brought to the well baby clinic from November, 1992 to March, 1993. The results were as foolows: 1) Among 366 infants, the number of all first illnesses observed at each interval were 259 cases (70.8%), of which 198 (54.1%) were associated with wheezing illnesses and 61 (16.7%) with non-wheezing lower respiratory illnesses. 2) Duration of breast feeding regardless of-whether other foods were given, was categorized as 3 grups, i. e., none or for less than a month (group), one to 4 months (group B), and 4 or more months (group C). Incidences of wheezing illnesses in the first 4 months of life were lower in group B(10.1%) and group C (8.4%) than group A (27.3%), respectively (p<0.01). Wheezing illnesses beyond 4 months of life and non-wheezing illnesses in all intervals seemed to be unrelated to the duration of breast feeding. 3) Considering a variety of other fisk factors, including sharing a room, parental childhood reapiratory trouble, sex and maternal education, children who received minimal breast feeding (group A) had the greater risk of early wheezing illnesses in the simultaneous exposure to sharing a room than group B and C (p<0.005). Our results suggest that decreased breast feeding is associated with a higher incidence of wheezing illnesses in the first 4 months of life, particularly in combination with other risk factors, such as sharing a room.
Breast Feeding* ; Breast* ; Child ; Education ; Hospitals, General ; Humans ; Incidence ; Infant ; Parents ; Respiratory Sounds ; Respiratory System* ; Retrospective Studies ; Risk Factors

Conventional medical therapies have not been very successful in treating adults with refractory septic shock. The effects of direct hemoperfusion using polymyxin B and veno-arterial extracorporeal membrane oxygenation (ECMO) for refractory septic shock remain uncertain. A 66-year-old man was admitted to the emergency department and suffered from sepsis-induced hemodynamic collapse. For hemodynamic improvement, we performed direct hemoperfusion using polymyxin B. Computed tomography scan of this patient revealed emphysematous pyelonephritis (EPN), for which he underwent emergent nephrectomy with veno-arterial ECMO support. To the best of our knowledge, this is the first report of successful treatment of EPN with refractory septic shock using polymyxin B hemoperfusion and nephrectomy under the support of ECMO.
Adult ; Aged ; Emergency Service, Hospital ; Endotoxins ; Extracorporeal Membrane Oxygenation* ; Hemodynamics ; Hemoperfusion ; Humans ; Nephrectomy* ; Polymyxin B ; Pyelonephritis ; Shock, Septic*

Primary malignant melanoma of the esophagus (PMME) is an extremely rare tumor with only scattered cases reported. Although surgical resection has been considered as the best possible option, the prognosis has been nonetheless poor. We report a case of PMME which was treated by surgical resection and additionally followed by chemotherapy. A 60-yr-old man underwent an esophagoscopy due to a 3-month history of dysphagia and upper abdominal discomfort. A pigmented polypoid mass in the lower third of the esophagus was discovered, and a biopsy identified the mass as a malignant melanoma. Consequently, a subtotal esophagectomy and intrathoracic esophagogastrostomy was carried out. At follow-up four months after discharge, lymph node enlargements in the cervical area and celiac axis area were found. As a result, the patients was started on systemic chemotherapy treatment, which included Dacarbazine. The patient has been doing well and is now 35 months post-operative.
Middle Aged ; Melanoma/pathology/*surgery ; Male ; Humans ; Esophageal Neoplasms/pathology/*surgery

BACKGROUND: The recent expansion of knowledge about various ABO alleles has led to the need for a comprehensive measure to cover the numerous polymorphisms dispersed in the ABO gene. A few studies have examined the diversity of the O allele compared to A or B subgroup alleles, resulting in antigenic changes. This study investigated the relationship between the serologic and molecular genetic characteristics of the O alleles in the Korean population. METHODS: One hundred and five samples from healthy blood group O subjects were selected randomly. The isoagglutinin titer was measured using a tube agglutination and gel microcolumn assay. The ABO alleles were analyzed by sequencing exons 6 and 7 of the ABO gene. When the origin of a heterozygous nucleotide sequence was ambiguous, it was separated into a single allele using mono-allele amplification or cloning. RESULTS: The median IgM isoagglutinin titer was eight. In contrast, the median IgG anti-A and anti-B isoagglutinin titers were 64 and 32, respectively. The IgG isoagglutinin titer showed a significant increase with age (P<0.0001). Six O alleles were observed in 105 blood group O populations by sequencing. The O01 and O02 alleles were common (0.57, 0.36). Three rare O alleles (O04, O05, and O06) and one novel non-deletional O allele were found. CONCLUSION: The distribution of isoagglutinin titers of blood group O and the genetic frequency of O alleles in this study would form the basis of the development and interpretation of ABO genotyping and serologic workup in the Korean population.
Agglutination ; Alleles ; Base Sequence ; Clone Cells ; Cloning, Organism ; Exons ; Immunoglobulin G ; Immunoglobulin M ; Molecular Biology ; Sequence Analysis

This study was to examine the actual conditions and contributing factors of absenteeism in manufacturing workers. Subjects were 1,184 workers employed in Taejon city and the observation period for absenteeism was 3 months (June to August), 1992. We obtained the following results. 1. Percentage of the absentees among the studied subjects were 21.1% in gross absence and 6.9% in sickness absence. Gross absence rate of subjects was 1.2% and sickness absence rate was 0.5%. 2. In the group of absentees, mean days of absence was 2.8 days and those of sickness was 4.4 days. Mean days of sickness absence due to injury was higher than that of illness, but the total days of sickness absence was high in extremity injuries, trunk injury, general fatigue, head injury, musculoskeletal problem in that order. 3. Variables contributing to the absence were job classification, education level, working hours per day, exposure of noxious factor, worker classification. 4. In the group of absentees, variables influencing the gross absence rate were working atmosphere, body mass index, working environment, working hours per day but those of the sickness absence were working hours per day, education level and working atmosphere.
Absenteeism* ; Atmosphere ; Body Mass Index ; Classification ; Craniocerebral Trauma ; Daejeon ; Education ; Extremities ; Fatigue

Subenpendymal giant cell astrocytoma is a rare cerebral glioma that mainly occurs in patients with tuberous sclerosis. In the following case, a subependymal giant cell astrocytoma in the absence of tuberous sclerosis occurred in the wall of the lateral ventricle and presented as an intraventricular mass cauing hydrocephalus by obstruction of the foramen of Monro. The mass was removed completely through transcallosal approach with the microsurgical technique.
Astrocytoma* ; Cerebral Ventricles ; Giant Cells ; Glioma ; Humans ; Hydrocephalus ; Lateral Ventricles ; Tuberous Sclerosis*

This study was performed to compare the cadmium accumulation levels in kidney with urinary cadmium excretion levels according to the duration of cadmium exposure in rats. Total 120 male rats, 6 weeks of age, were administered 0.5 mg/day of Cd to subcutaneously, intraperitoneally and orally 6 times per week for 12 weeks. The animals were sacrificed in the 1st day of 2nd, 4th, 6th, 8th, 10th and 12th week after beginning of cadmium administrations. Body weight, hematologic values, enzyme activities, renal Cd levels, urinary Cd and proteins were calculated and each value was compared according to the Cd administration routers. The Cd accumulation levels in the kidney of rats increased remarkably for 6-8th weeks which were experimented and urinary Cd excretion levels and urinary protein levels showed the tendency of increasing with the Cd accumulations in kidneys, especially in the subcutaneous injected rats. On the other hand, there was a significant positive correlation among the total Cd administration, the Cd accumulation in the kidneys, the urinary Cd excretion and protein.
Animals ; Body Weight ; Cadmium* ; Hand ; Humans ; Kidney ; Male ; Rats*

In 17 myotonic cases (16 of myotonic muscular dystrophy and 1 of congenital myotonia), 13 cases showed significant decremental responses on RNS study. The decremental responses had the tendency of more prominence on faster stimulating rate, and in the proximal limb muscles. This result suggests that the RNS test is useful but not specific for the disorder of neuromuscular junction.
Extremities ; Humans ; Muscles ; Muscular Dystrophies ; Neuromuscular Junction

The authors analyzed 105 cases of spinal cord tumor in regarding to the age, sex, location and distribution, clinical presentation and postoperative outcome. They were confirmed by pathologic study at the Kyung Hee Medical Cented from 1981 to 1991. The incidence of spinal cord tumors was slightly predominant in males. The most commom tumor was neurogenic tumor. The neurogenic tumor composed 43.8%(46 cases), and the rests were meningioma 15.2%(16 case), metstasis 10.5%(11 cases) and others. The tumor were located most frequently in the thoracic area(31.4%) and in the intradural extramedullary space(56.1%). Most common initial symptom of spinal cord tumors were pain and it's mean duration was 8.3 month. The patients were assigned to one of four groups according to their neurologic deficit. About 66.6%(70 cases) of the patients were included in Groups I and II(mild neurologic deficit), and others were classified in Groups III and IV(significant to severe neurologic deficit). Complete tumor removal was achieved in 70.4%(4 cases) of the patients, and subtotal removal was performed in 26.7%(28 cases), and biopsy was performed in 2.9%(3 cases). Among the 105 patients, the postoperative outcomes on dischage were recovery in 36 cases(34.3%), improved in 45 cases(42.9%), stationary state in 12 cases(11.4%), and progression in 12 cases(11.4%).
Biopsy ; Hospital Distribution Systems ; Humans ; Incidence ; Male ; Meningioma ; Neurologic Manifestations ; Spinal Cord Neoplasms ; Spinal Cord*