BACKGROUND: Intrathecal morphine provides good pain relief after anorectal surgery, but often associated with unpleasant side effects. Ondansetron, a selective 5-hydroxytryptamine3 (5-HT3) receptor antagonist, have been introduced for the prevention and treatment of emesis after chemotherapy in cancer patients and after general anesthesia. METHODS: Thus we studied the effect of ondansetron on the postoperative analgesic and side effects of spinal morphine in 60 patiens. The patients were given subarachnoid injection of 0.5% tetracaine 5 mg mixed with morphine 0.3 mg and positioned to jack-knife after fixation of anesthetic level. Either simple 5% dextrose solution 1000 ml or dextrose solution 1000 ml mixed with ondansetron 8 mg was injected intravenously in a rate of 100 ml/hr. The visual analog scale (VAS) of pain and incidence and severity of postoperative nausea, vomiting, pruritus and urinary retention were evaluated at 12 hour, 24 hour and 48 hour after injection of spinal morphine. RESULTS: The number of patients who became nauseated or vomited did not differ significantly between groups. Also, the VAS and the incidence and severity of other side effects such as pruritus and urinary retention did not differ significantly between groups. CONCLUSION: Ondansetron administered intravenously, did not prevent side effects of intrathecal morphine.
Analgesics ; Anesthesia, General ; Drug Therapy ; Glucose ; Humans ; Incidence ; Morphine* ; Ondansetron* ; Postoperative Nausea and Vomiting ; Pruritus ; Serotonin ; Tetracaine ; Urinary Retention ; Visual Analog Scale ; Vomiting

The prevalence of systemic lupus erythematosus (SLE) varies significantly based on ethnicity rather than geographic distribution; thus, the prevalence is higher in Asian, Hispanic, and Black African populations than in European populations. The risk of developing lupus nephritis (LN) is the highest among Asian populations. Therefore, we hypothesize that human genetic diversity between races has occurred through the early human migration and human genetic adaptation to various environments, with a particular focus on pathogens. Additionally, we compile the currently available evidence on the ethnic gene diversity of SLE and how it relates to disease severity. The human leukocyte antigen (HLA) locus is well established as associated with susceptibility to SLE; specific allele distributions have been observed across diverse populations. Notably, specific amino acid residues within these HLA loci demonstrate significant associations with SLE risk. The non-HLA genetic loci associated with SLE risk also varies across diverse ancestries, implicating distinct immunological pathways, such as the type-I interferon and janus kinase–signal transducers and activators of transcription (JAK–STAT) pathways in Asians, the type-II interferon signaling pathway in Europeans, and B cell activation pathway in Africans. Furthermore, assessing individual genetic susceptibility using genetic risk scores (GRS) for SLE helps to reveal the diverse prevalence, age of onset, and clinical phenotypes across different ethnicities. A higher GRS increases the risk of LN and the severity of SLE. Therefore, understanding ethnic gene diversity is crucial for elucidating disease mechanisms and SLE severity, which could enable the development of novel drugs specific to each race.

No abstract available.
Sarcoma*

Thrombotic thrombocytopenic purpura (TTP) can cause serious morbidity and mortality, and differentiating between this disease and systemic lupus erythematosus (SLE) can prove challenging. Although rare, TTP accompanied by SLE is linked to several complications and a higher mortality rate. Herein, we report a case of a 16-year-old boy who presented with systemic symptoms, such as petechiae, and was diagnosed with acquired TTP following a laboratory test. Steroid treatment was initiated and a diagnosis of SLE was reached after the symptoms had improved. Treatment with low-dose prednisone in addition to hydroxychloroquine was continued. The patient did not develop renal failure or neurologic deficit. No specific symptoms were observed after treatment and during the follow-up period. Early treatment of SLE is crucial, but it is difficult to reach an early diagnosis because the symptoms are similar to those of TTP. In the current study, an early diagnosis of TTP led to prompt treatment, thereby avoiding the fatal symptoms that could be caused by SLE.

PURPOSE: The purpose of theis study was to identify meuropsychological features in traumatic brain injured (TBI) group and temporal lobe epileptic (TLE) group. METHODS: Subjects were administered neuropsychological tests: the Wechsler Memory Scale, the Rey-Osterrieth Complex Figure Test, and the Wisconsin Card Sorting Test, the Token Test, the Dbject Naming Test, the Word Fluendy Test, and the Design Fluency Test. Pergormances of Neuropsychological tests in TBI group and TLE group were compared with psychiatric group and normal control group. RESULTS: TBI group and TLE group showed deficits in verbal and visual memory, visuo-spatial construct abilities, language comprehension and naming abilities, and executive functions. There were no signigicant differences between TBI group and RLe group in neuropsychological ablilities. Psychiatric patients showde lower pergormances in delayed recall of verbal and visual material and executive function than normal control group's. CONCLUSION: TBI group and TLE group showed neurop-sychological deficits such as memory dysfunctions, learning disabilities, language deficits, and frontallobe dysfunctions. This findings suggest that the TLE patients have diffuse damages in brain including frontal lobe cortex due to continuous seizure attack originated from temporal lobe.
Brain Injuries ; Brain* ; Comprehension ; Epilepsy, Temporal Lobe ; Executive Function ; Frontal Lobe ; Humans ; Learning Disorders ; Memory ; Neuropsychological Tests ; Seizures ; Temporal Lobe* ; Wisconsin

Benign ductal or glandular neoplasms of the esophagus unrelated to Barrett esophagus are extremely rare. Only 9 cases have been reported in the English language literature. We now report a case of esophageal gland duct adenoma incidentally found in a 73-year-old man. A 0.8 cm-sized, polypoid submucosal lesion in the distal esophagus was removed. Histologically, the lesion was well circumscribed and consisted of several ducts or cysts with focal papillary configurations. Interstitial lymphocytic infiltration with germinal centers was also observed. The lining cells of ducts or cysts were composed of two layers: an inner intensely eosinophilic luminal duct cell layer and an outer myoepithelial cell layer that was accentuated by alpha-smooth muscle actin. There was no significant nuclear atypia or mitosis. Mucin production was occasionally observed in a few goblet cells. To the best of our knowledge, this is the first case of benign ductal or glandular neoplasm of the esophagus among Koreans.
Actins ; Adenoma ; Aged ; Barrett Esophagus ; Eosinophils ; Esophagus ; Germinal Center ; Goblet Cells ; Humans ; Mitosis ; Mucins ; Muscles ; Neoplasms, Glandular and Epithelial ; Phenobarbital

No abstract available.

Extensor hood is a structure that stabilizes the extensor tendon at the dorsal side of the metacarpophalangeal joints and keeps the tendon in place during extension and flexion of the joint. Diagnosis of Extensor hood injury of a metacarpophalangeal joint is difficult to diagnose because its clinical symptoms are nonspecific such as pain and swelling. And swelling can interfere with the accurate physical examination. So the imaging findings are important for diagnosis of extensor hood injury. Magnetic resonance image (MRI) and ultrasonography (US) are both good imaging tools. An advantage of ultrasonography is dynamic assessment of extensor tendon and extensor hood. Here, we describe a case of US findings of extensor hood injury with dynamic approach and corresponding MRI findings.
Hypogonadism ; Imidazoles ; Joints ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Metacarpophalangeal Joint ; Mitochondrial Diseases ; Nitro Compounds ; Ophthalmoplegia ; Physical Examination ; Tendons

OBJECTIVES: The objective of this study was to identify the factors associated with suicidal ideation among the elderly living alone received the elderly care service in a rural area. METHODS: This study was surveyed 206 the elderly living alone who received the elderly care service in G-gun, Jeollanamdo. The collected data were socio-demographic and health-related characteristics, family support and suicidal ideation. The used methods for statistical analysis were used t-test, analysis of variance, Pearson's correlational analysis and the multiple logistic regression analysis. RESULTS: In univariate analysis, the suicidal ideation of the elderly living alone was statistically significant associated with age, monthly income, sufficiency of sleeping, depression, stress, activities of daily living, instrumental activities of daily living, perceived health status and family support. As a result of multiple regression analysis, the associated factors with suicidal ideation were age, depression, stress and the activities of daily living. CONCLUSIONS: The suicidal ideation of the elderly living alone in the rural area was associated with age, mental health and independency of living. It will be needed the multidisciplinary approaches to prevent the suicidal ideation and attempts of the elderly living alone.
Activities of Daily Living ; Aged* ; Depression ; Family Characteristics ; Humans ; Jeollanam-do ; Logistic Models ; Mental Health ; Suicidal Ideation*

OBJECTIVE: To evaluate the correlation between bone tunnel diameter after anterior cruciate ligament (ACL) reconstruction measured by computed tomography (CT) using multiplanar reconstruction (MPR) and stability or clinical scores. MATERIALS AND METHODS: Forty-seven patients (41 men and 6 women, mean age: 34 years) who had undergone ACL reconstruction with the double bundle technique using auto-hamstring graft and had subsequently received CT scans immediately after the surgery (T1: range, 1-4 days, mean, 2.5 days) and at a later time (T2: range, 297-644 days, mean, 410.4 days) were enrolled in this study. The diameter of each tunnel (two femoral and two tibial) at both T1 and T2 were independently measured using MPR technique by two radiologists. Stability and clinical scores were evaluated with a KT-2000 arthrometer, International Knee Documentation Committee objective scores, and the Lysholm score. Statistical analysis of the correlation between the diameter at T2 or the interval diameter change ratio ([T2 - T1] / T1) and clinical scores or stability was investigated. RESULTS: The tibial bone tunnels for the anteromedial bundles were significantly widened at T2 compared with T1 (observer 1, 0.578 mm to 0.698 mm, p value of < 0.001; observer 2, 0.581 mm to 0.707 mm, p value of < 0.001). There was no significant correlation between the diameter at T2 and stability or clinical scores and between the interval change ratio ([T2 - T1] / T1) and stability or clinical scores (corrected p values for all were 1.0). Intraobserver agreement for measurements was excellent (> 0.8) for both observers. Interobserver agreement for measurement was excellent (> 0.8) except for the most distal portion of the femoral bone tunnel for anterior medial bundle in immediate postoperative CT, which showed moderate agreement (concordance correlation coefficient = 0.6311). CONCLUSION: Neither the diameter nor its change ratio during interval follow-up is correlated with stability or clinical scores.
Adolescent ; Adult ; Anterior Cruciate Ligament/*radiography/surgery ; Anterior Cruciate Ligament Reconstruction ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tendons/anatomy & histology/*radiography ; Tibia/anatomy & histology/radiography ; *Tomography, X-Ray Computed ; Young Adult