BACKGROUND/AIMS: The caudal anesthsia is most commonly used for benign anorectal surgery, The combination of long-acting anesthetics and opiates has been used for longer duration and successful control of postoperative pain. But the side effects of peridural anesthesics and morphine have commonly occured in caudal anesthesia. This study was performed to assess the difference in clinical effects between peridural mepivacaine and bupivacaine with morphine. METHODS: We evaluated the clinical effects in 60 patients who had anal operation with Jack-Knife position under caudal anesthesia. We divided randomly these 60 patients into two groups, M and B groups (in each group, 30 patients included). Group M (n=30) was given 2% mepivacaine 20 ml with morphine 2 mg caudally, and Group B (n=30) was given 0.5% bupivacaine 20 ml with morphine 2 mg in the same manner. We measured the onset time, duration, postoperative analgesia, and side effects including urinary retention. RESULTS: The onset time for analgesia was significantly shorter in group M than in group B. The duration of postoperative pain complaints was significantly longer in group M than in group B. The postoperative analgesic effects and side effects were not significantly different between two groups. CONCLUSIONS: Caudal mepivacaine and morphine mixture is effective for control of postoperative pain without significant side effects.
Analgesia ; Anesthesia, Caudal* ; Anesthetics ; Bupivacaine* ; Humans ; Mepivacaine* ; Morphine* ; Pain, Postoperative ; Urinary Retention

No abstract available.
Hemochromatosis* ; Spleen*

We report a case of primary osteosarcoma of the breast which is rare and exhibits poor prognosis. A 52 years-old-woman was admitted with rapidly growing right mammary mass. A huge lobulated dense mass with speckled calcifications, suggesting malignancy, was observed on mammography. She underwent a radical mastectomy. Grossly, the mass measured 16 14 6 cm and showed grayish white hard lobulated tissue with focal hemorrhage and necrosis. Light microscopically, the tumor was confirmed as an osteosarcoma devoid of any epithelial components. In postoperative whole body bone scan, there was no evidence of the other malignancy. To the best of our knowledge, the present case is the first report of primary osteosarcoma of the breast in Korea.
Breast* ; Hemorrhage ; Korea ; Mammography ; Mastectomy, Radical ; Necrosis ; Osteosarcoma* ; Prognosis

For the purpose of elucidating relation between red cell electrolyte concentrations and serum digoxin level, measurement of red cell electrolyte concentrations and seum digoxin level by radioimmunoassay were done in 46 normal controls and 63 patients of CHF including 8 patients with digitalis intoxication. The results obtained were as follows: 1. Red cell sodium concentration and ratio of red cell sodium to red cell potassium concentration in normal males were significantly higher than those of females, and red cell potassium concentration in normal males was significantly lower than that of normal females. 2. Red cell potassium concentration in patients of CHF was significantly higher than that of normal controls, but there was no difference in the red cell sodium concentration between the groups. 3. There was no relation between red cell electrolyte concentrations and serum digoxin level, and red cell electrolyte concentration did not exactly estimate serum digoxin level. 4. Red cell electrolyte concentrations in the patient of CHF were valuable in detecting digitalis toxicity.
Digitalis ; Digoxin* ; Female ; Humans ; Male ; Potassium ; Radioimmunoassay ; Sodium

Aortopulmonary septal defect is a rare congenital cardiac anomaly. A 15 year old boy was admitted to Department of Internal Medicine of Seoul National University Hospital because of exertional dyspnea. Aortopulmonary septal defect was confirmed by cardiac catheterization demonstrating severe pulmonary hypertension and patent foramen ovale, and retrograde aortogram showing contrast material passing from the ascending aorta just above the aortic valve into the pulmonary trunk. We present a case of aortopulmonary septal defect with a review of literatures.
Adolescent ; Aorta ; Aortic Valve ; Aortopulmonary Septal Defect* ; Cardiac Catheterization ; Cardiac Catheters ; Dyspnea ; Foramen Ovale, Patent ; Humans ; Hypertension, Pulmonary ; Internal Medicine ; Male ; Seoul

Primary malignant lymphoma of the appendix is an unconnnon neoplasm although the gastrointestinal tract is the most common extranodal site of malignant lymphoma. We report a case of primary malignant lymphoma of the appendix in a 54-year-old male, who presented with pain in the right lower abdomen. An appendectomy was performed. The appendix measured 9.5 cm in length and 5.5 cm in diameter. Cut sections showed a solitary circumferential mass in the appendiceal lumen. Light microscopic features were compatible with malignant lymphoma of diffuse large cell type(Working Formulation) and the immunophenotype was B cell type.

Proliferations of the endometrial glands form a continuum from focal glandular crowding through simple hyperplasia, complex hyperplasia and atypical hyperplasia to frank adenocarcinoma. But objective criteria to distinguish these proliferative endometrial lesions are not clear-cut and terminology is confusing. The p53 protein is a nuclear phosphoprotein that can regulate cell proliferation and suppress tumor growth. Mutation in the p53 gene have been reported in a variety of human tumors, and in selected malignancies overexpression of p53 has been associated with poor prognosis. In this study we examined a series of endometrial proliferative lesion, including hyperplasia, adenocarcinoma, and adenomyosis to determine whether or not p53 is overexpressed in these lesions. In the result, p53 immunoreactivity was observed in 3 of 17 (17.6%) simple hyperplasia, one of 6 (16.6%) complex hyperplasia, none of 3 (O%) atypical hyperplasia, 6 of 13 (46.1%) adenocarcinoma and none of 10 (O%) adenomyosis. In conclusion, p53 mutation seems to play a role in oncogenesis of endometrial adenocarcinoma in early phase but there was no significant relationship between p53 overexpression and histologic grade of adenocarcinoma.
Adenocarcinoma* ; Adenomyosis ; Carcinogenesis ; Cell Proliferation ; Crowding ; Endometrial Hyperplasia* ; Female ; Genes, p53 ; Humans ; Hyperplasia ; Prognosis

OBJECTIVE: The purpose of this study was to evaluate the effect of length and shape of cutting flute on mechanical properties of orthodontic mini-implants. METHODS: Three types of mini-implants with different flute patterns (Type A with 2.6 mm long flute, Type B with 3.9 mm long and straight flute, Type C with 3.9 mm long and helical flute) were inserted into the biomechanical test blocks (Sawbones Inc., USA) with 2 mm and 4 mm cortical bone thicknesses to test insertion and removal torque. RESULTS: In 4 mm cortical bone thickness, Type C mini-implants showed highest maximum insertion torque, then Type A and Type B in order. Type C also showed shortest total insertion time and highest maximum removal torque, but Type A and B didn't showed statistically significant difference in insertion time and removal torque. In 2 mm cortical bone thickness, there were no significant difference in total insertion time and maximum removal torque in three types of mini-implants, but maximum insertion torque of Type A was higher than two other Types of mini-implants. CONCLUSIONS: Consideration about length and shape of cutting flute of mini-implant is also required when the placement site has thick cortical bone.
Torque

No abstract available.
Sinusitis*

BACKGROUND: Inguinal herniorrhaphy remains one of the most common general surgical operations. Mesh repair is advocated by several specialized hernia centers. The purpose of this study was to compare results of mesh and Shouldice repair for inguinal herniae. METHODS: A clinical review was made of 73 cases of inguinal herniae treated during the 3 years from January 1993 to December 1996 at the Department of Surgery, Dae Rim Saint Mary's Hospital, and at the Department of Surgery, Eum Sung Saint Mary's Hospital. We treated 38 patients with mesh repair and 35 patients with a Shouldice procedure. Among 73 cases, 72 cases were males and only one case was a female. All except 8 cases had indirect types of hernias. RESULTS: Mesh repair required less time (80 minutes) and was an easier operative technique than the Shouldice procedure (95 minutes), but postoperative pain was similar between the two procedures. Postoperative pain was relieved after one week in 60% of the patients and after four weeks in 88% of the patients. The complications following the operations were similar between the two procedures: voiding difficulties developed in two cases, wound infection in one case, and a hematoma in two cases. There were no recurrences during the 6 month to 3 year follow up. CONCLUSIONS: Inguinal herniorrhaphy using a mesh repair technique provides is simple, rapid, less painful, and effective.
Female ; Follow-Up Studies ; Hematoma ; Hernia ; Hernia, Inguinal ; Herniorrhaphy* ; Humans ; Male ; Pain, Postoperative ; Recurrence ; Saints ; Wound Infection