The objectives of this study were to investigate the efficacy and dose-effect relationship for glycopyrrolate in the suppression of the oculocardiac reflex, and to compare glycopyrrolate with the reported equivalent dose of atropine. Glycopyrrolate 5 and 7.5ug/kg and atropine 10 and 15ug/kg were studied in 40 paediatric patients to assess more fully the dose of glycopyrrolate required for adequate prevention of the oculocardiac reflex. The results obtained were summarized as follows: 1) The increase in the mean heart rate 5 min after the test drug was statistically significant in all of the four groups. 2) Both drugs showed a dose-related response for reduction in slowing of heart rate after rectus muscle traction. 3) There is great individual variation in response to muscle traction within each group, no group being fully protected from marked slowing in heart rate. 4) The frequency of arrhythmias with low doses of both drugs was more than in high doses with both drugs.
Anesthesia* ; Arrhythmias, Cardiac ; Atropine* ; Child* ; Glycopyrrolate* ; Heart Rate* ; Heart* ; Humans ; Reflex, Oculocardiac ; Traction

Sclerema neonatorum is an uncommon and fatal disease which encountered in premature & debilitated newborn infants. Recently we experienced a case of sclerema neonatorum in premature infant with congenital heart disease which was confirmed by autopsy. We present a case with a brief review of literatures.
Autopsy ; Heart Defects, Congenital ; Humans ; Infant, Newborn ; Infant, Premature ; Sclerema Neonatorum*

A case of pycnodysostosis in 12 years old girl was presented with a brief review ofliterature. This patient was admitted to our pediatric dept. of N.P.H. with chief complaints of loss of appetite and respiratory difficulty. She was characterized by a peculiar face with anterior bossing, exophthalmos, opened anterior fontanel and coronal suture and dwarfism. So bone series was performed and showed character of pycnodysostosis such as opened anterior fontanel and coronal suture, receding mandibular angle, inoreased bone density with narrowing bone marrow and acrcosteolytica on distal phalanx. But she died on the 25 th hospital day due to chronic renal failure.
Appetite ; Bone Density ; Bone Marrow ; Child ; Cranial Fontanelles ; Dwarfism ; Exophthalmos ; Female ; Humans ; Kidney Failure, Chronic ; Pycnodysostosis* ; Sutures

Intracranial nerve sheath tumors unrelated to the cranial nerve roots are extremely rare, and the origin of the tumors are debatable. We report a case of pathologically-proven neurofibroma inside the lateral ventricle. A 49-year-old man presented with headache of 6 months duration, urinary incontinence, visual disturbance and right hemiplegia. Brain CT scan showed a well defined isodense mass with homogenous contrast enhancement and marginal calcification. At surgery the tumor was found to be a 4cm-sized lobulated mass attached only to the choroid plexus. Histologically, the tumor masses consisted of fasciculating bundles of wavy spindle cells, with a considerable collagen laydown.
Brain ; Choroid Plexus ; Collagen ; Cranial Nerves ; Headache ; Hemiplegia ; Humans ; Lateral Ventricles ; Middle Aged ; Nerve Sheath Neoplasms ; Neurofibroma* ; Tomography, X-Ray Computed ; Urinary Incontinence

No abstract available.
Drug Therapy* ; Etoposide* ; Humans ; Leukemia* ; Mitoxantrone*

Bronchial carcinosarcoma is a very rare malignant tumor that is composed of carcinomatous and sarcomatous elements. We describe the first case in which digital tomosynthesis was useful for the evaluation of airway obstruction by bronchial carcinosarcoma that was overlooked on initial chest radiography.
Airway Obstruction* ; Carcinosarcoma* ; Radiography ; Thorax

PURPOSE: This study examined the effect of indirect medical oversight on the quality of prehospital emergency care by emergency medical technicians. METHODS: Indirect medical oversight was applied for a year and 119 rescue run sheets were retrospectively analyzed before and after the program to study the effect of an indirect medical oversight program in one city. The general characteristics of patients who visited hospitals before and after the program were analyzed, along with patient evaluation records, personal data, outbreak patterns, transfer information, direct medical oversight, and emergency medical services (EMS) mobilization reports. In addition, by comparing medical records and the 119 rescue run sheets, changes in the accuracy of 119 rescue run reports, the adequacy of patient classification, and the adequacy of medical direction were analyzed. After gathering these data, statistical analysis was performed and the level of significance was defined as p<0.05. RESULTS: After executing the indirect medical oversight, there was significant improvement in the accuracy of 119 rescue run sheets (p<0.001) and in the consistency of severity classification in 119 rescue run sheets compared with medical records (p=0.016). The adequacy of direct medical oversight request also showed improvement after the indirect medical oversight took effect (p<0.001). However, there was no statistical significance in prehospital procedures. CONCLUSION: Indirect medical oversight significantly improved the quality of emergency medical service by emergency medical technicians. However, the further application and improvement of indirect medical oversight programs are required for the development of prehospital emergency medical care.
Classification ; Emergencies* ; Emergency Medical Services* ; Emergency Medical Technicians* ; Humans ; Medical Records ; Retrospective Studies

BACKGROUND: It is known that air borne particulates are closely related with the respiratory symptoms and peak expiratory flow (PEF) in patients with respiratory diseases. In Korea, concentrations of airborne dust and inhalable particulates are dramatically increased by the Yellow sand phenomenon, especially in springtime. OBJECTIVE: This study was performed to evaluate the effect of Yellow sand-related airborne dust on the respiratory symptoms and pulmonary function of patients with bronchial asthma. METHOD: 21 non-smoking, tree pollen non-sensitized subjects with bronchial asthma in Seoul were included in this study. For each subject, asthma and rhinoconjunctivitis symptoms were recorded by self-administered standardized questionnaire and by monitoring PEF between April and May 2000. Symptom score and diurnal variability of PEF were compared with the levels of inhalable particulate matter (PM10) checked in that time at 25 points in Seoul. RESULTS: 15 (71.4%) of the enrolled subjects successfully finished this study. There was no statistically significant relationship between the increment of Yellow sand-related PM10 and respiratory symptom or PEF variability. Of the 15 subjects, there were increased symptoms for the eye in 2 (13.3%) subjects, nose in 3 (20.0%), and sinus in 1 (6.7%), which were associated with Yellow sand-related increase of airborne dust levels. 5 (33.3%) subjects showed changes of PEF variability proportional to the change of PM10. CONCLUSION: Meteorological phenomenon related with Yellow sand has a potential risk of aggravating the upper respiratory tract symptoms and of deteriorating pulmonary functions in patients with asthma.
Asthma* ; Dust ; Humans ; Korea ; Nose ; Particulate Matter ; Pollen ; Respiratory System ; Seoul ; Silicon Dioxide* ; Surveys and Questionnaires

No abstract available.
Humans ; Multiple Myeloma ; Plasma Cells ; Plasma ; Precursor Cell Lymphoblastic Leukemia-Lymphoma

PURPOSE: We conducted this study to determine the efficacy of conventional treatments for patients with Hodgkin's disease and identify the patients who have poor prognosis and need high-dose chemotherapy and autologous stem cell transplantation. MATERIALS AND METHODS: Between Jun. 1989 and Dec. 1997, 50 patients were enrolled and 39 patients were evaluable. Patients were treated with radiotherapy (5 patients) or combination chemotherapy (21 patients) or combined chemotherapy and radiotherapy (13 patients) according to their disease stage. Chemotherapy regimens were C-MOPP (cyclo- phosphamide, vincristine, procarbazine, and prednisone), MOPP (mechlorethamine, vin- cristine, procarbazine, and prednisone), ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine), alternating C-MOPP/ABVD, and MOPP/ABV hybrid. Radiation therapy was performed when there was residual tumor after chemotherapy or bulky disease. The response to treatments was analyzed by clinical stage I-II and stage III-IV patients group, respectively. RESULTS: The complete response rate was 76.9% for total patients, 83.3% for stage I-II patients, and 71.4% for stage III-IV patients. Of the 30 patients achieving complete response, four (13.3%) relapsed at 6, 12, 22, and 28 months after complete response, respectively. The median follow-up duration was 24 months. Nine patients died. Four patients died of Hodgkins disease. Three-year overall survival rate was 72.9% for total patients, 72.5% for stage I-II patients, and 70% for stage III-IV patients. Two-year disease- free survival rate was 77.6% for total patients, 79% for stage I-II stage patients, and 73.9% for stage III-IV patients. The prognostic factor analysis showed that performance status affected the disease-free survival rate. CONCLUSION: Conventional treatments in patients with Hodgkins disease showed results comparable to previous studies. But we were unable to identify the patients, who need high-dose chemotherapy and autologous stem cell transplantation, because of small number of study patients and short follow up duration.
Bleomycin ; Dimethoate ; Disease-Free Survival ; Drug Therapy ; Drug Therapy, Combination ; Follow-Up Studies ; Hodgkin Disease* ; Humans ; Neoplasm, Residual ; Procarbazine ; Prognosis ; Radiotherapy ; Stem Cell Transplantation ; Survival Rate ; Vinblastine ; Vincristine