On the basis of stastistical awlysis trend of increase in syphilis patients in Korea closely resembles that reported in other countries. Among these patients, it should be noticed that thy were highly infectious, showing early latent syphilis. Nevertheless, the available diagnstic test for syphilis has only been limited to the Non-treponemal antigen test. Moreover not only schedules employing in the treatment f disease have been different among physicians but the follow up test for each patient bas been quite impossible. In these respects, the author strongly suggests that the effective measures for the prevention and treatment of syphilis will be required as a national policy.
Appointments and Schedules ; Follow-Up Studies ; Humans ; Korea* ; Syphilis* ; Syphilis, Latent

In an attempt to treat the cold urticaria, a new bradykinin inhibitor, homoclomin was administered orally and effective result were obtained. The urticaria was confirmed by the employing the ice cube test on the patient and the positive reaction was appeared generally 10 sec. to 15 min. after application of ice cube on the forearm. After oral administration for 3 days (40mg/day) clinical symptoms were relieved temporarily and weakly positive or negative reaction observed in repeated ice cube test.
Administration, Oral ; Bradykinin ; Forearm ; Humans ; Ice* ; Urticaria*

One case of malignant acanthosis nigricans associated with internal malignany and oral florid papilloma has been presented and reviewed the subject of malignant acanthosis nigricans. The patient who was 34 year old man had been affected generalixed dark brownish hyperpigmentation with papillomatoses especially on forehead, neck, axillae, umbilical area, anogenital area, webs of fingers, palms and soles. And characteristically it was associated with severe florid papilloma on mucous membrane such as buccal mucosa, lip and glans penis. Histopathologically, internal malignancy was confirmed metastatic adenocarcinoma of stomach after autopsy, although previous biopsy finding was squamous cell carcinoma when explorative laparatomy was done. The response to Bleomycin, new antibiotic anticancer drug, followed by intravenous injection is good and satisfying. But the patient died due to sudden pulmonary hemorrhage which are serious side effect of Bleomycin.
Acanthosis Nigricans* ; Adenocarcinoma ; Adult ; Autopsy ; Axilla ; Biopsy ; Bleomycin ; Carcinoma, Squamous Cell ; Fingers ; Forehead ; Hemorrhage ; Humans ; Hyperpigmentation ; Injections, Intravenous ; Lip ; Male ; Mouth Mucosa ; Mucous Membrane ; Neck ; Papilloma* ; Penis ; Stomach

This report is concerned with our clinical experience of 150 cases of anesthesia for open heart surgery at department of anesthesiology, In chon Gil hospital from Februry, 1990 to April, 1993. The results were as follows ; 1) Among 150 cases, 68 cases (45.3%) were congenital heart disease and 82 cases (54.7%) were acquired heart disease. 62 cases (41.3%) were males and 88 cases (58.7%) were females. 2) Glycopyrrolate, diazepam, morphine, were used as premedicants. 3) Fentanyl, ketamine, diazepam, thiopental sodium were used as induction agents and injected singly or in combination. 4) In congenital cyanotic heart diseases, ketamine was used as main anesthetic agent. In other heart diseases, fentanyl, isoflurane, diazepam were used. 5) Vecuronium was used for intubation and maintenance of muscle relaxation. 6) Overall mortality rate was 3.3% (5 cases) and the causes of death were low cardiac output, respiratory insufficiency, mediastinal infection.
Anesthesia ; Anesthesiology ; Cardiac Output, Low ; Cause of Death ; Diazepam ; Female ; Fentanyl ; Glycopyrrolate ; Heart Defects, Congenital ; Heart Diseases ; Heart* ; Humans ; Incheon ; Intubation ; Isoflurane ; Ketamine ; Male ; Morphine ; Mortality ; Muscle Relaxation ; Respiratory Insufficiency ; Thiopental ; Thoracic Surgery* ; Vecuronium Bromide

BACKGROUND: Infants are very different from children and adults in the point of anatomy, physiology, pharmacology and psychology. The mortality rate of infant anesthesia is higher than that of child and adult. So that this study is to analyze the infant's operation and to recognize the tendency and problems of infant's anesthesia and also to improve the outcome. METHODS: A retrospective analysis was performed on 1436 infants who had operations from april 1987 to february 1995 according to age, sex, department, disease, operation time, postoperative complications, mortality rate and anesthetic method. RESULTS: Total number of operation tend to increase annually. The male to female ratio was 67.5% to 32.5%. The distribution of patients by department was 60.6% of general surgery, 21.0% of plastic surgery and small percentage of other department. The distribution of disease was the following : inguinal hernia - the most common; cleft lip and palate, intussusception and others. The postoperative complications developed in 98 of 1436. The most common complication was the respiratory problems, the others were sepsis, electrolyte unbalance, gastrointestinal and CNS problems. The total mortality rate was 3.6%. The emergency operation case was 17.9%. CONCLUSIONS: The most common distribution of age was neonate and the most commm department was general surgery and the most common disease was inguinal hernia. The most common postoperative complication was respiratory problems and the second was infection and sepsis. The mortality rate in preterm infant, neonate, emergency operation and long duration operation was higher than total motality rate.
Adult ; Anesthesia* ; Child ; Cleft Lip ; Emergencies ; Female ; Hernia ; Hernia, Inguinal ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Intussusception ; Male ; Mortality ; Palate ; Pharmacology ; Physiology ; Postoperative Complications ; Psychology ; Retrospective Studies* ; Sepsis ; Surgery, Plastic

BACKGROUND: Infants are very different from children and adults in the point of anatomy, physiology, pharmacology and psychology. The mortality rate of infant anesthesia is higher than that of child and adult. So that this study is to analyze the infant's operation and to recognize the tendency and problems of infant's anesthesia and also to improve the outcome. METHODS: A retrospective analysis was performed on 1436 infants who had operations from april 1987 to february 1995 according to age, sex, department, disease, operation time, postoperative complications, mortality rate and anesthetic method. RESULTS: Total number of operation tend to increase annually. The male to female ratio was 67.5% to 32.5%. The distribution of patients by department was 60.6% of general surgery, 21.0% of plastic surgery and small percentage of other department. The distribution of disease was the following : inguinal hernia - the most common; cleft lip and palate, intussusception and others. The postoperative complications developed in 98 of 1436. The most common complication was the respiratory problems, the others were sepsis, electrolyte unbalance, gastrointestinal and CNS problems. The total mortality rate was 3.6%. The emergency operation case was 17.9%. CONCLUSIONS: The most common distribution of age was neonate and the most commm department was general surgery and the most common disease was inguinal hernia. The most common postoperative complication was respiratory problems and the second was infection and sepsis. The mortality rate in preterm infant, neonate, emergency operation and long duration operation was higher than total motality rate.
Adult ; Anesthesia* ; Child ; Cleft Lip ; Emergencies ; Female ; Hernia ; Hernia, Inguinal ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Intussusception ; Male ; Mortality ; Palate ; Pharmacology ; Physiology ; Postoperative Complications ; Psychology ; Retrospective Studies* ; Sepsis ; Surgery, Plastic

The most interesting change in anesthetic technic for pain relief during labor and delivery has been the widespread acceptance of continuous lumber epidural analgesia. Primary effect of epidural analgesia is to relieve pain and therapy to preserve the morale and to prevent exhaustion of the mother. For the past year in our hospital, continuous lumbar epidural analgesia was attempted on 38 pregnant women and its effect was assessed. In established labor, epidural analgesia was started for pain relief and was maintained with intermittent injections until delivery; in 45% the duration exceeded six hours. Labor was slightly retarded, probably due to inadvertent selection of patients with slow and painful progress. Vacuum extraction was used in 52.6%. Fetal condition was excellent(Apgar score of 7 or greater in 97.4%). Continuous epidural analgesia gives superior relief of pain but cells for experienced management and nursing care.
Analgesia, Epidural* ; Female ; Humans ; Morale ; Mothers ; Nursing Care ; Pregnant Women ; Vacuum

BACKGROUND: Congenital heart disease may be complicated by pulmonary hypertension. We assessed whether inhaled nitric oxide would produce selective pulmonary vasodilation in pediatric patients with congenital heart disease and pulmonary hypertension. METHODS: Inhaled low dose (10 20 ppm) nitric oxide was administrated in patients who were at risk of pulmonary hypertension after operations for congenital heart disease. To identify the nitric oxide effects, we evaluated hemodynamic and ABGA data before (T0) and after (T1) inhaled nitric oxide and just before (T2) decreasing concentration of inhaled nitric oxide. RESULTS: Inhaled nitric oxide decreased pulmonary arterial pressure and increased PaO2/FiO2 without decreasing systemic arterial pressure. CONCLUSIONS: Inhaled nitric oxide selectively decreased pulmonary arterial pressure in patients with congenital heart disease complicated by pulmonary artery hypertension.
Arterial Pressure ; Heart Defects, Congenital ; Heart Diseases* ; Heart* ; Hemodynamics ; Humans ; Hypertension ; Hypertension, Pulmonary* ; Nitric Oxide* ; Pulmonary Artery ; Vasodilation

BACKGROUND: Inhaled nitric oxide (NO) therapy causes selective pulmonary vasodilation in patients with pulmonary hypertension. However, attempts to discontinue inhaled NO may be complicated by abrupt life-threatening rebound pulmonary hypertension (RPH). The purpose of this study was to determine the risk factors to develop RPH and to present the adequate weaning methods. METHODS: We studied 19 consecutive children who were treated with inhaled NO because of pulmonary hypertension after surgery for congenital heart disease. We compared the dose of NO at the time of start and withdrawal, the duration of weaning and treatment, hemodynamic data, and blood gas analysis before inhaled nitric oxide withdrawal, between patients without (group I, n = 13) and with RPH (group II, n = 6). RESULTS: Compared with group I, group II patients were older in age (1204 1688 versus 546 1654 days, P < 0.05), had a lower NO concentration just before withdrawal (3 +/- 1.6 versus 5 +/- 2.6 ppm, P <0.05), a shorter duration of NO weaning period (4 +/- 3.3 versus 15 +/- 13.4 hours, P < 0.05) and received NO therapy for a shorter duration (26 +/- 11.6 versus 57 +/- 46.0 hours, P < 0.05). CONCLUSIONS: We recommend a progressive withdrawal of inhaled nitric oxide to avoid life-threatening RPH observed in the sudden discontinuation.
Blood Gas Analysis ; Child ; Heart Defects, Congenital* ; Hemodynamics ; Humans ; Hypertension, Pulmonary* ; Nitric Oxide* ; Risk Factors ; Vasodilation ; Weaning