We evaluated the clinical manifestations, laboratory findings including renal biopsies and treatments in 30 cases of lupus nephritis who were seen between jan., 1981 to Dec., 1991 in Ewha Womans University Hospital.

The results were as follows:

1) Among 72 patients. 11 cases were men and 61 were women(M:F=1:5.5). The onset of disease were developed between 2nd and 3rd decades in 76% of cases. Their median age was 26.9 years.

2) The study of ARA criteria for SLE showed that the incidence of the renal disease was 81.8%, anemia 50% and antinuclear antibody(ANA) 77.3%.

3) At the time of the diagnosis. among 30 patients with lupus nephritis. 25% of patients had serum creatinine over 1.2mg/dl and 25% had proteiuria over 3.5g/day.

4) According to the WHO classification. 12 patients(66%) belonged to class IV and 2 patients(11.1 %) to class III. Among patients classified as class IV. the 33% showed nephrotic syndrome and 66.7% had serum creatinine over 1.2mg/dl.

5) At the time of the diagnosis, among 30 patients with lupus nephritis. the incidence of anti-DNA antibody was 66.7%. decreased C3 titer was 73.3 % and decreased C4 titer was 76.7%.

6) Among 18 patients with oral prednisolone alone, the rate of complete remission was 11.1% and deterioration including death was 33.3%. Among 7 patients with prednisolone plus cyclophophamide. the rate of complete remission was 14.3% and deterioration including death was 28.8%.

7) Among 30 patients with lupus nephritis. 6 patients died. Most common cause of death was cardiovascular disease with 3 cases, followed by infection, 2 cases and renal failure, 1 case.

Somatosensory Evoked Potential(SEP) is a useful study in animal experiments as well as in evaluation of human diseases. But in animal experiments most methods of obtaining the potential are difficult and usually require surgical or complex procedures. In this article easy and accurate methods of obtaining cervical SEPs is presented in addition to its normal data of 55 female Spraque-Dally rats. Another advantage of this methods is that serial studies are possible because of its relative noninvasiveness.

The present report described the cytogenetic findings in 262 cases under the age of 15 years were suspected as having chromosomal abnormalities clinically at department of pediatrics. Ewha womans university hospital. from May 1982 to April 1992.

The following results were obtained

1) Chromosomal abnormalities were found in 81(35%) of the cases studied.

2) Age distribution revealed 54% of all children subjected to chromosomal analysis to be under 1 month of age.

3) Sex distribution revealed boy to girl ratio to be 1.1:1.

4) In children with Down syndrome, Edwards syndrome, Patau syndrome, Cri-du-Chat syndrome, Turner syndrome, Klinefelter syndrome, growth and mental retardation, hematooncologic disease, multiple congenital anomaly were observed in 74%, 64%, 50%. 20%. 33%. 33%, 12%. 13% and 16% respectively.

5) The most frequent karyotype revealed in Down syndrome was 2l-trisomy type(94%). followed by translocation type(4%) and mosaicism type(2%).

6) The most frequent karyotype revealed in Edwards syndrome was 18-trisomy type(88%), followed by mosaicism type(12%).

7) The most frequent karyotype revealed in Patau syndrome was translocation type(67%) followed by 13-trisomy type(33%).

8) Among the various other clinical conditions such as sexual organ abnormality, failure to growth and mental retardation, hematooncologic disease, multiple congenital anomaly and other suspected chromosomal anomaly, chromosomal abnormality was found in 15 cases(10%) of 148 cases.

9) The maternal age of Down syndrome at delivary was between 20-29 years in 57%.

Serum folate levels have been estimated in 187 successively admitted inpatients at Department of Neuropsychiatry. Ewha Womans University Hospital. The mean age of the patients was 34.8±14.9, and the mean serum folate value was 8.0±4.0ng/ml.The younger age patients with sleep and conduct disorder and epilepsy had lower serum folate value than older patients with other diseases. In regard to the relation between folate deficiency and psychiatric diagnosis, epilepsy had the lowest serum folate value(3.6±l.6ng/ml) and neurosis had the highest value(10.4±5.5ng/ml). The patients with low(0~2.5ng/ml)serum folate value were 6 cases(3.2%), consisting of 4 schizophrenia, 1 mood disorder and 1 epilepsy. The ratio of patients with low and equivocal (below 5.0ng/ml) serum folate value was 24.6%, epilepsy had the highest proportion(66.6%). None of the alcoholism had low and equivocal serum folate value. 73.9% of patients with low and equivocal serum folate value were continously ill for more than year comparing to 48.9% of patients with normal serum folate value, and the difference was significant(X²=3.92, p<0.05). Since folate deficiency appeared to be in certain psychiatric disease and related to the chronicity of mental illness, it would be wise to carry out serum folate estimations and to treat the patients with subnormal serum folate value with folate supplements.

Since Willam Harvery had proposed the concepts of circulation in 1628. the anatomy and physiology of circulation has been intensively studied. Venous drainage of a musculocutaneous flap was shown to be of importance for the prevention of necrosis and successful flap taken.

We created an experimental model in rats in which the illiolumbar veins were used as the draining veins, and the following experiment was performed.

The experimental models were divided into 3 groups ;

Group I: bilateral illiolumbar neurovascular bundles of the grafts were not preserved as a control.

Group II: preserving the bilateral illiolumbar veins as the draining veins.

Group III: silastic sheet was placed between the musculocutaneous flap and the underlying bed. In this study, it was demonstrated that

1) Necrosis could be prevented by draining veins.

2) Group II with draining veins : it indicated that the number and size of the draining veins were critical for the survival of the flap.

3) Group III with silastic sheet protection of plasmatic circulation was showed that flap could not survived.

This study was undertaken to evaluate the value of the Papanicolaou smear(Pap smesar) for the screening and detection of the cervical cancer(ca).

274 patients who had cervicovaginal Pap smear and biopsy of the cervix were analysed at the Department of Obstetrics and Gynecology. Ewha Womans University Hospital from the Jan. 1988 to Dec. 1991.

The results were as follows;

1) The highest frequency was noted in the age group of the thirties(34.3%) followed by the age group of forties(30.3%) and the frequency of the age group of the fifties was 20.4%.

2) Six patients with Pap smear Class I showed ca in situ in 4 patients and invasive ca in 2 patients by histopathological study.

72% of the patients with Pap smear Class II had chronic inflammation and the rest of the patients had mild dysplasia(1 case), severe dysplasia(1 case), ca in situ(l case), and invasive ca(7 cases) by histopathological study.

73.2% of the patients with Pap smear Class III had the findings of dysplasia and the rest of the patients had those of chronic inflammation(9 cases). ca in situ(13 cases). microinvasive ca(3 cases), and invasive ca(5 cases).

70.0% of the patients with Pap smear Class IV had the findings of ca in situ. microinvasive ca, and invasive ca and the patients with severe dysplasia, ca in situ. microinvasive ca, and invasive ca consisted 90.0% of the patients with Pap smear Class IV.

90.0% of the patients with Pap smear Class V had ca in situ. microinvasive ca, and invasive ca in biopsy.

3) The sensitivity and positive predictive value for the Pap smear screening was 93.2%, and 94.0% respectively.

These data show that the Pap smear is essential for the screening and early detection of cervical cancer and we should reduce the failure occurring during the serial process such as sampling, fixation, staining, and interpretation.

The effect of radiation and Cis-dichlorodiammineplatinum(II)(Cis-DDP) in combination was studied in the renal histopathologic changes of the rat. The histologic evaluation was performed 30 days after the single dose of Cis-DDP(2.5mg/kg) and X-ray irradiation(6,8,10 Gy. single dose) and combination of Cis-DDP and X-ray. For the combined treatment a single dose of Cis-DDP was given 30 min before or immediately after radiation(pre-and post-radiation group).

Cis-DDP alone, showed mild necrosis, degeneration, hemorrhage and focal inflammatory cell infiltrations in the renal tubule and mild congestion of the glomerulus. In radiation alone. edema of the glomerulus and tubular degeneration was seen with 10 Gy and 8 Gy, respectively. With combined chemotherapy and radiation, edema of glomeruli and tubular degeneration was seen with 8 and 6 Gy irradiation, respectively in both pre-and post-radiation group. Tubular necrosis and degeneration and interstitial inflammatory cell infiltrations were more marked in pre-radiation group. When the edema of glomerulus was used as an endpoint, the enhancement ratio was 1.25 in normal rat kidney.

The aim of this study was to evaluate the effects of a transdermal scopolamine patch on the incidence and severity of postoperative nausea and vomiting in patients undergoing outpatient laparoscopy.

Transdermal scopolamine patch was placed behind ear the night before surgery in study group. Anesthesia was induced with thiopental(4~5mg/ku iv) and succinylcholine(1.5mg/kg) and maintained with meperidine. valium and N₂O(50%) in O₂.

The results were as follows :

1) Scopolamine-treated patients had significantly less nausea and vomiting compared with control group. Nausea and/or vomiting was present in 46.4% of the control group but only 18.5% of those getting the scopolamine-treated group.

2) Side effects were more frequent among scopollamine-treated patients than control patients (77.8% vs 32.1%) but were not troublesome The common reported side effects were a dry mouth and dizziness.

In conclusion transdermal scopolamine appears to be an effective antiemetic agent in patients undergoing outpatient laparoscopy.

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• Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta-analysis
  Stephanie Weibel, Gerta Rücker, Leopold HJ Eberhart, Nathan L Pace, Hannah M Hartl, Olivia L Jordan, Debora Mayer, Manuel Riemer, Maximilian S Schaefer, Diana Raj, Insa Backhaus, Antonia Helf, Tobias Schlesinger, Peter Kienbaum, Peter Kranke
  Cochrane Database of Systematic Reviews.2020;[Epub]     CrossRef

Mannitol is used to reduce brain volume and intracranial pressure.

These effects facilitate the surgical approach to deep-lying structures of cranial cavity. Intraoperatively, mannitol is administered in dose ranges of 0.25~1g/kg. The administration of mannitol may cause adverse effects. such as; rebound of intracranial pressure, transient increases in circulating blood volume, increased serum osmolality and decreased serum electrolytes.

This study examined the influence of 20% mannitol on serum osmolality and electrolytes in 24 patients undergoing brain tumor, cerebral aneurysm and intracerebral hemmorrhage surgery. Measurement were made before the infusion of mannitol. 15 minutes following infusion. after dural closure and in the ICU.

There was a significant increase in serum osmolalitv after infusion of mannitol.

There was a significant decrease .in serum Na⁺ only 15 minutes following infusion. There was a significant decrease in serum K⁺ 15 minutes postinfusion and dural closure.

In conclusion, it is important to measure osmolality and electrolytes before and after infusion and adjust fluid administration.

Doxapram is a central and peripheral respiratory stimulant that has been primarily used to counteract postanesthetic respiratory depression.

Administration of opioid in doses sufficient to produce anesthesia is invariably associated with respiratory depression.

While opioid-induced depression can be reversed by appropriate specific opioid antagonists, it has not been possible to ify the respiratory depressant effects of a opioid without simultaneously ifying the analgesic effects.

The purpose in the present study was to determined whether doxapram is able to reverse the respiratory depressant effects of balanced anesthesia with pethidine-diazepam-nitrous oxide.

Of a total of 30 patients. the control group of 15 patients was given saline lml, and the other 15 patients(doxapram group) were given doxapram hydrochloride 20mg intravenously, and observed blood pressure, heart rate, tidal volume, respiratory rate and arterial blood gas analysis.

In doxapram group(group II). systolic arterial pressure was significantly increased 1minute after administration and heart rate increased 3minute after administration.

Tidal volume significantly increased from 4.8±1.0 to 6.0±l.0ml/kg, but little change in respiratory rate in doxapram group.

PaO₂ significantly decreased in control group(group I) compared to doxapram group 30minute after administration, but not difference in pH, PaCO₂, base excess and oxygen saturation between control and doxapram group.

Reactive perforating collagenosis is a unique cutaneous disorder characterized clinically by recurrent, umbilicated, crusted papules arising in response to minor trauma. This disorder belongs to a group of dermatologic conditions that have been classified as "transepidermal elimination" syndrome.

We report a patient with acquired reactive perforating collagenosis without any associated disease and family history.