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United States ; Surgery/education/*history ; Physiology/history ; Neurosurgery/history ; Humans ; History, 20th Century ; History, 19th Century ; Blood Pressure Determination/history ; Bacteriology/history ; Animals ; Anesthesia/history

With increasing interest towards the proper management of the patient's anxiety and pain during diagnostic and therapeutic procedures, adequate sedation has become an essential part of a successful procedure. Due to recent advancements in modern medicine, many surgical procedures that were once done under general anesthesia are being increasingly replaced by minimally invasive procedures that are performed under sedation. However, the duration or degrees of pain that are caused by different types of procedures vary extensively. Some procedures are easily done under only light sedation, while others require extensive pain control and deeper sedation. Comfort and safety are essential components of 'successful sedation', and full understanding of the degree of pain and the physiologic changes that the procedure may cause is needed in order to offer this to the patient. The depth of sedation should be controlled with proper sedatives while adequate analgesia should be offered according to type of procedure. Choice and doses of drugs should always be tailored to the patient's general condition, and additional administrations should be done after the effect of the previous dose is observed in order to avoid overdosing. When combining sedatives and/or analgesics, the possible synergistic effects between different drugs should always be kept in mind. In order to choose the adequate type and dose of drug, knowledge regarding the pharmacodynamic and pharmacokinetic properties of commonly used drugs for procedures is needed for safe and effective sedation.
Analgesia ; Analgesics ; Anesthesia, General ; Anxiety ; Conscious Sedation ; History, Modern 1601- ; Humans ; Hypnotics and Sedatives ; Light ; Patient Safety

Chronic obstructive pulmonary diseases are being increased every year by many factors. But there are two important factors. First of all the atmospheric contamination is due to modern civilization, secondarily, the increase of old age population which is the result of prolonged life span by contribution of modern medicine. For these reasons increasing chronic obstructive pulmonary disease, anesthesiologists have had increased problems to administer anesthesia, because these patients are most difficult to manage for anesthesia. Author have studied for if it could be diminished these problems by comparing of the complications during period of anesthesia induction, maintenance, recovery and 5 postoperative days, with IPPB therapy and other physical therapy. The results of the study are as follows: 1) Pre and postoperative IPPB therapy is more useful to diminish anesthesia problems compared with other physical therapy. 2) Other physical therapy is useful when compared with controlled group. 3) IPPB therapy is the choice of treatment for postoperative atelectasis. Statistical significance was assessed by using student t test.
Anesthesia ; Civilization ; History, Modern 1601- ; Humans ; Intermittent Positive-Pressure Breathing* ; Lung Diseases, Obstructive ; Pulmonary Atelectasis ; Pulmonary Disease, Chronic Obstructive

The Korean Empire, its state sovereignty threatened by the Empire of Japan, joined the Geneva Conventions in 1903 for the purpose of neutral diplomacy and established the imperial Korean Red Cross Hospital in 1905. This hospital was a result of the effort of the Korean Empire to seek a new medical system based on the Western medicine. However, after the Russo-Japanese War, Japan interfered straightforwardly in the domestic affairs of Korea and eventually abolished the Korean Red Cross Hospital in 1907 to create Daehan Hospital under Japanese colonial rule. With newly-found historical records, this study investigates the whole process of the Korean Red Cross Hospital, which has remained unknown so far, despite its importance. From the very beginning, the Korean Red Cross Hospital was under strong influence of the Empire of Japan. The site for the hospital was chosen by a Japanese army doctor, Junryō Yoshimoto, and the construction was supervised by Rokurō Katsumata, who also later on are involved in the construction of Daehan Hospital. Moreover, all the main positions for medical treatments were held by Japanese practitioners such as Gorō Tatami and Kaneko Yano. Nevertheless, the Korean government had to shoulder the all operating costs. The office of the Korean Red Cross was relocated away from the Korean Red Cross Hospital, and the government of the Korean Empire was not willing to burden the expenses of the Hospital. Moreover, the list of employees of the Korean Red Cross and that of the Korean Red Cross Hospital were drawn up separately: the former is left only in Korea and the latter in Japan. These facts suggest that those two institutes were managed dualistically unlike any other nation, implying that this may have been a means to support the Daehan Hospital project. According to the statistics, health care services in the Korean Red Cross Hospital seems to have been carried out successfully. There had been an increase in the number of patients, and the ratio of female patients was relatively high (26.4%). Only Western medications were prescribed and surgical operations with anesthesia were performed routinely. The approach to Western medicine in Korea was changing during that period. The rise and fall of the Korean Red Cross Hospital represent the urgent situation of the Korean Empire as well as the imperialistic methodology of the Empire of Japan to use medicine as a tool for colonization. Although the transition process of medical policy by the Japanese Resident-General of Korea still remains to be fully elucidated, this paper contributes to a better understanding of the history of modern medicine in Korea.
Academies and Institutes ; Anesthesia ; Asian Continental Ancestry Group ; Colon ; Delivery of Health Care ; Diplomacy ; Female ; History, Modern 1601- ; Humans ; Japan ; Korea ; Red Cross* ; Shoulder ; Social Change

PURPOSE: Cataract and refractive surgical procedures which are one of the most common and successful surgeries in modern medicine. The purpose of this study is clear understanding of the current situation and future trends in cataract and refractive surgery. METHODS: Sixth annual survey forms consisted of 88 multiple-choice questions mailed to 281 ophthalmologists of the KSCRS in January 2001. Approximately 32% of the questionnaires were returned. The current data were compared with previous annual surveys and data of Japan and USA. RESULT: The hospitalized period is decreased annually, but the rate of topical anesthesia (44%) increases steadily. Self sealing wound construction was the main wound closure technique in phacoemulsification (48%). The most preferred intraocular lenses for small incision cataract surgery are silicone (48%), acrylic (40%), and polymethyl methacrylate (PMMA, 11%). 72% of the respondents were performing excimer laser keratectomy for refractive surgery, and its most common complication is the regression of visual acuity (35%). Most respondents preferred laser in situ keratomileusis (LASIK) without regard to diopter range and there is decreasing tendency of legal problems after refractive surgery. CONCLUSIONS: From this survey, we found that the current trend and changes in cataract and refractive surgery in Korea are similar to those of Japan and USA.
Anesthesia ; Cataract* ; Surveys and Questionnaires ; History, Modern 1601- ; Japan ; Keratomileusis, Laser In Situ ; Korea* ; Lasers, Excimer ; Lenses, Intraocular ; Phacoemulsification ; Polymethyl Methacrylate ; Postal Service ; Refractive Surgical Procedures* ; Silicones ; Visual Acuity ; Wound Closure Techniques ; Wounds and Injuries

Nowadays the importance of respiratory therapy is increasing with the development of modern medicine. Especially effective respiratory care in the field of anesthesia and intensive care unit has close relationship to the decrease of mortality or morbidity of the critically ill patients. Compared with spontaneous respiration, so various physiological changes related to these methods can occur. Because most modernized ventilations can choose the various respiratory patterns according to the patients' respiratory condition, it is ideal to select the respiratory mode which is least hazardous and most effective to the patients. To confirm the effects of respiratory therapy on the cardiovascular system and arterial blood gas in one-lung ventilation and in pulmonary edema, we made one-lung ventilation by deep right endobronchial intubation and ppulmonary edema was induced by oleid acid (0.05g/kg. IV) to 12 mongrel dogs. And we observed the cardiovascular changes and arterial blood gas analysis in the situation of applying the inspiratory pause(0.25sec. and 0.5sec) and positive end-expiratory pressure(5cm H2O and 10cm H2O). The results were as follows: 1) One-lung Ventilation. (i) Inspiratory pause-There were no changes of cardiovascular system and arterial blood gas in the inspiratory pause of 0.25 and 0.5 sec. (ii)PEEP-In 5cmH2O of PEEP there was no change of cardiovascular system, but there was decrease in PCO2(p<0.01) on arterial blood gas. In 10cmH2O of PEEP there was increase in heart rate(p<0.05) and decrease in cardiac output(p<0.05). There was decrease in PCO2(p<0.01), but there were no changes of pH and PO2 on arterial blood gas. 2) Pulmonary edema. (i) Inspiratory pause-There was increase in heart rate(p<0.01), but there was no change of arterial blood gas in the 0.25 and 0.5sec. inspiratory pause. (ii) PEEP- In 5cmH2O PEEP there was increase in heart rate(p<0.01), but there was no change of arterial blood gas in the 0.25 and 0.5 sec. inspiratory pause. In 10cmH2O PEEP there were decrease in sBP, dBP, MAP, increase in heart rate(p<0.05) and decrease in cardiac output(p<0.01). There were increase in pH(p<0.05) and PO2(p<0.01), decrease in PCO2. According to the above results in the condition of one-lung ventilation mechanical ventilation with inspiratory pause(0.25 or 0.5 sec) was not helpful to respiratory care. 5cmH2O PEEP could improve the pulmonary ventilation without ay changes of cardiovascular system, but 10cmH2O PEEP increased heart rate and decrease cardiac output. In the condition of pulmonary edema, mechanical ventilation with inspiratory pause(0.25 or 0.5 sec) could not improve the pulmonary ventilation with depression of cardiovascular system. PEEP (5 or 10 cmH2O) could improve the pulmonary condition in proportion to PEEP, but it also depressed the cardiovascular system. Therefore we concluded that mild degree PEEP (5cmH2O) may be helpful to the one-lung ventilation or pulmonary edema.
Anesthesia ; Animals ; Blood Gas Analysis ; Cardiac Output ; Cardiovascular System* ; Critical Illness ; Depression ; Dogs ; Edema ; Heart ; Heart Rate ; History, Modern 1601- ; Humans ; Hydrogen-Ion Concentration ; Intensive Care Units ; Intubation ; Mortality ; One-Lung Ventilation* ; Positive-Pressure Respiration ; Pulmonary Edema* ; Pulmonary Ventilation ; Respiration ; Respiration, Artificial ; Respiratory Therapy ; Ventilation