BACKGROUND: Tracheal extubation causes hypertension and tachycardia. In susceptable patients, even this short period of hypertension and tachycardia can result in myocardial ischemia. The purpose of this study was to evaluate the effect of esmolol and diltiazem in attenuating cardiovascular responses to tracheal extubation. METHODS: Changes in heart rate, systolic and diastolic blood pressure were measured during extubation and emergence from anesthesia in 60 ASA physical status I patients to assess the effect of esmolol and diltiazem. The patients were randomly assigned to one of three groups (n=20 for each group) : saline 5 ml (as a control), 0.2 mg/kg diltiazem and 1.5 mg/kg esmolol. These medications were given 2 min before tracheal extubation. RESULTS: Both groups of diltiazem and esmolol were greater attenuating effect on changes of heart rate, systolic and diastolic blood pressure than control group. The inhibitory effect on changes of heart rate was greater with esmolol than diltiazem, but the attenuating effect on changes of systolic blood pressure was greater with diltiazem than esmolol. CONCLUSIONS: We concluded that a bolus dose of intravenous diltiazem 0.2 mg/kg or esmolol 1.5 mg/kg given at 2 min before extubation was of value in attenuating the cardiovascular changes occuring in association with tracheal extubation and emergence from anesthesia. Esmolol is more effective than diltiazem in attenuating the heart rate changes. Diltiazem is more effective than esmolol in attenuating the systolic blood pressures changes.
Airway Extubation* ; Anesthesia ; Blood Pressure ; Diltiazem* ; Heart Rate ; Humans ; Hypertension ; Myocardial Ischemia ; Tachycardia

Acute thyroid abscess is an uneommon type of neck infection. We experieneed a case of staphylococcal thyroid abscess in 29 year old man, diagnosed by needle aspira~tion and culture of the aspirate. The patient had complained fever and slowly growing anterior neck swelling. Needle aspiration of the cold nodule prior to broad spectrum antibiotics was performed. After Surgical excision combined with antibiotics, he was discharged with elinical improvement. The laboratory diagnosis and clinical course was summarized and is reported with relevent references.
Abscess ; Anti-Bacterial Agents ; Clinical Laboratory Techniques ; Fever ; Humans ; Neck ; Needles ; Staphylococcus aureus ; Staphylococcus ; Thyroid Gland

OBJECTIVES: It is widely accepted that estrogen has favorable effects on cardiovascular diseases, especially in the postmenopausal women. Endothelin-1(ET-I), released from the vascular endothelium, is a 21-amino acid peptide with strong vasoconstrictor activity. However, the effect of estrogen on the vasoconstriction to ET-1 has not been extensively studied. METHODS: To investigate the effect of estrogen (175beta-estradiol) on the vascular contraction to ET-1, porcine coronary artery(PCA) rings were suspended in organ chambers(37 degrees C, 95% O2/5% CO2) for measurement of isometric tension change. Endothelium was removed mechanically if necessary. In acute experiments, vascular rings were preincubated for 15minutes with 3different concentrations of 170beta-estradiol(10(-6), 10(-5), 10(-4)M) and concentration-contraction curves to cumulative doses of ET-1 were constructed. In the experiments after a longer exposure to 17beta-estradiol, the vessels with endothelium were exposed in the 5% CO2 incubator to 3different concentrations of 17beta-estradiol(10(-9), 10(-8), 10(-7)M) for 44-50 hours, and then concentrationcontraction curves to ET-1 were obtained. RESULTS: Incubation for 15minutes with 170beta-estradiol(10(-4)M) inhibited ET-1-induced contraction in the vessels with endothelium(area under the curve and maximal contraction, p<0.05 compared with control). This effect persisted regardless of the sex and the presence or absence of the endotheliurn. Incubation of the vessels far a longer time with 170beta-estradiol(44-50 hours) resulted in the inhibition of maximal contraction to ET-1(p<0.05) by a lower concentration of 175beta-estradiol(10(-7)M) than in acute experiments in male PCA rings, but an enhanced contraction to ET-1(area under the curve; p<0.05) by 10M of 175beta-estradiol was observed in female PCA rings. CONCLUSION: Short-time incubation with 17Pbeta-estradiol has an inhibitory effect on the contraction to ET-1 in PCA rings. This effect is independent of the presence of the endothelium and the sex of the pigs. A longer incubation with 17beta-estradiol results in a similar inhibitory effect on male(but not female) PCA rings, suggesting that a sex-related difference may exist concerning the effect of 17beta-estradiol on ET-1-induced contraction.
Cardiovascular Diseases ; Coronary Vessels* ; Endothelin-1* ; Endothelins ; Endothelium ; Endothelium, Vascular ; Estrogens ; Female ; Humans ; Incubators ; Male ; Passive Cutaneous Anaphylaxis ; Swine ; Vasoconstriction

No abstract available.
Cholesterol* ; Female ; Hypertension, Pregnancy-Induced* ; Lipoproteins* ; Metabolism* ; Pregnancy ; Pregnancy*

OBJECTIVE: Unfolding is a rendering method to visualize organs at a glance by virtually incising them. Although conventional methods exploit gray-scale volume datasets such as CT or MR images, we use the Visible Korean Human dataset preserving actual color. This can be helpful for the study of anatomical knowledge. Segmented images of Visible Korean Human dataset store the boundary of organs. Since medical experts manually perform the segmentation from anatomical color images, it is very time-consuming. In general, therefore, some images selectively sampled with interval from entire color images are segmented. When we generate a segment volume dataset with the selected images, final results are deteriorated due to lack of segmentation information for missed images. In this paper, we solve this problem by generating intermediate images without performing a manual segmentation. METHODS: Firstly, after comparing differences of organ's contours in between two consecutive segmented images, we represent the differences as a user-defined value in the intermediate images. This procedure is repeated for all pairs of manually segmented images to reconstruct entire volume data consist of manually segmented images and their intermediate images. In rendering stage, we perform the radial volume ray casting along with the central path of target organ. If a ray reaches to a region having the user-defined values, we advance over the region without compositions to the boundary of that region. Then the color composition is begun by performing backtracking, since the advanced region is regarded to the thickness of it. RESULTS: As a result, we can produce high quality unfolding images for the stomach, colon, bronchus, and artery of the Visible Korea Human dataset. CONCLUSION: Since our approach can be applied to virtual dissection including actual human colors, it is helpful for the endoscopy and anatomy studies.
Arteries ; Bronchi ; Colon ; Endoscopy ; Humans ; Korea ; Stomach

OBJECTIVES: Despite the importance of human immunodefi-ciency virus(HIV) transmission through heterosexual contact, the features of heterosexual transmission has not been well studied in Korea. So we conducted a cross sectional study to determine the transmission rates in married couples and assess risk factors for male to female heterosexual transmission of HIV. METHODS: 169 HIV-infected males and their female sex partners were recruited from 1985 to June 1998. We examined female sex partners HIV infection status and interviewed male index partners and their female sex partners about demographic characteristics and sexual practices. We analysed heterosexual transmission rate by epidemiologic characteristics, disease status and sexual practices. And we assessed risk factors for HIV infection by univariate and multivariate analysis. RESULTS: 30 female sex partners were infected at enrollment, yielding an transmission rate of 17.8%. Among couples who had used condoms consistently, none of the female sex partners was infected with HIV. In univariate analysis the significant risk factors were full blown AIDS status (OR=4.1, 95% CI: 1.49-11.43) and low CD4 T cell count of index partners at enrollment (OR=7.8, 95% CI: 2.19-27.80). In multivariate analysis HIV-1 RNA levels was significant risk factor when adjusted by CD4 T cell counts and mean sexual contacts per month (OR=19.2, 95% CI: 1.03-357.59) CONCLUSION: The risk of male to female heterosexual transmission increased with advanced stages of HIV infection in the index male partners.
Cell Count ; Condoms ; Family Characteristics ; Female* ; Heterosexuality* ; HIV Infections ; HIV* ; HIV-1 ; Humans ; Korea* ; Male* ; Multivariate Analysis ; Risk Factors* ; RNA

OBJECTIVES: New organizational work systems, and their impact on the mental health of employees, are considered to beone of the most important topics in the area of industrial health. This study was conducted to compare job characteristics (job demand and decision latitude) levels, and psychosocial distress of workers in acompany introducing to new organizational work systems, to those of workers managed by traditional work systems. METHODS: A study sample of 627 shipbuilding workers (446the new work organizational system and 181the traditional system) were recruited for this study. A structured-questionnaire was used to assess general characteristics, job characteristics (work demand, decision latitude), and psychosocial distress. RESULTS: The decision latitude was not significantly higher in the new work system compared to the traditional system. However, the job demand was significantly higher in the new work system than in the traditional system. The psychosocial distress was higher within the new work system than the traditional system, but no significant relationships were found. The proportion of increased strain was significantly greater with the new system than the traditional system. CONCLUSION: These results suggest that increases in the decision latitude did not sufficiently compensate for higher job strain or increased work intensity. If the increase in the decision latitude was temporary, with the typical job demand remaining high, such work can be still be considered to have a job strain. Future research should consider psychosocial distress and fatigue as important problems caused by new work organizational systems, and should be performed to assess their impact through out industry.
Fatigue ; Mental Health ; Occupational Health

Diffuse telangiectatic type of pulmonary arteriovenous malformation (AVM) is an uncommon disease entity in which numerous small arteriovenous connections occur throughout the lungs. It has rarely been confirmed by pulmonary angiography. We report a case of diffuse telangiectatic pulmonary AVM occurring in a patient with dyspnea and confirmed by CT using the slab maximum intensity projection (MIP) technique and conventional direct pulmonary angiography.
Angiography ; Arteriovenous Malformations* ; Dyspnea ; Humans ; Lung ; Tomography, X-Ray Computed*

PURPOSE: Although inconsistent, reports have shown fibrinogen levels to be associated with atherosclerosis. Accordingly, since cigarette smoking is associated with increased levels of fibrinogen and atherosclerosis, it may also affect the association between fibrinogen and atherosclerosis. We investigated the associations between fibrinogen and carotid intima-media thickness (IMT) according to smoking status in a Korean male population. MATERIALS AND METHODS: Plasma fibrinogen levels were measured in 277 men aged 40-87 years without a history of myocardial infarction or stroke. High-resolution B-mode ultrasonography was used to examine the common carotid arteries. IMT level was analyzed both as a continuous (IMT-max, maximum value; IMT-tpm, 3-point mean value) and categorical variable (higher IMT; presence of plaque). Serial linear and logistic regression models were employed to examine the association between fibrinogen and IMT according to smoking status. RESULTS: Fibrinogen levels were positively associated with IMT-max (standardized beta=0.25, p=0.021) and IMT-tpm (standardized beta=0.21, p=0.038), even after adjusting for age, body mass index, systolic blood pressure, fasting glucose, and total cholesterol to high-density lipoprotein cholesterol ratio in current smokers (n=75). No significant association between fibrinogen and IMT, however, was noted in former smokers (n=80) or nonsmokers (n=122). Adjusted odds ratios (95% confidence interval) for having plaque per one standard deviation higher fibrinogen level were 2.06 (1.09-3.89) for current smokers, 0.68 (0.43-1.10) for former smokers, and 1.06 (0.60-1.87) for nonsmokers. CONCLUSION: Our findings suggest that cigarette smoking may modify the association between fibrinogen and carotid atherosclerosis. Further studies are required to confirm this finding in different populations.
Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group/*statistics & numerical data ; Atherosclerosis/*ultrasonography ; Blood Pressure ; Body Mass Index ; Carotid Artery Diseases/*blood/epidemiology/ultrasonography ; Carotid Artery, Common ; *Carotid Intima-Media Thickness ; Cholesterol/blood ; Cholesterol, HDL ; Cross-Sectional Studies ; Fibrinogen/*analysis ; Humans ; Lipoproteins, HDL/blood ; Logistic Models ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Risk Factors ; Sex Factors ; Smoking/*adverse effects/blood/epidemiology ; Surveys and Questionnaires

We report a case of rare cervical isthmic spondylolisthesis of C6-7 combined occult spinal bifida at C6, and review the radiologic finding, different diagnosis and treatment. A 23-year old female presented nuchal, back pain after traffic accident. Radiologic finding showed the 6th cervical isthmic defect, spondylolisthesis and dysplasia. The patient was conservatively treated about 8 weeks, and 10 months after injury, she was symptom free with full range of motion of cervical spine and she was followed up. Cervical spondylolysis is a very rare condition. This clinical importance is vulnerable to trauma. For whatever reasons, symptomatic patients need to be treated by conservative or surgical option.
Accidents, Traffic ; Back Pain ; Cervical Vertebrae ; Female ; Humans ; Range of Motion, Articular ; Spine ; Spondylolisthesis ; Spondylolysis