A clinical analysis of 1753 patients with dental surgery under the general anesthesia from January 1981 to December 1985 was made according to age, sex, disease, and status of intubation. The results were as follows: 1) Of 1753 patients with oral surgery, 1067 male and 686 female patients were operated on under general anesthesia and the male to female ratio was 1.6:l. 2) Of 1753 patients, there were 501 patients with oral surgery from 20 to 30 years of age and this was the most common age. 3) Benign tumors including cysts were the most common lesions operated on under general anesthesia. 4) Of 1753 patients, 1529 patients had nasotracheal intubations, but the patients with orotracheal intubations were 206, and the patients with endotracheal insertion through tracheostomy were only 18 (l%).
Anesthesia, General ; Female ; Humans ; Intubation ; Male ; Surgery, Oral* ; Tracheostomy

PURPOSE: Compared to urban areas, access to emergency medical services in rural areas is relatively restricted both in quality and quantity. However, based on the aged population model, the need for such services is greater in rural areas, due to accidents and underlying disease. We set out to investigate whether education for emergency medical services would be helpful for utilization of poor resources for emergency medical services in rural areas and how efficient it might be. METHODS: Goheung (n=796) and Haenam (n=819), which appeared to be similar in terms of area, population composition, and quality and quantity of emergency medical services, were selected. While one area received Life Helper for the Village, one of the educational programs for emergency medical services, the other did not. A questionnaire containing items on recognition of emergency medical services and roles of the primary responder was administered. RESULTS: Significant differences were observed in the recognition of emergency medical services and safety awareness in Goheung, to which education for emergency medical services was provided. However, we did not find a relationship between injury or accident development and education for the rural emergency medical service system in two areas. CONCLUSION: Thus, provision of education is needed for development of common residents into primary responders in alienated rural and fishing villages, offering them ongoing and repeating education in order to increase their recognition of emergency medical services and safety awareness, and expand such education to areas that are in a similar situation.
Aged ; Emergencies ; Emergency Medical Services ; Emigrants and Immigrants ; Humans ; Surveys and Questionnaires

PURPOSE: Ischemic brain injury following cardiac arrest presents as cerebral edema. Cerebral edema can be diagnosed using computed tomography (CT) by evidence of difference in the ratio between gray and white matter density. The prognostic value of CT scan use in determining neurologic outcomes remains unclear for cardiac arrest survivors treated with therapeutic hypothermia. We investigated the density of gray and white matter and found that their ratio was associated with neurologic outcome. METHODS: Our study data included 93 cardiac arrest survivors treated with therapeutic hypothermia from January 2008 to June 2011. Cranial CT was performed after the return of spontaneous circulation. Circular regions of CT measurement (9.4 mm2) evaluated locations of interest including the caudate nucleus, putamen, posterior limb of the internal capsule, and the corpus callosum. The average attenuation in Hounsfield Units (HU) for each region was recorded. Neurological outcome was ranked as good or poor at discharge with neurological outcome assessed according to the Cerebral Performance Category scale (CPC) with a poor outcome defined as a CPC of 3-5. RESULTS: Gray matter attenuation was found to be significantly different between the good and poor outcome cases while white matter attenuation was insignificant. All types of gray/white matter ratio were significantly different between two groups. Receiver operating characteristics analysis determined a cut-off value of gray/white matter ratio at less than 1.11 (sensitivity 29.8%) which results in a poor outcome with a specificity of 100%. CONCLUSION: A low gray/white matter ratio (<1.11), as evaluated by CT scan, is associated with poor outcome after cardiac arrest and therapeutic hypothermia. However, the results of a CT scan should be interpreted with caution as the gray/white matter ratio is a low sensitivity marker.
Brain Edema ; Brain Injuries ; Caudate Nucleus ; Corpus Callosum ; Dinucleoside Phosphates ; Extremities ; Heart Arrest ; Humans ; Hypothermia ; Hypothermia, Induced ; Internal Capsule ; Prognosis ; Putamen ; ROC Curve ; Sensitivity and Specificity ; Survivors

BACKGROUND/AIMS: The duodenal intubation test (duodenal secretin test; DST) is now considered the 'gold standard' test of exocrine pancreatic function in detecting exocrine pancreatic dysfunction in patients with chronic pancreatitis. However, the DST has not been widely used, because it is time-consuming, invasive, and labor-intensive. On the other hand, intraductal secretin test (IDST) with endoscopic retrograde cannulation of the main pancreatic duct has been showed similar diagnostic efficiency compared with DST. We assessed the clinical usefulness of IDST and investigated parameters for assessing impaired pancreatic function of IDST. METHODS: Pure pancreatic juices were collected from 12 patients with chronic pancreatitis by endoscopic cannulation after a bolus intravenous injection of secretin 100 U, for 15min in three 5-min intervals. Five parameters of IDST were measured, and the sensitivity, specificity, and accuracy of IDST evaluated compared with ERP. RESULTS: When we regarded mean-1.5 SD as the lower limits of IDST, the diagnostic sensitivity, specificity, and accuracy of five parameters to detect chronic pancreatitis were 91.7-100%, 75-87.5%, and 85-90%, respectively. Among five parameters, pancreatic juice secretory volume, bicarbonate concentration, and amylase output showed the highest diagnostic accuracy, followed by lipase output and bicarbonate output. A 10-min collection showed as much information as a 15-min collection. CONCLUSIONS: 10-min intraductal secretin test is useful as the conventional exocrine pancreatic function test in detecting exocrine pancreatic dysfunction in patients with chronic pancreatitis and the most discriminatory parameters are pancreatic juice secretory volume, bicarbonate concentration, and amylase output.
Amylases ; Catheterization ; Hand ; Humans ; Injections, Intravenous ; Intubation ; Lipase ; Pancreatic Ducts ; Pancreatic Function Tests ; Pancreatic Juice ; Pancreatitis, Chronic* ; Secretin* ; Sensitivity and Specificity