BACKGROUND: Laryngoscopy and tracheal intubation for general anesthesia are potent stimuli to the cardiovascular system due to sympathetic stimulation. The aim of this study was to compare the hemodynamic responses with different administration routes of lidocaine on blood pressure and heart rate changes associated with tracheal intubation. METHODS: Sixty patients were randomly assigned to spray group (Group 1, n=20) received 10% lidocaine 1.5 mg/kg spray to intratracheally immediately before tracheal intubation, IV group (Group 2, n=20) received 2% lidocaine 1.5 mg/kg intravenously before 90 sec tracheal intubation and control group (Group 3, n=20). Anesthesia was induced with thiopental 5 mg/kg IV, vecuronium 0.1 mg/kg and 50% N2O-O2- 2vol % enflurane. After 5 minutes, tracheal intubation was performed. Mean arterial pressure and heart rate were measured at preintubation and immediately postintubation, 1, 3, 5 mins after tracheal intubation. RESULTS:The differences of mean arterial pressure which were measured at preintubation and immediately postintubation and 1 minute after intubation in group 1 were significantly lower than those in other group (p<0.05). The differences of heart rate which measured at preintubation and 1 minute after intubation were lower than those in group 3 (p<0.05). CONCLUSIONS: For the suppression of sympathetic stimulation following tracheal intubation, 10% lidocaine spray to the laryngotrachea is an effective method to suppress cardiovascular response.
Anesthesia ; Anesthesia, General ; Arterial Pressure ; Blood Pressure ; Cardiovascular System ; Enflurane ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Intubation* ; Laryngoscopy ; Lidocaine* ; Thiopental ; Vecuronium Bromide

BACKGROUND: The diagnosis of malaria has been usually made using microscopic examination of Wright stained thin blood films in Korean army. This method is labor-intensive, time consuming and requires the microscopic expertise. Therefore, the alternative techniques, rapid diagnostic test, have been sought for use in Korean army. We performed a comparison of the OptiMAL test with GENEDIA Malaria (P. vivax) Ab Rapid I, II to assess its sensitivity and specificity of Plasmodium vivax malaria. METHODS: Blood specimen were collected from 51 patients who were presented and initially diagnosed for P. vivax by the microscopy of blood smears and from 30 control patients without malaria infection at the Capital Armed Forces General Hospital (CAFGH) between October 2000 and February 2001. Among the 51 patients, we also collected 24 samples from 24 patients at 2 or 3 days after therapy. The OptiMAL test and GENEDIA Malaria (P. vivax) Ab Rapid I, II were performed according to the manufacturer's instructions on all samples respectively. RESULTS: Compared with the blood film, sensitivities and specificities of the OptiMAL test, GENEDIA Malaria (P. vivax) Ab Rapid I and GENEDIA Malaria (P. vivax) Ab Rapid II were 94.1~100% (29/29), 80.4~83.3%, 96.1~96.7% respectively. One case was interpreted as 'undetermined' by OptiMAL test. In 24 patients during therapy, the sensitivities of the OptiMAL test, GENEDIA Malaria (P. vivax) Ab Rapid I and GENEDIA Malaria (P. vivax) Ab Rapid II on 8 specimens with mean 120/microliter parasitemia and 16 specimens with negative parasitemia were 75~43.8%, 87.5~81.3%, 100~100% respectively. CONCLUSION: Our data demonstrated that the sensitivity and specificity of the GENEDIA Malaria (P. vivax) Ab Rapid I were not satisfactory, but the sensitivity and specificity of the OptiMAL test and GENEDIA Malaria (P. vivax) Ab Rapid II were relatively high and useful diagnostic tests for diagnosis of P. vivax in areas like the militaries where laboratory facilities are poor or non-existent.
Arm ; Diagnosis* ; Diagnostic Tests, Routine ; Hospitals, General ; Humans ; Malaria* ; Malaria, Vivax ; Microscopy ; Military Personnel* ; Parasitemia ; Plasmodium vivax* ; Plasmodium* ; Sensitivity and Specificity

BACKGROUND: The appropriate procedures and equipment for the pretransfusion test are fundamental to a safe blood transfusion. The present study aimed to assess the current status of procedures and equipment for pretransfusion tests at small- and medium-sized medical institutions, as well as to use this basic raw data to better manage blood transfusions at these institutions. METHODS: Offline and online questionnaire surveys were performed at institutions that used between 24 and 1,000 units of blood products in 2014. A total of 338 institutions participated, and the survey results were subsequently analyzed. RESULTS: Among 307 institutions where on-site ABO blood typing was performed, 15.0%, 2.1%, and 43.5% did not conduct ABO serum typing, RhD typing, and irregular antibody screening tests, respectively, and 12.8% only conducted the saline phase for crossmatching. Moreover, among 338 institutions, only 66.7% of blood banks had centrifuges, 84.5% had 37℃ incubators, 41.1% had slide view boxes; in addition, 66.1% and 18.6% had refrigerators and deep freezers, respectively, for blood storage. CONCLUSION: Certain small- and medium-sized institutions did not have the essential equipment required to operate as blood banks. Moreover, they also needed to improve their testing procedures. To address these issues, the initiation of systematic training programs and the employment of institutional strategies are necessary to enhance testing procedures and equipment, respectively.
Blood Banks ; Blood Grouping and Crossmatching ; Blood Transfusion ; Education ; Employment ; Incubators ; Korea* ; Mass Screening

The halogenated anesthetics, halothane, enflurane and isoflurane undergo biotransformation in man. They produce inorganic fluoride ion as a metabolite, which is well known as the cause of methoxyflurane induced nephrotoxicity. This study was done to investigate the rapidity and extent of biotransformation of volatile anesthetics for 2 hours of operation. Thirty patients were randomly divided into halothane, enflurane and isoflurane group according to anesthetics. Blood and urine sampling was done before operation, post-induction 10 min, 20 min, 30 min, 1 hour, 1 hour 30 min and 2 hours for the measurement of inorganic fluoride ion. Aspartate aminotransferase, alanine aminotransferase, blood urea nitrogen and creatinine levels were measured before and 24 hours after operation. The results were as follows ; 1) The values of blood fluoride ion in halothane and isoflurane group were decreased with time during operation and there was no change in enflurane group. 2) The values of urine fluoride ion in three groups were increased with time during operation. The rate of increase was the greatest in enflurane group. 3) There were no changes in the value of AST, ALT, BUN and creatinine. The above results suggest that the biotransformation of volatile anesthetics to inorganic fluoride ion was the greatest in enflurane, but the level was insufficent to cause renal dysfunction during 3.18 hour operation.
Alanine Transaminase ; Anesthetics* ; Aspartate Aminotransferases ; Biotransformation* ; Blood Urea Nitrogen ; Creatinine ; Enflurane ; Fluorides ; Halothane ; Humans ; Isoflurane ; Metabolism ; Methoxyflurane

It is essential to keep sirway during, general anesthesia. Tracheal intubation is the most useful and safe method to keep airway. But there are hemodynar. ic changes in using laryngoscope and tracheal intubation. And also sore throat may by developed in postoperative period. In 1983, Brain introduced laryngeal mask as a new airway and thereafter its use is increasing. Laryngeal mask have many advantages of easy intubation, insertion without muscle relaxant, and decreasing damage of larynx and pharynx, and also useful in difficult intubation. We studied hemodynamic changes during tracheal intubation and laryngeal mask insertion, and examined postoperative sore throat in postoperative 24 hours. The results are as follows: 1) There were significant increase in systolic, diastolic, mean arterial pressure and heart rate in both groups, but degree and duration of increase was more in endotracheal intubation group. 2) There were more cases of sorethroat in control group than mask group, but no significance was noted between them.
Anesthesia, General ; Arterial Pressure ; Brain ; Heart Rate ; Hemodynamics ; Intubation* ; Intubation, Intratracheal ; Laryngeal Masks* ; Laryngoscopes ; Larynx ; Masks ; Pharyngitis ; Pharynx ; Postoperative Period

Holoprosencephaly is a rare malformation complex or development defect including different degrees of incomplete cleavages of the embryonic prosencephalon and varying degrees of the midface defects, resulting from the defect of prechordal mesoderm, migrating forward into the area anterior to the notochord during the third week of fetal development. Early antenatal diagnosis of holoprosencephaly is important to find out its severity, to predict its prognosis, and to determine proper management according to its prognosis and severity. The possibility of early antenatal diagnosis of holoprosencephaly by ultrasound has been suggested, but occasionally missed and rarely confirmed. We present one case of lobar holoprosencephaly, diagnosed postnatally and one case of alobar holoprosencephaly, diagnosed antenatally in our hospitals.
Fetal Development ; Holoprosencephaly* ; Mesoderm ; Notochord ; Prenatal Diagnosis ; Prognosis ; Prosencephalon ; Ultrasonography

BACKGROUND AND OBJECTIVES: The sense of smell plays an important role in the quality of life. Loss of smell is common in the elderly and it results from respiratory diseases, certain disease states (Alzheimer disease, chronic renal failure (CRF), multiple sclerosis), medications, and surgical interventions. Many studies have shown a declining odor perception in the CRF patients. The objectives of the present study were to test odor identification ability in patients with CRF and the effect of hemodialysis on olfactory recognition, and to examine the possible correlations between smell identification test score and various clinical parameters. MATERIALS AND METHOD: We performed a case-control study comparing the Cross- Cultural Smell Identification Test (CC-SIT) scores of CRF patients with hemodialysis, and those without hemodialysis, and age-sex matched healthy controls. RESULTS: Healthy controls had significantly high CC-SIT scores compared to those of CRF patients without hemodialysis. No significant differences were observed in the CC-SIT scores between CRF patients with hemodialysis and healthy controls and in CRF patients before and after the hemodialysis session. No significant positive correlation was found between CC-SIT score and creatinine clearance in the dialysis group. CONCLUSION: Acute removal of uremic toxins by hemodialysis does not correct olfactory disturbances. Odor perception is severly impaired in patients with CRF and is related to the degree of renal impairment.
Aged ; Case-Control Studies ; Creatinine ; Dialysis ; Humans ; Identification (Psychology) ; Kidney ; Kidney Failure, Chronic* ; Odors ; Quality of Life ; Renal Dialysis* ; Renal Insufficiency, Chronic ; Smell

When spine-pelvic motion is normally coordinated, the pelvis may tilt posteriorly and acetabular anteversion may increase as the patient's position changes from standing to sitting; this scenario allows for improved clearance of the femoral head and neck during hip flexion. However, changes in the mobility of the spine and pelvis may result in impingement after total hip arthroplasty (THA), with the most obvious complication being dislocation. Understanding the spinal-pelvic relationship in the sagittal plane is essential for planning THA in patients with spinal fusion or a known spine disease. Careful attention should be payed to the cup position when performing THA on patients with an increased risk of dynamic impingement.
Acetabulum ; Arthroplasty, Replacement, Hip ; Dislocations ; Head ; Hip ; Humans ; Neck ; Pelvis ; Spinal Fusion ; Spine

Rosai-Dorfman disease (RDD) is a benign proliferative histiocytic disorder of unknown etiology, which typically manifests as lymphadenopathy and systemic symptoms. Lymph node involvement is typical, but soft tissue RDD without nodal or systemic involvement is extremely rare. We report on a case of soft tissue RDD in a 16-year-old girl with a palpable mass on her buttock. It was firm, mobile, and discrete without tenderness. Excisional biopsy was performed, then RDD was confirmed histologically. RDD is a non-neoplastic disease that should be considered in the differential diagnosis of other soft tissue tumors. While the optimal treatment for extranodal RDD remains controversial, surgical excision is typically curative.
Adolescent ; Biopsy ; Buttocks ; Diagnosis, Differential ; Emperipolesis ; Female ; Histiocytosis, Sinus* ; Humans ; Lymph Nodes ; Lymphatic Diseases

BACKGROUND AND OBJECTIVES: Despite significant improvement in the field of angioplasty, restenosis remains a major obstacle to the long-term success of the procedure. Radiation can effectively inhibit neointimal hyperplasia by causing the arrest of mitosis during cell division and limiting proliferation by reducing the number of regenerating clonal progenitors. Balloon injury could induce the cell adhesion molecule, ICAM-1 and VCAM-1, on SMCs and regenerating endothelial cells (ECs). ICAM-1 and/or VCAM-1 may play a role in the progression of neointimal hyperplasia induced by balloon injury and external radiation may effectively inhibit neointimal hyperplasia by attenuating their expression. The purpose of this study was to examine the effect of external radiation against ICAM-1 and VCAM-1 on neointimal hyperplasia after balloon injury in rat carotid arteries. MATERIAL AND METHODS: A standardized carotid balloon catheter arterial injury was produced in 51 rats and external beam radiation with doses from 5-20 Gy were delivered in 28 rats (radiation treated group) at 24 hours after injury. To investigate the effect of the external radiation on neointimal hyperplasia, the intima area and the intima/medial area of arteries were measured at day 14 after injury. The expressions of ICAM-1 and VCAM-1 at day 2, day 7, and day 10 after injury were studied in control group and radiation treated group by immunohistochemistry. RESULTS: Means of intimal area and intima/medial ratio in radiation treated group were significantly lower than those in control group and significantly reduced with increasing radiation dosage. At day 2 after injury, medial SMCs of injury group extensively expressed ICAM-1, while it was focally expressed with 10 Gy radiation treated group. At day 7 and day 10 after injury, ICAM-1 expression on medial SMCs was attenuated and neointimal ICAM-1 expression was increased. As compared with control group, ICAM-1 expression after radiation was weak and focal just around the internal elastic lamina. At 2 days after injury, medial SMCs moderately expressed VCAM-1, which was weakly and focally expressed with 10 Gy radiation treated group. At day 7 and day 10 after injury, focal expression of VCAM-1 was noted around the internal elastic lamina, but there was no VCAM-1 expression on neointima with radiation. CONCLUSION: External radiation after carotid arterial injury may potentially inhibit SMC proliferation and neointimal hyperplasia, and balloon injury-induced or upregulated expressions of ICAM-1 and VCAM-1 may be attenuated with external radiation.
Angioplasty ; Animals ; Arteries ; Carotid Arteries ; Catheters ; Cell Adhesion* ; Cell Division ; Endothelial Cells ; Hyperplasia* ; Immunohistochemistry ; Intercellular Adhesion Molecule-1* ; Mitosis ; Neointima ; Radiation Dosage ; Rats* ; Vascular Cell Adhesion Molecule-1