BACKGROUND: The laparoscopy requires carbon dioxide (CO2) insufflation and Trendelenburg position for operational convenience. However, the above circumstances affect the cardiopulmonary systems significantly and intraocular pressure (IOP) may be also influenced. METHODS: In 27 non-glaucoma patients right and left intraocular pressure (RIOP, LIOP) were measured 5 minutes after induction of general anesthesia (control value), 15 and 30 minutes after CO2 insufflation and endelenburg-lithotomy position. RESULTS: The control values of RIOP and LIOP were 11.3 4.7 mmHg and 11.5 4.7 mmHg respectively. At 15 minutes after CO2 insufflation and Trendelenburg-lithotomy position, they increased to 16.6 5.3 mmHg and 17.0 5.9 mmHg (p<0.05). At 30 minutes, 18.4 3.5 mmHg and 18.2 4.1 mmHg (p<0.05). CONCLUSION: CO2 insufflation and Trendelenburg-lithotomy position increase IOP significantly in non-glaucoma patients during laparoscopy.
Anesthesia, General ; Carbon Dioxide ; Head-Down Tilt ; Humans ; Insufflation* ; Intraocular Pressure* ; Laparoscopy*

OBJECTIVES: This study was conducted to measure the decline in the health-related quality of life (HRQoL) associated with some diseases in South Korean adults. METHODS: The EQ-5D health states in the 2005 National Health and Nutrition Examination Survey (NHNES) and the Korean EQ-5D valuation set were used to obtain the EQ-5D indexes of the study subjects. Each disease group was defined when the subjects reported to the NHNES that they were diagnosed with the corresponding disease during the previous 1 year by physicians. Since the distributions of the EQ-5D indexes in each subgroup were negatively skewed, median regression analysis was used to estimate the effects of specific diseases on the HRQoL. Median regression analysis produced estimates that approximated the median of the EQ-5D indexes and there are more robust for analyzing data with many outliers. RESULTS: A total of 16,692 subjects (6,667 patients and 10,025 people without any disease) were included in the analysis. As a result of the median regression analysis, stroke had the strongest impact on the HRQoL for both males and females, followed by osteoporosis, osteoarthritis, rheumatic arthritis, and herniation of an intervertebral disc. While asthma had a significant impact on the HRQoL only in men, cataract, temporo-mandibular dysfunction, and peptic ulcer significantly affected the HRQoL only in women. CONCLUSIONS: Stroke and musculoskeletal diseases were associated with the largest losses of the HRQoL in Korean adults.
Adult ; Female ; Health Status ; Humans ; Korea ; Male ; Middle Aged ; Musculoskeletal Diseases/etiology ; *Quality of Life ; Questionnaires ; Regression Analysis ; Sex Factors ; Sickness Impact Profile ; Stroke/etiology

BACKGROUND: There are limited data regarding smoking cessation treatment by physicians in Korea. Thus, we investigated the attitude to smoking cessation intervention and services among Korean physicians. METHODS: This survey was conducted in 987 participating physicians who had experiences in smoking cessation services. The subjective difficulties of smoking cessation services and its causes and the presumptive reasons for failure of smoking cessation among their patients were investigated using questionnaires. RESULTS: Overall smoking rate among Korean physicians who participated in this survey was 12.6%. Most participating physicians had a difficulty in smoking cessation services and its causes were high cost of medication for smoking cessation due to non-imbursement (50.7%) and the absence of a medical fee on smoking cessation services (34.8%). The high cost of medication for smoking cessation due to non-imbursement (29.5%) also ranked high in the presumptive reasons for failure of smoking cessation among their patients. CONCLUSION: The smoking rate of Korean physicians in this survey was lower than those of the general population. Most participating physicians had a difficulty in offering smoking cessation services. And the most common cause for the difficult was non-imbursement of their services and medication.
Fees, Medical ; Humans ; Korea ; Smoke ; Smoking ; Smoking Cessation ; Surveys and Questionnaires

Hepatoblastoma is a rare pediatric malignancy which frequently presents at an advanced unresectable stage. Complete surgical resection after chemotherapy is the definitive treatment for hepatoblastoma. Liver transplantation should be considered for children who have unresectable hepatoblastoma. We report a case of a 18-month-old boy with unresectable hepatoblastoma who had transplantation with pre- and post-operative chemotherapy.
Child ; Drug Therapy ; Hepatoblastoma* ; Humans ; Infant ; Liver Transplantation* ; Liver* ; Living Donors* ; Male

Dysbiosis in gut microbiota is known to contribute to development of irritable bowel syndrome. We tried to investigate the effect of Bifidobacterium longum on repeated water avoidance stress (WAS) in a Wistar rat model. The three groups (no-stress, WAS, and WAS with B. longum) of rats were allocated to sham or WAS for 1 hour daily for 10 days, and B. longum was administered through gavage for 10 days. Fecal pellet numbers were counted at the end of each 1-hour session of WAS. After 10 days of repeated WAS, the rats were eutanized, and the feces were collected. WAS increased fecal pellet output (FPO) significantly in both sexes (P < 0.001), while the female B. longum group showed significantly decreased FPO (P = 0.005). However, there was no consistent change of myeloperoxidase activity and mRNA expression of interleukin-1ββ and TNF-αα. Mast cell infiltration at colonic submucosa increased in the female WAS group (P = 0.016). In terms of fecal microbiota, the repeated WAS groups in both sexes showed different beta-diversity compared to control and WAS with B. longum groups. WAS-induced mast cell infiltration was reduced by the administration of B. longum in female rats. Moreover, administration of B. longum relieved WAS-caused dysbiosis, especially in female rats. In conclusion, B. longum was beneficial for WAS-induced stress in rats, especially in females.

BACKGROUND: The margin of safety is the length of the mainstem bronchi, over which double-lumen endotracheal tubes (DLTs) can be moved and still be correctly positioned. A negative value of margin of safety means that DLTs may not be safe. We measured the length of the left and right mainstem bronchi and margin of safety in Korean adults. METHODS: One hundred and fifty-six ASA I or II adult patients undergoing an elective surgery were examined. After nduction of general anesthesia, we measured the lengths from the upper incisor to the tracheal carina, to the proximal margin of the left and right upper lobe bronchial opening using a fiberoptic bronchoscope. We calculated the lengths of the left and right mainstem bronchi and margin of safety using the measured lengths. RESULTS: In Korean adults, the average margin of safety of left-sided DLTs of males and females was 2.4 +/- 1.0 cm and 1.9 0.7 cm and right-sided DLTs of males and females was 1.0 +/- 0.9 cm and 0.8 +/- 0.3 cm, respectively. The percentage of a negative value of the margin of safety in positioning right-sided DLTs was 10.4% in males and 8.6% in females. However, all values of the margin of safety in left-sided DLTs were positive. CONCLUSIONS: Using left-sided DLTs, regardless of the operative side, is better than right-sided DLTs because left-sided DLTs have a greater margin of safety in positioning. If we use right-sided DLTs, we should confirm the proper position of tubes using a fiberoptic bronchoscope.
Adult* ; Anesthesia, General ; Bronchi ; Bronchoscopes* ; Female ; Humans ; Incisor ; Male ; One-Lung Ventilation

BACKGROUND: The overall rate of renal complication after surgery on the suprarenal aorta remains high. In this study, the changes in renal blood flow (RBF), urinary oxygen tension (PuO2), renal vascular resistance (RVR), and urinary volume following fenoldopam administration were investigated in supraceliac aortic cross-clamping and unclamping animal model. METHODS: Twelve dogs were divided into two groups; control group (n = 6), fenodopam group (n = 6). After brachial, femoral, and pulmonary arterial catheterization, midline abdominal incision was made. For the aortic cross-clamping the supraceliac aorta was exposed. A doppler flowmeter probe was placed around right renal artery. A ureteral catheter was positioned at the right renal pelvis to measure urine volume and urinary oxygen tension (PuO2). In fenoldopam group, 0.5microgram/kg/min of fenoldopam was administered immediately before suprarenal aortic reperfusion. Systemic hemodynamics, renal blood flow, renal vascular resistance, PuO2, and urine volume were compared between two groups. RESULTS: The systemic hemodynamics were not significantly different between the two groups throughout the experiment. After aortic reperfusion, the RVR significantly increased in control group, but the RVR in fenoldopam group remained to baseline level. The urine output, RBF, and PuO2 significantly increased in fenoldopam group compared to control group. BUN and serum creatinine were not different between the two groups. CONCLUSIONS: High dose of fenoldopam administration reverse ischemic renal insufficiency after supraceliac aortic cross clamping.
Animals ; Aorta ; Catheterization ; Catheters ; Constriction ; Creatinine ; Dogs ; Fenoldopam* ; Flowmeters ; Hemodynamics ; Kidney Pelvis ; Models, Animal ; Oxygen ; Renal Artery ; Renal Circulation ; Renal Insufficiency ; Reperfusion ; Urinary Catheters ; Vascular Resistance

BACKGROUND AND OBJECTIVES: Small dense low density lipoproteins (sd-LDL) are a risk factor for coronary artery disease and are known to stimulate platelet function in vitro. This study aimed to evaluate whether high proportion of sd-LDL is associated with high on-treatment platelet reactivity (HOPR). SUBJECTS AND METHODS: From January 2009 to March 2010, 439 subjects (mean age: 64.3+/-9.7, Male : Female=306 : 133) were enrolled from the low density LIPOProtein-cholesterol Size measurement Registry with coronary artery disease, who had undergone elective percutaneous coronary intervention and measured both LDL particle size and on-treatment platelet reactivity (OPR). Mean LDL particle size was measured by gradient gel electrophoresis (Quantimetrix, Lipoprint(TM)) and OPR by the VerifyNow(TM) system (aspirin and P2Y12). RESULTS: Between pattern A (large, buoyant LDL dominant) and B (sd-LDL dominant) population, there were no significant difference in OPR to aspirin (441.3+/-71.9 vs. 434.07+/-63.45 aspirin reaction units, p=0.351) or clopidogrel (237.9+/-87.3 vs. 244.9+/-80.7 P2Y12 reaction units, p=0.465). There was no difference in LDL particle size between patients with HOPR compared with non-HOPR patients (aspirin: 26.8+/-0.5 vs. 26.7+/-0.6 nm, p=0.078, clopidogrel: 26.7+/-0.6 vs. 26.8+/-0.5 nm, p=0.857). Pearson's correlation coefficients between LDL particle size and platelet reactivity were not statistically significant (aspirin assay: r=0.080, p=0.098, P2Y12 assay: r=-0.027, p=0.568). CONCLUSION: There was no significant association between LDL particle size and OPR in patients with coronary artery disease.
Aspirin ; Blood Platelets ; Coronary Artery Disease ; Coronary Vessels ; Electrophoresis ; Humans ; Lipoproteins ; Lipoproteins, LDL ; Male ; Particle Size ; Percutaneous Coronary Intervention ; Platelet Function Tests ; Risk Factors ; Ticlopidine

PURPOSE: To evaluate the quality of prehospital CPR (cardiopulmonary resuscitation) performed by 119 rescue personnel and bystanders in Seoul and to recognize the present problems in the pre-hospital emergency medical service system (EMS). METHODS: We enrolled all patients in cardiac arrest visiting the emergency rooms of 9 university hospitals in Seoul via 119 rescue services from 16 October to 26 November 2006, prospectively investigating the environments in which arrest occurred and the factors associated with CPR. RESULTS: Among 73 patients, the most common place of arrest was in the home(45.2%), CPR by bystander was performed in 8 cases(10.7%), endotracheal intubation by EMS personnel was performed in 10 cases(14.1%). Average time from call to CPR was 11.9 minutes and the number of discharges alive was 3 cases(4.1%). CONCLUSION: To improve the rate of alive discharges, development of CPR education program for lay rescue, education in basic and advanced life support, and management of quality for EMS personnel are needed.
Cardiopulmonary Resuscitation ; Emergencies ; Emergency Medical Services ; Heart Arrest ; Hospitals, University ; Humans ; Hypogonadism ; Intubation, Intratracheal ; Mitochondrial Diseases ; Ophthalmoplegia ; Out-of-Hospital Cardiac Arrest ; Prospective Studies

BACKGROUND/AIMS: This study was aimed at evaluating differences in the effects of repeated water avoidance stress (rWAS) on colonic movement, mucosal mast cell counts, cytokine levels, and visceromotor response (VMR) to colorectal distension (CRD) in rats of both sexes. METHODS: Wistar rats were divided into stress and no-stress groups. Rats in the stress group were exposed to rWAS (1 hr/day) for 10 days. Mucosal mast cells were immunohistochemically stained with anti-mast cell tryptase antibody and counted. The colonic mucosal cytokine levels were measured with enzyme-linked immunosorbent assay. The VMR to CRD (visceral analgesia) was assessed by using a barostat and noninvasive manometry. RESULTS: The mean number of fecal pellets in the rWAS group increased significantly as compared with that in the no-stress group in both sexes. After adjustment for body weight, the female rats had a significantly higher pellet output than the male rats. The mucosal mast cell count of the female rWAS group was higher than that of the male rWAS group (13.0 ± 0.9 vs 8.8 ± 0.6; P < 0.001). The colonic mucosal interleukin-1β level was also higher only in the female rats of the rWAS group than in those of the no-stress group. On days 10 and 11, a decrease in VMR to CRD was observed at 40 and 60 mmHg in both sexes of the rWAS group, without a sex-based difference. CONCLUSIONS: The colonic response to stress appeared to be more sensitive in the female rats than in the male rats. However, stress-induced visceral analgesia had no sex-related difference and the underlying mechanism needs to be further evaluated.
Analgesia ; Animals ; Body Weight ; Colon* ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Male ; Manometry ; Mast Cells* ; Rats ; Rats, Wistar* ; Sex Characteristics* ; Tryptases ; Water*