No abstract available.
Busan* ; Cytogenetics*

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second*

No abstract available.
Animals ; Cell Line* ; Guinea Pigs* ; Guinea* ; Hantaan virus* ; Humans*

Tetralogy of Fallot constitutes the highest proportion of cyanotic congenital heart disease and has four basic abnormal anatomical pictures including ventricular septal defect, pulmonary stenosis, aortic overriding and right ventricular hypertrophy. The work of Edward, et al(1965), Guntheroth, et al(1965) and Lev and Eckner(1964) has shown that the anatomical picture in a combination of just first two morphological characteristics, the aortic overriding and right ventricular hypertrophy being a consequence of the ventricular septal defect and pulmonary stenosis. Basic signs involve two categories, one is change of shunt rate depending on pulmonary stenosis, ventricular septal defect and systemic vascular resistance, and the other is physiological response to the chronically lowered PaO2. Thus the pathophysiological status presents to us more problems than other congenital heart disease in the care of patients during operation and anesthesia. Therefore, the anesthesiologist must understand the basic pathophysiology, various findings of examination, symptoms and signs, the problems during anesthesia and postoperative care. The purpose of this study was to evaluate the anesthetic management in total corrective surgery of tetralogy of Fallo which was performed at Severance Hospital. Out of consecutive 160 cases of tetralogy of Fallot in our past ten years experiences from 1971 to 1980, we selected the clinical results on anesthetic care of 12 cases which received total corrective surgery under hypothermia and extracorporeal circulation. The results were as follows: 1) Out of 121 cases, 82 cases were male(67.8%) and female was 39 cases(32.2%). The group aging from 6 to 10 year old was the highest proportion (44.6%) and the next proportion was the group aging from 11 to 15(22.3%). 2) Out of 121 cases, 91 cases were cyanotic(75.2%). On the diagnostic distribution, tetralogy of Fallot without any other anomaly was the most common(66.9%). 3) As for premedicants, secobarbital was the highest proportion(28.1%). For anesthetic maintenance, methoxyflurane with nitrous oxide was the most common(43.8%). 4) During cardio-pulmonary bypass, high flow perfusion was commonly used and the highest mean arterial pressure was 89.09+/-1.21 mmHg and the lowest mean arterial pressure was 36.33+/-1.21mmHg. 5) The major complications after operation and anesthesia were dysrhythmia(13.1%), pleural effusion(10.3%), main wound infection(10.3%), hemorrhage(8.3%), acute renal failure(8.3%), heart failure(6.9%), low output syndrome(4.1%) and cerebral infarction due to air emboliam(2.7%). 6) Out of 121 cases were expired and hospital mortality was 23.1%. The causes of death were heart failure(50%), acute renal failure(14.3%) and cerebral infarction(14.3%). in conclusion, anesthetic care for total corrective surgery of teralogy of Fallot should be based upon the understanding of the pathophysiology of disorder itself.
Female ; Humans ; Mortality

Postoperative muscle pain is well known to occur in man following intravenous administration of succinylcholine. The mechanism of muscle pain is yet unknown. A number of methods for preventing muscle pains or decreasing their severity have been suggested, including nondepolarizing relaxants prior to succinylcholine (Churchill-Davidson, 1954: Cullen, 1971: Wig and Bali, 1979) or lidocaine(Usubiaga et al., 1967: Haldia et al., 1973: Fry, 1975), use of vitamin C (Gupte & Savant, 1971), procaine chloride(Morris & Dunn, 1957), thiopental sodium (Craign, 1964) or diazepam (Verma et al., 1978) and the use of a "self-taming" method of succinylcholine by prior injection of a small dose(Baraka, 1977). To investigate methods of preventing muscle pains or decreasing their severity after intravenous injection of succinylcholine, we studied four groups, a control group and three experimental groups (a lidocaine group, a d- Tubocurarine group and a succinylcholine self-taming group). The following results were obtained: 1) In the lidocaine group, the incidence of muscle pain was lower than in the control group, but there was no significant difference between the two groups. However the incidence of muscle pain in the d-Tubocurarine group or the succinylcholine self-taming group were lower than in the control group and there were statistically significant differences(p<0.0005). 2) In most of the patients of each group, the degree of postoperative muscle pain was mild and a difference of degree of muscle pain was not found in each group (p>0.05).3) The muscle pain usually appeared in the first day after operation and disappeared usually within three days. 4) The degree of muscle fasciculation showed a significant decrease with lidocaine, d-Tubocurarine or the succinylcholine self-taming group over the control group(p<0.0005), but there was no significant relationship between the degree of muscle fasciculation and the incidence of postoperative muscle pain(p>0.05). 5) The degree of muscle relaxation during intubation in the d-Tubocurarine group was less complete than in the other 3 groups and it was statistically significant(Zi>1.96). It is suggested from the above results that d-Tubocurarine(0.05~0.06mg/kg) prior to succinylcholine or the method of self-taming of succinylcholine(prior use of succinylcholine 0.15mg/kg) can be used as methods to prevent muscle pain after intravenous administration of succinylcholine, but lidocaine(2mg/kg) prior to succinylcholine is not effective in preventing muscle pain following succinylcholine administration.
Administration, Intravenous ; Ascorbic Acid ; Diazepam ; Fasciculation ; Humans ; Incidence ; Injections, Intravenous ; Intubation ; Lidocaine ; Methods ; Muscle Relaxation ; Myalgia* ; Procaine ; Succinylcholine ; Thiopental ; Tubocurarine

At present, spinal anesthesia is often recommanded for a safe operation and the management of pain. However the complications from the spinal anesthesia, such as hypotension, dyspnes, nauses and vomiting, pulmonary embolism, headache, auditory and visual disturbances, lumbago, urinary difficulty and neurologic sequelae have often reported from time to time. Thus an attempt to study the complications of spinal anesthesia, particularly the differences of complications between needle sizes(22 gauge and 25 gauge), has been done by our department. The following results were observed: 1) The most common sequelae of spinal anesthesia was hypotension(35.6%) and in order frequency, urinay difficulty(23.3%), headache(16.7%), lumbago(15.3%), nauses of and vomiting(12.8%), dyspnes(8.9%), auditory and visual disturbances(0.83%) and minor neurologic sequelse(0.56%). 2) The incidence of headache and lumbago was more frequent in the 22G, group, but there were no statistically significant differences(p>0.05). 3) The incidence of headache was higher in the females than the males and there were statistically significant differences(p<0.01). 4) The incidence of lumbago was higher in the fourth decade (21.7%), and females showed a higher incidence than in males and there were statistically significant differences(p<0.05). 5) The incidence of lumbago and headache and the degree of headache was without correlation to the number of punctures in both groups(22G group and 26G group). 6) The time to postoperative urination had no correlation to the level of anesthesia.
Anesthesia ; Anesthesia, Spinal* ; Female ; Headache ; Humans ; Hypotension ; Incidence ; Low Back Pain ; Male ; Needles ; Pulmonary Embolism ; Punctures ; Urination ; Vomiting

OBJECTIVES: The challenge of an increasing elderly population has coupled with everpresent social concerns in Korea. A major problem in health center for the frail older people is that medical, healthcare, and welfare services are often fragmented in terms of providers and settings without appropriate coordination. The purpose of this study was to investigate the need of health center-based integrated healthcare services and its related factors for the elderly. METHODS: A total of 110 elderly people who had visited at a county Health Center were interviewed using a self-administered questionnaire from November to December, 2005. The questionnaire consists of five domains according to the Program of All-inclusive Care for the Elderly. RESULTS: Respondents had high need (total mean score with the 5-point Likert-type sacle: 3.67) of health center-based integrated healthcare services including home visiting service (mean: 4.08), chronic disease care service (mean: 4.06), and transportation service (mean 4.05). According to the results of hierarchical multiple regression analysis, among three regression models the magnititude of the variance of full model that is explained by the need of welfare-domain service was significantly larger than two reduced model. Income was a significant variable in increasing the need of health care and welfare services. CONCLUSIONS: This study suggests that the health center-based integrated healthcare services for the elderly must be continuously developed and provided for the health promotion and improved the quality of life of the elderly who live in rural area in Korea.
Aged* ; Chronic Disease ; Delivery of Health Care* ; Health Promotion ; House Calls ; Humans ; Korea ; Quality of Life ; Surveys and Questionnaires ; Transportation

PURPOSE: This study was carried out to identify the factor of decisional balance for exercise. This was composed of a set of variables at the level of decision making when the elderly decide to do exercise. It was used to classify and identify the characteristics of the stages of change for exercise to which the elderly belong, and was used to identify the variables of decisional balance which influence the stage of change for exercise in the elderly. METHODS: Convenient samples of 198 subjects over age 60 in Seoul( mean age=70) were selected from community living, mentally competant older adults and the data was collected from April 1, 1999 to May 31, 1999. The research instrument was the Decisional Balance Measure for Exercise(Marcus &Owen., 1992), Stage of Change Measure(Marcus et al,1992). The data was analyzed by SAS Program. RESULTS: 1. According to stage of change measure, without missing data,191 subjects were distributed in each stage of change for exercise: 50 subjects(26.1%), 7 subjects (3.6%), 52 subjects(27.2%), 4 subjects(2%), and 78(40.8%) belonged to the pre- contemplation stage, contemplation stage, preparation stage, action stage and maintenace stage. 2. Factor analysis identified 3 factors of decisional balance as appropriate factors for exercise of the elderly and named by researchers; 1)'Perceived Physical-psychological benefit', 2)'Perceived Physical-psychological burden', and 3)'Perceived time burden'. 3. The analysis of variance showed that the two components Perceived Physical - psychological benefit(F=45.95, P=.0001), and Perceived Physical-psychological burden (F=26.52, P=.0001) were significantly associated with stage of change. 4. Through the discriminant analysis, it was found that both 'Self Perceived Physical - Psychological benefit' and 'Perceived Physical-Psychological burden' were the influential variables in discriminating the three stages of change(pre-contemplation, preparation, and maintenance). CONCLUSION: Results are consistent with the application of the Transtheoretical model, which has been used to understand how people change health behaviors. Even though this study is a cross-sectional, not a longitudinal study, the findings of this study give useful information for exercise intervention about especially the factors relating to decision making for exercise of the elderly in the different stages of change of exercise.
Adult ; Aged* ; Decision Making ; Health Behavior ; Humans

The purpose of this study was to identify causal relationships among variables of transtheoretical model for exercise in the elderly. A predictivel model explaining the stage of change was constructed based on a transtheoretical model. Empirical data for testing the hypothetical model was collected from 198 old adults over 60 years old in a community setting in Seoul, Korea in April and May,1999. Data were analyzed by descriptive statistics and correlational analysis using pc-SAS program. The Linear Structural Modeling (LISREL) 8.0 program was used to find the best fit model which predicts causal relationship of variables. The fit of the hypothetical model to the data was X2=132.85. (df=22, p=.000). GFI=.88, NNFI=.35, NFI=.77, AGFI=.59 which was not favorable but the fit of modified model to the data was X2=46.90. (df=27, p=.01).GFI= .95, NNFI=.91, NFI=.92, AGFI=.87) which was more than moderate. The predictable variables of stage of change for exercise of the Korean elderly were helping relationship, self cognitive determination, conversion of negative condition in process of change and efficacy for exercise . These variables explained 68% of stage of change for exercise of the Korean elderly.
Adult ; Aged* ; Humans ; Korea ; Middle Aged ; Models, Structural ; Self Efficacy ; Seoul

Purpose: This study was performed to identify the factors that change exercise behave. This study will also classify and identify the characteristics of excercise stages to which the elderly belong Also, to identify the processes of change which influence on the changes in exercise performed by the elderly. Methods: Convenient samples of 198 subjects over the age 60 in Seoul Korea(mean age=70) were selected from elderly communities and were all mentally conpetant older adults. The data were collected from April 1,1999 to May 30, 1999. The research instruments were measured the change in exercise (Marcus et al., 1992b), such as Stage of Change measure(Marcus et al,1992a). The data were analyzed by SAS Program. Results: 1. According to the measure of change without missing data, 191 subjects were distributed each stage of change for exercise: 50 subjects (26.1%), 7 subjects (3.6%), 52 subjects (27.2%), 4 subjects (2%), and 78 (40.8%) belonged to the precontemplation stage, the contemplation stage, the preparation stage, the action stage and the maintenace stage. 2. According to the factor analysis, 6 factors of change were identified as appropriate processes of change and were named by the researchers. The names were; 'Supportive helping relationship', 'Self cognitive determination', 'Environmental reinforcement', Consciousness raising', Reinforcement of negative condition and 'Conversion of negative condition'. 3. According to the stage of change, there were significant mean differences in the 'Supportive helping relationship(F=22.04, p=.0001)', 'Self cognitive determination (F=50.87, p=.0001)', 'Reinforcement of negative condition(F=7.84,p=.0006)'. 4. Through the discriminant analysis, it was found that Self cognitive determination is the most influential variable as one of the processes of change which can discrimiate the three stages of change (precontemplation, preparation, and maintenance). Also the next significant variable was Reinforcement of negative condition. Conclusion: The process of the dey change is one of concepts of The transtheoretical model known as strategies and the techniques people use as they go through the different stages of change. Even though this study is cross- sectional not longitudinal study, the finding of this study gives useful information for exercise intervention, by using this strategy of exercise for elderly in different stages of change in exercise.
Adult ; Aged* ; Consciousness ; Humans ; Seoul