Serum is free of cellular components. Because DNA is located in the nuclei or mitochondria of cells, serum could be assumed DNA free. Few previously published case reports to date have used serum for DNA typing. Here, we report on human genotyping via short tandem repeat (STR) analysis using serum as a sample, and discuss problems involved in the process.
DNA Fingerprinting* ; DNA* ; Humans ; Microsatellite Repeats* ; Mitochondria

Background: The absence of effective antiviral medications and vaccines increased the focus on non-pharmaceutical preventive behaviors for mitigating against the coronavirus disease 2019 (COVID-19) pandemic. To examine the current status of non-pharmaceutical preventive behaviors practiced during the COVID-19 outbreak and factors affecting behavioral activities, we compared to the 2015 Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in Korea. Methods: This was a serial cross-sectional population-based study in Korea with four surveys conducted on June 2 and 25, 2015 (MERS-CoV surveys), and February 4, and April 2, 2020 (COVID-19 surveys). Of 25,711 participants selected using random digit dialing numbers, 4,011 participants (aged ≥ 18 years) were successfully interviewed, for the 2020 COVID-19 (n = 2,002) and 2015 MERS-CoV (n = 2,009) epidemics were included. Participants were selected post-stratification by sex, age, and province. The total number of weighted cases in this survey equaled the total number of unweighted cases at the national level. We measured the levels of preventive behaviors (social distancing [avoiding physical contact with others]), and practicing transmission-reducing behaviors such as wearing face mask and handwashing. Results: Between the surveys, respondents who reported practicing social distancing increased from 41.9%–58.2% (MERS-CoV) to 83.4%–92.3% (COVID-19). The response rate for the four surveys ranged between 13.7% and 17.7%. Practicing transmission-reducing behaviors (wearing face masks and handwashing) at least once during COVID-19 (78.8%, 80.2%) also increased compared to that during MERS-CoV (15.5%, 60.3%). The higher affective risk perception groups were more likely to practice transmission-reducing measures (adjusted odds ratio, 3.24–4.81; 95 confidence interval, 1.76–6.96) during both COVID-19 and MERS-CoV. Conclusion The study findings suggest markedly increased proportions of non-pharmaceutical behavioral practices evenly across all subgroups during the two different novel virus outbreaks in Korea. Strategic interventions are needed to attempt based on preventive behavior works.

BACKGROUND: It used to induce hypercarbia that carbon dioxide insufflated into the peritoneum in laparoscopic surgery. It might stimulate sympathetic nervous system, and decrease splanchnic circulation, hepatic function, and metabolism of anesthetics. The purpose of the present study was to examine the influence of hypercarbia on concentrations of propofol at the time of eye opening and recovery of orientation after propofol target controlled infusion (TCI) during a laparoscopic cholecystectomy. METHODS: Fifty patients were divided randomly into a laparoscopic group (group 1, n = 25) and an exploratory group (group 2, n = 25). A propofol infusion was started at a propofol target concentration of 6microgram/ml, and anesthesia was maintained at 4microgram/ml by using a Diprifusor (TM) turing the operation, intraabdominal pressure was maintained automatically at 12 14 mmHg by a CO2 insufflator and controlled ventilation settings were adjusted about 50 mmHg of PaCO2 after peritoneal insufflation. This ventilatory setting was not changed throughout the operation. We evaluated the estimated plasma concentrations of propofol at the time of eye opening and recovery of orientation in each group using user interface of a Diprifusor (TM). RESULTS: In the laparoscopic group, PaCO2, and PetCO2 increased significantly at 5, 15, 30 minutes after carbon dioxide insufflation, but there was no significant difference in concentrations of propofol at eye opening and orientation after propofol TCI between the two groups. CONCLUSIONS: Hypercarbia induced by insufflation of carbon dioxide into peritoneum didn't give rise to an influence on awakening concentrations after propofol TCI during a laparoscopic cholecystectomy.
Anesthesia ; Anesthetics* ; Carbon Dioxide ; Cholecystectomy, Laparoscopic* ; Humans ; Insufflation ; Laparoscopy ; Metabolism ; Peritoneum ; Plasma ; Propofol* ; Splanchnic Circulation ; Sympathetic Nervous System ; Ventilation

BACKGROUND: We evaluated the potentiating effect of anesthetics to vecuronium, and recovery profiles, and cost according to the consumption amounts, and usefulness of newly developed anesthetic agents for ambulatory anesthesia. METHODS: Seventy-five patients undergoing a major gynecological surgery were randomly divided into three groups. Group 1 received isoflurane, group 2 received sevoflurane, and group 3 received desflurane. Clinical duration, recovery index, recovery time in each group, and consumption of volatile anesthetics by weighing the vaporizes were measured. RESULTS: Emergence from anesthesia was more rapid in the group 2 and 3, and there was no significant difference in potentiating effect of anesthetics to a neuromuscular blocker among the three groups. Costs according to the comsumption amount were significantly higher in the group 2 and 3. CONCLUSIONS: Sevoflurane and desflurane clinically represent a more efficient alternative to isoflurane in ambulatory anesthesia because of their rapid emergence without side effects.
Anesthesia* ; Anesthetics ; Female ; Gynecologic Surgical Procedures ; Humans ; Isoflurane* ; Muscle Relaxation* ; Neuromuscular Blockade ; Vecuronium Bromide

BACKGROUND: Midazolam is often used as an anxiolytic premedication before surgery. Although the sedative, anxiolytic, and amnestic properties of midazolam may be desirable before the induction of general anesthesia, respiratory function is impaired frequently by larger doses of midazolam. Therefore, we evaluated the adequate doses of midazolam premedication on anxiolytic and sedation without its serious side effects. METHODS: Eighty ASA I or II adult patients scheduled for elective minor surgery were randomly allocated to four groups according to premedication doses of midazolam. They were group 1: midazolam 0.05 mg/kg IM for lean body mass (LBM); group 2: midazolam 0.075 mg/kg IM for LBM; group 3: midazolam 0.1 mg/kg IM for LBM.; group 4: midazolam 0.125 mg/kg IM for LBM. Blood pressure, heart rate, bispectral index (BIS), oxygen saturation (SpO2), anxiety visual analogue scale (VAS), and observer's assessment of alertness and sedation (OAA/S) scores were measured before and at 30 minutes after midazolam premedication. The frequency of apnea, defined as a cessation of spontaneous respiration for more than 10 seconds, was recorded. Induction time and dose requirements in propofol-induced general anesthesia were recorded at the loss of opening their eyes on verbal command and eyelid reflex after starting the propofol infusion. Following intubation, blood pressure and heart rate were measured. RESULTS: The bispectral index and anxiety VAS was significantly decreaced in group 3 and group 4. However, oxygen saturation were significantly lower in group 4 compared with group 3. CONCLUSIONS: We concluded that group 3 (midazolam 0.1 mg/kg IM for LBM) is the proper premedication dosage for anxiolytic and sedation in Koreans without respiratory side effects.
Adult ; Anesthesia, General ; Anxiety ; Apnea ; Blood Pressure ; Eyelids ; Heart Rate ; Humans ; Intubation ; Midazolam* ; Oxygen ; Premedication* ; Propofol ; Reflex ; Respiration ; Surgical Procedures, Minor

Background: Myringotomy with tympanostomy tube insertion (MTI) is a superficial surgical procedure used to prevent hearing loss in children with serous otitis media. Intravenous anesthesia, often ketamine, is preferred for this procedure because of its ability to induce sedation without compromising airway reflexes. However, ketamine alone may be insufficient and potentially lead to spontaneous movement during surgery. This study evaluated the effectiveness of midazolam and fentanyl as adjuvants to ketamine in reducing spontaneous movement during MTI and enhancing the quality of recovery. Methods: This study involved two groups of 30 patients each: one group received intravenous ketamine (1.5 mg/kg) with an equal volume of normal saline (K group), while the other received a combination of midazolam, fentanyl, and ketamine (0.05 mg/kg, 1 μg/kg, and 1.5 mg/kg, respectively; MFK group). We assessed side effects, intraoperative patient movement, surgeon satisfaction, and emergence agitation scores. Results: The MFK group exhibited significantly lower scores for patient movement (p<0.01) and emergence agitation (p<0.01) and markedly higher surgeon satisfaction scores (p<0.01) than the K group. Conclusion Administering a midazolam-fentanyl-ketamine combination effectively reduced spontaneous movement during surgery and emergence agitation during recovery without prolonging discharge times in children undergoing MTI.

An extended-release (ER) fixed-dose combination (FDC) of tramadol 37.5 mg/acetaminophen 325 mg was developed due to the demand for varying dosages. This study aimed to evaluate the pharmacokinetics (PKs) for two tablets of the new developed tramadol 37.5 mg/acetaminophen 325 mg ER FDC (DW-0920, Wontran Semi ER®) as test formulation compared to one tablet of the tramadol 75 mg/acetaminophen 650 mg ER FDC (DW-0919, Wontran ER®) as reference formulation. A randomized, open-label, 2-way crossover study was conducted in 30 healthy subjects. Subjects were orally administered one of 2 formulations followed by an alternate formulation with a 7-day washout period. Blood samples were collected up to 36 hours post-dose. Plasma concentrations of tramadol and acetaminophen were determined using a validated high-performance liquid chromatography with tandem mass spectrometric method. The geometric mean ratios (GMRs) and their 90% confidence intervals (90% CIs) of test formulation to reference formulation were calculated for the maximum plasma concentration (Cmax) and the area under the plasma concentration-time curve from zero to the last measurable time point (AUClast). The PK profiles of 2 formulations were comparable. The GMRs (90% CI) of Cmax and AUClast for tramadol were 1.086 (1.047–1.127) and 1.008 (0.975–1.042), respectively. The corresponding values for acetaminophen were 0.956 (0.897–1.019) and 0.986 (0.961–1.011), respectively. All the values were within the bioequivalence range of 0.80–1.25. Two tablets of DW-0920 were comparable to one tablet of DW-0919. The DW-0920 may be used for optimal pharmacotherapy for pain control with a lower dose.

BACKGROUND: Postoperative nausea and vomiting (PONV) is a common problem after general anesthesia. Compared with inhalational anesthetics, propofol has an antiemetic effect. We investigated the incidence of PONV after propofol and sevoflurane anesthesia for strabismus surgery in pediatric patients, and evaluated the effectiveness of ondansetron prophylaxis after sevoflurane anesthesia. METHODS: A healthy pediatric patients (n = 150) were divided into three groups. Group P (n = 50) received intravenous anesthesia with propofol; Group S (n = 50), inhalational anesthesia with sevoflurane; and Group S-O (n = 50), inhalational anesthesia with sevoflurane and 0.06 mg/kg (up to 4 mg) of ondansetron. The occurrence and intensity of PONV were recorded. RESULTS: The incidence of PONV after sevoflurane-ondansetron anesthesia did not differ from that after propofol anesthesia, but was significantly attenuated. The recurrence of PONV after sevoflurane-ondansetron was lower than after propofol and sevoflurane anesthesia. CONCLUSIONS: Sevoflurane anesthesia with ondansetron prophylaxis may be a good alternative to propofol in terms of avoiding PONV.
Anesthesia ; Anesthesia, General ; Anesthesia, Intravenous ; Anesthetics ; Antiemetics ; Humans ; Incidence ; Ondansetron ; Pediatrics* ; Postoperative Nausea and Vomiting* ; Propofol* ; Recurrence ; Strabismus*

Stevens-Johnson syndrome is considered to be a severe type of erythema exsudativum multiforme. It is characterized by erythema with vesicobullous and eroded lesions of skin and mucous membranes. The importance in anesthetic management of Stevens-Johnson syndrome is preventing injury of the oropharyngeal and tracheal membrane at intubation because soft oral airways may cause bleeding and push tissue debris into the pharynx and larynx. In addition, anesthesiologist should take care of complications such as transitory atrial fibrillation, interstitial myocarditis, pericarditis, pneumothrax, acute renal insufficiency and conjunctivitis. A 5-year-old male, previously diagnosed with Stevens-Johnson syndrome and treated with a steroid, was noted as having dyspnea on rest, coughing, jaundice, and fever. Even after aggressive medical management for status asthmaticus during the preoperative period, dyspnea and expiratory wheezing did not improve. He underwent a resection of the gall bladder, lung and liver biopsy in spite of a great risk of perioperative pulmonary complications. After treatment with epinephrine, and aminophylline, the peak inspiratory pressure was 40 cmH2O with mild hypercarbia (PaCO2 45 50 mmHg). We report the anesthetic considerations for a case of Steven-Johnson syndrome with status asthmaticus.
Acute Kidney Injury ; Aminophylline ; Atrial Fibrillation ; Biopsy ; Child, Preschool ; Conjunctivitis ; Cough ; Cytochrome P-450 CYP1A1 ; Dyspnea ; Epinephrine ; Erythema ; Fever ; Hemorrhage ; Humans ; Intubation ; Jaundice ; Larynx ; Liver ; Lung ; Male ; Membranes ; Mucous Membrane ; Myocarditis ; Pericarditis ; Pharynx ; Preoperative Period ; Respiratory Sounds ; Skin ; Status Asthmaticus* ; Stevens-Johnson Syndrome* ; Urinary Bladder

BACKGROUND: To investigate the risk factors for vaginal infections and antimicrobial susceptibilities of vaginal microorganisms among women who experienced preterm birth (PTB), we compared the prevalence of vaginal microorganisms between women who experienced preterm labor (PTL) without preterm delivery and spontaneous PTB. METHODS: Vaginal swab specimens from 126 pregnant women who experienced PTL were tested for group B streptococcus (GBS), Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum, Chlamydia trachomatis, Trichomonas vaginalis, Neisseria gonorrhoeae, Treponema pallidum, herpes simplex virus (HSV) I and II, and bacterial vaginosis. A control group of 91 pregnant women was tested for GBS. Antimicrobial susceptibility tests were performed for GBS, M. hominis, and U. urealyticum. RESULTS: The overall detection rates for each microorganism were: U. urealyticum, 62.7%; M. hominis, 12.7%; GBS, 7.9%; C. trachomatis, 2.4%; and HSV type II, 0.8%. The colonization rate of GBS in control group was 17.6%. The prevalence of GBS, M. hominis, and U. urealyticum in PTL without preterm delivery and spontaneous PTB were 3.8% and 8.7% (relative risk [RR], 2.26), 3.8% and 17.3% (RR, 4.52), and 53.8% and 60.9% (RR, 1.13), respectively, showing no significant difference between the 2 groups. The detection rate of M. hominis by PCR was higher than that by culture method (11.1% vs. 4.0%, P=0.010). The detection rates of U. urealyticum by PCR and culture method were 16.7% and 57.1%, respectively. CONCLUSIONS: There was no significant difference in the prevalence of GBS, M. hominis, and U. urealyticum between the spontaneous PTB and PTL without preterm delivery groups.
Female ; Humans ; Microbial Sensitivity Tests ; Mycoplasma Infections/complications/microbiology ; Mycoplasma hominis/isolation & purification ; Obstetric Labor, Premature/*epidemiology/etiology ; Pregnancy ; Pregnancy Complications, Infectious/epidemiology/microbiology ; Premature Birth/*epidemiology/etiology ; Prevalence ; Risk Factors ; Streptococcal Infections/complications/microbiology ; Streptococcus agalactiae/isolation & purification ; Ureaplasma Infections/complications/microbiology ; Ureaplasma urealyticum/isolation & purification ; Vagina/*microbiology