No abstract available.
Accidents, Traffic* ; Fistula*

Sine 1961, Dr. Safar postulated the new form of patient, so called "progressive patient care", the hospital service in all countries are fashioned with intensive therapy unit. Particulary the- World Federation Society of Anesthesiologists who have discusincerly at several International congress. we were interested from the literature and visited England, Denmark, United States. and Japan. Of course in Korea, the intensive therapy unit developed from the recovery room and is thus intimately oonnected with anesthesiologists. Here we reviewed with literature and introduced the activities af the intensive therapy unit of Hanyang University Hospital from May 1972 to October 1973, from the point view of the definition, building design, location, capacity, equipment, staff organization and charge of patient, several problems and regulations. Furthermore we recommended with the following new ideas for establishment in hospital of an intensive therapy. unit. a. The design should be arranged on the same floor (OR-RR-Anes.-1TU) and in central part of building. b. Several isolation rooms should be made in 1-T-U. c. One central monitoring system will serve each units. d. The 1-T-U equipment should be used with wall trolly system. e. The regulations of 1-T-U should be noted and advocated by all hospital members. f. The beds in 1-T-U should be arranged with open system.
Denmark ; England ; Humans ; Japan ; Korea ; Recovery Room ; Social Control, Formal ; United States

Benzodiazepine derivatives, chlordiazepoxide(Librium), diazepam(Valium), nitrazepam(Mogadon) and oxazepam(Serenid-D) are mainly used as hypnotics at present. Diazepam has been used mainly for premedication in anesthesia and as an intravenous anesthetic agent. The pharmacological actions of these drugs are tranquilizing effects for central nervous system, slight depression on the cardiovascular and respiratory system, anticonvulsant, anxiolytic and antidepressant effects. A new benzodiazepine derivative, Flunitrazepam(Ro 5-4200) has strong hypnotic action, is anticonvulsant and antidepressant in spite of slight depression of the cardiovascular and respiratory systems. Furthermore the onset and duration of this drug are shorter than the others. In our clinical study, flunitrazepam in the dosage of 0.005mg/kg was administered intravenously, as an intravenous anesthetic induction agent, for 22 surgical adult patients. In each patient, the blood pressure, pulse rate, respiratory rate, minutes volume and arterial gas study were done, before and after administration of the Ro 5-4200. The results are as follows; 1. Dosage of this flunitrazepam is not constant as other benzodiazepines. 2. The effects of flunitrazepam on the cardiovascular system showed slight depression but no effect by one hour post-operation. 3. In respiratory system, the minute volume was depressed slightly and the respiratory rate was increased but negligibly. 4. Undesirable side effects attributed to this drug were not found, except the developing of cough (one case).
Adult ; Anesthesia ; Benzodiazepines ; Blood Pressure ; Cardiovascular System ; Central Nervous System ; Clinical Study* ; Cough ; Depression ; Diazepam ; Flunitrazepam ; Heart Rate ; Humans ; Hypnotics and Sedatives ; Premedication ; Respiratory Rate ; Respiratory System ; Tranquilizing Agents

BACKGROUND: Endotracheal intubation is a common procedure in anesthesia, which can usually be accomplished easily. However, if the attempt is unexpectedly difficult the patient may be seriously at risk. If we can anticipate difficult intubation by assessing the airways in advance, anesthesiologists can plan the safest and most effective way of managing tracheal intubation. The purpose of this study is to evaluate a correlation between airway assessment factors and laryngoscopic grades for predicting difficult intubation. METHODS: The data were collected from a total of 427(male 189) patients older than 16 years of age undergoing non-emergency surgery. Seven airway assessment factors, measured at three levels of severity, were evaluated. Airway assessment factors include inter incisor gap, Samsoon and Young classification, thyromental distance, head and neck movement, body weight, history of difficult intubation and buck teeth. RESULTS: There was a significant correlation between total airway score and laryngoscopic grade. The incidence of difficult intubations was 9 out of 427 patients. Samsoon and Young classification, thyromental distance, head and neck movement, history of difficult intubation were significantly independent airway factors for predicting difficult intubations. Increase of total airway score represents the risk of difficult intubations. CONCLUSION: We suggest that total airway score could be used as a valuable predictor for assessing difficult intubations.
Anesthesia ; Body Weight ; Classification ; Head ; Humans ; Incidence ; Incisor ; Intubation* ; Intubation, Intratracheal ; Neck ; Tooth

Although tubal pregnancy is increasing, primary ovarian ectopic pregnancy has remained a rare event. However, recent reports suggest an increasing incidence to both tubal and term pregnancies. Ovarian pregnancy occurs within the ovary and on the corpus luteum. Earlier diagnosis is now possible, owing to the availability of highly specific radioimmunoassay for human chorionic gonadotrophin and the development of transvaginal ultrasonography. Clinical and even intraoperative diagnosis is difficult and confirmation may be made only by microscopic examination of the tissue specimen. Current understanding of the etiological factors, classification, possible pathogenesis, clinical presentation, diagnostic steps, reevaluation of diagnostic criteria, preferred management and future fertility are detailed. The therapy is surgical and currently more conservative than in the past, because of improvement in operative laparoscopy. We report a case of primary ovarian pregnancy treated conservatively under laparoscopic surgery with a brief review of literature.
Chorion ; Classification ; Corpus Luteum ; Diagnosis ; Female ; Fertility ; Humans ; Incidence ; Laparoscopy ; Ovary ; Pregnancy ; Pregnancy, Ectopic* ; Pregnancy, Tubal ; Radioimmunoassay ; Ultrasonography

Cervical incompetence is one of the main contributors to repeated pregnancy loss and preterm delivery. Typically it results in progressive cervical dilatation, leading to a painless second or early third trimester abortion. Emergency cerclage can be used in the setting of advanced cervical incompetence, even when fetal membranes bulge through the dilated cervix. To facilitate the procedure, various techniques have been developed to replace the fetal membranes into the uterine cavity. We performed six successful cases of emergency cerclage combined with amnioreduction in advanced incompetent internal os of cervix (IIOC). Interval from emergency cerclage to delivery was 8.1 +/- 2.4 weeks (range 4-10 weeks) and we delivered viable fetuses in all but one. Hereby we report our experiences with a brief review of literature.
Cervix Uteri ; Emergencies* ; Extraembryonic Membranes ; Female ; Fetus ; Humans ; Labor Stage, First ; Pregnancy ; Pregnancy Trimester, Third

Nuclear protein-1 (NUPR1) is a small nuclear protein that is responsive to various stress stimuli. Although NUPR1 has been associated with cancer development, its expression and roles in cholangiocarcinoma have not yet been described. In the present study, we found that NUPR1 was over-expressed in human cholangiocarcinoma tissues, using immunohistochemistry. The role of NUPR1 in cholangiocarcinoma was examined by its specific siRNA. NUPR1 siRNA decreased proliferation, migration and invasion of human cholangiocarcinoma cell lines (HuCCT1 and SNU1196 cells). From these results, we conclude that NUPR1 is over-expressed in cholangiocarcinoma and regulates the proliferation and motility of cancer cells.
Cell Line ; Cholangiocarcinoma ; Humans ; Immunohistochemistry ; Nuclear Proteins ; RNA, Small Interfering

In the present study, we investigated the effect of staurosporine on the formation of cellular processes in human gingival fibroblasts and rat astrocytes. Staurosporine caused a rapid induction of process formation in human gingival fibroblasts and rat astrocytes in a concentration dependent manner. The process formation of human gingival fibroblasts and rat astrocytes was prevented by the pretreatment with N-acetylcysteine, suggesting that staurosporine-induced ROS production was responsible for the process formation. Colchicine, a microtubule depolymerizing agent, inhibited the staurosporine-induced process formation, whereas cytochalasin D, an actin filament breakdown agent, failed to suppress the formation of cellular processes. This result indicated that polymerization of microtubule, and not actin filament, was responsible for the formation of cellular processes induced by staurosporine. In support of this hypothesis, Western blot analysis was conducted using anti-tubulin antibody, and the results showed that the amount of polymerized microtubule was increased by the treatment with staurosporine while that of depolymerized beta-tubulin in soluble fraction was decreased. These results indicate that staurosporine induces ROS-mediated, microtubule-dependent formation of cellular processes in human gingival fibroblasts and rat astrocytes.
Acetylcysteine ; Actin Cytoskeleton ; Animals ; Astrocytes* ; Blotting, Western ; Colchicine ; Cytochalasin D ; Fibroblasts* ; Humans ; Microtubules ; Polymerization ; Polymers ; Rats* ; Staurosporine* ; Tubulin

BACKGROUND: Urinalysis is a useful laboratory test in the diagnosis of various diseases. In sampling for the urinalysis, there is much concern about contamination that can lead to misdiagnosis in the mid-stream urine sampling method. We conducted this study to determine, in terms of concordance of results and contamination in culture, whether there was any superiority in mid-stream sampling methods with or without disinfection measures compared to the catheterization method. MATERIALS AND EMTHODS: We used three kinds of urine sampling methods sequentially, mid-stream non-clean catch, mid-stream clean catch, and catheterization, for ambulatory, non-pregnant, non-menstruating female patients who visited NHIC Ilsan Hospital emergency department during a one-week period in September 2001. Each sample was electrophotometrically analyzed for leukocyte esterase, nitrite, and blood by using a reagent strip and was cultured immediately or after overnight refrigeration. RESULTS: Of the 41 patients, 9 had culture-proven urinary tract infections. The concordance rates(kappa) for nitrite, blood, and leukocyte esterase were 0.875, 0.403, and 0.406 between non-clean catch and catheterized samples and 0.875, 0.481, and 0.560 between clean catch and catheterized samples, respectively. The contamination rate of the non-clean catch, the clean catch, and the catheterized samples were statistically different: 51.2%, 29.3% and 0%, respectively. CONCLUSION: We found that cleaning with disinfectant was effective for reducing the contamination rate, even though the best urine sampling method for zero contamination was catheterization. We recommend considering cost, patients' comfort, an acceptable threshold for contamination, and the necessity for a culture before choosing a urine sampling method for women who visit the emergency department.
Catheterization ; Catheters ; Diagnosis ; Diagnostic Errors ; Disinfection ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Leukocytes ; Reagent Strips ; Refrigeration ; Urinalysis ; Urinary Tract Infections

Polycythemia is a condition in which the red blood cell count is increased due to an inherited or acquired mutation, a physiologic response to hypoxia, autonomous erythropoietin production, or deliberate erythropoietin administration. Higher testosterone levels appear to act as a stimulus for erythropoiesis and testosterone replacement therapies have rarely been reported as causes of polycythemia. We report here a case of a 51-year-old man with polycythemia that was caused by long-acting testosterone undecanoate (Nebido(R)).
Anoxia ; Erythrocyte Count ; Erythropoiesis ; Erythropoietin ; Humans ; Middle Aged ; Polycythemia ; Testosterone