The authors analyzed statistically, 2,290 cases of anesthesia for emergency Cesarean section perfomed at Ewha Womans University Hospital from January 1978 to December 1982. The results are as follows: 1) The incidence of emergency Ceaarean section was 73.8% of total Cesarean sections. 2) The most common indication was CPD(41.4%). 3) The most common gestational age group was 38-42 weeks(85.2%). 4) In NPO time, general anesthesia was twice in more than 6 hours, but spinal anesthesia was twice in less than 6 hours. 5) General anesthesia was increaaed but spinal anesthesia was decreased during the five year period. 6) In estimated blood loss, less than 1,000 ml was 80.0%. 7) Neonates with poor Apgar score (0-3 point) were 5.9% which related to prolonged induction-delivery time and general anesthesia. 8) A drop in blood pressure developed within 5 minutes in 58.3% after spinal anesthesia.
Anesthesia ; Anesthesia, General ; Anesthesia, Spinal ; Apgar Score ; Blood Pressure ; Cesarean Section* ; Emergencies* ; Female ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Pregnancy

With the exception of choriocarcinoma, the central nervous system (CNS) is rarely associated with metastases from gynecological malignancy. Cerebral involvement in ovarian carcinoma is generally regarded as occurring in 1% of cases. Overall incidence of cerebellar metestases is 27% of CNS metastases. However higher rates have been reported following initial platinum-based chemotherapy. We experienced a cerebellar metastatic cancer patient treated with craniectomy and radiation therapy. So we report the case with a brief review of literature.
Central Nervous System ; Choriocarcinoma ; Drug Therapy ; Female ; Humans ; Incidence ; Neoplasm Metastasis* ; Pregnancy

The authora have had contact with 951 cases of surgery of the lower extremities receiving various kinds of anesthtic methods and these cases were analyzed at the department of Anesthesiology, Ewha Womans University Hospital during the 7 year period from January 1970 to December 1982. The result are as follows: 1) There is a trend towards increasing numbers of operations annually. 2) The most common age group was 3rd decade(24%) 3) Ratio of males to females was 2:1. 4) Class I of physical status(ASA) was most common(61.2%) 5) For premedication, meperidine and atropine sulfate were commonly used(32.9%). 6) In the section of surgery, Orthopedic surgery is most common(90.4%) 7) General anesthesia was the most commonly used technique(69.8%) 8) Most cases ended within 2 hours(60.1%)
Anesthesia* ; Anesthesia, General ; Anesthesiology ; Atropine ; Female ; Humans ; Lower Extremity* ; Male ; Meperidine ; Orthopedics ; Premedication

OBJECTS: Residents are exposed to various hazards and harassed by sleep deficiency due to overwork. This study was performed to outline the health condition of residents and develop the ways of improving it. METHODS: A questionnaire was distributed to 881 army doctors who enrolled at the Korea Third Military Academy and The Armed Force Health Service School in 2000 with the exception of medical doctors who joined the armed service without going through intern and resident periods , dental and oriental medical doctors. 784 (89.0%) of the 881 questionnaires were returned of which 704 cases (79.9%). This should actually be 89.0% were regarded for analyses as being reliable data. RESULTS: More than 20% of residents were exposed to radiation, laser, disinfectants, anesthetic gas, and anticancer drugs during their training periods with preventive measures for each of these hazards taken in about 10% of the cases of the lesser hazards but in about 35% for the hazards from radiation and laser. 91.1% of residents had experience of needlestick injuries during their training periods with over 36.3% being exposed to patients with infection during that time. The cases contracting HBV and HCV diseases due to pricking are 2.3 and 0.6% respectively. The average number of night duties per month during a one-year resident's period was about 19. The average sleeping time on duty during a one-year residents was less than 4 hours .28.4% of respondents were not satisfied with their occupation, 96.5% felt tired from overwork and 69.5% wanted to change their occupation to another that would pay the same salary. CONCLUSION: Residents are exposed to harmful physical , chemical and biological factors, but the preventive care seldom undertaken. In addition, their overwork brings about lack of sleep which causes them problems when giving medical treatment to patients during their training periods. Despite the resident's interest in an occupation as a doctor, many intend to select other occupations if they can receive the same salary. According to the above results, preventative systems and measures should be prepared with environmental improvements for residents, and proper rewards for their overwork should be accomplished.
Arm ; Biological Factors ; Data Collection ; Disinfectants ; Health Services ; Humans ; Korea ; Military Personnel ; Needlestick Injuries ; Occupations ; Questionnaires ; Reward ; Salaries and Fringe Benefits

When a Korean child is living in close contact with a person with active pulmonary tuberculosis, the risk of his acquiring the disease is great. In seeking an effective means of reducing this risk to the chi1d, isoniazid was given as secondary chemoprophylaxis to 233 tuberculin-positive children under 5 years of age who were clinically free of disease but were living in close contact with a household member with active tuberculosis. The condition of these children after 9 to 12 months of chemoprophylaxis was compared with a similar control group of 216 children living under exact1y comparable circumstances. An analysis of tile results of this study indicates that secondary chemoprophylaxis with isoniazid is effective and worthwhile for children under 4 years of age who are under constant exposure to tuberculosis. That there was such a protection is indicated by the fact that (1) isoniazid markedly reduced the size of the tuberculin reaction and that (2) only 2 children receiving isoniazid developed active tuberculosis (0.8%) as against the 8 controls who did (3.70%). The faithful cooperation of parents in administering prophylactic isoniazid to small children is often difficult to obtain. This difficulty is suggested by the fact that in the case of the 2 children in the isoniazid test group who developed active tuberculosis, the actual drug intake had been irregularly given and amounted to less than half the prescribed dose.
Chemoprevention ; Child ; Family Characteristics* ; Humans ; Isoniazid ; Parents ; Tuberculin ; Tuberculosis ; Tuberculosis, Pulmonary*

Blood pressures and heart rates were recorded with Twin-Viso (Sanborn, USA) for comparative estimations of cardiovascular responses by injection of intravenous anesthetic agents-2.5% solution of Pentothal Sodium (Abbott Laboratory, USA) and Thiotal (Samsung Pharmaceutical Co., ROK) mongrel dogs. Dogs were evaluated the hepatic function by biochemical studies of blood such as total protein, albumin, total bilirubin, direct bilirubin, thymol turbidity test, alkaline phosphatase, serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGOT). Liver biopsies were performed in dogs for identifications of hepatic darnages by injection of the above barbiturates, The following results were observed: 1) It was observed the remarkable negative inotropic effect in myocardium of the mongrel dogs intravenously injected with 20 mg/kg of the above barbiturates for three minutes (Table 7, Fig. 8) 2) It was noted slight negative inotropic effect in mongrel dogs intravenously injected with 10 mg/ kg of the above barbiturates for thirty seconds (Table 8, Fig. 8). 3) It was more shorter recovery time from negative inotropic effects in mongrel dogs injected with Thiotal than in the dogs injected with Pentothal Sodium. 4) It was noted no significant changes in pathological studies of Hematoxylin-Eosin stained liver specimen and liver function studies of the blood by biochemical analysis in mongrel dogs intravenously injected everyday with 10 mg/kg of the above barbiturates. 5) It was noted slight changes in mongrel dogs injected with 20 mg/kg of the above barbiturates on TTT, Alkaline Phosphatase, SGOT and SGPT as biochemical analysis in comparing with controI values. These values, however, were not concided with the pathological findings of HematoxyIin-Eosin stained liver biopsy specimen. The facts explain to be inquired into further investigations in the pathological and biochemical aspect.
Alanine Transaminase ; Alkaline Phosphatase ; Animals ; Aspartate Aminotransferases ; Barbiturates ; Bilirubin ; Biopsy ; Dogs ; Heart Rate ; Liver ; Myocardium ; Sodium ; Thiopental* ; Thymol

OBJECTIVES: To assess height, weight and body mass index from childhood to adolescence according to the age at menarche and hence to study the influence of childhood growth on the menarche age. METHODS: "The Kangwha Study" was a community-based prospective cohort study which included the entire population of 219 female first graders in Kangwha county in 1986. Among the 219 girls, 119 girls who had received complete follow up checks during the study period(1986~1997), were included in this study, except one for whom menarche age information was unavailable. The remaining 118 girls were divided into three groups according to the timing of menarche : early(<25 percentile), intermediate and late(> or =75 percentile) maturers. RESULTS: The average age at menarche was 12.7 years : early 11.3 years, intermediate 12.6 years and late 13.7 years. The early maturers were taller and heavier between 6~8 years. But, the mean weight and body mass index at the menarche age did not differ statistically among the three groups. The weight and body mass index of the early maturers were consistently higher than those of the late maturers over the entire period of the study. CONCLUSIONS: Critical body weight and body mass index must be attained for menstruation to be attained and the age at menarche is largely determined by the childhood growth. In addition, it seems that childhood growth and age at menarche are associated with adolescent weight and body mass index.
Adolescent* ; Body Mass Index ; Body Weight ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Menarche* ; Menstruation ; Prospective Studies

Insulin-dependent diabetes mellitus (IDDM) is an autoimmune disease occurring among genetically susceptible individuals. Although the HLA class II genes and immunological abnormalities are clearly associated with IDDM in all racial groups, there are considerable variations in associated genotypes and prevalence of autoantibodies. Especially, it seems that adult-onset IDDM is somewhat different from childhood-onset IDDM in clinical and immunogenetic aspect. In order to determine the characteristics of the immunogenetic patterns and to use these results as an early diagnostic tool and a guideline of the therapeutic plan in Korean adult- onset IDDM, we investigated the clinical and immunogenetic characteristics in adult-onset IDDM patients. METHODS: We investigated the clinical and biochemical characteristics, and measured anti-GAD antibody by immunoradiometric assay or immunoprecipitation after in vitro translation of human GAD cDNA and IA-2 antibody by immunoprecipitaion after in vitro translation of human IA-2cDNA. The distribution of HLA-DR serotypes by lymphocyte microcytotoxicity method, HLA-DQA1 genotypes by restriction fragment length polymorphism and HLA-DQB1 genotypes by dot-blotting analysis using sequence specific oligonucleotide probe were analysed in 233 IDDM patients and controls. RESULTS: 1) Adult-onset patients had more preserved beta cell functions and slowly evolving form of clinical pattern rather than childhood-onset cases. 2) Each prevalences of anti-GAD and IA-2 antibody were 64% and 14.4% in adult-onset patients. Among them, the group with DR9-DQ9 had higher prevalence of antiGAD antibody rather than DR4-DQ4 group. 3) There were increased frequencies of HLA-DR4 and -DR9 in adult-onset patients. Considering the frequency of HLA-DQA1 and -DQB1 and the distribution of DQ heterodimers, they had no significantly increased genotypes or haplotypes. But childhood-onset cases had high frequencies in HLA DR3, -DR4, -DR9 serotypes and DQA1*0301, DQA1*0501, DQB1*0201 genotypes. CONCLUSION: Korean adult-onset IDDM patients have relatively higher prevalence of anti-GAD antibody implicating autoimmune pathogenesis. HLA genetic markers in adult-onset IDDM were somewhat different from those in childhood-onset cases. This pathogenetic heterogenesity according to age of onset may be due to the influences of other genetic markers and environmental factors involved in the etiology of Korean IDDM.
Adult* ; Age of Onset ; Autoantibodies ; Autoimmune Diseases ; Diabetes Mellitus* ; Diabetes Mellitus, Type 1 ; DNA, Complementary ; Genes, MHC Class II ; Genetic Markers ; Genotype ; Haplotypes ; HLA-DR Antigens ; HLA-DR4 Antigen ; Humans ; Immunogenetics* ; Immunoprecipitation ; Immunoradiometric Assay ; Insulin* ; Korea* ; Lymphocytes ; Polymorphism, Restriction Fragment Length ; Prevalence

BACKGROUND: The radial forearm flap is a versatile, widely used flap. However, the possibility of donor site complications has led to concern over its use. Some surgeons prefer using other flaps whose donor sites can be closed primarily with less morbidity, including avoiding unpleasant scarring. However, in our experience, donor site stability of the radial forearm flap can be reliably achieved by using well-implemented specific procedures. Here, we present a collection of donor site cases of the radial forearm flap and investigate factors that affect the aesthetic results as the basis for a reference for selecting a radial forearm flap. METHODS: In this retrospective study, we reviewed 171 cases in which a radial forearm flap was used for free tissue transfer after resecting head and neck cancer. We focused on donor site morbidity rates. Each operation involved a detailed procedure designed to minimize donor site morbidity. Moreover, statistical investigations were conducted for 22 cases to determine factors affecting the scar appearance. RESULTS: Only one case developed total skin graft necrosis as a major complication. Scar-related aesthetic results were acceptable, and the body-mass index, body weight, diabetes, and cardiac problems were significant factors related to the appearance of scars. CONCLUSIONS: Performing the radial forearm flap using a well-implemented detailed technique helps achieve acceptable donor site morbidity results. The aesthetic results were more promising for patients without excess body weight, diabetes, or cardiac problems. Therefore, anxiety about donor site morbidity should not be a reason to avoid selecting the radial forearm flap in suitable patients.
Anxiety ; Body Weight ; Cicatrix ; Esthetics ; Forearm* ; Free Tissue Flaps* ; Head and Neck Neoplasms ; Humans ; Necrosis ; Retrospective Studies ; Skin ; Skin Transplantation ; Tissue Donors* ; Transplants

The purpose of this study was to investigate the effects of inhibitors of the Na+, K(+)-pump and membrane depolarizing agents on endothelium-dependent acetylcholine-induced relaxation in the rabbit thoracic aorta. Aortic rings were prepared from the rabbit descending thoracic aorta and the contractility of the ring was measured in various conditions such as application of ouabain, exposure to K(+)-free Krebs-Henseleit solution and high K+. Ouabain or exposure to K(+)-free Krebs-Henseleit solution inhibited acetylcholine or sodium nitroprusside-induced relaxation. KCl also inhibited the acetylcholine or sodium nitroprusside-induced relaxation. These results suggest that the Na+, K(+)-pump may play a role in endothelium-dependent acetylcholine-induced relaxation.
Acetylcholine/*pharmacology ; Animal ; Aorta/drug effects/physiology ; Endothelium, Vascular/physiology ; In Vitro ; Na(+)-K(+)-Exchanging ATPase/drug effects/*physiology ; Nitroprusside/pharmacology ; Ouabain/pharmacology ; Rabbits ; Support, Non-U.S. Gov't ; Vasodilation/*drug effects