BACKGROUND: Intubating conditions would be excellent and hemodynamic variables would be relatively stable during rapid- sequence anesthesia induction if tracheal intubation was performed at a proper time. The purpose of this study was to identify the ideal intubation time after rocuronium with either thiopental or propofol. METHODS: 113 patients, ASA physical status I or II, were randomly divided into four groups. Patients in group TR60 (thiopental-rocuronium) and in group PR60 (propofol-rocuronium) were intubated within 60 s, while groups TR90 and PR90 were intubated within 90 s after the administration of rocuronium. Intubating conditions were graded by an experienced anesthesiologist, and hemodynamic variables were noted just before induction (baseline), immediate after induction, immediate after intubation, and 5 min after intubation. RESULTS: Clinically acceptable intubating conditions (good or excellent) were not statistically different among the four groups. However, 55 and 64% of patients in groups TR90 and PR90, respectively, had excellent intubating conditions compared to only 39 and 38% in groups TR60 and PR60 (P < 0.05). Mean arterial pressure and rate pressure product (RPP) immediately after intubation were relatively stable in groups TR90 and PR90 compared to those in groups TR60 and PR60 (P < 0.05). CONCLUSIONS: The intubation time after rocuronium, rather than the choice of induction agent, is the deciding factor affecting intubating conditions and hemodynamic variables during rapid-sequence anesthesia induction. Ninety seconds after the administration of rocuronium with either thiopental or propofol might be an ideal intubation time.
Anesthesia ; Arterial Pressure ; Hemodynamics* ; Humans ; Intubation* ; Propofol ; Thiopental

PURPOSE: The present study is focused on understanding weight perception related with individual- and school-level multifactorial origins, underestimated and overestimated respectively, in normal body weight adolescents. METHODS: Using the 2017 Korea Youth Risk Behavior Web-based Survey data of 45,902 students from 799 secondary schools, a multilevel multinomial logistic regression analysis was performed where adolescents (level1) were nested within schools (level 2). RESULTS: At the school level, the average school body mass index (BMI, kg/m²) and physical education were associated with weight perception among both boys and girls. In boys, geographic areas were associated with weight underestimation. At the individual level, perceived economic status, weekly allowance, BMI (kg/m²), smartphone usage time (hrs/day) and perceived stress were associated with weight perception among both boys and girls. Age, paternal education, academic achievement and alcohol use were associated with weight perception among girls, while part-time job and physical activity were associated with weight perception among boys. CONCLUSION: Our findings underscore the importance of individual- and school-level environments in developing correct weight perception and have implications for school health education to establish healthy lifestyle behaviors for all adolescents.
Adolescent ; Body Mass Index ; Education ; Female ; Humans ; Ideal Body Weight ; Korea ; Life Style ; Logistic Models ; Motor Activity ; Multilevel Analysis ; Paternal Age ; Physical Education and Training ; Risk-Taking ; School Health Services ; Smartphone ; Weight Perception

Recently, aging process and westernization of life style are increasing the incidence of colonic diverticulum. About 30% of colonic diverticulm result in diverticular bleeding, which often causes acute lower gastrointestinal bleeding. In most cases, the bleeding stops spontaneously. But when relapsing or causing massive bleeding, it sometimes needs emergent surgery. Generally, treatments for colonic diverticular bleeding consist of conservative ones. But recently, urgent colonoscopy is important procedure since it estimates the needs for surgery, or when bleeding foci being identified, endoscopists frequently can stop the bleeding by only colonoscopic procedures such as injection therapy, band ligation, hemoclipping and argon plasma coagulation, etc. In patients with hematochezia, we made early detection of diverticular bleeding foci by urgent colonoscopy, and then we were able to treat them successfully by argon plasma coagulation and hemoclipping. Thus we report these with literature review.
Aging ; Argon Plasma Coagulation ; Colon* ; Colonoscopy ; Diverticulum ; Diverticulum, Colon ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Hemostasis ; Humans ; Incidence ; Life Style ; Ligation

BACKGROUND: Alteration of p53 genes is rare, but it is related with progressive diseases in hematologic malignancies. The wild type of p53 protein is not usually detected, but mutated p53 proteins are accumulated in the nuclei of tumor cells, which can be detected by immunohistochemical stain. Anti-p53 antibodies are found in the sera of patients with various malignant tumors as the result of immune response to accumulation of mutated p53 protein in tumor cells. METHODS: The relation of serum anti-p53 anti-bodies and cellular p53 protein expression to clinical features in 36 cases of myelodysplastic syndrome (MDS) and 58 cases of acute myeloid leukemia (AML) was analyzed. Anti-p53 antibodies in the patient's sera were measured with enzyme immunoassay (p53 autoantibodies ELISA, Dianova, Hamburg, Germany). Immunohistochemical staining for p53 protein was performed with the streptavidin-biotin-peroxidase method (LSAB kit, DAKO, Denmark) and anti-p53 monoclonal antibody (DO-7, DAKO, Denmark) in paraffin embedded bone marrow biopsy sections. RESULTS: Anti-p53 antibodies were positive in one of 36 (2.7%) MDS cases, and in four of 58 (6.8%) AML cases. Overexpression of p53 protein was seen in five (13.9%) of MDS and in five (8.6%) of AML. Serum p53 antibodies and p53 protein overexpression were more frequently found in RAEB, RAEB-t and M6 sutypes. There was no relation between anti-p53 antibodies and p53 protein overexpression in MDS and AML. The patients of MDS with anti-p53 antibodies and p53 overexpression tended to have severe dyserythropoiesis, higher Bounemouth scores and poor prognostic karyotypes and associated with shorter survival duration as compared to those without anti-p53 antibodies and p53 overexpression (4+/-1 vs 26+/-4 months, P=0.007). The patients of AML with anti-p53 antibodies and p53 protein overexpression tended to have poor prognostic karyotypes and resistance to chemotherapy. CONCLUSION: Anti-p53 antibodies are rarely observed in sera of patients with MDS and AML, probably reflecting the relatively low incidence of p53 mutation. But the findings suggest that the presence of p53 alteration could be useful to predict resistance to chemotherapy and short survival in particular sutypes of MDS and AML.
Anemia, Refractory, with Excess of Blasts ; Antibodies* ; Autoantibodies ; Biopsy ; Bone Marrow ; Drug Therapy ; Enzyme-Linked Immunosorbent Assay ; Genes, p53 ; Hematologic Neoplasms ; Humans ; Immunoenzyme Techniques ; Incidence ; Karyotype ; Leukemia, Myeloid, Acute* ; Myelodysplastic Syndromes* ; Paraffin

Food-dependent exercise-induced anaphylaxis (FDEIA) is a specific variant of exercise-induced anaphylaxis that requires both vigorous physical activity and the ingestion of specific foods. In particular, it is rare occurrence for FDEIA to be associated with meat in Korea. A 15-year-old female had generalized urticaria, dyspnea, severe cough, headache, dizziness, and vomiting after singing and dancing for 1 hour and after ingesting grilled pork. Skin prick tests showed a strong positive reaction to pork, whereas the results of an oral food challenge and exercise provocation tests were negative. However, the exercise provocation test after pork ingestion showed a positive reaction manifested by generalized urticaria, cough, mild dyspnea, and a 23% decreased peak expiratory flow rate. Three allergens to pork (67 kDa, 90 kDa, and 15 kDa) reacted with the patient's serum on immunoglobulin E immunoblotting. We report a case of pork-dependent exercise-induced anaphylaxis in a patient who was sensitive to pork.
Adolescent ; Allergens ; Anaphylaxis ; Cough ; Dancing ; Dizziness ; Dyspnea ; Eating ; Female ; Food Hypersensitivity ; Headache ; Humans ; Immunoblotting ; Immunoglobulin E ; Immunoglobulins ; Korea ; Meat ; Motor Activity ; Peak Expiratory Flow Rate ; Singing ; Skin ; Urticaria ; Vomiting