BACKGROUND: Tracheal intubation is accompanied by varing degrees of sympathetic stimulation as reflected by increases in heart rate, and blood pressure and several clinical trials to reduce the effects on blood pressure and heart rate by pharmacologic agents such as and blockers, calcicum channel blockers, narcotics and lidocaine, have been reported. METHODS: To evaluate the effect of fentanyl, lidocaine, esmolol on the hemodynamic changes induced by intubation, we administered thiopental 5 mg/kg only (group 1, n=12), fentanyl 2 g/kg with thiopental 5 mg/kg (group 2, n=12), lidocaine 1 mg/kg with thiopental 5 mg/kg group 3, n=12) or esmolol 0.5 mg/kg with thiopental 5 mg/kg (group 4, n=12) for induction of anesthesia, and measured heart rate, systolic blood pressure, diastolic blood pressure, mean arteiral pressure, and rate-pressure products (RPP) before induction, after induction, after intubation and at 1, 2, 3, and 5 minutes after intubation. RESULTS: There was a significant increase in heart rate, systolic blood pressure and RPP after intubation and 1 min after intubation in all groups, but in group 2, group 3 and group 4, the cardiovascular responses were more attenuated compared to group 1. CONCLUSION: The preintubation intravenous injection of fentanyl, lidocaine and esmolol may offer important roles in the hemodynamically unstable patients because it attenuate cardiovascular responses with intubation.
Anesthesia ; Blood Pressure ; Fentanyl* ; Heart Rate ; Hemodynamics* ; Humans ; Injections, Intravenous ; Intubation ; Lidocaine* ; Narcotics ; Thiopental

OBJECTIVES: The aim of this study was to investigate whether verbal and spatial working memory functions were impaired not only in patients with schizophrenia but also in people at ultra-high risk for first-episode psychosis. METHODS: Twenty-five patients (M 13, F 12) with schizophrenia (SPR), 21 people at ultra-high risk for psychosis (UHR)(M 10, F 11) and 19 normal controls (NC)(M 10, F 9) were recruited. The working memory was assessed by using the verbal and spatial n-back test. The working memory load increased incrementally from the 0-back to the 3-back condition. RESULTS: SPR performed significantly lower than NC and UHR in terms of hit rates of verbal and spatial n-back test. UHR subjects conducted significantly lower than NC and higher in trend-level than SPR in terms of hit rates of verbal and spatial n-back test. These differences were derived from the high working memory load (2-back and 3-back), not from the low working memory load (0-back and 1-back). There was no significant difference between the verbal and spatial n-back test across the three groups. CONCLUSION: These findings suggest that verbal and spatial working memory dysfunction may be general rather than differential in terms of stimuli modality, and this working memory deficit may be an important trait factor in schizophrenia.
Humans ; Memory, Short-Term ; Psychotic Disorders ; Schizophrenia

PURPOSE: To comparatively analyze treatment-related adverse events and the treatment dropout rate between immunochemotherapy and target therapy in Korea. MATERIALS AND METHODS: Forty-nine subjects with metastatic renal cell carcinoma (21 target therapy recipients and 28 immunochemotherapy recipients) who underwent either 6-week cycles of sunitinib treatment (50 mg once daily for 4 weeks on and 2 weeks off) or 8-week cycles of immunochemotherapy (combination of interleukin [IL]-2, interferon [IFN]-alpha, and 5-fluorouracil [FU]) were enrolled. Treatment-related toxicity was objectively graded and quantitative analysis was performed with a scoring system. Patient compliance was categorized into three classes (1: administration as scheduled, 2: dose modification required, 3: discontinuation required). RESULTS: Compared with those of the immunochemotherapy group, subjects of the sunitinib-treatment group had higher occurrence rates of mucositis-stomatitis (43% vs. 10%), hand-foot syndrome (38% vs. 0%), diarrhea (33% vs. 14%), and hypertension (33% vs. 14%). According to the toxicity-grade-based scoring system, the total incidence and severity of toxicities were not significantly different between the two groups (p>0.05), whereas high-grade hematologic toxicities were more frequent in the immunochemotherapy group. The dropout rate of the immunochemotherapy group was significantly higher than that of the sunitinib group (administration as scheduled: 52% vs. 21%, p=0.026; discontinuation required: 19% vs. 50%, p=0.037). CONCLUSIONS: The results of this study are indicative of a comparable treatment-related toxicity profile of sunitinib and greater adherence to the treatment protocol in comparison with immunochemotherapy in patients with metastatic renal cell carcinoma (mRCC).
Carcinoma, Renal Cell ; Clinical Protocols ; Diarrhea ; Fluorouracil ; Hand-Foot Syndrome ; Humans ; Hypertension ; Immunotherapy ; Incidence ; Indoles ; Interferons ; Interleukins ; Korea ; Patient Compliance ; Patient Dropouts ; Pyrroles

There are diverse surgical methods for treating large bladder stones, such as transurethral cystolithotripsy (TUCL), percutaneous suprapubic cystolithotripsy (PCCL), open surgery, and laparoscopic methods. We report here a case of two large bladder stones treated by using a combined surgical method of a laparoscopic approach and direct visual lithotripsy.
Chimera ; Laparoscopy ; Lithotripsy ; Surgical Procedures, Minimally Invasive ; Urinary Bladder ; Urinary Bladder Calculi

PURPOSE: The aim of this research was to compare surgical outcomes and complications of obese and non-obese patients who underwent open radical nephrectomy (ORN) and laparoscopic radical nephrectomy (LRN). MATERIALS AND METHODS: The data of 26 ORN patients and 30 LRN patients between January 2006 and December 2008 were analyzed. Patients with a body mass index (BMI) of 25.0 kg/m2 or more were defined as obese, and those with a BMI of <25.0 kg/m2 were defined as non-obese. All patients were divided into two groups according to the criteria above to compare demographic and clinical and pathologic parameters. RESULTS: The mean BMIs of the 15 obese patients in the ORN group and the 13 obese patients in the LRN group were 26.8+/-1.1 and 27.7+/-2.4, respectively. LRN was enormously effective for lowering estimated blood loss (EBL) and postoperative days compared with ORN. Operation times and EBL in ORN were affected by obesity, both of which were increased. In contrast, the data of both LRN groups indicated similar outcomes. The perioperative data of obese patients revealed LRN to have reduced blood loss (143.0+/-62.7 vs. 446.7+/-222.4 ml, p=0.001) and not significantly different postoperative days (7.3+/-2.2 vs. 8.4+/-1.5 days, p=0.065). Operation time, however, did not differ significantly among obese patients between ORN and LRN. The complications due to LRN had no relation with obesity, whereas ORN had an increased complications rate (34.6% vs. 3.8%). CONCLUSIONS: This study shows that LRN is more effective than ORN for both obese and non-obese patients with regard to perioperative outcomes and complication rates.
Body Mass Index ; Carcinoma, Renal Cell ; Humans ; Laparoscopy ; Nephrectomy ; Obesity

PURPOSE: Although its incidence has decreased with the widespread use of less invasive surgical techniques including laparoscopic surgery, postoperative ileus remains a common postoperative complication. In the field of urologic surgery, with the major exception of radical cystectomy, few studies have focused on postoperative ileus as a complication of laparoscopic surgery. The present study aims to offer further clues in the management of postoperative ileus following urological laparoscopic surgery through an assessment of the associated risk factors. METHODS: The medical records of 267 patients who underwent laparoscopic surgery between February 2004 and November 2009 were reviewed. After excluding cases involving radical cystectomy, combined surgery, open conversion, and severe complications, a total of 249 patients were included for this study. The subjects were divided into a non-ileus group and an ileus group. The gender and age distribution, duration of anesthesia, American Society of Anesthesiologists Physical Status Classification Score, body mass index, degree of operative difficulty, presence of complications, surgical procedure and total opiate dosage were compared between the two groups. RESULTS: Of the 249 patients, 10.8% (n = 27) experienced postoperative ileus. Patients with ileus had a longer duration of anesthesia (P = 0.019), and perioperative complications and blood loss were all correlated with ileus (P = 0.000, 0.004, respectively). Multiple linear regression analysis showed that the modified Clavien classification was an independent risk factor for postoperative ileus (odds ratio, 5.372; 95% confidence interval, 2.084 to 13.845; P = 0.001). CONCLUSION: Postoperative ileus after laparoscopic urologic surgery was more frequent in patients who experienced more perioperative complications.
Age Distribution ; Anesthesia ; Body Mass Index ; Cystectomy ; Humans ; Ileus ; Incidence ; Laparoscopy ; Linear Models ; Medical Records ; Postoperative Complications ; Risk Factors ; Urology

Orbital complications of sinus disease continue to appear in clinical practice. Acute visual loss may occur in association with sinusitis either as a complication of orbital cellulitis or, less frequently, as a part of the orbital apex syndrome. The classification which defines the degree of orbital extension is valuable, therapeutically and prognostically. The orbital apex syndrome is associated with an affection of the vessels and nerves passing through the superior orbital fissure and the optic foramen and characterized by visual loss and ophthalmoplegia. But it has minimal or no signs of orbital inflammation such as proptosis, chemosis, or lid edema. We experienced a case of temporary monocular visual loss and ophthalmoplegia caused by mucocele in the sphenoid sinus. Thus, we report, with a review of literature, a case of orbital apex syndrome caused by mucocele in the sphenoid sinus in a 53 year-old male patient.
Classification ; Edema ; Exophthalmos ; Humans ; Inflammation ; Male ; Middle Aged ; Mucocele* ; Ophthalmoplegia ; Orbit* ; Orbital Cellulitis ; Orbital Diseases ; Sinusitis ; Sphenoid Sinus* ; Vision Disorders

Pulmonary edema is a potentially life-threatening complication of acute airway obstruction. Occasionally, patients experience sudden, unexpected and severe pulmonary edema during treatment of upper airway obstruction. Two forms of postobstructive pulmonary edema (POPE) have been identified. Type I POPE follows a sudden, severe episode of upper airway obstruction and type II POPE develops soon after the relief of chronic upper airway obstruction. The pathogenesis of POPE is multifactorial. The application of moderate continuous positive airway pressure in conjunction with the administration of diuretics usually clears pulmonary edema in these clinical settings within 24 hours. Awareness of this uncommon condition is crucial for the otolaryngologist to make an early diagnosis and initiate successful treatment. We present two cases of postobstructive pulmonary edema after treatment for upper airway obstruction.
Airway Obstruction ; Continuous Positive Airway Pressure ; Diuretics ; Early Diagnosis ; Humans ; Pulmonary Edema*

Non-human primates, due to their high genetic similarity to humans, are used as laboratory animals in biotechnology researches. The growing demand has recently led to a shortage of primate resources, which has become a significant issue both domestically and internation-ally. This shortage has been further exacerbated by the COVID-19 pandemic. Consequently, the importance of resource conservation through effective primate management is increas-ing. This requires the establishment of proper quarantine procedures and infectious disease control. Quarantine is an important process that protects not only animal health but also pub-lic health significance. Non-human primate quarantine procedures were organized in order.We compared the differences in quarantine procedures not only in Korea but also in variouscountries such as the US, EU, and Australia. In addition, the etiology, clinical symptoms, diagnosis, and treatment methods of representative infectious diseases of quarantine concern(tuberculosis, monkeypox, monkey immunodeficiency virus, salmonellosis, and shigellosis) were summarized. A literature review of nonhuman primate quarantine procedures in other countries revealed minimal differences in the basic structure. The quarantine periods were similar around 30 days, but we found some differences in details such as legal requirements, documentation forms, and quarantine authorities. These findings are expected to contributeto the development of strategies for improving methods to prevent the spread of infectious diseases and enhancing quarantine management methods.

Non-human primates, due to their high genetic similarity to humans, are used as laboratory animals in biotechnology researches. The growing demand has recently led to a shortage of primate resources, which has become a significant issue both domestically and internation-ally. This shortage has been further exacerbated by the COVID-19 pandemic. Consequently, the importance of resource conservation through effective primate management is increas-ing. This requires the establishment of proper quarantine procedures and infectious disease control. Quarantine is an important process that protects not only animal health but also pub-lic health significance. Non-human primate quarantine procedures were organized in order.We compared the differences in quarantine procedures not only in Korea but also in variouscountries such as the US, EU, and Australia. In addition, the etiology, clinical symptoms, diagnosis, and treatment methods of representative infectious diseases of quarantine concern(tuberculosis, monkeypox, monkey immunodeficiency virus, salmonellosis, and shigellosis) were summarized. A literature review of nonhuman primate quarantine procedures in other countries revealed minimal differences in the basic structure. The quarantine periods were similar around 30 days, but we found some differences in details such as legal requirements, documentation forms, and quarantine authorities. These findings are expected to contributeto the development of strategies for improving methods to prevent the spread of infectious diseases and enhancing quarantine management methods.