BACKGROUND: Experience of awareness and recall during general anesthesia would be most distressing for patients. Especially for the cesarean section, medical team must consider both maternal awareness and fetal safety. Authors tried to know the possibility of propofol use as induction and maintenance agent of anesthesia for the cesarean section in respect of maternal awareness, recall and fetal safety. METHODS: Forty patients (ASA physical status 1, 2) were allocated randomly to either propofol (n=20) (P) or thiopental-enflurane (n=20) (T-E) group. We checked B.P, pulse rate, and the incidence of maternal awareness using the isolated forearm technique (IFT). The postoperative interview was conducted between 12~24h after operation. RESULTS: The incidence of maternal awareness signaled by flexing fingers in response to voice commands were significantly lower in the T-E group (20% after induction, no response during other times) than the P group (45% after induction, then 35%, 30%, after 5, 10 min delivery respectively). Seven patients had postoperative recall of introspective awareness in the P group but no patients in the T-E group. The 1 min Apgar score of the newborn were significantly lower in the P group than the T-E group but both groups were within normal range. CONCLUSIONS: Our date indicated that, in comparison with thiopental-enflurane, propofol infusion (6 mg/kg/h) were associated with a greater incidence of awareness during surgery and recall.
Anesthesia* ; Anesthesia, General ; Apgar Score ; Cesarean Section* ; Female ; Fingers ; Forearm ; Heart Rate ; Humans ; Incidence ; Infant, Newborn ; Pregnancy ; Propofol ; Reference Values ; Voice

Diaper dermatitis is an infant dermatosis associated with the wearing of diapers, Despite of its high frequency in clinical pediatrics the clinical characteristics are not well described in the korean literatvre. We investigated the clinical and mycological characteritics of diaper dermatitis in 50 serial patients. Clinically diaper dermatitis was classified. into five categories,irritant contact derniatitis(ID), candidiasis(CD). combined rash of ID and CD(CR.), intertrigo, and miliari. Of 50 patients with diaper dermatitis, 18 had ID; 16, CI3; 10, CR; 5, intertrigo, and 1, miliaria, The mean age of patients with ID (11.8 months) was higher than that of patients with CD (4.0 months). Candida albicans(C. albicans) w is isolated from 25 patients with diaper dermatitis. The rate of positive cultures by clinical diagnosis was 130% in CD, 11.1% in ID, 60, 0% in CR, and 20.0% in intertrigo. C. albicons was isolated from 23 patients(82.1%) of patients with clinically suspected Ci") and 2 of 22 patients without the characteristic erythematous papulesThe presence of eryhematous papules was the most characteristic clinical feature of infection, Other candida species isolated from cut,aneous lesions were C. tropicalsis, C.'. parapsiolosis, and C. stellatoidea.
Candida ; Candidiasis ; Dermatitis* ; Diagnosis ; Exanthema ; Humans ; Infant ; Intertrigo ; Miliaria ; Pediatrics ; Skin Diseases

BACKGROUND: The analgesic properties of the nonsteroidal antiinflammatory drugs (NSAIDs) have been attributed to their effects on the peripheral synthesis of prostaglandins. Although the preoperative use of NSAIDs has been increasing because of concerns regarding the side effects of opioid analgesics but results of clinical preemptive analgesia studies remain inconclusive. So, we studied the efficacy of preemptive analgesic effects of tenoxicam, new NSAID, on postoperative continuous intravenous analgesia with morphine. METHODS: We studied 40 parturients, undergoing cesarean section, ASA class I or II, randomly divided into two groups. Tenoxicam group were injected tenoxicam 0.3 mg/kg and control group were injected normal saline 3 ml at ten min. before induction. For both groups morphine 0.1 mg/kg was administered as loading dose and 0.015 mg/kg/hr as maintenance dose. We examined verbal quantitative score (VQS) at postoperative 30 min, 1, 6, 12, 24 and 48 hr. Maternal satisfaction, side effects, hepatic and renal function also evaluated after pain control. RESULTS: The values of VQS showed no significant differences between two groups 30 min, 1 and 6hr after start of morphine infusion, but there was significant decrease in tenoxicam group compared to control group 12, 24 and 48 hr after start of morphine infusion (p<0.05). There was no significant difference in maternal satisfaction between two groups and also there were no significant differences in the overall incidences of side effects between two groups. CONCLUSIONS: Preoperative single injection of tenoxicam showed incomplete preemptive analgesic effects on postoperative pain control after cesarean section.
Analgesia* ; Analgesics, Opioid ; Anti-Inflammatory Agents, Non-Steroidal ; Cesarean Section* ; Female ; Incidence ; Morphine* ; Pain, Postoperative ; Pregnancy ; Prostaglandins

This paper is aimed to study the incidence, age and sex distribution, and type of lateral meniscal lesion including discoid meniscus in Korea. It is reported higher incidence of lateral meniscal lesion in Korea. 132 cases with meniscal lesions were surgically treated at the Department of Orthopedic Surgery, Seoul National University Hospital between 1973 and 1982. Of the 98 patients who had lateral meniscal lesions, forty-four (44.9%) were found to have a discoid meniscus. The mean age of the patients with discoid meniscus was 17.9 years, and 30 patients of them were younger than 20 years of age. The patients with discoid meniscus were followed after meniscectomy for an average of 6 months. The summary of this study are as follows: l. Over-all incidence of discoid meniscus were 44 cases (33.3%) out of 132 cases of the meniscal disease. All forty-four cases had a lateral discoid meniscus, and they formed 44.9% among 98 cases of lateral meniscal injury. 2. The discoid meniscus was most frequent in the age group between 11 and 20 years old (65.9%), and was more prevalent in female by a ratio of 1.4. 3. Qf the 26 patients with torn discoid meniscus, twelve (46.2%) denied the history of trauma. 4. Symptom of click sound was present in 42 cases (95.5%), and the rate of positive McMurray sign was 81.8%.
Clinical Study ; Female ; Humans ; Incidence ; Korea ; Orthopedics ; Seoul ; Sex Distribution

OBJECTIVES: The main purpose of this study was to explore whether the use of big data can effectively reduce healthcare concerns, such as the selection of appropriate treatment paths, improvement of healthcare systems, and so on. METHODS: By providing an overview of the current state of big data applications in the healthcare environment, this study has explored the current challenges that governments and healthcare stakeholders are facing as well as the opportunities presented by big data. RESULTS: Insightful consideration of the current state of big data applications could help follower countries or healthcare stakeholders in their plans for deploying big data to resolve healthcare issues. The advantage for such follower countries and healthcare stakeholders is that they can possibly leapfrog the leaders' big data applications by conducting a careful analysis of the leaders' successes and failures and exploiting the expected future opportunities in mobile services. CONCLUSIONS: First, all big data projects undertaken by leading countries' governments and healthcare industries have similar general common goals. Second, for medical data that cuts across departmental boundaries, a top-down approach is needed to effectively manage and integrate big data. Third, real-time analysis of in-motion big data should be carried out, while protecting privacy and security.
Delivery of Health Care ; Health Care Sector ; Imidazoles ; Nitro Compounds ; Privacy

Neonatal cholestasis is caused by various forms of liver injury and has a complex etiological background. Among these, cases of severe cholestasis due to primary hemolytic disease are rare. Herein, we report a case in which thalassemia-induced severe hemolysis caused bile duct injury by hemosiderosis, with cholestasis occurring shortly after birth and lasting for >4 months. In addition, complete recovery of liver pathology was observed both biochemically and histologically. Hence, clinicians should consider hemolytic disease as a rare cause of neonatal cholestasis in the differential diagnosis of neonates as well as the advisability of conservative treatment based on case progression.

The purpose of this study is to develop species-specific DNA probes and polymerase chain reaction (PCR) primers for detection and identification of Prevotella nigrescens (P. nigrescens) 9336. This study procedure includes (1) whole-genomic DNA extraction of P. nigrescens 9336 (2) construction of the genomic DNA library, (3) screening of strain-specific DNA probe by reverse dot Hybridization method, (4) confirmation of strain-specific DNA probe by Southern blot analysis, (5) determination of nucleotide sequences of strain-specific DNA probe. Thirty-five restriction fragments of P. nigrescens 9336 genomic DNA digested with the Hind III were obtained. Reverse dot hybridization and Southern blot analysis data showed that three of them, Pn10, Pn23, and Pn35, could be P. nigrescens 9336-specific DNA probes. These data indicated that these DNA probes could be useful in detection and identification of the P. nigrescens 9336.
Base Sequence ; Blotting, Southern ; Clone Cells* ; Cloning, Organism* ; DNA Probes* ; DNA* ; Gene Library ; Mass Screening ; Polymerase Chain Reaction ; Prevotella nigrescens* ; Prevotella*

OBJECTIVE: The purposes of this study were to determine the accuracy of crown and root length measurements of premolars using cone-beam computed tomography (CBCT) and to generate reference CBCT-based data on incisor, canine, and premolar lengths in patients with malocclusions. METHODS: Imaging was performed using a CBCT scanner with a 0.292-mm voxel size and 12-bit grayscale. The CBCT-based length measurements were compared with direct measurements of 94 subsequently extracted premolars without metal restorations using the paired t-test. Furthermore, the crown and root lengths of incisors, canines, and premolars in 62 Korean patients with malocclusions were measured using CBCT, and Pearson's correlation coefficients were calculated to examine the relationship between the crown and root length measurements of each tooth type. RESULTS: The differences between the CBCT-based and direct measurements of the extracted premolars were not significant, with 95% limits of agreement of -0.90 to 0.90 mm for crown length and -1.23 to 1.18 mm for root length. Weak positive correlations between the crown and root length measurements were observed for the mandibular canine and premolars. CONCLUSIONS: The CBCT-based measurements showed a wider range of limits of agreements for root length than for crown length. The CBCT-based data can be used as a reference for evaluating root length and resorption of teeth without metal restorations in patients with malocclusions.
Bicuspid* ; Cone-Beam Computed Tomography* ; Crowns* ; Humans ; Incisor* ; Malocclusion* ; Root Resorption ; Tooth

PURPOSE: It was well known that transforming growth factor (TGF)-beta1 plays a pivotal role in interstitial fibrosis and loss of podocyte. We explored the effects of exogenous administration of TGF-beta1 latency-associated peptide (LAP) in a model of renal fibrosis induced by unilateral ureteral obstruction (UUO) and examined whether TGF-beta1 LAP can inhibit apoptosis of podocyte. METHODS: Twenty four male BALB/c mice were unilaterally obstructed of proximal ureters by ligation. Half of the mice with operation and half of 8 control were administered recombinant human LAP intraperitoneally. One to three mice per group were euthanized on days 3, 7, 14, and 21 after operation for observation of renal fibrosis and apoptosis of podocyte. RESULTS: Interstitial fibrosis was less severe in LAP-treated group. Obstructed kidneys from LAP- untreated mice had more glomerular apoptotic podocytes (TUNEL assay) compared to LAP-treated mice at day 7, 14, and 21 after operation. CONCLUSION: Intraperitoneal administration of TGF-beta1 LAP prevents the loss of podocyte & renal damage partially up to day 14 after operation.
Animals ; Apoptosis ; Fibrosis ; Humans ; Kidney ; Ligation ; Male ; Mice ; Podocytes ; Transforming Growth Factor beta1 ; Transforming Growth Factors ; Ureter ; Ureteral Obstruction

Central hypoventilation syndrome is a rare and fatal condition resulting from various central nervous system disorders that is characterized by a failure of automatic breathing. We report a case of central hypoventilation syndrome following posterior circulation stroke whose pulmonary function was improved by respiratory rehabilitation. A 59-year-old woman with a history of hemorrhagic stroke of the bilateral cerebellum was hospitalized due to pneumonia. A portable ventilator was applied via tracheostomy, recurrent episodes of apnea and hypercapnia impeded weaning. A respiratory rehabilitation program including chest wall range of motion exercise, air stacking exercise, neuromuscular electrical stimulation (NMES) on abdominal muscles, upper extremity ergometer, locomotor training, high-frequency chest wall oscillator, mechanical insufflation, and exsufflation was employed, as spirometry showed a severe restrictive pattern. A spontaneous breathing trial was started, and a portable ventilator was applied for 8 hours, only during nighttime, to prevent sudden apneic event. After 4 weeks of treatment, follow-up spirometry showed much improved respiratory parameters. This case suggests that respiratory rehabilitation can improve pulmonary function parameters and quality of life in central hypoventilation syndrome.
Abdominal Muscles ; Apnea ; Central Nervous System Diseases ; Cerebellum ; Electric Stimulation ; Female ; Follow-Up Studies ; Humans ; Hypercapnia ; Hypoventilation ; Insufflation ; Middle Aged ; Pneumonia ; Quality of Life ; Range of Motion, Articular ; Rehabilitation ; Respiration ; Respiratory Center ; Spirometry ; Stroke ; Thoracic Wall ; Tracheostomy ; Upper Extremity ; Ventilators, Mechanical ; Weaning