BACKGROUND: A study was done to determine if there is any difference in the quality of anesthesia and time to reach maximum anesthesia between the induction of lumbar epidural anesthesia in the sitting and supine position in young male patients undergoing appendectomy. METHODS: We randomly divided 30 patients to 2 groups. An epidural catheter was inserted at L2~3 interspace. In group 1, with the patient sitting, 3 ml of 1% lidocaine with 5mcg/ml epinephrine was injected as a test dose via the epidural catheter, and then 3 minutes later, 0.5% bupivacaine 30 ml was given through the same catheter. After maintaining sitting position for 5 minutes, the patient changed to a supine position and the quality of anesthesia was assessed at 3-minute intervals for 30 minutes. In group 2, after the epidural catheter was inserted at the sitting position, the patient changed to a supine position immediately. Remaining procedures were the same. RESULTS: The two groups showed no difference in maximum cephalad spread of anesthesia and motor block. CONCLUSIONS: The position of the patient during induction of epidural anesthesia has no effect on the cephalad sensory and motor block.
Anesthesia ; Anesthesia, Epidural* ; Appendectomy ; Bupivacaine ; Catheters ; Epinephrine ; Humans ; Lidocaine ; Male ; Posture* ; Supine Position

No abstract available.
Gaucher Disease* ; Humans ; Siblings*

PURPOSE: Joubert syndrome presents neonatal respiratory abnormalities and other clinical manifestations. Pathologically the patients show hypoplasia or agenesis of cerebellar vermis and other intracranial anomalies. Our purpose is to evaluate the clinical manifestations and MR findings of Joubert syndrome. MATERIALS AND METHODS: Among the patients presenting with clinical stigmata of Joubert syndrome and agenesis of vermis on MR imaging, eight patients who did not satisfied the criteria of Dandy-Walker malformation, tectocerebellar dysraphia and rhombencephalosynapsis were selected. MR findings and clinical manifestation were analyzed. RESULTS: On MR imaging, agenesis of the cerebellar vermis (all cases), hypoplasia of the cerebellar peduncle (6cases), fourth ventricular contour deformity(6cases), tentorial elevation (4cases), deformity of the lateral ventricles (4cases), dysgenesis of the straight sinus (3cases) were demonstrated. Other findings were abnormalities of corpus callosum (3cases), falx anomalies (3 cases), occipital encephalomeningocele (2 cases) and fluid collection in posterior cranial fossa (2cases). Clinical manifestations were developmental delay (5cases), abnormal eyeball movement (3cases), hypotonia (2 cases), neonatal rerspiratoy abnormality (2cases), etc. CONCLUSION: Joubert syndrome showed various clinical manifestations and intracranial anomalies. MR imaging is an useful modality in detection of the cerebellar vermian agenesis and other anomalies of the patients.
Christianity ; Congenital Abnormalities ; Corpus Callosum ; Cranial Fossa, Posterior ; Dandy-Walker Syndrome ; Humans ; Lateral Ventricles ; Magnetic Resonance Imaging* ; Muscle Hypotonia

A 46 years old woman developed a sudden transcalvarial brain herniation 1 hour after removal of a huge right frontal arteriovenous malformation intraoperatively. In spite of all possible anes- thesiologic resuscitative treatments, the brain swelling was not subsided. Resuscitative resection of the frontal lobe was done. The brain CT taken immediately postoperatively showed a large unsuspected epidural hematoma over the contralateral left temporal and occipital areas. This rare complication should be remembered during brain surgery if unexpected brain swelling occurs without apparent reasons after resection of arteriovenous malformation.
Arteriovenous Malformations ; Brain ; Brain Edema ; Craniotomy ; Female ; Frontal Lobe ; Hematoma* ; Humans ; Intracranial Arteriovenous Malformations* ; Middle Aged

OBJECTIVES: The purpose of this study is to investigate the characteristics of drinking patterns and the prevalence of hazardous drinking and alcohol use disorder with the assessment of alcohol policy needs in community population of urban city in Korea. METHODS: Data was collected from 1,000 residents in a single urban city in Korea, from June 1 to July 31, 2011 by a questionnaire. As research tools, socio-demographic characteristics composed of variables based on study purpose, alcohol problems and alcohol use disorder state scales composed with Alcohol Use Disorder Identification Test(AUDIT) and Cut down, Annoyed, Guilty, Eye-opener(CAGE), and the assessment of alcohol policy needs in community population questions were used. RESULTS: The lifetime experience of alcohol drinking was 97.4%. For the frequency of drinking, 21.9% of population responded 2 to 4 times per weekly. 24.4% of male had one time or more high risk drinking, defined as having four or more drinks in a sitting, per week. 51.6% experienced the first time drinking of alcohol in adolescence. The lifetime prevalence of hazardous drinking and alcohol use disorder were 14.9% and 3.3%, respectively using AUDIT. Alcohol use disorder were 9.6% with the CAGE scale. Problem drinking were 8.4% in this study. They requested the program such as prevention education(57.2%), construction of liaison system to treatment facilities( 50.1%), alcohol counseling and intervention(41.7%), and rehabilitation program(39.8%). CONCLUSIONS: These results demonstrate that alcohol problem and alcohol use disorder were much prevalent, and these problem started in the earlier age. It is necessary to develop an effective alcohol prevention program or policy with considering the needs in community population.
Adolescent ; Alcohol Drinking ; Counseling ; Drinking ; Humans ; Korea ; Male ; Prevalence ; Questionnaires ; Weights and Measures

PURPOSE: The purpose of this study is to report on the short term follow-up of patients who underwent arthroscopic acetabular labral repair for femoroacetabular impingement and acetabular labral tear. MATERIALS AND METHODS: A total of 45 consecutive patients who underwent arthroscopic acetabular labral repair after diagnosis of femoroacetabular impingement and acetabular labral tear from January 2008 to December 2010 were included in this study. Modified Harris hip score (MHHS), VAS, Hip outcomes score (HOS), and patient satisfaction were used for evaluation of the clinical results. RESULTS: Patients included 22 males and 23 females, and the mean age of the patients was 33.0(range, 16-54) years old, and the mean follow up period was 26.7(range, 24-56) months. Of the clinical results, mean VAS score was 6.4 and 2.5 points before and after surgery, respectively, and mean MHHS score improved from 59.5 points before surgery to 85.4 points after surgery. Activities of daily living and sports-related activities of HOS were 58.3% and 51.2%, respectively, before surgery, and 83.0% and 79.8% after surgery. Revision arthroscopic surgery was performed on five cases(12.1%); labro-synovial adhesion, three cases, pull-out of suture anchor, one case, heterotropic ossification, one case. CONCLUSION: Arthroscopic acetabular labral repair is considered an effective treatment for femoroacetabular impingement and accompanying acetabular labral tear.
Activities of Daily Living ; Arthroscopy ; Female ; Femoracetabular Impingement ; Follow-Up Studies ; Hip ; Humans ; Male ; Patient Satisfaction ; Suture Anchors

Neonates with severe respiratory distress syndrome who require high levels of assisted ventilation have a high mortality and morbidity rate. Morbidity is mainly composed of bronchopulmonary dysplasia which is a result of air leak syndrome(ALS), oxygen toxicity. Even with unsolved controversy, there is a possibility that high-frequency oscillatory ventilation would decrease the development or progression of ALS in infants with severe respiratory distress syndrome. ALS is defined as pulmonary interstitial emphysema or gross air leak such as pneumothorax. We experienced HFOV to be effective in the treatment of newborn infant with pneumothorax.
Bronchopulmonary Dysplasia ; Emphysema ; High-Frequency Ventilation ; Humans ; Infant ; Infant, Newborn ; Mortality ; Oxygen ; Pneumothorax ; Ventilation*

PURPOSE: Vancomycin-resistant enterococci (VRE) are now nosocomial pathogens in Korea. But little is known about the prevalence of stool colonization with VRE in neonates in Korea. So we studied the prevalence and risk factors of VRE colonization in the Neonatal Intensive Care Unit (NICU). METHODS: From January 2000 to December 2004, the medical records of 294 neonates (127 cases of VRE group and 167 cases of non-VRE group, according to the results of stool culture) were reviewed retrospectively. We studied the annual prevalence of VRE and risk factors of VRE colonization in neonates. RESULTS: From 2000 to 2003, the prevalence rate of VRE in NICU increased. After preventing VRE transmission, the prevalence rate of VRE has decreased. CONCLUSION: VRE colonization increased recently. Risk factors of VRE colonization were prematurity, lower birth weight, longer hospitalization and use of vancomycin or 3rd generation cephalosporin, compared with the non-VRE group. To prevent VRE transmission among newborns, aggressive infection control strategies by NICU staffs must be implemented immediately for all babies.
Birth Weight ; Colon* ; Hospitalization ; Humans ; Infant, Newborn* ; Infection Control ; Intensive Care, Neonatal ; Korea ; Medical Records ; Prevalence* ; Retrospective Studies ; Risk Factors* ; Vancomycin

OBJECTIVE: To analyze the clinical data and surgical results from symptomatic chronic subdural hematoma (CSDH) patients who underwent burr-hole drainage (BHD) at the maximal thickness area and twist-drill craniostomy (TDC) at the precoronal point. METHODS: We analyzed data from 65 symptomatic CSDH patients who underwent TDC at the pre-coronal point or BHD at the maximal thickness area. For TDC, we defined the pre-coronal point to be 1 cm anterior to the coronal suture at the level of the superior temporal line. TDC was performed in patients with CSDH that extended beyond the coronal suture, as confirmed by preoperative CT scans. Medical records, radiological findings, and clinical performance were reviewed and analyzed. RESULTS: Of the 65 CSDH patients, 13/17 (76.4%) with BHD and 42/48 (87.5%) with TDC showed improved clinical performance and radiological findings after surgery. Catheter failure was seen in 1/48 (2.4%) cases of TDC. Five patients (29.4%) in the BHD group and four patients (8.33%) in the TDC group underwent reoperations due to remaining hematomas, and they improved with a second operation, BHD or TDC. CONCLUSION: Both BHD at the maximal thickness area and TDC at the pre-coronal point are safe and effective drainage methods for symptomatic CSDHs with reasonable indications.
Catheters ; Drainage* ; Hematoma ; Hematoma, Subdural, Chronic* ; Humans ; Medical Records ; Sutures ; Tomography, X-Ray Computed

PURPOSE: Nocodazole, a microtubule disrupting reagent, is known to arrest cells in the M phase, To gain insight on the regulatory mechanism of H2B histone gene expression by nocodazole in HL-60 cell, the binding pattern of nuclear proteins to cis element in the human H2B histone gene promoter has been investigated with DNase I footprinting and DNA mobility shift assay. MATERIALS AND METHODS: Northern blot hybridization was performed by the method of Virca et al. A Hinc II-Sac I fragment of pSPH28 was used as probe for Northern blot analysis of H2B histone mRNA. DNase I footprinting and DNA mobility shift assay were performed by the method of Lim et al. End labeled DNA oligomer (upper strand, 5'-CTTCACCTTATTTGCATAA GCGATTC-3') for octamer binding activity was mixed with nuclear extracts in a 20 ul reaction volume containing 60 mM KC1, 12 mM HEPES, pH 7.9, 5 mM MgCl2, 0.2 mM EDTA, 0.2 mM DTT, 12% glycerol, and 2 ug of poly [dI-dC]. RESULTS: The level of H2B histone mRNA rapidly was reduced at 24 hours in nocodazole-treated HL-60 cells and the mRNA was repressed in proportion to the concentration of nocodazole. Nocodazole-dependent repression of H2B histone gene was restored by replacement with nocodazole-free media. In DNase I footprinting analysis, one nuclear factor bound at 42 bp site (octamer motif) in the absence of nocodazole. In the presence of nocodazole, the binding of nuclear factor on octamer motif partially vanished. In DNA mobility shift assay, one DNA-protein complex (Octl) was formed when octamer motif was incubated with nuclear extract of HL-60 cell. After nocodazole treatment, Octl binding activity was reduced by time dependent manner. CONCLUSION: These results suggest that nocodazole-dependent repression of H2B histone gene is correlated with reduction of Octl binding activity in HL-60 cell.
Blotting, Northern ; Cell Division ; Deoxyribonuclease I ; DNA ; Edetic Acid ; Electrophoretic Mobility Shift Assay ; Gene Expression* ; Glycerol ; HEPES ; Histones* ; HL-60 Cells* ; Humans ; Hydrogen-Ion Concentration ; Magnesium Chloride ; Microtubules ; Nocodazole* ; Nuclear Proteins ; Repression, Psychology ; RNA, Messenger