BACKGROUND: Korean Journal of Anesthesiology was published in 1968 and its volume has been increased every year. The purpose of this study was to investigate and to clarify the trend of increasing volumes for 28 years (1968~1996) as quantitative analysis. METHODS: Using computerized index of Korean Journal of Anesthesiology (""ART""), the trend, volumes and cumulative records (top ranked 22 frequently cited key words, 16 persons and 10 departments of University) were calculated. Some key words such as ""Anesthetic techniques: spinal, Anesthetics, intravenous:, Anesthetics, volatile: halothane, Complications:"" was traced every year for grasping the trend of academic concerns. RESULTS: 1. Total volumes of articles were about 3,000 (1968~1996). The volumes were increased slowly until 1976 and steeply since 1986. 2. The ratio of clinical case reports has been decreased every year. 3. Key words ""Anesthetic techniques"", ""Surgery"" and ""Complications"" were more frequently cited than the others. 4. Tracing some key words showed their vitality in anesthetic fields. 5. The personal top ranked number of records revealed each author's contribution to Korean Journal of Anesthesiology and the number of records in each department of University could be used as an index of academic activity. CONCLUSIONS: The extent of the increasing volumes was great especially from 1986 to 1996 and the proportion of original articles has been increased every year. The frequency of the investigated key words showed their own vitality in the field of anesthesiology. The rank according to personal and departmental records suggested the possibility of reflecting a measure of academic concerns and activity.
Anesthesiology* ; Anesthetics ; Anesthetics, Intravenous ; Halothane ; Hand Strength ; Humans

Purpose: To evaluate the risk factors for the development of osteonecrosis in civilian professional divers by an epidemiologic study and to determine the correlation between osteonecrosis in divers and coagulopathy by analysis of serologic markers that are related to thrombophilia and hypofibrinolysis. Materials and Methods: Forty-two divers, who collected pen shells (Atrina pinnata), and among whom 10 had osteonecrosis (group 1), were compared with 32 divers without osteonecrosis (group 2). Both groups were evaluated based on the number of years of diving experience, number of dives per year, mean number of dives per day, mean diving time and depth, and diving methods. We determined any statistically significant differences among these variables. We measured the levels of serologic markers that were related to hyperlipidemia, thrombophilia, and hypofibrinolysis from the divers and a control group of 20 physicians (group 3). The levels of the serologic markers were compared between groups 1 and 2 and between the divers and the control group, in order to determine the relationship between the serologic markers and the development of dysbaric osteonecrosis. Results: None of the variables demonstrated any statistically significant differences, except for the mean diving time, in which group 1 had a mean diving time of 124 minutes and group 2 had a mean diving time of 62.1 minutes (P<0.05). In the analysis of the serologic markers, there were no statistically significant differences between groups 1 and 2; however, in comparison with the group 3, the divers demonstrated significantly decreased activity levels of proteins C and S (Protein C: P<0.05; Protein S: P<0.05), and an increase in the levels of plasminogen activator inhibitor-1 (PAI-1) (P<0.05). Conclusion: The divers with osteonecrosis had a longer mean diving time than did those divers without osteonecrosis. In the serologic marker analysis, the divers with osteonecrosis demonstrated significantly decreased activity levels of Proteins C, S and a significant increase in the levels of PAI-1, compared with the control group.
Biomarkers* ; Diving ; Epidemiologic Studies* ; Epidemiology ; Hyperlipidemias ; Osteonecrosis* ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Protein S ; Risk Factors ; Thrombophilia

Laryngoscopy and intubation cause an adrenergic response manifested by tachycardia and hypertension. Various phamacological agents have been administered prior to induction in an attempt to attenuate the adrenergic response but they all have limitations. The objective of our study was to determine if esmolol would be equally effective when adrninistered in a bolus with and without fentanyl. A double-blind, randomized trial was conducted in sixty ASA physical status 1 patients undergoing elective surgery. All patients were premedicated with 0.2 mg/kg diazepam orally and glycopyrrolate 0.04 mg/kg intramuseularyly 1 hour beforehand. Induction of anesthesia was accomplished with 4 mg/kg thiopental intravenously foUowed immediately by 0.15-0.2 mg/kg vecuronium and study drug (placebo, esmolol 150 mg, esmolol 150 mg and fentanyl 100 mcg). Endotracheal intubation was performed at 2 minutes after study drug adrninistration. Anesthesia was maintained with 1 MAC (+/-10%) isoflurane in 60% nitrous oxide in oxygen at a 5 L/min flow for 6 minutes. Heart rate and blood pressure were measured every minute by an automatic recording device. After laryngoscopy and intubation, maximum increase in stolic blood pressure above awake levels was 33 mmHg (p<0.05) and 14 mmHg (p<0.05) in esmolol 150 mg, esmolol 150 mg with fentanyl 100 mcg respectively, whereas systolic blood pressure increased 62 mmHg after tracheal intubation in patients with placebo. In six patients with esmolol 150 mg, rate-pressure product reached a level considered potentially dangerous to patients with coronary artery disease. However, when used with fentanyl, esmolol provides effectvie protection against the adrenergic response and increase of the rate-pressure product to laryngoscopy and intubation.
Anesthesia ; Blood Pressure* ; Coronary Artery Disease ; Diazepam ; Fentanyl* ; Glycopyrrolate ; Heart Rate* ; Heart* ; Humans ; Hypertension ; Intubation ; Intubation, Intratracheal* ; Isoflurane ; Laryngoscopy ; Nitrous Oxide ; Oxygen ; Tachycardia ; Thiopental ; Vecuronium Bromide

Crohn' s disease is a chronic inflammatory disease that may affect any part of the gastrointestinal system and multiple extraintestinal organs. Right lower quadrant abdominal pain with fever may be mistaken as a acute appendicitis. Pancreatitis has rarely been reported as a complication of Crohn' s disease. However, we experienced one case of Crohn' s disease with pancreatitis : the histologic examination after appendectomy of a 12-year-old female child who complained about abdominal pain and high fever.
Abdominal Pain ; Appendectomy* ; Appendicitis ; Child ; Crohn Disease* ; Female ; Fever ; Humans ; Pancreatitis

STUDY DESIGN: The authors reviewed the dural tears in the thoracolumbar fractures treated surgically. OBJECTIVES: To evaluate the incidence and the predictive values for the presence of dural tears in the thoracolumbar fractures. SUMMARY OF LITERATURE REVIEW: Many authors reported that the dural tear was usually related to the thoracolumbar fractures especially with laminar fracture and neurologic deficit. The dural tears may lead complications such as the entrapment of spinal nerve root, delayed wound healing, cerebrospinal fluid fistula, and myelomeningocele. Previous reports emphasized posterior approach to confirm and treat the dural tears using laminectomy. So it is very important that surgeons should identify the presence of dural tear preoperatiyely to determine the surgical approach and treatment options. MATERIALS AND METHODS: The authors reviewed 22 patients of thoracolumbar fractures treated with posterior laminectomy, posterior decompression, posterolateral fusion, and instntmentation from August 1993 to August 1996. The follow-up period was minimally 12 months. We checked the canal compromise, the injury of the posterior column including laminar fracture and ligamental injury, and neurologic deficits as the predictive values. The statistical analysis was done to evaluate the relationship between the dural tear and the predictive values. RESULTS: The incidence of dural tear was 54.4% of the thoracolumbar fractures. The canal encroachment, the injury of the posterior column, and the neurologic deficits were not significantly related with the dural tears in statistical analysis. But we could find the tendency that is related to the dural tear and posterior column injury. CONCLUSION: The authors concluded that we could find the possible presence of dural tears in the severe thoracoiumbar which were needed the surgical treatment and we could suggest the injury of posterior column was a possible value that could predict the presence of dural tear.
Cerebrospinal Fluid ; Decompression ; Fistula ; Follow-Up Studies ; Humans ; Incidence ; Laminectomy ; Ligaments ; Meningomyelocele ; Neurologic Manifestations ; Spinal Nerve Roots ; Tears* ; Wound Healing

PURPOSE: The purpose of this study was to examine the effects of laughter therapy on mood, state anxiety, and serum cortisol based on a Stress-Coping Model for preoperative breast cancer patients. METHODS: The study used a nonequivalent control group pretest-posttest design. The participants were 40 breast cancer patients who were admitted to one general hospital for surgery in 2009 (experimental group 23, control group 17). The experimental group received one hour laughter therapy consisting of dance, lots of laughter techniques, and meditation. RESULTS: The mean ages were 47 years (experimental group) and 49 years (control group). There were no significant differences in demographic and disease-related characteristics between the two groups. After the intervention, the scores of mood and state-anxiety of experimental group were significantly improved than those of control group. However, no difference was found in serum cortisol. CONCLUSION: The laughter therapy was partially effective in improving stress response in patients with breast cancer. Further research is needed to develop and evaluate the longer periods of interventions to testify the effects on serum cortisol, and other biochemical variables.
Anxiety ; Breast ; Breast Neoplasms ; Hospitals, General ; Humans ; Hydrocortisone ; Laughter ; Laughter Therapy

A silicone-covered modified Gianturco stent in patients with malignant esophageal stricture is an easy, safe, and effective palliative procedure, but reports of complications arising from stent placement in patients with this condition are numerous. There have been no reports of fracture of the modified Gianturco esophageal stent. We report a case of stent fracture in association with gastric migration of modified Gianturco esophageal stent in a patient with malignant esophageal stricture. It appears that the fracture was probably due to oxidation of the stent by gastric juice.
Esophageal Stenosis* ; Gastric Juice ; Humans ; Stents*

PURPOSE: Bipolar hemiarthroplasty of the hip has been used as a treatment modality for displaced femoral neck and intertrochanteric fractures in elderly patients, inflammatory and degenerative diseases of the hip, osteonecrosis of femoral head and limb salvage procedure after tumor resection. Because of the intrinsic stability of the biarticular structure, it is also used for treatment of recurrent dislocation after total hip replacement arthroplasty. However, despite its intrinsic stability, dislocation does occur even after bipolar hemiarthroplasty, and poor prognosis after the dislocation has been reported. So, we tried to investigate the incidence, risk factors, treatment and preventive methods of dislocation after bipolar hemiarthroplasty. MATERIALS AND METHODS: We reviewed 138 patients and 138 bipolar hemiarthroplasties retrospectively to analyze the incidence, timing, risk factors, treatment and preventive methods of the dislocation. RESULTS: The incidence of dislocation was 5.8% (8/138). Female gender, intertrochanteric fracture, pre-existing neuromuscular disorders including cerebrovascular accident, long period of pre-operative and postoperative immobilization were statistically significant (P<0.05) as a risk factor. Related muscular weakness was the most significant predisposing factor for dislocation. CONCLUSIONS: In order to prevent dislocation after bipolar hemiarthroplasty performed in the patients with above risk factors, we must try and encourage early operation, early ambulation, muscle strengthening exercise and application of abduction hip brace.
Aged ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Braces ; Causality ; Dislocations* ; Early Ambulation ; Female ; Femur Neck ; Head ; Hemiarthroplasty* ; Hip Fractures ; Hip* ; Humans ; Immobilization ; Incidence ; Limb Salvage ; Muscle Weakness ; Osteonecrosis ; Prognosis ; Retrospective Studies ; Risk Factors ; Stroke

BACKGROUND AND PURPOSE: The progression of migraine into chronic daily headache involves multiple risk factors, but the main contributor is not known. Glutamate is the major excitatory neurotransmitter in central sensitization, which is an important process in the pathogenesis of migraine transformation. The glutamate transporter protein excitatory amino acid transporter 2 (EAAT2) is the primary modulator of glutamatergic neurotransmission, and genetic polymorphisms of its gene, EEAT2, have been identified. The aim of this study was to determine the effect of EAAT2 polymorphisms on migraine transformation into chronic daily headache. METHODS: We included 74 migraine patients with episodic attack (M-E) and 59 migraine patients with chronic daily headache (M-CDH). After amplifying EAAT2 by polymerase chain reaction, we assessed its genotype frequencies based on restriction fragment length polymorphisms. We reclassified all migraine patients into two groups according to their EAAT2 genotype, either with the A allele (n=62) or without it (n=71), and compared the clinical variables between the two groups. RESULTS: The genotype frequencies of EAAT2 polymorphisms did not differ between the M-E and M-CDH groups. Comparison between EEAT2 genotypes revealed that the frequency of analgesic usage was significantly higher among migraine patients with the A allele (12.9+/-1.6 days/month) than in those without the A allele (8.1+/-1.2 days/month; p=0.019). The other clinical variables of migraine did not differ between the two groups. CONCLUSIONS: The results suggest that EEAT2 polymorphism contributes to the tendency toward frequent analgesic usage in migraine patients. This implies a potential genetic influence on the progression of migraine into chronic daily headache through the development of medication-overuse headache.
Alleles ; Amino Acid Transport System X-AG ; Central Nervous System Sensitization ; Excitatory Amino Acid Transporter 2 ; Genotype ; Glutamic Acid ; Headache ; Headache Disorders ; Humans ; Migraine Disorders ; Neurotransmitter Agents ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length ; Risk Factors ; Synaptic Transmission

OBJECTIVE: To evaluate the frequency and obstetric consequences of women with uterine anomalies and correlation between obstetric consequence and congenital uterine anomalies. Materials and METHODS: A retrospective study was made on 65 patients with uterine anomalies in order to evaluate the obstetric consequence at department of obstetrics and gynecology, Soonchunhyang University Hospital from January 1994 to June 1997. The diagnosis of uterine anomalies was made with hysterosalpingogram or ultrasonogram, or at the time of cesarean section. The uterine anomalies were classified according to the classification of Buttram and Gibbons and compared the pregnancy outcome for each classification. The obstetric consequences were divided into preterm delivery, premature rupture of membranes, intrauterine growth restriction, and abnormal presentation of fetus. Statistical analysis was carried out using chi-square test, the significance was defined as P< 0.05. RESULTS: 1. The incidence of uterine anomalies accounted for 1.04% (65/6,250 deliveries). 2. The most common uterine anomalies were class III (Uterine didelphys, 47.7%). 3. We noted preterm birth rate (16.9%), premature rupture of membranes rate (20%), intrauterine growth restriction rate (9.2%) in 65 patients. 4. The rate of breech presentation was 41.5% and the mean birth weight was 2,747 gram. 5. When uterine anormalies were present, the incidence of obstetric consequences was significantly increased. CONCLUSION: We concluded that congenital uterine anomalies were closely related to obstetric consequences, such as preterm, breech presentation, intrauterine growth retardation.
Birth Weight ; Breech Presentation ; Cesarean Section ; Classification ; Diagnosis ; Female ; Fetal Growth Retardation ; Fetus ; Gynecology ; Humans ; Hylobates ; Incidence ; Membranes ; Obstetrics ; Pregnancy ; Pregnancy Outcome ; Premature Birth ; Retrospective Studies ; Rupture ; Ultrasonography