In the modern practice of general anesthesia, endotracheal intubation is routinely used for controlled ventilation. To facilitating intubation, succinlycholine is the most valuable muscle relaxant. But succinylcholine has many untoward reactions such as elevation of intraocular pressure, increased plasma potassium, increased intragastric pressure, bradycardia and the development of postperative muscle pain, etc. Several attempts have study was intended to determine adequate doses of gallamine triethiodide for endotracheal intubation in patients to avoid the development of bradycardis. The authors measured the heart rate just beofre, immediately after and 5 minutes after intubation. The total number of patients in this study was 67, and the patients were divided into five groups: Group 1: consisting of 10 patients, receiving 1.5 mg/kg of gallamine triethiodide. Group 2: of 10 patients, receiving 2.0 mg/kg of gallamine. Group 3: of 22 patients, receiving 2.5 mg/kg of gallamine. Group 4: of 15 patients, receiving 3.0 mg/kg of gallamine. Group 5: of 10 patients, receiving 3.5 mg/kg of gallamine. The authors tried to choose the least difficult intubation after gallamine triethiodide, the amount administered and the patient's reaction to stimulation. The conclusions are summarized as follows: 1) The adequate dose of gallamine triethiodide for endotracheal intubation is 2.5mg/kg. 2) The duraion of action of gallamine triethiodide is dose dependent. 3) Increase of heart rate in each group is significant after gallamine triethiodide.
Anesthesia, General ; Bradycardia ; Gallamine Triethiodide* ; Heart Rate ; Humans ; Intraocular Pressure ; Intubation ; Intubation, Intratracheal* ; Myalgia ; Plasma ; Potassium ; Succinylcholine ; Ventilation

PURPOSE: The purpose of this study was to identify the influence of posttraumatic growth and meaning in life on health promotion behavior in cancer patients. METHODS: The participants were 124 cancer patients who were treated at a general hospital in Pusan. Data were collected for posttraumatic growth, meaning in life, and health promotion behavior. The data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson correlation coefficients and stepwise multiple regression with SPSS 21.0. RESULTS: The mean scores were health promotion behavior 2.72+/-0.47, posttraumatic growth 3.38+/-0.89, and meaning in life 3.29+/-0.59. The scores of health promotion behavior were significantly different by gender, perceived economic status, and economic difficulties due to diagnosis. Health promotion behavior had a significant correlation with posttraumatic growth and meaning in life. In multiple regression analysis, meaning in life and posttraumatic growth accounted for 26.0% of health promotion behavior. CONCLUSION: Posttraumatic growth and meaning in life were important factors that could be used to improve the health promotion behavior of cancer patients.
Busan ; Diagnosis ; Health Promotion* ; Hospitals, General ; Humans

BACKGROUND: Tumor necrosis factor(TNF)-alpha and Interleukin(IL)-1beta are thought to play a major role in the pathogenesis of the septic syndrome, which is frequently associated with adult respiratory distress syndrome(ARDS). In spite of many reports for the role of TNF-alpha in the pathogenesis of ARDS, including human studies, it has been reported that TNF-alpha is not sensitive and specific marker for impending ARDS. But there is a possibility that the results were affected by the diversity of pathogenetic mechanisms leading to the ARDS because of various underlying disorders of the study group in the previous reports. The purpose of the present study was to evaluate the roles of TNF-alpha and IL-lbeta as a predictable marker for development of ARDS in the patients with septic syndrome, in which the pathogenesis is believed to be mainly cytokine-mediated. METHODS: Thirty-six patients of the septic syndrome hospitalized in the intensive care units of the Asan Medical Center were studied. Sixteens suffered from ARDS, whereas the remaining 20 were at the risk of developing ARDS(acute hypoxemic respiratory failure, AHRF). In all patients venous blood sample were collected in heparin-coated tubes at the time of enrollment, at 24 and 72 h thereafter. TNF-alpha and IL-lbeta was measured by an enzyme-linked immunosorbent assay (ELISA). All data are expressed as median with interquartile range. RESULTS: 1) Plama TNF-alpha levels: Plasma TNF-beta levels were less than 10pg/mL, which is lowest detection value of the kit used in this study within the range of the mean+/-2SD, in all of the normal controls, 8 of 16 subjects of ARDS and in 8 in 20 subjects of AHRF. Plasma TNF-alpha levels from patients with ARDS were 10.26pg/mL(median;<10-16.99pg/mL, interquartile range) and not different from those of patients at AHRF(10.82, <10-20.38pg/mL). There was also no significant difference between pre-ARDS(<10, <10-15.32pg/mL) and ARDS(<10, <10-10.22pg/mL). TNF-alpha levels were significantly greater in the patients with shock than the patients without shock(12.53pg/mL vs. <10pg/mL) (P<0.01). There was no statistical significance between survivors(< 10, <10-12.92pg/mL) and nonsurvivors(11.80, <10-20.8pg/mL) (P=0.28) in the plasma TNF-alpha levels. 2) Plasma IL-lbeta levels: Plasma IL-1beta levels were less than 0.3ng/mL, which is the lowest detection value of the kit used in this study, in one of each patients group. There was no significant difference in IL-1beta levels of the ARDS(2.22, 1.37-8.01ng/mL) and of the AHRF(2.13, 0.83-5.29ng/mL). There was also no significant difference between pre-ARDS(2.53, <0.3-8.34ng/mL) and ARDS(5.35, 0.66-11.51ng/mL), and between patients with septic shock and patients without shock (2.51, 1.28-8.34 vs 1.46, 0.15-2.13ng/mL). Plasma IL-19 levels were significantly different between survivors(1.37, 0.4-2.36ng/mL) and nonsurvivors(2.84, 1.46-8.34ng/mL). CONCLUSION: Plasma TNF-alpha and IL-1beta level are not a predictable marker for development of ARDS. But TNF-alpha is a marker for shock in septic syndrome. These result could not exclude a possibility of pathophysiologic roles of TNF-alpha and IL-1beta in acute lung injury because these cytokine could be locally produced and exert its effects within the lungs.
Acute Lung Injury ; Adult* ; Chungcheongnam-do ; Enzyme-Linked Immunosorbent Assay ; Humans ; Intensive Care Units ; Interleukin-1beta* ; Lung ; Lymphotoxin-alpha ; Necrosis ; Plasma ; Respiratory Distress Syndrome, Adult* ; Respiratory Insufficiency ; Shock ; Shock, Septic ; Tumor Necrosis Factor-alpha*

No abstract available.
Female ; Ovary* ; Teratoma*

Two cases of spontaneous kidney rupture with literatural review was presented at first in Korea. 1) 56 years male patient and 25 years male patient admitted to our department of Urology through Emergency Room after onset of 2 and 1 day. after treatment at local clinic. 2) Chief complaints were one side flank pain which was followed by total gross hematuria. 3) Preoperative diagnoses were kidney rupture due to necrotic pelvic tumor in 56 years male and hypernephroma in 25 years male patient. 4) Operation was procedured at 8 days and 4 days after admission respectively. 5) The operative procedure were nephrectomy in both cases. 6) The pathological diagnoses were pelvis rupture due to renal stone and parenchymal rupture due to renal infarction in each case.
Carcinoma, Renal Cell ; Diagnosis ; Emergency Service, Hospital ; Flank Pain ; Hematuria ; Humans ; Infarction ; Kidney* ; Korea ; Male ; Nephrectomy ; Pelvis ; Rupture ; Rupture, Spontaneous* ; Surgical Procedures, Operative ; Urology

Degenerative disc disease has traditionally been thought of as low back pain caused by changes in the nucleus pulposus and annulus fibrous, in recent studies, however, changes in the upper and lower endplates cause degeneration of the disc, resulting in mechanical pressure, inflammatory reactions and low back pain. Recently, the bone marrow of the vertebral body-endplate-nucleus pulposus and annulus fibrous were considered as a single unit, and the relationship was explained. Once the endplate is damaged, it eventually aggravates the degeneration of the bone marrow, nucleus pulposus, and annulus fibrosus. In this process, the compression force of the annulus fibrosus increases, and an inflammatory reaction occurs due to inflammatory mediators. Hence, the sinuvertebral nerves and the basivertebral nerves are stimulated to cause back pain. If these changes become chronic, degenerative changes such as Modic changes occur in the bone marrow in the vertebrae. Finally, in the case of degenerative intervertebral disc disease, the bone marrow of the vertebral body-endplate-nucleus pulposus and annulus fibrous need to be considered as a single unit. Therefore, when treating patients with chronic low back pain, it is necessary to consider the changes in the nucleus pulposus and annulus fibrosus and a lesion of the endplate.

BACKGROUND: In spite of the successful reperfusion therapy, coronary blood flow in infarcted myocardium was known to decrease for a long time. Abciximab is known to inhibit the final pathway of platelet aggregation and maintenance the large vessel patency. But abciximab may have another important effect beyond the these effect. TIMI frame count method is simple, reproducible, objective and quantitative index of coronary flow. We tried to define the effect of abciximab that used with primary angioplasty on the coronary blood flow using TIMI frame count methods. METHODS: We consecutively studied 30 patients who admitted for acute myocardial infarction without cardiogenic shock from September 1997 to August 1999. We analyzed the changes of corrected TIMI frame count(CTFC) between the baseline(immediate after the angioplasty) and follow-up(post-op 7th day) coronary angiogram and compared the results between the group of primary angioplasty with abciximab(abciximab group, n=1) and the group of primary angioplasty without abciximab(non-abciximab group, n=9). RESULTS: There were no differences between abciximab group and non-abciximab group in baseline characteristics, treatment modalities and angiographic results. According to the results of the comparison of deltaCTFC, changing rate of CTFC, deltavelocity and changing rate of velocity, there were significant improvement of the coronary blood flow in infarct related artery in the abciximab group than non-abciximab group. But there were no differences in the changes of coronary blood flow in non-infarct related artery between two groups. The frequency of major adverse coronary events during follow up periods(mean 6 months) were similar(9.1% and 5.2% each other, p>0.05). CONCLUSIONS: Abciximab used with primary angioplasty in acute myocardial infarction improved the coronary blood flow significantly in infarcted myocardium. This finding may be related that abciximab enhance the perfusion and function of microvasculature in infarcted myocardium.
Angioplasty* ; Arteries ; Coronary Vessels* ; Follow-Up Studies ; Humans ; Microvessels ; Myocardial Infarction* ; Myocardium ; Perfusion ; Platelet Aggregation ; Reperfusion ; Shock, Cardiogenic

In most cases, extubation may be safely performed in the operating rooms. However, some cases need leaving the endotracheal tube in place until the patient's condition is appropriate, usually in the Postaneshesia Care Unit (PACU) or Intensive Care Unit (ICU). We retrospectively reviewed the recovery room record of 4,241 patients who performed on operation under general anesthesia at Inha Hospital from January 1993 to December 1993, and then examined into details how many factors are influenced to the time of extubation following surgery. The results were as follows; 1) The overaU frequency of delayed extubation (or PACU extubation) was 9.8% (423/4,241). 2) The surgical disciplines which had the highest number and incidence of delayed extubations were the general surgery (172 cases) and dental surgery (25%), respectively. 3) According to sex, the male patients (243) outnumbered the female counterparts (180). 4) According to age, delayed extubation was most common among infants (<1 year of age) (21.4%). 5) According to operation site, delayed extubation occurred most commonly among operations involving upper abdominal regian (36.1%) followed by thoracic region (22.9%). In conclusion, extubation should be performed when the patient is nearly fuUy awake, of acceptable respiratory rate and depth, and when the effects of muscle relaxants have been fully reversed.
Anesthesia, General* ; Female ; Humans ; Incidence ; Infant ; Intensive Care Units ; Male ; Operating Rooms ; Recovery Room ; Respiratory Rate ; Retrospective Studies

Myasthenia Gravis is a chronic disease of disputed etiology, possibly an auto-immune reaction to the moter end-plate, characterized by exacerbations and remissions, a rare disease entity in Korea. Myasthenia Gravis has offered many anesthetic problems because it affects respiratory muscles occasionally and bronchial secretion from preoperative anticholinesterase therapy. The chief concern is to ensure adequate respiration both during and after operation. During the year 1976-1982, we have experienced the anesthetic management of 8 patients with myasthenia gravis and thymectomy. From our experiences, we conclude that respiratory care and disuse of relaxants is the key to successful management.
Chronic Disease ; Humans ; Korea ; Myasthenia Gravis* ; Rare Diseases ; Respiration ; Respiratory Muscles ; Thymectomy

Heart disease is one of the major cause of death in diabetic patients, but the thogenesis of diabetic cardio-myopathy remains unclear. In this experiment, to sess the significance of G protein signaling pathways in the pathogenesis of abetic cardiomyopathy, we analyzed the expression of G proteins and the tivities of second messenger dependent protein kinases: cAMP-dependent protein nase (PKA), DAG-mediated protein kinase C (PKC), and calmodulin dependent otein kinase II (CaM kinase II) in the streptozotocin induced diabetic rat art. The expression of Galphaq was increased by slightly over 10% (P<0.05) in abetic rat heart, while Galphas, Galphai, and Gbeta remained unchanged. The A activity in the heart did not change significantly but increased by 27%<0.01) in the liver. Insulin treatment did not restore the increased activity the liver. Total PKC activity in the heart was increased by 56% (P<0.01), and sulin treatment did not restore such increase. The CaM kinase II activity in e heart remained at the same level but was slightly increased in the liver 4% increase, P<0.05). These findings of increased expression of Galphaq in the reptozotocin-diabetic rat heart that are reflected by the increased level of C activity and insensitivity to insulin demonstrate that alteration of Galphaq y underlie, at least partly, the cardiac dysfunction that is associated with abetes. Copyright 2000 Academic Press.
Animal ; Ca(2+)-Calmodulin Dependent Protein Kinase/metabolism ; Cyclic AMP-Dependent Protein Kinases/metabolism ; Diabetes Mellitus, Experimental/metabolism* ; Diabetes Mellitus, Experimental/drug therapy ; Diabetes Mellitus, Experimental/chemically induced ; GTP-Binding Proteins/metabolism* ; Insulin/pharmacology ; Liver/metabolism ; Liver/drug effects ; Male ; Myocardium/metabolism* ; Protein Kinase C/metabolism ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; Streptozocin