The usefulness of a nondepolarizing muscle relaxant for endotracheal intubation is limited by its relatively slow onset of neuromuscular block compared to that achieved with succinylcholine. Several attempts have been made to produce a more rapid onset of muscle relaxation for endotracheal intubation. A large dose of nondepoarizing muscle relaxant may produce rapid onset but cauae undesirable side effects and a prolonged duration of neuromuscular block. The authors observed the degree of vocal cord relaxation and intubation condition 2 minutes after administration of atracurium and measured changes in mean arterial blood pressure and heart rate at the time of arrival in the operating room, just before abministration of atracurium, 2minutes after administration, and 5mins after intubation. The 40 of patients in this observation were divided into four groups. Group 1; 10patients, received 0.3 mg/kg of atracurium Group 2; 10patients, received 0.4 mg/kg of atracurium Group 3; 10patients, received 0.5 mg/kg of atracurium Group 4; 10patients, received 0.6 mg/kg of atracurium The results were as follows; 1) There were better intubating conditions in Group 3 and 4 than in Group 1 and 2(p<0.001). 2) Mean arterial blood pressure and heart rate did not change significantly after administration of atracurium in all four groups. From the above results we conclude that 0.5~0.6 mg/kg of atracurium provides satisfactory intubation condition 2 minutes after administration without hemodynamic changes.
Arterial Pressure ; Atracurium* ; Heart Rate ; Hemodynamics ; Humans ; Intubation ; Intubation, Intratracheal* ; Muscle Relaxation ; Neuromuscular Blockade ; Operating Rooms ; Relaxation ; Succinylcholine ; Vocal Cords

This study was to investigate the effect of the education about general nutrition knowledge on the acceptance of TV food advertisements in adolescents. Twenty hours of nutrition related education in home economics classes were done during 3 months, to conveniently selected 784 first grade middle school students living in large and small cities and rural areas of Chungnam Province. The education effects were evaluated through questionnaire surveys before and after the education and their comparative analysis. Average TV watching time was 2.92 +/- 1.66 hours per day, which was about one hour longer on weekends. Nearly half of the subjects watched TV mainly after 9 PM. After nutrition education, nutrition knowledge scores of total subjects were significantly increased from 7.73 +/- 2.16 to 10.25 +/- 2.51 with a full score of 16. Food attitude and food habit scores also significantly increased from 32.45 +/- 4.65 (full score 50) to 33.93 +/- 4.68 and from 36.20 +/- 5.70 to 37.29 +/- 5.87, respectively. The general acceptance of TV food advertisements scored 25.25 +/- 4.44 (full score 40) before education and 26.90 +/- 4.55 after education, which was significantly raised by the education. Acceptance scores of TV food advertisements showed significant positive relationships with the scores of nutrition knowledge, food attitudes, and food habits. In addition, TV watching time had negative relationships with nutrition knowledge, food attitudes, and food habits scores, but not with acceptance score of TV food advertisements. The above results suggested that school-based nutrition education improved slightly but significantly the attitude of accepting TV food advertisements maybe through increasing nutrition knowledge and making food attitudes and habits better. Nutrition education focused on the evaluation and acceptance of food advertisements are further needed to improve the TV food advertisement acceptance of adolescents.
Adolescent ; Chungcheongnam-do ; Education* ; Food Habits ; Humans ; Surveys and Questionnaires

Pheochromocytoma is functioning tumor which originates in the adrenal medulla or in chromaffin tissue along the paravertebral sympathetic chain. This tumor releases epinephrine and norepinephrine causing increase of peripheral resistance and resulting in increased blood pressure and reducing plasma volume. The anesthetic management of patients with pheochromocytoma presents many difficult problems such as hypertension, cardiac arrhythmias, and hypotension. A 40 year-old female underwent resection of pheochromocytoma under general anesthesia. Thiopental was used for induction followed N2O-O2-enflurane supplemented with fractional doses of fentanyl and vecuronium for muscle relaxation. Hypertensive crisis during induction of anesthesia and surgical manipulation of the tumor were managed with phentolamine and sodium nitroprusside, and premature ventricular beats were controlled with lidocaine. We experienced marked fluctuation of blood pressure during anesthetic course.
Adrenal Medulla ; Adult ; Anesthesia ; Anesthesia, General ; Arrhythmias, Cardiac ; Blood Pressure ; Epinephrine ; Female ; Fentanyl ; Humans ; Hypertension ; Hypotension ; Lidocaine ; Muscle Relaxation ; Nitroprusside ; Norepinephrine ; Phentolamine ; Pheochromocytoma* ; Plasma Volume ; Thiopental ; Vascular Resistance ; Vecuronium Bromide ; Ventricular Premature Complexes

No abstract available.
Humans ; Intensive Care Units* ; Critical Care* ; Korea*

No abstract available.
Anesthesia* ; Emergencies*

No abstract available.
Infection Control* ; Jeollanam-do*

OBJECTIVES: Temperamental and sociodemographic characteristics of developmentally delayed preschool children have not been adequately studied. This research compares temperamental and sociodemographic characteristics in 3 groups of preschool children: those with communication disorder (CD), those with mental retardation (MR), and those with pervasive developmental disorder (PDD). METHODS: One hundred ninety eight preschool children (160 males, 38 females, average age 37.8 months) with delayed language development were included in this study. Developmental status of children was assessed by Bayley scales of infant development II, and temperamental characteristics were assessed by PTQ (Parental Temperamental Questionnaire). Sociodemographic characteristics of children were assessed with a questionnaire developed by us. Subjects were divided into three groups according to Bayley scale and Childhood autism rating scale (CARS). RESULTS: CD groups showed higher scores on rhythmicity and persistence than MR and PDD groups. CD group showed lower scores on threshold of reaction than MR group. On intensity of reaction and quality of mood, CD group showed higher scores than the PDD group. Sociodemographic characteristics were not different among the 3 groups. CONCLUSION: There are differences in temperamental characteristics but not in sociodemographic characteristics among CD, MR, and PDD.
Autistic Disorder ; Child ; Child Development ; Child, Preschool* ; Communication Disorders ; Female ; Humans ; Intellectual Disability ; Language Development* ; Male ; Periodicity ; Surveys and Questionnaires ; Temperament* ; Weights and Measures

Combined anesthesia has been associated with less sedation, earlier ambulation, higher pulmonary flow rates, improved oxygenation, blunting of stress response and better pain control in the postoperative period than general anesthesia. Total intravenous anesthesia has many advantages compared with inhalation anesthesia, but also has several disadvantages such as hypertension, inappropriate anesthetic, delayed recovery and emergence delirium For improvement of this problems, the authors tried epidural anesthesia combined with continuous intravenous infusion of propofol which is a short acting intravenous anesthetic and has characteristics of rapid and clear-headed recovery. Fifty-three patients undergoing elective thoracic operation were randomly assigned to receive anesthesia with N2O-O2-enflurane (n=23), epidural anesthesia combined with N2O-O2-propofol infusion (3 mg/kg/hy; n=15), or epidural anesthesia combined with medical air-O2-propofol infusion (6 mg/kg/hy; n=15). We studied the hemodynamic changes and occurence of awareness and recovery time on those three groups. Although there were significant changes in the hemodynamics among the groups except CVP, but all values were within normal limit and there were no difference in the recovery time. We concluded that epidural anesthesia with medical air-O2-propofol infusion (6 mg/kg/hr) is acceptable altemative method for thoracic surgery.
Anesthesia ; Anesthesia, Epidural* ; Anesthesia, General ; Anesthesia, Inhalation ; Anesthesia, Intravenous ; Delirium ; Hemodynamics ; Humans ; Hypertension ; Infusions, Intravenous* ; Oxygen ; Postoperative Period ; Propofol* ; Thoracic Surgery* ; Walking

Objectives: To identify the clinical utility of the Korean version of the Barkley Deficits in Executive Functioning Scale (K-BDEFS) assessing executive functioning. Methods: The patient group included 144 adult attention-deficit/hyperactivity disorder (ADHD) patients visiting the Adult ADHD Outpatient Clinic of the National Center for Mental Health. Adult ADHD Self-Report Scale version 1.1, Mini International Neuropsychiatric Interview, and K-BDEFS were used. The control subjects were 144 age, sex, and education-matched general adults who participated in the study of the validity of the K-BDEFS in Samsung Medical Center. Results: An analysis of the mean total K-BDEFS score, executive functioning symptom count, and ADHD-executive function (EF) index score revealed a significant difference between the adult ADHD and control group (p<0.05). Five subscales of the K-BDEFS, which assess the specific domains of the executive function, revealed a significant difference between the ADHD group and control group (p<0.05). The area under curve (AUC) of the K-BDEFS total score, the EF symptom count, and the ADHD-EF index were 0.943, 0.949, and 0.908, respectively, in the analysis using the receiver operating characteristic curve. All AUC values were over 0.90. Therefore, KBDEFS is a reliable and valid screening instrument for diagnosing adult ADHD. In an assessment of the sensitivity and specificity of the cutoff scores, a cutoff of 183.5 points for the K-BDEFS total score, 26.5 points for the EF symptom count, and 23.5 points for the ADHD-EF index showed a reliable sensitivity and specificity above 80%. Conclusion To the best of the authors’ knowledge, this is the first study to examine the predictive validity and clinical utility of K-BDEFS in adult ADHD. The results suggest that the K-BDEFS could be used as a valid and reliable tool for the diagnosis and clinical intervention of adult ADHD.

A 55 years old female was admitted for nausea, vomiting and right upper quadrant pain. On the admission physical examination revealed icteric sclera and right upper quadrant tenderness. She had no history of surgery and alcoholic intake. The levels of bilirubin and liver enzyme(ALT, AST) were elevated without evidence of viral hepatitis. After abdominal sonography, CT and ERCP, diagnosis was cholelithiasis. The laparoscopic cholecystectomy was done under enflurane anesthesia for 90 minutes without transfusion of blood and blood products. On the 9th postoperative day, she was discharged with symptomatic improvement and almost normal laboratory data. On the 20th postoperative day, she was admitted for follow up study and elevated liver enzyme were found. On the 30th postoperative day, she had suffered from acute hepatitis with symptoms of nausea, vomiting, chilling and jaundice and marked elevation of ALT, AST and eosinophilia. There were no evidence of viral hepatitis and remnant stone. The liver function was more aggravated and more advanced parenchymal damage of liver was shown by liver scan and sonography but liver function was improved gradually after 55th postoperative day. She recovered gradually and went home in good health on the 105th postoperative day. Postoperative hepatotoxicity might be developed as a result of many causes and we had suspected enflurane but the exact causes in this case were still unknown.
Alcoholics ; Anesthesia ; Anesthesia, General* ; Bilirubin ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy, Laparoscopic ; Cholelithiasis ; Diagnosis ; Enflurane* ; Eosinophilia ; Female ; Follow-Up Studies ; Hepatitis* ; Humans ; Jaundice ; Liver ; Middle Aged ; Nausea ; Physical Examination ; Sclera ; Vomiting