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

No abstract available.
Pregnancy*

The Marfan syndrome is classified as a heritable disorder of connective tissue with clinical and pathological alterations involving supporting elements. In its classic form, the Marfan syndrome is associated with abnormalities of the eye(ectopia lentis), aorta(aortic dilatation and aortic regurgitation) and skeleton(dolichostenomelia, arachnodactyly and pectus deformity). The authers have experienced a case of marfan syndrome recently. The patient was 30-years-old male complaining of anterior chest pain radiating to upper back. Physical examination showed tall status, increased length of the limbs as compared with the trunk and arachnodactyly. On auscultation, heart sound was normal without murmur. He wore glasses because of moderate myopia. Roentgenogram of the chest P-A revealed normal cardiac and aortic contours and lung fields. Left lateral view of chest X-ray revealed concave depression of sternum showing mild pectus excavatum, fusiform dilatation of aorta from aortic root to mid portion of thoracic aorta and resulting in obliteration of retrosternal clear space. Echocardiogram demonstrated moderate dilatation of aortic root A-P diameter(4.5cm) without aortic or mitral valvular abnormalities and normal size of left ventricular cavity(EDD:5.3cm). These data coupled with a distinct family history could permit the diagnosis of Marfan syndrome.
Aorta ; Aorta, Thoracic ; Arachnodactyly ; Chest Pain ; Connective Tissue ; Depression ; Diagnosis ; Dilatation ; Extremities ; Eyeglasses ; Funnel Chest ; Glass ; Heart Auscultation ; Humans ; Lung ; Male ; Marfan Syndrome* ; Myopia ; Physical Examination ; Sternum ; Thorax

Our hospital has been experienced pulmonary edema during general anesthesia for cesarean section of pre-eclampsia. But, the patient recovered rapidly without complication. Therefore, we think that before anesthesia, accurate laboratory data and careful attention are needed for general anesthesia of pre-eclamsia.
Anesthesia ; Anesthesia, General* ; Cesarean Section ; Female ; Humans ; Pre-Eclampsia* ; Pregnancy ; Pulmonary Edema*

PURPOSE: The purpose of this study was to examine the relationship of job stress, hardness and burnout among emergency room nurses. METHODS: The subjects were 110 emergency room nurses from three university hospital and three general hospital, with more than 500 beds, in G city and J region. Data collection was done from October 11 to November 12, 2010. RESULTS: The score of job stress was 3.8 out of 5 point, the score of hardness was 2.6 out of 4 point, and the score of burnout was 3.3 out of 5 point. Burnout was found to be in a significant positive correlation with job stress and significant negative correlation with hardness. The main predictors of burnout were to hardness, job stress and night duty, and these variables explained 45.2% about burnout. CONCLUSION: In conclusion, the higher job stress was in higher burnout and the higher hardness was in the lower burnout. It is necessary to create improvement ways and programs to reduce and prevent burnout of emergency room nurses.

PURPOSE: The purpose of this study was to examine the relationship of job stress, hardness and burnout among emergency room nurses. METHODS: The subjects were 110 emergency room nurses from three university hospital and three general hospital, with more than 500 beds, in G city and J region. Data collection was done from October 11 to November 12, 2010. RESULTS: The score of job stress was 3.8 out of 5 point, the score of hardness was 2.6 out of 4 point, and the score of burnout was 3.3 out of 5 point. Burnout was found to be in a significant positive correlation with job stress and significant negative correlation with hardness. The main predictors of burnout were to hardness, job stress and night duty, and these variables explained 45.2% about burnout. CONCLUSION: In conclusion, the higher job stress was in higher burnout and the higher hardness was in the lower burnout. It is necessary to create improvement ways and programs to reduce and prevent burnout of emergency room nurses.

Paraffinoma is a well known complication of previous paraffin injection into the subcutaneous layer that presents as various conditions including firm mass formation, edema, induration, ulceration, and skin necrosis. Paraffinoma can mimic neoplasm on physical examination and imaging studies and may complicate ultrasonographic diagnoses due to typical posterior shadowing and high echogenicity. When paraffinomas involve around the thyroid gland, the diagnosis of thyroid tumors is very difficult. We present a case of thyroid cancer, the evaluation of which was complicated by the presence of cervical paraffinoma.
Edema ; Hydrazines ; Necrosis ; Paraffin ; Physical Examination ; Shadowing (Histology) ; Skin ; Thyroid Gland ; Thyroid Neoplasms ; Ulcer

Hysterosalpingograms of 375 patients with infertility were reviewed with reference to radiological features of each pathology and a comparative study of hysterosalpingography and laparoscopy in 36 patients was presented. The results were as follows; 1. In 375 cases infertility, 191 cases (50.9%) were primary infertility and 181 cases(49.1%) were secondary infertility. 2. The peak age distribution was 26 to 30 year old group in 211 cases (56.3%),and the peak duration of infertility was less than 3 years in 256 cases (68.3%). 3. Abnormal uterine findings were 115 cases (30.7%) and there were 73 cases of filling defects, 13 cases of irregularity , 12 cases of uterineflexion, 11 cases of congenital anomaly, and 9 cases of hypoplasia among them. 4. Abnormal tubal findings were 196 cases (52.3%) and there were 103 cases of simple obstruction, 69 cases of hydrosalpinx, and 50 cases of peritubal adhesion among them. 5. Intravasation of contrast media was noted in 42 cases (11.2%). 6. In 36 cases of laparoscopy, 23 cases (63.7%) was agreed to hysterosalpingography. 7. Aothough laparoscopy was better than hysterosalpinography in external anatomy of salpinx and relationship to overay, hysterosalpingography should be important for fundamental study of infertile women because of lower failure rate, lower risk of complications,therapeutic effect, and lower cost.
Age Distribution ; Contrast Media ; Fallopian Tubes ; Female ; Humans ; Hysterosalpingography ; Infertility ; Laparoscopy ; Pathology

PURPOSE: The purpose of this study is to evaluate the differences of the clinicopathological features and survival rates in gastric cancer according to the sex of the patients. MATERIALS AND METHODS: We reviewed 5,784 cases of gastric cancer patients who underwent laparotomy at the Department of Surgery, Seoul National University Hospital fmm Jan. 1986 to Dec. 1995. We have analyzed clinicopathologic features including tumor location, Bonmann type, depth of invasicm, lymph node metastasis, distant metastasis, TNM stage, histologic differentiation and survival rates according to the sex of the patients. RESULTS: The mean age of female patients was 52.4 years, which is lower than that of male, 54.8 years. There were no differences in tumor location, Borrmann type, depth of invasion, lymph node metastasis, distant metastasis, TNM stage of tumor between male and female. But there were some differences in histologic differentiation; well- and moderately differentiated cancers were more common in male and signet-ring cell cancers were more common in female. Female shows slightly better prognosis than male. But the prognosis of young female was poorer than that of young male. CONCLUSION: In gastric cancer patients, differences in histologic differentiation and more aggressive nature of the signet-ring cell cancer in female may affect the survival differences according to the sex.
Female* ; Humans ; Laparotomy ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Prognosis ; Seoul ; Stomach Neoplasms* ; Survival Rate

BACKGROUND: Helicobacter pylori (H. pylori) is closely associated with gastritis, peptic ulcer and gastric carcinoma. We evaluated the reliability and usefulness of 73C-urea breath test (13C-UBT) for the detection of H. pylori infection and searched for the cut-off value of the test. METHOD : We investigated 45 patients, who underwent esophagoduodenoscopy with multiple biopsy specimens taken for culture, histology and rapid urease test, and 13C-UBT. Sensitivity and specificity of UBT were calculated against the combined biopsy-based test results. RESULT: Of 45 patients, 26 were found to be H. pylori-positive according to combined biopsy-based test-results. Sensitivity and specificity of the 13C-UBT were 100.0% and 89.5 %, respectively. CONCLUSION: The urea breath test provides a simple and reliable and noninvasive method of assessing HL pylori infection status.
Biopsy ; Breath Tests* ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Peptic Ulcer ; Sensitivity and Specificity ; Urea* ; Urease