BACKGROUND: Respiratory depression with high dose of propofol during induction is one of the major complications. We studied the effects of midazolam as premedicant on frequency and duration of apnea and frequency of loss of consciousness in relation to single dose of propofol. METHODS: We selected 194 adult patients who had clear consciousness and no depression of respiration. We allocated patients randomly to control group and midazolam group. In midazolam group, we injected 0.06mg/kg of midazolam intravenously 10min before induction, and in control group, we did nothing. Under mask oxygenation with 100% oxygen, we administered a bolus of propofol (1, 1.5, 2 mg/kg to subgroup 1, 2, 3 respectively) intravenously. The change of respiration and loss of consciousness were observed. RESULTS: The frequency and duration of apnea increased with the dose of propofol in both control and midazolam group. But there were no difference between groups except frequency of apnea with 1.5 mg/kg of propofol. In control group, frequency of loss of consciousness increased with the increasing dose of propofol. But in midazolam group, nearly all the patients was slept without difference by the dose. CONCLUSIONS: Premedication with midazolam reduce the sleeping dose of propofol to induce anesthesia, so the frequency and duration of apnea which is caused by high dose of propofol can be decreased.
Adult ; Anesthesia ; Apnea* ; Consciousness ; Depression ; Humans ; Masks ; Midazolam* ; Oxygen ; Premedication ; Propofol* ; Respiration ; Respiratory Insufficiency ; Unconsciousness*

No abstract available.
Ambulances* ; Cardiopulmonary Resuscitation*

With simple abdomen, double contrast colon study, and ultrasongraphy, authors retrospectively analyzedradilogic findings of 46 cases which were proved periappendiceal abscess, due to perforation of appendix, byhistology or follow-up ultrasnongraphy from May in 1983 to July in 1985 at Yeung-Nam University Hospital. Theresuls obtained were as follows: 1. Of 46 cases, 24 cases were males and 22 cases females, with the results ofabove statistics, periappendiceal abscess was not influenced by sex. 2. Periappendiceal abscess was mostfrequently demonstrated in forties. 3. Comparison of ultrasonography and B.E. Pseudorenal pattern(Ultrasonography)- well defined defect (B.E.) Cystic pattern(Ultrasonography)- serrated defect (B.E.) 4. Missed 2 cases inultrasonography were detected in B.E., i.e. sensitivity of B.E. is higher than that of ultrasonography. 5.Differences of ultrasonography and B.E.
Abdomen ; Abscess ; Appendix ; Colon ; Female ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography

OBJECTIVES: The hospital standardized mortality ratio (HSMR) has been widely used because it allows for robust risk adjustment using administrative data and is important for improving the quality of patient care. METHODS: All inpatients discharged from hospitals with more than 700 beds (66 hospitals) in 2008 were eligible for inclusion. Using the claims data, 29 most responsible diagnosis (MRDx), accounting for 80% of all inpatient deaths among these hospitals, were identified, and inpatients with those MRDx were selected. The final study population included 703 571 inpatients including 27 718 (3.9% of all inpatients) in-hospital deaths. Using logistic regression, risk-adjusted models for predicting in-hospital mortality were created for each MRDx. The HSMR of individual hospitals was calculated for each MRDx using the model coefficients. The models included age, gender, income level, urgency of admission, diagnosis codes, disease-specific risk factors, and comorbidities. The Elixhauser comorbidity index was used to adjust for comorbidities. RESULTS: For 26 out of 29 MRDx, the c-statistics of these mortality prediction models were higher than 0.8 indicating excellent discriminative power. The HSMR greatly varied across hospitals and disease groups. The academic status of the hospital was the only factor significantly associated with the HSMR. CONCLUSIONS: We found a large variation in HSMR among hospitals; therefore, efforts to reduce these variations including continuous monitoring and regular disclosure of the HSMR are required.
*Hospital Mortality ; Hospitals/*statistics & numerical data ; Humans ; Logistic Models ; Outcome Assessment (Health Care)/standards ; Quality of Health Care/standards ; Republic of Korea

Kearns-Sayre Syndrome (KSS) is rare mitochondrial disorder characterized by chronic progressive external ophthalmoplegia, atypical retinal pigmentation and complete heart block. It is occasionally combined endocrinologic symptoms such as hypoparathyroidism, short stature, diabetes mellitus and hypothyroidism. We reported the effect of Coenzyme Q10 on total serum calcium concentration in 17 years old girl with KSS and hypoparathyroidism. The patients was treated with alfacalcidol (1alpha-OHD3), Coenzyme Q10 and oral calcium agent. Total serum calcium concentration had even remained within normal range and hypercalcemia was developed suddenly after treatment of combination of Coenzyme Q10 and alfacalcidol (1alpha-OHD3). After stop of all medication, her total calcium concentration was decreased to 7.6 mg/dL and remained in normal range with oral calcium (2 g/day) and Coenzyme Q10 (150 mcg/day) daily. The action of Coenzyme Q10 is not clearly defined but, we could explain Coenzyme Q10 activates the capacity of the patient to produce the active form of Vitamin D, 1alpha-OHD3.
Adolescent ; Calcium ; Diabetes Mellitus ; Female ; Heart Block ; Humans ; Hypercalcemia* ; Hypoparathyroidism* ; Hypothyroidism ; Kearns-Sayre Syndrome* ; Mitochondrial Diseases ; Ophthalmoplegia, Chronic Progressive External ; Pigmentation ; Reference Values ; Retinaldehyde ; Vitamin D

BACKGROUND: After the resurgence of endemic malaria case in 1993, the number of malaria cases is increasing in succeeding years and most of patients were soldiers who served in the northern parts of Kyeonggi-do and Kangwon-do. Because group donations of blood from soldiers are frequent in these area, it is possible that donated blood from these area cause malaria. So we examined blood donation history of malaria patients to know their donation behavior. METHODS: The subject was 1,671 malaria patients who were diagnosed in 1997 and referred to blood transfusion research institute and their past donation history, time and frequency of donation were examined. The database consisted of malaria patients and blood donors who are known to be related with transfusion-transmitted malaria has been retrieved at each red cross blood center for every blood donors. The results were analyzed from January to December, 1998. RESULTS: About 60% (1,017) of 1,691 malaria patients in 1997 had donated their blood before diagnosis. The number of one time donation was 268; two time 289; more than three time was 460. Two hundred thirty six donors were checked by malaria registry file. In 236 donors, 92 cases were diagnosed with malaria, 96 cases were suspected to have malaria, 48 cases were namesakes. Conclusion: Because some malaria patients donate their blood after their diagnosis, it would be necessary to operate 'the computerized retrieving programme'to detect their donation after the diagnosis. Also, an education for malaria patients for their risk of transmitting malaria and strict history taking from donors for malaria will be required.
Academies and Institutes ; Blood Donors* ; Blood Transfusion ; Diagnosis ; Education ; Gangwon-do ; Gyeonggi-do ; Humans ; Malaria* ; Military Personnel ; Red Cross ; Tissue Donors

No abstract available.
Acyclovir* ; Necrosis*

No abstract available.

STUDY DESIGN: In a prospective study of 38 patients undergoing lumbar pedicle screw instrumentation 200 pedicle hole were tested intraoperatively using electrical stimulation. OBJECTIVES: To evaluate the searching stimulus intensity at pedicle in Korean and to identify the most vulnerable root in transpedicular screw fixation of lumbosacral spine. MATERIALS AND METHOD: Electromyelogram(EMG) was monitored from eight lower extremity muscles bilaterally. Constant current stimulation pulses(0.2msec duration) were delivered through a ball-tipped nasopharyngeal probe used to evaluate each pedicle hole, and evaluated for searching stimulus intensity, the current necessary to evoked EMG RESULTS: The searching stimulus intensity above 5 mA were 194 cases(97.0%), above 7mA 151cases(75.5%), above 10 mA 107 cases(53.5%) and below 5 mA were 6 cases(3.0%). The vastus medialis muscle is most sensitive in L2(100%), L3(83.3%), tibialis anterior is in L4(68.4%), peroneus longus is in L5(44.2%) and gastrocnemious is in S1(64.5%). CONCLUSIONS: Stimulus-evoked EMG monitoring is a valuable and efficacious adjunct to lumbar pedicle screw instrumentation. A stimulation threshold greater than 5 mA reliably indicates adequate screw position and the root located at infero-medial side of pedicle is most vulnerab18 in transpedicular screw fixation.
Electric Stimulation ; Humans ; Lower Extremity ; Muscles ; Prospective Studies ; Quadriceps Muscle ; Spine

No abstract available.
Pregnancy*