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*

PURPOSE: To describe the MR features of intraspinal cysticercosis. MATERIALS AND METHODS: Medical records and MR images of four cases of intraspinal cysticercosis were retrospectively reviewed. The MR findings were described with regard to the location and signal intensity of the lesions, contrast enhancement, presence or absence of associated intracranial cysticerci, and other findings. RESULTS: There were three cases of subarachnoidal form and one case of intramedullary form. Cysticerci of subarachnoidal form in three cases were located in retromedullary space at C2 level, anterior to cord at C1 -C6 levels, and lumbosacral area, respectively. The signal intensities of the lesions were same as those of CSF. Localized arachnoidal enhancement was found in all three cases. In one case there was a large area of high signal intensity within the spinal cord on T2 weighted image suggesting either ischemia secondary to vascular compromise or inflammatory edema. All of these three cases accompanied intracranial cysticercosis. Intramedullary cysticercosis in one case was shown as a single I cm cystic lesion at C2 level, which showed hypointense signal on T1 weighted image, hyperintense signal on T2-weighted image, and signet-ring-like enhancement. This lesion did not accompany intracranial cysticerci. CONCLUSION: lntraspinal cysticercosis manifested as single or multiple cysts within either spinal cord or subarachnoid space, and were frequently associated with arachnoiditis.
Arachnoid ; Arachnoiditis ; Cysticercosis* ; Edema ; Ischemia ; Magnetic Resonance Imaging* ; Medical Records ; Retrospective Studies ; Spinal Cord ; Subarachnoid Space

PURPOSE: Authors reviewed CT and MR findings of patients with parapharyngeal masses, and their incidence and characteristic findings were studied. MATERIALS AND METHODS: We reviewed 27 CT and 9 MR of pathologically proven 29 patients with primary parapharyngeal mass Neurogenic tumor (17 cases) and other rare masses (3 carotid body tumors, 2 pleomorphic adenomas, 2 cavernous hemangiomas, 1 cavernous lymphangioma, 2 carotid artery pseudoaneurysms, 1 non-Hodgkin's lymphoma, 1 idiopathic cervical fibrosis) were included and the characteristic CT and MR findings were studied. RESULTS: Neurilemmoma was seen as a well-demarcated, solid mass of heterogeneous attenuation or intensity, so that pleomorphic adenoma of minor salivary gland origin could not be differentiated by demarcation, attenuation, or signal intensity of the tumor itself. The direction of carotid artery displacement was not constant in cases of neurilemmomas while the styloid process was constantly displaced laterally in all cases. Characteristic CT and MR findings of other rare tumors were described. CONCLUSION: Neurogenic tumor is the most common parapharyngeal space mass and the direction of displacement of styloid process might be helpful in differential diagnosis from pleomorphic adenoma. Other rare tumors showed very characteristic CT and MR finidings and could be differentiated easily.
Adenoma, Pleomorphic ; Aneurysm, False ; Carotid Arteries ; Carotid Body Tumor ; Diagnosis, Differential ; Hemangioma, Cavernous ; Humans ; Incidence ; Lymphangioma ; Lymphoma, Non-Hodgkin ; Neurilemmoma ; Salivary Glands, Minor

Anti-M antibody is usually a naturally occurring antibody reacting optimally 4 degrees C and is not considered to be clinically significant. Rarely has anti-M been implicated in hemolytic disease of the newborn(HDN) and the true incidence of HDN due to anti-M has not been well delineated. Authors report the second case of hemolytic disease of the newborn due to anti-M in Korea. A 3-days old baby boy was admitted due to jaundice and severe anemia which were developed at birth. The blood type of his mother was A, CcDEe, Ns, while the blood type of the infant of was A, CcDEe, MNs. The mother's serum had anti-M which wits strongnly positive in room temperature and albumin phase. The reaction was only weakly positive in the antiglobulin phase. Direct antiglobulin test of baby's red cells was negative, while the serum was weakly positive in polyethylene glycol-Coombs test. The antibody was found to be partially IgG through the treatment with dithiothreitol. After an exchange transfusion and phototherapy, the anemia and jaundice were corrected and and the patient discharged at the age of 16.
Anemia ; Coombs Test ; Dithiothreitol ; Humans ; Immunoglobulin G ; Incidence ; Infant ; Infant, Newborn* ; Jaundice ; Korea ; Male ; Mothers ; Parturition ; Phototherapy ; Polyethylene

PURPOSE: The purpose of this study is to describe the anglographic findings of collateral vessels in cervicofacial vascular lesions with previously ligated carotid arteries and to evaluate the extent of anglographic assessmant needed before embolization. MATERIALS AND METHODS: We retrospectively reviewed 10 cervicofacial vascular lesions with previously ligated carotid artery, which were 6 cases of arteriovenous malformation, 2 cases of carotid cavernous fistula, 1 case of hemangioma and 1 case of arteriovenous realformation with carotid cavernous fistula. The previously ligated arteries are proximal external carotid artery (n=5), branches of external carotid artery (n=2) and common carotid artery (n=3). Common carotid artery or internal carotid artery (n=9), vertebral artery (n=5), ipsilateral external carotid artery (n=4), contralateral external carotid artery (n=5), costocervical trunk (n=2), thyrocervical trunk (n=2) were assessed by conventional angiography. Angiography of both carotid and vertebral arteries was performed in 5 cases. RESULTS: The collateral vascular channels were inferolateral trunk of internal carotid artery (n=8), vertebral artery (n=5), contralateral external carotid artery (n=5), ipsilateral external carotid artery (n=4), deep cervical artery (n=2) and ascending cervical artery (n=l). Embolizations were performed in 9 cases with operative cannulation(n=4), embolization via collateral branches of ipsilateral external carotid artery (n=l), embolization via collateral branches of contralateral external carotid artery (n=3) and balloon occulusion via direct puncture (n=l). CONCLUSION: The collateral channels in cervicofacial vascular lesions with previouly ligated carotid artery were inferolateral trunk of internal carotid artery, contralateral or ipsilateral external carotid artery, vertebral artery, deep cervical artery and ascending cervical artery on angiography. Complete anglographic assessment of possible collateral channels is mandatory for the effective and safe embolization.
Angiography ; Arteries ; Arteriovenous Malformations ; Carotid Arteries* ; Carotid Artery, Common ; Carotid Artery, External ; Carotid Artery, Internal ; Fistula ; Hemangioma ; Punctures ; Retrospective Studies ; Vertebral Artery

No abstract available.
Acneiform Eruptions ; Bevacizumab

PURPOSE: With the increase of foreigners using Korea health facilities, it is important for nurses to be culturally competent. Thus, the purpose of this study was to examine the effects of a cultural competence educational program on the cultural competence of nursing students. METHODS: A quasi-experimental study with a non-equivalent control group pretest-posttest design was used. For the experimental group there were 42 participants from one school and for the control group, 40 from another school. The experimental group participated in the 14 week multicultural nursing education program while the control group participated later after the experiment was finished. Data were collected using self-report structured questionnaires prior to the intervention and right after the intervention, and were analyzed using descriptive statistics, χ² test, and independent t-test with SPSS 18.0 program. RESULTS: The experimental group reported significant positive changes for cultural knowledge (t=3.99, p<.001), cultural awareness (t=3.92, p<.001), cultural acceptance (t=2.25, p=.027), and cultural competence behaviors (t=4.30, p<.001) compared to the control group. CONCLUSION: The results of the study indicate that the cultural competence educational program developed by the researchers is effective in raising the level of cultural knowledge, cultural awareness, cultural acceptance, and cultural competence behaviors of nursing students.
Cultural Competency* ; Education, Nursing ; Emigrants and Immigrants ; Health Facilities ; Humans ; Korea ; Non-Randomized Controlled Trials as Topic ; Nursing* ; Students, Nursing* ; Transcultural Nursing

No abstract available.
Nephrosis, Lipoid*

No abstract available.
Malaria*

PURPOSE: After Langendorff made aortic perfusion system with the extracted animal heart for the experimental study regarding cardiac mechanical action and rhythm, this system has been modified by various methods for the hemodynamic studies. The authors developed cardiac perfusion system using personal computer for mechanical cardiac contraction and electrophysiologic studies without the effects of autonomic nervous system and hemodynamic influences from various causes. METHODS: This system consisted of perfusion system, electrical pulse generator, and data acquisition system. the perfusion system has reservoir containing physiologic solution, heat exchange system, and organ chamber. The pulse generator composed of personal computer and digital/analog converter can produce electrical pulses with adjustable amplitude and cycle length. The mode of stimulations were as follows; maintenance, programmed, and burst mode. The data acquisition system was composed of amplifier, analog/digital converter, and AcqKnowledge program that are provided by Biopac system. The data were sampled at 1kHz as a digitized form, and the noises wee reduced by filtering at band width 30-500Hz. Krebs' solution was used as perfusate through the aorta of isolated heart with mean pressure of 40mmHg. RESULTS: With this system, AH and HV interval, refractory period of AV node and His-Purkinje system, and Wenckebach cycle length were measured. CONCLUSION: Studies for cardiac mechanical contraction as well as electrophysiologic properties in vitro with or without specific cardiac drugs would be possible with this system in isolated experimental heart without autonomic nervous effects.
Animals ; Aorta ; Atrioventricular Node ; Autonomic Nervous System ; Electrophysiology ; Heart ; Hemodynamics ; Hot Temperature ; Humans ; Microcomputers* ; Noise ; Perfusion*