No abstract available.
Animals ; Calcitonin* ; Female ; Osteoporosis* ; Ovariectomy* ; Rats* ; Tamoxifen*

The purpose of this study was to investigate the incidence rate of hepatitis B in the military service and to examine the effect of the asymptomatic HBsAg carriers on the incidence of hepatitis B. The subject were 223,270 men who were conscripted to the Korean Army from 1991 to 1994 year. According to the conscripted year, four conscription cohort were constructed. At the screening examination for military service no test for hepatitis B were performed in 1991 and 1992. In 1993, a screening test for hepatitis B were performed and those who were confirmed as HBsAg positive or > or = SGPT 100IU were excluded from conscription. In 1994, the criteria for conscription was changed and those who were HBsAg positive were not excluded from conscription. Only those who were > or =SGPT 100IU were excluded. The main results were as follows ; 1. The positive rate of HBsAg is 5.5% in the conscripted men. 2. The incidence rates of the hepatitis B in 1991 and 1992 conscription cohort were 9.96 and 8.10 per ten thousand per son - year, respectively. The incidence rate of the hepatitis B was 1.34 per ten thousand per son - year in 1993 conscription cohort which was confirmed as HBsAg negative at the screening test, and 7.41 per ten thousand per son - year in 1994 conscription cohort which included the HBsAg positive. 3. The incidence rate of hepatitis B was 99.98 per ten thousand per son- year in HBsAg positive group and 2.25 per ten thousand per son - year in HBsAg negative group. The incidence rate of the group with high SGPT and HBsAg positive was 255 times higher than that of normal population. 4. The incidence of hepatitis B in HBsAg negative group did not increase even though the probability of personal contact with HBsAg positive had been increased. From the above result s, the men who have high SGPT with HBsAg positive should be excluded from military service, and it can not be said that asymptomatic HBsAg carrier s influence on the hepatitis B incidence among the HBsAg negative through personal contact.
Alanine Transaminase ; Cohort Studies ; Hepatitis B Surface Antigens* ; Hepatitis B* ; Hepatitis* ; Humans ; Incidence* ; Male ; Mass Screening ; Military Personnel*

The management of ipsilateral fractures of the femoral neck and shaft has proved to be a challenge to the orthopedist. Most major institutions have treatment protocols that emphasize early rigid stabilization of the femoral neck fracture to minimize the incidence of avascular necrosis of the femoral head and the shaft fractures were fixed prior to definitive neck stabilization. Whenever possible, patients should be followed for a minimum of three years to rule out aseptic necrosis of the femoral head. These dual fractures are usually encountered in the young, associated with high-velocity accidents and usually accompanied by multiple system trauma. At the department of orthopedic surgery, Eul Gi General Hospital, from June, 1986 to August, 1993, 21 cases of the concomitant ipsilateral femoral neck and shaft fractures had been treated. The mean follow-up was 2.8 years(ranging from 1.6 to 5.8 years). The diagnosis of femoral neck fracture was delayed in two patients. Seventeen of the 21 cases underwent surgery had a relatively satisfactory functional outcome without complication of femoral head. In two patient, a symptomatic varus nonunion and varus malunion developed. In two cases, osteonecrosis of femoral head developed and one case of these patients was treated with Meyer techniqe of muscle pedicle graft. Our series emphasize that the recommended treatment consists of a closed intramedullary fixation of the femoral shaft fracture followed by ASNI screw fixation of the femoral neck fracture, with good long term functional results and minimum complication. And approaches to the treatment of concomitant femoral neck and femoral shaft fractures should be selected according to the skill and experience of the surgeon and the availability of equipment.
Clinical Protocols ; Diagnosis ; Femoral Neck Fractures ; Femur ; Femur Neck ; Follow-Up Studies ; Head ; Hospitals, General ; Humans ; Incidence ; Neck ; Necrosis ; Orthopedics ; Osteonecrosis ; Transplants

Due to the increased use of tracheostomy and intermittent positive pressure ventilation, patients with trscheal stenosis have become more frequent. Recently we experienced a patient with tracheal stenosis who was tracheostomized upon admission, but unfortunately the stenotic lesion was located below the end of the tracheostomy tube. The stenotic lesion was l.6cm above the carina, its diameter was 0.5 cm, and the length of the stenotic segment was about 2cm, A3,5 mm(I.D.) endotracheal tube was passed through the stenotic lesion via the tracheostomy site, and high frequency jet ventilation was applied with a swivel connector. Immediately after the start of surgery, CO2retention occurred and the driving gas pressure increased from 4p to 5p psi, the I:E ratio from 1:2 to 1: 3, but the respiration rate (100 bpm) was maintained as before. CO2retention was relieved soon. Following end to end anastomosis a 6. 0 mm(I.D.) cuffed endotracheal tube was intubated orally and inhalation anesthesia using N2O-O2-Halothane was maintained until the surgery was completed.
Anesthesia, Inhalation ; Constriction, Pathologic ; High-Frequency Jet Ventilation ; Humans ; Intermittent Positive-Pressure Ventilation ; Respiratory Rate ; Tracheal Stenosis* ; Tracheostomy

The use of LASER in medicine has increased since the early 1960s. The advantages of LASER are clear cut, less bleeding, less post-operative edema and rapid wound healing. But the disadvantages are penetration of normal tissue, endotracheal of tube ignition or penetration and chronic exposure. Therefore, through managemnt of anesthesia is required in the usuage of the LASER for the laryngeal surgery. We have experienced anesthesia in 28 cases of ENT patients using CO2 LASER without specific problems except one patient, who had the complication of penetration of the endotracheal tube cuff by the LASER beam after the main procedure. The anesthetic management to avoid LASER complications and emergency treatment after the complication are discussed with references.

No abstract available.
Humans

When the endotracheal tube is removed, blood pressure elevates and heart rate increases. In order to evaluate the hemodynamic changes after removal of a new developed device-laryngeal mask airway, we measured the change of the systolic & diastolic blood pressure and heart rate of 120 patients undergoing general anesthesia. The results were elevation of blood pressure and heart rate after extubation or removal on both groups immediately. But the degree of changes were 18.7+/-1.6% in the endotracheal tube groups and 12.3+/-1.4% in the laryngeal mask airway groups in systolic blood pressure respectively. Therefore the degree of changes of the laryngeal mask airway groups was significantly small (p<0.05). The comparison of the change of diastolic blood pressure was not significant. The degree of the change in heart rate was 19.6+/-2.8% in the endotracheal tube groups and 9.2+/-2.2% in the laryngeal mask airway groups. Therefore the degree of the ehange in blood pressure and heart rate of the laryngeal mask airway groups was significantly small (p<0.05).
Anesthesia, General ; Blood Pressure* ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Laryngeal Masks* ; Masks

BACKGROUND: Hyperbaric oxygen (HBO) therapy is applied for the treatments of various diseases inducing hypoxic states. However, reoxygenation of previously hypoxic tissue results in significant tissue damages through the mechanisms of oxygen toxicity. The authors investigated the characteristics of the EEG changes by hyperbaric oxygenation after the exposure to carbon monoxide, and the protective effects of allopurinol, an inhibitor of xanthine oxidase (XO), to the brain. METHODS: Sixty eight male rabbits of New Zealand white weighing 1,350-2,000 gm, were used. The rabbits were divided in 4 groups and measured EEG for 21 hours of experiments. RESULT: The delta waves were significantly increased and alpha waves significantly decreased, during CO exposure, HBO exposure only, and HBO exposure after CO exposure (P< 0.05 in all groups). The wave changes were most remarkable in CO-HBO group, and in this case the changes continued to the last period of the ambient air exposure stage. The brain injury did not decrease as appeared in EEG changes in rabbits treated with allopurinol. This result suggests that many other mechanisms might be involved in CO-HBO condition. The paroxysmal electrical discharges were mostly appeared during or after HBO exposure stages. CONCLUSION: The changes of EEG characteristic in hyperbaric oxygenation are the increase of delta wave and electrical paroxysmal discharges. There is no protective effect of allopurinol to the brain, which suggests that many other mechanisms other than XO might be involved.
Allopurinol ; Brain ; Brain Injuries ; Carbon Monoxide* ; Carbon* ; Electroencephalography* ; Humans ; Hyperbaric Oxygenation ; Male ; New Zealand ; Oxygen ; Rabbits ; Xanthine Oxidase

Intractable pain associated with advanced cancer is an important and complicated clinical problem. One hundred and forty cases with cancer pain were treated by several nerve blocking techniques at the pain clinic of Yonsei Medical Center during 4 year period from January 1978 to December 1981. These cases had intractable pain from non-resectable or recurrent cancer of the stomach (35 cases), pancreas(24 cases), lung (17 cases), uterine cervix(14 cases), rectum (13 cases), colon, lymphoma, liver, gall bladder and the others. After careful evaluation, they were given celiac plexus block with pure and/or 50% alcohol in 73 cses, intrathecal block with 10% phenol glycerine in 19 cases, continuous epidural block with 1% lidocaine in 35 cases and micellaneous nerve blocks including sympathetic ganglion block and local infiltration in 13 cases. Good to excellent pain relief was achieved in the aobve groups as follows: celiac pleuxs, 93.2%: intrathecal, 89.5%: continuous epidural, 60,5%: miscellaneous, 61.5%. Over all after block, life duraion ranged from 2 weeks to 12 months with an average of 2.4 months. When patients are selected carefully, and the block is performed with great caution, risk is minimal, and long lasting relief of intractable pain is possible in the majority of these patients led normal lives until they died.
Celiac Plexus ; Colon ; Ganglia, Sympathetic ; Glycerol ; Humans ; Lidocaine ; Liver ; Lung ; Lymphoma ; Nerve Block* ; Pain Clinics ; Pain, Intractable ; Phenol ; Rectum ; Stomach Neoplasms ; Urinary Bladder

Objective: To describe the burden of severe acute respiratory infection (SARI) and the infrastructure and current practices of SARI management in hospitals in Viet Nam. Methods: We conducted a short observational study at critical care units (CCUs) in 32 district hospitals and 16 provincial hospitals in five provinces in Viet Nam from March to July 2019. We collected data on hospital equipment and medicines used in SARI management. At the patient level, data were collected for 14 consecutive days on all patients presenting to CCUs, including information on demographics, intervention and treatment within 24 hours of CCU admission and 7-day outcome. Results: There were significant differences between district and provincial hospitals in the availability of microbial culture, rapid influenza diagnostic tests, inflammatory markers and mechanical ventilation. Among 1722 eligible patients admitted to CCUs, there were 395 (22.9%) patients with SARI. The median age of SARI patients was 74 (interquartile range: 58–84) years; 49.1% were male. Although systemic antibiotics were available in all hospitals and were empirically given to 93.4% of patients, oseltamivir was available in 25% of hospitals, and only 0.5% of patients received empiric oseltamivir within 24 hours of admission. The 7-day mortality was 6.6% (26/395). Independent factors associated with 7-day mortality were septic shock and requiring respiratory support within 24 hours of admission. Discussion: SARI is a major burden on CCUs in Viet Nam. Barriers to delivering quality care include the limited availability of diagnostics and medication and non-protocolized management of SARI in CCUs.