A 41 year-old male underwent resection of a pheochromocytoma under general anesthesia. The patient was treated with phenoxybenzamine for 14 days preoperatively and premedicated with triflupromazine, diazepam, pethidine and hydroxyzine in combination. Following induction of anesthesia with intravenous morphine, thiopental sodium and alcuronium, endotracheal intubation was performed. As soon as intubation, tachycardia(143/min) and hypertension(170/100 mmHg) developed, but were controlled by intravenous injection of propranolol. Anesthesia was maintained with nitrous oxide, oxygen and enflurane, and alcuronium. Blood pressure during manupulation of tumor mass was 160/100 mmHg without arrhythmia but gradually was controlled to the range of 120-130/80-85 mmHg after intravenous infuaion of nitroglycerine at the rate of 0.5-2 ug/kg/min. After removal of the tumor mass, the blood pressure dropped to 100/70 mmHg. Blood pressure was controlled by I.V. low molecular weight dextran, and Hartmanns solution, but a vasoconstrictive agent was not needed. There was no marked tachycardia or arrhythmia during anesthesia. The importance of preoperative preparation, premedication, selection of anesthetics and nitroglycerne for controling the episodic hemodynamic pressure response is discussed.
Adult ; Alcuronium ; Anesthesia ; Anesthesia, General ; Anesthetics ; Arrhythmias, Cardiac ; Blood Pressure ; Dextrans ; Diazepam ; Enflurane ; Hemodynamics ; Humans ; Hydroxyzine ; Injections, Intravenous ; Intubation ; Intubation, Intratracheal ; Male ; Meperidine ; Molecular Weight ; Morphine ; Nitroglycerin* ; Nitrous Oxide ; Oxygen ; Phenoxybenzamine ; Pheochromocytoma* ; Premedication ; Propranolol ; Tachycardia ; Thiopental ; Triflupromazine

No abstract available.
Epidemiologic Studies*

Fifteen cases of corrective operation for the ascending aortic aneurysm performed under general anesthesia from 1979 to 1985 in Severance Hospital were studied retrospectively. There were ten male patients and 5 female and their average age were 36.6 years(range 25~50 years). Most of the patients showed aortic regurgitation. Thus the anesthetic management involved consideration for patients with aortic dissection combined with aortic incompetence(annuloaortic ectasia). Patients were premedicated with atropine or glycopyrrolate in 14 cases and a combination of triflupromazine, hydroxyzine, diazepam and pethidine in 13 cases or a combination of hydroxyzine and morphine in 2 cases. Anesthesia was induced with thiopental sodium and/or diazepam and/or midazolam and/or morphine IV. Morphine and a mixture of 50% nitrous oxide and oxygen was administered for maintenance of anesthesia. Supplementary volatile anesthetics were inhaled as needed. Vasodilating therapy and avoidance of bradycardia during anesthesia are the most importance considerations for the reduction of left ventricular wall tension and to maximize the myocardial oxygen supply while maintaining cardiac output. Operative complications were reoperation due to bleeding in four cases, myocardial infarction in two cases, pericardial tamponade and urethral track infection in one case each. One patient died of sepsis. Fourteen patients improved in their heart size and function.
Anesthesia ; Anesthesia, General ; Anesthetics ; Aortic Aneurysm* ; Aortic Valve Insufficiency ; Atropine ; Bradycardia ; Cardiac Output ; Cardiac Tamponade ; Diazepam ; Female ; Glycopyrrolate ; Heart ; Hemorrhage ; Humans ; Hydroxyzine ; Male ; Meperidine ; Midazolam ; Morphine ; Myocardial Infarction ; Nitrous Oxide ; Oxygen ; Reoperation ; Retrospective Studies ; Sepsis ; Thiopental ; Triflupromazine

Fourty one cases with coronary occlusive disease were anesthetised for aortocoronary bypass graft from May 1977 to December 1983 st Severance Hospital, Yonsei University Medical Center. The main anesthetic agents were diazepam-morphine-pancuronium-O2-N2O in most cases, and supplemented with halothane, enflurane of methoxyflurane in some cases. Nitroglycerin, nitroprusside, triflupromasine, and dopamine were used for keeping the hemodynamic stability before, during and after anesthesia depending on the needs. Two operative death occured in our early years. The mortality rate was 4.87% and no late deaths. The overall anesthetic management for aortocoronary bypass graft surgery is disscussed.
Academic Medical Centers ; Anesthesia* ; Anesthetics ; Coronary Artery Bypass ; Dopamine ; Enflurane ; Halothane ; Hemodynamics ; Methoxyflurane ; Mortality ; Nitroglycerin ; Nitroprusside ; Transplants*

PURPOSE: This study attempted to investigate the prevalence and related factors of Clonorchiasis among five major riverside residents in South Korea. METHODS: This study is descriptive research, nationwide survey, and the subjects are 23,492 residents selected by convenience sampling. Data collection was conducted between March 1 and June 30, 2011, and stool collection and questionnaire survey were conducted by affiliated public health centers in 38 cities and Gun's. RESULTS: The prevalence rates of Clonorchiasis in the five major riversides were as follows: the Guem River 15.2%; the Nakdong River 11.9%; the Seomjin River 10.9%; the Han River 5.7%; and the Yeongsan River 3.9%. The prevalence rates were shown to be significantly high among people who had highly frequent experiences of eating and cooking freshwater raw fish, were diagnosed with liver and/or biliary tract diseases, and drank less than once a month. CONCLUSION: These results suggest that it is necessary to improve awareness of Clonorchiasis and provide intensive public health education for the riverside residents. And the target groups should be set up by reflecting the characteristics of at-risk groups, and it is necessary to prepare customized strategies for prevention and management of Clonorchiasis.
Biliary Tract Diseases ; Clonorchiasis* ; Clonorchis sinensis ; Cooking ; Data Collection ; Eating ; Education ; Fresh Water ; Health Behavior ; Korea* ; Liver ; Parasite Egg Count ; Parasites ; Prevalence* ; Public Health ; Rivers

BACKGROUND: The rapid diagnostic tests for tuberculosis are needed to facilitate early treatment of tuberculosis and prevention of Mycobacterium tuberculosis transmission. The Xeniss Rapid TB kit is a rapid, card-based immunochromatographic test for the detection of antibodies directed against M. tuberculosis antigens including antigen 5(38-kDa antigen). The objective of this study was to evaluate the performance of the Xeniss Rapid TB kit for the diagnosis of active tuberculosis with serums from patients, asymptomatic healthy and close contact controls. METHOD: 188 patients with active tuberculosis were tested; 177 with pulmonary tuberculosis(18 with combined pleurisy), and 11 with extrapulmonary tuberculosis. The control groups were composed of 82 close contacts and 57 healthy adults. Study subjects were drawn from one national tuberculosis hospital for patients and close contacts, and another private hospital for healthy adults in Masan city, Korea. The Xeniss Rapid TB kit(Xeniss Life Science Co., Ltd., Seoul, Korea) was evaluated by using serum samples according to the instructions of the manufacturer by an investigator masked to the clinical and microbiological status of the study subjects. RESULTS: The diagnostic sensitivity of the Xeniss Rapid TB kit was 73.9% in patients and specificities were 73.2% and 93.0% in close contact and healthy adults respectively. The positive predictive value in patients was 84.2% and the negative predictive value in controls was 85.8%. CONCLUSIONS: This study shows that the Xeniss Rapid TB test is a simple and fast method to diagnose active TB. The results of the sensitivity and specificites suggest that serodiagnosis using this point of care testing(POCT) device would be valuable and advantageous for screening tuberculosis in the clinical field.
Adult ; Antibodies ; Biological Science Disciplines ; Diagnosis* ; Diagnostic Tests, Routine ; Hospitals, Chronic Disease ; Hospitals, Private ; Humans ; Korea ; Masks ; Mass Screening ; Mycobacterium tuberculosis ; Research Personnel ; Seoul ; Serologic Tests ; Tuberculosis*

PURPOSE: The purpose of this study was to examine the effects of a stress-management program on stress coping methods, interpersonal relations and quality of life in patients with chronic mental illness. METHODS: A nonequivalent control group pre-posttest design was used for this quasi-experimental study. The study was conducted from May 1 to December 30, 2010. The 41 participants in this study were selected from patients with chronic mental illness (20 for the experimental group and 21 for the control group). Datas were analyzed chi2-test, t-test, paired t-test, and one-way ANCOVA with the SPSS/WIN 15.0 program. RESULTS: There were significant changes in stress coping methods scores, interpersonal relations scores and quality of life scores in the experimental group before and after treatment, which were significantly different from those in the control group. CONCLUSION: The results of the study indicate that the stress-management program resulted in significant improvement in stress coping methods, interpersonal relations and quality of life for patients with chronic mental illness. Therefore, this study shows stress-management programs are useful in clinical practice as effective nursing interventions in patients with chronic mental illness.
Humans ; Interpersonal Relations* ; Nursing ; Quality of Life*

BACKGROUND AND OBJECTIVES: It has been demonstrated that the estimated infarct size is a prognostic variable which significantly influences the short-term and long-term prognosis after an acute myocardial infarction (AMI). Recently, the late peak level of troponin-T has been determined as a reliable and simple non-invasive method for estimation of infarct size. This study was performed to determine whether the late peak level of troponin-T can be used to predict cardiovascular events during in-hospital stay and out-patient follow-up in patients with AMI. MATERIALS AND METHOD: The study was comprised 100 patients (male 91, mean age 57+/-1 years) with AMI and thrombolysis which was initiated within 6 hours after the onset of symptoms. The late peak concentration of troponin-T was defined as a more larger level between 48 and 72 hours after thrombolysis. We investigated the factors influencing on the late peak level of troponin-T and assessed the relation of the late peak level and cardiovascular events. RESULTS: 1) The late peak level of troponin-T was significantly correlated with the peak creatine kinase (CK) level, (r=0.69, p=0.0001) but not ejection fraction of left ventricle (LVEF) at 7 days after AMI. The late peak level of troponin-T was significantly higher in patients with LVEF of <40% at 7 days after AMI (13.49+/-3.62 vs. 6.44+/-0.72, p=0.035) but not different by location of AMI and reperfusion status. 2) During clinical follow-up at a mean duration of 27 months, 1 cardiac death, 10 congestive heart failure, 8 recurrent infarction, and 20 post-myocardial infarction angina were occurred. 3) In patients who occurred cardiac events during in-hospital stay, the peak level of CK (4377+/-938 vs. 2661+/-234, p=0.001) and TIMI forward flow grade < 3 (5/13 vs. 6/55, p=0.022) were significantly higher, but the late peak level of troponin-T (8.69+/-1.22 vs. 6.91+/-0.79, p=0.021) and the peak level of troponin-T (21.09+/-2.29 vs. 13.28+/-1.37, p=0.021) were significantly higher in patients who occurred cardiac events during out-patient follow-up. On multi-variate analysis by logistic regression, the late peak level of troponin-T was predicted the cardiac events during clinical follow-up (CI 1.022-1.196, p=0.022). CONCLUSIONS: The late peak level of troponin-T is significantly correlated with peak CK level and higher in patients with LVEF of Creatine Kinase ; Death ; Follow-Up Studies ; Heart Failure ; Heart Ventricles ; Humans ; Infarction ; Logistic Models ; Myocardial Infarction* ; Outpatients ; Prognosis ; Reperfusion ; Troponin T*

PURPOSE: Iron deficiency anemia (IDA) is one of the most common nutritional deficiencies in children on a weaning diet. We investigated weaning practices in infants and children, as well as their mothers' knowledge about weaning. METHODS: We investigated 129 children with IDA and 166 without IDA (aged 6-36 months) who had visited 10 university hospitals between March 2006 and July 2007. We investigated the hematologic values of both groups. A questionnaire on weaning was answered by the mothers of these children. RESULTS: The hematologic values in the IDA group showed a significant difference from those in the comparison group (P<0.05). Children who were solely breastfed until 6 months of age were 85%, 34% (P<0.05), and weaning was started by 6.3, 6.4 months, respectively (P>0.05). Rice gruel, boiled rice, and fruit juice accounted for approximately 8 0% of the starting foods in both groups (P>0.05). Only 40% of the children in the IDA group had a balanced diet within a month, versus 38% in the comparison group. In response to questions about the necessity of iron-fortified foods for breast-fed infants, less than 50% of mothers in both groups answered correctly. In the IDA group, 42% showed serum ferritin less than 10 ng/ mL, while 92% showed serum MCV less than 72 fL. CONCLUSION: In conclusion, collection of information on history should be thorough for feeding and selective examinations for IDA in high-risk groups. Considering the adaptation period, we suggest beginning children on a weaning diet at 45 months. In addition, we need to educate mothers on weaning practice, especially on the necessity of iron-fortified foods for breast-fed infants.
Anemia, Iron-Deficiency ; Child ; Diet ; Ferritins ; Fruit ; Hospitals, University ; Humans ; Infant ; Iron ; Malnutrition ; Mothers ; Surveys and Questionnaires ; Weaning

PURPOSE: It has been postulated that dopamine release in the striatum underlies the reinforcing properties of nicotine. Substantial evidence in the animal studies demonstrates that nicotine interacts with dopaminergic neuron and regulates the activation of the dopaminergic system. The aim of this study was to visualize the dopamine release by smoking in human brain using PET scan with [11C]raclopride. MATERIALS AND METHODS: Five male non-smokers or ex-smokers with an abstinence period longer than 1 year (mean age of 24.4+/-1.7 years) were enrolled in this study. [11C]raclopride, a dopamine D2 receptor radioligand, was administrated with bolus-plus- constant infusion. Dynamic PET was performed during 120 minutes (3x20s, 2x60s, 2x120s, 1x180s and 22x300s). Following the 50 minute-scanning, subjects smoked a cigarette containing 1 mg of nicotine while in the scanner. Blood samples for the measurement of plasma nicotine level were collected at 0, 5, 10, 15, 20, 25, 30, 45, 60, and 90 minute after smoking. Regions for striatal structures were drawn on the coronal summed PET images guided with co-registered MRI. Binding potential, calculated as (striatal-cerebellar) /cerebellar activity, was measured under equilibrium condition at baseline and smoking session. RESULTS: The mean decrease in binding potential of [11C]raclopride between the baseline and smoking in caudate head, anterior putamen and ventral striatum was 4.7 %, 4.0 % and 7.8 %, respectively. This indicated the striatal dopamine release by smoking. Of these, the reduction in binding potential in the ventral striatum was significantly correlated with the cumulated plasma level of the nicotine (Spearman's rho=0.9, p=0.04). CONCLUSION: These data demonstrate that in vivo imaging with [11C]raclopride PET could measure nicotine-induced dopamine release in the human brain, which has a significant positive correlation with the amount of nicotine administered by smoking.
Animals ; Basal Ganglia ; Brain ; Dopamine* ; Dopaminergic Neurons ; Head ; Humans ; Magnetic Resonance Imaging ; Male ; Nicotine ; Plasma ; Positron-Emission Tomography ; Putamen ; Receptors, Dopamine D2 ; Smoke ; Smoking ; Tobacco Products