No Abstract available.
Chungcheongnam-do* ; Infection Control*

No abstract available.

There are many reports that d-tubocurarine has marked species and individual variations in the matter of muscle relaxation. Therefore the dose-related neuromuscular blocking effect of d-tubocurarine was studied in anesthetized patients. Eighty adult patients were studied during halothane-N2O-O2 anesthesia for various kinds of surgery. These patients were in good physical shape, without known or suspected liver, kidney, neuromuscular or hormonal disease, and were not taking medication known to influence the action of relaxants. Preanesthetic medication consisted of atropine 0.01mg/kg and valium 0.18 mg/kg intramuscularly 60 minutes before anesthesia. Anesthesia was induced with thiopental 4~5mg/kg. Succinylcholine 1mg/kg was used to faciliate tracheal intubation. Moderate hyperventilation was maintained throughout by a mechanical ventilator and patient temperature was maintained at 35~36 degrees C during the study. Forty patients received a single intravenous d-tubocurarine 0.1mg/kg(group A) after the succinylcholine effect had worn off and the other forty patients received a single intravenous d-tubocurarine 0.2mg/kg(group B) after the succinylcholine effect had disappered. Prior to the administration of d-tubocurarine, the patient's forearm and hand were firmly fixed to a specially constructed metal armboard. The thumb was abducted, fixed and connected to a electrical kymograph, Harvard apparatus. The ulnar nerve was stimulated at the wrist subcutaneous needle electrodes by means of supramaximal stimull from a peripheral nerve stimulator(model 91-M3, Emerson, USA). Square wave of "Train of Four" stimuli of 0.2msec duration were delivered at a frequency of 0.1Hz. The evoked twitch and tracing of the adductor muscle of the thumb was recorded continuously on a electrical kymograph. Upon recovery from the initial dose of succinylcholine, a stable baseline twitch tension was recorded for 15 minuts. At this point a single intravenous injection of d-tubocurarine, either 0.1mg/kg or 0.2mg/kg, was given. The data were plotted as onset time of twitch depression and percentage depression of twitch height and the recovery time of "Train of four" response were analysed in each group. The results were as follows: 1) In d-tubocurarine 0.1mg/kg group: the effect of d-tubocurarine was variable, ranging from no effect on twitch tension to abolition of the twitch response. Mean maximal twitch depression was 59.4%. Recovery index which showed more than 75% twitch depression was 39.9minutes. 2) In d-tubocurarine 0.2mg/kg group: the effect of d-tubocurarine obtained consistent and solid neuromuscular relaxation. Mean maximal twitch depression was 95.2%. Recovery index was 58.1 minutes.
Adult ; Male ; Female ; Humans

OBJECTIVE: Interhemispheric subdural hematoma (IHSDH) is uncommon, because of their unusual location. However, it is a distinct lesion with its unique characteristics. We investigated clinical features and outcomes of consecutive 42 patients with IHSDH, retrospectively. METHODS: From 2006 to 2015, we treated 105 patients with IHSDH. All patients were diagnosed by computed tomography (CT) or magnetic resonance imaging. We selected 42 patients with thick (3 mm or more) IHSDH. We retrospectively reviewed the clinical and radiological findings, management and outcomes. RESULTS: The male to female ratio was 2:1. Two thirds of the patients were over 60 years old. Slip or fall was the most common cause of trauma. The level of consciousness on admission was Glasgow Coma Scale (GCS) 13 to 15 in 25 patients. The most common symptom was headache. All IHSDH was hyperdense in CT at the time of diagnosis. IHSDH frequently accompanied convexity subdural hematoma. The outcome was favorable in 27 patients, however, six patients were expired. Twenty-two patients were managed conservatively. Surgery was performed in ten patients to remove the concurrent lesion. The outcome was poor in spontaneous one, patients with low GCS, and patients with conservative treatment. CONCLUSION: IHSDH is rare especially the isolated one. The outcome was dependent to the severity of injury. Surgery may be helpful to remove the concurrent mass lesion, however, conservative treatment is generally preferred.
Consciousness ; Craniocerebral Trauma ; Diagnosis ; Female ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Headache ; Hematoma, Subdural* ; Humans ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; Symptom Assessment

OBJECTIVE: From November 30, 2016, the Korean Government carried the revised Medical Dispute Mediation and Arbitration Act into effect. Mediation will start automatically without agreements of the defendant, when the outcome of the patient was death, coma more than a month or severe disability. Cerebral aneurysm has a definite risk of bad outcome, especially in the worst condition. Any surgical intervention to this lesion has its own high risk of complications. Recently, Seoul central district court decided 50% responsibility of the doctors who made a rupture of the aneurysm during coiling (2015Ga-Dan5243104). We reviewed judicial precedents related to cerebral aneurysms in lawsuit using a web search.METHODS: We searched judicial precedents at a web search of the Supreme Court, using the key words, "cerebral aneurysm".RESULTS: There were 15 precedents, six from the Supreme Court, seven from the High Court, and two from district courts. Seven precedents were related to the causation analysis, such as work-relationship. Five precedents were malpractice suits related bad results or complications. Remaining three precedents were related to the insurance payment. In five malpractice precedents, two precedents of the Supreme Court reversed former two precedents of the High Court.CONCLUSION: Judicial precedents on the cerebral aneurysm included not only malpractice suits, but also causation analysis or insurance payment. Attention to these subjects is needed. We also need education of the independent medical examination. To avoid medical disputes, shared decision making seems to be useful, especially in cases of high risk condition or procedures.
Aneurysm ; Coma ; Decision Making ; Dissent and Disputes ; Education ; Expert Testimony ; Humans ; Insurance ; Intracranial Aneurysm ; Malpractice ; Negotiating ; Rupture ; Seoul

This analysis was performed to investigate the relationship between nutrition and anthropometric indices using the data from a cross-sectional survey of a large national sample, '98 Korean national health and nutrition examination survey. Subjects were selected by stratified multistage probability sampling design and completed dietary questionnares including food intakes for one day by 24-hour recall method. For this analysis, 6566 subjects were selected by age(over 20 years old). For anthropometry, height, weight, and waist- and hip- circumference were measured. They were classified by body mass index(BMI, weight(Kg)/height2(m2)) and waist-hip ratio(WHR, waist circumference(Cm)/hip circumference(Cm)). The nutrients intake of subjects were compared with the recommended daily allowances(RDA). Mean adequacy ratio(MAR) was calculated. Mean heights, weights, BMIs were higher in the groups with nutrient intake over 125% of RDA than the lower intake groups for most nutrients. However, Mean WHR was the highest in the groups with nutrient intake under 75% of RDA for most nutrients excluding iron intake of women aged 20~64 years. Among women aged 20~64 years, means of MAR were 0.71 for obese individuals(BMI>30), 0.72 for subjects with underweight(BMI<18.5), and 0.76 for subjects with normal weight(18.5< or = BMI<25). Normal subjects has statistically significantly higher MAR than those of other groups. However, among elderly people aged over 65 years, obese group had the highest MAR, 0.68. Women with abdominal obesity(WHR>0.9) had lower MAR, 0.71 than those with normal weight(MAR=0.76). From these results, obesity and abdominal obesity seems to be the results of malnutrition including both undernutrition and overnutrition rather than simple problem of excess energy intake. Obesity in elderly people needs to be handled differently from adults.
Adult ; Aged ; Anthropometry ; Cross-Sectional Studies ; Energy Intake ; Female ; Humans ; Iron ; Malnutrition ; Nutrition Surveys* ; Obesity ; Obesity, Abdominal ; Overnutrition ; Weights and Measures

This analysis was performed to investigate the relationship between nutrition and anthropometric indices using the data from a cross-sectional survey of a large national sample, '98 Korean national health and nutrition examination survey. Subjects were selected by stratified multistage probability sampling design and completed dietary questionnares including food intakes for one day by 24-hour recall method. For this analysis, 6566 subjects were selected by age(over 20 years old). For anthropometry, height, weight, and waist- and hip- circumference were measured. They were classified by body mass index(BMI, weight(Kg)/height2(m2)) and waist-hip ratio(WHR, waist circumference(Cm)/hip circumference(Cm)). The nutrients intake of subjects were compared with the recommended daily allowances(RDA). Mean adequacy ratio(MAR) was calculated. Mean heights, weights, BMIs were higher in the groups with nutrient intake over 125% of RDA than the lower intake groups for most nutrients. However, Mean WHR was the highest in the groups with nutrient intake under 75% of RDA for most nutrients excluding iron intake of women aged 20~64 years. Among women aged 20~64 years, means of MAR were 0.71 for obese individuals(BMI>30), 0.72 for subjects with underweight(BMI<18.5), and 0.76 for subjects with normal weight(18.5< or = BMI<25). Normal subjects has statistically significantly higher MAR than those of other groups. However, among elderly people aged over 65 years, obese group had the highest MAR, 0.68. Women with abdominal obesity(WHR>0.9) had lower MAR, 0.71 than those with normal weight(MAR=0.76). From these results, obesity and abdominal obesity seems to be the results of malnutrition including both undernutrition and overnutrition rather than simple problem of excess energy intake. Obesity in elderly people needs to be handled differently from adults.
Adult ; Aged ; Anthropometry ; Cross-Sectional Studies ; Energy Intake ; Female ; Humans ; Iron ; Malnutrition ; Nutrition Surveys* ; Obesity ; Obesity, Abdominal ; Overnutrition ; Weights and Measures

No abstract available.
DNA* ; Mycobacterium tuberculosis* ; Mycobacterium*

No abstract available.
DNA* ; Mycobacterium tuberculosis* ; Mycobacterium*

Human caspase-2, Ich-1 (Ice and Ced-3 homolog), has two different forms of mRNA species derived from alternative splicing, which encodes Ich-1 and Ich-1s. Ich-1v which induces apoptosis is antagonist of Ich-1s which suppresses Rat-1 cell death by serum deprivation. To investigate functions of Ich-1 and Ich-1s in T celi apoptosis, the fusion DNA constructs were made with the ecto and transmembrane of CDB and Ich-lv or Ich-1s and CDS-Ich-1 or CD8-Ich-1s chimeric protein was transiently expressed on Jurkat T cells. Tyrosine phosphorylation of intracellular proteins was induced in these transfectans when activated shortly by anti-CDB Ab. CDB-Ich-li transfectant in serum-rich condition and CDB-Ich-ls transfectant in serum-deprived condition underwent apoptosis when treated with anti-CDS Ab or incubated with NIH3T3 cells expressing stably Fas-L on their surface. We also made six antisense DNA constructs which could specifically inhibit the expression of Ich-1v, Ich- 1s, and then they were transiently transfected into Jurkat T cell. The overexpression of both of the antisese- Ich-1 against N-terminal 42 bp and against C-terminal 366 bp inhibited apoptosis through Fas signalling. But, when three different forms of antisense-Ich-1s were overexpressed in their transfectants, antisense-DNA against N-terminal 197 bp increased knd the one against C-terminal 66 bp inhibited apoptosis, instead the full size of antisense-DNA did not give any effects on apoptosis through Fas pathway.
Humans