BACKGROUND: Tourniquet induced hypertension, defined as a more than 30% increase in either systolic or diastolic arterial pressure in patients with a tourniquet inflated for at least an hour, may develop despite adequate anesthesia for surgical procedure. The mechanism is uncertain. We investigated the effect of stellate ganglion block (SGB) on tourniquet induced arterial pressure and heart rate changes. METHODS: Twenty-two patients of ASA physical status class 1 and 2, scheduled for lower extremity surgery using a tourniquet, were randomly assigned into two groups (SGB group, Control group). SGB was done before induction, and anesthesia was maintained with 1.5-2.0 vol% sevoflurane and 50% N20 in O2 with endotracheal intubation. The changes of heart rate, systolic, diastolic blood pressure, end tidal CO2 and end tidal sevoflurane concentration were measured before induction, 10 minutes after induction, 10, 30, and 60 minutes after tourniquet inflation, just before tourniquet deflation and 10 minutes after tourniquet deflation. RESULTS: Heart rate increased significantly at 10 minutes after induction and 10 minutes after tourniquet inflation compared to before induction in SGB group. In both groups, systolic arterial pressure increased significantly just before tourniquet deflation compared to before induction, and there was no difference between groups. In SGB group, diastolic arterial pressure decreased significantly compared to control group at 30 minutes after tourniquet inflation. CONCLUSIONS: Preoperative stellate ganglion block was not effective in blunting tourniquet induced hypertension.
Anesthesia ; Arterial Pressure ; Blood Pressure ; Control Groups ; Heart Rate ; Humans ; Hypertension* ; Inflation, Economic ; Intubation, Intratracheal ; Lower Extremity ; Stellate Ganglion* ; Tourniquets*

After a traumatic brachial plexus injury, 80% of patients develop severe pain in the deafferentated arm. This type of pain is considered very resistant to many forms of therapy. When we plan treatments for the patient who suffer from a pain from traumatic brachial plexus injury, clarifying the location of injured nerve is very important. EMG (electromyography), NCV (nerve conduction study), MRI (magnetic resonance imaging) and CT (computed tomography) myelography are recommended diagnostic method for this purpose. Here, we presented a patient who was suspected to have both preganglionic and postganglionic brachial plexus lesion by EMG and NCV study, he showed favorable response after spinal cord stimulation.
Arm ; Brachial Plexus ; Humans ; Myelography ; Spinal Cord ; Spinal Cord Stimulation

Malaria is one of the most common infectious diseases in the world. Plasmodium falciparum accounting for nearly all malaria mortality, kills an estimated 1 to 2 million persons yearly and has several features thai make it deadlist of malarias. While cerebral malaria is the most common presentation of severe disease, acute lung injury associated with malaria is uncommon but serious and fatal complication. We report two cases of severe malaria with ARDS and multi-organ failure. All two patients traveled to foreign countries, Kenya, Papua New Guinea where choroquine-resistant malaria is distributed. The first case, which developed cerebral malaria hypoglycemia, multi-organ failure, and ARDS, treated with quinine and mechanical ventilator, but expired due to oxygenation failure. Autopsy showed acute necrotizing infiltration, diffuse eosinophilic fibrinoid deposits along the alveolar space, and alveolar macrophage with malaria pigment The second case also developed multi-organ failure, followed by ARDS, and was treated with quinine, exchange transfusion, plasmapheresis, and mechanical ventilator. He recovered with residual restrictive lung change after treatment.
Acute Disease ; Asian Continental Ancestry Group ; Autopsy ; Communicable Diseases ; Eosinophils ; Humans ; Hypoglycemia ; Kenya ; Lung ; Lung Injury ; Macrophages, Alveolar ; Malaria* ; Malaria, Cerebral ; Mortality ; Oxygen ; Papua New Guinea ; Plasmapheresis ; Plasmodium falciparum ; Quinine ; Respiratory Distress Syndrome, Adult* ; Ventilators, Mechanical

Instant noodle is one of the most popular foods in Korea. The objective of this study was to examine the association of instant noodle consumption and food and nutrient intake among children and teenagers in Korea. We used dietary data from 24-h recall of 1,748 subjects aged 7-19 years who participated in the 2005 Korea National Health and Nutrition Examination Survey. Those who consumed instant noodle once or more during the survey period were categorized as "instant noodle consumer (INC)" and were compared for food and nutrient intakes with the others (non-INC). The average age of the INC was 13.4 and that of the non-INC was 12.4; girls consumed more instant noodles than boys (p < 0.05). There was no significant difference in BMI between the two groups. With the exception of grains, as compared to the non-INC, the INC consumed significantly less amounts of potatoes, vegetables, mush-rooms, fruits, spices, seafood, and milk and dairy products. With respect to nutrient intakes, the INC-group showed significantly higher nutrient intakes of energy, fat, carbohydrate, sodium, thiamine, and riboflavin; however, as compared to the non-INC-group, the INC-group showed significantly less intakes of calcium, niacin, and vitamin C. The overall result suggests that consuming instant noodles may lead to excessive intake of fat and sodium, but it may cause an increased intake of thiamine and riboflavin. Therefore, nutrition education that helps children and teenagers choose a balanced meal while consuming instant noodle should be carried out. In addition, manufactures of instant noodles should consider nutritional aspects in product development processes.
Adolescent ; Aged ; Ascorbic Acid ; Calcium ; Child ; Dairy Products ; Edible Grain ; Fruit ; Humans ; Korea ; Meals ; Milk ; Niacin ; Nutrition Surveys ; Riboflavin ; Seafood ; Sodium ; Solanum tuberosum ; Spices ; Thiamine ; Vegetables

OBJECTIVES: We estimated the population prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including unreported infections, through a Korea Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission (K-SEROSMART) in 258 communities throughout Korea. METHODS: In August 2022, a survey was conducted among 10,000 household members aged 5 years and older, in households selected through two stage probability random sampling. During face-to-face household interviews, participants self-reported their health status, COVID-19 diagnosis and vaccination history, and general characteristics. Subsequently, participants visited a community health center or medical clinic for blood sampling. Blood samples were analyzed for the presence of antibodies to spike proteins (anti-S) and antibodies to nucleocapsid proteins (anti-N) SARS-CoV-2 proteins using an electrochemiluminescence immunoassay. To estimate the population prevalence, the PROC SURVEYMEANS statistical procedure was employed, with weighting to reflect demographic data from July 2022. RESULTS: In total, 9,945 individuals from 5,041 households were surveyed across 258 communities, representing all basic local governments in Korea. The overall population-adjusted prevalence rates of anti-S and anti-N were 97.6% and 57.1%, respectively. Since the Korea Disease Control and Prevention Agency has reported a cumulative incidence of confirmed cases of 37.8% through July 31, 2022, the proportion of unreported infections among all COVID-19 infection was suggested to be 33.9%. CONCLUSIONS The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19, confirming that most individuals possess antibodies to SARS-CoV-2 and that a significant number of unreported cases existed. Furthermore, this study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.