BACKGROUND: Outpatient procedures account for more than half the operations performed in the United States, but the status of outpatient anesthesia in Korea has not been documented yet. The present study was designed to evaluate the current status of outpatient anesthesia in university hospitals in Korea. METHODS: Thirty-nine university hospitals were surveyed by questionnaire in February 1997. Objects were patients underwent outpatient operations under general, intravenous or regional anesthesia except local anesthesia by surgeon from January 1996 to December 1996. RESULTS: One university hospital started outpatient anesthesia in 1980 and now ten of 39 universities (25.6 %) provide the procedures. In 1995 one of 10 university hospitals has opened day- surgery center having 7 operating rooms and the capability of 24 hours overnight stays. The other 9 hospitals use one of in-patient operating rooms for outpatient procedures. The utility rate per year was 3.06 +/- 1.59 % and 11.49 % in 9 university hospitals and day-surgery center respectively during 1996. Outpatients were mainly classified as physical status 1 and 2 by American Society of Anesthesiologists, and 54.0 38.3 % to 70 % of patients were distributed under 15 years of age. Surgical procedures were relatively simple and 10 surgical departments were participated into the field of outpatient anesthesia. Inhalation techniques and intravenous anesthesia were used predominantly. Complications were sore throat, nausea and vomiting, delayed recovery of consciousness, bleeding at the operative site, fever and so on. CONCLUSIONS: I think that outpatient anesthesia in Korea has grown at very slow rate over the last 4 decades and that it is very low utility rate per year compared to United States. So we have to try to get more interests and supports about the outpatient anesthesia setting.
Ambulatory Surgical Procedures ; Anesthesia* ; Anesthesia, Conduction ; Anesthesia, Intravenous ; Anesthesia, Local ; Consciousness ; Fever ; Hemorrhage ; Hospitals, University* ; Humans ; Inhalation ; Korea* ; Nausea ; Operating Rooms ; Outpatients* ; Pharyngitis ; Surveys and Questionnaires ; United States ; Vomiting

No abstract available.
Anesthesia* ; Ventilators, Mechanical*

No abstract available.
Colorectal Neoplasms* ; Humans ; Male*

The Rendu-Osler-Weber syndrome (hereditary hemorrhagic telangiectasia) is an autosomal dominant disorder of blood vessels associated with mucocutaneous telangiectasis and arterivenous malformations in several organs. A pulmonary arteriovenous fistulae can cause hypoxemia, hemoptysis, polycythemia and clubbing. However the condition is often not recognized until the 3rd decade of life. The authors report a case of a 28-year-old male patient who had been suffering from telangiectasis of the upper lip and upper portion of the chin and unexpedly became undersaturated of hemoglobin through general anesthesia during an operation of the upper lip lesion.
Adult ; Anesthesia, General ; Anoxia ; Arteriovenous Fistula ; Blood Vessels ; Chin ; Hemoptysis ; Humans ; Lip ; Male ; Polycythemia ; Telangiectasia, Hereditary Hemorrhagic* ; Telangiectasis

The carpal injury is difficult to diagnose due to anatomical complexity and the like. So, in order to get radiological knowledge of normal wrist, the authors measured the values which will be described on the wrist PA and lateral roengenogram obtained from 440 normal wrists(male : 188 cases, female : 252 cases) in randomly selected patients. The following results were obtained. l. Ulnar variance(mm±standard deviation): Total 1.1±1.2 : negative variance : 9.3%, positive variance : 56.1%, 2. Scapholunate Gap(mm±standard deviation): Total 0.4±0.7, 3. Ulnar Tilt(degrees±standard deviation): Total 23.6±5.3, 4. Volar Tilt, 5. Carpal height rstio : Total 0.52±0.05 male 0.53±0.04 female 0.51±0.05 : Total 13.1±5.9, 6. Carpal ulnsr distance ratio Total 0.05±0.05, 7. Scapholunate Angle : Total 49.9'±10.1', 8. Capitatolunate Angle Total 17.5'±10.0', 9. Radiolunate Angle Total 8.8'±6.7', 10. Carpal width ratio Total 0.72±0.08 11. Carpal thickness ratio Total 0.49±0.07.
Female ; Humans ; Male ; Wrist

No Abstract Available.
Heparitin Sulfate* ; Orientia tsutsugamushi*

This report is a prospective study comparing conventional direct laryngoseopy with tube-over-tube intubation ("TOTI") method in 42 male patients, whose tracheas were difficult to intubate. ("TOTI") method using two different-sized endotracheal tubes, the newly devised technique has not been mentioned yet. And the comparative studies have not been performed to evaluate relative efficacy, speed, or incidence of complications for the conventional versus "TOTI" method in endotracheal intubation. Overall number of attempts (mean+/-SE) in conventional group was 3.62+/-0.37(range; 1-8), while "TOTI" one was 1.1+/-0.07 (range; 1-2). The time required for intubation ranged from 25 to 64 seconds in TOTI group and 37 to 2015 sec in conventional one, average (mean+/-SE) 37.19+/-1.87 and 542.71+/-111.54sec, respectively. No complications of endotracheal intubation occured in "TOTI" group, whereas in coventional one there occurred fourteen patients with sore throat, seven with hoarseness and five with temporary short-lived dysrhythmia.
Adult* ; Hoarseness ; Humans ; Incidence ; Intubation* ; Intubation, Intratracheal ; Male ; Pharyngitis ; Prospective Studies ; Trachea

Congenital hypertrophic pyloric stenosis is one of the most common gasttointestinal abnonnalities occurring in the first six months of life. Although the primary therapy for pyloric stenosis is surgical, it is essential to realize that pyloric stenosis is medical and not a surgical emergency. Preoperative preparation is the primary factor contributing to the low perioperative complication rates and the necessity to recognize fluid and electrolyte imbalance is the key to successful anesthetic management. The anesthetic records of 156 infants with congenital hypertrophic pyloric stenosis were reviewed. Seventy-six per cent of the infants were male(i.e., 3:1 male to female ratio). Surgical correction was undertaken between age of 2 and 3 weeks, and the average weight of the infants at the time of surgery was 3.74+/-0.68 kg. All the infants received general anesthesia for the surgical procedure and assist respiration through the laryngeal mask airway was applied increasingly from 1992. There were no perioperative deaths.
Anesthesia ; Anesthesia, General ; Emergencies ; Female ; Humans ; Infant* ; Laryngeal Masks ; Male ; Pyloric Stenosis ; Pyloric Stenosis, Hypertrophic* ; Respiration

In addition to premedicants, adjuvants and inhalation of dried anesthetic gas mixture during anesthesia, pain after upper abdominal operation may cause obtundation of cough reflex, limitation of lung function, and decreased movement of respiratory cilia, resulting in postoperative pulmonary complications such as pneumonia and atelectasis. Epidural injection of local anesthetic may produce enough analgesic action without depression of pulmonary function for the majority of upper abdominal surgery cases, while intramuscular injection of analgesic which has been applied for postoperative pain relief might cause depression of pulmonary function and increase of mortality and morbidity of pulmonary complications. This study was designed to compare the effects of above two pain-relief methods on pulmonary function at the postoperative 24 hour and 44 adult patients who have been operated in upper abdomen which were allocated randomly with either epidural injection group (10 of male, 9 of female) or intramuscular injection group (17 of male, 8 of female). The results were as follows; 1) All patients have markedly decreased pulmonary function in the preoperative period, comparing with the predictive values. 2) The results of postoperative pulmonary function test of all patients in intramuscular injection group was similar to the results of preoperative pulmonay function test and not improved. 3) Patients in epidural injection group have markedly improved in nearly all pulmonary functions after operation. The degree of improvement was increased in order as following; MEF50> MEF75> IRV (or TV)> FEV1/FVC. And there was no difference of results between male and female. 4) Vital capacity in epidural injection group was increased to about 25~42% from the preoperative period, while it was decreased to about 22~29% in intramuscular injection group. With the above results, we suggest that single or continuous epidural injection of local anesthetic will be an appropriate way of postoperative pain-relief methods, especially in the patients who has markedly decreased pulmonary function and upper abdominal surgery.
Abdomen ; Adult ; Anesthesia ; Cilia ; Cough ; Depression ; Female ; Humans ; Inhalation ; Injections, Epidural* ; Injections, Intramuscular ; Lung ; Male ; Mortality ; Pain, Postoperative ; Pneumonia ; Preoperative Period ; Pulmonary Atelectasis ; Reflex ; Respiratory Function Tests* ; Vital Capacity

Verrucous carcinoma of the larynx is a distinct and uncommon variant of well-differentiated squamous cell-carcinoma. The authors hybridized in situ a case of laryngeal verrucous carcinoma with DNA prebes to humman papillomavirus (HPV) 6, 11, 16, 18, 31, 33 and 35. The DNAs from the verrucous carcinoma of larynx hybridized with mixed DNA probes HPV-16/18 and 31/33/35. In addition, there was an evidence of HPV infection based on hybridization with mixed DNA probe HPV-6/11 in the adjacent papilloma tissue. By in situ DNA hybridization techniques, we clearly demonstrated human papillomavirus (HPV-16/18, and 31/33/35) related sequences in this neoplasm. These findings suggest the role of HPV-6/11 in the development of laryngeal papilloma ad HPV-16/18 and 31/33/35 probably on the progression to verrucous carcinoma.
Humans