Blood flow velocity changes induced by the focal brain activation can be assessed by using Transcranial Doppler sonography (TCD). To explore the hemispheric dominant hemodynamic effect by performing calculation, we applied TCD technique to detect cerebral blood velocity asymmetry. METHODS Twenty healthy right-handed subjects were tested. We measured mean flow velocities (MFV) in the middle and posterior cerebral arteries (MCA, PCA). Photic stimulation was given separately as a control task for calculation. RESULTS While the photic stimulation increased the blood velocity only in PCAs, performing calculation increased the velocity in MCAs. Right-left difference was noted by performing calculation with greater increase in left MCA (right: 8.8 %; left: 21.2 %). CONCLUSION Application of TCD enabled us to measure the hemodynamic changes supporting the left hemispheric dominance of calculation task. Futhermore, increase in non-dominant right hemisphere suggests the functional interaction of cerebral activity.
Blood Flow Velocity* ; Brain ; Dominance, Cerebral ; Hemodynamics ; Passive Cutaneous Anaphylaxis ; Photic Stimulation ; Posterior Cerebral Artery ; Ultrasonography, Doppler, Transcranial

PURPOSE: There have been several reports claiming benefits for the simplified method of appendectomy over the traditional method of embedding suture at the stump, without contradictory opinions ever having been published. Nevertheless, most surgeons continue to carry out purse-string sutures in daily practices of open appendectomy as long as the stump situation permits. In case where the cecum near the stump is friably swollen due to the spread of inflammation in advanced appendicitis, we have often faced uncomfortable pulling of cecal stitches during embedding procedures experiencing tearing or incomplete approximation of the pulled wall. To avoid this difficulty and shorten the procedure, we have been performing simple double ligations of the stump and observed the results. METHODS: Prospectively we assigned patients to an operative method of either simple ligations or embedding sutures, alternatively upon admission, and performed this method of stump management with two surgeons for 4 years, and postoperative complications were observed in 362 and 273 cases respectively. RESULTS: There was no advantage of one method over the other in recovery course, and in view of the complication rates associated with stump inadequacy and adhesive ileus, even in cases of perforated appendicitis also. CONCLUSION: When possible, Stump ligations simplify appendectomy procedure without increased operative sequelae, even in cases of perforated appendicitis. So this procedure could be recommended instead of purse-string sutures, especially in cases of thick and friable cecal wall due to acutely disseminated appendiceal inflammation.
Adhesives ; Appendectomy* ; Appendicitis ; Cecum ; Humans ; Ileus ; Inflammation ; Ligation* ; Postoperative Complications ; Prospective Studies ; Sutures*

PURPOSE: Until recently, the surgical treatment of perforated appendicitis in South Korea showed a relatively high incidence of postoperative infectious complications compared with centers having protocols for managements. Authors have been performing appendectomies for perforated cases under the principle of massive irrigation of the peritoneal cavity and primary closure of incision wound that leaves a suction drain from pelvic cavity, expecting reducing chance of infective complications and thus reducing the stress faced by operators. METHODS: Among 788 cases of appendicitis from September 1997 to December 2002, 172 patients showing perforation and peritonitis in the operative field were reviewed retrospectively. All the operations were performed by the principle mentioned above, and data were collected on various major complications, especially infective wound and intra-abdominal complications. RESULTS: There were 7 cases of suppurative wound infection, and 5 cases of intra-abdominal abscess, representing a total incidence of 7.0% (n=12) in 172 patients. Other major complications such as adhesive ileus (n=3), intestinal fistula (n=1), or remote organ infective event (n=1) were also recognized. CONCLUSION: Massive saline irrigation during appendectomy of perforated appendicitis-without antibiotic mixture-that leaves a negative suction drain from the pelvic cavity and the primary closure of incision wounds have yielded satisfactory results concerning various aspects, especially in lessening infective postoperative complications.
Abdominal Abscess ; Adhesives ; Appendectomy ; Appendicitis ; Humans ; Ileus ; Incidence ; Intestinal Fistula ; Korea ; Peritoneal Cavity ; Peritonitis ; Postoperative Complications ; Retrospective Studies ; Suction ; Wound Infection ; Wounds and Injuries

Central venous catheters provide long-term available vascular access. They are useful for central venous pressure monitoring, rapid fluid management, massive transfusion and direct cardiovascular medication, especially in operation. Central venous catheterization is usually performed by the landmark bedside technique without imaging guidance. The complications of central venous catheterization are frequent, which include malposition, pneumothorax, hemothorax, chylothorax, arterial puncture, hematoma, air embolism and infection. Malposition of a central venous catheter is not rare and may cause several complications such as malfunction of the catheter, default measurement of central venous pressure, catheter erosion, thrombophlebitis and cardiac tamponade. In this case, we report a malposition of central venous catheter with 9-Fr introducer sheath which is located in the right subclavian vein via ipsilateral internal jugular vein and the correction of this misplacement assisted by mobile type diagnostic X-ray apparatus (C-arm fluoroscope).
Cardiac Tamponade ; Catheterization ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters* ; Central Venous Pressure ; Chylothorax ; Embolism, Air ; Hematoma ; Hemothorax ; Jugular Veins ; Pneumothorax ; Punctures ; Radiography* ; Subclavian Vein ; Thrombophlebitis

Stellate ganglion block (SGB) is a procedure that is widely used for many diseases associated with sympathetically-maintained pain in the head, neck, and upper extremities. Various hemodynamic changes may occur after SGB. Among them, we experienced two patients who developed highly increased blood pressure after SGB. We suspect that the spread of local anesthetics produced parasympathetic blockade of the vagus nerve, an imbalance between the sympathetic and parasympathetic activities and deafferentiation of the glossopharyngeal and vagus nerve, which both innervated the carotid sinus, as the mechanism of this increased blood pressure.
Anesthetics, Local ; Blood Pressure ; Carotid Sinus ; Head ; Hemodynamics ; Humans ; Neck ; Stellate Ganglion ; Upper Extremity ; Vagus Nerve

Background: Health information should be accurate and of high quality. While search websites are widely used to obtain health information, search results can vary depending on the availability of information in each language and the algorithms of search websites. We compared the search results and their reliability on popular search websites in Korea and the United States. Methods: Using the most popular search websites in Korea (A) and the US (B), with B divided into KR and US domains, we evaluated the search results for three diseases (hypertension, diabetes, osteoporosis) and two medications (Lipitor, Norvasc). We compared the proportion of paid ads and website categories, as well as quality and accuracy using a validated scoring tool. Results: Search website A had a high proportion of paid ads (40.3%), compared to B KR (4.3%) and B US (0%). B US had the highest proportion of reliable websites (58.1%), followed by B KR (52.9%) and A (14.6%). B US had the highest median quality score (25) while A had the lowest (14).Additionally, B US had the highest accuracy (95%), followed by B KR (87.7%) and A (52.2%). Conclusions Our data suggest that health information provided by popular search website in Korea is inaccurate and of low quality compared with that provided by its counterpart in the US. Users should prioritize credible websites, be cautious of ads, and seek professional advice. In addition, jointefforts from the government, search websites, and healthcare professionals are needed to provide accurate online health information.

Background: Health information should be accurate and of high quality. While search websites are widely used to obtain health information, search results can vary depending on the availability of information in each language and the algorithms of search websites. We compared the search results and their reliability on popular search websites in Korea and the United States. Methods: Using the most popular search websites in Korea (A) and the US (B), with B divided into KR and US domains, we evaluated the search results for three diseases (hypertension, diabetes, osteoporosis) and two medications (Lipitor, Norvasc). We compared the proportion of paid ads and website categories, as well as quality and accuracy using a validated scoring tool. Results: Search website A had a high proportion of paid ads (40.3%), compared to B KR (4.3%) and B US (0%). B US had the highest proportion of reliable websites (58.1%), followed by B KR (52.9%) and A (14.6%). B US had the highest median quality score (25) while A had the lowest (14).Additionally, B US had the highest accuracy (95%), followed by B KR (87.7%) and A (52.2%). Conclusions Our data suggest that health information provided by popular search website in Korea is inaccurate and of low quality compared with that provided by its counterpart in the US. Users should prioritize credible websites, be cautious of ads, and seek professional advice. In addition, jointefforts from the government, search websites, and healthcare professionals are needed to provide accurate online health information.

Background: Health information should be accurate and of high quality. While search websites are widely used to obtain health information, search results can vary depending on the availability of information in each language and the algorithms of search websites. We compared the search results and their reliability on popular search websites in Korea and the United States. Methods: Using the most popular search websites in Korea (A) and the US (B), with B divided into KR and US domains, we evaluated the search results for three diseases (hypertension, diabetes, osteoporosis) and two medications (Lipitor, Norvasc). We compared the proportion of paid ads and website categories, as well as quality and accuracy using a validated scoring tool. Results: Search website A had a high proportion of paid ads (40.3%), compared to B KR (4.3%) and B US (0%). B US had the highest proportion of reliable websites (58.1%), followed by B KR (52.9%) and A (14.6%). B US had the highest median quality score (25) while A had the lowest (14).Additionally, B US had the highest accuracy (95%), followed by B KR (87.7%) and A (52.2%). Conclusions Our data suggest that health information provided by popular search website in Korea is inaccurate and of low quality compared with that provided by its counterpart in the US. Users should prioritize credible websites, be cautious of ads, and seek professional advice. In addition, jointefforts from the government, search websites, and healthcare professionals are needed to provide accurate online health information.

Background: Health information should be accurate and of high quality. While search websites are widely used to obtain health information, search results can vary depending on the availability of information in each language and the algorithms of search websites. We compared the search results and their reliability on popular search websites in Korea and the United States. Methods: Using the most popular search websites in Korea (A) and the US (B), with B divided into KR and US domains, we evaluated the search results for three diseases (hypertension, diabetes, osteoporosis) and two medications (Lipitor, Norvasc). We compared the proportion of paid ads and website categories, as well as quality and accuracy using a validated scoring tool. Results: Search website A had a high proportion of paid ads (40.3%), compared to B KR (4.3%) and B US (0%). B US had the highest proportion of reliable websites (58.1%), followed by B KR (52.9%) and A (14.6%). B US had the highest median quality score (25) while A had the lowest (14).Additionally, B US had the highest accuracy (95%), followed by B KR (87.7%) and A (52.2%). Conclusions Our data suggest that health information provided by popular search website in Korea is inaccurate and of low quality compared with that provided by its counterpart in the US. Users should prioritize credible websites, be cautious of ads, and seek professional advice. In addition, jointefforts from the government, search websites, and healthcare professionals are needed to provide accurate online health information.

Background: Recombinant human follicle-stimulating hormone (rhFSH) is commonly used to treat female infertility, but its short half-life necessitates multiple doses. Even corifollitropin alfa, with an extended half-life, requires supplementary injections of rhFSH after 7 days. This study aimed to develop and evaluate a long-acting follicle-stimulating hormone (FSH) formulation using anti-serum albumin Fab-associated (SAFA) technology to avoid additional injections and enhance ovarian function. Methods: SAFA-FSH was synthesized using a Chinese hamster ovary expression system. Its biological efficacy was confirmed through assays measuring its ability to stimulate cyclic adenosine monophosphate (cAMP) production, estradiol synthesis, and the expression of human cytochrome P450 family 19 subfamily A member 1 (hCYP19α1) and human steroidogenic acute regulatory protein (hSTAR) in human ovarian granulosa (KGN) cells. To evaluate the effects of SAFA-FSH, we compared its impact on serum estradiol levels and ovarian weight increase with that of rhFSH in Sprague-Dawley (SD) rats using the modified Steelman-Pohley test. Results: The results indicated that SAFA-FSH induces cAMP synthesis in KGN cells and upregulates the expression of hCYP19α1 and hSTAR in a dose-dependent manner. Female SD rats, aged 21 days, receiving daily subcutaneous human chorionic gonadotropin injections for 5 days exhibited a significant increase in serum estradiol levels and ovarian weight when administered SAFA-FSH on the first day or when given nine injections of rhFSH over 5 days. Notably, the group receiving SAFA-FSH on the first and third days demonstrated an even greater rise in serum estradiol levels and ovarian weight. Conclusion These findings suggest that SAFA-FSH presents a promising alternative to current rhFSH treatments for female infertility. However, further research is essential to thoroughly assess its safety and efficacy in clinical contexts.