One of the goals of anesthesia is complete, comfortable and rapid recovery without sequelae from anesthesia. We compared the recovery pattern between anesthesia with propofol and thiopental/isoflurane. The fifty patients undergoing emergency appendectomy were allocated randomly to receive one of the anesthesia with propofol or thiopental/isoflurane. All of the patients were also given fentanyl, atracurium in equivocal dosage per weight and 50% N2O. Group 1(patient No; 25) was received anesthesia with fentanyl, atracurium, N2O and continuous injection of 6~12 mg/kg/hour of propofol. Group 2(patient No; 25) was received anesthesia with thiopental, fentanyl, atracurium, N2O and 1~2 MAC(minimal alveolar concentration) of isoflurane. We studied the duration of return of self respiration from discontinuation of anesthetics and recovery pattern in time sequence. The results were as following; The group 1 compared with group 2 at early recovery phase. 1) The duration of return of self respiration from discontinuation of anesthetics retured more rapid. 2) Emergence time was more rapid. 3) Postoperative sequelae(nausea, vomiting, sedation, drowsiness, memory dysfunction, pain) rate was less severe. But at recovery phase after 24 hours, there were no significant difference in postoperative sequelae and recovery condition in both groups. Therefore, we concluded that propofol is better than thiopental/isoflurane for anesthesia of emergency appendectomy in view of early recovery pattern.
Anesthesia* ; Anesthetics ; Appendectomy ; Atracurium ; Emergencies ; Fentanyl ; Humans ; Isoflurane ; Memory ; Propofol* ; Respiration ; Sleep Stages ; Thiopental ; Vomiting

Injury of diaphragm mainly occur in penetrating, crush and blunt injuries to the lower chest or upper abdomen, and it is most often secondary to automobile accidents. Diaphragmatic rupture is most frequent in blunt chest trauma and the rate is below 1% of them. Traumatic rupture of the diaphragm is responsible for the herniation of abdominal viscera. Physical finding and radiographic sign of diaphragmatic hernia is nonspecific and misreading. Therefore, the diagnosis of traumatic rupture of diaphragm may be difficult during the early period after the injury, especially when clinical features are dominated by associated injuries. Emergency surgical management is necessary when it is complicated with serious complication. We experienced the case of traumatic diaphragmatic hernia detected after the operation of femur fracture. The patient was injured by motor vehicle accident 6 days before the operation of the femur fracture. There was no specific symptom and sign and the manifestation of the diaphragmatic hernia. in radiographic studies until operation of the femur fracture was done. Diaphragmatic hernia was confirmed by chest X-ray and arterial blood gas analysis after operation of the femur fracture. The repair of the diaphragmatic hernia was directly performed after the diagnosis. The prognosis was favorable, and she was discharged to ward from intensive care unit after 1 day of operation. We must consider the possibility of traumatic diaphragmatic hernia in the patient who have the history of blunt chest or abdominal trauma.
Abdomen ; Analgesia, Patient-Controlled* ; Automobiles ; Blood Gas Analysis ; Diagnosis ; Diaphragm ; Emergencies ; Femur* ; Hernia, Diaphragmatic ; Hernia, Diaphragmatic, Traumatic* ; Humans ; Intensive Care Units ; Morphine* ; Motor Vehicles ; Prognosis ; Rupture ; Thorax ; Viscera ; Wounds, Nonpenetrating

We studied 21 neonates who required mechanical ventilation during study period in NICU OF Il Sin Christian Hospital with diagosis of prematurity, IRDS, pneumothorax and diaphragmatic hernia to evaluate the accuracy of pulse oximeter in predicting the arterial oxygen saturtion, hypoxia and hyperoxemia. We also studied whether the changes of birth weight, hematocrit, blood pressure and body temperature affect the accuracy of pulse oximeter. The results are 1) Linear regression analysis revealed a close correlation between in vivo pulse oximeter readings and in vitro SaO2 measurements in patients (Y=0.008X+12.34, r=0.946) 2) The changes of birth weight, hematocrit, blood pressure and body temperature did not affect the accuracy of pulse oximeter. 3) SpO2-PaO2 relationship was similar to the SsO2-PaO2 relationship. 4) When Nellcor N-100 pulse oximeter was setted at alarm limit 96% to avoid hyperoxemia, it identified 16 of 22 hyperoxemic instances (sensitivity 73%) and alarmed falsely in 48 of 92 nonhyperoxemic instances (specificity 59%).
Anoxia ; Birth Weight ; Blood Pressure ; Body Temperature ; Hematocrit ; Hernia, Diaphragmatic ; Humans ; Infant, Newborn ; Linear Models ; Oxygen* ; Pneumothorax ; Reading ; Respiration, Artificial

BACKGROUND: One of the factors that affect the anesthetic risk is preoperative status especially in geriatric patients. So we studied about followings; 1) Can we use APACHE scoring index when we assess the physical status of geriatric patients preoperatively? 2) Is it meaningful in saying the risk of anesthesia? 3) Which one is more significant in predicting the morbidity and mortality: acute physiologic status vs chronic health status? METHOD: Preoperative status of the geriatric patients (above 65 years old), who were received operation from June 1994 to March 1996 at Hanil General Hospital, were assessed by APACHE scoring index and ASA classification. Age, sex, type of operation, emergency or elective, method of anesthesia, duration of procedure, APACHE scoring index, ASA classification, perioperative complication, postoperative complication is coded by grading or type. RESULT: Perioperative complication was showed statistically significant with acute physiologic score (APS) and duration of procedure. Postoperative complication was showed statistically significant with APACHE score or ASA class. Total complication was affected by duration of procedure and APS score. There was also correlation between ASA class and total complication. Among 265 cases, 1 case expired during operation and 7 cases expired after operation. Causes of postoperative death were pneumonia, hemorrhagic shock etc. CONCLUSION: In geriatric patients, 1) APACHE scoring index is available for preoperative assessment. 2) APACHE scoring index is meaningful in predicting the risk of anesthesia. 3) Perioperative complication was more correlated with acute physiologic status than chronic health evaluation.
Anesthesia ; APACHE* ; Classification ; Emergencies ; Hospitals, General ; Humans ; Mortality ; Pneumonia ; Postoperative Complications ; Shock, Hemorrhagic

PURPOSE: This study was performed to determine effects of a structure-centered cooperative learning safety education program based on blended learning for elementary school students. METHODS: The study is developed in non-equivalent control group non-synchronized design. The subjects included 24 sixth grade students in the experimental group and 23 sixth grade students in the control group, respectively. To prevent diffusion of the experiment, it was carried out from May 20th to June 24th in 2015 with the control group and the other from August 26th to September 30th in 2015 with the experimental group. It was performed on experimental group after the structure-centered cooperative learning safety education program based on blended learning once a week for 6weeks. Data were analyzed by using descriptive statistics, paired t-test and independent t-test. RESULTS: After the intervention, the experimental group showed significant increases in the self-directed learning attitudes and safety behavior compared to the control group except for the academic self-efficacy. CONCLUSION: The results indicate that the structure-centered cooperative learning safety education program based on blended learning program is effective in safety education for 6th graders.
Diffusion ; Education ; Humans ; Learning ; Self Efficacy

No abstract available.
Hemoptysis*

Leber's hereditary optic neuropathy is caused by a single nucleotide change in the mitochondrial deoxynucleic acid(mtDNA) and accounts for 30% of bilateral optic atrophy of unknown etiology. The authors found 11778 mtDNA mutation in 12 patients and evaluated the clinical manifegtations. We confirmed various phenotypes exist in Leber's hereditary optic neuropathy in Korea.
DNA, Mitochondrial* ; Humans ; Korea ; Optic Atrophy ; Optic Atrophy, Hereditary, Leber* ; Phenotype

This study was conducted to evaluate the effect of a teaching program on patients with myocardial infarction. Forty-five patients were randomly selected 22 were assigned to a teaching group and 23 to a control group. An individualized teaching program was delivered to the teaching group during the hospitalization period. It covered aspects such as: the characteristics of heart disease, the anatomy and physiology of the heart, risk factors of atherosclerosis, medication and diet and exercise therapy. When these subjects were discharged to their homes, they received regular supportive care via telephone or mail for 12 weeks. Atherosclerotic risk factors, including, smoking, exercise, blood lipid profile and BMI were measured before and after the teaching program. Post-testing revealed that the numbers of those who exercised and the number of non-smokers were significantly higher in the teaching group than in the control group. Increased HDL cholesterol (High-Density Lipoprotein cholesterol) was significantly greater in the teaching group than in the control group. The above findings suggest that this individualized teaching program might be helpful at reducing the risk factors of atherosclerosis in myocardial infarction patients.
Adult ; Aged ; Arteriosclerosis/etiology/*prevention & control ; Comparative Study ; Exercise ; Female ; Human ; Lipids/blood ; Male ; Middle Age ; Myocardial Infarction/*prevention & control ; *Patient Education ; Risk Factors ; Smoking

OBJECTIVES: This study is based on the report including the psychological assessment results and therapeutic interventions of the survivors from hijacked Samho Jewerly by Somali pirates on January 15th, 2011. METHODS: We first assessed the emotional, cognitive, and personality functions of 7 crews, took 4-sessions of cognitive behavioral therapeutic intervention, conducted after-treatment assessments, and compared them with the previous results. RESULTS: Some of the crew showed PTSD due to the exposure to the stress triggered by the extreme state of fear, presented reexperience, avoidance of the trauma and chronical arousal state. CONCLUSION: Although this study was investigated with the minority group related to the one single accident, each case revealed the changes of symptoms and course after the trauma. The same traumatic event had different influences as how each individual perceived the experience. Furthermore, each clinical course was individually different either, depending on age, psychological resource, social support, daily life stress, or secondary gain.
Arousal ; Humans ; Minority Groups ; Ships ; Stress Disorders, Post-Traumatic ; Stress, Psychological ; Survivors

OBJECTIVES: This study was performed to determine whether the corpus callosum is involved in pathophysiology of schizophrenia and measured corpus callosal areas of first episode, chronic schizophrenic patients and controls. METHODS: We obtained the brain magnetic resonance imaging of 23 schizophrenic inpatients(15 males, 8 females)and 23 controls(11 males, 12 females)with simple headache or dizziness. Among the schizophrenic group, first episode patients were 13, chronic patients were 10. In mid-sagittal plane, the corpus callosum was divided into 7 areas and the cerebral area was measured. This data was analyzed with NIH image 1.60 software. We compared the corpus callosal areas of schizophrenics with controls by t-test and by ANOVA according to sex. Thereafter, ANCOVA was performed with mid-sagittal cerebral area as covariant. Comparison of first episode, chronic schizophrenics and controls was carried out by MANCOVA that was adjusted with age and mid-sagittal cerebral area. RESULTS: The schizophrenics, compared with controls, had smaller corpus callosal areas except for the 3rd, 6th callosal area, but statistical significance was absent. According to sex, male schizophrenics had insignificantly smaller total callosal areas than male controls and female schizophrenics had larger ones. In comparision of first episode, chronic schizophrenic patients and controls, first episode patients had smaller every corpus callosal areas than chronic ones, chronic ones had larger total callosal area than controls and first episode ones had smaller total area than controls, but statistical significances were absent also. CONCLUSION: Our study did not reveal the structural abnormality of corpus callosum in schizophrenic patients, but many controversial results have been reported in other studies. This inter-study inconsistency could be explained by the hypotheses of not only clinical but also biological different phenotypes within the schizophrenia.
Brain ; Corpus Callosum ; Dizziness ; Female ; Headache ; Humans ; Magnetic Resonance Imaging* ; Male ; Phenotype ; Schizophrenia