The present study atternpted. to expiore the new benzodiazepine, midazolam, which is water-soluble, shorter-acting, more potent, and less irritating to inject than diazepam, and which has been used as premedication before induction of anesthesia in various elective surgeries. Forty patients (aged 20 to 50 and in ASA class I or II ) about to undergo simple elective surgery under general anesthesia entered the study. The patients were divided into the study group (n=20) that recieved 0.07 mg/Kg i.m midazolan premedication and the control group (n= 20) that recieved normal saline as sham premedication. The changes in the values of various hemodynamic parameters, i.e., heart rate and systolic, diastolic, mean arterial pressures, were monitored first before tracheal intubation, then at the time of intubation and 5, 10 and 30 minutes after intubation. The concentrations of plasma catecholamines i.e., epinephrine and norepinephrine, were measured before intubation and 5, 30 minutes after intubation. Systolic pressure and plasma epinephrine concentration before induction was significantly low in the study compared with the controls. At the time of intubation, sytolic, diastolic & mean arterial pressures were significantly low in the study group compared with the controls. Heart rates measured at 10 and 30 minutes postintubation were significantly low at 30 minutes postintubation in the study group compared with the controls as was plasma epinephrine levels at each instance of its measurement. In conclusion, midazolam-premedicated patients appear to maintain stable hemodynamies and plasma catecholamine levels. Our findings support that midazolam premedication effectively reduces stress response during induction period making it suitable induction for elective surgery.
Anesthesia ; Anesthesia, General ; Arterial Pressure ; Benzodiazepines ; Blood Pressure ; Catecholamines ; Diazepam ; Epinephrine ; Heart Rate ; Hemodynamics* ; Humans ; Intubation ; Midazolam* ; Norepinephrine ; Plasma* ; Premedication*

PURPOSE: We investigated whether there are independent intradaily changes in bilirubin levels in normal neonates. METHODS: During the period of January 1996 till July 1996, 100 healthy newborn infants were studied for at least 3 consecutive days. Starting from the third day of life, consistent intradaily changes of bilirubin concentration were observed. And obstetric history, birth history, weight change at 3 days were recorded from chart review. A complete blood cell count was obtained from each subject at the beginning of the study. RESULTS: The mean bilirubin concentrations at morning were 10.4 +/- 1.8mg/dl (3rd day), 11.6 +/- 2.1mg/dl (4th day) and 11.2 +/- 2.7mg/dl (5th day). The mean bilirubin concentrations at evening were 11.1 +/- 2.1mg/dl (3rd day), 11.3 +/- 2.2mg/dl (4th day) and 10.8 +/- 2.8mg/dl (5th day). Interdaily changes of bilirubin levels were found: morning levels were higher compared with those of the evening. CONCLUSION: We showed a consistent diurnal rhythm in bilirubin levels, with higher levels in the morning than in the evening. This diurnal rhythm in serum bilirubin concentration affects endogenous factors as well as exogenous. Mechanism of diurnal variation was unknown.
Bilirubin* ; Blood Cell Count ; Circadian Rhythm ; Humans ; Hyperbilirubinemia, Neonatal ; Infant, Newborn* ; Reproductive History

BACKGROUND: Granisetron, a new 5-HT3 receptor antagonist, was reported as a highly effective antiemetics, especially in combination with dexamethasone, in the prevention of acute emesis induced by cisplatin. But there is lack of data about effectiveness in the prevention of delayed emesis. In this study, the efficacy of granisetron plus dexamethasone in the prevention of delayed emesis induced by cisplatin was evaluated. MATERIALS AND METHODS: Sixty-four patients who were to receive high-dose cisplatin containing chemotherapy regimen were enrolled in this study. They were received 20 mg of dexamethasone and 3 mg of granisetron at 30 min and 10 minutes prior to cisplatin infusion, respectively. They were monitored for 5 days, first 24 hours for acute nausea/ vomiting and the subsequent 4 days for delayed nausea/vomiting. Antiemetic effect of granisetron was evaluated according to the criteria of Italian Group of Antiemetic Research. RESULTS: Control of delayed nausea and vomiting was achieved in 58% and 84%, respectively. Eastern Cooperative Oncology Group performance status was a statistically significant prognostic factor for control of acute vomiting and delayed nausea/vomiting. There were no stastically significant differences between control of delayed nausea/ vomiting and other prognostic factors, including sex, age, and prior history of cisplatin therapy. The antiemetic effect was greater in the patients who had controled acute nausea/ vomiting than those who had not. CONCLUSION: Granisetron plus dexamethasone is an excellent regimen in the control of not only acute emesis but also delayed emesis induced by high-dose cisplatin chemotherapy.
Antiemetics ; Cisplatin ; Dexamethasone* ; Drug Therapy ; Granisetron* ; Humans ; Nausea* ; Receptors, Serotonin, 5-HT3 ; Serotonin ; Vomiting*

BACKGROUND: Inhalation anesthetics are known to depress ventilatory response to hypercapnea. Doxapram hydrochloride is an analeptic drug, which acts as a respiratory stimulant via peripheral and central chemoreceptors. Although the postoperarive infusion of doxapram hydrochloride is known to attenuate the impairment of respiratory function, no report is available on respiratory response to this drug when applied during anesthesia. Therefore, the present study aimed to evaluate the effect of doxapram hydrochloride on respiratory function during anesthesia. METHODS: Sixty adult patients undergoing operation under spontaneous ventilation via laryngeal mask airway (LMA) were randomly categorized into 3 groups: A control group, which received 5% dextrous infusion, and two groups in which patients were infused with doxapram hydrochloride (0.5 or 2 mg/kg/hr) starting 15 min after commencement operation. Anesthesia was maintained with 1 MAC sevoflurane - 4 L N2O - 2 L O2 under spontaneous ventilation via LMA. Tidal volume (VT), respiratory rate (RR), and arterial carbon dioxide tension (PaCO2) were measured just before and 15 min after the induction of anesthesia, 15 min after the start of operation and 15, 30, 45, and 60 min after the start of doxapram hydrochloride infusion. RESULTS: Measured values of RR and PaCO2 were significantly elevated during anesthesia venous those measured just before the induction of anesthesia in all groups. VT was significantly reduced during anesthesia venous just before the induction of anesthesia in all groups. All percent changes of VT, RR and PaCO2 were similar all any measurement times, and showed no significant changes after the infusion of doxapram hydrochloride in all groups. CONCLUSIONS: Intraoperative doxapram hydrochloride treatment did not produce any significant respiratory response improvement during 1 MAC sevoflurane anesthesia.
Adult ; Anesthesia ; Anesthesia, General* ; Anesthetics, Inhalation ; Carbon Dioxide ; Doxapram* ; Humans ; Laryngeal Masks* ; Respiratory Insufficiency ; Respiratory Rate ; Tidal Volume ; Ventilation*

BACKGROUND: The purpose of this study is to assess the prevalence of falls and to correlate if the fear of falling results in avoidance of activities in a rural community elderly population. METHODS: A cross-sectional study was done in 299 rural residents in Korea aged >60 years, between June 19, 2007 and June 21, 2007. Questionnaires about basic demographics, falling events, fear of falling (K-ABC), and limitations of daily activities (K-IADL) were completed. RESULTS: Among the 299 participants, 26.1% had experienced a fall. 197 participants confirmed that they experienced fear of falling (66.9%). This was further broken down to participants who were 'a little concerned'(31.4%), 'much concerned' (20.7%), and 'very much concerned' (13.7%). 183 people (61.2%) had limited daily activities caused by a fear of falling. Fallers experienced higher levels of anxiety and fear of falling than non-fallers (p<0.001). Comparing fear of falling with limited daily activities shows that the greater the fear of falling, the larger the limitation in daily activities and the lower the K-IADL score. After adjusting for falling, multiple linear regression showed that fear of falling and limited daily activities were positively correlated (p<0.001). Among groups with fear of falling, non-fallers, exercise group (p=0.024), and good perceived health group (p=0.022) had no limitations in activities compared with the control groups. CONCLUSION: Modifying drinking habits, diet habits, and social activities associated with perceived health states may improve daily activity levels in the elderly residing in rural communities, even though they have the fear of falling.
Aged ; Anxiety ; Cross-Sectional Studies ; Demography ; Drinking ; Food Habits ; Humans ; Korea ; Linear Models ; Prevalence ; Surveys and Questionnaires ; Rural Population