BACKGROUND: Intubating conditions would be excellent and hemodynamic variables would be relatively stable during rapid- sequence anesthesia induction if tracheal intubation was performed at a proper time. The purpose of this study was to identify the ideal intubation time after rocuronium with either thiopental or propofol. METHODS: 113 patients, ASA physical status I or II, were randomly divided into four groups. Patients in group TR60 (thiopental-rocuronium) and in group PR60 (propofol-rocuronium) were intubated within 60 s, while groups TR90 and PR90 were intubated within 90 s after the administration of rocuronium. Intubating conditions were graded by an experienced anesthesiologist, and hemodynamic variables were noted just before induction (baseline), immediate after induction, immediate after intubation, and 5 min after intubation. RESULTS: Clinically acceptable intubating conditions (good or excellent) were not statistically different among the four groups. However, 55 and 64% of patients in groups TR90 and PR90, respectively, had excellent intubating conditions compared to only 39 and 38% in groups TR60 and PR60 (P < 0.05). Mean arterial pressure and rate pressure product (RPP) immediately after intubation were relatively stable in groups TR90 and PR90 compared to those in groups TR60 and PR60 (P < 0.05). CONCLUSIONS: The intubation time after rocuronium, rather than the choice of induction agent, is the deciding factor affecting intubating conditions and hemodynamic variables during rapid-sequence anesthesia induction. Ninety seconds after the administration of rocuronium with either thiopental or propofol might be an ideal intubation time.
Anesthesia ; Arterial Pressure ; Hemodynamics* ; Humans ; Intubation* ; Propofol ; Thiopental

OBJECTIVES: The aim of the study was to analyze the factors related to the illegal dental treatment experience (IDTX) among Korean adults. METHODS: The raw data for the analysis of IDTX among Korean adults were obtained from the dataset of the Fourth Korea National Health and Nutrition Examination Survey conducted in 2007-2009. Stratified weighted subjects aged > or =45 years were selected according to region by using clustered sampling methods. In total, the data of 9,254 subjects, who participated in the interview and dental examinations related to the experience of illegal dental treatments, were analyzed using chi-square test, general linear model, and logistic regression analysis with complex sampling design by considering demographic and socioeconomic variables (age, gender, region, educational level, household income, and medical and dental delivery system) as well as oral status variables (prosthesis and number of natural remaining teeth). RESULTS: IDTX rate was <10% among adults aged 35-44 years or below. However, it increased to 15% among adults aged 45-54 years and was >30% among adults aged > or =65 years. The age group with a high IDTX rate coincided with the age group with a high number of lost teeth. Most of the IDTX cases were presumed to be prosthetic treatments. The model comprising demographic, socioeconomic, and oral status variables had the highest explanation power. Significant variables were educational level, household income, prosthesis status, and number of remaining teeth. Women and persons under the medicaid system were more likely to undergo illegal dental treatments. CONCLUSIONS: Comprehensive prosthetic treatments are suggested to be included in the care services of the national health insurance and medicaid system to reduce the number of illegal dental treatments.
Adult* ; Dataset ; Dental Care ; Family Characteristics ; Female ; Humans ; Korea ; Linear Models ; Logistic Models ; Medicaid ; National Health Programs ; Nutrition Surveys* ; Prostheses and Implants ; Socioeconomic Factors ; Tooth

Purpose: To assess characteristics the application of mobile medication system and medication administration error (MAE) alerts in a general hospital. Methods: The subject hospital adopted a mobile medication system in 2016. All medication administrations in the general wards and ICUs were automatically recorded in real-time using identification barcodes, drug barcodes, and hand-held point-of-care devices. MAE alert logs were recorded from April 1st 2017 to March 31st 2018. For this study analysis was done using Pearson’s chi-squared test for potentially related factors of MAE alerts included administration time, order type, medication route, and length of nurse’s employment. Results: The total number of medications during the period of this study was 3,227,990. Among them, 2,698,317 medication doses were recorded, resulting in the system application rate of 83.6%. The system application rate was significantly correlated with all factors related to potential MAE alters. In this study 23,314 MAE alerts(0.9% of the total medication doses) were identified. The MAE alerts were related to new (OR=2.26, p<.001) and emergency (OR=2.25, p<.001) orders, and administration at a non-standard time (OR=2.032, p<.001). Medication route (p<.001), and nurse’s employment duration(p<.001) were also related. Conclusion A mobile medication system contributes to improving patient safety by preventing potential MAEs. The MAE alerts were related to administration time, order type, medication route, and duration of nurse’s employment. In order to prevent medication administration errors, it is necessary to standardize the process of medication and create an environment in which medication administration can be performed in a planned situation.

Recently, aging process and westernization of life style are increasing the incidence of colonic diverticulum. About 30% of colonic diverticulm result in diverticular bleeding, which often causes acute lower gastrointestinal bleeding. In most cases, the bleeding stops spontaneously. But when relapsing or causing massive bleeding, it sometimes needs emergent surgery. Generally, treatments for colonic diverticular bleeding consist of conservative ones. But recently, urgent colonoscopy is important procedure since it estimates the needs for surgery, or when bleeding foci being identified, endoscopists frequently can stop the bleeding by only colonoscopic procedures such as injection therapy, band ligation, hemoclipping and argon plasma coagulation, etc. In patients with hematochezia, we made early detection of diverticular bleeding foci by urgent colonoscopy, and then we were able to treat them successfully by argon plasma coagulation and hemoclipping. Thus we report these with literature review.
Aging ; Argon Plasma Coagulation ; Colon* ; Colonoscopy ; Diverticulum ; Diverticulum, Colon ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Hemostasis ; Humans ; Incidence ; Life Style ; Ligation

Food-dependent exercise-induced anaphylaxis (FDEIA) is a specific variant of exercise-induced anaphylaxis that requires both vigorous physical activity and the ingestion of specific foods. In particular, it is rare occurrence for FDEIA to be associated with meat in Korea. A 15-year-old female had generalized urticaria, dyspnea, severe cough, headache, dizziness, and vomiting after singing and dancing for 1 hour and after ingesting grilled pork. Skin prick tests showed a strong positive reaction to pork, whereas the results of an oral food challenge and exercise provocation tests were negative. However, the exercise provocation test after pork ingestion showed a positive reaction manifested by generalized urticaria, cough, mild dyspnea, and a 23% decreased peak expiratory flow rate. Three allergens to pork (67 kDa, 90 kDa, and 15 kDa) reacted with the patient's serum on immunoglobulin E immunoblotting. We report a case of pork-dependent exercise-induced anaphylaxis in a patient who was sensitive to pork.
Adolescent ; Allergens ; Anaphylaxis ; Cough ; Dancing ; Dizziness ; Dyspnea ; Eating ; Female ; Food Hypersensitivity ; Headache ; Humans ; Immunoblotting ; Immunoglobulin E ; Immunoglobulins ; Korea ; Meat ; Motor Activity ; Peak Expiratory Flow Rate ; Singing ; Skin ; Urticaria ; Vomiting