PURPOSE: Due to remarkable developments in technology and great efforts made by Health Organizations, most of infectious diseases had been under control. However, ecological changes and biological variations resulted in emerging and re-emerging infectious diseases, which threaten the global health and may have the possibility of being abused as biological weapon. Therefore it is indispensable to understand the latest information and knowledge in order to cope with the emergency situation. RESULTS: In Korea, several reemerging diseases such as Malaria, Hepatitis A, Shigellosis, Mumps, and food poisoning has been increasing conspicuously since 1990. Also Diphtheria, plague, yellow fever and dengue fever have been potential threats, considering substantial international trades. CONCLUSION: There have many newly emerged and re-emerged infectious diseases identified in recent few decades in Korea. Thus as epidemiologic professionals, we have to get ready, particularly following missions to be carried out : 1) to keep eyes open to look for emerging and reemerging diseases continuously and keep up the latest global information, 2) establish the co-operational organizations to prepare immediate action against the sudden outbreak, 3) publicize, educate, establish and perform the missions, taking initiative in training clinicians, 4) upgrade professional competency by familiarizing ourselves with epidemiologic investigations, and 5) fulfill the responsibilities as health keepers of the nation.
Biological Warfare Agents ; Communicable Diseases ; Communicable Diseases, Emerging ; Dengue ; Diphtheria ; Dysentery, Bacillary ; Emergencies ; Epidemiology* ; Foodborne Diseases ; Hepatitis A ; Humans ; Korea ; Malaria ; Missions and Missionaries ; Mumps ; Plague ; Yellow Fever

Kawasaki disease that had been identified and reported as a new syndrome complex by a Japanese pediatrician Kawasaki in 1967 still remains as a disease of unknown etiology despite the enormous research efforts throughout the world. We conducted this literature review study with an attempt to formulate causal gypothesis on Kawasaki disease based on research findings published. Summarizing the research results in terms of clinical, pathologic and epidemiologic characteristics we could characterize the causative agent as followings: (1) The agent should have high infectivity and low pathogenicity causing generalized infection, perhaps with more frequent inapparent infection than apparent infection, particularly among immunocompromized, feeble children by preceded infection, (2) The target organ of the agent seems to be endothelial cells of arteries, (3) The agent appears to take airborne transmission route in very special environment where the agent can be supplied by reservoirs other than human beings, and (4) the agent should be quite ubiquitous around human living environment resulting in high herd immunity among adult population. For the time being we propose Coxiella burneti as a possible causative agent that could satisfy the most of the above characteristics.
Adult ; Arteries ; Asian Continental Ancestry Group ; Child ; Coxiella ; Endothelial Cells ; Humans ; Immunity, Herd ; Mucocutaneous Lymph Node Syndrome* ; Virulence

No abstract available.
Seroepidemiologic Studies*

No abstract available.
Adenocarcinoma* ; alpha-Fetoproteins*

The usefulness of a nondepolarizing muscle relaxant for endotracheal intubation is limited by its relatively slow onset of neuromuscular block compared to that achieved with succinylcholine. Several attempts have been made to produce a more rapid onset of muscle relaxation for endotracheal intubation. A large dose of nondepoarizing muscle relaxant may produce rapid onset but cauae undesirable side effects and a prolonged duration of neuromuscular block. The authors observed the degree of vocal cord relaxation and intubation condition 2 minutes after administration of atracurium and measured changes in mean arterial blood pressure and heart rate at the time of arrival in the operating room, just before abministration of atracurium, 2minutes after administration, and 5mins after intubation. The 40 of patients in this observation were divided into four groups. Group 1; 10patients, received 0.3 mg/kg of atracurium Group 2; 10patients, received 0.4 mg/kg of atracurium Group 3; 10patients, received 0.5 mg/kg of atracurium Group 4; 10patients, received 0.6 mg/kg of atracurium The results were as follows; 1) There were better intubating conditions in Group 3 and 4 than in Group 1 and 2(p<0.001). 2) Mean arterial blood pressure and heart rate did not change significantly after administration of atracurium in all four groups. From the above results we conclude that 0.5~0.6 mg/kg of atracurium provides satisfactory intubation condition 2 minutes after administration without hemodynamic changes.
Arterial Pressure ; Atracurium* ; Heart Rate ; Hemodynamics ; Humans ; Intubation ; Intubation, Intratracheal* ; Muscle Relaxation ; Neuromuscular Blockade ; Operating Rooms ; Relaxation ; Succinylcholine ; Vocal Cords

BACKGROUND AND OBJECTIVES: Age and gender are known to influence the mechanisms of paroxysmal supraventricular tachycardia (PSVT), but large scale data regarding this subject is limited. In addition, data regarding the mechanisms of PSVT in the Korean population is limited. In this study, we sought to investigate the different mechanisms of PSVT according to age and gender in Korean patients. SUBJECTS AND METHODS: Database of 3,176 patients diagnosed with PSVT excluded atrial flutter or atrial fibrillation and referred for electrophysiologic study from 1986 to 2004 was retrospectively analyzed. The mechanisms of PSVT were classified as: WPW syndrome (WPW), atrioventricular reentrant tachycardia (AVRT) due to a concealed bypass tract (CBT), atrioventricular nodal reentrant tachycardia (AVNRT), atrial tachycardia (AT). RESULTS: The mean age was 40.7+/-16.0 (1-90) and 53.3% of the patients were male. The mean age of females was significantly higher than males. (43.0+/-16.1 vs. 38.6+/-15.6, p<0.001) Overall, the dominant mechanism of tachycardia was AVRT at 62.6% (WPW: 31.1%, CBT: 31.5%), compared to AVNRT at 34.1 and AT at 3.1%. This was mainly due to the predominance of AVRT (74.2%; WPW: 38.1%, CBT: 361%) in male. The mechanisms of PSVT differed according to gender with 63.2% (1257/1988) of AVRT patients being males where as 64.6% (700/1084) of the AVNRT patients were females. The distribution of PSVT mechanisms differed according to gender. In males, the proportions of AVNRT : CBT : WPW were 22.7 : 36.1 : 38.1%, whereas in females the proportion was 47.2 : 26.3 : 23.0%. Age had a significant influence upon the mechanism of PSVT in both genders with an increasing proportion of AVNRT and a decreasing proportion of AVRT in the older age groups. AVRT was the dominant mechanism of PSVT in all age groups for males, where as AVNRT was the dominant mechanism of PSVT for females over 50 years of age. CONCLUSION: The mechanism of PSVT differs significantly according to age and gender. This may be due to the increased degeneration of accessory pathway with age and difference in the conduction properties of the accessory pathway according to gender. In Koreans, the overall dominant mechanism of PSVT was AVRT mainly due to it a greater male population.
Atrial Fibrillation ; Atrial Flutter ; Female ; Gender Identity ; Humans ; Male ; Retrospective Studies ; Tachycardia ; Tachycardia, Atrioventricular Nodal Reentry ; Tachycardia, Supraventricular* ; Wolff-Parkinson-White Syndrome

Pheochromocytoma is functioning tumor which originates in the adrenal medulla or in chromaffin tissue along the paravertebral sympathetic chain. This tumor releases epinephrine and norepinephrine causing increase of peripheral resistance and resulting in increased blood pressure and reducing plasma volume. The anesthetic management of patients with pheochromocytoma presents many difficult problems such as hypertension, cardiac arrhythmias, and hypotension. A 40 year-old female underwent resection of pheochromocytoma under general anesthesia. Thiopental was used for induction followed N2O-O2-enflurane supplemented with fractional doses of fentanyl and vecuronium for muscle relaxation. Hypertensive crisis during induction of anesthesia and surgical manipulation of the tumor were managed with phentolamine and sodium nitroprusside, and premature ventricular beats were controlled with lidocaine. We experienced marked fluctuation of blood pressure during anesthetic course.
Adrenal Medulla ; Adult ; Anesthesia ; Anesthesia, General ; Arrhythmias, Cardiac ; Blood Pressure ; Epinephrine ; Female ; Fentanyl ; Humans ; Hypertension ; Hypotension ; Lidocaine ; Muscle Relaxation ; Nitroprusside ; Norepinephrine ; Phentolamine ; Pheochromocytoma* ; Plasma Volume ; Thiopental ; Vascular Resistance ; Vecuronium Bromide ; Ventricular Premature Complexes

There are few methods to control heavy intra-operative bleeding during cesarean delivery of placenta previa. Transient occlusion of uterine arteries (TOUA) during operation has previously been reported as a quick and safe method to control intra-operative uterine bleeding. We reported 2 cases of cesarean delivery with complete placenta previa in which TOUA was performed to safely reduce intra-operative complication, especially heavy intra-operative bleeding. In the 2 cases, cesarean deliveries were safe and without any complications under the TOUA method. TOUA can be a good method to control heavy intra-operative bleeding during cesarean delivery of complete placenta previa with risk of heavy bleeding.
Hemorrhage* ; Placenta Previa* ; Placenta* ; Uterine Artery* ; Uterine Hemorrhage

Fatty liver is caused by derangement of fat metabolism and can be reversed by removal of contributing factors. The contributing factors of fatty liver is known to be overweight, chronic alcoholism, diabetes mellitus, malnutrition, and drug abuse such as tetracycline. This study was carried out on 1335 persons who visited 'Soon Chun Hyang Human Dock Center' from March to June 1990. In analysis of the data, prevalence of fatty liver diagnosed by ultrasonogram by age and sex, laboratory finding between fatty liver group and normal group, and odds ratio of known contributing factors, were compared. The results obtained are as following; 1) The prevalence rate of fatty liver diagnosed by ultrasonogram is 29.6% in male and 11.5% in female. 2) Age groups with high prevalences are 40~50's in male (32.0%) and 50's in female (24.5%). 3) The fatty liver shows significant association with style (p<0.05), whereas not with hepatitis B-virus surface antigen (p>0.05). 4) All laboratory values except alkaline phosphatase and bilirubin are elevated significantly in accordance with the degree of fatty liver (p<0.01). 5) Fatty liver diagnosed by ultrasonogram showed so strong associations with body index, triglycerides and gamma-glutamyl transferase for males, and body index and fasting blood sugar for females that these factors may be used as supplementary data in establishing diagnosis of fatty liver. 6) Odds ratio of contributing factors are as follows; If the odds ratio of below 29 year of age is 1.0 then that of 30~39 is 1.74 (p=0.33), 40~49 is 2.47 (p=0.10), 50~59 is 2.86 (p=0.0570), over 60 is 1.81 (p=0.34). If the odds ratio of female is 1.0 then that of male is 5.67 (p<0.01). If the odds ratio of body index below zero is 1.0 then that of 0~9 is 5.08 (p<0.01), 10~19 is 12.37 (p<0.01), 20~29 is 29.19 (p<0.01), 30 above is 154.02 (p<0.01). If the odds ratio of below 99 mg/dl FBS is 1.0 then that of 100~120 is 106 (p=0.76), over 120 is 1.91 (p=0.02). If the odds ratio of below 29 micron/1 gamma-GT is 1.0 then that of 30~s59 is 2.11 (p<0.01), 60~90 is 1.87 (p<0.05), 90 above is 1.69 (p=0.15). If the odds ratio of below 149 mg/dl TG is 1.0 then 150~199 is 1.49 (p=0.05), 200~250 is 1.09 (p=0.77), 250 above is 2.53 (p<0.01). In summary, early diagnosis of fatty liver could be made by ultrasonogram supplemented with body index and serum triglyceride. The fatty liver could be preventive by avoiding contributing factors such as obesity, alcohol intake, high blood sugar appropriately.
Alcoholism ; Alkaline Phosphatase ; Antigens, Surface ; Bilirubin ; Blood Glucose ; Cross-Sectional Studies* ; Diabetes Mellitus ; Diagnosis ; Early Diagnosis ; Fasting ; Fatty Liver* ; Female ; Hepatitis ; Humans ; Male ; Malnutrition ; Metabolism ; Obesity ; Odds Ratio ; Overweight ; Prevalence* ; Substance-Related Disorders ; Tetracycline ; Transferases ; Triglycerides ; Ultrasonography*

BACKGROUND/AIMS: Bile acid is an important luminal factor that affects gastrointestinal motility and secretion. We investigated the effect of bile acid on secretion in the proximal and distal rat colon and coordination of bowel movements in the guinea pig colon. METHODS: The short-circuit current from the mucosal strip of the proximal and distal rat colon was compared under control conditions after induction of secretion with deoxycholic acid (DCA) as well as after inhibition of secretion with indomethacin, 1,2-bis (o-aminophenoxy) ethane-N,N,N′,N′-tetra-acetic acid (an intracellular calcium chelator; BAPTA), and tetrodotoxin (TTX) using an Ussing chamber. Colonic pressure patterns were also evaluated in the extracted guinea pig colon during resting, DCA stimulation, and inhibition by TTX using a newly developed pressure-sensing artificial stool. RESULTS: The secretory response in the distal colon was proportionate to the concentration of DCA. Also, indomethacin, BAPTA, and TTX inhibited chloride secretion in response to DCA significantly (P < 0.05). However, these changes were not detected in the proximal colon. When we evaluated motility, we found that DCA induced an increase in luminal pressure at the proximal, middle, and distal sensors of an artificial stool simultaneously during the non-peristaltic period (P < 0.05). In contrast, during peristalsis, DCA induced an increase in luminal pressure at the proximal sensor and a decrease in pressure at the middle and distal sensors of the artificial stool (P < 0.05). CONCLUSIONS: DCA induced a clear segmental difference in electrogenic secretion. Also, DCA induced a more powerful peristaltic contraction only during the peristaltic period.
Animals ; Bile ; Calcium ; Colon ; Deoxycholic Acid* ; Gastrointestinal Motility ; Guinea Pigs* ; Guinea* ; Indomethacin ; Intestine, Large* ; Peristalsis ; Phenobarbital ; Rats* ; Tetrodotoxin