BACKGROUND: Both propofol and ketamine are useful hypnotics for induction of anesthesia, and the combination of propofol and ketamine has been used for total intravenous anesthesia. The aim of this study was to evaluate the dose response of propofol, ketamine and combination of these drug, and determine possible interaction between two drugs in patients. METHODS: The effect of ketamine on the dose response curve for propofol was studied in unpremedicated 165 ASA physical status I or II patients who were scheduled for elective operation. As an endpoint of hypnosis, ability to open eyes on verbal command was checked. Dose response curves for propofol and ketamine were determined with a probit procedure and their type of pharmacologic interaction was determined by fractional and isobolographic analysis. RESULTS: At the hypnotic endpoint, the ED50s were 1.13 mg/kg propofol, 0.66 mg/kg ketamine, and the ED95s were 1.67 mg/kg propofol, 1.09 mg/kg ketamine. The type of interaction between two drugs for hypnosis was found to be additive and ketamine was 1.7 times potent than propofol as an equieffective dose of hypnosis. CONCLUSIONS: The type of interaction between propofol and ketamine for hypnosis was additive.
Anesthesia* ; Anesthesia, Intravenous ; Humans ; Hypnosis ; Hypnotics and Sedatives ; Ketamine* ; Propofol*

BACKGROUND: Propofol is useful agents for anesthesia induction and maintenance, but pain on injection and possible hypotension are a commonly encountered problems during induction. Meanwhile, ketamine has potent analgesic and sympathomimetic effect. Therefore, we evaluated the effect of ketamine pretreatment on injection pain and hemodynamic changes during induction with propofol. METHODS: Premedicated one hundred and twenty ASA physical status I or II patients scheduled for elective surgery were randomly allocated into one of four groups (group 1; propofol only, group 2, 3, 4; pretreatment with 25%, 50%, 75% dose of hypnotic ED50 of ketamine, respectively) groups. Intensity and frequency of injection pain, mean arterial pressure and pulse rate were checked for evaluation of ketamine pretreatment on injection pain and hemodynamic changes during induction with propofol. RESULTS: Incidence of pain on injection was significantly reduced in group 2,3 and 4 compared with group 1. Group 2 and 3 showed more stable hemodynamic changes than Group 1 and 4. CONCLUSIONS: 25-50% of hypnotic ED50 of ketamine (0.17-0.33 mg/kg) pretreatment reduced pain on injection and hemodynamic changes during propofol induction significantly.
Anesthesia* ; Arterial Pressure ; Heart Rate ; Hemodynamics* ; Humans ; Hypotension ; Incidence ; Ketamine* ; Propofol* ; Sympathomimetics

No abstract available.
Kidney Transplantation* ; Urinary Tract Infections* ; Urinary Tract*

Backgound: The placement of stents in coronary arteries has been shown to reduce acute closure and restenosis in comparison to balloon angioplasty. However, clinical use of intracoronary stents is impeded by the subacute stent thrombosis and hemorrhagic complications associated with the anticoagulant regimen. It's known that the complete stent deployment with high pressure inflation and new antiplatelet agents are effective in reduction of subacute thrombosis and hemorrhage. So we evaluated initial results (success and complication rate) after high pressure-stent deployment with new anticoagulation protocol. METHODS: One hundred and ninety one patients with 201 lesions were treated with 231 stents of various types. The high pressure balloon inflation and antiplatelets agents were used in all cases. Final high pressure balloon inflation guided by IVUS were performed in 23 consecutive cases with incomplete stent deployment according to angiographic findings. RESULTS: 1) The indications of stenting (n=210) were De novo in 124 (59%), bailout procedure in 57 (27%), suboptimal result after PTCA in 19 (8%), and restenosis after PTCA in 14 (6%). The location of lesions were LAD in 101, RCA in 67, circumflex in 28, ramus intermedius in 3, and LMT artery in 2 lesions. Angiographic morphologic characteristics were type A in 2, type B in 158 (B1: 57, B2: 101), and type C in 22 lesions. 2) The angiographic and clinical success rate was 96% (192/201) and 92% (186/201) respectively. 3) In angiographic analysis, the baseline average reference vessel dirmeter was 3.33+/-0.35 mm. Baseline minimum lumen diameter (MLD) was 0.58+/-0.29 mm, with baseline percent diameter stenosis of 82.86+/-8.64%. The final stent diameter was 3.37+/-0.29 mm, with mean final percent stenosis of 0.63+/-8.25. The mean MLD after stenting was significantly increased (p<0.001). The mean MLD within stent increased 14%, from 2.91+/-0.39 mm at the nominal balloon inflation (inflation pressure=7 atm) to 3.37+/-0.29 mm at high pressure balloon inflation (inflation pressure <0A65B>12atm) (p<0.001). The length of lesions in GR I (cook), GR II, and Micro II stents were significantly longer than ones in PS, Cordis, Wiktor, Nir (p<0.001). 4) In intravascular ultrasound analysis, the mean lumen CSA at the tightest point within stent increased 11%, from 8.4+/-2.4 mm2 at the intial intravascular ultrasound to 9.4+/-2.1 mm2 at the final intravascular ultrasound (p<0.001). 5) The procedural and postprocedural complications were 2 acute closures associated with AMI and emergent CABG, 1 subacute closure which was revascularized by bail out stenting, 5 major hemorrhage requiring transfusion associated with 1 CVA and 2 metabolic acidosis induced by acute renal failure, and 5 death. CONCLUSION: The high pressure stent deployment procedure and new anticoagulation protocol associating tidopidine and aspirin without coumadin or prolonged heparin infusion allow us to obtain an acceptably low subacute thrombosis or bleeding complication rate. These results are encouraging and allow a wide use of coronary stenting.
Acidosis ; Acute Kidney Injury ; Angioplasty, Balloon ; Arteries ; Aspirin ; Constriction, Pathologic ; Coronary Vessels* ; Hemorrhage ; Heparin ; Humans ; Inflation, Economic ; Platelet Aggregation Inhibitors* ; Stents* ; Thrombosis ; Ultrasonography ; Warfarin

OBJECTIVES: The purpose of this study was to heighten the community residents' support and approval on the community water fluoridation program, which presents the basic data in devising strategies that will expand the program. METHODS: The research subjects of this study were 700 adults, over the age of 20, who resided in the Incheon Metropolitan City. In order to analyze the factors that were related to the approval on administering the community water fluoridation program, the data were analyzed using a chi-squared test and a multiple logistic regression analysis. RESULTS: Respondents approving the implementation of the community water fluoridation program, in Incheon Metropolitan City, were 58.7%. Major reasons for opposing the program were 'harmful', 'influence the taste and color of water', and 'objections without a particular reason'. The approval rate for implementation of the program was higher in the group who perceived that oral health was good and practiced oral health behaviors, like visiting the dental clinics on a regular basis. Also, it was higher in the group who had the experience of hearing of this program at least once and a higher knowledge of the community water fluoridation program. Especially, the strongest correlations were found between the knowledge of community water fluoridation program and the approval rate for implementation the program. CONCLUSIONS: In order to enhance the rate of approval on administrating the community water fluoridation program, it is necessary to publicize the purpose, effect, and stability of this program, through a diverse mass media and reinforce the health education program to oral health management.
Adult ; Surveys and Questionnaires ; Dental Caries ; Dental Clinics ; Fluoridation ; Health Education ; Hearing ; Humans ; Logistic Models ; Mass Media ; Oral Health ; Research Subjects

PURPOSE: Lennox-Gastaut syndrome is an intractable epilepsy which is comprised of several types of etiology and generalized seizures. It also combines with mental retardation. The present study was made to ascertain the clinical study on Lennox-Gastaut syndrome in Korea. METHODS: From January, 1985 to December, 1995, 31 children, diagnosed with Lennox-Gastaut syndrome at Kyung Hee University Hospital, were analyzed retrospectively. RESULTS: The ratio of male to female was 2.4:1. With regard to etiology, idiopathic form was found in 7 cases (22.6%) and symptomatic form in 24 cases (77.4%). Transition from West syndrome to Lennox-Gastaut syndrome was observed in 14 cases (45.2%). The most common type of seizure was tonic seizure which was seen in 19 cases (61.3%) and atypical absence, myoclonic seizure and atonic seizure were also observed. The most common clinical signs and symptoms were mental retardation, but others such as progressive loss of psychomotor function and attention deficit were also frequently associated with this syndrome. The EEG usually had abnormal background activity, slow spike and wave complexes and often showed multifocal abnormalities. In spite of intractable epilepsy, 18 cases (58.1%) were controlled with complex anticonvulsant therapy. CONCLUSION: Lennox-Gastaut syndrome manifested itself in children aged 1-6 years and had polyetiology. Most tonic seizures and mental retardation were observed. After complex anticonvulsant therapy with vigabatrin, complete remission was induced in many cases.
Child ; Electroencephalography ; Epilepsy ; Female ; Humans ; Infant ; Infant, Newborn ; Intellectual Disability ; Korea ; Male ; Retrospective Studies ; Seizures ; Spasms, Infantile ; Vigabatrin

OBJECTIVES: Chromosomal anomalies are common disease entity among genetic diseases. But there are scanty reports about the status of chromosomal abnormalities in Korean. In addition, the comprehensive multi-center study of chromosomal abnormalities in Korean has never been performed. METHODS: We have collected 1,793 cases (394 abortuses; 198 chorionic villi; 1,060 amniotic fluid cells; 141 fetal blood), which showed abnormal karyotype results from twenty three cytogenetic centers in Korea from the year of 1977 to 1999. RESULTS: In abortuses, numerical chromosomal abnormalities was 85%, and structural abnormalities was 13% and the most frequent anomaly was trisomy 16. In chorionic villi, numerical anomaly was 60.0% and structural anomaly was 31.3% and the most frequent karyotype was Down syndrome. In amniotic fluid cells, structural anomaly exceeded the number of numerical anomaly and the most frequent anomaly was Down syndrome. In fetal blood, numerical anomaly was 63.8% and the most frequent karyotype was trisomy 18 (23.4%) CONCLUSIONS: This may be the first comprehensive and multi-center study in Korea. The proportion of the abnormal karyotypes in each specimens was different from each other. Based on this study, the more comprehensive study should be performed to all the Korean population.
Abnormal Karyotype ; Amniotic Fluid ; Chorion* ; Chorionic Villi* ; Chromosome Aberrations ; Cytogenetics ; Down Syndrome ; Female ; Fetal Blood* ; Karyotype ; Korea ; Trisomy

No abstract available.
Animals ; Lordosis*

Objectives: The purpose of the study was to investigate the factors affecting unmet dental care needs among elderly living alone. Methods: The study subjects were 19,019 elderly living by themselves, who participated in the Korea Community Health Survey 2018 (KCHS, 2018). The data were analyzed using frequency analysis, Rao-Scott chi-square test, t-test, and binary logistic regression analysis, using the SAS 9.4 software. Results: Results from the multiple logistic regression analysis revealed a higher odds ratio (OR) for unmet dental care needs among those with a monthly household income below KRW 1,000,000 (OR=1.64, 95% confidence interval, 95%CI=1.39-1.92), compared to those with an income of above KRW 2,000,000. With regards to stress levels, unmet dental care needs were more prevalent among participants in the “stress moderate” (OR=1.19, 95% CI=1.06-1.33) and “stress” groups (OR=1.68 95% CI=1.48-1.92), compared to the “no stress” group. Furthermore, the OR for unmet dental care needs was significantly higher among participants in the “depression” group (OR=1.84, 95% CI=1.61-2.11) than the “no depression” group. Conclusions Higher unmet dental care needs were found among participants in the low monthly household income, stress, and depression groups. Further study is needed to analyze the association between factors and needs related to unmet dental care.

Objectives: The purpose of the study was to investigate the factors affecting unmet dental care needs among elderly living alone. Methods: The study subjects were 19,019 elderly living by themselves, who participated in the Korea Community Health Survey 2018 (KCHS, 2018). The data were analyzed using frequency analysis, Rao-Scott chi-square test, t-test, and binary logistic regression analysis, using the SAS 9.4 software. Results: Results from the multiple logistic regression analysis revealed a higher odds ratio (OR) for unmet dental care needs among those with a monthly household income below KRW 1,000,000 (OR=1.64, 95% confidence interval, 95%CI=1.39-1.92), compared to those with an income of above KRW 2,000,000. With regards to stress levels, unmet dental care needs were more prevalent among participants in the “stress moderate” (OR=1.19, 95% CI=1.06-1.33) and “stress” groups (OR=1.68 95% CI=1.48-1.92), compared to the “no stress” group. Furthermore, the OR for unmet dental care needs was significantly higher among participants in the “depression” group (OR=1.84, 95% CI=1.61-2.11) than the “no depression” group. Conclusions Higher unmet dental care needs were found among participants in the low monthly household income, stress, and depression groups. Further study is needed to analyze the association between factors and needs related to unmet dental care.