BACKGROUND: Tramadol is a centrally acting analgesic with weak opioid agonist properties and has effect on the spinal inhibition of pain. This study was designed to evaluate the efficacy of tramadol in the treatment of postanesthetic shivering. METHODS: Sixty patients (ASA class I/II) who showed postanesthetic shivering were randomly assigned into three groups (n=20): Normal saline group; normal saline 10 ml, tramadol (TRD) 0.5 mg/kg group; tramadol 0.5 mg/kg, TRD 1.0 mg/kg group; tramadol 1.0 mg/kg. And all patients received standard postoperative management in the recovery room. Evaluation of the grade of shivering was done at 30 seconds, 2, 5 and 10 minutes from the beginning of the treatment by the same investigator who had injected the drug. The age, sex, weight, duration of anesthesia and axillary temperature were recorded. RESULTS: By 30 seconds, 2 minutes, 5 minutes, and 10 minutes, 0, 4, 9, 9 patients of the 0.5 mg/kg tramadol group (n=20) and 7, 18, 19, 19 patients of the 1.0 mg/kg tramadol group (n=20) stopped the shivering respectively. But in 3 patients of 0.5 mg/kg tramadol group who stopped shivering by 5 minutes, shivering was recurred within 10 minutes and in 3 patients who had not stopped shivering by 5 minutes, shivering stopped by 10 minutes. In the placebo group, only 1 patient stopped shivering by 5 minutes. CONCLUSION: 1.0 mg/kg of tramadol was effective for the treatment of postanesthetic shivering but 0.5 mg/kg of tramadol was ineffective.
Anesthesia ; Humans ; Recovery Room ; Research Personnel ; Shivering* ; Tramadol*

BACKGROUND: Tramadol is a centrally acting analgesic with weak opioid agonist properties and has effect on the spinal inhibition of pain. This study was designed to evaluate the efficacy of tramadol in the treatment of postanesthetic shivering. METHODS: Sixty patients (ASA class I/II) who showed postanesthetic shivering were randomly assigned into three groups (n=20): Normal saline group; normal saline 10 ml, tramadol (TRD) 0.5 mg/kg group; tramadol 0.5 mg/kg, TRD 1.0 mg/kg group; tramadol 1.0 mg/kg. And all patients received standard postoperative management in the recovery room. Evaluation of the grade of shivering was done at 30 seconds, 2, 5 and 10 minutes from the beginning of the treatment by the same investigator who had injected the drug. The age, sex, weight, duration of anesthesia and axillary temperature were recorded. RESULTS: By 30 seconds, 2 minutes, 5 minutes, and 10 minutes, 0, 4, 9, 9 patients of the 0.5 mg/kg tramadol group (n=20) and 7, 18, 19, 19 patients of the 1.0 mg/kg tramadol group (n=20) stopped the shivering respectively. But in 3 patients of 0.5 mg/kg tramadol group who stopped shivering by 5 minutes, shivering was recurred within 10 minutes and in 3 patients who had not stopped shivering by 5 minutes, shivering stopped by 10 minutes. In the placebo group, only 1 patient stopped shivering by 5 minutes. CONCLUSION: 1.0 mg/kg of tramadol was effective for the treatment of postanesthetic shivering but 0.5 mg/kg of tramadol was ineffective.
Anesthesia ; Humans ; Recovery Room ; Research Personnel ; Shivering* ; Tramadol*

OBJECTIVE: To evaluate the safety and potential efficacy of "recombinant human growth hormone (rhGH)" on the functional recovery of completed stroke patients. METHOD: Completed stroke patients were recruited. All participants were randomly assigned to the GH group (rhGH injection and rehabilitative therapy) or the control group (only rehabilitative therapy). Above all, they were closely monitored for safety. Further, for the efficacy measurement, Korean Modified Barthel Index (K-MBI), Manual Muscle strength Test (MMT), and Fugl-Meyer assessment (FMA) were assessed to determine the changes of functional recovery during 6-months of the study period. Along with it, diffusion tensor image was taken as the baseline, and a followed-up study to observe the changes in diffusion tensor tractography (DTT), during the period, and one patient in the GH group was also examined with functional MRI (fMRI). Index of fatigue on 5 point scale for the study period was also assessed. RESULTS: Twenty-two patients were enrolled, and 15 completed the study and were included in the analysis. No harmful adverse events were observed in the GH group. By comparison between the groups, the GH group showed more improvement in K-MBI than the control group (p<0.05). DTT showed less decrement of fibers in the GH group than in the control group, without statistical significance. fMRI showed an increment in the activated area. Patients in the GH group expressed no fatigue at all, during the study period (p=0.00). CONCLUSION: The administration of rhGH in long term resulted in the improvement in K-MBI, and subjectively less tiredness during the injection period.
Diffusion ; Fatigue ; Growth Hormone ; Human Growth Hormone ; Humans ; Insulin-Like Growth Factor I ; Magnetic Resonance Imaging ; Muscle Strength ; Stroke

BACKGROUND: Although topically applied laryngeal lidocaine is known to be effective in preventing the cardiovascular events associated with endotracheal intubation, it is still debated whether the mechanism of action of topically applied laryngeal lidocaine is via increased plasma concentration of lidocaine or via topically induced superficial anesthesia. The purpose of the present study is to observe vocal cord responses to stimulation and to find out whether topically induced superficial anesthesia with 10% lidocaine spray is effective under propofol anesthesia. METHODS: Twenty-four patients scheduled for operation on the upper or lower extremities were randomly allocated to two groups: (1) twelve patients who did not receive 10% lidocaine spray before the insertion of a laryngeal mask airway (LMA), (2) twelve patients who received 10% lidocaine spray before the insertion of LMA. The vocal cords of each patient were stimulated by the spraying of 0.2 ml distilled water or directly by bronchoscope tip, and the evoked responses were assessed by analyzing the hemodynamic and respiratory variables and vocal cord movement. The vocal cord movements elicited by the laryngeal stimulation were classified into four grades. RESULTS: There was a significant difference between the groups regarding vocal cord movement (P < 0.05). There were no differences between the groups regarding hemodynamic and respiratory variables. CONCLUSIONS: The result indicates that there is a topical anesthetic effect on the vocal cords by 10% lidocaine spray on the larynx.
Anesthesia ; Anesthetics* ; Bronchoscopes ; Hemodynamics ; Humans ; Intubation, Intratracheal ; Laryngeal Masks ; Larynx* ; Lidocaine* ; Lower Extremity ; Plasma ; Propofol ; Vocal Cords ; Water

Hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome is a variant presentation of severe preeclampsia/eclampsia. A 24-year old woman presented herself at 34 wk of pregnancy. Based on the clinical and laboratory assessment, HELLP syndrome was diagnosed. Cesarean section was performed under general anesthesia without invasive monitoring due to stable blood pressure. The course of anesthesia and surgery was uneventful and she delivered female neonate weighing 1770 gram. After the operation, the patient was transferred to the intensive care unit immediately. During the intensive care bleeding started and signs of disseminated intravascular coagulopathy showed up. Any improvement was not made after transfusion and every other supportive therapy. By the request of guardian, she was transferred to tertiary hospital, where she died.
Anesthesia* ; Anesthesia, General ; Anesthesia, Obstetrical ; Blood Pressure ; Cesarean Section* ; Female ; HELLP Syndrome* ; Hemolysis ; Hemorrhage ; Humans ; Infant, Newborn ; Critical Care ; Intensive Care Units ; Liver ; Pregnancy ; Tertiary Care Centers ; Young Adult

BACKGROUND: The recovery of spontaneous ventilation is delayed in elderly patients in whom muscle relaxants has been administered for general anesthesia. We evaluated the appropriateness of microscopic cataract surgery without using muscle relaxants in elderly patients. METHODS: Forty two ASA physical status I and II patients for cataract surgery were randomly assigned to two groups. Glycopyrrolate 0.2 mg, fentanyl 2 mcg/kg and propofol 2 mg/kg were administered intravenously followed by vecuronium 1 mg/kg iv in group I and 10% lidocaine 1.5 mg/kg spray into oropharynx in group II. Laryngeal mask (LMA) was inserted for airway management and anesthesia was maintained by only propofol infusion in both groups. Whether the patient moved during the surgery, whether ephedrine was administered and the propofol infusion rate were recorded. RESULTS: Six patients of group I and 1 patient of group II were moved during surgery. Only in group II, 7 patients received intravenously ephedrine administration. Mean infusion rate of propofol was 0.114 mg/kg/min in group I and 0.159 mg/kg/min in group II. CONCLUSION: In general anesthesia for microscopic cataract surgery, the combination of fentanyl 2 mcg/kg, propofol 2 mg/kg and infusion, 10% lidocaine spray and laryngeal mask without muscle relaxants is a good alternate method of keeping airway.
Aged ; Airway Management ; Anesthesia* ; Anesthesia, General ; Cataract* ; Ephedrine ; Fentanyl ; Glycopyrrolate ; Humans ; Laryngeal Masks ; Lidocaine ; Oropharynx ; Propofol ; Vecuronium Bromide ; Ventilation

BACKGROUND: The recovery of spontaneous ventilation is delayed in elderly patients in whom muscle relaxants has been administered for general anesthesia. We evaluated the appropriateness of microscopic cataract surgery without using muscle relaxants in elderly patients. METHODS: Forty two ASA physical status I and II patients for cataract surgery were randomly assigned to two groups. Glycopyrrolate 0.2 mg, fentanyl 2 mcg/kg and propofol 2 mg/kg were administered intravenously followed by vecuronium 1 mg/kg iv in group I and 10% lidocaine 1.5 mg/kg spray into oropharynx in group II. Laryngeal mask (LMA) was inserted for airway management and anesthesia was maintained by only propofol infusion in both groups. Whether the patient moved during the surgery, whether ephedrine was administered and the propofol infusion rate were recorded. RESULTS: Six patients of group I and 1 patient of group II were moved during surgery. Only in group II, 7 patients received intravenously ephedrine administration. Mean infusion rate of propofol was 0.114 mg/kg/min in group I and 0.159 mg/kg/min in group II. CONCLUSION: In general anesthesia for microscopic cataract surgery, the combination of fentanyl 2 mcg/kg, propofol 2 mg/kg and infusion, 10% lidocaine spray and laryngeal mask without muscle relaxants is a good alternate method of keeping airway.
Aged ; Airway Management ; Anesthesia* ; Anesthesia, General ; Cataract* ; Ephedrine ; Fentanyl ; Glycopyrrolate ; Humans ; Laryngeal Masks ; Lidocaine ; Oropharynx ; Propofol ; Vecuronium Bromide ; Ventilation

Athletic performance is a complex multifactorial trait involving genetic and environmental factors. The heritability of an athlete status was reported to be about 70% in a twin study, and at least 155 genetic markers are known to be related with athlete status. Mitochondrial DNA (mtDNA) encodes essential proteins for oxidative phosphorylation, which is related to aerobic capacity. Thus, mtDNA is a candidate marker for determining physical performance. Recent studies have suggested that polymorphisms of mtDNA are associated with athlete status and/or physical performance in various populations. Therefore, we analyzed mtDNA haplogroups to assess their association with the physical performance of Korean population. The 20 mtDNA haplogroups were determined using the SNaPshot assay. Our result showed a significant association of the haplogroup F with athlete status (odds ratio, 3.04; 95% confidence interval, 1.094 to 8.464; p = 0.012). Athletes with haplogroup F (60.64 ± 3.04) also demonstrated a higher Sargent jump than athletes with other haplogroups (54.28 ± 1.23) (p = 0.041). Thus, our data imply that haplogroup F may play a crucial role in the physical performance of Korean athletes. Functional studies with larger sample sizes are necessary to further substantiate these findings.
Athletes ; Athletic Performance ; DNA, Mitochondrial ; Genetic Markers ; Humans ; Oxidative Phosphorylation ; Sample Size

OBJECTIVE: The aim of this study was to examine the effects of maternal age on perinatal and obstetric outcomes with respect to maternal age older than 40 years. METHODS: A retrospective review of maternal and newborn medical records of women who delivered their babies in the hospitals of the Catholic University of Korea between January 1, 2000 and July 1, 2005 was conducted to compare pregnancy complications and perinatal outcomes in three age groups; women aged 25~29 years (group A; n=214), those aged 35~39 years (group B; n=276), and those aged 40 years and older (group C; n=347). RESULTS: The incidences of GDM (gestational diabetes mellitus), preterm birth and cesarean section in group C were by far the greatest among the three groups. The incidence of postterm delivery in group A was the highest among the three groups. Previous cesarean section and elderly gravida were the most frequent causes of cesarean section in group C. The incidences of low birth weight (<2,500 g) and the NMICU(neonatal medical intensive care unit) admission rate in group C were higher than those in group B, but not significantly different from those in group A. CONCLUSION: Maternal ages of 35~39 years do not appear to be associated with adverse perinatal and obstetrical outcomes. Maternal ages of over 40 years influence the incidences of PIH (pregnancy induced hypertension), GDM, preterm birth, cesarean section, placenta previa, low birth weight and NMICU admission.
Aged ; Cesarean Section ; Female ; Humans ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Critical Care ; Korea ; Maternal Age* ; Medical Records ; Placenta Previa ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome* ; Pregnancy* ; Premature Birth ; Retrospective Studies

BACKGROUND: It has been reported that heat shock protein 70 (HSP70) and interleukin-8 (IL-8) play an important role in cells during the wound healing process. However, there has been no report on the effect of HSP70 and IL-8 on the blisters of burn patients. OBJECTIVE: This study aimed to evaluate the serial quantitative changes of HSP70 and IL-8 in burn blisters. METHODS: Twenty-five burn patients were included, for a total of 36 cases: twenty cases on the first day, six cases on the second, five cases on the third, three cases on the fourth, and two cases on the fifth. A correlation analysis was performed to determine the relationship between the concentration of HSP70 and IL-8 and the length of the treatment period. RESULTS: The HSP70 concentration was the highest on the first day, after which it decreased down to near zero. Most HSP70 was generated during the first 12 hours after the burn accident. There was no correlation between the concentration of HSP70 on the first day and the length of the treatment period. No measurable concentration of IL-8 was detected before 5 hours, but the concentration started to increase after 11 hours. The peak value was measured on the fourth day. CONCLUSION: While HSP70 increased in the first few hours and decreased afterwards, IL-8 was produced after 11 hours and increased afterward in burn blister fluid. These findings provide new evidence on serial changes of inflammatory mediators in burn blister fluid.
Blister* ; Burns* ; Heat-Shock Proteins* ; Hot Temperature* ; HSP70 Heat-Shock Proteins* ; Humans ; Interleukin-8 ; Wound Healing ; Wounds and Injuries