BACKGROUND: This study was performed to compare anesthetic agents and adjuvants for general anesthesia or regional anesthesia between university hospitals, resident-training general hospitals and hospitals without training program of residents. METHODS: We surveyed university hospitals, resident-training hospitals and hospitals without training program of residents and divided randomly each hospital groups to become twenty hospitals. We compared the use frequency of inhalation anesthetics, muscle relaxants, induction agents, reversing agents, local anesthetics, premedicants, cardiovascular drugs and plasma expanders. RESULTS: Enflurane was most commonly used inhalation anesthetic in all hospital groups. Isoflurane was less commonly used inhalation anesthetic in hospitals without training program of residents. Pancuronium was most commonly used muscle relaxant in university hospitals. Midazolam, ketamine, fentanyl, propofol were commonly used induction agents during induction in university hospitals and resident-training general hospitals. Differences of use frequency of local anesthetics among hospital groups were not significant, but epinephrine mixing with local anesthetics was more frequent in university hospitals and resident-training general hospitals. Midazolam as a premedicant and norepinephrine, phenylephrine, amrinone, esmolol, pentastarch were less used in hospitals without training program of residents. CONCLUSIONS: These results suggest that university hospitals and resident-training general hospitals didn't show difference in anesthestics or adjuvants but hospitals without training program of residents used less commonly isoflurane, atracurium, midazolam, ketamine, propofol, fentanyl, cardiovascular drugs and pentastarch.
Amrinone ; Anesthesia, Conduction ; Anesthesia, General ; Anesthetics* ; Anesthetics, Inhalation ; Anesthetics, Local ; Atracurium ; Cardiovascular Agents ; Education ; Enflurane ; Epinephrine ; Fentanyl ; Hospitals, General* ; Hospitals, University* ; Hydroxyethyl Starch Derivatives ; Inhalation ; Isoflurane ; Ketamine ; Midazolam ; Norepinephrine ; Pancuronium ; Phenylephrine ; Plasma ; Propofol

PURPOSE:There were many controversies whether constitutional delay of growth and puberty(CDGP) is simple varient of normal growth pattern, or one of the cause of growth disturbance induced by the disturbance of growth hormone secrtion or its function. So we studied about the difference in serum peak growth hormone level after insulin, L-dopa provocation test, and serum IGF-I leve between constitutional delay of growth and puberty(CDGP) and familial short stature(FSS). METHODS:Measurement of serum peak growth hormone and insulin like growth factor-I(IGF-I) level after insulin, L-dopa provocation test were performed in 33 children with costitutional delay of growth and puberty (CDGP). Two groups of children with familial short stature (FSS) whose height were below 10 percentile for chronologic age of Korean national height standards were included as control groups. RESULTS: 1)There were no significant difference of serum peak growth hormone level between children with CDGP and children with FSS and these results were similar in both sex. 2)The mean serum IGF-I level of children with CDGP were 125.69+/-4.06 ng/ml(71.53-189.34ng/ml) in male, 157.7+/-3.17ng/ml(81.9-279.2ng/ml) in female. Both results were significantly lower to those of FSS children by chronologic age group because the mean serum IGF-I level of FSS children were 190.19+/-7.97ng/ml (87.64-297.6ng/ml) in male, 205.47+/-15.87ng/ml(61.7-433.1ng/ml) in female. But compared to FSS children by bone age of 72-96 months, there were no significant difference noted because the mean serum IGF-I level of children with FSSwere130.47+/-0.27ng/ml(63.24-198.2ng/ml)inmale,162.35+/-9.43ng/ml(54.9-217.53 ng/ml) in female. CONCLUSIONS:The results of this study showed that the serum peak growth hormone level after insulin, L-dopa provocation test with children of CDGP revealed no significant difference with those of FSS children in both sex. Serum IGF-I level of CDGP children was lower significantly to those of FSS children by chronologic age group, but no much difference with FSS children of bone age group.
Adolescent ; Child* ; Female ; Growth Hormone* ; Humans ; Insulin* ; Insulin-Like Growth Factor I ; Levodopa* ; Male ; Puberty*

No abstract available.
Crohn Disease*

On 6 healthy adult males aged 20-30 years, oxygen pulse was observed during carrying sand bags weighting 10, 20 and 30kg on a level treadmill running with speeds of 3,4 and 5 km/hr. The results obtained were as follows. 1. Oxygen pulse during load carrying on a level treadmill was proportionately increased with an increase of work load, average oxygen uptake per minute. Regression equation of oxygen pulse (y: ml/beat) on the average oxygen uptake (x:l/min) required for each grade of work was expressed as y=3.34x + 5.99, sy.x=0.858. 2. Oxygen pulse reached the highest value 2-5 minutes after the start of load carrying, and thereafter it decreased gradually to some extend as the load carrying was continued. Rate of decrease in the oxygen pulse was gerater in lighter works. 3. In lighter works requiring less than 2.0 l/min of oxygen uptake, oxygen pulse was larger in case of carrying a losd by embrace, in both hands and on head than on back or on shoulder.
Adult ; Hand ; Head ; Humans ; Male ; Oxygen* ; Running ; Shoulder ; Silicon Dioxide

On 6 healthy adult males aged 20-30 years, oxygen pulse was observed during carrying sand bags weighting 10, 20 and 30kg on a level treadmill running with speeds of 3,4 and 5 km/hr. The results obtained were as follows. 1. Oxygen pulse during load carrying on a level treadmill was proportionately increased with an increase of work load, average oxygen uptake per minute. Regression equation of oxygen pulse (y: ml/beat) on the average oxygen uptake (x:l/min) required for each grade of work was expressed as y=3.34x + 5.99, sy.x=0.858. 2. Oxygen pulse reached the highest value 2-5 minutes after the start of load carrying, and thereafter it decreased gradually to some extend as the load carrying was continued. Rate of decrease in the oxygen pulse was gerater in lighter works. 3. In lighter works requiring less than 2.0 l/min of oxygen uptake, oxygen pulse was larger in case of carrying a losd by embrace, in both hands and on head than on back or on shoulder.
Adult ; Hand ; Head ; Humans ; Male ; Oxygen* ; Running ; Shoulder ; Silicon Dioxide

PURPOSE: The aims of this study were to investigate the frequencies and role of hepatitis B virus(HBV) precore and core promotor mutations in children with chronic hepatitis B infection. METHODS: Sera from 46 children with chronic hepatitis B infection were analyzed by direct sequencing of polymerase chain reaction product of HBV DNA. In this study, the patients were divided into vertical and non-vertical groups according to the mode of HBV transmission. Statistical analysis was performed by using Fisher's exact test. RESULTS: Forty-six adr type of HBV DNA were analyzed. The mutations in HBV precore region were observed in 12(26.1Yo) of 46 cases. The GA mutation of nucletide(nt) 1896 was observed in 5 cases(10.9Yo). The frequency of mutations in HBV precore region of the non-vertical group (6/16; 37.5Fo) was higher than that of the vertical group(6/30; 20M), but there was no statistical significance. The mutation in HBV core promotor region was observed in 40(87.0%) of 46 cases. The A-->T mutation of nt 1762 or G-->A mutation of nt 1764 were observed in 24(52.2%) of 46 cases, and 23 cases revealed combined mutation at both positions 1762 and 1764. The frequency of mutations in HBV core promotor region of the vertical group(28/30; 93.3Yo) was higher than that of the non-vertical group(12/16; 75.0M), but there was no statistical significance. The frequencies of mutations in HBV precore and core promotor regions of the HBeAg negative patients was higher than that of HBeAg positive patients, but there was no statistical significance. Also there were no significant correlations between the frequencies of mutations in HBV precore and core promotor regions and AST, ALT level or the level of HBV DNA. CONCLUSION: These observations suggest that mutations in HBV precore and core promotor regions were frequently detected in children with chronic hepatitis B infection. There were no statistical significant differences in the frequencies of mutations in HBV precore and core promotor regions between vertical and non-vertical transmission groups. (J Korean Pediatr Soc 2000; 43:779-791)
Child* ; DNA ; Hepatitis B e Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis B, Chronic* ; Hepatitis* ; Hepatitis, Chronic* ; Humans ; Polymerase Chain Reaction ; Promoter Regions, Genetic

A 63-year-old Korean man presented with generalized, asymptomatic, discrete papules and coalescent annular plaques for one year. Interestingly, the patient complained of conjunctival congestion, concurrently with aggravation of the skin lesion. Histopathologic findings of the skin lesion and conjunctiva revealed giant cells engulfing fragmented elastic fibers, and a diagnosis of actinic granuloma with ocular involvement was made. Ten months later, the patient revisited with a two-week history of bilateral temporal headache, neck pain, intermittent jaw claudication, and blurred vision. Biopsy of the temporal artery confirmed the clinical diagnosis of temporal arteritis. Both actinic granuloma and temporal arteritis show similar pathologic process, and this case supports the hypothesis that actinically degenerated elastic tissue is likely to be the antigenic basis of actinic granuloma of the skin and temporal arteritis.
Actins* ; Biopsy ; Conjunctiva ; Diagnosis ; Elastic Tissue ; Estrogens, Conjugated (USP) ; Giant Cell Arteritis* ; Giant Cells ; Granuloma* ; Headache ; Humans ; Jaw ; Middle Aged ; Neck Pain ; Skin ; Temporal Arteries

PURPOSE: Traditional anterior colporrhaphy repair can have a high recurrence rate. Therefore, the use of synthetic mesh to reinforce the anterior vaginal wall support has been proposed to prevent recurrence. The objective of our study was to compare the anatomic recurrence rates in patients that underwent the traditional anterior colporrhaphy with patients who add a monofilament polypropylene mesh repair(Gynemesh PSTM). MATERIALS AND METHODS: We reviewed the charts of patients who underwent transvaginal cystocele repair between January 2003 and June 2006. All patients had a physical examination and staging of the prolapse; the International Continence Society(ICS) system was used for the staging. Mid urethral sling operations were performed when stress incontinences was an associated feature. An anatomic recurrence was defined as an ICS stage 2 or greater anterior prolapse on the last recorded physical examination. The subjective patient satisfaction was also recorded. RESULTS: Seventy-one patients were available for study with a mean follow- up of 18.4 months. Thirty-eight patients underwent traditional anterior colporrhaphy, while 33 patients underwent cystocele repair using the monofilament polypropylene mesh(Gynemesh PSTM). Among the 71 patients, 9(12.7%) had recurrence of the cystocele. Based on the type of repair, 21.1%(8/38) of the patients with traditional repair had a recurrence compared to 3.0%(1/33) of the patients with the polypropylene mesh repair(p=0.03). With regard to satisfaction, 76.3%(29/38) of the patients with anterior colporrhaphy and 97.0%(32/33) with the mesh repair were satisfied with the outcome of the surgery(p=0.02). One patient had erosion of the mesh, at the midline, in front of the vaginal scar, at 12 months after the procedure. CONCLUSIONS: Our results suggest that the monofilament polypropylene mesh(Gynemesh PSTM) repairs improved the outcomes of anterior colporrhaphy with regard to the prevention of recurrent cystoceles.
Cicatrix ; Cystocele ; Humans ; Patient Satisfaction ; Physical Examination ; Polypropylenes ; Prolapse ; Recurrence ; Suburethral Slings

OBJECTIVE: To investigate the regional differences of skin blood flow and to evaluate the effects of foot temperature on the severity of neuropathic pain and to predict the development of plantar foot ulceration by measuring of the temperature variations on the plantar surface of feet in the diabetic patients. METHOD: We measured the temperature variations on plantar surface of the feet in controls (n=18) and diabetic patients with(n=20) or without(n=23) polyneuropathy. The surface temperature from the 3rd metatarsal head(MTH), greater toe(GT), heel, medial and lateral longitudinal arch(LA) was measured by Digital Infrared Thermographic Imaging(DITI). RESULTS: The mean foot temperature of diabetic patients with polyneuropathy was significantly increased compared to controls or diabetic patients without polyneuropathy(p<0.001). The surface temperature readings of the GT, medial LA and the 3rd MTH tended to be increased in controls and patients with polyneuropathy. The mean plantar surface temperature was significantly increased according to the duration of diabetes mellitus(DM)(p<0.05). CONCLUSION: The results suggest that DITI provides a diagnostic modality in the prediction of neuropathic foot and increased risks of foot ulcer development in the diabetic patients.
Diabetic Neuropathies ; Foot Ulcer* ; Foot* ; Heel ; Humans ; Metatarsal Bones ; Neuralgia ; Polyneuropathies ; Reading ; Skin

OBJECTIVE: To analyze the diagnostic value of digital infrared thermographic imaging(DITI) and to compare the therapeutic effects of lidocaine injection(LI) and dry needling(DN) in the treatment of myofacial pain syndrome(MPS) by using the DITI and visual analogue scale(VAS). METHOD: After 20 minutes adaptation time, 41 patients with MPS and 15 controls undertook DITI. LI and DN were randomly given in the trigger points of the patient group and to either side of the upper trapezius muscle in the controls. The effects of treatment were immediately assessed by measuring the temperature difference(deltaT) of the involved area and the corresponding area on the opposite side of the body using the DITI and VAS. Follow up assessments of VAS, change of VAS, deltaT and change of deltaT were performed 1, 3, 5 and 7 days after the treatment, respectively. RESULT: 1) The sensitivity and specificity of hot spots for TrP were 78.1% and 73.3 %, respectively. 2) deltaT and VAS continuously declined for 7 days after the treatment as compared to before the treatment in groups Ia (n= 16, deltaT>0.6degrees C, LI) and Ib (n=16, deltaT>0.6degrees C, DN). 3) deltaT and VAS ware not statistically different for groups Ia and Ib. 4) There was no statistically significant correlation between deltaT and VAS in both groups I and Ib. CONCLUSION: These data suggest that DITI can be used as one of the valuable tools for the evaluation of trigger points. No significant difference noted in the therapeutic effects of LI and DN for MPS.
Facial Pain ; Follow-Up Studies ; Humans ; Lidocaine* ; Myofascial Pain Syndromes* ; Sensitivity and Specificity ; Superficial Back Muscles ; Thermography ; Trigger Points