It is well known that lidocaine and propranolol possess antiarrhythmic properties. In addition, the former has direct myocardial depressant effects with indirect stimulant effects mediated by the autonomic nervous system and the latter has negative chronotropic, inotropic and dromotropic effects through beta-adrenergic blockade. The heart rate is one of the principle determinants of myocardial oxygen demand, so prevention and treatment of tachycardia are very important during anesthesia. Therfore, the present study was undertaken to evaluate the effects of lidocaine(1mg/kg) and propranolol (0.02mg/kg) on the heart rates and blood pressures in patients with tachycardia(100~120 beats per minute) under halothane-nitrons oxide anesthesia. The results were as follows: 1) In the lidocaine receiving group, the heart rate and blood pressure decreased slightly, but these changes were not statistically significant. 2) in the propranolol receiving group, the heart rate decreased significantly and reached steady value(13bpm, p<0.01) at 7 min and blood pressure decreased slightly, but these changes were not statistically significant. 3) In propranolol-lidocaine mixture receiving group, heart rate decreased significantly and reached to steady value(13bpm, p<0.01) at 5 min and systolic blood pressure decreased about 5 torr(p<0.05), but the diastolic blood pressure remained unchanges. From the above results, it is suggested that the lidocaine and propranolol mixture rather than individual is more valuable in restoring the heart rate and blood pressure to normal value.
Anesthesia* ; Autonomic Nervous System ; Blood Pressure* ; Heart Rate* ; Heart* ; Humans ; Lidocaine* ; Oxygen ; Propranolol* ; Reference Values ; Tachycardia

BACKGROUND: Oral allergy syndrome(OAS) is composed of it,ching sense and edema in oral cavity, lips, throat, pharynx, and larynx following eating some fresh fruits or vegetables. It has been known that most of patients with OAS are allergic to pollens. Common epitopes were found among pollens, fruits and vegetables. Although OAS is a common farm of food allergy in adults, this is the first epidemiologic study of OAS in Korea. MATERIAL AND METHOD: One hundred and fifty one patients who showed positive skin reaction to pollens were telephone-interviewed. Investigation of the prevalence and clinical manifestations of OAS was possible in 81 patients. RESULT: The prevalence of OAS among these patients was 34.6% (28/81). OAS was found in 24(48%) out of 50 patients sensitized to tree pollens, whereas 4(13%) of 31 grass or weed pollen-sensitized paients had OAS. Most common causative food was apple and all of 17 apple- OAS patients were sensitized to tree pollens. Peach was the second common food and 14 of 15 peach-OAS patients were sensitized to tree pollens. Besides oral symptoms, rhinitis, asthma, diarrhea, nausea, vomiting or generalized urticaria were accompanied in half of the OAS patients (14/28). Some patients showed OAS to some unique Korean foods such as dropwort, taro and Aster. CONCLUSION: OAS was very common in pollen-sensitized patients. Larger epidemiologic studies are needed to find unique Korean foods and their antigensm causing OAS.
Adult ; Asthma ; Colocasia ; Diarrhea ; Eating ; Edema ; Epidemiologic Studies ; Epitopes ; Filipendula ; Food Hypersensitivity ; Fruit ; Humans ; Hypersensitivity* ; Korea ; Larynx ; Lip ; Mouth ; Nausea ; Pharynx ; Poaceae ; Pollen* ; Prevalence ; Prunus persica ; Rhinitis ; Skin ; Urticaria ; Vegetables ; Vomiting

We retrospectively reviewed the medical records of 25 cases of removal of macular epiretinal membrane who had been treated by vitrectomy. Indication for vitrectomy was decreased central vision less than 20/60, metamorphopsia or progressive decreased vision (more than 2 lines on Snellen chart) during 6 months.Preoperative and postoperative examination include best corrected visual acuity, biomicroscopic fundus examination with contact and other routine ocular examination.A standard three port pars plana vitrectomy with removal of membrane was performed in all cases, and the lens was removed when necessary.The average follow up period was 12.9 +/-8 . 4 months.Nineteen of 25 eyes (76%)showed a postoperative visual improvement of two lines or more on Snellen chart.Postoperative visual acuity was improved more than 20/40 in 10 of 25 eyes (40%).Postoperative complications were recurrence of uveitis in 3 eyes, progressive cataract in 6 of 14 phakic eyes and recurrent epiretinal membrane in 1 eye.This study demonstrates that vitrectomy for macular epiretimnal membrane results in the overall favorable visual prognosis without serious complication.
Cataract ; Epiretinal Membrane* ; Follow-Up Studies ; Medical Records ; Membranes ; Prognosis ; Recurrence* ; Retrospective Studies ; Uveitis ; Vision Disorders ; Visual Acuity ; Vitrectomy

BACKGROUND: Chronic cough is a common clinical problem to which various etiologies are attributable; postnasal drip, asthma, gastroesophageal reflux (GER) and chronic bronchitis, However, in some cases, no particular etiology can be confirmed. OBJECTIVE: This study was aimed to evaluate cough sensitivity and the clinical manifestations of patients with idiopathic chronic cough. MATERIALS AND METHODS: We recruited 70 non-smoking patients who had been coughing for more than 3 weeks without any history, symptoms or signs of rhinitis, sinusitis, typical asthma, GER or recent upper respiratory infection episodes. Nineteen healthy controls were also enrolled. Bronchial provocation tests with methacholine, capsaicin and distilled water (DW) were performed. RESULTS: Thirteen patients were positive to rnethacholine test (PC20 < 25mg/ml) and defined as cough variant asthma. The others are classified into idiopathic chronic cough. By capsaicin and DW challenge tests, idiopathic cough patients could be divided into two groups, i.e., increased cough sensitivity (ICS) and normal cough sensitivity (NCS) groups. DW- induced cough counts were negatively correlated with C7 (lowest capsaicin concentration inducing continuous 7 or more coughs) (r=-0.739, p<0.001). No difference was found in clinical features such as age, sex, atopy, or peripheral eosinophil counts between these two groups but cough counts per cough burst were significantly higher in the ICS group. CONCLUSION: The heterogeneity in cough sensitivity of idiopathic chronic cough patients may refiect different pathophysiologic mechanisms. It is unclear whether patients with NCS merely have habitual or psychogenic cough or not. These suggest that different therapentic strategies should be established on idiopathic chronic cough patients according to cough sensitivity.
Asthma ; Bronchial Provocation Tests ; Bronchitis, Chronic ; Capsaicin ; Cough* ; Eosinophils ; Gastroesophageal Reflux ; Humans ; Methacholine Chloride ; Population Characteristics ; Rhinitis ; Sinusitis ; Water

Immunosuppressive agent has been used as a therapeutic agent for Endogeneous posterior uveitis[EPU]. But serious side effect of steriod or cyclosporine and frequent recurrence of ocular inflammation warrant the addition of other immunosuppressive agents. In this study, we evaluated the therapeutic effectiveness of low dose triple therapy using steroid, cyclosporine and azathioprine when combination therapy with steroid and cyclosporine had failed. We reviewed the records of 10 Behcet's patients[18 eyes]and 2 sympathetic ophthalmia patients[2 eyes]who had been resistant to steroid and cyclosporine combination therapy. The median follow up duration of triple therapy was 16.3 months. Recurrence, severity of inflammation, systemic manifestations associated with Behcet's disease, and side effect of therapeutic agents were evaluated. There was a significantly decrease in the frequency[0.37/month during pretriple therapy and 0.14/month after triple therapy]and severity of ocular inflammation[p<0.01]. The frequency and severity of systemic manifestations also decreased. Visual acuity remained stable in 7 eyes[35%]and improved in 13 eyes[65%]. No serious side effects or newly developed side effect were developed during triple therapy except reversible mild anemia in 1 patient. The results of our study suggest that triple agent immunosuppressive therapy is well tolerated and appears to be effective for the severe uveitis which is refraction to steroid and cyclosporine combination therapy.
Anemia ; Azathioprine ; Cyclosporine* ; Follow-Up Studies ; Humans ; Immunosuppressive Agents ; Inflammation ; Ophthalmia, Sympathetic ; Recurrence ; Uveitis* ; Visual Acuity

BACKGROUND: Herpetic disorders cause pain and skin lesion. So, asymmetric temperature of both sides of the involving dermatome has been reported in thermogram. This study examined the usefulness of infrared thermography for a predictor of post-herpetic neuralgia (PHN). METHODS: Patients with acute herpes zoster who underwent nerve block were randomly selected. Biographic data, including age, gender and times of onset of the skin lesions, development of PHN, combined diseases were recorded. Infrared thermography was performed and subjective pain severity, dysesthesia and allodynia, skin lesion size were assessed. RESULTS: The temperature differences between the lesion site and the contralateral site at lateral and posterior were significantly correlated with lesion size (P < 0.01) and the temperature differences at anterior and lateral site were correlated with duration of disease (ant: P < 0.01, lat: P < 0.05). The temperature differences were not correlated with the pain severity, dysesthesia and allodynia (P > 0.05). PHN was correlated with skin lesion size and infrared thermal imaging (P < 0.01). CONCLUSIONS: Infrared thermal imaging cannot demonstrate subjective pain objectively in herpes zoster. Short duration showed high temperature on the lesion sites compared to the contralateral sites. The patients with big skin lesions developed PHN more. The PHN can be predicted by the infrared thermal imaging as low temperature on the lesion site compared to the contralateral site.
Herpes Zoster* ; Humans ; Hyperalgesia ; Nerve Block ; Neuralgia ; Paresthesia ; Skin ; Thermography

BACKGROUND: Although adequate removal of small solutes are essential for effective hemodialysis, many patients are suffering from inadequate delivery of hemodialysis, especially with the conventional fixed regimen of dialysis for 4 hours three times per week. We tried to evaluate actual delivered dose of hemodialysis in patients receiving 4 hours of low-flux hemodialysis, and to analyze factors affecting inadequate delivery of hemodialysis. METHODS: 97 stable maintenance hemodialysis patients who were undergoing 4 hours of hemodialysis thrice weekly were included for analysis. Prescribed dose of dialysis was calculated by Kt/V where K was in vitro urea clearance of dialyzer membrane and V was estimated according to the Watson's formula. Delivered dose of dialysis was calculated according to the Daugirdas equation. To find factors that may impair adequate delivery of hemodialysis, various clinical and technical parameters were analyzed. RESULTS: Prescribed dose of hemodialysis was 1.37+/-0.21, while delivered dose was 1.23+/-0.27, and thus, there was a significant difference (p <0.03). In 45% of the patients, delivered dose was less than 1.2. They were heavier and prescribed dose was low. delta Kt/V (Prescribed dose-Delivered dose) was significantly greater in patients who did not use heparin therapy compared to patients who used heparin. Other parameters such as hypotension, missed treatment, sex, type of vascular access and degree of recirculation were not associated with impaired delivery of hemodialysis.
Dialysis* ; Heparin ; Humans ; Hypotension ; Membranes ; Renal Dialysis* ; Urea

Pulmonary sequestration is a congenital anomaly of lung in which a portion of lung par-enchyma has no communication with the tracheobronchial tree and receives its blood supply via systemic artery. Sequestration represents a developmental anomaly of tracheobronchial branching with persistence and localized development of a separated branch fragment and retention of its embryonic systemic vascular supply. In the review of the literature, this disease is so rare that only 540 cases were reported worldwide. The anomaly is divided into 2 types; intralobar and extralobar. The ratio of intralobar type and extralobar type is about 3.5 : 1 and intralobar type is more common than the latter in all age groups. The intralobar type is contiguous with normal lung parenchyma and within the same visceral pleural envelope ; in contrast, the extralobar type is enclosed within its own pleural membrane, usually close to a normal lung but separated and discovered most commonly in the left hemithorax with rare cases in the abdominal cavity. Traditionally, this disease has been presented as an incidental lung mass in routine chest X-ray in the postnatal period and with confirmation by aortic angiography, but recently, pulmonary sequestration is diagnosed in the antenatal period along with the development of antenatal ultrasonography. Ultrasonography shows the pulmonary sequestration as a hyperechogenic mass near the diaphragm with posterior echo-free shadow. We have experienced one case of pulmonary sequestration which was found by antenatal ultrasonography and confirmed by operation and histopathologic report in the neonatal period, and we present the case with a brief review of the literatures.
Abdominal Cavity ; Angiography ; Arteries ; Bronchopulmonary Sequestration* ; Diaphragm ; Humans ; Lung ; Membranes ; Thorax ; Ultrasonography*

The purpose of this study is to propose learning objectives in social dental hygiene by analyzing and reviewing learning objectives in oral health administration area of the existing public oral health. This study is a cross-sectional study. The subjects of the study selected with convenience extraction were 15 members of the social dental hygiene subcommittee of the Korean Society of Dental Hygiene Science. Data collection was conducted by self-filling questionnaire. The research tool is from 48 items of A division in the book of learning objectives in the dental hygienist national examination, and this study classified each of them into ‘dental hygiene job relevance’, ‘dental hygiene competency relevance’, ‘timeliness’, and ‘value discrimination of educational goal setting’ to comprise 192 items. Also, to collect expert opinions, this study conducted Delphi survey on 7 academic experts. Statistical analysis was performed using the IBM SPSS Statistics ver. 23.0 program (IBM Co., Armonk, NY, USA). Recoding was performed according to the degree of relevance of each learning objective and frequency analysis was performed. This study removed 18 items from the whole learning objectives in the dental hygienist national examination in the oral health administration area of public oral health. Fifteen revisions were made and 15 existing learning objectives were maintained. Forty-five learning objectives were proposed as new social dental hygiene learning objectives. The topics of learning objectives are divided into social security and medical assistance, oral health care system, oral health administration, and oral health policy. As a result of this study, it was necessary to construct the learning objectives of social dental hygiene in response to changing situation at the time. The contents of education should be revised in order of revision of learning objectives, development of competency, development of learning materials, and national examination.
Cross-Sectional Studies ; Data Collection ; Dental Hygienists ; Discrimination (Psychology) ; Education ; Expert Testimony ; Humans ; Hygiene ; Learning* ; Medical Assistance ; Oral Health* ; Oral Hygiene* ; Social Security