OBJECTIVES: We investigated the effects of changes in obesity and life style factors, such as cigarette smoking, alcohol drinking, and exercise, on the changes in blood pressure and serum cholesterol among Korean men. METHODS: This study included 7,205 healthy male employees in the steel manufacturing industry. Each subject underwent health examination in 1994 and was re-examined in 1997. The study subjects were classified into four categories, according to changes in body mass index (BMI) (loss; stable; mild gain; severe gain), cigarette smoking (quitter; non-smoker; smoker continued; smoker started), alcohol drinking (quitter; non-drinker; drinker continued; drinker started) and exercise (more exercise; continuous regular exercise; continuous irregular or no exercise; less exercise), respectively. We evaluated the relationship between the categories of change in those independent variables and the changes in blood pressure and serum cholesterol, adjusted for BMI in 1994 and age by analysis of variance. RESULTS: The change in systolic blood pressure was positively associated with the changes in BMI (p<0.001) and drinking (p=0.001), but negatively with smoking (p=0.004), compared to the first category of each independent variables. The systolic blood pressure was significantly less increased in the continuous smoking group than quitter or non-smoker. The changes in diastolic blood pressure and serum cholesterol appeared to have statistically significant linear relationships only with the change in BMI. The change in exercise showed a marginal significance with diastolic blood pressure (p=0.088). CONCLUSIONS: These prospective data emphasize the importance of obesity as a determinant of the changes in blood pressure and serum cholesterol. In addition, the changes in smoking and drinking habits can affect systolic blood pressure.
Alcohol Drinking ; Blood Pressure* ; Body Mass Index ; Cholesterol* ; Drinking ; Follow-Up Studies* ; Humans ; Life Style* ; Male ; Obesity ; Prospective Studies ; Smoke ; Smoking ; Steel*

OBJECTIVES: We evaluated demographic, socioeconomic, smoking-related, other health behavior, and disease factors associated with smoking cessation. METHODS: This study included 5,493 male employees in a steel manufacturing industry, who smoked at health examination underwent in 1998. Quitters were defined as those who had stopped smoking at least one month prior to re-examination in 1999. The information on related factors was collected by self-administered questionnare. RESULTS: At 12 months of follow-up, 1,955 patients (35.6 %) had quit smoking. The quit rate was higher in middle-aged, white collar, and high rank personnels. The quit rate increased with decreasing amount of cigarette, decreasing duration of smoking, and increasing age of starting smoking. There were higher quit rates among smokers who drank less or exercise. However, the existence of disease did not affect the quit rate. CONCLUSION: This study showed that many demographic, socioeconomic, smoking-related and other health behaviors associated with smoking cessation. These results could be of use in the other worksite smoking cessation campaigns to enhance the quit rate.
Follow-Up Studies ; Health Behavior ; Humans ; Male ; Smoke* ; Smoking Cessation* ; Smoking* ; Steel* ; Tobacco Products ; Workplace*

No abstract available.
Cutaneous Fistula ; Glomerulonephritis, Membranous* ; Humans ; Sarcoma, Kaposi*

BACKGROUND: The purpose of this study was to find out the effect of hypnotics and analgesics on oxygen saturation by pulse oximetry in surgery patients under spinal anesthesia. METHODS: Sixty-five patients classified ASA physical status 1 or 2 scheduled for surgery under spinal anesthesia were studied. These patients were divided into three groups. The 22 subjects of the first group did not receive either midazolam or fentanyl. The 22 subjects of the second group received midazolam. The 21 subjects of the third group received midazolam (0.03 mg/kg) and fentanyl (1.0 microgram/ kg). Oxygen saturation was measured with a pulse oximetry. Measurements were made before spinal anesthesia, 5 minutes, and 10 minutes after starting of spinal anesthesia, 5 minutes, 10 minutes, 30 minutes, and 60 minutes after the start of the operation or intravenous injection of drugs. In addition, measurements were made on arrival in the recovery room, and 5 minutes, 10 minutes, 20 minutes, and 30 minutes after arrival in the recovery room. RESULTS: There were statistically significant differences in oxygen saturation at 5 minutes after the start of the operation or intravenous injection of drugs. The mean oxygen saturation for the first group was 98.2 +/- 1.8%, for the second group 97.9 +/- 2.6%, and for the third group 92.4 +/- 2.8%. Hypoxia cases at 5 minutes after the start of the operation or intravenous injection of a drug occurred in 4.5% of the first group, 9.1% of the second group, and 57.1% of the third group CONCLUSIONS: We concluded that oxygen saturation monitoring should be done routinely in patients receiving hypnotics and analgesics during spinal anesthesia, and oxygen should be administered to patients who develope hypoxia during spinal anesthesia.
Analgesics* ; Anesthesia, Spinal* ; Anoxia* ; Fentanyl ; Humans ; Hypnotics and Sedatives* ; Incidence* ; Injections, Intravenous ; Midazolam ; Oximetry ; Oxygen ; Recovery Room

PURPOSE: This study was conducted to develop an evaluation framework for QI activity in medical institutions and to analyze QI activity cases by applying the developed evaluation framework. METHOD: A four-phase process was employed to develop the evaluation framework, and a descriptive survey was used for the QI case study. Data were collected in April, 2010 by examining 157 QI activity cases presented at conferences and published in Journal of Korean Society of Quality Assurance in Health Care over the past three years. Developed QI activity evaluation instruments were used for data collection. Data were analyzed using the SPSS 18.0 for Windows program. RESULT: A QI Activity Evaluation Framework was developed. This framework consisted of 45 items. The department with the highest level of QI participation was the nursing department. The most frequent QI activity theme was patient safety. QI activity levels in Korean medical institutions are relatively equalized without significant differences according to institution characteristics. CONCLUSIONS: From the quality aspect of QI activity, more systematic and scientific approaches are required to upgrade QI activity. This study could provide methodological guidelines for QI activity and be useful in setting goals and directions for QI activity in medical institutions in Korea.
Congresses as Topic ; Data Collection ; Delivery of Health Care ; Korea ; Patient Safety ; Qi ; Quality Improvement

PURPOSE: The aim of this study was to identify the mediating effects of perceived stigma and family strength on the relationship between family stress and adaptation in family members of patients with mental illness. METHODS: Participants were 189 primary family caregivers of persons with mental illness in G city, C, G, and J provinces. Data were collected from May to June 2018 using the FILE (Family Inventory of Life Events and Changes), K-ISMI (Korean Version of Internalized Stigma of Mental Illness Scale), FAS III (Family Adaptability Scale III), and KFSS-II (Korea Family Strengths Scale). Collected data were analyzed with t-tests, one-way ANOVAs with Scheffé' test, Pearson's correlation coefficients, and PROCESS macro mediation analysis. Mediators were tested by calculating bias-corrected 95% confidence intervals using bootstrapping with 5,000 resampling. RESULTS: Family stress was directly associated with family adaptation. Family strengths had a partially mediating effect on the relationship between family stress and adaptation, but perceived stigma did not. CONCLUSION: Based on our study findings, developing a nursing intervention program focused on improving family strengths might be necessary to facilitate family members' successful adaptation to persons with mental illness.
Adaptation, Psychological ; Caregivers ; Humans ; Mental Disorders ; Negotiating ; Nursing ; Social Stigma

The number of latex-induced allergic reactions, including anaphylaxis, has been increasing since latex induced contact urticaria was first reported in surgical patients by Nutter in 1979. Latex allergy is frequently seen in the healthcare industry, and is associated with systemic symptoms, hand eczema, and allergic contact dermatitis. Reactions range from contact urticaria, rhinitis and conjunctivitis, angioderma or bronchospasm to the recently recognized severe anaphylactic shock with cardiovascular collapse. We encountered a 55-year-old female patient who developed a severe anaphylactic reaction after manual vetilatory support using a facemask that contained latex. A subsequent allergy workup revealed a delayed-type hypersensitivity to latex. This case highlights the need for anesthesiologists to be able to diagnose the signs and symptoms of allergic reactions in patients during the peri-anesthetic period. Two types of allergic reactions to natural rubber latex (NRL) and rubber products are now known to exist: type I (immediate-type) and type IV (delayed-type hypersensitivity [DTH]). Patients with NRL allergy should be provided with information on non-latex devices and latex avoidance in medical, dental, and occupational settings. In addition, we should pay more attention to the management of allergic reactions to latex in high risk groups.
Anaphylaxis ; Bronchial Spasm ; Conjunctivitis ; Dermatitis, Allergic Contact ; Dermatitis, Contact ; Eczema ; Female ; Hand ; Health Care Sector ; Humans ; Hypersensitivity ; Latex ; Latex Hypersensitivity ; Masks ; Middle Aged ; Rhinitis ; Rubber ; Urticaria

Refractory status epilepticus is defined as seizure activity that continues after treatment with conventional anticonvulsants. An 8-month-old male had an operation for repair of small bowel perforation, and he suffered a febrile seizure that developed into refractory status epilepticus. Febrile seizure is the most common etiology for children with status epilepticus. We report here on a case of a patient with refractory status epilepticus, and he was managed with sevoflurane, an inhalational anesthetic. The patient was given an inspired concentration of 0.6-2 vol% sevoflurane for 15 days. After stopping of sevoflurane inhalation, he continued to experience intermittent convulsive status epilepticus that was successfully managed with using conventional anticonvulsants.
Anticonvulsants ; Child ; Humans ; Infant ; Inhalation ; Male ; Seizures ; Seizures, Febrile ; Status Epilepticus*

Quadriplegia is a serious or complete loss of motor function of all four limbs that is commonly caused by spinal cord injuries secondary to damage to the cervical spine. In this situation, there is a higher risk of pneumonia due to paralysis of the respiratory muscles. Tracheostomy is preferred over endotracheal intubation for the effective elimination of sticky bronchial secretion. The safest technique for a tracheostomy is to carry it out under general anesthesia with endotracheal intubation. However, endotracheal intubation may be difficult and cause other complications in patients with laryngotracheal stenosis caused by repeated tracheostomy and a limitation of neck movement as a result of the fixation of the cervical vertebral bodies due to the cervical spine fracture. We report a case of a tracheostomy performed sucessfully under intravenous anesthesia using a laryngeal mask airway without muscle relaxants in a patient with quadriplegia caused by a cervical spine injury.
Anesthesia, General ; Anesthesia, Intravenous ; Constriction, Pathologic ; Extremities ; Humans ; Intubation, Intratracheal ; Laryngeal Masks ; Muscles ; Neck ; Paralysis ; Pneumonia ; Quadriplegia ; Respiratory Muscles ; Spinal Cord Injuries ; Spine ; Tracheostomy

OBJECTIVES: Magnetic resonance imaging (MRI)-guided high intensity focused ultrasound surgery (MRgFUS) is a newly emerging non-invasive technique for the treatment of uterine fibroids. The purpose of this study is to review the clinical impact of MRgFUS. METHODS: This study examined 157 patients. The high intensity focused ultrasound (HIFU) utilized in this study was Philips Achieva 1.5 Tesla MR (Philips Healthcare, Best, the Netherlands) and Sonalleve HIFU system. The patients were followed in post-operative Month 1, Month 3, and Month 6 to investigate any change. Then, these were further classified according to the use of uterine stimulant (oxytocin) in parallel, Funaki Type of uterine fibroid, HIFU intensity, and non-perfused volume (NPV) ratio. RESULTS: When the uterine stimulant was utilized, the HIFU intensity was measured at significantly lower levels, compared with the group not using uterine stimulant, and treatment duration was significantly. The NPV ratio was found significantly higher in the group using uterine stimulant. Concerning the correlation between Funaki Type of uterine fibroid and average sonication power, it was found that the closer to Type I, the lower the sonication power, the shorter the treatment duration, and the higher the NPV ratio significantly. CONCLUSIONS: In this study, it was found that the lower the Funaki Types of uterine fibroids, and the higher the NPV ratio immediately after the operation, the larger the uterine fibroid volume decrease and SSS change were. Also, if uterine stimulant was used in parallel in treatment, treatment duration and HIFU intensity could become shorter and lower.
Delivery of Health Care ; High-Intensity Focused Ultrasound Ablation ; Humans ; Leiomyoma* ; Magnetic Resonance Imaging ; Myoma ; Oxytocin ; Sonication ; Ultrasonography*