No abstract available.
Humans ; Internship and Residency*

This study was carried out to see the effect of individualized diet education on the improvement of blood glucose level according to the changes of nutrient intake with the subjects of 25 people. Among 25 people who participated in diabetic education program held in Chilgok-gun public health center, Gyeongbuk, there were 15 diabetic patients(3 males and 12 females) and 10 healthy people(2 males and 8 females) and after the diet education, the results were as follows. As for clinical characteristics, the diabetic group tended to have slightly higher blood pressure than the control group, especially diastolic blood pressure of diabetic group was higher than the control group with a significant level(p<0.05). Blood glucose level measured 2 hours after the meal was higher in the diabetic group than the control group with significant level(p<0.0001). For the clinical characteristic changes before and after the diet education, the blood glucose level in the diabetic group reduced significantly(p<0.01). For the daily diet intake, intake of fat in the diabetic group increased significantly compared to the one before the education(p<0.05). When comparing the ratio of carbohydrate: protein: fat, it was changed from 72.9 : 16.2 : 12.9 before the education to 63.8 : 15.1 : 21.1 after the education. From the above results, it is necessary to perform the diet education which carries out in the health center for diabetic patients with individualized goal by stepwise way rather than as one time try, and by developing the diabetic education media which is appropriate for the patients.
Blood Glucose ; Blood Pressure ; Diabetes Mellitus ; Diet* ; Education* ; Gyeongsangbuk-do ; Humans ; Male ; Meals ; Public Health*

Magnesium salts have been reported to be effective in the treatment of atrial, junctional and ventricular arrhythmias resulting from myocardial ischemia, digitalis poisoning, alcoholism, diuretic therapy and coronary artery disease. The mechanism of antiarrhythmic effect is thought to inhibit the efflux of potassium, supress inward sodium movement, and mimic calcium channel blocking drugs by inhibiting cellular calcium uptake. The purpose of this study is to evaluate the antiarrhythmic effect of MgSO4 by inhibiting intracellular calcium transport and dose-related effect. The experiments were composed of four steps. 16 ug/Kg of epinephrine was injected in twenty rabbits anesthetized with halothane (experiment 1). Ventricular arrhythmia was developed in all rabbits. At 15 minutes later, after the retum of sinus rhythm, CaCl2 (10 mg/Kg) was injected slowly for 5 min, and than 16 ug/Kg of epinephrine was injected immediately after the administration of CaC12 (experiment 2). After 45 mins, 8 mg/Kg (experiment 3, n=10) and 16 mg/Kg (experiment 4, n=10) of MgSO4 were injected for 5 mins, and than CaCl2 and epinephrine were administrated as experiment 2. The onset and duration of ventricular arrhythmia following each experiment were observed. The results were as follows; 1) 16 ug/Kg of epinephrine induced ventricular arrhythmia in all cases. 2) CaCl2 infusion caused a reduction in onset and increase in duration of epinephrine-induced-arrhythmia, but there was no significanee. 3) MgSO4-pretreatment caused a increase in onset and reduetion in the CaCl2-caused increase in arrhythmia duration. Only MgSO4-16 mg/Kg values were significant. In conclusion, magnesium salts pretreatment demonstrated effectiveness in preventing ventricular arrhythmia associated with epinephrine usage and hypercalcemic condition during halothane anesthesia.
Alcoholism ; Anesthesia ; Arrhythmias, Cardiac* ; Calcium ; Calcium Channel Blockers ; Coronary Artery Disease ; Digitalis ; Epinephrine* ; Halothane ; Magnesium ; Myocardial Ischemia ; Poisoning ; Potassium ; Rabbits ; Salts ; Sodium

PURPOSE: This study was carried out to accumulate basic data for nursing intervention development by evaluating the stress and emotional status of patients and their families after receiving hematopoietic stem cell transplantation (HSCT), illucidating and analysing related factors in order to decrease the negative effects of HSCT on their emotion. METHODS: Data were collected using a questionnaire to 53 HSCT patients and 50 families, who were older than 18 at tertiary-care institutions in Seoul, from January, 2000 to August, 2003. RESULTS: There was a significant score difference in stress (t=-2.302, p<0.05). Correlation between stress and emotional status was statistically significant (r=0.486, p<0.01; r=0, p<0.05). Economical burden of cost had significant effects on stress of patients (F=4.194, p<0.05). The series of emotional status of patients without jobs were higher (T=-2.583, p<0.05). The emotional status of families were influenced by monthly income (F=4.036, p<0.05) and patients' diagnosis (F=3.088, p<0.05). CONCLUSION: These results suggest that the cares for families should be considered with great concern as well as the ones for patients. In addition, such factors as economical burden by medical cost, monthly income and job status should not be excluded in transplantation nursing plans.
Diagnosis ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Nursing ; Surveys and Questionnaires ; Seoul

Carcinoma of the parathyroid gland is rare, comprising only 0.1% to 5% of all patients with primary hyperparathyroidism. It presents with severe hypercalcemia, bone disease, palpable neck mass, renal involvement and etc. Since the initial operation offers the best chance for cure, preoperative localization and intraoperative recognition of parathyroid cancer are essential. Recently parathyroid imaging has been described with 99mTc-sestamibi as an alternative to 201Tl. This newer agent has many physical and dosirnetric advantages and represents higher detection sensitivity than 201Tl-99mTc subtraction scan. We experienced a 41-year-old man presenting with recurrent hyperparathyroidism in spite of 2 previous operations. In preoperative localization, there was no abnormal uptake in 201Tl-99mTc subtraction scan but 99mTc-sestamibi scan revealed metastatic foci on right cervical area. He was successfully treated with modified radical neck dissection.
Adult ; Bone Diseases ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Hyperparathyroidism, Primary ; Neck ; Neck Dissection ; Parathyroid Glands ; Parathyroid Neoplasms* ; Technetium Tc 99m Sestamibi*

The adverse cardiovascular effects of laryngoscopy and endotracheal intubation are well known. In marked contrast, insertion of the laryngeal mask is associated with cardiovascular stability. We undertook this study to investigate this observation of hypertensive patients (World Health Organization has defined hypertension as systolic blood pressures above 160 mmHg and/or diastolic blood pressures greater than 95 mmHg). Forty patients undergoing gynecological procedures were anesthetized and airway was maintained with either the endotracheal intubation(n=20) or insertion of laryngeal mask(n=20). They received thiopental sodium 5 mg/kg and succinylcholine 1 mg/kg intravenously for induction. Blood pressure and pulse rate were measured immediately pre-induction control value, post-intubation or post-insertion of laryngeal mask 1 minute, 2 minute, 3 minute, 5 minute. All measurements were made with a Criticon Dinamap oscillotonometric device. After direct laryngoscopy and endotracheal intubation, systolic blood pressure increased significantly(p<0.05) by 12% from control values and heart rate increased 10% from control values significantly(p<0.05). After insertion of the la- ryngeal mask, the systolic blood pressure decreased significantly by 14% from control values(p <0.05) and heart rate decreased 6.6% from eontrol values. We believe that the ability to gain control of the airway without subjecting the hypertensive patients to the stress of laryngosco- py and endotracheal intubation is a great advantage of the laryngeal mask, especially in patients most at risk-those with hypertension and/or coronary or cerebrovascular disease.
Blood Pressure ; Heart Rate ; Humans ; Hypertension ; Intubation, Intratracheal ; Laryngeal Masks* ; Laryngoscopy ; Masks ; Succinylcholine ; Thiopental ; World Health Organization

The adverse cardiovascular effects of laryngoscopy and endotracheal intubation are well known. In marked contrast, insertion of the laryngeal mask is associated with cardiovascular stability. We undertook this study to investigate this observation of hypertensive patients (World Health Organization has defined hypertension as systolic blood pressures above 160 mmHg and/or diastolic blood pressures greater than 95 mmHg). Forty patients undergoing gynecological procedures were anesthetized and airway was maintained with either the endotracheal intubation(n=20) or insertion of laryngeal mask(n=20). They received thiopental sodium 5 mg/kg and succinylcholine 1 mg/kg intravenously for induction. Blood pressure and pulse rate were measured immediately pre-induction control value, post-intubation or post-insertion of laryngeal mask 1 minute, 2 minute, 3 minute, 5 minute. All measurements were made with a Criticon Dinamap oscillotonometric device. After direct laryngoscopy and endotracheal intubation, systolic blood pressure increased significantly(p<0.05) by 12% from control values and heart rate increased 10% from control values significantly(p<0.05). After insertion of the la- ryngeal mask, the systolic blood pressure decreased significantly by 14% from control values(p <0.05) and heart rate decreased 6.6% from eontrol values. We believe that the ability to gain control of the airway without subjecting the hypertensive patients to the stress of laryngosco- py and endotracheal intubation is a great advantage of the laryngeal mask, especially in patients most at risk-those with hypertension and/or coronary or cerebrovascular disease.
Blood Pressure ; Heart Rate ; Humans ; Hypertension ; Intubation, Intratracheal ; Laryngeal Masks* ; Laryngoscopy ; Masks ; Succinylcholine ; Thiopental ; World Health Organization

BACKGROUND: Spinal cord stimulation (SCS) is a clinical off spring of the gate-control theory and known as an effective treatment for pain from a neurogenic origin. The prolonged pain relief following a short stimulation period is believed to be related with the GABAergic system. The aims of this study were to see if the SCS, similar to that being used in clinical condition, suppressed the nociceptive transmission in the spinal dorsal horn, and if so, which type of GABA receptor may be involved in the antinociceptive process. METHODS: The cord dorsum potential (CDP) was recorded at the dorsal root entry zone of the lumbosacral enlargement for a long time period (60 min) in response to electrical stimulation of the dorsal root, respectively, after SCS in anesthetized cats. CDP was recorded after intrathecal application of bicuculline (GABA (A) receptor antagonist) and phaclofen (GABA (B) receptor antagonist) and 20 min after SCS that followed the intrathecal application of bicuculline or phaclofen. Asigma- and C-fiber wave responses were differentiated according to the conduction velocity. RESULTS: The C-fiber wave decreased significantly after SCS but the Asigma-fiber wave did not on the CDP. After intrathecal administration of bicuculline, the Asigma- and C-fiber waves increased significantly and bicuculline also prevented a SCS-induced reduction of the C-fiber wave. Phaclofen did not change the amplitude of Asigma- and C-fiber wave. When the phaclofen was administered intrathecally, SCS did not decrease the amplitude of the Asigma- and C-fiber waves. CONCLUSIONS: In conclusion, the present results indicate that SCS suppresses C-fiber transmission of acute nociceptive electrical stimuli and both GABA (A) and (B) receptors mediate the long-lasting antinociceptive effect of SCS.
Animals ; Bicuculline ; Cats* ; Cytidine Diphosphate ; Electric Stimulation ; gamma-Aminobutyric Acid ; Horns ; Receptors, GABA ; Spinal Cord Stimulation ; Spinal Cord* ; Spinal Nerve Roots

BACKGROUND: Several survey reported that use of dietary supplements including herbal medicine was common in the preoperative period. The use of such remedies has implications for the anesthesiologists because of the potential for drug interactions and side effects. Little information is available on the frequency of use in the surgical population in Korea. This study was purposed to find out the frequency and predictors of the use of dietary supplements in presurgical patients. METHODS: A questionnaire was distributed to all patients at the preoperative visit from May 2006 to August 2006. The questionnaire inquired as to basic demographics, use of dietary supplements, the name and number of dietary supplements used, reasons to take the dietary supplements, and whether the patient had informed anesthesiologist of the use. RESULTS: A total 1,072 completed surveys showed that overall 37% of presurgical patients reported the use of dietary supplements. Less than half of the patients told their anesthesiologists that they were using dietary supplements. The most commonly used dietary supplements were ginseng, soy, glucosamine, garlic, prunus mume, mushroom, siberian ginseng, fish oils, aloe, ginger, and gingko in order of incidence. Young age was predictor associated with lower use of dietary supplements. CONCLUSIONS: Use of dietary supplements is common in the preoperative period in Korea. Documentation of the use of these products in the perioperative period is important to consider the potential interaction of dietary supplements with medical medicine or anesthetics.
Agaricales ; Aloe ; Anesthetics ; Demography ; Dietary Supplements* ; Drug Interactions ; Eleutherococcus ; Fish Oils ; Garlic ; Ginger ; Ginkgo biloba ; Glucosamine ; Herbal Medicine ; Humans ; Incidence ; Korea ; Panax ; Perioperative Period ; Preoperative Period ; Prunus

Iatrogenic aortic dissection (IAD) is a life-threatening complication that can occur during open heart surgery, therefore IAD requires early diagnosis and prompt management. We describe here a case of IAD that occurred during mitral valve replacement. The transesophageal echocardiography (TEE) evaluation revealed features indicative of acute aortic dissection and the tear was successfully repaired by interposition of a graft.
Early Diagnosis ; Echocardiography, Transesophageal ; Mitral Valve* ; Thoracic Surgery ; Transplants