Objectives: This study aimed to identify the opinions of Gyeongsangbuk-do residents on out-of-hours (OOH) pharmacies and to examine the operating experiences of pharmacists who are operating OOH pharmacies in other areas. Methods: Cross-sectional survey was carried out for 1,000 Gyeongbuk residents employing a questionnaire via online or face-to-face, and 82 pharmacists who currently operate OOH pharmacies employing a postal questionnaire. Out of eighty-two, 46 pharmacists replied (response rate 56.1%). Results: As for the necessity of introducing OOH pharmacies in Gyeongsangbuk-do, 84.9% answered more than necessary.86.1% favored the local government support for OOH pharmacies. The necessity of OOH pharmacies was highly evaluated among participants who experienced to be unable to use medicines or services in out of service hours, regardless of their characteristics or health condition. County residents consistently put a positive opinion for the necessity of OOH pharmacies if they have elderly family member(s), while city residents had significant differences across subgroups depending on their conditions (family members, household economics, health status, etc.). Almost all (95.7%) pharmacist participants highly evaluated the necessity of OOH pharmacies and the majority of them (63.0%) felt satisfied. However, 60.9% of participants have ever considered closing their OOH pharmacy business due to private, business management and professional reasons. Conclusion This study made suggestions to address anticipated issues for the Gyeongbuk-style OOH pharmacy model.

Although it has been accepted that metoclopramide provides the effects of antiemetics, enhance- ment of intestinal motility and acts as antagonist on dopamine receptor, there is still controversy over inhibitory action of plasma cholinesterase. We examined the effect of preoperative intravenous administration of metoclopramide 10mg (group 2,4) on the duration of neuromuscular block induced by an intubating dose (1 mg/kg) of succinylcholine. Forty female adult patients were devided into four groups, scheduled for cesarean section (group 3,4) or other elective operations (group 1,2). The 1 H2single twitch height of the adductor pollicis muacle was recorded on paper to 1 H2single twitch stimulus by a nerve stimulator (Accelograph). The patients in group 2 and 4 received metoclopramide 10 mg i.v followed by succinylcholine 1mg/kg, and the patients in group 1 and 3 received succinylcholine 1mg/kg alone. The time from disappearance of 1 H, single twitch height to reappearance of that did not significantly differ between group l and 3. However, there was significant prolongation of the time from disappearance of 1H2single twitch height to reappearance of that in patients who received metoclopramide followed by succinylcholine in group 2 and 4. Also, we examined the effect of preoperative intravenous administration of metoclopramide 10mg on the duration of neuromuscular block by 0.5mg/kg of succinylcholine in twenty female patients for elective operations (group 5,6). There was no significant prolongation of the time from disappearance of 1 H, single twitch height to reappearance of that.
Administration, Intravenous ; Adult ; Antiemetics ; Cesarean Section ; Cholinesterases ; Female ; Gastrointestinal Motility ; Humans ; Metoclopramide* ; Neuromuscular Blockade ; Plasma ; Pregnancy ; Receptors, Dopamine ; Succinylcholine*

BACKGROUND: Patients receiving surgery under local anesthesia might feel anxiety during surgery and suffer pain due to the insufficiency of local anesthesia. The purpose of this study was to evaluate the efficacy and side effects of patient-controlled sedation and analgesia in patients undergoing endoscopic sinus surgery (ESS). METHODS: We studied 63 adult patients. A mixture of 400 mg of propofol and 200microgram of fentanyl (total 44 ml) was infused to the patient at a rate of 10 ml/hr using a PCA device. The lock-out time was 1 minute and the bolus dose was 1 ml. During surgery, we monitored vital signs and sedation state. At the end of surgery, we assessed the degree of satisfaction about pain and anxiety relieving effects by using a questionnaire with a 1 to 10 scale. RESULTS: About 90% of patients were wide awake during surgery, others were drowsy or intermittently sleeping. About 95% of the patients were satisfied with anxiety relief (more than a score of 8) and 84% were satisfied with pain relief in painful episodes (more than a score of 8). Vital signs were within normal limits. The oxygen saturation was maintained above 94% during surgery, except three patients whose oxygen saturation was 92% for short while. Twenty-two percent of the patients complained of pain at their drug infusion sites. CONCLUSIONS: We concluded that patient-controlled sedation and analgesia using the mixture of fentanyl and propofol might be a good way to relieve patient's anxiety and pain without respiratory depression and excessive sedation for those undergoing ESS under local anesthesia.
Adult ; Analgesia* ; Anesthesia, Local ; Anxiety ; Fentanyl ; Humans ; Oxygen ; Passive Cutaneous Anaphylaxis ; Propofol ; Surveys and Questionnaires ; Respiratory Insufficiency ; Vital Signs

No abstract available.
Puberty, Precocious* ; Sertoli-Leydig Cell Tumor*

BACKGROUND: Desflurane and sevoflurane have been shown to induce pharmacologic preconditioning in experimental studies. The present study was aimed at comparing the myocardial protective effects of these two halogenated anesthetics in terms preconditioning induction. METHODS: Three groups of Sprague-Dawley rat hearts (n = 10 each) were perfused with oxygenated modified Kreb's solution using a Langendorff perfusion device. All groups underwent 30 minutes of global ischemia and 60 minutes of reperfusion after a stabilization period of 30 minutes. Before ischemia, hearts underwent a preconditioning period consisting of either no inhalation for 20 minutes (control group), or 15 minutes of either MAC desflurane or sevoflurane followed by 5 minutes of washout. Left ventricular end systolic pressure (LVESP), left ventricular end diastolic pressure (LVEDP), heart rate (HR) and maximal rate of change of ventricular pressure (dP/dt) were measured at after inhalation, before ischemia, and 5 minutes, 30 minutes and 60 minutes after reperfusion. Coronary sinus effluent also was measured. Infarct size was measured by triphenyl tetrazolium staining. RESULTS: LVESP and dP/dt were decreased in the control group, but remained unchanged in the desflurane and sevoflurane groups during the reperfusion period. LVEDP was increased in all groups, but the magnitude of the increase was smaller in the desflurane and sevoflurane groups than in the control group during the reperfusion period. HR was increased in the control group, but remained unchanged in the desflurane and sevoflurane groups during the reperfusion period. Coronary blood flow was decreased in all groups. Infarct size for the two anesthetics were smaller than in the control group. Differences in hemodynamics was observed between the desflurane and sevoflurane group at any time. CONCLUSIONS: Desflurane and sevoflurane had similar myocardial preconditioning effects in isolated rat heart.
Anesthetics ; Animals ; Blood Pressure ; Coronary Sinus ; Heart Rate ; Heart* ; Hemodynamics ; Inhalation ; Ischemia* ; Ischemic Preconditioning, Myocardial ; Oxygen ; Perfusion ; Rats* ; Rats, Sprague-Dawley ; Reperfusion Injury* ; Reperfusion* ; Ventricular Pressure

The purpose of this study was to develop a nutrition education website for children, especially those around the 4th-6th grade levels. Among the already existing websites providing nutritional information for children, 7 websites with comparable amounts of information were evaluated in terms of their topics, credibility, content, ease of use, and aesthetics. In addition, a survey was conducted to assess the need for nutrition information among 305 elementary students. The food pyramid was the topic offered most often on those websites. Information on nutrients, digestion, food safety, nutrition labeling, and healthy eating habits were available on the websites. Some of those websites also provided games or quizzes to attract the children's interest. However, seine of the websites did not give any information on the person responsible for providing the information, which is most important in determining the credibility of the website. Other problems were that some information was too difficult for children, and some of the websites did not provide a way to search for information. According to the survey results, the topics that children wanted to know about were 'desirable weight', 'cooking', 'correct food choice', 'weight control method', 'calories consumed during exercise' but, they did not have a high interest in 'asking questions', 'books with nutrition messages', 'under weight', 'negative effect of weight control' and 'helping hungry children'. Based on these results, we developed a new nutrition education web-site, ifood' (http://ifood.or.kr). We focused on helping children develop healthy eating habits by providing information which is easy and practical for children. However, we neither included the program to assess their dietary intake, nor provided entertaining background sounds, which children like. Also, the game section is composed mainly of quizzes. Therefore, we need to further develop exciting games to teach nutrition to children. In the near future, the newly developed website should be evaluated by children regarding understandability and coverage of the contents as well as usability and design, and then revised to improve the educational effect.
Child* ; Digestion ; Eating ; Education* ; Esthetics ; Food Labeling ; Food Safety ; Humans ; Internet

OBJECTIVES: A mesiodens appears most commonly as a supernumerary tooth impacted in the anterior maxilla. The purpose of this study is analyze mesiodens clinically. MATERIALS AND METHODS: Gender, crown form, direction of impaction, relation to permanent incisors, and chief complaints of patients with extracted mesiodens were analyzed. RESULTS: Patients were analyzed for motivation to visit the hospital; 85.4% of the patients were referred from other hospitals. Mesiodens was more common in males than in females (3.7:1), and 70.1% of patients had only one mesiodens, while 29.6% had two mesiodenses. Of the mesiodenses, 61.4% were of the aconical form, and the most common direction was upward (62.4%), followed by the normal position (26.0%) and the horizontal position (11.6%). The mesiodenses caused orthodontic problems with the permanent incisors in 46.3% of cases. Mesiodens associated with dentigerous cyst was rarely observed in our patient group. CONCLUSION: Mesiodens is more common in males than in females and often affects the permanent incisors. Thus, careful clinical and radiological evaluations of mesiodenses are important.
Crowns ; Dentigerous Cyst ; Female ; Humans ; Incisor ; Male ; Maxilla ; Motivation ; Tooth Abnormalities ; Tooth, Supernumerary

BACKGROUND: Renal dysfunction is a serious complication that sometimes occurs after on-pump coronary artery bypass grafting. Recently, the off-pump coronary artery bypass (OPCAB) is used. We investigated whether this practice can reduce renal compromise. METHODS: Eighty patients underwent CABG surgery between March 2001 and March 2002. Among these, 50 patients received CABG with cardiopulmonary bypass (CPB) and 30 patients received OPCAB. The data collected included age, gender, history of diabetes, history of hypertension, history of congestive heart failuere, preoperative serum creatinine (PreCr) level, peak postoperative serum creatinine (Peak PostCr) level, preoperative and postoperative left ventriclular ejection fraction, preoperative ACE inhibitor use, perioperative angiography with contrast dye. Perioperative changes in creatinine clearance (DCrCl) were calculated using changes in the pre and postoperative serum creatinine values. Moderate postoperative renal dysfuntion was defined as a peak postoperative creatinine value of greater than 1.5 times and below 2.0 times the preoperative creatinine value. Severe postoperative renal dysfunction was defined as a peak postoperative creatinine of more than twice the preoperative creatinine value. RESULTS: Moderate renal dysfunction was observed in 10% of patients in the on-pump group and in 17.6% of the patients in the off-pump group. Severe renal dysfunction was observed in 6.7% of patients in the on-pump group and in 5.9% of the patients in the 0ff-pump group. Multivariate liner regression analysis showed that the preoperative and immediate postoperative creatinine clearance are associated with postoperative renal dysfuntion in both groups. CONCLUSIONS: In this retrospective study, we could not confirm that OPCAB reduces perioperative renal dysfunction more so than CABG with CPB. Diabetes was found to be significantly associated with postoperative renal dysfunction in CABG with CPB.
Angiography ; Cardiopulmonary Bypass ; Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump ; Creatinine ; Estrogens, Conjugated (USP) ; Heart ; Humans ; Hypertension ; Retrospective Studies

BACKGROUND: Sevoflurane, a newly developed halogenated inhalation anesthetic agent shows myocardial protective effects against global ischemia like other inhalation agents. We investigated differences between pharmacologic preconditioning effects at various concentrations of sevoflurane. METHODS: Forty male Sprague-Dawley rats were subdivided into 4 groups (each n = 10). All groups underwent the same procedure (Langendorff preparation, 30 minutes ischemia and 60 minutes reperfusion) except for the concentrations of sevoflurane. The control group received no sevoflurane treatment. The sevo 1.6% group was given 1.6% sevoflurane before ischemia, the sevo 205% group was given 2.05% sevoflurane before ischemia, and the sevo 2.5% group was given 2.5% sevoflurane before ischemia. Hemodynamic parameters of all groups were recorded through a thin, saline-filled latex balloon and a transducer. Coronary flows were also measured. All hearts were stained by triphenyl tetrazolium to measure infarct size. RESULTS: The sevoflurane administered groups showed higher left ventricular end systolic pressures and lower left ventricular end diastolic pressures than the control group after ischemia and reperfusion. The dP/dtMAX of the sevoflurane administration groups showed a more rapid recovery pattern after ischemia than the control. But no differences were found between the sevoflurane administered groups. Infarct sizes in the sevoflurane administered groups were smaller than those in the control group, and there were no significant differences between the sevoflurane administered groups. CONCLUSIONS: Sevoflurane (even below one MAC) administration before myocardial ischemia has a superb cardioprotective effects, i.e., rapid recovery of left ventricular fuctions, less stiffness development, and a reduced infarct size. There were no significant differences between the sevoflurane administered groups.
Animals ; Heart* ; Hemodynamics ; Humans ; Inhalation ; Ischemia* ; Latex ; Male ; Myocardial Ischemia ; Rats* ; Rats, Sprague-Dawley ; Reperfusion ; Transducers ; Ventricular Function, Left

Purpose: The aim of this study was to evaluate the clinical efficacy of a Tanner-Whitehouse 3 (TW3)-based fully automated bone age assessment system on hand-wrist radiographs of Korean children and adolescents. Materials and Methods: Hand-wrist radiographs of 80 subjects (40 boys and 40 girls, 7-15 years of age) were collected. The clinical efficacy was evaluated by comparing the bone ages that were determined using the system with those from the reference standard produced by 2 oral and maxillofacial radiologists. Comparisons were conducted using the paired t-test and simple regression analysis. Results: The bone ages estimated with this bone age assessment system were not significantly different from those obtained with the reference standard (p>0.05) and satisfied the equivalence criterion of 0.6 years within the 95% confidence interval ( - 0.07 to 0.22), demonstrating excellent performance of the system. Similarly, in the comparisons of gender subgroups, no significant difference in bone age between the values produced by the system and the reference standard was observed (p>0.05 for both boys and girls). The determination coefficients obtained via regression analysis were 0.962, 0.945, and 0.952 for boys, girls, and overall, respectively (p=0.000); hence, the radiologist-determined bone ages and the system-determined bone ages were strongly correlated. Conclusion This TW3-based system can be effectively used for bone age assessment based on hand-wrist radiographs of Korean children and adolescents.