Although there are many peri-operative measures to reduce core temperature loss during operation, rapid drop has been experienced in the first sixty minutes following induction of general anesthesia. Recently, preoperative warming has been emphasized to prevent inadvertant hypothermia during operation. The purpose of this study is to find the effect of preoperative warming on reducing rectal temperature drop in surgical patients. With informed consent, 46 female adult patients, scheduled for total abdominal hysterectomy or salpingo-oophorectomy in the Seoul National University Hospital from September 3, 1996 to September 19, 1996 were divided into two groups. The variables of age and body surface were matched between the two groups as possible. Among them, 24 patients were preparatively covered up to the shoulders with a forced-air warming blanket(WARM TOUCHTM). set between 36-40degrees C for prewarming, and the other 22 patients(control group)were not before the induction of anesthesia. Rectal temperature was measured by mercury thermometer for rectum after admission to the operating room and by rectal probe which was inserted in the rectum just before the induction during the operation. The rectal temperature was monitored and recorded at every fifteen minutes for the first sixty minutes after the induction and each step during the surgery(intubation, surgical draping, peritoneum opening, one hour and the end of the operation) Collected data were analyzed by means of t-test, Repeated Measures Analysis of Variance with PC-SAS. The results of this study are as following. (1) There was no significant difference between the two groups in age, weight, height, room temperature, basal rectal temperature, operation time. (2) Temperature gradient of the rectal temperature in the warming group was less steeper than that in the control roup during the first sixty minutes after general anesthesia. (3) The rectal temperature measured at every fifteen minutes for the first sixty minutes and the end of surgery after the general anesthesia showed the difference between the two groups during surgery. (4) There was no rectal temperature difference during the intubation, however there was significant temperature difference between the two groups from draping to the end of surgery. In conclusion, prewarming of the surgical patient before induction resulted in increased the skin temperature and heat content, which relieved the dangerous core temperature drop which is potential to be provoked within one hour after induction of the surgical patients and kept the rectal temperature higher than that of the control group during surgery. The suggestions from this study shown below : First, further study is needed to find the preventive effect of the core temperature drop in the first sixth minutes after anesthetic induction by preoperative warming for gastrorectal, thoracic surgery patients who man have the core temperature drop during the operation. Second, in other to keep patient normothermia during the surgery, it needs to study whether using pre-and peri-operative warming can prevent hypothermia or not. Finally, the study of the peroperative warming effect on surgical patients' relaxation and thermal discomfort before the operation is needed because most patients in the case group said to have felt thermal comfort ; 'comfortable' and 'good'.
Adult ; Anesthesia ; Anesthesia, General ; Female ; Hot Temperature ; Humans ; Hypothermia ; Hysterectomy ; Informed Consent ; Intubation ; Operating Rooms ; Peritoneum ; Rectum ; Relaxation ; Seoul ; Shoulder ; Skin Temperature ; Thermometers ; Thoracic Surgery

No abstract available.
Carcinoma, Bronchogenic* ; Lung, Hyperlucent*

Medpor, the high density porous polyethylene, which permits rapid ingrowth of both soft tissues and vasculatures, is highly stable but somewhat flexible and is also easy to shape. So it has been often used for plastic and reconstructive surgeries including facial bone fractures, as well as orbital wall fractures. The authors investigated sex and age distribution, causes of injury, combined ocular injuries, and fracture sites of 45 blow-out fractures. And 27 orbital reconstructions was performed by using 0. 85mm thickness Medpor within 2 weeks after injury, if possible. During post-operative follow up, the preoperative diplopia was resolved or decreased in all cases, but the enophthalmos was not completely resolved. Much researches will be needed for choice of Medpor`s thickness or operation methods, and long term stability shoud be approved through further follow up.
Age Distribution ; Diplopia ; Enophthalmos ; Facial Bones ; Follow-Up Studies ; Orbit ; Orbital Fractures* ; Plastics ; Polyethylene

No abstract available.
Occupations*

No abstract available.
Calcaneus*

Ascariasis is the most common helminthic infection in humans. However, its prevalence has been very low in Korea since the 1990s. Recently, there have been several case reports on intestinal obstruction or pancreaticobiliary disease due to infection with Ascaris lumbricoides in adults. However, cases of ascariasis in children have rarely been reported in Korea. We report a case of ascariasis in a 2-year-old boy who experienced expulsion of an adult ascaris worm from his anus. His mother found the worm in his diaper in the morning. His medical history was nonsignificant for any previous illnesses. There were no specific symptoms, and no abnormal findings were found on physical examination. The worm was pink, elongated, and cylindrical; it was 25 cm long and 5 mm wide. Unfertilized eggs of A. lumbricoides were detected in his stool specimen. He was treated with albendazole and remained asymptomatic at follow-up. As long as the number of immigrants from endemic areas and people returning from overseas trips, and import of agricultural products keep increasing, ascariasis can still occur in Korea. Therefore, it is necessary to raise awareness regarding ascariasis.

Retroperitoneal duodenal rupture is rare and is often difficult to diagnose on the plain abdominal x-ray. From a review of the plain abdomen films of 21 cases with retroperitoneal duodenal rupture, confirmed by operation, pneumoretroperitoneum was revealed in 16 cases; Air in the peritoneum was manifested as a bubbly shadow in 12 cases, a renal halo in 9 cases, air shadow along the right psoas margin in 2 cases, air along the diaphragmatic crus in 2 cases and air in the right properitoneal fat in 2 cases, US and CT also revealed air bubbles and fluid collection around the right kidney. We recommend the plain abdomen as a useful diagnostic method for detection of pneumoretroperitoneum.
Abdomen* ; Kidney ; Methods ; Peritoneum ; Retropneumoperitoneum ; Rupture*

OBJECTIVE: The purpose of this study was to evaluate the efficacy and effect of various cryopreservation method on the survival and the cytoskeletal stability of metaphase II mouse oocyte. METHODS: Mouse ovulated oocytes were collected and cryopreserved by a modified slow-freezing method with 1.5 M 1,2-propanediol (PrOH)+0.1 M sucrose or by vitrification using cryo loop and EM grid with 40% ethylene glycol+0.6 M sucrose. Four hours after thawing, intact oocytes were fixed and stained with fluorescein isothiocyanate (FITC)-conjugated monoclonal anti-beta-tubulin antibody to visualize spindle and propidium iodide (PI) to visualize chromosome. Spindle morphology was classified as follows: normal (barrel-shaped), slightly and absolute abnormal (multipolar or absent). RESULTS: Survival rate of the frozen-thawed oocytes in vitrification group was significantly higher than that of slow-freezing group (62.7% vs. 24.4%, p<0.01). Vitrification with cryo loop showed significantly higher survival rate than that with EM grid (67.7% vs. 53.5%, p<0.05). On the other hand, proportion of normal spindle and chromosome configurations of the frozen-thawed oocytes between two vitrification group was not significantly different. CONCLUSION: For mouse ovulated oocytes, vitrification with cryo loop may be a preferable procedure compared to slow-freezing method. Further study should be needed to investigate developmental competency of frozen-thawed mouse oocytes.
Animals ; Cryopreservation* ; Fluorescein ; Hand ; Metaphase ; Mice* ; Oocytes* ; Propidium ; Propylene Glycol ; Sucrose ; Survival Rate ; Vitrification

BACKGROUND: Patency of the infarct-related coronary artery may influence LV remodeling, provide a more stable electrophysiologic milieu and improves the outcome of patient with acute myocardioal infarction. The result from clinical trials have confirmed that early reperfusion in humans induced by a thrombolytic agent is associated with limitation of infarct size, preservation of ventricular function, and improved survival. The purpose of this study was evaluate the effect of thrombolytic therapy on the severity of the residual stenosis, antegrade flow of infarct-related coronary artery after acute myocardial infarction, and investigate left ventricular function and regianal wall motion abnormality depending on the thrombolytic therapy. METHODS: A retrosperctive study was performed in 166 patients with acute myocardial infarction with underwent coronary angiography within 8 days after acute attack from Oct. 1990 to Sep. 1994. Patients were grouped as thrombolysis group(n=64) who had undertaken urokinase infusion therapy within 6 hours of symptom onset and conservatively treated group(n=102) who had not received thrombolytic trerapy. At 8+/-7days, cardiac catheterization was performed. Status of the infarct related artery was assessed by resiudal % diameter stenosis, TIMI and collateral trading. Left ventricular function and wall motion were analyzed. RESULTS: 1) The was no statistical differenccs in age, sex and risk factors(diabetes, hypertension, smoking and hypercholesterolemia)between two groups. 2) The peak serum CK level was higher(2719+/-2333 vs 1951+/-2064 IU/L) and time to peak CK enzyme level was shorter(19+/-13 vs 32+/-24 hr) in thrombolysis group than conservatively treated group. 3) There was lower incidence of total occlusion(12.5% vs 30.4%), residual % diameter stenosis of infarct-related artery(67+/-34% vs 80+/-27%) and better antegrade flow(TIMI grade 0-1, 12.5% vs 32.4%) in thrombolysis group than conservatively treated group(p<0.05). 4) There were no statistical differences of ejection fraction(51+/-15 vs 51+/-14%). left ventricular end diastolic pressure(21+/-10 vs 21+/-16mmHg) and regional wall motion score(8.6+/-3.4 vs 9.1+/-3.1) between thrombolysis group and conservatively treated group(p>0.05). CONCLUSION: Thrombolytic therapy in acute myocardial infarction resulted in dquisition of early infarct-related arterial patency, effectiove antegrade flow and reduced incidence of totoal occlusion of infarct-related artery. Left ventricular ejection fraciton, regional wall motion score was not affected by thrombolytioc therapy in inhospital period.
Arteries ; Cardiac Catheterization ; Cardiac Catheters ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels* ; Humans ; Hypertension ; Incidence ; Infarction ; Myocardial Infarction* ; Reperfusion ; Smoke ; Smoking ; Thrombolytic Therapy ; Urokinase-Type Plasminogen Activator ; Ventricular Function ; Ventricular Function, Left*

"Background: In using the Double-lumen tube (DLT), knowing the minimum bronchial cuff volume (MCV) for an effective air-tight seal will be useful; to provide a collapse of the lung; and to avoid pressure damage. The aims of the present study are thus three-fold: to measure the MCV; to measure the diameter of left main bronchus (LMBD); and to prove any relationships between two parameters. METHODS: One hundred men and forty women who needed intubation of left-sided DLT were enrolled in this study. 37 Fr DLTs were used in male patients, and 35 Fr DLTs were used in female patients. We evaluated the MCV by air bubble method and measured the LMBD in chest PA. We also evaluated the pressure/volume characteristics of the bronchial cuffs by control inflator. RESULTS: 29 patients of 100 patients (29%) exhibited persistent air leakage in 2.5 ml cuff volume in male patients (group of MCV >2.5). On the contrary, 18 patients of 40 patients (45%) did not require any cuff volume in female patients (group of MCV 0). The mean LMBD were 13.23 1.45 mm in male and 11.09 0.96 mm in female. There were significant positive correlations between MCV and LMBD in both sex and their respective correlation coefficients were 0.264 (P=0.008) in male and 0.484 (P=0.002) in female. The equations of linear regression were: LMBD = 12.394 0.429xMCV in male, LMBD = 10.725 0.438xMCV in female. CONCLUSIONS: The MCV of the brochial cuffs in left-sided DLTs has significant relationships with the LMBD measured in chest PA.
Bronchi ; Female ; Humans ; Intubation ; Linear Models ; Lung ; Male ; Thorax