BACKGROUND: Endobroncheal intubation or extubation may occur accidentally when the patient's neck is flexed or extended even in the appropriate endotracheal intubation. The purpose of this study is to examine the effect of fixation or unfixation of the endotracheal tube at the teeth level on the displacement of its distal end when the patient's neck is extended or flexed. METHODS: This study was conducted in 37 patients who underwent endotracheal general anesthesia. The patients with the evidence of pathology in head, neck and chest were excluded from the study. Individual patient's displacement in endotracheal tube tip compared unfixed cases with fixed cases when the change of neck position. The moved distance was measured by fiberoptic bronchoscope. The data were statistically analyzed by Student's paired t-test. RESULTS: The endotracheal tube moved away from the carina when the patient's neck was extended, while it moved toward the carina when flexed in all cases. When the patient's neck was extended the average distance displaced 1.2 0.7 cm in fixed cases and 1.1 0.9 cm in unfixed cases. when the neck was flexed, they were 1.2 0.5 cm and 1.0 0.8 cm respectively. There were not statistically significant between the fixed and the unfixed cases. CONCLUSIONS: It is concluded that the displacement of the endotracheal tube is not related to its fixation or unfixation at the teeth level and therefore, unfixation does not provide any benefits in terms of the displacement of the distal end of the tube in adult trachea.
Adult ; Anesthesia, General ; Bronchoscopes ; Head ; Humans ; Intubation ; Intubation, Intratracheal ; Neck* ; Pathology ; Thorax ; Tooth ; Trachea

Lithium is a commonly prescribed drug for bipolar disorder. Because of the narrow therapeutic range, lithium intoxication continues to be prevalent. Drugs that alter renal function such as ACEI, ARB, NSAIDS, and thiazide can increase the risk of chronic lithium toxicity even to stable patients. A 65-year old woman was admitted for hand tremor, cognitive impairment, and lethargy. A medical history included major depressive disorder, mitral stenosis, atrial fibrillation, and hypertension. Her prescription included lithium, quetiapine, digoxin, furosemide, and warfarin. She recently received Atacand Plus (candesartan plus thiazide) for hypertension. At the time of admission, the patient was drowsy and confused. The serum lithium level was 4.25 mEq/L. The patient received hydration. Due to neurologic complications and the degree of lithium toxicity, a total of three sessions of hemodialysis were performed, and the post-dialysis serum lithium level was 0.54 mEq/L. The neurologic symptoms recovered completely after a third dialysis session.
Aged ; Anti-Inflammatory Agents, Non-Steroidal ; Atrial Fibrillation ; Bipolar Disorder ; Depressive Disorder, Major ; Dialysis ; Digoxin ; Female ; Furosemide ; Hand ; Humans ; Hypertension ; Lethargy ; Lithium* ; Mitral Valve Stenosis ; Neurologic Manifestations ; Poisoning* ; Prescriptions ; Renal Dialysis* ; Tremor ; Warfarin ; Quetiapine Fumarate

BACKGROUND: Many disinfectants have been used clinically in both single and combination applications, but there have been few studies on disinfective power according to sterilization sequence when using a combination of disinfectants. The purpose of this study was to evaluate the disinfective power of a combination of 70% isopropyl alcohol and 10% povidone-iodine (PVP-I) according to sterilization sequence. METHODS: Two hundred healthy volunteers were recruited. Subjects were disinfected with a combination of 70% isopropyl alcohol and 10% PVP-I on both forearms, in varying sequence. The AP group included disinfections on the left forearm with isopropyl alcohol first followed by 10% PVP-I, while the PA group included disinfections on the right forearm with same disinfectants in reverse order. Skin cultures were obtained using cotton swabs 3 min after application of each disinfectant, and then were inoculated on blood agar plates for bacterial culture. Cultures were incubated at 37degrees C under aerobic conditions for 48 hours. RESULTS: There was no significant difference in the number of positive cultures after the 1st disinfection (AP, 45; PA, 36, P = 0.262) or the 2nd disinfection (AP, 6; PA, 13, P = 0.157), suggesting that there is no relationship between disinfective power and the sequence of the disinfectants used. The number of positive cultures significantly decreased after the 2nd disinfection (P < 0.01), however. CONCLUSIONS: There was no significant difference in disinfective power according to sterilization sequence with 70% isopropyl alcohol and 10% PVP-I in healthy volunteers. The combination of 70% isopropyl alcohol and 10% PVP-I was more effective than disinfection with a single agent regardless of sterilization sequence.
2-Propanol* ; Agar ; Disinfectants ; Disinfection ; Forearm ; Healthy Volunteers ; Povidone-Iodine* ; Skin ; Sterilization

PURPOSE: The purpose of this study was to describe technological development, caring attributes and professional self-concept as perceived by nurses in YanBian. METHOD: Data were collected using an instrument containing 137 Likert items was administered to 477 RN's working in general hospitals in YanBian. The instrument contained sections which examined technological influences questionnaire(TIQ), caring attributes questionnaire(CAQ), and professional self-concept nursing inventory(PSCNI). RESULT: Descriptive and inferential statistics revealed by marital status and position. Married, working special ward nurses reported a higher TIQ score than that of unmarried and working general ward and OPD. PSCNI and CAQ score of head or supervisor nurses were higher than that of staff nurses. Subjects revealed very low score of CAQ, while PSCNI score was higher than that of other Asian countries such as Korea, Beijing China, HongKong China and Japan as proved in former study. CONCLUSION: Useful information for educators and nurse administrators is provided from this results. Further study needs to be done to discuss in the light of cultural and environmental differences between YanBian(Korean-Chinese) and Korean nurses.

OBJECTIVES: This study aimed to determine the general predictive factors of change in drinking behavior and to provide materials for preventing drinking problems during early adulthood through examining genetic and psychosocial factors affecting the change of drinking behavior in college students. METHODS: The subjects were 101 male college students, a part of 534 students who had completed the previous study in 2000. In the present study as a 6-years follow up, we reassessed the drinking pattern and psychosocial variables and compared the results with previous data of the same subjects. To identify factors affecting the current drinking pattern, we used stepwise multiple regression and logistic regression analysis. RESULTS: D allele (ALDH2) was found to reduce the degree of drinking and suppress problematic drinking, and C allele (TPH) had a suppression effect on problematic drinking. Drinking motive had a direct effect on the degree of drinking and problematic drinking. Negative cognitive expectancy had a direct effect on problematic drinking. CONCLUSION: Authors found some factors affecting the change of alcohol drinking behavior in college students and confirmed that there were hierarchies of significance among these factors. These may be applicable as variables for predicting drinking behavior in early adulthood.
Alcohol Drinking ; Alleles ; Drinking Behavior* ; Drinking* ; Follow-Up Studies ; Humans ; Logistic Models ; Male* ; Psychology*

A 23-year-old female patient was diagnosed with congenital long QT syndrome, discovered when she visited our cardiac department due to chest discomfort, because she had a prolonged QTc interval on ECG, history of syncopal attacks and seizures several times every year, and ingestion of anticonvulsants for several years. It is well known that the long QT syndrome is associated with sudden death secondary to ventricular tachyarrhythmia or fibrillation at a young age. Moreover cardiac arrests during induction, maintenance, and awakening of anesthesia of these patients have been reported, and may be due to asymmetrical adrenergic stimuli in the heart, especially in the unrecognised case. This case report describes the anesthetic management of a patient with congenital long QT syndrome, who presented for cervicothoracic sympathectomy for a more permanent control of life-threatening ventricular arrhythmias, and reviews the related literature.
Anesthesia ; Anticonvulsants ; Arrhythmias, Cardiac ; Death, Sudden ; Eating ; Electrocardiography ; Female ; Heart ; Heart Arrest ; Humans ; Long QT Syndrome* ; Seizures ; Sympathectomy* ; Tachycardia ; Thorax ; Young Adult

PURPOSE: This study set out to identify the association between the intraperitoneal CO₂ concentrations and postoperative pain by dividing the participants into a control group and 2 experimental groups receiving irrigation (1 L and 2 L), and directly measuring their intraperitoneal CO₂ concentrations with a CO₂ gas detector. METHODS: A total of 101 patients, American Society of Anesthesiologists physical status classification I and II patients aged 18–65 years were enrolled in the study. Group 1 did not receive irrigation with normal saline, while groups 2 and 3 were administered irrigation with 1 L and 2 L of normal saline, respectively, after laparoscopic cholecystectomy. Intraperitoneal CO₂ concentrations were measured with a CO₂ gas detector through the port, and postoperative pain was assessed on a visual analogue scale at 6, 12, and 24 hours after surgery. RESULTS: The intraperitoneal CO₂ concentrations were 1,016.0 ± 960.3 ppm in group 1, 524.5 ± 383.2 ppm in group 2, and 362.2 ± 293.6 ppm in group 3, showing significantly lower concentrations in groups 2 and 3. Postoperative pain was significantly lower in group 3 at 6 hours after surgery, and in groups 2 and 3 at 12 hours after the surgery. However, there was no significant difference between the 3 groups in postoperative pain 24 hours after the surgery. CONCLUSION: This study found a causal relationship between the amount of normal saline used for irrigation and the intraperitoneal CO₂ concentrations in that irrigation with normal saline reduces pain on the day of the surgery.
Cholecystectomy, Laparoscopic* ; Classification ; Humans ; Pain, Postoperative* ; Saline Waters