80 patients, 40 patients without preexisting EKG abnormality (group 1) and 40 patients with preexisting abnormalities of EKG (group 2), receiving general anesthesia in the operating room were monitored continously with electrocardioscope, Servomed SMK 155-1 and were recorded. 1) 7 cases(17.5%) of group 1 developed a variety of arrhythmia, and 13 cases (32.5%) of group (32.5%) of group 2 developed a variety of arrhythmia. 2) The most common arrhythmia was premature ventricular contraction including bigeminies (13 cases, 60% of the total arrhythemia) and the most serious arrhythmia was seen 1 case of rapid ventricular tachycardia without artrial activity. 3) Continous cardiac monitoring is valuable, easy and practical in virtually all instance during anesthesia and surgery.
Anesthesia ; Anesthesia, General ; Arrhythmias, Cardiac* ; Electrocardiography ; Humans ; Operating Rooms ; Perioperative Period* ; Tachycardia, Ventricular ; Ventricular Premature Complexes

To evaluate the historical trend of anesthetic experience for the past 22 years a total of 68,473 cases which were performed at the National Medical Center from 1959 to 1981 were studied. To simplify the analysis statistically, the author selected the anesthetic cases every other year(12 years). 1) General anesthesia was performed in more than 78% of the total cases and of this number endotracheal intubation has been used with increasing frequency(average 92.8%). 2) For intravenous induction, thiopental sodium was used as the main agent, in more than 90% since 1980. 3) Trichlorethylene, cyclopropane and ethylchloride which had been used since 1961, were abandoned from 1978 except for training purposes. Methoxyflurane was used from 1973 to 1979, but given up there after because of it's nephrotoxicity. The use of halothane has steadily increased(86% of the total inhalation anesthetics) and ethrane has also been used with increasing frequency since 1980. 4) Pancuronium has been used as a primary muscle relaxant instead of gallamine and D-tubocurarine which had been used as the main durgs from 1959 till 1979. 5) Innovar and morphine as intravenous anesthetics, have recently been with increasing grequency.
Anesthesia, General ; Anesthetics, Intravenous ; Enflurane ; Gallamine Triethiodide ; Halothane ; Inhalation ; Intubation, Intratracheal ; Methoxyflurane ; Morphine ; Pancuronium ; Thiopental ; Tubocurarine

PURPOSE:Idiopathic ketotic hypoglycemia (IKH) is an important cause of hypoglycemia in children. The purpose of this study was to determine the prevalence of ketotic hypoglycemia and to describe the clinical manifestation. METHODS:We conducted a retrospective chart review of children presenting hypoglycemia to the emergency department (ED) of Ewha Womans University Hospital between January 1995 and June 2004. Information recorded for subject included age, gender, weight, time of presentation, presenting symptoms, and laboratory data. RESULTS:Eighty two children were identified for hypoglycemia during the study period. IKH was the ultimate diagnosis for 66 patients (80.5%). Other diagnoses included hyperinsulinism (2.4%), drug adverse event (1.2%), sepsis (1.2%), and other disorder. The mean age for presentation of IKH was 37.9+/-18.6 months. Thirty eight boys and twenty eight girls were identified. The median time of presentation was 9:48 a.m. Of the 66 subjects, body weight of 46.9% patients was below 25th percentile for age. The average blood glucose was 41.4+/-14.2 mg/dL. Symptoms at presentation included lethargy (24.2%), mental change (16.7%) and vomiting (16.7%). 49 patients (74.2%) were described as having a concomitant illness. CONCLUSION: IKH was responsible for 80.4% of cases of hypoglycemia in pediatric ED and it had usually concomitant intercurrent illness which resulting in poor oral intake. Awareness of IKH, and its presenting characteristics, will be helpful in the ED when taking care of hypoglycemic children.
Blood Glucose ; Body Weight ; Child ; Diagnosis ; Emergency Service, Hospital ; Female ; Humans ; Hyperinsulinism ; Hypoglycemia* ; Lethargy ; Prevalence* ; Retrospective Studies ; Sepsis ; Vomiting

No abstract available.
Infection Control*

Though the incidence of paragonimiasis has been remarkably decreased since 1970, it is still not a rare disease in Korea. Major problems in the diagnosis of pulmonary paragonimiasis on chest radiography are its differentiation from pulmonary tuberculosis and lung cancer. Chest radiographic findings have been described in detail, but little have been reported on CT findings. We reviewed CT findings of 10 patients with pulmonary paragonimiasis. The characteristic CT findings were similar to those on chest radiography, such as air-space consolidation (70%), nodular mass (50%), pleural effusion (40%), cystic lesion (30%), small low density within the mass (30%), linear density (20%), pneumothorax(20%), and burrow track (20%). CT depicted the cystic lesions and the burrow tracks more clearly and showed the small worm-retaining cysts within the mass that were not detectable on chest radiography. In conclusion, all of these CT findings are useful in the diagnosis of pulmonary paragonimiasis especially when differentiation from tuberculosis or lung canceris difficult on chest radiography.
Diagnosis ; Humans ; Incidence ; Korea ; Lung ; Lung Neoplasms ; Paragonimiasis* ; Pleural Effusion ; Radiography ; Radiography, Thoracic ; Rare Diseases ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary

Drug-induced parkinsonism (DIP) is the second-most-common etiology of parkinsonism in the elderly after Parkinson's disease (PD). Many patients with DIP may be misdiagnosed with PD because the clinical features of these two conditions are indistinguishable. Moreover, neurological deficits in patients with DIP may be severe enough to affect daily activities and may persist for long periods of time after the cessation of drug taking. In addition to typical antipsychotics, DIP may be caused by gastrointestinal prokinetics, calcium channel blockers, atypical antipsychotics, and antiepileptic drugs. The clinical manifestations of DIP are classically described as bilateral and symmetric parkinsonism without tremor at rest. However, about half of DIP patients show asymmetrical parkinsonism and tremor at rest, making it difficult to differentiate DIP from PD. The pathophysiology of DIP is related to drug-induced changes in the basal ganglia motor circuit secondary to dopaminergic receptor blockade. Since these effects are limited to postsynaptic dopaminergic receptors, it is expected that presynaptic dopaminergic neurons in the striatum will be intact. Dopamine transporter (DAT) imaging is useful for diagnosing presynaptic parkinsonism. DAT uptake in the striatum is significantly decreased even in the early stage of PD, and this characteristic may help in differentiating PD from DIP. DIP may have a significant and longstanding effect on patients' daily lives, and so physicians should be cautious when prescribing dopaminergic receptor blockers and should monitor patients' neurological signs, especially for parkinsonism and other movement disorders.
Aged ; Anticonvulsants ; Antipsychotic Agents ; Basal Ganglia ; Calcium Channel Blockers ; Dopamine Plasma Membrane Transport Proteins ; Dopaminergic Neurons ; Humans ; Movement Disorders ; Organothiophosphorus Compounds ; Parkinson Disease ; Parkinsonian Disorders ; Tremor

No abstract available.
Cellulitis* ; Dermatitis, Allergic Contact*

PURPOSE: The aim of this study was to investigate the level of resilience and related factors in patients with Parkinson's disease (PD) in Korea. METHODS: Data were obtained from 148 patients using the Resilience Scale (RS), Beck's Depression Inventory (BDI), and Spielberger's Anxiety Inventory (AI). RESULTS: The mean scores of the RS, BDI, and AI were 127.7+/-21.6, 12.9+/-9.3, and 41.9+/-11.1, respectively. The RS score was strongly correlated with the BDI score (r=-.531, p<.001) and the AI (r=-.572, p<.001). The resilience was significantly revealed by household income (F=4.002, p=.009) and presence of a hobby (t=-3.300, p=.001). In addition, resilience was significantly correlated with age of disease onset (r=.164, p=.046), years of living with PD (r=-.262, p=.001), and the length of treatment with levodopa (r=-.283, p<.001). From the stepwise multiple regression analysis, the most important factors related to the RS score were the AI score, household income, and length of treatment with levodopa. CONCLUSION: Understanding these factors is essential for developing effective interventions to improve resilience in patients with PD.
Anxiety ; Depression ; Family Characteristics ; Hobbies ; Humans ; Korea ; Levodopa ; Parkinson Disease

The purpose of this study was to assess the structure of the decision and the importance of the attributes in choosing food-related tour program. Questionnaires were developed in three languages- Japanese, Chinese, and English- given to 300 foreign tourists who have visited Korea in 2002. Statistical data analysis was completed using SPSS Win (ver 11.0) for descriptive analysis and conjoint analysis. The results of this study showed that the 'price' was the most important attribute (35.62%) in choosing a hypothetical food tourism program, followed by 'place' (27.35%), 'time' (26.01%), and 'type of program' (10.22%). With respect to the relative importance values for each attribute by different groups, English- and Chinese-speaking tourists considered 'price' more than other factors, while 'time' was regarded as the most important factor for Japanese tourists. Therefore, it indicated the need to recognize the different needs among tourists and put these factors into consideration in developing the programs.
Asian Continental Ancestry Group ; Data Interpretation, Statistical ; Humans ; Korea

BACKGROUND: To determine whether multiple short-term surveillances are as effective as long-term surveillance for estimating the incidence rates of nosocomial infections (NIs), we prospectively performed 9-month surveillance in four intensive care units (ICUs). METHODS: NI surveillance was performed prospectively from November 2002 through July 2003, with long-term surveillance performed over the 9-month period, and short-term surveillance performed during the middle 3 weeks of each calendar quarter. The incidence rate of NIs or device-associated infections was calculated as the number of infections per 1,000 patient-days or device-days. RESULTS: We observed no significant differences between the incidence rates of total NIs determined from these two methods (9.6 [CI95 8.2-11.3] vs 10.4 [CI95 7.5-14.4], P=.66). In addition, these two methods did not differ significantly in estimating the rates of ventilator-associated pneumonia (5.1 [CI95 3.4-7.6] vs 7.5 [CI95 3.8-15.0], P=.35), catheter-associated urinary tract infection (2.4 [CI95 1.7-3.4] vs 1.7 [CI95 0.7-4.1], P=.47), and central line-associated bloodstream infection (2.2 [CI95 1.4-3.4] vs 3.7 [CI95 1.9-7.4], P=.21). Plotting of the NI rates showed that the trends in multiple short-term surveillances were similar to those in long-term surveillance, except in one ICU. CONCLUSION: Our findings suggest that multiple short-term surveillances could replace long-term surveillance in estimating the baseline incidence rates of NIs in the circumstances of the relatively large number of patients in the ICUs, which would be especially useful in countries with limited resources.
Cross Infection* ; Epidemiology ; Humans ; Incidence ; Infection Control ; Intensive Care Units ; Pneumonia, Ventilator-Associated ; Prospective Studies ; Urinary Tract Infections