No abstract available.
Bilirubin* ; Infant, Newborn ; Jaundice, Neonatal*

Heart transplantation is an accepted procedure for treatment of end-staged cardiac failure. A return to near-normal quality on life can be expected in many patients with a nonrejecting cardiac allograft, and many of these patients will return to the operating room for noncardiac surgical procedures. Anesthesiologists should be alert to recognizing problems caused by the presence of infection in immunosuppressed patients, modes of presentation of rejection phenomena and how transplanted organs, notably significantly denervated ones, may behave and respond under the pathophysiologic circumstance that arise during surgery, resuscitation and intensive care. The use of regional techniques require adequate preloading to avoid exaggerated hypotension and aseptic technique to avoid infection. Hypobaric spinal anesthesia has some benefit. It does not depress cardiovascular and respiratory system and keep adequate venous return by trendelenberg position. We report herein a case of successfully undergone total hip replacement in a patient who had previously undergone orthotopic heart transplantation under hypobaric spinal anesthesia.
Allografts ; Anesthesia, Spinal* ; Arthroplasty, Replacement, Hip ; Heart Failure ; Heart Transplantation ; Heart* ; Humans ; Hypotension ; Critical Care ; Operating Rooms ; Respiratory System ; Resuscitation

No abstract available.

The use of the computer in medicine has been increasing rapidly. Despite this growing use of them, however, they have yet to assume a major role in assisting the physician. The purpose of this article, using dBASE ll, is to assist an anesthesiologist by rapid search of his(her) own references in preparing educational material or do research and so on. This software was written to be an efficient alternative to the conventional manual searching and to provide the following features: 1) personnel unfamiliar with computer technology could achieve satisfactory results. 2) rapid data entry of raw data with conventional keystrokes. 3) extensive data editing and manupulation capabilities. 4) entering each data typed by user was indexed alphabetically in sequence of authors' name. 5) easy search of data through the authors name, title, keyword and identifying of them in CRT displays or printer. Using a microcomputer for data processing had several advantages over a conventional manual method.: 1) less time required to retrieve information. 2) visual presentation of data was facilitated. 3) data were more readily obtainable. But the major disadvantage of a computerized system were the initial time consumed during the input of the data.
Microcomputers*

Phrenic nerve palsy is a well-known complication following cardiac surgery in children. The incidence is approximately 1~2%. In infants and young children, it often causes a life-threatening respiratory distress. They must be treated with mechanical ventilation in the ICU. Many patients with phrenic nerve injury who is impossible to wean from a ventilator are candidates of diaphragmatic plication. Diaphragmatic plication is performed to restore the normal pulmonary parenchymal volume by replacing the diaphragm to its proper location. This is a case of 2-months-old infant who had phrenic nerve palsy after the removal of cavernous lymphangioma of the chest. He underwent 4 operations to remove the mass and to have pericardiotomy. We tried to wean him from the ventilator but failed several times in the ICU. After 4th operation, right diaphragmatic elevation was noted from the chest X ray. Phrenic nerve palsy was confirmed with fluoroscopy and he underwent diaphragmatic plication on 42 days after his 4th operation. Three days after the diaphragmatic plication, weaning was successfully carried out.
Child ; Diaphragm ; Fluoroscopy ; Humans ; Incidence ; Infant* ; Lymphangioma* ; Paralysis* ; Pericardiectomy ; Phrenic Nerve* ; Respiration, Artificial ; Thoracic Surgery ; Thorax ; Ventilators, Mechanical ; Weaning*

BACKGROUND: Postoperative ileus is a universal complication after major intraabdominal surgery. Choice of postoperative analgesia may affect the rate of functional recovery of bowel. Epidural analgesia with morphine and bupivacaine is a popular method for pain relief. However little is known about the effects of this regimen on bowel motility. METHODS: Forty patients undergoing partial or total gastrectomy were randomized into two groups. All groups received a standardized general inhalation anesthesia with enflurane. Control group received traditional intramuscular(IM) administration of meperidine for the postoperative analgesia. Experimental group received a bolus of epidural 0.5% bupivacaine 10 ml followed by continuous epidural infusion of 0.21% bupivacaine with 0.01% morphine, started at the end of operation with the basal infusion rate of 1 ml/hours, bolus 1 ml, and ldegrees Ckout interval 30 min during 48 hr. We compared the analgesic effect, side effects and restoration of bowel function(first passage of flatus and feces)between two groups. Postoperative pain was assessed using the 10 cm visual analog pain scale (0=no pain, 10=worst imaginable pain) at rest. Scores were taken at 1, 6 hours after operation and 7 AM, 6 PM of the 1st postoperative day and 7 AM of the 2nd postoperative day. RESULTS: Experimental group revealed superior analgesia(p<0.005) but had a greater incidence of nausea, pruritus and urinary retention. No significant difference was found in restoration of bowel function between two groups. CONCLUSION: There was no superior effect of epidural analgesia with morphine and bupivacaine on bowel motility after gastrectomy than the effect of traditional IM meperidine administration.
Analgesia ; Analgesia, Epidural* ; Anesthesia, Inhalation ; Bupivacaine* ; Enflurane ; Flatulence ; Gastrectomy* ; Humans ; Ileus ; Incidence ; Meperidine ; Morphine* ; Nausea ; Pain Measurement ; Pain, Postoperative ; Pruritus ; Urinary Retention

BACKGROUND: The purpose of this study is to examine the effect of intravenous ketorolac administration before surgical stimulation for postoperative pain control. METHODS: Forty four patients scheduled for total hip replacement were randomly assigned to one of three groups of prospectively designed study. Group 1 (n=14) received intravenous saline (placebo) and Group 2 (n=15) received intravenous ketorolac (30 mg) at one hour after skin incision and Group 3 (n=15) received intravenous ketorolac (30 mg) before induction. Postoperative pain relief was provided with intravenous morphine from PCA system. Postoperative visual analogue pain score (VAS), analgesic requirement and side effects were evaluated and compared between groups for postoperative two days. RESULTS: VAS at rest were significantly less in Group 2,3 than in Group 1 at 3 hours after surgery (p<0.05) and significantly less in group 3 than in group 1 at 6 and 9 hours after surgery (p<0.05). VAS on movement were significantly less in group 3 than group 1 at 1 hour and significantly less in group 2,3 than group 1 at 3 and 6 hours after surgery (p<0.05). Patient controlled morphine consumption in group 1 was significantly higher than in group 2,3 for 12 hours after surgery. After administration of intravenous ketorolac any side effect did not occur. CONCLUSIONS: Administration of intravenous ketorolac before skin incision as a pre-emptive analgesia has better analgesia than those of 1 hour after skin incision and no administration of ketorolac.
Analgesia ; Arthroplasty, Replacement, Hip* ; Humans ; Ketorolac* ; Morphine ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Prospective Studies ; Skin

The Committee of Education of the Korean Diabetes Association discussed the need to develop the Diabetes Education Recognition Program. In 2011, the current certification program was reviewed and a survey was conducted to improve the Diabetes Education Recognition Program. This improved program will be a standard for qualified diabetes education for diabetes educators and institutes, and will ultimately become a national standard for diabetes education.
Academies and Institutes ; Certification ; Diabetes Mellitus ; Patient Education as Topic

The Diabetes Educator Training Module (DETM), which was developed in 2011, contained more than 900 slides. The purpose of the DETM is to help Korean diabetes educators develop programs for diabetic patients and health professionals. In this paper, we present information regarding the history, the principles of development, the contents, and the use of the DETM program. We hope that the DETM will be a useful tool for helping diabetic patients to understand their disease and to improve their glycemic control and treatment adherence.
Health Occupations ; Humans ; Patient Education as Topic ; Teaching Materials

OBJECTIVES: A web-based survey has been administered annually since 2005 throughout Korea to assess the prevalence of adolescent health risk behaviors among middle and high school students. The aim of this study was to evaluate the test-retest reliability of the Korea Youth Risk Behavior Web-based Survey (KYRBWS) questionnaire. METHODS: A convenience sample of 2298 middle and high school students participated in self-administered questionnaire surveys twice, approximately two weeks apart, in 2008. The percent agreement, kappa statistics, and prevalence rates at the first and second surveys were computed for the core subset of 39 self-reported health risk behavior indices of the KYRBWS. RESULTS: Among 39 indices, seven indices had kappas > or = 0.81 and all of the indices had kappas > or = 0.41. Based on non-overlapping 95% confidence intervals, three indices had significantly different prevalence rates between the first and second surveys. In the subgroup analyses by school grade and gender, two indices had significantly different reliability estimates between middle and high school students. There were no significantly different reliability estimates between male and female students, except for one index. CONCLUSIONS: This study demonstrated that the reliability estimates for the KYRBWS questionnaire are varied, but generally reliable over time. The indices with low reliability estimates need to be evaluated further in order to determine whether the indices should be modified or deleted from future versions of the KYRBWS.
Adolescent ; *Adolescent Behavior ; Alcohol Drinking/*epidemiology ; Child ; Confidence Intervals ; Data Collection ; Female ; Humans ; Hypersensitivity/epidemiology ; Internet ; Male ; Oral Health ; Pregnancy ; Prevalence ; *Questionnaires ; Reproducibility of Results ; Republic of Korea/epidemiology ; *Risk-Taking ; Sexual Behavior ; Smoking/*epidemiology ; Substance-Related Disorders/*epidemiology ; Time Factors