A 46-year-old woman underwent a right thyroidectomy with left neck dissection under general anesthesia. The operation was performed successfully for over the course of 3 hours 30 minutes. After extubation, the patient was transferred to post-anesthetic care unit (PACU). After 10 minutes, dyspnea, chest discomfort, desaturation was suddenly occurred. Intubation was performed in PACU. The emergency chest X-ray revealed a right pneumothorax, and the patient was treated by chest tube insertion. The patient was improved and was discharged uneventfully from hospital 8 days later.
Anesthesia, General ; Chest Tubes ; Dyspnea ; Emergencies ; Female ; Humans ; Intubation ; Middle Aged ; Neck ; Neck Dissection ; Pneumothorax ; Thorax ; Thyroidectomy

BACKGROUND: Hypothermia following the induction of anesthesia is caused by core to peripheral redistribution of body heat. It has been reported that propofol causes more severe hypothermia than sevoflurane by inhibiting thermoregulatory vasoconstriction during surgical procedures. Therefore, we evaluated the induction and maintenance of anesthesia with intravenous propofol to determine if it causes more core hypothermia than inhaled sevoflurane. METHODS: Forty-five patients who underwent hysterectomy were divided into two groups randomly, a propofol-remifentanil (PR) anesthesia group and a sevoflurane-remifentanil (SR) anesthesia group. Each group was subjected to anesthetic induction with either 1.5 mg/kg propofol or inhalation of 5% sevoflurane, respectively. Anesthesia in the former group was maintained with propofol while it was maintained with sevoflurane in the latter group. Specifically, 6-10 mg/kg/hr propofol, 3 L/min medical air, 2 L/min O2, and 0.25 mg/kg/hr remifentanil were used in the PR group for maintenance, while 1.5 vol% sevoflurane, 3 L/min medical air, 2 L/min O2 and 0.25 mg/kg/hr remifentanil were used for maintenance in the SR group. We measured the core temperature 8 times, prior to induction and 10, 20, 30, 45, 60, 75 and 90 minutes after induction. RESULTS: Core temperatures decreased in both the PR and SR group during surgical operation, but there was no significant difference between the two groups. CONCLUSIONS: Anesthesia induced and maintained by propofol did not cause a greater degree of hypothermia than sevoflurane.
Anesthesia ; Hot Temperature ; Humans ; Hypothermia ; Hysterectomy ; Inhalation ; Methyl Ethers ; Piperidines ; Propofol ; Vasoconstriction

BACKGROUND: Location of the tip of a central venous catheter (CVC) within the pericardium has been associated with potentially lethal cardiac tamponade. The purpose of this study was to show the relationship between the height of patients and the depth of CVC. METHODS: We enrolled 262 adult patients into this study. All patients were divided to three groups according to the height; Group S, M and L. Central venous catheterization was performed through the right subclavian vein and the CVC was fixed at the depth of 15 cm from the skin. The distance between the CVC tips and the carina was measured by chest X-ray and was analyzed. RESULTS: The mean (SD) tip position placed via the right subclavian vein was 0.04 (1.6) cm above the carina; Group S, 0.01 (1.8) above the carina, Group M, 0.16 (1.4) above the carina, and Group L, 0.16 (1.8) below the carina. CVC locations could be predicted with a margin of error between 3.1 cm below the carina and 3.2 cm above the carina in 95% of patients. There was no significance difference among the three groups. CONCLUSIONS: The relationship between the height of patient and the depth of CVC was low. Because many of the CVC tips were positioned below the carina regardless the height of patients on routine 15 cm-length method, it is recommended not to use the routine 15 cm method with right subclavian CVC placement as far as possible.
Adult ; Cardiac Tamponade ; Catheterization ; Catheterization, Central Venous ; Central Venous Catheters ; Humans ; Pericardium ; Skin ; Subclavian Vein ; Thorax

No abstract available.
Catheterization ; Catheters ; Hemothorax ; Jugular Veins ; Subclavian Artery

Background: Plastic waste generates pollutants in the process of incineration or landfilling, and accumulates in water or marine organisms, causing adverse effects on the environment and the human body. Recently, various eco-friendly oral hygiene products (Eco-OHPs) such as bamboo toothbrushes and biodegradable plastic toothbrushes have been developed. Therefore, this study aimed to investigate the current level of awareness and purchasing status of eco-OHPs among adults who are interested in eco-friendly products. Methods: This study included adults aged ＞19 years who regularly visited eco-friendly shops and online sites; the online survey links were distributed during their visits to eco-friendly Internet cafés and companies. Of the 22 questions, seven assessed the participants’ general characteristics, three assessed the general oral hygiene care products used, six assessed the level of awareness of Eco-OHPs, and six assessed the purchasing status of Eco-OHPs. Frequency analysis, chi-square test, and regression analysis were performed using SPSS software. Results: Among the respondents, 108 (51.4%) were aware of Eco-OHPs, and 79 (37.6%) had experience purchasing Eco-OHPs. The most common reason for not purchasing was the lack of information about related brands or products (74, 56.5%). The most common platform used in obtaining information was the Internet (general: 31.5%, eco-friendly: 46.3%), such as Social Network Service, Internet cafes, and blogs. The experience in purchasing Eco-OHPs was affected by whether the respondents recognized the possibility of contributing to environmental preservation, availability of vendors, product safety, and the number of eco-friendly products purchased. Conclusion In order to expand the use of Eco-OHPs, various efforts such as promotion of eco-friendly characteristics, determination of related vendors, reliable analysis of product safety, and expansion of product experience opportunities are required.

BACKGROUND: We analyzed our experience of arrhythmia surgery in patients with congenital heart disease. MATERIAL AND METHOD: A retrospective review was performed on 43 consecutive patients with congenital heart disease, who underwent arrhythmia surgery between June 1998 and June 2006. RESULT: The median age at surgery was 52 years (4~75 years). The most frequent cardiac anomaly was an atrial septal defect (23/43, 53.5%). The types of arrhythmias were atrial flutter-fibrillation, intermittent non-sustainable ventricular tachycardia and others in 37, 2 and 4, respectively. Arrhythmia surgery consisted of a bi-atrial maze operation in 18 patients (modified cox maze III procedure in 5 patients, and a right side maze plus pulmonary vein cryo-isolation in 13), right side maze operation in 18 patients, cavo-tricuspid isthmus cryoablation for benign atrial flutter in 4 patients, right ventricular endocardial cryoablation in 2 patients and extranodal cryoablation for atrioventricular node re-entry tachycardia in 1 patient. The median follow-up was 23.8 months (1~95.2 months). There was no early mortality, and one late non-cardiac related death. The overall rates of restored sinus rhythm before discharge and 3~6 months after surgery were 79% and 81%, respectively (bi-atrial maze group: 72% and 83%, right-side maze group: 77%, 77%). CONCLUSION: Arrhythmias associated with congenital heart disease can be safely treated surgically with an excellent intermediate-term outcome.
Arrhythmias, Cardiac* ; Atrial Fibrillation ; Atrial Flutter ; Atrioventricular Node ; Cryosurgery ; Follow-Up Studies ; Heart Defects, Congenital* ; Heart Septal Defects, Atrial ; Humans ; Mortality ; Pulmonary Veins ; Retrospective Studies ; Tachycardia ; Tachycardia, Ventricular