Purpose: This study investigated knowledge of and attitudes toward advance directives (ADs) among middle-aged women in South Korea, their willingness to write ADs in the future, and the factors related to knowledge of and attitudes toward ADs. Methods: Data were collected using a self-administrated questionnaire completed by 154 middle-aged women aged 50 to 64 from February to March 2020. The questionnaire asked about participants’ knowledge of and attitude toward ADs, willingness to write ADs in the future, experiences with life-sustaining treatment within their families, experience making decisions about life-sustaining treatment, and demographic characteristics. Results: Scores for both knowledge of and attitude toward ADs were relatively high. About 60% of participants gave wrong answers when asked if attorneys were required for writing ADs. A higher knowledge score was significantly associated with a higher attitude score (r=0.227, P＜0.01).The women were more likely to be willing to write ADs in the future when they reporteda middle income level rather than a lower income level (odds ratio [OR]=5.952, P＜0.01), considered themselves unhealthy (OR=5.873, P＜0.01), and graduated college or higher (OR=4.096, P＜0.05). Furthermore, women who thought that ADs would have an impact on treatment (OR=1.869, P＜0.05) and on their families (OR=1.447, P＜0.05) were morelikely to be willing to write an AD. Conclusion This study shows that wrong information about ADs persists among middle-aged women, and significant factors associated with knowledge of and attitude toward ADs were identified. Targeted education programs about ADs need to be developed for middle-aged women.

Purpose: This study investigated knowledge of and attitudes toward advance directives (ADs) among middle-aged women in South Korea, their willingness to write ADs in the future, and the factors related to knowledge of and attitudes toward ADs. Methods: Data were collected using a self-administrated questionnaire completed by 154 middle-aged women aged 50 to 64 from February to March 2020. The questionnaire asked about participants’ knowledge of and attitude toward ADs, willingness to write ADs in the future, experiences with life-sustaining treatment within their families, experience making decisions about life-sustaining treatment, and demographic characteristics. Results: Scores for both knowledge of and attitude toward ADs were relatively high. About 60% of participants gave wrong answers when asked if attorneys were required for writing ADs. A higher knowledge score was significantly associated with a higher attitude score (r=0.227, P＜0.01).The women were more likely to be willing to write ADs in the future when they reporteda middle income level rather than a lower income level (odds ratio [OR]=5.952, P＜0.01), considered themselves unhealthy (OR=5.873, P＜0.01), and graduated college or higher (OR=4.096, P＜0.05). Furthermore, women who thought that ADs would have an impact on treatment (OR=1.869, P＜0.05) and on their families (OR=1.447, P＜0.05) were morelikely to be willing to write an AD. Conclusion This study shows that wrong information about ADs persists among middle-aged women, and significant factors associated with knowledge of and attitude toward ADs were identified. Targeted education programs about ADs need to be developed for middle-aged women.

It is difficult to analyze the chemical compositions of aqueous humor because of the impossibility of collection of aqueous humor in normal situation, lack of analyzing technique, limited amount of aqueous humor. We measured the glucose concentration of aqueous humor both in cataractous patients with diabetes mellitus and in cataractous patients without diabetes mellitus, thus we compared and analyzed glucose concentration in aqueous humor and correlation between blood glucose con centration and aqueous humor glucose concentration in cataractous patients with diabetes. The mean concentration of glucose in aqueous houmor in diabetics was 92.81 +/- 35.58mg/dl and that of non-diabetics was 53.62 +/- 34.42mg/dl. Aqueous glucose concentration in diabetics was statistically significantly higher than that in non-diabetics.
Aqueous Humor* ; Blood Glucose ; Cataract* ; Diabetes Mellitus ; Glucose* ; Humans

OBJECTIVE: To provide normal reference values of the sonographic diameters and cross sectional area (CSA) of the posterior tibialis tendon (PTT) in Korean adults for early diagnosis and treatment of PTT dysfunction. METHOD: 240 feet from 120 healthy volunteers (63 males; 57 females, mean age: 36.40+/-11.37) were included in this study. Those with a previous history of surgery or trauma to the lower extremities and systemic disease, such as, hypertension, diabetes, or rheumatoid arthritis were excluded. PTT was examined through ultrasonograhy with the patient placed in the prone oblique position, with the knee extended, and ankle dorsiflexed to neutral angle. We evaluated the anterioposterior (AP) and transverse diameter and CSA of the PTT along the line that connected from the posteroinferior angle of the medial malleolus to the heel. RESULTS: The AP diameter of PTT measured by sonography was 3.42+/-0.03 mm and the transverse diameter of the PTT was 9.20+/-0.08 mm. The CSA was 21.46+/-0.26 mm2. Differences in diameters and CSA related to sidedness, sex did not show statistical significance (p>0.05). There was weak linear relationship in AP and transverse diameter and CSA with weight, height, leg and foot length. CONCLUSION: The normal Korean reference values of the PTT diameter and CSA that we obtained from ultrasonography can be used as useful reference data in diagnosing early pathologic conditions of PTT dysfunction.
Adult ; Animals ; Ankle ; Arthritis, Rheumatoid ; Early Diagnosis ; Female ; Foot ; Heel ; Humans ; Hypertension ; Knee ; Leg ; Lower Extremity ; Reference Values ; Tendons

BACKGROUND: Partially paralyzed patients may be placed in the risk of pharyngeal dysfunction. Bupivacaine acts as acetylcholine receptor ion channel blocker and may synergistically interact with rocuronium to augment NM blockade. Thus, this study aims to elucidate whether or not, at a therapeutic concentration, bupivacaine by itself may cause NM blockade and reduce an effective concentration of rocuronium. METHODS: Twenty-two left phrenic nerve-hemidiaphragms (Male SD rats, 150-250 g) were hung in Krebs solution. Three consecutive ST, 0.1 Hz and one TT, 50 Hz for 1.9 s were obtained before drug application and at each new drug concentration. A concentration of bupivacaine in Krebs solution (n = 5) was cumulatively increased by way of 0.01, 0.1, 1, (1, 2, 3, 4, 5, 6, 7) x 10 microM. In a Krebs solution, pre-treated with bupivacaine 0 (n = 5), 0.1 (n = 5), 1.0 (n = 5), 10 (n = 2) microM, and then concentrations of rocuronium were cumulatively increased by way of 1, 3, 5, 7, 9, 12, 14, 16, 18, 20 microM. EC for each experiment were determined by a probit. The EC50's of rocuronium were compared using a Student's t-test with Bonferroni's correction. Differences were considered significant when P < 0.05. RESULTS: The potency of bupivacaine for normalized TF was 11.4 (+/- 1.1) microM. Below 30 microM of bupivacaine, the single twitch potentiation sustained despite the development of tetanic fade and partial inhibition of PTT. Bupivacaine significantly facilitated the NM blockade induced by rocuronium. CONCLUSIONS: Clinicians should be aware that bupivacaine by itself at its therapeutic concentration inhibit NM conduction and enhances rocuronium-induced muscle relaxation.
Acetylcholine ; Androstanols ; Animals ; Bupivacaine ; Humans ; Ion Channels ; Isotonic Solutions ; Muscle Relaxation ; Neuromuscular Blockade ; Rats ; Refractory Period, Electrophysiological

No abstract available.
Anesthesia, Spinal ; Humans ; Hypertension ; Pheochromocytoma

BACKGROUND: Emergence delirium is a common problem after general anesthesia in children. Postoperative pain control reduces the incidence of emergence delirium. Opioids and NSAIDs have been successfully used to inhibit intraoperative and postoperative pain. Instead of them, acetaminophen is used to reduce side effects of opioids and NSAIDs. This study evaluated the effect of acetaminophen on emergence delirium after general anesthesia in children undergoing a epiblepharon correction. METHODS: Sixty children, aged 1-10 years (ASA physical status I, II) undergoing epiblepharon correction, were enrolled in this study. Acetaminophen (group A) received 15 mg/kg of acetaminophen, control group (group C) received 1.5 ml/kg of normal saline. Anesthesia was induced with 2.0 mg/kg of ketamine and maintained by 2.0-3.0 vol% sevoflurane with N2O 1.5 L/min-O2 1.5 L/min. The delirium score was recorded at 10 minutes after arrival at recovery room by an independent observer using the four point scale of Aono. RESULTS: There were no significant differences between the two groups regarding the time to extubation and discharge from the recovery room. The incidence of emergence delirium was 23% in group A and 32% in group C, but this did not have statistical significance. The incidence of vomiting was similar in both group. CONCLUSIONS: Preoperative intravenous acetaminophen of 15 mg/kg application does not reduce the incidence of postoperative delirium in children undergoing epiblepharon correction.
Acetaminophen ; Aged ; Analgesics, Opioid ; Anesthesia ; Anesthesia, General ; Anti-Inflammatory Agents, Non-Steroidal ; Child ; Delirium ; Humans ; Incidence ; Ketamine ; Methyl Ethers ; Pain, Postoperative ; Recovery Room ; Vomiting

OBJECTIVE: We investigated the clinical and radiological advantages of unilateral laminectomy in posterior lumbar interbody fusion (PLIF) procedure comparing with bilateral laminectomy, under the same procedural condition including bilateral instrumentation and insertion of two cages, in patients with degenerative lumbar disease with unilateral leg symptoms. METHODS: We retrospectively reviewed 124 consecutive cases of PLIF via unilateral or bilateral approach between January 2006 and April 2010. In 80 cases (bilateral group), two cages were inserted via bilateral laminectomy, and in 44 cases (unilateral group), via unilateral laminectomy. The average follow-up duration was 29.5 months. The clinical outcomes were evaluated with the Visual Analogue Scale (VAS) and the Oswestry disability index (ODI). The fusion rates and disc space heights were determined by dynamic standing radiographs and/or computed tomography. Operative times, intra-operative and post-operative blood losses and hospitalization periods were also evaluated. RESULTS: In clinical evaluation, the VAS and ODI scores showed excellent outcomes in both groups. There were no significant differences in term of fusion rate, but the perioperative blood loss and the operative time of the unilateral group were lower than that of the bilateral group. CONCLUSION: Unilateral laminectomy can minimize the operative time and perioperative blood loss in PLIF procedure. However, the different preoperative disc height between two groups is a limitation of this study. Despite this limitation, solid fusion and satisfactory symptomatic improvement could be achieved uniquely by our surgical method. This surgical method can be an alternative surgical technique in patients with unilateral leg pain.
Follow-Up Studies ; Hospitalization ; Humans ; Laminectomy ; Leg ; Operative Time ; Retrospective Studies

OBJECTIVES: Currently established first line therapy of acute (presumed bacterial) rhinosinusitis (ARS) consists of 10 to 14 days of oral amoxicillin or cephalosporins. This study compared the clinical efficacy and tolerance of cefcapene pivoxil (CP) and amoxicillin-clavulanate (AMC) in patients with ARS. METHODS: A randomized, open labeled, double-blinded trial of ARS patients over 15 years of age was performed. Patients diagnosed with ARS received paranasal sinus X-rays and nasal endoscopies and 2 weeks of either CP (150 mg, 3 times/ day) or AMC (625 mg, amoxicillin 500 mg, 3 times/day). All patients revisited the clinic on days 7, 14, and 28 for evaluation of changes in symptoms, endoscopy, and monitoring of any adverse reactions. Demographics, clinical characteristics and drug efficacy were also compared between the two groups. RESULTS: Among the 60 initially enrolled patients (CP 30, AMC 30), 5 patients in the CP group and 6 in the AMC group were excluded due to poor compliance. There were no significant differences in demographic data including age, sex, initial signs and symptoms, endoscopic and X-ray findings between the two groups. Rates of improvement after 2 weeks were 96% and 95.8% in the CP and AMC group, respectively. Sinus symptoms were changed significantly after 2 and 4 weeks, however, there was no difference between groups (P=0.41). The most common adverse reaction was gastrointestinal complication, diarrhea occurred in 1 patient in the CP group and 6 in the AMC group (P=0.04). CONCLUSION: CP and AMC were both effective in treating ARS. The difference of treatment outcome was not found between the two groups, however, gastrointestinal complications were less prevalent in the CP group.
Amoxicillin ; Amoxicillin-Potassium Clavulanate Combination ; Bacterial Infections ; Cephalosporins ; Clavulanic Acid ; Compliance ; Demography ; Diarrhea ; Double-Blind Method ; Endoscopy ; Humans ; Sinusitis ; Treatment Outcome

BACKGROUND:Many patients with symptom of recurrent episodic vertigo can neither be diagnosed nor treated. The purpose of this study is to review clinical features of a group of patients with recurrent episodic vertigo that is not defined to specific diagnosis of vertigo and to test the effectiveness of phenytoin sodium in the patients. METHOD & MATERIAL:11 of 32 patients with recurrent vertigo not defined to specific diagnostic category of vertigo who visited dizziness center of a tertiary care university hospital from November 1995 to April 2004 were studied. The patient's charts were reviewed retrospectively. A thorough otolaryngologic and neurotologic evaluation was performed in every case to determine the specific cause of dizziness. Vestibular function test, hearing test, magnetic resonance imaging of brain, electroencephalogram, and 24 hour Holter EKG monitoring were performed in all cases. Consultations to psychiatrist and neurologist were obtained. All patients were treated with phenytoin sodium. RESULT:The results of the vestibular function test, audiogram, MRI of brain, electroencephalogram, 24-hr holter monitoring were normal. Any definitive diagnosis could not be reached to this group. Vertigo was controlled by phenytoin sodium in all 11 cases. CONCLUSION:We report a group of patients with recurrent episodic vertigo that is not defined to any specific diagnosis of vertigo. The vertigo symptom was controlled successfully by phenytoin sodium. This patients were diagnosed as benign episodic vertigo as a separate disease entity.
Brain ; Diagnosis ; Dizziness ; Electrocardiography ; Electrocardiography, Ambulatory ; Electroencephalography ; Hearing Tests ; Humans ; Magnetic Resonance Imaging ; Phenytoin* ; Psychiatry ; Referral and Consultation ; Retrospective Studies ; Sodium* ; Tertiary Healthcare ; Vertigo* ; Vestibular Function Tests