No abstract available.
Occupational Health*

BACKGROUND: Crucial to the success of fiberoptic awake tracheal intubation is proper preparation of the patient; this technique will work well in most patients when they are quiet and cooperative and have a larynx nonreactive to physical stimuli. We have attempted to ascertain how well these conditions are achieved with a low-dose infusion of propofol, because of its pharmacological profile. METHODS: Thirty patients, physical status by American Society of Anesthesiologists (A. S. A.) I-II, scheduled for oral and maxillofacial surgery, were randomly assigned to receive either propofol infusion 1 mg kg-1 h-1 preceded by a 1 mg kg-1 bolus (Group P) or intravenous fentanyl 1ug kg-1 and midazolam 0.05 mg kg-1 (Group F). These two groups were compared in terms of hemodynamic profile, sedation score, condition for intubation, coughing and swallowing. RESULTS: There were no statistically significant differences in mean arterial blood pressures according to time between two groups. But in Group F, heart rates were significantly increased in immediately after transtracheal injection of lidocaine, immediately before the fiberoscopy was started, 1, 2 minutes after start of fiberoscopy, compared to Group P (p<0.05). The patients in Group P were more sedated than those in Group F (p<0.05) but there were no significant differences in condition for intubation, reflex of coughing and swallowing, duration of fiberoptic intubation. CONCLUSIONS: We conclude that propofol is useful sedative agent in fiberoptic awake intubation with similar efficacy to midazolam and fentanyl but with more profound sedation and stable hemodynamic profile. These represent significant advantages for severe anxious or hypertensive patients and prolonged procedure of intubation.
Arterial Pressure ; Cough ; Deglutition ; Fentanyl* ; Heart Rate ; Hemodynamics* ; Humans ; Intubation* ; Larynx ; Lidocaine ; Midazolam* ; Propofol* ; Reflex ; Surgery, Oral

BACKGROUND: This study was done to identify factors that influence the willingness to be vaccinated with the human papilloma virus (HPV) vaccine in female college students eligible for a catch-up vaccination program. METHODS: This cross-sectional study included 572 female students aged 18-26 years attending one selected university in the Gyeongbuk Province. From March 2 to 6, 2009, they completed a self-administered questionnaire on their HPV vaccination status. Thereafter, unvaccinated participants were educated about the vaccination program, and each participant's willingness to be vaccinated was assessed. RESULTS: Of the 572 participants, 18 (3.1%) were already vaccinated with the HPV vaccine. The number of participants advised to be vaccinated was 102 (17.8%). Of the 554 unvaccinated participants, 305 (55.1%) were willing to be vaccinated after being educated about the vaccination program. Of the remaining 249 unvaccinated participants, 116 (48.7%) refused the vaccine due to its high cost. Advice by family members was related significantly to the willingness to be vaccinated (odds ratio, 2.37; 95% confidence interval, 1.09-5.14). CONCLUSIONS: The results of this study suggest that the willingness to be vaccinated with the HPV vaccine could be increased in female college students if they are advised to do so by their family members after being educated about the vaccination program.
Aged ; Cross-Sectional Studies ; Female ; Humans ; Papilloma ; Vaccination ; Viruses ; Surveys and Questionnaires

From Dec. 1992 to Dec. 1995, 20 patients with atherosclerotic occlusive disease in the lower extremities underwent arter al bypass surgery. The age of the patients ranged between 46 and 77 years(mean .60.8 years) and the most prevalent incidence was in the 7th decades. The mean follow up period was 18.8 months ranging from 4 to 36 months. Associated diseases were diabetus mellitus(25%), hypertension (35%), cerebrovascular accident(25%), and acute myocardial infarction(5%). Disabling intermittent claudifcation(35%), resting pain(20%) or ischemic gangrene(or ulceration)(45%) were operative indications. Aorto-bifemoral bypass in 4 cases, aorto-single femoral bypass in 2 cases, Aorto-bifemoral bypass and femoropopliteal bypass in 3 cases, aorto-single femoral bypass and femoropopliteal bypass in 1 case, femoropopliteal bypass in 4 cases, femorotibial bypass in 1 case, popliteotibial bypass 4 cases and femorofemoral bypass in 1 case were the surgical approches. Early thrombosis(2 cases) and wound infection(2 case) were main complication. Postoperative complication rate was 20%. Postoperative patency rates re 92.6% at 6 months, 84.2% at 1 year, 75.4% at 2 years and 69.4% at 3 years.
Follow-Up Studies ; Humans ; Hypertension ; Incidence ; Lower Extremity* ; Postoperative Complications ; Wounds and Injuries

From Dec. 1992 to Dec. 1995, 20 patients with atherosclerotic occlusive disease in the lower extremities underwent arter al bypass surgery. The age of the patients ranged between 46 and 77 years(mean .60.8 years) and the most prevalent incidence was in the 7th decades. The mean follow up period was 18.8 months ranging from 4 to 36 months. Associated diseases were diabetus mellitus(25%), hypertension (35%), cerebrovascular accident(25%), and acute myocardial infarction(5%). Disabling intermittent claudifcation(35%), resting pain(20%) or ischemic gangrene(or ulceration)(45%) were operative indications. Aorto-bifemoral bypass in 4 cases, aorto-single femoral bypass in 2 cases, Aorto-bifemoral bypass and femoropopliteal bypass in 3 cases, aorto-single femoral bypass and femoropopliteal bypass in 1 case, femoropopliteal bypass in 4 cases, femorotibial bypass in 1 case, popliteotibial bypass 4 cases and femorofemoral bypass in 1 case were the surgical approches. Early thrombosis(2 cases) and wound infection(2 case) were main complication. Postoperative complication rate was 20%. Postoperative patency rates re 92.6% at 6 months, 84.2% at 1 year, 75.4% at 2 years and 69.4% at 3 years.
Follow-Up Studies ; Humans ; Hypertension ; Incidence ; Lower Extremity* ; Postoperative Complications ; Wounds and Injuries

A 40-year-old woman underwent plication by video-assisted thoracoscopy for left diaphragmatic eventration. Normalization in the position of the left diaphragm and a marked improvement in the left lung expansion were identified on the chest X-ray. This technique offers the patients many advantages of the minimally invasive operation.
Adult ; Diaphragm ; Diaphragmatic Eventration* ; Female ; Humans ; Lung ; Thoracoscopy ; Thorax

OBJECTIVES: This study was conducted to assess the development of posttraumatic stress disorder (PTSD) after occupational physical injuries and the risk factors in occupational accident patients for PTSD. METHODS: Forty-seven occupational accident patients with physical injuries were administered BDI, STAI I and II, SCL-90-R, IES and questionnaires for risk factors and Clinician-Administered PTSD Scale(CAPS). RESULTS: 1) 12 patients(25%) were diagnosed as PTSD. 2) The BDI, STAI I and II and IES scores are significantly high(<0.05) in PTSD group than non-PTSD group. 3) The subscales of SCL-90-R, with an exception of PAR subscale, showed higher scores(<0.05) in PTSD group. 4) The loss of consciousness(LOC) was only significant risk factor in the occupational accident-related factors(<0.05). CONCLUSION: The results of this study show the development of PTSD among occupational accident patients. The loss of consciousness(LOC) was the only signiticant risk factor for PTSD in occupational accident patients.
Accidents, Occupational* ; Humans ; Surveys and Questionnaires ; Risk Factors ; Stress Disorders, Post-Traumatic*

PURPOSE: This study was conducted to perform a comparative analysis of the efficacy and safety of conventional transurethral resection of the prostate (TUR-P), transurethral resection in saline (TURIS), and TURIS-plasma vaporization (TURIS-V) when performed by a single surgeon for benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: The clinical data of 73 consecutive men who underwent conventional TUR-P (39), TURIS (19), or TURIS-V (15) for BPH were retrospectively analyzed. All procedures were carried out by a single surgeon between October 2007 and April 2010. The patients were assessed preoperatively and perioperatively and were followed at 1, 3, and 6 months postoperatively. Patient baseline characteristics, perioperative data, and postoperative outcomes were compared, and major complications were recorded. RESULTS: In all groups, significant improvements in subjective and objective voiding parameters were achieved and were sustained throughout follow-up. TURIS-V had the shortest operation time compared with conventional TUR-P and TURIS (p=0.211). TURIS-V significantly decreased procedural irrigation fluid volume, postoperative irrigation duration, catheter duration, and hospital stay compared with conventional TUR-P and TURIS. There were no significant differences between the groups in hemoglobin levels or serum sodium levels before and after the operations. There were three transfusions and four clot retentions in the TUR-P group, and one transfusion and one clot retention in the TURIS group. The TURIS-V group had no complications. CONCLUSIONS: TURIS and TURIS-V were effective for the surgical treatment of BPH in addition to conventional TUR-P. TURIS-V was not inferior to conventional TUR-P or TURIS in terms of safety.
Catheters ; Follow-Up Studies ; Hemoglobins ; Humans ; Length of Stay ; Male ; Pilot Projects ; Prostate ; Prostatectomy ; Prostatic Hyperplasia ; Retention (Psychology) ; Retrospective Studies ; Sodium ; Transurethral Resection of Prostate ; Urologic Surgical Procedures ; Volatilization

BACKGROUND: To evaluate the short-term effect of dynamic cardiomyoplasty on circulatory function and detect the related factors that can affect it, experimental cardiomyoplasties were performed under the state of normal cardiac function and heart failure. MATERIAL AND METHOD: A total of 10 mongrel dogs weighing 20 to 30kg were divided arbitrarily into two groups. Five dogs of group A underwent cardiomyoplasty with latissimus dorsi(LD) muscle mobilization followed by a 2-week vascular delay and 6-week muscle training. Then, hemodynamic studies were conducted. In group B, doxorubicin was given to 5 dogs in an IV dose of 1 mg/kg once a week for 8 weeks to induce chronic heart failure, and simultaneous muscle training was given for preconditioning during this period. Then, cardiomyoplasties were performed and hemodynamic studies were conducted immediately after these cardiomyoplasties in group B. RESULT: In group A, under the state of normal cardiac function, only mean right atrial pressure significantly increased with the pacer-on(p<0.05) and the left ventricular hemodynamic parameters did not change significantly. However, with pacer-on in group B, cardiac output(CO), rate of left ventricular pressure development(dp/dt), stroke volume(SV), and left ventricular stroke work(SW) increased by 16.7+/-7.2%, 9.3+/-3.2%, 16.8+/-8.6%, and 23.1+/-9.7%, respectively, whereas left ventricular end-diastole pressure(LVEDP) and mean pulmonary capillary wedge pressure(mPCWP) decreased by 32.1+/-4.6% and 17.7+/-9.1%, respectively(p<0.05). In group A, imipramine was infused at the rate of 7.5mg/kg/hour for 34+/-2.6 minutes to induce acute heart failure, which resulted in the reduction of cardiac output by 17.5+/-2.7%, systolic left ventricular pressure by 15.8+/-2.5% and the elevation of left ventricular end-diastole pressure by 54.3+/-15.2%(p<0.05). With pacer-on under this state of acute heart failu e, CO, dp/dt, SV, and SW increased by 4.5+/-1.8% and 3.1+/-1.1%, 5.7+/-3.6%, and 6.9+/-4.4%, respectively, whereas LVEDP decreased by 11.7+/-4.7%(p<0.05). Comparing CO, dp/dt, SV, SW and LVEDP that changed significantly with pacer-on, both under the state of acute and chronic heart failure, augmentation widths of these left ventricular hemodynamic parameters were significantly larger under the state of chronic heart failure(group B) than acute heart failure(group A)(p<0.05). On gross inspection, variable degrees of adhesion and inflammation were present in all 5 dogs of group A, including 2 dogs that showed no muscle contraction. No adhesion and inflammation were, however, present in all 5 dogs of group B, which showed vivid muscle contractions. Considering these differences in gross findings along with the following premise that the acute heart failure state was not statistically different from the chronic one in terms of left ventricular parameters(p>0.05), the larger augmentation effect seen in group B is presumed to be mainly attributed to the viability and contractility of the LD muscle. CONCLUSION: These results indicate that the positive circulatory augmentation effect of cardiomyoplasty is apparent only under the state of heart failure and the preservation of muscle contractility is important to maximize this effect.
Animals ; Atrial Pressure ; Capillaries ; Cardiac Output ; Cardiomyoplasty* ; Dogs ; Doxorubicin ; Heart Failure* ; Heart* ; Hemodynamics* ; Imipramine ; Inflammation ; Muscle Contraction ; Stroke ; Ventricular Pressure

A life-long anticoagulation for the prevention of ischemic cerebral events by thromboemboli has been conventionally introduced for the treatment of an atrial septal aneurysm. However, due to the recent decrease of the risks in the open heart surgery, the alternative therapeutic modality has been introduced for the prevention of complications of the anticoagulation. A 41-year old female with dizziness was admitted to our hospital. She was diagnosed a shaving atrial fibrillation and a cerebellar infarction, and an atrial septal aneurysm was detected by transesophagel echocardiography that was not detected by the transthoracic echocardiography. Surgery was approached to the right submammarial anterolateral thoracotomy. The atrial septal aneurysm was obliterated by a purse-string suture and plication. Surgial results were excellent with normal sinus rhythms and esthetically satisfying appearance.
Adult ; Aneurysm* ; Atrial Fibrillation ; Dizziness ; Echocardiography ; Female ; Heart Septum ; Humans ; Infarction ; Sutures ; Thoracic Surgery ; Thoracotomy