No abstract available.
Beckwith-Wiedemann Syndrome*

BACKGROUND: The usage of appropriate disinfectants is essential for infection control in a hospital. Inadequate use of disinfectants is the cause of human or environmental toxicity and is a waste of cost. The objective of this study was to describe the status of the usage of disinfectants in Korean hospitals. METHOD: One hundred and eighty three hospitals of over 300 beds were investigated by a questionnaire distributed by mall. Data collection was done on November 1999. The questionnaire was made by the Association of Infection Control Nurses in Korea, based on references and protocols of the Korean Society of Nosocomial Infection Control. Numerical and percentage data were analyzed by SPSS. RESULTS: The collection rate of the questionnaire was 43.7% (80/300). Thirty five hospitals (46.7%) had an official process in selecting disinfectants in their hospitals. Regarding skin antiseptics, 10% povidone iodine and 70% alcohol were commonly used in skin preparation for intravenous catheterization or pre-operative skin disinfection, For disinfection of mucosal membranes such as mouth and periurethral area, 3% boric acid solution or 3% H202 were used. Most of the hospitals decontaminated contaminated medical instruments manually with dodecyl diamino ethyl glycine (20.8%). glutaraldehyde (15.6%). quaternary ammonium compounds (13.8%), virkon (12.3%) and sodium hypochlorites (11.7%). Glutaraldehyde and virkon were frequently used for disinfection of endoscopes. Sodium hypochlorites (48.9%) and quaternary ammonium compounds (19.8%) were the most commonly used environmental disinfectants. Some noticeable problems in disinfectants were as follows. First, for mouth care, many hospitals (41.7%) over-used boric acid, which has cumulative toxicity for humans. Second, many hospitals had an incorrect protocol of disinfecting endoscopes. Third, for environmental decontamination and instrument cleaning, some hospitals used high level disinfectants such as glutaraldehyde, which is too costly and provides unnecessary safety problems. Fourth, after patient discharge, many hospitals did not use disinfectants at all. Considering the specific Korean medical environment of high incidence of multi-drug resistant microorganisms, use of disinfectants for discharged environments may be warranted. CONCLUSION: This study included only hospitals of over 300 beds, which has a limitation in representing the status of disinfectants usage in a country. However, significant problems from misunderstanding the basic principles of disinfectants and misusages of disinfectants were observed in this investigation. These observations will provide useful information for designing a guideline for the appropriate uses and for efficient education of disinfectants, and also for planning a national control program for proper disinfectants usage in this country.
Anti-Infective Agents, Local ; Catheterization ; Catheters ; Cross Infection ; Data Collection ; Decontamination ; Disinfectants* ; Disinfection ; Education ; Endoscopes ; Glutaral ; Glycine ; Humans ; Incidence ; Infection Control ; Korea* ; Membranes ; Mouth ; Patient Discharge ; Povidone-Iodine ; Quaternary Ammonium Compounds ; Skin ; Sodium ; Surveys and Questionnaires

BACKGROUND: Vecuronium and Pancuronium have been proven to be associated with nicotinic receptor of skeletal muscle. Generally, nondepolarizing muscle relaxant is associated with contraction of smooth tracheal muscle, but there have been few studies about effects of nondepolarizing muscle relaxant on the smooth tracheal muscle. METHODS: We studied the acetylcholine dose response curve of the tracheal smooth muscle contraction and effects of propranolol, L-NAME after pretreating with vecuronium and pancuronium. RESULTS: Vecuronium shifted the acetylcholine dose-response curve of the tracheal contraction to the left, and pancuronium shifted the curve to the right. Vecuronium and Pancuronium reduced the contraction of smooth tracheal muscle with the use carbachol. Propranolol and L-NAME had no effect on the contraction of smooth tracheal muscle after pretreating with vecuronium and pancuronium. CONCLUSION: We suggest that vecuronium has an anticholinergic effect, while pancuronium has some effect on the muscarinic receptor in addition to its anticholinergic effect.
Acetylcholine ; Animals ; Carbachol ; Muscle, Skeletal ; Muscle, Smooth* ; NG-Nitroarginine Methyl Ester ; Pancuronium* ; Propranolol ; Rats* ; Receptors, Muscarinic ; Receptors, Nicotinic ; Trachea* ; Vecuronium Bromide*

No abstract available.
Danazol* ; Panniculitis*

No abstract available.
Urachus*

No abstract available.
Chlorpromazine* ; Hyperpigmentation ; Pigmentation*

The dose-response for glycopyrrolate and heart rate in anesthetized children has not heen defined. We determined the dose-response for glyeopyrrolate and heart rate in 50 children, ASA physical status l and 2, anesthetized with halothane and nitrous oxide. Anesthesia was induced with 60-70% nitrous oxide in oxygen and halothane(1.5-2.0 vo1%). After induction of aneethesia, glycopyrrolate in a dose of 4, 6, 8, 12 or 16ug Xkg(-1) was administered by rapid infusion to each subject. The effects of glycopyrrolate on heart rate, heart rhythm and systolic blood pressure were compared among dosage groups, and dose-response curve for peak heart rate was constructed, Glycopyrrolate increased the heart rate in a dose-related manner upto 12 ug X kg(-1) except 16 ugX kg(-1). Fifty percent maximal response corresponded to 6.1 ug X kg(-1), and 95% maximal response corresponded to 11.1 ug X kg(-1) . None of the patients had nonsinus rhythm after glycopyrrolate injection. Except for glycopyrrolate given at 4 ug x kg(-1), the systolic blood pressure increased significantly after all other doses. Glycopyrrolate in doses greater than or equal to 6 ug X kg(-1) increased the heart rate and systolic blood pressure in children anesthetized with halothane and nitrous oxide.
Anesthesia ; Anesthetics ; Blood Pressure ; Child* ; Glycopyrrolate ; Halothane* ; Heart Rate* ; Heart* ; Humans ; Nitrous Oxide* ; Oxygen

Atlanto-axial instability is an important condition that may threaten the integrity of spinal cord, leading to tetraplegia or sudden death. Many of these require operative stability, and several different operations have been advocated. Among these methods, Brooks and Jenkins posterior fusion for eleven cases of atlanto-axial instability (fresh fracture of odontoid process in nine, nonunion of odentoid fracture in one, Cl-2 rotary subluxation in one) was performed in Baik Hospital from July 1978 to June 1987, and the following results were obtained. l. Accurate reduction and immediate rigid stability were obtained with Brooks and Jenkins posterior fusion, so early ambulation with simple external support was begun within 2 weeks after operation. 2. Radiological fusion of atlanto-axial instability were seen in average 12 weeks after operation. Therefore posterior atlanto-axial fusion by Brooks and Jenkins method is an excellent method for operative treatment of atlanto-axial instability.
Death, Sudden ; Early Ambulation ; Methods ; Odontoid Process ; Quadriplegia ; Spinal Cord

BACKGROUND: Etomidate is an intravenous anesthetic which has properties of hemodynamic stability, minimal respiratory depression, and cerebral protection. Also, it is a useful induction agent for patients compromised by asthma and other reactive airway diseases. The aim of this study was to investigate the effect and action mechanism of etomidate on isolated tracheal smooth muscle in rats. METHODS: The rat's trachea was dissected free, cut into rings (2 mm) and mounted for isometric tension in Tris Tyrode solution. Cumulative dose-response curves for etomidate (3 X 10(-7) 3 X 10 (-4) M) were obtained from the tension measurements of acetylcholine (10 (-5)M)-contracted rings. The effects of propranolol, L-NAME and indomethacin on the etomidate induced tracheal response were investigated. Also, the effect of etomidate on the extracellular Ca2+ influx and Ca2+ release from internal stores was investigated. RESULTS: Etomidate produced relaxation of acetylcholine-precontracted trachea in a dose-dependent fashion. Pretreatment with propranolol, L-NAME had no effects on concentration-response curves to acetylcholine. Pretreatment with indomethacin had an effect on the concentration-response curve to acetylcholine. Pretreatment with etomidate inhibited acetylcholine-induced contractions in the absence of extracelluar Ca2+ and the presence of extracellular Ca2+ . CONCLUSIONS: The tracheal smooth muscle relaxation by etomidate is not related with beta-adrenergic activation and NO synthesis but related with prostaglandin production. The relaxation effect of etomidate is induced by a decrease in concentration of intracellular Ca2+ through the blockade of extracellular Ca2+ influx and the simultaneous release of Ca2+ from internal stores.
Acetylcholine ; Animals ; Asthma ; Etomidate* ; Hemodynamics ; Humans ; Indomethacin ; Muscle, Smooth* ; NG-Nitroarginine Methyl Ester ; Propranolol ; Rats* ; Relaxation ; Respiratory Insufficiency ; Trachea

BACKGROUND: Hypothermia after induction of anesthesia results initially from core-to-peripheral redistribution of body heat. Both central inhibition of tonic thermoregulatory vasoconstriction in arteriovenous shunts and anesthetic induced vasodilation contribute to core-to-peripheral redistribution of heat. Ketamine increases peripheral arteriolar resistance uniquely; in contrast, propofol causes profound venodilatation that other anesthetics do not. The aim of the present study is to evaluate core temperature and skin-surface temperature gradients in use of ketamine for anesthetic induction compared with propofol in children. METHODS: Forty pediatric patients of ASA status I or II, undergoing elective surgery for strabismus or inguinal hernia were studied. The patients were allocated randomly to one of two groups: (i) GROUP P (n = 20): Anesthesia was induced with propofol and maintained with sevoflurane in combination with 60% nitrous oxide in oxygen. (ii) GROUP K (n = 20): Anesthesia was induced with ketamine and maintained with sevoflurane in combination with 60% nitrous oxide in oxygen. Core temperature, forearm skin temperature, fingertip skin temperature and Forearm minus fingertip, skin-temperature gradients were recorded before induction of anesthesia, 3 min after administering ketamine or propofol (just before endotracheal intubation), 5 min, and at 5-min intervals after induction of anesthesia. RESULTS: After induction of anesthesia, core temperature in the two groups was decreased but results did not differ significantly between two groups. Forearm skin temperature was increased significantly after 20 min of anesthesia in propofol group and 15 min of anesthesia in ketamine group, but results did not differ significantly between two groups. Finger tip skin temperature was increased significantly after 3 min of anesthesia in the propofol group and 10 min of anesthesia in the ketamine group. Finger tip skin temperature of 5 min of anesthesia in propofol group increased significantly greater than in ketamine group. Forearm minus finger skin surface temperature gradients was decreased statistically significantly at 3 min of anesthesia in the propofol group and 10 min of anesthesia in the ketamine group, gradients of 5 min of anesthesia was presented statistically significant between two groups. CONCLUSIONS: For pediatric patients, after induction of anesthesia with ketamine arteriovenous shunt vasomoter status was well maintained. And maintaining vasoconstriction during induction of anesthesia reduced the magnitude of redistribution hypothermia.
Anesthesia ; Anesthetics ; Child* ; Fingers ; Forearm ; Hernia, Inguinal ; Hot Temperature ; Humans ; Hypothermia ; Ketamine* ; Nitrous Oxide ; Oxygen ; Propofol* ; Skin ; Skin Temperature ; Strabismus ; Vasoconstriction ; Vasodilation