Publication lag is a determinant to journal efficiency that was not yet studied concerning Korean medical journals. To measure publication lag, we investigated the publication timestamps of 4,762 articles published by 10 Korean medical journals indexed in Scopus database, randomly selected from the KoreaMed Synapse since 2013. The total publication lag was 246.5 (Q1, Q3; 178.0, 347.0) days. The overall acceptance lag was 102.0 (65.0, 149.0) days. The overall lead lag was 123.0 (63.0, 236.0) days. The year of publication did not significantly affect the acceptance lag (P = 0.640), supposedly shortening it by about 1.4 (97.5% confidence interval [CI], −5.2 to 8.0) days/year, while the date affected the lead lag (P = 0.028), shortening it by about 12.9 (1.3 to 24.5) days/year. The Korean medical journals have reduced the total publication delay entirely by means of reducing the lead lag, not by reducing the acceptance lag.
Bibliometrics ; Peer Review ; Publications* ; Synapses

No abstract available.
Scientific Misconduct

BACKGROUND: Rapid-sequence induction is common technique to reduce anesthetic complications. Due to side effects of succinylcholine, nondepolarizing muscle relaxants have been tried. The authors tried to observe the effect of lidocaine on the onset of vecuronium. METHODS: Sixty patients were divided into lidocaine group(L) and control group(C). Anesthetic induction with 4-5 mg/kg of thiopental and 0.1 mg/kg of vecuronium was made. The L-group received 1.5 mg/kg of lidocaine 90 seconds prior to the injection of vecuronium and the C-group received normal saline with the same volume and at the same time like L-group. The ulnar nerve stimulations were applied to detect the contraction of the adductor pollicis on thumb by using Accelograph . The condition of intubation, the appearanee of arrhythmias, side effects of drugs, and the changes of mean arterial pressure and heart rate were checked and compared in peri-induction periods. RESULTS: The results are followings; (1) There were no differences in changes of MAP and HR, and the appearance of arrhythmias in 2 groups, (2) the conditions of intubation were satisfactory with same degree in 2 groups, (3) ths lidocaine pretreatment decreased significantly the onset of vecuronium (137.5+/-33.4 seconds vs. 176.4+/-62.7 seconds) comparing to the C-group and augumented the potency of vecuronium by 28% CONCLUSIONS : From the above results, the authors concluded that 1.5mg/kg of intravenous lidocaine at 90 seconds before induction can be safely used to reduce the onset time of vecuronium especially in the case of rapid endotracheal intubation. Furthermore, it is expected that lidocaine in combination with other techniques will be more effective in shortening the onset of vecuronium.
Anesthetics ; Arrhythmias, Cardiac ; Arterial Pressure ; Heart Rate ; Humans ; Intubation ; Intubation, Intratracheal ; Lidocaine* ; Neuromuscular Blockade* ; Succinylcholine ; Thiopental ; Thumb ; Ulnar Nerve ; Vecuronium Bromide

No abstract available.
Anesthesiology*

This article examined repeated measures analysis of variance (RMANOVA). Within-subjects repeated measurements are unavoidable during clinical and experimental investigation, and between- and within-subject variability should be treated separately. Only through proper use and meticulous interpretation can ethical and scientific integrity be guaranteed. The philosophical background of, and knowledge pertaining to, RMANOVA are described in the first half of this text. The sphericity assumption and associated issues are discussed in the latter half. The final section provides a summary measure analysis, which was neglected by P value-dependent interpreters.
Analysis of Variance

BACKGROUND: Tracheal extubation provokes hypertension and tachycardia, as does tracheal intubation. Especially hypertensive patients are more likely to exhibit substantial fluctuations in hemodynamics and myocardial ischemia than normotensive patients during these stressful periods. The aim of present study was to evaluate the effects of intravenous diltiazem in attenuating mean arterial pressure(MAP) and heart rate(HR) responses to tracheal extubation in hypertensive patients. METHODS: Thirty-seven hypertensive patients who were to undergo elective surgery were randomly assigned to one of three groups : saline (control), lidocaine 1 mg/kg, and diltiazem 0.2 mg/kg. These drugs were given 2 minutes prior to tracheal extubation. Anesthesia was induced by the injection of fentanyl 1.5 microgram/kg, thiopental 5 mg/kg, and vecuronium 0.1 mg/kg and maintained with 50% N2O in O2 and 1~2 vol.% enflurane. Changes in HR and MAP were measured during and after tracheal extubation. RESULTS: In the diltiazem group, the MAP decreased significantly at drug administration, extubation, and post-extubation 1 min. However there were no significant differences in HR among 3 groups. CONCLUSIONS: These data suggest that intravenous injection of diltiazem 0.2 mg/kg given 2 minutes before tracheal extubation was effective in attenuating MAP changes associated with tracheal extubation. But HR changes were not different significantly among 3 groups. Further studies are required for the effective prophylaxis against tachycardia associated with tracheal extubation.
Airway Extubation* ; Anesthesia ; Arterial Pressure* ; Diltiazem* ; Enflurane ; Fentanyl ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Hypertension ; Injections, Intravenous ; Intubation ; Lidocaine ; Myocardial Ischemia ; Tachycardia ; Thiopental ; Vecuronium Bromide

BACKGROUND: Critical care physician staffing is a crucial element of the intensive care unit (ICU) organization, and is associated with better outcomes in ICUs. Adult ICUs in Korea have been suffering from inadequate full-time intensivists and nurses because of insufficient reimbursement rates (<50% of the original critical care cost) from the National Health Insurance System. Recently, full-time intensivists have been introduced as a prerequisite for adult ICUs of tertiary hospitals in Korea. The purpose of this study was to examine the perception of intensivist staffing among critical care program directors regarding the barriers and solutions when implementing an intensivist model of critical care in Korea. METHODS: An email survey of critical care program directors in designated teaching hospitals for critical care subspecialty training by the Korean Society of Critical Care Medicine was performed. The survey domains included vision, culture, resources, barriers, and potential solutions to implementing intensivist physician staffing (IPS). RESULTS: Forty-two critical care program directors were surveyed. A total of 28 directors (66.7%) responded to email queries. Of these, 27 directors (96.4%) agreed that IPS would improve the quality of care in the ICU, although half of them reported a negative perception of relevant clinical colleagues for the role of full-time intensivists and poor resources for IPS in their hospitals. Increased financial burden due to hiring full-time intensivists and concerns regarding exclusion from the management of their critically ill patients in the ICU, together with loss of income for primary attending physicians were stated by the respondents to be major barriers to implementing IPS. Financial incentives for the required cost from the health insurance system and enhancement of medical law relevant to critical care were regarded as solutions to these issues. CONCLUSIONS: Critical care program directors believe that intensivist-led critical care can improve the outcome of ICUs. They indicated the financial burden due to IPS and underestimation of a full-time intensivist's role to be major barriers. The program directors agreed that a partnership between hospital leaders and the Ministry of Health and Welfare was needed to overcome these barriers.
Adult* ; Critical Care ; Critical Illness ; Electronic Mail ; Hospitals, Teaching ; Humans ; Insurance, Health ; Intensive Care Units ; Jurisprudence ; Korea ; Motivation ; National Health Programs ; Personnel Staffing and Scheduling ; Surveys and Questionnaires ; Tertiary Care Centers

It has been suggested that propofol has the protective effect on cerebral ischemia-reperfusion injury. The aim of this study is to evaluate the effect of propofol pretreatment on incomplete forebrain ischemia-reperfusion injury in rats. Thirty Sprague-Dawley rats were anesthetized with isoflurane in oxygen and randomly allocated into propofol group (n=13) and saline group (n=17). In propofol group, propofol was pretreated in a step-down scheme before inducing forebrain ischemia by occlusion of both common carotid arteries and arterial hypotension. After ischemia (20 min) and reperfusion (30 min), rats were decapitated. Brain was sliced to obtain coronal slices of 4-12 mm from frontal pole, which were reacted with 2% 2,3,5-triphenyl-2H-tetrazolium chloride (TTC) for 10 min to differentiate the damaged tissues from normal tissues. Median (interquartile range) values of the average percent infarct area were 0.0 (8.6)% and 20.1 (41.2)% in propofol and saline groups, respectively. There was significant difference between the groups. In conclusion, propofol may have a protective effect on incomplete forebrain ischemia-reperfusion injury.
Animal ; Brain Ischemia/prevention & control* ; Brain Ischemia/pathology ; Cerebral Infarction/prevention & control ; Cerebral Infarction/pathology ; Disease Models, Animal ; Free Radical Scavengers/pharmacology* ; Mitochondria/enzymology* ; Neuroprotective Agents/pharmacology* ; Oxidative Phosphorylation ; Propofol/pharmacology* ; Prosencephalon/metabolism ; Prosencephalon/injuries ; Prosencephalon/drug effects* ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury/prevention & control* ; Reperfusion Injury/pathology ; Tetrazolium Salts

While arthroscopic shoulder surgery is considered relatively safe, complications have been reported.Though rare, pneumothorax has been reported in patients undergoing arthroscopic shoulder surgery.Tension pneumothorax must be immediately recognized and treated due to its potentially life threatening consequences.The authors present a case of a patient who developed tension pneumothorax after arthroscopic shoulder surgery, and its anesthetic managements.
Humans ; Pneumothorax ; Shoulder