BACKGROUND: The aims of this national survey were to determine the views of Korean people regarding the specialty of anesthesiology and the role of anesthesiologists and to consider the ways in which individual anesthesiologists and the Korean Society of Anesthesiologists inform the public. METHODS: This off-line national survey was conducted by a professional research organization to obtain exact and reliable data. The questionnaire included structured questions to identify perceptions of the specialty of anesthesiology and the role of anesthesiologists inside and outside the operating room, people's desire for explanation of anesthesia by anesthesiologists, and their opinion about the best way to raise awareness about anesthesia and anesthesiologists. RESULTS: Of the respondents, 25.2% did not know that anesthesiologists are in charge of anesthesia during surgery. Furthermore, even respondents who knew that had very little knowledge of anesthesiologists' actual roles inside and outside the operating room. Respondents wanted their anesthesiologist to inform them about their anesthesia. CONCLUSIONS: The public's awareness regarding the role of anesthesiologists seems to be inadequate. To improve this awareness, in hospitals, each anesthesiologist should provide patients with more exact and detailed information. Simultaneously, the National Society of Anesthesiology should provide systematic information reflecting the public's thoughts.
Anesthesia ; Anesthesiology* ; Surveys and Questionnaires ; Humans ; Operating Rooms ; Physician's Role ; Public Opinion

OBJECTIVE: Vascular endothelial growth factor(VEGF)-C is involved in lymphangiogenesis and spreading of cancer cells via lymphatic vessels. The aim of the present study is to investigate the relationship between the absence of cerebral lymphatic vessels and low metastatic rate of brain tumors. METHODS: Immunohistochemical stains were performed for VEGF-C and VEGF in surgically resected specimens from 57 patients with primary(38 cases, low grade : 10 cases, high grade : 28 cases) and metastatic(19 cases) brain tumor. RESULTS: The expression of VEGF-C was higher in metastatic carcinoma(68%) than in high-grade primary tumor(29%). There was no difference for VEGF expression between high grade brain tumor (71%) and metastatic carcinoma(58%). CONCLUSION: Low VEGF-C expression of primary brain tumors may play a role in low metastatic rate of brain tumors.
Brain Neoplasms* ; Brain* ; Coloring Agents ; Humans ; Lymphangiogenesis ; Lymphatic Vessels ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factor C*

BACKGROUND: Sometimes hypoxemia occurs in the postoperative recovery room because of postoperative residual curarization (PORC). Some reports show that postoperative residual curarization is common. PORC occurs after the use of the long-acting muscle relaxants. It has been recommended to use intermediate-acting muscle relaxants and a TOF monitor to decrease PORC. The purpose of this study was to examine whether the use of the TOF monitor during propofol anesthesia affects the incidence of postoperative residual curarization. METHODS: 38 ASA I or II patients were divided randomly into two groups of 19 each. They received propofol-fentanyl-nitrous oxide for anesthesia. Pancuronium (80 100 microgram/kg) was used to facilitate tracheal intubation and additional doses were used to maintain surgical relaxation. The requirement for incremental doses of pancuronium and adequacy of recovery following reversal were assessed, either with (control group:n = 19) or without (experimental group:n = 19) TOF monitoring. Fifteen minutes after the arrival at the recovery room, neuromuscular function was assessed clinically and by using TOF. RESULTS: There were no statistical differences in body weight, age, or duration of operation between the two groups. There was no statistical difference in the total dose of pancuronium and total dose of pancuronium relative to body weight and duration of operation. There were statistical differences in TOF ratio in the recovery room (0.73 vs. 0.86). The incidence of PORC was 47% in the control group and 5% in the experimental group. CONCLUSIONS: Though the monitoring of TOF did not effect the dose of muscle relaxant, it may have reduced the incidence of PORC. However, the PORC had no clinical significance because the mean TOF ratio in the two groups was over 0.7 and there were no clinical signs of residual muscle weakness.
Anesthesia* ; Anoxia ; Body Weight ; Humans ; Incidence ; Intubation ; Muscle Weakness ; Pancuronium ; Propofol* ; Recovery Room ; Relaxation

Pulmonary alveolar proteinosis is characterized by the remittent or progressive accumulation of lipid-rich proteinaceous material within the alveolar sacs in the absence of inflammatory response. Whole-lung lavage is the only consistent treatment for pulmonary alveolar proteinosis. We have utilized whole-lung lavage for the successful treatment of a 62 year-old female patient with pulmonary alveolar proteinosis. There was no persistent complication during the procedure and the postanesthetic recovery except temporary fever and hypoxic event. The patient was symptomatically, physiologically, and radiologically improved within days after the procedures.
Female ; Fever ; Humans ; Middle Aged ; Pulmonary Alveolar Proteinosis* ; Therapeutic Irrigation*

The surgeries based on the outpstient department have increased recently. One of the indications of outpatient surgery is chemical peeling of the face that usually re- quires only deep sedation of short duration. The purpose of this study was to evaluate the effeets of ketamine and midszolam for out patient facial chemical peeling. Fifty-nine unpremedicated patients undergoing chemical peeling of the face were anesthetized with bolus intravenous injection of 1mg/kg of ketamine and 0.1 mg/kg of midazolam. Additional dose of ketamine(10-20mg) was given as needed. During operation, we observed systolic and diastolic blood pressure with noninvasive blood pressure monitor and peripheral oxygen saturation(SpO2) with pulse oximeter. All patients were allowed to breathe spontane- ously without ventilatory support during the operation. There was no case of airway ob- struction and SpO2 value was over 97% in most cases. The systolic and diastolic blood pressure and pulse rate were increased after the injection of ketamine and midazolam. And we observed the untoward effect of anesthetics such as the purposeless movement(6.8%), involuntary phonation(3.4%), skin rash(3.4%) and headache(1.7%). In postoperative analysis about the recall, bad dream, mood, and the degree of satisfaction of this type of anesthesia, the rate of patient's positive acceptance was high(86.4%) and the reeovery time was 58min. We conclude that combination of intravenous ketamine and midszolam can produce satisfactory anesthesia with few complications for outpatient chemical peeling surgery of the face.
Ambulatory Surgical Procedures ; Anesthesia* ; Anesthetics ; Blood Pressure ; Blood Pressure Monitors ; Deep Sedation ; Dreams ; Heart Rate ; Humans ; Injections, Intravenous ; Ketamine* ; Midazolam* ; Outpatients* ; Oxygen ; Skin

We experienced a case of postoperative quadriparesis secondary to operative position in a patient with pre-existing, asymtomatic,cervical neurilemmoma. The patient was admitted with chronic otitis media for mastoidectomy on right side. There was no specific event throughout operation and anesthesia but developed quadriparesis one hour after arrival on ward. With magnetic resonance imaging, the patient was dignosed to have cervical neurilemmoma. On seventh postoperative day the patient had second operation,cervical laminectomy and tumor removal. Ten days after second operation he was discharged without any complication. Eight months later he had mastoidectomy on the left side and was discharged without any sequale.
Anesthesia ; Anesthesia, General* ; Humans ; Laminectomy ; Magnetic Resonance Imaging ; Neurilemmoma ; Otitis Media ; Quadriplegia*

An one day old female baby was admitted to the Pediatric department of Korea University Anam Hospital for the evaluation of her facial anomaly. She was born by spontaneous vaginal delivery at term weighing 3.8 kg. On initial examination, she was noted to have congenital trismus and have cleft lip and palate. Bands of fibrous tissue were noted to extend from the superior alveolar part to inferior part at decidual molar tooth region and allowed oral opening of only 5 mm. She was transfered to the Plastic Surgery department under the diagnosis of cleft palate lateral synechia syndrome for resection of her synechial bands. In the operating room ECG, pulse oximeter and precordial stethoscope were applied to the patient and then, anesthesia was induced with , O2, N2O and enflurane. The 60 cm Olympus fiberscope with an external diameter of 2 mm was used and well lubricated 3.0 mm uncuffed endotracheal tube was threaded over the fiberscope through the oral cavity. The fiberscope was advanced into the midtrachea, then the endotracheal tube was passed over the fiberscope into the trachea After securing of the endotracheal tube, two lateral synechial bands were surgically divided. She tolerated oral feedings on postoperative 5 days without difficulty and discharged from the hospital on postoperative 6 days.
Anesthesia ; Cleft Lip ; Cleft Palate* ; Diagnosis ; Electrocardiography ; Enflurane ; Female ; Humans ; Infant, Newborn* ; Intubation* ; Intubation, Intratracheal ; Korea ; Molar ; Mouth ; Operating Rooms ; Palate ; Stethoscopes ; Surgery, Plastic ; Tooth ; Trachea ; Trismus

Nosocomial infection represent a significant cause of patient morbidity and mortality, especially in the ICU and nosocomial pneumonia that cause high mortality may arise from contaminated respiratory equipments. This study was done to investigate the relationship of micro-organisms in upper respiratory tract and ventilatory equipment, especially humidifier. The total number of cases in this study was 20 and the specimen for bacteriologic culture were taken from the pharynx, the distilled water and the inner wall of humidifier and toilet of trachea at the 0, 4, 8, 12, 24, 48 hours after initiation of mechanical ventilation. The results obtained from the bacteriologic culture were as follows. 1) The most frequently found organism at the pharynx was Pseudomonas aeruginosa and next was Coagulase Negative Staphylococcus, followed by Streptococcus viridans, Klebsiella pneumoniae, Staphylococcus aureus, Streptococcus group D, Enterobacter agglomerans, Acinetobacter spp. 2) The most frequently found organism at the trachea was Pseudomonas aeruginosa and next was Klebsiella pneumoniae followed by Coagulase Negative Staphylococcus, Streptocoecus viridans, Pseudomonas picketti, Staphylococcus aureus and no growth in 5 cases. 3) The most frequently found organism in the fluid of humidifier was Pseudomonas aeruginosa and next was Pseudomonas picketti, Klebsiella pneumoniae, Streptococcus group D and no growth in 2 cases. 4) The most frequently found organism at the pharynx was Pseudomonas aeruginosa and next was Pseudomonas picketti, Klebsiella pneumoniae, Streptococcus group D, Serratia liquefacines, Acinetobacter spp and no growth in 3 cases. 5) The number of isolated organisms in the fluid of humidifier was 3 at 0 hour and 18 after 48 hours and at the wall 2 at 0 hour and 15 after 48 hours. 6) The number of same organism that was isolated between the pharynx and trachea was 13 among 15 cases and between the wall and fluid of humidifier was 15 among 16 cases and between trachea and fluid of humidifier was 10 among 14 cases.
Acinetobacter ; Coagulase ; Cross Infection ; Enterobacter ; Enterococcus faecalis ; Humans ; Klebsiella pneumoniae ; Mortality ; Pharynx ; Pneumonia ; Pseudomonas ; Pseudomonas aeruginosa ; Respiration, Artificial ; Respiratory System ; Serratia ; Staphylococcus ; Staphylococcus aureus ; Trachea ; Ventilators, Mechanical* ; Viridans Streptococci ; Water

Endotracheal intubation has been widely used for general anesthesia and patency of airway. But intubation granuloma may be developed after intubation. From Feb. 1986 to Jun. 1993, the authors encountered 20 cases of intubation granuloma in Korea University Hospital and following results were obtained. 1) The incidence of intubation granuloma was 0.017%. 2) The age range was from 24 to 49 years. 3) The ratio of male to female was 1 to 19. 4) All cases located at posterior one third of vocal cord, 6 cases were bilateral, 14 were unilateral, of them 10 were in the right sides. 5) Eleven cases were occurred after caesarian section, and the ineidence of which was 0.134% . 6) Hoarseness was the main symptom in 18 cases. 7) The duration from intubation to development of symptom was 15 days to 4 months.
Anesthesia, General ; Female ; Granuloma* ; Hoarseness ; Humans ; Incidence ; Intubation* ; Intubation, Intratracheal ; Korea ; Male ; Vocal Cords

A 36-year-old woman (para 1-0-2-1) was transferred to Korea University Hospital at 38 weeks gestation for dyspnea and chest pain. On admission, her blood pressure ranged from 130/ 70 to 230/130 mmHg, the heart rate was 144 beats/min and respiratory rate was 36/min. The ECG pattern, serum creatinine phosphokinase and lactic dehydrogenase levels were consistent with acute myocardial infarction. The baby was delivered by cesarean section under general anesthesia with nitroglycerin and propranolol support, After delivery, the patient was diagnosed as having pheochromocytoma by hormone study, abdominal magnetic resonance imaging, and computerized tomography scan. Removal of tumor was suceessfully done under combined general and epidural anesthesia after preoperative preparation with phenoxybenzamine and propranolol for two weeks. Postanesthetic recovery was uneventful.
Adult ; Anesthesia, Epidural ; Anesthesia, General ; Blood Pressure ; Cesarean Section ; Chest Pain ; Creatinine ; Dyspnea ; Electrocardiography ; Female ; Heart Rate ; Humans ; Korea ; Magnetic Resonance Imaging ; Myocardial Infarction* ; Nitroglycerin ; Oxidoreductases ; Phenoxybenzamine ; Pheochromocytoma* ; Pregnancy ; Pregnant Women* ; Propranolol ; Respiratory Rate