The effect of heated breathing circuit on body temperature and humidity of anesthetic gas in major burns / 대한마취과학회지

BACKGROUND: Cold and dry gas mixtures during general anesthesia cause the impairment of cilliary function and hypothermia. Hypothermia and pulmonary complications are critical for the patients with major burn. We examined the effect of heated breathing circuit (HBC) about temperature and humidity with major burned patients. METHODS: Sixty patients with major burn over total body surface area 25% scheduled for escharectomy and skin graft were enrolled. We randomly assigned patients to receiving HBC (HBC group) or conventional breathing circuit (control group) during general anesthesia. The esophageal temperature of the patients and the temperature and the absolute humidity of the circuit were recorded every 15 min after endotracheal intubation up to 180 min. RESULTS: There was no significant difference of the core temperature between two groups during anesthesia. The relative humidity of HBC group was significantly greater compared to control group (98% vs. 48%, P < 0.01). In both groups, all measured temperatures were significantly lower than that after intubation. CONCLUSIONS: The use of HBC helped maintain airway humidity, however it did not have the effect to minimize a body temperature drop in major burns.

The BIS and hemodynamic changes in major burn patients according to a slow infusion of propofol for induction / 대한마취과학회지

BACKGROUND: Many pathophysiologic alterations in patients with major burns can cause changes in the response of propofol. The aim of this study is to determine the appropriate induction dose of propofol using a slow infusion rate for major burn patients to obtain desirable sedation and hypnotic conditions with minimal hemodynamic changes. METHODS: 45 adults with major burns and who were electively scheduled for escharectomy less than a week after injury were recruited. For induction with propofol, the patients were randomly allocated to one of two groups (group 1: 1.5 mg/kg, n = 20 and group 2: 2.0 mg/kg, n = 25). The infusion rate was 20 mg/kg/hr. The systolic and diastolic blood pressure (SBP, DBP), the heart rate, the bispectral index and the modified observers' assessment of the alertness/sedation scale (OAA/S) were measured before the induction and after the propofol infusion, as well as immediately, 3 and 5 minutes after intubation. RESULTS: The SBP and DBP were significantly decreased after the propofol infusion in both group, but there were no significant differences between the two groups. The BIS values after the propofol infusion and intubation were 44.2 +/- 16.1 and 43.5 +/- 13.8 in group 1, and 45.6 +/- 10.3 and 46.5 +/- 11.4 in group 2, respectively, and there were no differences between the 2 groups. CONCLUSIONS: When propofol is administrated to major burn patients, an induction dose of 1.5 mg/kg is appropriate and a slow infusion rate of 20 mg/kg/hr is safe for maintaining the desired hypnotic conditions and this dose and rate cause no significant hemodynamic problems.

Characteristics of Chronic Sensory Abnormalities in Korean Burn Patients / 대한통증학회지

BACKGROUND: After burn patients are discharged from the hospital, they may continue to feel pain and paresthetic sensations at the site of a healed burn and these problems may persist for years. This study was designed to describe the characteristics of these symptoms in terms of intensity, frequency, and influencing factors. METHODS: Patients that developed paresthetic sensations at sites of a healed burn were recruited from the pain management center from January 2003 to April 2006. Data was collected using a structured interview protocol. RESULTS: Fifty one adults, with a total body surface area burned (TBSA) of 21.1 +/- 16.3% aged 42.0 +/- 12.9 years were studied. A paresthetic sensation was reported to be present every day in 52.9% (27/51) of the subjects. A variation in the intensity was most commonly related to changes in the weather. A tight sensation and itching types of sensations were significantly more frequent in patients with more extensive injuries. CONCLUSIONS: Recognition and understanding of the chronic paresthetic sensation that many burn patients continue to experience at sites of a healed burn deserve further attention. Not only do clinicians need to be aware of these problems but also strategies for prevention and alleviation shoul\d be explored.

A Study on Type A Behavior Pattern(TABP), Stress, Depression and HIT-6 in the Patients with Chronic Headache / 성인간호학회지

PURPOSE: To examine an estimate factor and grasp the relation of difference for Type A Behavior Pattern(TABP), Perceived Stress Questionnaire, Depression and HIT-6 in the Chronic headache client. METHOD: Data collected by self-reported questionnaires from 38 client in S city who were selected by criteria of IHS, from the 19th of October to 10th of December, 2004. RESULT: 1) Differences between biographical data by TABP was significant by SaSang constitutions, by Stress was significantly influenced by age, and by Depression were significantly influenced health status and SaSang constitutions. 2) Correlations Coefficients among Study Variables were Stress and Depression(r=.494, p=.002) and Depression and HIT-6(r=.432, p=.010).3) In regression analysis, HIT-6 were significantly influenced by Depression and Type A Behavior Pattern(TABP). These variables explained 38% and 34% respectively. CONCLUSION: The result suggest that chronic headache management with psychological aspect, as well as physical aspect should be a focus to enhance the quality of life.

Development of Korean Standard Brain Templates According to Gender and Age / 대한해부학회지

Researches on brain functions using MRI or PET generally involve the process that normalizes spatially the results of functional images into a standard brain template in order to find out a common activation area of multiple subjects. So far MNI305, which is Western people's standard brain template, has been commonly used. However, the brain may be different morphologically and structurally among human races, so the use of MNI305 may produce inaccurate results. Furthermore, because the size and shape of the brain vary according to gender and age, if brain temperatures are developed considering these factors, brain activation areas may be identified more precisely. This study collected MR brain images from 121 men and women in their 20s (23.0 +/-2.6 years on the average) and 99 men and women in their 40s (47.5 +/-3.7 years on the average). After eight reference points were defined using the method proposed by Nowinski, the image that had the least error from the mean distances among the reference points was selected as the representative brain image. All images were affine-transformed into the representative brain image, and average brain templates were created by age and gender through averaging the brightness of images. The results of this study may be utilized in Korean brain probability maps to be developed in the future for more precise research on the functions of Koreans' brain.

Measuring of the Cerebellar Volume of Normal Koreans in Their 20s and 40s Using Magnetic Resonance Imaging

PURPOSE: This study purposed to measure the standard volume of the cerebellum of normal Koreans who were in their 20s and 40s, and we also wished to find out the difference in the volume of the cerebellum according to gender and age. MATERIALS AND METHODS: This study collected MR brain images from 118 people in their 20s (males: 58, females: 60) and 100 people in their 40s (males: 41, females: 59), for a total of 218 people. For each of sagittal, coronal and axial sections, the cerebellar part of the images was segmented using automatic and manual methods, and the volume was then measured. In order to observe differences according to gender and age and also to observe the interactive effect between gender and age, a two-way ANOVA test was performed using gender (2 levels) and age (2 levels) as independent variables. RESULTS:The average volume of the cerebellum of Koreans in their 20s was 133.74 (cm3) and that of Koreans in their 40s was 121.83 (cm3). The average volume of the cerebellum of male Koreans in their 20s and 40s was 134.55 (cm3) and that of female Koreans was 123.06 (cm3). The volume of the cerebellum was significantly larger in Koreans in their 20s than those volumes of the cerebellum of Koreans in their 40s, and the cerebellum volumes in male Koreans were larger than those of the Korean females. Moreover, the reduction of the volume of the cerebellum with age was significantly larger in male Koreans than in the Korean females. CONCLUSION: According to the results of measuring the volume of the cerebellum for normal Koreans in their 20s and 40s, the volume was significantly different according to gender and age, and the reduction of the volume of the cerebellum with age was significantly larger in men than in women.

Two cases of conjoined twins / 대한산부인과학회잡지

No abstract available.

Two Cases of Hyperkeratosis of the Nipple and Areola / 대한피부과학회지

We report two cases of hyperkeratosis of the nipple and areola which occurred in 22-year-old woman and 13-year-old girl. The former was suffered from mild pruritic, verrucous thickening and brownish discoloration of both nipples and areolae for 5 years. The latter had asymptomatic, verrucous thickening and dark brownish hyper- pigmentation of the right nipple and areola for 3 years. Both showed mild to marked hyperkeratosis and papillomatosis with increased pigmentation in the basal cell layer histopathologically. In both cases, the lesions were not responsive to the topical medications including steroids and keratolytic agents. Therefore we recommended surgical excision because the patients are greatly disturbed by the appearance of the lesions.

A Case of Angiokeratoma of the Vulva / 대한피부과학회지

We report s case of angiokeratoma of the vulva occuring in a 36-year-old woman. Numerous grayish dark purple papulovesicular lesions, ranging from 0.2 to 2.0mm in size, were observed on the right labium majus. All lesions were excised under local snesthesia after the diagnosis of angio keratoma was made histopathologically. No new lesions appeared during the follow-up period of one year.

Two Cases of Bullous Dermatitis Herpetiformis / 대한피부과학회지

Dermatitis herpetiformis occurs rarely in childhood and certain features of the disease in children differ from its manifestation in adults. The eruptions are commonly bullous, show little predilection for the typical regional pattern of the adults, may be nonpruritic, have a shorter course, and often are resistant to the usual therapy. A review of literature shows that in patients over 50 years of age or older the tendency is to manifecst predominantly, although not as strikingly for children, a vesicobullous type of dermatitis herpetiformis with large bullae, varying 1 to 5cm or more in diameter. The authors present two cases of bullous dermatitis herpetiformis confirmed by histology; the first case is a 5 year-old boy who has tense bullae, pustules, and pigmentations on the inguinal region, lower abdomen, buttocks, face, and extensor surfaces of the extremities of 1 yars duration; the second case is a 44 year old housewife who has eruptions of vesicles, bullae, and erosion on the buttccks, back, abdomen, ext;remities, oral cavity, and vulva of 15 days' duration. The authors reviewed the relevant literature and discussed the clinicaI feat ures of both cases thoroughly.

The Present Status of Venereal Disease Morbidity for prostitutes of Foreign Soldiers / 대한피부과학회지

Two hundreds and ninty-four prostitutes of foreign soldiers of K2 area in Taegu were investigated for their general circumtances, clinical and bacteriological studys from Mar. 1978 to May 1979. The results were as foIIows: The age group of 20-24 year-old constituted highest proportion at the level of about 53.4% Averge age of total casea was about 26.2. The propartion of those who were more than 35 occupied about 7.2%. The positive rate of Cram negative displococci (GND) on dirert smers showed highest in December and, January and lowest in-April. Wcekly distribution shwed a higher in second and fourth week. Nongonococcal infect.ions occupied about 45.4%. and total raes. The causative oanism. were niostly Gram negative and Gram positive bacilli. The mothly spells and perons with gonorrhea priod prevaIence rate showed a higher rate in Becember, January and July. The prevalence ratio of gonorrhea and syphilis was 13: 1. The examined cases occupied about 34.3, during first 2 month is after registration. The seasoal vari tion of registrators and cancellators were both most in winter. The positive rate of GND was ahout 53.1% in new comers less than two month-examinations after regiatration. Cervical erosion or chronic cervicitis .;howed about 44.8% among the examined 96% cases. Gonococci were isoIated about 25.6% among the ones with cervical lesions on Thayer-Martin media. On the other hand, the ones without lesions were about 11.3% comparatively. Syphilis period prevalence rate was about 8. 5 A. The titers of VDRL slide test were low (1; 8 or less). Two-thirds of positive cases of GND were treated by penicillin, although tetracycline and spectinomycin were also used in a few cases. The penicillin hypersensitivity sho- wed positive results in 9.7% of all treated cases.

A Case of Granuloma Faciale / 대한피부과학회지

A case of 38 year old woman had noted 3 lesions with asymptomatic, reddish brown colored, coin sized, slightly elevated, confluent patches on the right postauri-cular for about 20 years. The infiltrate in the patches felt moderately firm to the touch. the lesions were suspected to be chronic dermatitis group, erythema multiforme or granuloma annulare clinically, but the histopathologic features showed the typical findings of granuloma faciale. Literature was briefly reviewed for the discussion and comparision of clinical features and histopathological findings of author's case with the 2 cases previously reported in Korea.

A Case of Atrophie Blanche / 대한피부과학회지

Atrophie blanche is a rare vasculitis reported by Milian in 1929, that is characterizel by small erythematous, telangiectatic purpura which developes central hemorragic curst or painful ulceration and heals with atrophic white scar several months later. It is seen more commonly in middle-aged women and become worse in summer. It manifests primarly on the lower legs, ankles and dorsa of the feet, rarely on the elbows and dorse of the hands, where are the areas of the poor blood circulation. This case was 45 year-old woman who had suffered from periodic painful ulceration on the legs, ankles, dorsa of feet k hands and. elbows for about 18 years. Histopathologic findings showed fibrinoid degeneration R partial occlusion in the capillaries and mild perivascular chronic inflammatory cells infiltration in the upper corium. The lesion was not so improved by systemic k local corticosteroid therapy for about 3 months,

Three Cases of Darier's Disease Occuring in One Family / 대한피부과학회지

Darier's disease is a congenital dyskeratosis and is as an autosomal dominant reait but a case with a family history is relatively rare and only 2 such cases have been reported in Korea. We present typical Darier's disease occuring in a mother and her 2 daughters. A 45 year-old female has shown muitiple, confluent, dirty verrucous keratotic papules on the seborrheic area and whitish papules on the sotf palate since the age of 7 year-ole. Histologically there, are corps ronds, grains and suprabssal lacunae in the epidermis.