The Educational and Vocational Status of Muscular Dystrophy Patients

OBJECTIVE: To investigate the current condition of education and vocation of patients with muscular dystrophy in Korea and to identify the factors determining their educational and vocational status. METHOD: This study included 129 patients with muscular dystrophy. Functional level of patients was evaluated by modified Barthel index (MBI). The current condition of education and vocation of patients was evaluated by self reports. The mean age of the patients was 23.5 years and 84.5% were men. RESULTS: Education duration of patients was 11.8 years, similar to that of general Korean population. University graduation rate of patients was 29.8%, which is higher than average rate of general Korean population. The unemployment rate of patients was 77.4%, which is much higher than average rate of general Korean population. Education duration was correlated with the onset age of disease symptom and with the functional level at the end of education period. The vocational status was related with education duration and functional level. The factor which influenced most negatively on maintaining education and vocation was physical limitation. CONCLUSION: For muscular dystrophy patients with physical limitation, equal opportunities and environment for exercising their ability should be secured with the specific policies and regulations, which consider their physical disabilities and interconnect educational field with vocational field.

Anesthetic Management of Small Bowel Transplantation for Infant Who Had Done Small Bowel Resection Operation: A case report / 대한마취과학회지

Small bowel transplantation is becoming the treatment of choice for short-gut syndrome. Improvements in surgical techniques, immunosuppressants, and anesthetic management of patients have allowed this procedure to become the standard of treatment for patients who are unable to continue total parenteral nutrition (TPN) therapy due to TPN-associated complications. We experienced small bowel transplantation in a 10-month-old male infant who had small bowel resection for small bowel volvulus and has suffered from complications such as recurrent sepsis, disseminated intravascular coagulation (DIC) due to long-term TPN. We report our experience with a brief review of the relevant literature.

Teatment by Emergency Cesarean Section Immediately Followed by Operative Repair of the Aortic Dissection under General Anesthesia in a Patient with Pregnancy-Induced Hypertension: A case report / 대한마취과학회지

Acute aortic dissection can occur in pregnancy in association with severe hypertension due to preeclampsia, coarctation of the aorta, or connective tissue diseases such as Marfan syndrome. The aims of anesthesia are to minimize fetal exposure to cardiopulmonary depressant drugs prior to delivery while ensuring a well-controlled hemodynamic environment for the mother. We encountered a case of a 31-year-old pregnant woman (gestational age 38 weeks) with preeclampsia, gestational DM, and acute aortic dissection (Stanford type A, DeBakey type II). The patient successfully underwent an emergency cesarean section and the subsequent repair of the aortic dissection under general anesthesia. We report this experience with a brief review of the relevant literature.

The Effect of Low Dose i.v. Ketamine in Combination with Epidural Morphine on Postoperative Pain / 대한마취과학회지

BACKGROUND: The purpose of this study was to evaluate the effect of low dose i.v. ketamine in combination with epidural morphine on postoperative pain after gastrectomy. METHODS: 40 patients scheduled for elective gastrectomy were investigated in a randomized study. All patients received epidural morphine (0.05 mg/kg) and bupivacaine (0.25%) as a bolus dose of 10 ml 40 min prior to skin incision. In addition, patient- controlled epidural analgesia (PCEA) with epidural bupivacaine (0.125%) and morphine (0.1 mg/ml) (bolus dose 1 ml, continuous infusion 1 ml/h, lock out interval 15 min) was offered from the time after 10 ml bolus dose. In the ketamine group, ketamine 0.5 mg/kg was administered 10 min prior to skin incision and then maintained continuously until skin closure at a dosage of 10microgram/kg/min. In the second group anesthesia was induced with thiopental sodium 4 mg/kg, midazolam 0.5 mg/kg, vecuronium 0.1 mg/kg and maintained with 66% N2O-O2, 1-3 vol% enflurane. The intensities of spontaneous pain and of coughing associated pain were measured using a visual analogue scale. Cumulative morphine consumption was measured at 2, 6, 12, 24, 48 h after surgery. Side effects were evaluated at 48 h after surgery. RESULTS: VAS and cumulative morphine consumption at 2, 6, 12, 24, 48 h postoperatively showed no statistical differences between the two groups, and no statistical differences in side effects were observed at 48h after surgery. CONCLUSIONS: We were unable to demonstrate any additional analgesic effect of low dose i.v. ketamine in combination with epidural morphine and bupivacaine.

Immediate Hypersinsitivity Reaction in Chronic Urticaria / 대한피부과학회지

In a large proportion of patients with chronic urticaria, at present, the definite tiology can't be found. There have been occasional attempts to identify the aIIergic causes uaing allergic skin tests, only ta suggest the Candicla albicans and. some food yeasts ae probabIe causes. Thia atady was designed to investgate how often patients with chronic urticaria from Chonnam Province react positively to skin tests with extracts of 42 common. allergene in the standard group Al-13 produced by Bencard Ltd. in England. The authora alao surveyed the clinical characteristics of 63 patients with chronic urtimria of more than 3 months duration, who bad visited the skin clinic of Chosun Univeresity HcepitaI from May. 1977 throug 3. Apr. 1979. The results were summarized as follows; 1. Among 63 patients, the maIe to female ratio was 1: l.2, and the peak incidence was in the 20s and 30s. 2, In regard to the duration of chroic urticaria, the highst frequency waa below one year duration. 3. Among 60s of the pa,tients who experienced seasonal changes, 32.4% had suffered aggravation during the winter. 4. The most common diseases combined with chronic urticaria were allergic rhinitis and atopic dermatitis, occuring in 9.5% of all subjects. 5. Of thase examined, 69.8% showed positive reactions to the prick test with the peak incidence in the 20s and 30s. 6. Among 42 allergens used far the prick test, 28 allergens turned out to be possibly casal agents, the rnost frequent group of allergens involved were grain du sts (27.1%), animal hairs(21.8%) and moulds(16.5%) in that order of frequency and occupying over 65% of the total positive reactions. And the most frequently involved specific allergens were hay dust, mixed grain dust straw dust and tree in that order of frequency. Moreover, 90 of the involved allergens were inhalants. 7. In teen-agers, the reactions to grain dusts, animal ha.irs, rnoulds and pollens were the rnost frequent while reactions to food allergens were most frequent in the 20s, and cotton and house dust are most frequently involved in tbe 40s. 8. Multiple sensitivity was not:d in a majority of cases and the most frequent combination was 2 to 5 allergens. 9. The rnost common abnormal hematologic finding in chronic urticaria was eosinophilia.