The implication of using dominant hand to perform laryngoscopy: an analysis of the laryngoscopic view and blade-tooth distance

BACKGROUND: Existing laryngoscopes are designed to be handled by the left hand, whereas most healthcare professionals are right-handed. However, controlling the laryngoscope device requires considerable strength and refinement to control the blade. We examined the usefulness of a right-handed laryngoscope to validate its clinical applicability. METHODS: One hundred sixty-four patients for general anesthesia were involved. Laryngoscopy was performed twice for each patient, once using a conventional left-handed Macintosh No. 3 laryngoscope and once using a right-handed one, by 25 right-handed and 18 left-handed laryngoscopists. The perpendicular distance from the tip of the maxillary incisor to the flange of each blade was measured when the maximum visibility of the glottis was obtained. We compared the distances, chances of directly contacting the tooth, laryngoscopic views and subjective feeling of difficulty in handling device between the two laryngoscopes. RESULTS: For the right-handed laryngoscopists, distance varied significantly between the two laryngoscopes (5.0 ± 3.5 and 5.7 ± 3.7 mm [mean ± standard deviation] for the conventional and right-handed laryngoscopes, respectively [P < 0.001]). The right-handed laryngoscope was associated with a decreased chance of directly contacting the teeth (P = 0.001). Additionally, the right-handed laryngoscope provided a better view than the conventional one (P = 0.005). Conversely, most of the left-handed laryngoscopists felt that the procedure using a conventional laryngoscope was easier than with a right-handed one. CONCLUSIONS: When a right-handed laryngoscopist uses a right-handed laryngoscope, a better laryngoscopic view and a reduced chance of blade contact with the teeth can be achieved.

The Survey of Outcome Measures in Department of Rehabilitation Medicine in Hospitals of Korea

OBJECTIVE: The objective of present study was to identify the rehabilitation outcome measures currently used in Korea. METHOD: The survey was conducted by e-mail questionnaire to 165 department of rehabilitation medicine in hospitals of Korea. Non-responders were sent a second copy of the questionnaire if they did not answer within 1 week. Data from the returned questionnaires were entered into a Microsoft Excel and subjected to descriptive and simple quantitative analysis. RESULTS: A total of 99 (60%) responses were received. Of these, 95% units collected some outcome assessment measure as part of routine clinical practice. Korean version of Modified Barthel Index (K-MBI) (80%) was the most popular global outcome measures. The Korean version of Berg Balance Scale (K-BBS) (53%) was used most frequently for balance assessment. Upper extremity function was checked with hand grip strength test (70%) and Box and block test (67%) most commonly. Korean version of Mini Mental State Examination (K-MMSE) was the most popular cognitive function test (75%). PARADISE Korean version-Western Aphasia Battery (PARADISE K-WAB) was the most popular language test (67%). Sixty-three (67%) units used outcome results for discussion and goal setting. Seventy-eight (78%) units responded that they would use a standardized outcome measures if there is an agreed standardized outcome measures lists (80%) and support of money and time (43%). CONCLUSION: The survey demonstrated that quite widespread use of outcome assessments in routine clinical rehabilitation within Korea. There is also an agreement for need of common 'basket' of recommended instruments for rehabilitation.

The Survey of Outcome Measures in Department of Rehabilitation Medicine in Hospitals of Korea

OBJECTIVE: The objective of present study was to identify the rehabilitation outcome measures currently used in Korea. METHOD: The survey was conducted by e-mail questionnaire to 165 department of rehabilitation medicine in hospitals of Korea. Non-responders were sent a second copy of the questionnaire if they did not answer within 1 week. Data from the returned questionnaires were entered into a Microsoft Excel and subjected to descriptive and simple quantitative analysis. RESULTS: A total of 99 (60%) responses were received. Of these, 95% units collected some outcome assessment measure as part of routine clinical practice. Korean version of Modified Barthel Index (K-MBI) (80%) was the most popular global outcome measures. The Korean version of Berg Balance Scale (K-BBS) (53%) was used most frequently for balance assessment. Upper extremity function was checked with hand grip strength test (70%) and Box and block test (67%) most commonly. Korean version of Mini Mental State Examination (K-MMSE) was the most popular cognitive function test (75%). PARADISE Korean version-Western Aphasia Battery (PARADISE K-WAB) was the most popular language test (67%). Sixty-three (67%) units used outcome results for discussion and goal setting. Seventy-eight (78%) units responded that they would use a standardized outcome measures if there is an agreed standardized outcome measures lists (80%) and support of money and time (43%). CONCLUSION: The survey demonstrated that quite widespread use of outcome assessments in routine clinical rehabilitation within Korea. There is also an agreement for need of common 'basket' of recommended instruments for rehabilitation.

Comparison of the Quality of Bowel Preparation for Double Contrast Barium Enema According to Remind Calls: A Double-Blind Clinical Trial / 가정의학회지

BACKGROUND: Adequate bowel preparation is essential for accurate double-contrast barium enema (DCBE) examination. Several protocols have been performed including controlled diet, split dosage of cathartic, fasting dinner 1 day before the exam. The aim of this study was to compare the effect of remind calls on the quality of bowel preparation. METHODS: We conducted a clinical trial for 248 subjects who did DCBE at the health promotion center of a single hospital. One hundred and seven patients received instructions and remind calls one day before starting bowel preparation, and the others received only instructions. Two specialized radiologists rated the quality of bowel preparation on a scale of excellent/good/fair/poor. In addition, we collected data for age, sex, education, income, and the reason for the exam with a detailed questionnaire. RESULTS: The basal characteristics of subjects between 'remind call' and 'no remind call' groups were similar except age (57.0 +/- 9.8 years, 54.4 +/- 8.1 years, respectively P = 0.021). The proportion of 'excellent' was higher in the 'remind call' group (35.5%) than in the 'no remind call' group (23.4%) with statistical significance (P = 0.037). The adjusted odds ratio was 2.015 for 'remind calls' (P = 0.017), and 0.958 for age (P = 0.011). CONCLUSION: Remind calls and age were associated with the quality of bowel preparation. Remind calls increased the proportion of 'excellent' quality of bowel preparation, which can help accurate assessment.

Ultrasonographic Measurement of Thickness of Extensor Carpai Radialis Brevis Tendons for Lateral Epicondylitis / 대한정형외과학회잡지

PURPOSE: To evaluate the ultrasonographic measurements of the thickness of the extensor carpai radialis brevis tendons in patients with lateral epicondylitis. MATERIALS AND METHODS: Twenty nine patients diagnosed with lateral epicondylitis were examined prospectively. Eight were male and twenty one were female. The mean age was 48 (34-62) years. The average time from the onset of symptoms until the examination was 9 (1-24) months. Eighteen patients did not show improvement in their symptoms after conservative treatment. Six underwent arthroscopic debridement and 4 underwent electric shock wave therapy. Three patients showed calcification on the simple x-ray. The thickness of the extensor carpai radialis brevis tendons on both the lesion and contralateral sides was measured and compared using ultrasonography. RESULTS: There were no significant differences in age and gender between the thickness of the extensor carpai radialis brevis tendons on the lesion and contralateral sides (p=0.83, 0.25, 0.80, 0.64). The thickness of the extensor carpai radialis brevis tendons on the lesion and contralateral sides were 4.9 mm and 3.2 mm, respectively, and the lesion side was significantly thicker (p<0.001). The best cut off value of the ECRB thickness at its origin was 3.95 mm, which had a sensitivity, specificity and accuracy of 96.6%, 79.3% and 87.9%, respectively. CONCLUSION: Sonographic measurements of the thickness of the ECRB tendons are valuable for diagnosing lateral epicondylitis.

Long-term Maintenance of Smoking Cessation and Related Factors of Relapse / 가정의학회지

BACKGROUND: Long-term maintenance of smoking cessation is important to reduce smoking related diseases. There are few studies that evaluated long-term maintenance and related factors. For effective cessation treatment, we analyzed the relapse pattern after cessation and related factors. METHODS: We selected people who visited a health care center more than two times between January 1995 and December 2006 and who have succeeded in cessation after the first visit. Telephone survey was done and their medical records was analyzed. A total of 308 people whose medical records corresponded to the results of the telephone survey were finally included and analyzed. RESULTS: The mean follow-up duration was 112 months and the mean age of the first visit was 47.9 years. The median maximum duration of abstinence was 5.50 years, and the annual hazard ratio of relapse was about 2.5-4.2% from two to seven years of duration of abstinence. Mean age of smoking onset was 22.9 years, the mean smoking duration was 24.5 years, and the mean smoking amount per a day was 20.0 cigarettes. In single-variate analysis, the total number of cessation success, the age of smoking onset, the mean smoking duration, the mean smoking amount per day, the cessation method, the reason for trying cessation were related with the long-term cessation maintenance. In multivariate analysis, the total number of success for cesstion, the reason for trying cessation, the cessation method, the mean number of cigarettes per day were related. CONCLUSION: The experience of relapse, the motive of cessation and self-willingness were shown to be important for long-term maintenance of smoking cessation.

More Than 5 Year Follow-Up of Thoracolumbar Fractures Treated By Pedicle Screw Fixation / 대한척추외과학회지

STUDY DESIGN: This is a retrospective study. OBJECTIVES: We wanted to analyze the frequency of instrument breakage and the long term reduction loss for patients who received pedicle screw fixation for thoracolumbar fractures. SUMMARY OF THE LITERATURE REVIEW: A pedicle screw fixation system for thoracolumbar fractures has become popular since the late 1980s, but it is difficult to find articles mentioning its mid and long term results. MATERIALS AND METHODS: Twenty-seven patients those received pedicle screw fixation for thoracolumbar fractures and dislocations and who were followed up more than 5 years were included. The average follow-up period was 139.0 months. We compared the anterior column height, the kyphotic angle and the local kyphotic angle on serial radiographs, and we measured the changes of the intervertebral disc height and the changes of the angle between screws. We also investigated the breakage and loosening of instruments. RESULTS: The breakage of screws was observed in 11 cases (40.7%) and it had a statistical correlation with the loss of the lower intervertebral disc height and the loss of angles between the screws. During the follow-up, the kyphotic angle, the upper and lower disc height and the interscrew angle were decreased over time, whereas the anterior column height and wedge angle of the vertebra were maintained after the operation. There was no statistical correlation between the breakage of instruments and the degree of lower back pain. CONCLUSIONS: On the mid and long-term follow-up of the patients who were treated by pedicle screws for thoracolumbar fractures, the correction of the kyphotic angle was lost over time and breakage of screws may eventually occur. The loss of the kyphotic angle was mainly due to the continuous loss of the intervertebral disc height.

Multiple Rice Bodies in Subacromial Space: A Case Report

Multiple rice bodies are a rare disorder that is most commonly observed in chronic rheumatoid arthritis patients and as a complication of chronic inflammation in the bursa. However, it can occur in the absence of an underlying systemic disorder. Although it resembles synovial chondromatosis clinically and on imaging, the condition can be discriminated by an analysis of the radiographic and MR appearances. We encountered a case of multiple rice body formation with subacromial bursitis on the shoulder of a 37-year old man suffering from pain and motion limitation. The patient was treated by arthroscopic removal of the multiple rice bodies and a subacromial bursectomy. We present this case with a review of the relevant literature.

The influence of epinephrine concentration in local anesthetics on pulpal and gingival blood flows / 대한치과보존학회지

No abstract available.

Effect of Glutathione on Oxidant-induced Neurotoxicity in Cultured Spinal Motor Neurons / 대한마취과학회지

BACKGROUND: Free radical reactions are a part of normal human metabolism. When produced in excess, radicals can cause tissue injury. The present study was aimed to investigate neurotoxic effect of oxygen free radicals and neuroprotective effect of antioxidant(glutathione). METHODS: Neurotixic effect of oxygen radicals was evaluated by MTT[3-(4,5-dimethylthiazol-2,5- diphenyltetrazolium bromide] assay and neurofilament enzyme-immunoassay after culturing of spinal motor neuron cell line of mouse(NSC-34). Then these cells were exposed to various concentrations of xanthine oxidase(XO) and hypoxanthine(HX). In addition, neuroprotective effect of antioxidant against oxidant-induced neurototoxicity on these cultures was examined. RESULTS: Exposure of neurons to 25mU/ml XO and 0.2mM HX for 3 hours resulted in a significant cell death and also glutathione(GSH) blocked the neurotoxicity induced by oxygen radicals in cultured mouse spinal motor neurons. CONCLUSION: From the above results, it is suggested that oxygen radicals are toxic in NSC-34. Selective antioxidants such as GSH are effective in blocking oxidant-induced neurotoxicity on these cultures.