Lifestyle Factors and Bowel Preparation for Screening Colonoscopy

PURPOSE: The quality of bowel preparation is a major determinant of the quality of colonoscopy. This study evaluated lifestyle factors, including usual dietary style, associated with bowel preparation. METHODS: This retrospective study evaluated 1,079 consecutive subjects who underwent complete colonoscopy from December 2012 to April 2014 at National Cancer Center of Korea. Questionnaires on bowel preparation were completed by the subjects, with the quality of bowel preparation categorized as optimal (excellent or good) or suboptimal (fair, poor or inadequate). Lifestyle factors associated with bowel preparation were analyzed. RESULTS: The 1,079 subjects included 680 male (63.0%) and 399 female patietns (37.0%), with a mean age of 49.6 ± 8.32 years. Bowel preparation was categorized as optimal in 657 subjects (60.9%) and as suboptimal in 422 (39.1%). Univariate analyses showed no differences between groups in lifestyle factors, such as regular exercise, alcohol intake, smoking, and dietary factor. Body mass index (BMI) > 25 kg/m2 was the only factor associated with suboptimal bowel preparation on both the univariate (P = 0.007) and the multivariate (odds ratio, 1.437; 95% confidence interval, 1.104–1.871; P = 0.007) analyses. CONCLUSION: Most lifestyle factors, including dietary patterns, exercise, alcohol intake and smoking, were not associated with suboptimal bowel preparation in Koreans. However, BMI > 25 kg/m2 was independently associated with suboptimal bowel preparation. More intense preparation regimens before colonoscopy can be helpful in subjects with BMI > 25 kg/m2.

Correlation Between Bowel Preparation and the Adenoma Detection Rate in Screening Colonoscopy

PURPOSE: The adenoma detection rate is commonly used as a measure of the quality of colonoscopy. This study assessed both the association between the adenoma detection rate and the quality of bowel preparation and the risk factors associated with the adenoma detection rate in screening colonoscopy. METHODS: This retrospective analysis involved 1,079 individuals who underwent screening colonoscopy at the National Cancer Center between December 2012 and April 2014. Bowel preparation was classified by using the Aronchick scale. Individuals with inadequate bowel preparations (n = 47, 4.4%) were excluded because additional bowel preparation was needed. The results of 1,032 colonoscopies were included in the analysis. RESULTS: The subjects' mean age was 53.1 years, and 657 subjects (63.7%) were men. The mean cecal intubation time was 6.7 minutes, and the mean withdrawal time was 8.7 minutes. The adenoma and polyp detection rates were 28.1% and 41.8%, respectively. The polyp, adenoma, and advanced adenoma detection rates did not correlate with the quality of bowel preparation. The multivariate analysis showed age ≥ 60 years (hazard ratio [HR], 1.42; 95% confidence interval [CI], 1.02–1.97; P = 0.040), body mass index ≥ 25 kg/m² (HR, 1.56; 95% CI, 1.17–2.08; P = 0.002) and current smoking (HR, 1.44; 95% CI, 1.01–2.06; P = 0.014) to be independent risk factors for adenoma detection. CONCLUSION: The adenoma detection rate was unrelated to the quality of bowel preparation for screening colonoscopy. Older age, obesity, and smoking were independent risk factors for adenoma detection.

Nailfold capillary microscopy for evaluating hand-arm vibration syndrome

OBJECTIVES: We evaluated nailfold capillary abnormalities in patients with hand-arm vibration syndrome using nailfold capillary microscopy. METHODS: Fifty workers who underwent a special health examination because of exposure to hand-arm vibration at Ulsan University Hospital in 2012 (exposed group) and a control group of 50 white-collar employees were evaluated through a questionnaire survey regarding their present tasks, types of tools used, vibration exposure duration, use of protective wear, and medical history. Then, an occupational physician performed a physical examination for any hand deformities, skin problems, or motor and sensory dysfunctions of the upper extremities. The nailfold capillary morphologies (tortuous, crossing, bushy, meandering, branching, hemorrhage, avascular area, enlarged, and giant), capillary dimensions (afferent, top, venous, total width, and length), and specific counts (crossing and branching) on both fourth fingers were determined by a rheumatologist. Thereafter, the exposed subjects were assessed according to the Stockholm workshop classification scale. In total, 8 and 6 subjects in the exposed and control groups, respectively, were excluded from the study because of poor capillary microscopic image quality. In addition, 24 subjects in the exposed group with Stockholm vascular stage 0 were excluded. Finally, capillary morphology, dimensions, and specific counting were compared between the exposed (n = 18) and control groups (n = 44). RESULTS: The exposed group had significantly greater crossing capillaries and abnormal capillary numbers that included crossing capillaries (crossing, branching, bushy, and meandering) but smaller branching and abnormal capillary numbers that excluded crossing capillaries (branching, bushy, and meandering) than the control group did. No significant difference in capillary dimensions was observed between the two groups. Despite the adjustment for age, smoking status, and underlying diseases, the statistical significance was unchanged. In the specific counting of the type of capillaries, the exposed group had a significantly higher total crossing count but fewer total branching count than the control group did. However, no statistical significance resulted after adjustment for age, smoking status, and underlying diseases. CONCLUSIONS: In this study, the exposed group had significantly more crossing capillaries and a higher crossing count than the control group did.

Iron Deficiency is Not Associated with Increased Blood Cadmium in Infants

OBJECTIVES: To determine whether blood cadmium concentration is elevated in iron-deficient infants. METHODS: Blood cadmium and serum ferritin concentrations, serum iron/total iron-binding capacity (Fe/TIBC) and complete blood counts were measured in 31 iron deficient and 36 control infants, aged 6-24 months. All 31 iron-deficient infants received iron supplementation for 1-6 months. RESULTS: Blood cadmium concentrations were measured again in 19 of the iron deficient infants after their ferritin levels returned to the normal range. The mean blood cadmium concentration did not differ significantly in iron deficient and control infants. The mean blood cadmium concentration in the 19 iron-deficient infants was not significantly altered by ferric hydroxide treatment, while their hemoglobin, ferritin, and Fe/TIBC (%) concentrations were significantly higher after than before treatment. CONCLUSION: These findings indicate that iron deficiency does not increase blood cadmium concentrations in infants, in contrast with the effects of iron deficiency on manganese and lead concentrations.

The Complication Rate according to the Method of Pancreaticojejunostomy after Pancreaticoduodenectomy

PURPOSE: This study was designed to compare and analyze the complication rates of different anastomotic methods of pancreaticojejunostomy after performing pancreaticoduodenectomies by a single surgeon. METHODS: From January 2000 to August 2007, 92 patients underwent pancreaticoduodenectomy at a single institution. According to the texture of the pancreas and pancreatic duct size (below or above 3 mm), the type of pancreaticojejunal anastomosis was selected (either duct-to-mucosa pancreaticojejunostomy or end-to-side pancreaticojejunostomy with polyethylene tube). RESULTS: The pathologic diagnosis of the 92 patients included 81 patients with adenocarcinoma, five with chronic pancreatitis and three with GIST that developed in the duodenum. The adenocarcinomas include 33 distal CBD cancers, 18 pancreatic head cancers, 27 Ampulla of Vater cancers and 6 duodenal cancers. The pancreatic fistula rate was not significantly different between the duct-to-mucosa group and the end-to-side pancreaticojejunostomy group (nine of the 43 patients in the duct-to-mucosa group (20.9%) and six of the 46 patients in the tube insertion group (13.0%) (p=0.4). The rate of pancreatic fistula, as classified by three different consecutive periods (period I: 2000-2003; period II: 2004-2005; period III: 2006-2007), was markedly decreased and there were less complications with increasing experience (period I: 33.3%; II: 7.1%; III: 6.4%) (p=0.001). CONCLUSION: When performing pancreaticojejunostomy, both the duct-to-mucosa method and the tube insertion method were effective in decreasing the complication rate if the appropriate method was selected according to the texture of the pancreas and the size of pancreatic duct. The surgeon's experience and skill can affect the occurrence of pancreatic fistula after pancreaticojejunostomy. Enough experience is the most important factor to decrease the complication rate after pancreaticoduodenectomy.

A Study of Skin Color by Melanin Index According to Site, Gestational Age, Birth Weight and Season of Birth in Korean Neonates

Human skin color shows variations throughout life and influenced by various factors such as race, sex, age and hormones. Since the development of spectrophotometer, many studies on human skin color have been done. However, few studies have been carried out to measure the skin color of neonatal infants. The aim of our study was to assess the variations in skin color according to site, gestational age, birth weight and season of birth in Korean neonates. A total of 447 healthy neonates (3 days after birth, 213 males and 234 females) were enrolled in the present study. Skin pigmentation was measured by reflectance spectrophotometer (Derma-Spectrophotometer(R), Cortex technology, Hadsund, Denmark) at four different sites (forehead, upper arm, abdomen, and inguinal area). The forehead showed highest melanin index in all sites measured (p<0.05). There was no significant difference according to gestational age, birth weight, and season of birth. This result imply that the skin color in neonates is mainly determined genetically.

Congenital Ectopic Toenail: A Case Report and Review of the Literature

No abstract available.

Acquired, Bilateral Nevus of Ota-like Macules (ABNOM) Associated with Ota's Nevus: Case Report

Ota's nevus is mongolian spot-like macular blue-black or gray-brown patchy pigmentation that most commonly ocurrs in areas innervated by the first and second division of the trigeminal nerve. Acquired, bilateral nevus of Ota-like macules (ABNOM) is located bilaterally on the face, appears later in life, is blue-brown or slate-gray in color. It is not accompanied by macules on the ocular and mucosal membranes. There is also debate as to whether ABNOM is part of the Ota's nevus spectrum. We report an interesting case of ABNOM associated with Ota's nevus. A 36-yr-old Korean women visited our clinic with dark bluish patch on the right cheek and right conjunctiva since birth. She also had mottled brownish macules on both forehead and both lower eyelids that have developed 3 yr ago. Skin biopsy specimens taken from the right cheek and left forehead all showed scattered, bipolar or irregular melanocytes in the dermis. We diagnosed lesion on the right cheek area as Ota's nevus and those on both forehead and both lower eyelids as ABNOM by clinical and histologic findings. This case may support the view that ABNOM is a separate entity from bilateral Ota's nevus.

A study on the Relationship of the Severity of Psoriasis, Serum Soluble E-selectin, MCP-1 and RANTES / 대한피부과학회지

BACKGROUND: Psoriasis is a chronic skin disease characterized histologically by prominent keratinocyte hyperplasia and an early inflammatory cell infiltrate. However, the pathogenesis is not fully understood yet. Recently, the evidence that T lymphocytes play a key role in the pathogenesis of psoriasis is compelling. OBJECTIVE: The purpose of this study is to evaluate serum soluble E-selectin, MCP-1 and RANTES as severity indices or disease marker. In this study, we investigated a possible correlation between disease activity in psoriasis and serum soluble E-selectin, MCP-1 and RANTES, respectively. METHODS: Fifteen patients with psoriasis and fifteen normal controls were included in this study. The patients were evaluated for the symptoms and signs according to PASI score. We measured soluble E-selectin, MCP-1 and RANTES levels with blood samples drawn from patients and normal controls. RESULTS: 1. Soluble E-selectin serum levels were significantly increased in psoriatic patients compared with normal controls (p<0.05). Moreover, a significant correlation was demonstrated between serum soluble E-selectin values and PASI scores (r=0.54, p<0.05). 2. Serum MCP-1 levels were significantly increased in psoriatic patients compared with normal conrols (p<0.05). However, no significant correlation was observed between MCP-1 values and PASI scores (r=-0.12). 3. Serum RANTES levels were significantly increased in psoriatic patients compared with normal controls (p<0.05). Moreover, a positive correlation was observed between serum RANTES levels and PASI scores (r=0.63, p<0.05). CONCLUSION: These results suggest that serum levels of soluble E-selectin and RANTES could be used as marker of the disease activity in psoriatic patients.

Acquired Perforating Dermatosis in Patients with Chronic Renal Failure and Diabetes Mellitus

Acquired perforating dermatosis (APD) is a skin disorder occurring in the patients with chronic renal failure (CRF), diabetes mellitus (DM) or both. The purpose of this study was to clarify the clinical and histopathological features of APD, and evaluate role of scratching in the pathogenesis of APD. Twelves patients with APD associated with CRF and DM were enrolled in the study. In six patients who required hemodialysis, the lesions appeared 2-5 yr (mean 3 yr) after the initiation of dialysis, 18-22 yr (mean 19.3 yr) after the occurrence of DM. The other patients who did not receive hemodialysis noted the lesions 4-17 yr (mean 9.5 yr) after the onset of DM. All patients had an eruption of generally pruritic keratotic papules and nodules, primarily on the extensor surface of the extremities and the trunk. The histologic features of our cases showed a crateriform invagination of the epidermis filled by a parakeratotic plug and basophilic cellular debris. The period of treatment for patients who suffered from severe (7 cases) or very severe (3 cases) on the pruritus intensity was longer than that of patients who had mild pruritus (2 cases). These data showed that scratching appear to play a critical part in the pathogenesis of APD.

Efficacy of Narrow-Band UVB Phototherapy in Vitiligo Patients / 대한피부과학회지

BACKGROUND: The treatment of vitiligo requires several months of treatment and often results in disappointing outcomes. Recently, narrow band UVB phototherapy has been reported to be an effective and safe therapeutic option in patients with vitiligo. OBJECTIVE: We attempted to evaluate the clinical efficacy and safety of narrow band UVB phototherapy in vitiligo patients. METHODS: In an open trial, thirteen vitiligo patients were treated twice weekly with narrow band UVB phototherapy for at least six months. The degree of repigmentation was divided into 4 categories(below 25%, 26-50%, 51-75%, and above 75%). The disease activity by history was scored by means of the "vitiligo disease activity score (VIDA score)" before and 12 months after therapy. RESULTS: In the majority of the patients(85%), more than 25% repigmentation was observed. More than 75% repigmentation was seen in 7 patients(54%). The disease activity, as represented by VIDA scores, was significantly decreased after narrow band UVB therapy(P<0.05). Adverse effects were mild erythema and pruritus in 4 patients. CONCLUSION: According to our results, narrow band UVB phototherapy is an effective therapy which is convenient and safe in vitiligo patients.

A Case of Cutaneous Metastasis from Carcinoma of the Urinary Bladder / 대한피부과학회지

Metastasis to the skin from the urinary bladder carcinoma are very rare and their incidence is 1% to 2% of the cutaneous metastasis. A 78-year-old man developed cutaneous metastasis 2 years later after the diagnosis of carcinoma of the bladder had been made. He visited our department with skin colored, soft, tender, subcutaneous nodule on the lower abdomen which had been detected 5 days ago. Histologic examination of the skin lesion showed atypical cells having hyperchromatic and pleomorphic nuclei. Herein we report a case of cutaneous metastasis from carcinoma of the urinary bladder in a 78-year-old man.

A Case of Segmental Neurofibromatosis on the Right Knee / 대한피부과학회지

Segmental neurofibromatosis is rare disorder characterized by cafe-au-lait macules and neurofibromas, or only neurofibromas, limited to one region of the body. Typically the neurofibromas are unilateral and are occupied a single dermatome in most patients. We report a 62-year-old man with segmental neurofibromatosis on the right knee in the distribution of dermatomes L3 and L4.

Clinicopathologic Characteristics and Treatment Modalities about Vulvar Vestibulitis Syndrome: A study of 30 Cases / 대한산부인과학회잡지

OBJECTIVE: This study was performed to evaluate and introduce the clinicopathologic characteristics and treatment modalities of vulvar vestibulitis, a subset of vulvodynia, may cause physical disabilities, phycological or emotional distress, sexual dysfunction and limitation of daily activities. But its etiologies and treatments are not defined yet. We want to summarize the diagnostic methods and treatments patients of vulvar vestibulitis syndrome, could be easily overlooked in your offices. METHODS: This retrospective study was based on medical records including pathologic reports of 30 patients who underwent skin biopsy among the patients who were diagnosed as vulvar vestibulitis syndrome from August 1999 to February 2002 at Kyung-Hee University Medical Center. Skin biopsy was taken at a most painful area of vestibule in Dermatology Department to improve the accuracy of diagnosis. We evaluated the clinicopathologic characteristics of patients RESULTS: The mean age of these patients was 53.4+/-10.4 years and the mean parity was 3.13+/-1.4 times. The mean duration from symptom onset to diagnosis was 26.2+/-24.1 months. The skin biopsies showed chronic inflammation in 21 cases (70.0%), chronic inflammation with koilocytosis in 5 cases (16.7%), subacute inflammation in 3 cases (10.0%), and acute inflammation in 1 case (3.3%). The most predominant painful area is right posterior vestibular site and all patients felt pain on that site with swab test. There were 70% improvement among 30 patients with non-surgical modalities. CONCLUSION: Vulvar vestibulitis syndrome is a syndrome of severe pain, burning, stinging, irritative or raw sensation within the vestibular area by vestibular touch or attempted vaginal entry such as tampon use or intercourse. It also has vestibular redness, urge to urinate frequently or suddenly and is confirmed by history, moistened cotton-tipped swab test and gentian violet staining on the lesions. Its prevalence is 15% and it is frequently accompanied by physical disabilities, limitation of daily activities, sexual dysfunction and psychologic distress. Even though it could be seen frequently in our offices and has a tendency to become a chronic disease requiring long-term treatments, it has been being overlooked in offices due to lack of understanding of its etiologies, diagnostic criteria and treatments. Here we need more concerns and studies of vulvar vestibulitis syndrome.

The Effect of Nerve Growth Factor on Proliferation of Cultured Human Melanocytes / 대한피부과학회지

BACKGROUND: Nerve growth factor(NGF) is a neurotrophic polypeptide necessary for the survival and growth of some central neurons, as well as sensory afferent and sympathetic neurons. In addition to its actions on the nervous system, it also has significant biologic effects on cells of the immune-inflammatory compartment. NGF can variably induce melanocyte mitosis, increase melanogenesis, enhance dendricity and prevent apoptotic cell death following the UV injury. OBJECTIVE: The purpose of this study is to evaluate the effects of NGF on proliferation of cultured human melanocytes. METHODS: The effects of NGF on proliferation of cultured human melanocytes were evaluated. To specify the NGF effect on proliferation of human melanocytes, excess of anti-NGF neutralizing polyclonal antibody was added. RESULTS: 1) In 1% of melanocyte growth supplement(MGS) medium, all experimental groups showed no significant increase of cell number. The addition of anti-NGF polyclonal antibody did not influence the proliferation of melanocytes. 2) In 0.2% of MGS medium, all experimental groups showed no significant increase of cell number. The addition of anti-NGF polyclonal antibody did not influence the proliferation of melanocytes. CONCLUSION: These results suggest that, even though NGF has many biological influencse on melanocytes, it does not play a significant role in the proliferation of melanocyts.

A Clinical and Histopathologic Study of Syringoma / 대한피부과학회지

BACKGROUND: Syringoma is a relatively common benign appendageal tumor derived from the intraepidermal eccrine ducts. It occurs predominantly in women at puberty or later in life. The lesions usually are multiple and may be present in great numbers. Histopathologically, numerous small ducts are embedded in a fibrous stroma and their walls are lined by two rows of epithelial cells. OBJECTIVE: The aim of this study is to investigate clinical and histopathologic features of syringoma in Koreans. METHODS: Total 32 patients were included in this study. Data complied were sex, age, onset of disease, symptoms, family history, localization, distribution, and some histopathologic findings including acanthosis, basal hyperpigmentation, proliferation of fibrous stroma, vacuolization of cells, keratin-filled cyst, and characteristic tad-pole appearance. RESULTS: 1. It was observed predominantly in females as the sex ratio of 31:1. The mean age at diagnosis was 37.5-years-old. 2. The age of onset was in the 2nd decade in 9 patients, 3rd decade in 10 patients, 4th decade in 7 patients, 5th decade in 5 patients, and 7th decade in 1 patient. 3. Only two patients complained of mild itching. 4. Family history was noted in 14 patients. 5. It occurred most frequently in the upper and lower eyelids(28 cases), and followed by forehead(5 cases), genitalia(3 cases), temple(2 cases), cheek(1 case), and neck(1 case). 6. The distribution was bilateral except two patients. 7. The color of lesion showed skin-colored(23 cases), yellowish(6 cases), and brownish (3 cases). 8. Twelve cases of acanthosis, 11 cases of basal hyperpigmentation, 26 cases of proliferation of fibrous stroma, 13 cases showing vacuolization of inner cell layer of ducts, 8 cases showing keratin-filled cysts and 15 cases showing characteristic tad-pole appearance were observed. CONCLUSION: According to our study, syringoma predominantly occurs in eyelids of women as bilateral asymptomatic skin-colored papules and histopathologic findings frequently shows keratin-filled cysts.

Hypervascularity on palatal mass; Acinic cell carcinoma, a case report

Effects of Enflurane Anesthesia and Surgery on Thyroid Function / 대한마취과학회지

This study was performed to investigate the effects of enflurane anesthesia and surgery on thyroid function by determining the plasma concentration of thyroxid(T4) and trilodothyronine(T3) in 10 patients who had neither hepatic disorder nor endocrine disease. Each patient was premedicated with diazepam 10mg and atropine sulfate 0.5mg intramuscularly one hour before induction of anesthesia. Anesthesia was induced with pentohal sodium and maintained with enflurane and oxygen supplemented with pancuronium bromide in divided dose as needed. plasma concentrations of thyroxine and triiodothyronine were measured by means of radiommunoassay. The results obtained were as follows: 1) No significant change in the plasma concentration of thyroxine was detected during enflurane anesthesia and surgery. 2) Plasma concentration of triidothyronine decreased significantly, compared with the control level, during enflurane anesthesia alone and anesthesia plus surgery. Although the precise mechanisms for the decrease in triiodothyronine following anesthesia and surgery remain unknown, decreased peripheral conversion from T4 to T3 may be responsible for this decline. Our data imply that enflurane anesthesia did not stimulate thyroid funcion judged by plasma concentration of T4 or T3. Therefore, enflurane anesthesia may be an useful anesthetics for patients with hyperthyroidism.

Effects of Halothane Anesthesia and Surgical Procedure on Human Growth Hormone , Insulin and Glucose Level in Plasma / 대한마취과학회지

This study was undertaken to investigate the effects of halothane anesthesia alone on blood glucose metabolism in ten surgical patients by determining plasma growth hormone ,(HGH), insulin and glucose, and to compare these with the effects of halothane anesthesia plus surgery. Each patient was premedicated with diazepam, 5 mg and atropine sulfate, 0. 5mg intramuscu Jarly one hour before the induction of halothane anesthesia. After endotracheal intubatien had been carried out following SCC 30-40mg, anesthesia was mairrtained with halothane and oxygen. The muscle relaxant (gallamine) in divided doses was injected during surgery when needed and ventilation was controlled or assisted intermittently throughout the procedure. A moderate depth of anesthesia was maintained according to clinical judgement, based on signs including blood pressure, pulse rate and somatie reflex responses to the surgical xtimulation. Eight blood samples were obtained from each patient:( I ) at 09.00 a.m. immediately before :induction of anesthesia (this sample served as acoatrol value) (2) the next three were after 15. 30 and 45 minutes of halothane anesthesia but before the start of the operation; (3) further three, 15,30 and 45 minutes, after the start of the operation;(4) in the recovery room after fully awaking. HGH RIAKIT was utilized as a kit for determination of human growth hormoae by radioimmunoassay and also lNSULIN-RIAKlT for insulin levels in the blood, For the determination of blood glucose level, OTB method was utilized. The ratio between male and female pgtients was 5:5, mean age 39. 2+/-12. 1 and average body weights 55. 5+/-8 .5 kg. The mean control plasma growth hormone level(HGH) in 10 surgical patients after premedication, and immediately before induction of anesthesia was 2. 03+/-0. 28ng/ml. The mean yre-surgical concentration of HGH in plasma after 15, 30 and 45 minutes of halothane anesthesia rose to 2.63+/-0.41 ng/ml, 2.76+/-0.35 ng/ml, and 2.95+/-0.42 ng/ml, respectively but these values were not significantly elevated above the control value. The plasma levols significantly increased to 3. 42+/-0. 5 mg/ml (P <0. 05), 6. 64+/-0. 6 mg/ml (p <0.001) and 7.83+/-0,75 ng/ml. (p<0.001) 15 minutes, 30 minutes and 45 minutes respectively after the start of the operation. It decreased to 3. 58+/-0. 68 ng/ml. (p<0. 05) in the recovery room when the patient awoke fully. The mean pre-anesthetic control insulin level in plasma. in 10 surgical patients was 12. 6+/-2. 0 ng/ml which was within the normal range. This level. did not vary appreciably during halothane anesthesia alone, during operation or in the post-operative period. The mean control pre-anesthetic blood glucose level was 78. .7+/-3.9 mg/100ml. It rose to 80. 6+/-2. 9 mg/100ml. 83. 2+/-3. 6mg/100 ml 30minutes, 45minutes and of halothane anesthesia alone and 15 minutes of the start of the operation but these changes were not significant. It increased significanty to 98. 2+/-4. 4 mg/100ml(p<0. 05) and 103. 9+/-4. 0 mg/100ml (p<0. 001) 30 minutes and 45 minutes respectively after the start of the surgery but it rose to 95.7+/-3.1mg/ 100ml (p <0. 01) in the post-operative period. Consequently the plasma HGH level during halothane anesthesia alone for 45 minutes was slightly, increased and rose significantly during operation and in the post-operative period. The peak level was achieved 45 minutes after the start of surgery. Plasma insulin levels did not change appreciably during anesthesia alone or during surgery. Blood glucose levels increased slightly during anesthesia alone but rose significantly during operation and in the post-operative period.

Report of Pediatric Anesthesia with Ambu Valve / 대한마취과학회지

The choice of equipment for the administration of anesthesia depends to a considerable extent upon personal preference. Underlying factors must guide this choice, however. Equipment is suited to the individual patient, with especial care to avoid resistance, dead space, fatigue, and trauma, since all of these insults are easily imposed upon small patients. As we have had good experience in pediatric anesthesia with the Ambu valve and the results were satisfactory, we report with discussion of references.