A Survey of the Radiation Exposure Protection of Health Care Providers during Endoscopic Retrograde Cholangiopancreatography in Korea

BACKGROUND/AIMS: During endoscopic retrograde cholangiopancreatography (ERCP), all efforts should be made to be aware of radiation hazards and to reduce radiation exposure. The aim of this study was to investigate the status of radiation protective equipment and the awareness of radiation exposure in health care providers performing ERCP in Korean hospitals. METHODS: A survey with a total of 42 questions was sent to each respondent via mail or e-mail between October 2010 and March 2011. The survey targeted nurses and radiation technicians who participated in ERCP in secondary or tertiary referral centers. RESULTS: A total of 78 providers from 38 hospitals responded to the surveys (response rate, 52%). The preparation and actual utilization rates of protective equipment were 55.3% and 61.9% for lead shields, 100% and 98.7% for lead aprons, 47.4% and 37.8% for lead glasses, 97.4% and 94.7% for thyroid shields, and 57.7% and 68.9% for radiation dosimeters, respectively. The common reason for not wearing protective equipment was that the equipment was bothersome, according to 45.7% of the respondents. CONCLUSIONS: More protective equipment, such as lead shields and lead glasses, should be provided to health care providers involved in ERCP. In particular, the actual utilization rate for lead glasses was very low.

Evaluation of a Rapid Enrichment-PCR Method for the Detection of vanA Vancomycin-resistant Enterococci in Fecal Specimens / 대한임상미생물학회지

BACKGROUND: Rapid and accurate surveillance is crucial in controlling vancomycin-resistant enterococci (VRE). Culture-based surveillance takes more than 4 days and direct polymerase chain reaction (PCR) is rapid but compromised by a low sensitivity. In this study, we evaluated the performance of an enrichment-PCR method for vanA VRE surveillance. METHODS: In July 2006, 100 fecal specimens were inoculated to Enterococcosel agar (EA) and Enterococcosel broth (EB) containing 6 microgram/mL vancomycin. After 1 or 2 day-incubation bacterial pellets were obtained from 1 mL of blackened EB and VanA PCR were performed with DNA extract of the pellets (EB+PCR). Blackened EB were also subcultured on EA (EB+EA). Black colonies on EA were submitted to identification and antimicrobial susceptibility test and, if necessary, they were confirmed with vanA PCR. The electronic medical records were reviewed for previous history of colonization or infection of VRE. RESULTS: A total of 59 specimens were positive for VRE by at least one method. VanA VRE was detected from 43, 54, and 53 specimens by EA, EB+ PCR, and EB+EA, respectively; 54 EB+PCR positive specimens comprised 43 EA-positive, 7 EA-negative/ EA+EB-positive and 4 EB+PCR-only-positive, and 11 EA-negative/EB+PCR-positive specimens were from the previous VRE-colonizers. The five EB+PCR-negative specimens were EB+EA-positive, suggesting false negativity, probably due to PCR inhibitors. The average turn-around time for EA was 88+/-35 h, whereas 98% of EB+PCR positive results were obtained at day 1. CONCLUSION: Enrichment in EB followed by PCR (EB+ PCR) appears to be a rapid and sensitive method for the detection of vanA VRE in stool specimens. Internal control would be required to detect false negative results.

Annual Report on External Quality Assessment in Diagnostic Genetics in Korea (2003) / 임상검사와정도관리

The importance of quality control for dramatically growing genetic tests continues to be emphasized with increasing clinical demands. Diagnostic genetics subcommitee of KSQACP performed two trials for cytogenetic study in 2003. Cytogenetic surveys were performed by 33 laboratories and answered correctly in most laboratories except some problems in nomenclature and analysis for FISH and complex cytogenetic abnormalities in neoplasia. The molecular genetic test surveys include M. tuberculosis, HBV, HPV, leukemia/lymphoma, ApoE genotyping, Duchenne muscular dystrophy, myoclonic epilepsy and ragged red muscle fibers, and spinal and bulbar muscular atrophy. HPV, myoclonic epilepsy and ragged red muscle fibers, and spinal and bulbar muscular atrophy were the first challenge of the genetic survey. Molecular genetic survey showed excellent results in most participants, however, HPV tests should be improved by quality control in a few laboratories. External quality assessment program for cytogenetic analysis could be helpful to give participants many chances of continuous education and of interesting case materials.

Annual Report on External Quality Assessment in Diagnostic Genetics in Korea (2002) / 임상검사와정도관리

The importance of quality control for dramatically growing genetic tests continues to be emphasized with increasing clinical demands. Diagnostic genetics subcommitee of KSQACP performed two trials for cytogenetic study in 2002. Cytogenetic surveys were performed by 33 laboratories and answered correctly in most laboratories except some problems in nomenclature and analysis for mosaicism and cytogenetics of neoplasia. The molecular genetic test surveys include M. tuberculosis, HCV, HBV, leukemia/lymphoma, ABO genotyping, ApoE genotyping, spinocerebellar ataxia (SCA), spinal muscular atrophy (SMA), and mitochondrial encephalomyopathy, lactic acidosis, and stroke like episodes (MELAS). HBV, SCA, SMA, MELAS tests were the first challenge of the genetic survey. Molecular genetic survey showed excellent results in most participants, however, ABO genotyping tests should be improved by new methods in a few laboratories. External quality assessment program for diagnostic genetics could be helpful to give participants many chances of continuous education and of interesting case materials.

A Case of Prenatally Detected Trisomy 9 Associated with Dandy Walker Syndrome / 대한산부인과학회잡지

Complete trisomy 9 is a rare chromosomal aneuploidy in live born infants. The majority of cases of trisomy 9 end in spontaneous abortion in the first trimester. Clinical finding of co-mplete trisomy 9 demonstrate multiple organ abnormalities in the craniofacial, cardiovascular, skeletal, genitouronary systems. We report a fetus with Dandy Walker syndrome which was diagnosed prenatally and was subsequently found to have a complete trisomy 9.

A statistical analysis of methicillin-resistant staphylococcus aureus

No abstract available.

Serum Testosterone in Man during Thalamonal Anesthesia and Surgery / 대한마취과학회지

The relationship between the Ledig cell of testis and the tropic hormones of the anterior pituitary gland has been ineddquately expiored in man because of methodological difficulties levels in human serum. As testosterone in one of the most important anabolie hormones, it would therefore serve as an index to hormanal response to stress in man. This study was performed to inveatigate the effect of thalamonal-N2O-O2 anesthesia and surgery on human sex hormone by radioimmunoassay method. Measured serum testosterone lexels in the preanesthetic period, 60 minutes after anesthesia and surgery, and at full rectxary from anesthesia were 5.64ng/ml 4.40ng/ml and 5.02ng/ml, respectively.

Serum Testosterone in Man during Methoxyflurane Anesthesia and Surgery / 대한마취과학회지

The relationship between the Leydig cell of testis and the tropic hormones of the anterior pituitary gland has been inadequately explored in man because of methodological difficulties. A report has appeared on the effect of anesthesia per se on sex hormone levels in human serum. As testosterone is one of the most important anabolic hormones, it would therefore serve as an index to hormonal response to stress in man. Tcsticular blood level of testcsterone in man was increased by ether anesthesia but plasma testcsterone one in man was decreased by halothane anesthesia. Plasma testostercne levels were measured by others. by a competitive protein binding method. This study was performed to investigate the effect of methoxyflurane anesthesia and surgery on human sex hormone by a radioimmunoassay method. Serum testosterone levels measured in the pre-anesthetic period, (60 minutes after anesthesia and surgery, and at full recovery from. anesthesia were 3.80+/-1. 75 ng/ml, 0. 58+/-1. 22 ng/ml and 3. 55+/-1. 85 ng/ml, respectively. No statistical significance was observed. The obtained value of testostercne was the lowest when compared with the values reported by others.

Serum Testosterone in Man during Halothane Anesthesia and Surgery / 대한마취과학회지

The relationship between the Leydig cell of testis and the tropic hormones of the anterior pituitary gland has been inadequately explored in man because of methodological difficulties. Ether anesthesia has been shown to increase testicular blood level of testosterone in man. Some report has appeared on the effect of anesthesia person sex hormone levels in human serum. As testosterone is one of the most important anabolic hormones, it would therefore serve as an index to hormonal response to stress in man. Testosterone levels were measured by Oyama et al by competitive protein binding method. This study was done to investigate the effect of halothane anesthesia and surgery on human sex hormone by radioimmunoassay method. Serum testosterone levels measured at preanesthetic period, 60 minutes after anesthesia and surgery, and full recovery from anesthesia were 4. 18+/-l. 64 ng/ml, 4. 19+/-1.40 ng/ml and 3. 74+/-1. 65 ng/ml, respectively. No statistical significance was noticed each other. The obtained value of testosterone was the lowest compared with the values reported by other authors.

Observations in the Recovery Room according to Post-Anesthetic Recovery Score / 대한마취과학회지

A postanesthetic recovery score to provide objective information on the phsical condition of patients arriving in the recovery room after anesthesia. The status of the patients was judged after arriving in the recovery room and every 30minutes thereafter, until their discharge to the ward or Intensive Care Unit. To study this method, 324 patients were selected at random to include as many variants of anesthesia as possible. The patients were transported to the recovery room within 10 minutes of the completion of the anesthesia; Once there, the first score was made by the anesthesiologist. Thereafter, the evaluation was made by the same anesthesiologist. Depending on the length of stay in recovery room, this evaluation was repeated 30, 60, and 90 minutes after the patients arrival. The various signs were evaluated. The independent variables such as age, sex, physical status, anesthetic agents or technics, type of surgery, use of muscle relaxants, duration of anesthesia were correlated with the proportional number of patients receiving top or safe score 10, 9 or 8, and those given 7 or less, which were considered low or dangerous.

The recovery of brain damage caused by cardiac arrest during anesthesia / 대한마취과학회지

The recovery process of brain damage caused by an acute severe cerebral hypoxia has been reported in various literatures. And the possibility of complete recovery of such case was said to be good in younger age group than in adult's group. We experienced a case of cardiac arrest of a 12 year old girl during halothane anesthesia induction and the cardiac and pulmonary resuscitation was succeeded promptly. But the hypotensive period persted for few minutes before the diagnosis was made. The condition of the patient after the resuscitation was good except that her unconsciousness state persisted unusually. The proposed appendectomy performed uneventfully and the anesthesia recovery of the patient was carefully observed in our I.C.U. The uncoscious state lasted for 2 days with agitated movements of legs, EEG showed abnormal, irregular patterns but showed no signs of damage of gobus pallidum and putamen. During the first month, the order of recovery of cerebral function was comatous state, swallowing, eating, and urination. The cerebellar dysunction was prominent. Then recovery of amnesia and defection followed. Speech and gate started to regain in the 26 and 36 post-operative day respectively. Writing function started recover quickly with the recovery of speech function, which occurred in 4 to 6 post-operative months. Recovery of intelligence was slowest and gradually reached to the intelligent level of 11 year old child in one year. It was found the primitive function recovered first and the highly cultivated function recovered last.

Anesthesia or Kidney Transplantation - report of 5 cases / 대한마취과학회지

This is a report of anesthesia for five cases of renal transplantation which was performed between February 1969 and August 1969 at St. Mary's Hospital, Catholic Medical College, Seoul, Korea. General of renal insufficiency of the operated cases were described. Operative technique were unilateral nephrectomy for three cases and bilateral nechprectomy with splenectomy for 2 cases ; Anesthesia was induced with epontol (propanidid) 250mgs i.v. and 4% halothane-oxygen and maintained with 1% halotbane-oxygen which was supplemented by nitrous oxide occasionally. 6% dextrose and lactated-Ringer's solution were infused. For transfusion, whole blood was given to replace the operative blood loss. Dextran was also used to maintain adequate blood volume. Shortly before anastomosis of renal and femoral vessels, patients were haparinized. Fluids and electrolytes balance were studied pre-and post-operatively. Preoperatively, uremia and hyperpotassemia was corrected by several hemodyalysis. Urinary output after surgery showed a marked degree of diuresis up to 1800 ml/hr until second post-operative day. The special concern of anesthesia for kidney transplantation were: 1. Patients were suffering from severe uremia and metabolic disterbances. 2. Acidosis and hyperpotassemia should be corrected before surgery by hemo-or peritoneal dialysis. 3. Immunosuppressive agents made the patient less resistant to infection. 4. Anemia and hydrops was difficult to be corrected before surgery. 5. Muscle relaxants of choice were depolarizing agents, because of impaired renal excretion.