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Background: The depth of anesthesia is an essential factor in surgical prognosis. The neurotoxic effect of chemotherapeutic drugs affects the sensitivity to anesthetics. This study was conducted to determine whether the effect-site concentration (Ce) of propofol for loss of consciousness (LOC) differs in patients undergoing preoperative chemotherapy. Methods: A total of 60 patients scheduled for surgery for colorectal cancer under general anesthesia were included in this study. Patients who had received chemotherapy comprised the experimental (C) group, and those without a previous history of chemotherapy comprised the control (N) group. Propofol was administered as an effect-site target-controlled infusion, and the Modified Observer’s Assessment of Alertness/Sedation (MOAA/S) scores were evaluated. When the plasma concentration and Ce were similar, and if the MOAA/S score did not change, the target Ce was increased by 0.2 μg/ml; otherwise, the Ce was maintained for 2 min and then increased. Results: The Ce values of propofol for loss of verbal contact (LVC) in groups C and N were 2.40 ± 0.39 and 2.29 ± 0.39 μg/ml (P = 0.286), respectively, and those for LOC in groups C and N were 2.69 ± 0.43 and 2.50 ± 0.36 μg/ml (P = 0.069), respectively. No significant difference was observed in Ce values between the two groups.Conclusions: Chemotherapy had no effect on the Ce of propofol for LVC and LOC in patients with colorectal cancer. We do not recommend reducing the dose of propofol for the induction of LOC in patients with colorectal cancer undergoing chemotherapy.

Background: Postoperative sore throat (POST) is a complication that decreases patient satisfaction and increases postoperative complaints. The present study was conducted to investigate effects of gargling with dexamethasone, intravenous dexamethasone injection and the combination of the two on the incidence and severity of POST.Methods: Study participants were 96 patients who had undergone laparoscopic cholecystectomy, randomly allocated into three groups. Group G gargled with 0.05% dexamethasone solution and were infused intravenous 0.9% normal saline before general anesthesia; group I gargled with 0.9% normal saline and were infused intravenous 0.1 mg/kg dexamethasone; group GI gargled with 0.05% dexamethasone solution and were infused intravenous 0.1 mg/kg dexamethasone. The incidence and severity of POST, hoarseness and cough were evaluated and recorded at 1, 6, and 24 h after the surgery.Results: There were no significant differences in the total incidence of POST up to 24 postoperative hours among Group G, Group I and Group GI (P = 0.367, Group G incidence = 34.38%, [95% confidence interval, 95% CI = 17.92–50.83], Group I incidence = 18.75%, [95% CI = 5.23–32.27], Group GI incidence = 28.13%, [95% CI = 12.55–43.70]). The other outcomes were comparable among the groups.Conclusions: In patients who had undergone laparoscopic cholecystectomy, gargling with 0.05% dexamethasone solution demonstrated the same POST prevention effect as intravenous injection of 0.1 mg/kg dexamethasone. The incidence and severity of POST were not significantly different between the combination of gargling with 0.05% dexamethasone solution and intravenous injection of 0.1 mg/kg dexamethasone and use of each of the preventive methods alone.

Background: Higher levels of anxiety increase the risks of surgery, including morbidity and mortality. The objectives of this study were to measure anxiety and depression during the preoperative period and to identify the degree of knowledge and concerns of older patients and their family protectors regarding anesthesia, and the causes of these concerns. Methods: We administered a questionnaire to older patients scheduled to undergo surgery and their family protectors one day prior to the surgery. The questionnaire included tools for quantifying anxiety and depression (Anxiety-Visual Analogue Scale, the Amsterdam Preoperative Anxiety and Information Scale, State-Trait Anxiety Inventory Korean YZ Form, and Short Form Geriatric Depression Scale). We also asked about the concrete causes of anxiety using pre-created forms.Results: There were 140 older patients and family protectors who participated in the study. The majority of older patients (n = 114, 81.4%) undergoing surgery and their family protectors (n = 114, 81.4%) indicated that they were anxious. Most of the older patients and their family protectors responded that they had insufficient knowledge about anesthesia, and they were mostly worried about failure to awaken following surgery, and postoperative pain. Older patients with higher anxiety scores showed higher depression scores. There were significant differences in depression scores depending on the presence of cohabitating family members. Conclusions: It is important to remember that older patients with higher depression scores have higher anxiety during the preoperative period.

Background This clinical trial was conducted to determine whether combined use of magnesium sulfate and vitamin C more significantly reduced postoperative fentanyl consumption and pain than magnesium sulfate or vitamin C alone. Methods The prospective, double-blinded, randomized controlled study enrolled 132 patients scheduled for laparoscopic gynecologic surgery. The patients were randomly allocated to one of the four groups (n = 33 for each group; Group M [magnesium sulfate 40 mg/kg], Group V [vitamin C 50 mg/kg], Group MV [magnesium sulfate 40 mg/kg and vitamin C 50 mg/kg] and Group C [isotonic saline 40 ml]). Cumulative postoperative fentanyl consumption (primary endpoint measure), postoperative pain score by numeric rating scale, and postoperative nausea and vomiting were recorded at 1, 6, 24, and 48 h after discharge from the postanesthesia care unit. Results Cumulative postoperative fentanyl consumption was significantly less in Groups M, V, and MV than in Group C at all time points. Group MV showed significantly less cumulative postoperative fentanyl consumption than Group M at postoperative 24 h (mean ± standard deviation, 156.6 ± 67.5 vs. 235.6 ± 94.6 µg, P = 0.001), as well as significantly less consumption than Groups M and V at postoperative 48 h (190.8 ± 74.6 vs. 301.0 ± 114.8 or 284.1 ± 128.6 µg, P < 0.001, P = 0.003, respectively). Conclusions Combined use of magnesium sulfate and vitamin C provides an additional benefit in postoperative pain management after laparoscopic gynecologic surgery in comparison to single administration of magnesium sulfate or vitamin C.

Optimum processing conditions were obtained by evaluating the hot working behavior of commercially pure Ti using hot torsion tests. Hot torsion tests were conducted at temperatures ranging from 800 °C-1000 °C and strain rates ranging from 0.1-10 s-1. The flow curves show that the peak stress increases as the temperature decreases and the strain rate increases. The optimum processing conditions were derived by comparing the processing and activation energy maps. The microstructure was characterized based on various regions of the processing map. The activation energy for plastic deformation was obtained using the constitutive equation. The activation energy differs depending on the constituent phases.

Hot torsion tests were performed on an Al-Zn-Mg alloy modified with CaO-added Mg to investigate the effects of the Mg additive on the high temperature deformation characteristics. Effective stress- strain curves and processing maps were established from the experimental results under a range of deformation conditions. The fracture strain of the CaO-added Al-Zn-Mg alloy was higher than that of the Al-Zn-Mg alloy. The CaO-added Al-Zn-Mg alloy did not show an instability region in the processing map but the commercial Al-Zn-Mg alloy exhibited adiabatic shear bands at low temperatures and at a high strain rate. The results shown in this study were attributed to the reduction of the second phase by the addition of CaO-added Mg.

Many investigators have demonstrated that a large number of patients who experience anaphylaxis during anesthesia have a history of atopic disease or allergy to a specific substance. Here, we review a hypersensitivity reaction to ketamine in a nine-year-old child with a history of atopic disease.

정보화 사회의 도래로 아카이브 기관은 대국민 서비스의 일환으로 디지털 기술을 도입하여 보존과 전시에 활용하기에 이르렀다. 본 연구의 목적은 급변하는 기술의 발전으로 인하여 아카이브 전시에 다양한 디지털 기술을 사용하는 것에 대한 필요성을 고찰하는 것이다. 이를 위해 아카이브와 디 지털 전시의 개념과 유형을 살펴보고, 아카이브에 디지털 전 시방법을 사용할 때 그 활용도를 조사하였다. 또한 구체적인 기록물관 리기관의 디지털 전시사례를 조사하였다. 아카이브자료를 웹 페이지를 통하여 전시했을 때 가장 큰 장점은 기록물이 가지는 본연의 정보 제공의 기능과 더불어 하이퍼링크 기술을 통한 정보의 무한 확장성을 들 수 있다. 디지털전시의 방법으로 가상현실은 평면적인 아카이브에 입체감과 현실감을 넣어 이 용자의 흥미와 관심을 불러일으킨다. 또한 스토리텔링은 온라인상에 이용자와의 커뮤니케이션의 장을 만들어 서로 상호작용을 하며 이 과정까지도 스토리에 반영되어 새로운 콘텐츠로 탄 생된다. 이러한 일련의 기능들이 아카이브에 대한 관심과 흥 미를 높여 이용자들의 정보의 공유, 참여를 가져오고, 더불어 디지털 전시를 통한 새로운 콘텐츠 자원은 문화 자원과 관광 자원으로 지역사회와 기관을 홍보하므로 아카이브 전시에 다양한 디지털 기술을 사용하는 것은 그 의의가 있다.주제어: 아카이브, 디지털 전시, 스토리텔링, 가상현실(VR), 커뮤니케이션, 콘텐츠 자원

Background Reduction of intraoperative bleeding is necessary to achieve the ideal surgical field for the endoscopic sinus surgery (ESS). Intraoperative intra nasal bleeding is influenced by various anesthetics. This study compared surgical field condition between propofol/remifentanil (PR) based anesthesia and desflurane/remifentanil (DR) based anesthesia. Methods American Society of Anesthesiologists physical status class I or II patients undergoing ESS were randomly assigned to group PR (n = 36) or group DR (n = 32). The extent of the preoperative surgical lesion was classified as high (> 12) and low (≤ 12) Lund-Mackay (LM) scores according to the computed tomography findings. The target mean blood pressure was maintained at 70-80 mmHg. Only one surgeon was involved in rating the visibility of the surgical field on a numeric rating scale (NRS) every 10 minutes. Results There was a different surgical field grade from PR to DR. The mean (SD) surgical field score of NRS for the PR and DR was 2.3 (0.57) and 2.7 (0.67), respectively (P = 0.006). Especially in the high-LM score patients, the mean (SD) of surgical field score for the PR and DR was 2.4 (0.67) and 3.0 (0.63), respectively (P = 0.012). Conclusions In the high-LM score patients, PR based anesthesia resulted in better surgical field condition for ESS than DR based anesthesia. In ESS, PR based anesthesia is considered to be helpful.

Povidone-iodine (polyvinylpyrrolidone iodine, PI), which is commonly used as a pre- and postoperative oral antiseptic, has been reported to cause pneumonia secondary to its pulmonary aspiration. Because no studies have yet investigated the underlying mechanisms of PI-induced pneumonia, we conducted an animal study to analyze the effect of PI on the lung following its pulmonary instillation. The lungs of 61 male Sprague–Dawley rats (150–250 g) were instilled with varying volumes of either phosphate-buffered saline or PI solutions varying in strength from 0.01% to 10%. The lungs were harvested from the rats 1 h or 1, 3, 5, 7, 14, or 21 days after instillation for radiologic examination, macroscopic and light and scanning electron microscopic assessment, and an assessment of pulmonary toxicity using an MTT-based cytotoxicity assay. Macroscopically, atelectasis was the primary pulmonary lesion after PI instillation. The primary light and scanning electron microscopic findings were an initial inflammatory phase with edema, alveolar rupture, and leukocyte infiltration into the pulmonary interstitium, which progressed into a phase of lung parenchyma loss, and then resolved itself with scar tissue formation. Lung tissue viability following 1-day exposure to 0.01%, 0.1%, 1%, or 5% PI progressively decreased in a significant dose-dependent manner. PI aspiration can cause lung injury, including pulmonary fibrosis.

Background: Pain after laparoscopy is multifactorial and different treatments have been proposed to provide pain relief. Multimodal analgesia is now recommended to prevent and treat post-laparoscopy pain. Dexamethasone is effective in reducing postoperative pain. The timing of steroid administration seems to be important. We evaluated the analgesic efficacy of preoperative intravenous dexamethasone 1 hour before versus during laparoscopic cholecystectomy with multimodal analgesia. Methods: One hundred twenty patients aged 20 to 65 years old were allocated randomly into one of three groups (n = 40, in each). The patients in the group N received normal saline 1 hour before induction and after the resection of gall bladder. The patients in the group S1 received dexamethasone 8 mg 1 hour before induction and normal saline after the resection of gall bladder. The patients in the group S2 received normal saline 1 hour before induction and dexamethasone 8 mg after the resection of gall bladder. Results: VAS scores of group S1 and S2 were lower than that of group N during 48 hours after laparoscopic cholecystectomy. There were no significant differences of VAS scores between the group S1 and the group S2. The analgesic consumption of group S1 and S2 were significantly lower than that of group N. Conclusions: A single dose of dexamethasone (8 mg) intravenously given 1 hour before induction or during operation was effective in reducing postoperative pain after laparoscopic cholecystectomy with multimodal analgesia. The analgesic efficacy of preoperative intravenous dexamethasone 1 hour before versus during surgery was not significantly different. (Korean J Anesthesiol 2011; 61: 315-319)

The use of ketamine may be associated with the recall of unpleasant dreams after sedation. We hypothesized that a positive suggestion before sedation could reduce the incidence of ketamine-induced unpleasant dreams. To test this hypothesis, we randomized 100 patients receiving sedation with ketamine for their procedure into 2 groups with 1 group having an anesthesiologist provide a mood-elevating suggestion to the patient before ketamine administration (suggestion group), whereas in the control group no suggestion was provided. Patients were provided with a pleasantness/unpleasantness scale to rate "the overall mood of the dream" as very unpleasant (grade 1), quite unpleasant (grade 2), neither or mixed (grade 3), quite pleasant (grade 4), and very pleasant (grade 5). In those patients who lost consciousness, the frequencies of grades 1, 2, 3, 4, and 5 were 0%, 0%, 46%, 24%, and 30% in the suggestion group and were 6%, 2%, 70%, 12%, and 10%, respectively, in the control group (P=0.01). In the intent-to-treat population the overall frequency between groups was very similar. This study implies that when administering ketamine as part of a sedation regimen, positive suggestion may help reduce the recall of unpleasant dreaming.

This article intends to explore the meaning of record and role of record management in electronic record environments, based on appraisal theory of Records Continuum. Appraisal theory of Records Continuum can provide to explore the mean of record and role of record management in new social environment. And it try to build the Concept of archival contents for expanding the meaning and utilization of record based on appraisal theory of Records Continuum.

This article minutely examines functional appraisal process tha t focuses on not content but function in which the records are created. Taking everythin g into consideration, functional appraisal in electronic record environments constitu tes consecutive process that is performed organically in pre-creation stage of records. Ultimately functional appraisal in electronic record environments is organic process selecting electronic records across phases of whole record management, which assure business context and recordness, and need to run organization and perform business. KEYWORDS Electronic Record, Electronic Record Environment, Record, Archi ve, Record Management, Appraisal, Functional Appraisal, Appraisal System 1. 서론 기록물의 평가는 무수히 많은 양의 기록물 가운데 일정 가치를 지닌 대상을 한정시켜 보존케 하는 과업이라는 점에서, 평가의 논리 및 방식은 시대 및 환경에 대응하며 부단히 변모해왔다. 21세기 전자기록 환경을 맞아 기존의 종이기록에 기반을 두어 온 평가 논리 및 방식 역시 변화가 불가피하게 되었다. 즉 개별 기록물의 내용적 가치에 바탕을 둔 사후적 평가는 전자기록의 특성상 원론적으로 적용할 수 없기 때문이다. 이와 더불어 평가의 개념 역시 부분적인 수정이 요구되고 있다. 지금까지 라이프사이클과 결부된 평가 논리는 생산 목적과는 상관없는 역사적⋅문화적 가치를 지닌 대상, 즉 아카이브(Archive)를 선별하는 행위로 인식되어 왔다면, 컨티뉴엄 사고에 토대를 둔 전자기록 환경에서의 평가는 종래의 이차적 가치뿐만 아니라 현용적 가치 역시 새롭게 주목받고 있기 때문이다(김명훈 2008).이러한 상황에서 전자기록 환경에서의 평가방식으로 새롭게 주목받고 있는 것은 기능평가(Functional Appraisal)이다. 기능평가는 개별 기록의 내용적 가치에 따른 평가를 지양하고, 기록이 생성된 기능상의 중요도를 기반으로 중요 기록물을 선별하는 방식이다. 기능평가는 전자기록의 증거성 확보를 위해 행해지는 사전적인 업무분석과 밀접히 연계되어 수행된다는 점에서, 전자기록 환경에서 필연적 평가방식으로 자리하고 있다. 이를 반영하듯 전자기록 환경 하의 국제 기록관리 표준으로 전세계적으로 수용되고 있는 ISO 15489에서는 기

This article intends to provide a direction for reconstructing the national regime of archival appraisal in electronic record environments. Functional appraisal, which inevitably carries out for appraising electronic records, has defects in aspect of selecting archives important in a national point of views. To do so, this article discusses defects of functional appraisal, and then suggests the necessity of archival appraisal strategies that complements functional appraisal. To investigate this archival appraisal strategies, it analyzes Australia`s Whole-of-Government Functional Analysis, United Kingdom`s Acquisition Policy and Appraisal Policy, Germany`s Cooperative Cross-Archives Appraisal and Canada`s Macro Appraisal. Ultimately, this analysis is able to establish a base of the regime of archival appraisal which will harmonize primary value at current stage with secondary value at non-current stage in a national point of views.

This article analyzes the direction of `business-Friendly` record management in electronic records environment which means paradigm shift in record management. In the first place, this article investigates the interrelationship of business, records and record management through natures of electronic records, and analyzes direction of purposes and roles of record management in electronic records environment. After all, this article rebuilds a significance and roles of record management in active stage, and provides theoretical bases for close relation between record management and information management in electronic records environment.

We propose a simple and scalable scheduler called Elapsing Time-based Priority (ETP) scheduler for the optical burst switch (OBS) control channel; it eliminates the requirements of global synchronization and core-state information. This scheduler reduces edge-to-edge delays of burst control packets and total latencies of data bursts.

Myocardial infarction (MI) results in the substantial loss of functional cardiomyocytes, which frequently leads to intractable heart disorders. Cardiac stem cells (CSCs) that retain the capacity to replace all cardiac cells might be a promising strategy for providing a source of new functional cardiomyocytes; however, the poor survival and engraftment of transplanted CSCs in the hostile environment of MI critically mitigate their therapeutic benefits. To capitalize their therapeutic potential, an ex vivo strategy in which CSCs were introduced to the recombinant heat shock protein 27 (Hsp27) through a TAT protein transduction domain for increasing the viability and engraftment in the infarcted myocardium was designed. A recombinant TAT fused Hsp27 (TAT-Hsp27) was able to enter CSCs in a dose-dependent manner. CSCs transduced with TAT-Hsp27 expressed not only endogenous Hsp27 but externally introduced Hsp27, resulting in substantial increase of their anti-oxidative and anti-apoptotic properties via suppressing reactive oxygen species production, the MAPKs signaling pathway, and caspase activation. TAT-Hsp27 enabled CSCs to be protected from apoptotic- and hypoxic-induced cell death during in vitro cardiomyogenic differentiation. In vivo studies demonstrated that CSCs transduced TAT-Hsp27 significantly increased the survival and engraftment in the acutely infarcted myocardium, which is closely related to caspase activity suppression. Finally, CSCs transduced TAT-Hsp27 improved cardiac function and attenuated cardiac remodeling in comparison with non-transduced CSCs. Overall, our approach, which is based on the ex vivo intracellular transduction of TAT-Hsp27 into CSCs before myocardial delivery, might be effective in treating MI.