Momordica charantia is therophyte vine plants. It is called natural insulin and contains carantine and vitamin C and so on. Momordica charantia is one of the representative subtropical crops as a functional crop, showing efficacy on improvement of diabetes, cancer, abdominal obesity and improvement of hypertension. According to climate change, Momordica charantia is growing cultivation area, but there is still insufficient research for insect pest occurrence and insecticides. Due to the lack of proper control measures, the damage caused by insect pests is increasing as the year goes by. This study was conducted to investigate the occurrence and damage of insect pests in Momordica charantia and utilize it as basic data for development of insect pest control technology. As a result, 5 orders of 13 species of insect pests were investicated. Among them, Aphis gossypii, Frankliniella intonsa, and Frankliniella occidentalis showed high density. In particular, Aphis gossypii showed the highest density in mid-May, also Frankliniella intonsa and Frankliniella occidentalis showed high density in the middle of June. The leaf damage caused by the larvae of Palpita indica was observed in late June. After mid July, the biginning of the high temperature period, the insect pest density decreased, but the damages caused by moths were severe.

This is the case report of a 58-year-old man who developed acute severe hypoglycemia after a spinal block. He had a history of injecting insulin combined with 50% dextrose for hyperkalemia control. After the spinal block, he presented with hypo-glycemic symptoms and went into convulsions. Following injection of midazolam and 10 ml of 50% dextrose, his mental state returned to alert. We recommend careful monitoring of blood sugar level of chronic kidney disease patients who under-go neuraxial block.

We experienced an 18-month-old patient with congenital lobar emphysema who underwent one-lung ventilation. With con-sideration that positive pressure ventilation could induce cardiopulmonary distress, induction was performed with spontane-ous breathing using sevoflurane without neuromuscular blocking agent. Bronchospasm occurred after intubation and posi-tion change, twice. He was relieved by administration of neuromuscular blocking agents. We discussed induction methods with minimal positive-pressure ventilation and the treatments for bronchospasm.

In treatment of right ventricular failure with pulmonary hypertension, milrinone has not only an inotropic effect but also a vasodilating effect, thus, recently, it has been widely used. Recent studies have reported on the direct stimulation effects of doxapram on the central nervous system. A 91-year-old female underwent hemiarthroplasty under spinal anesthesia. When transported to the recovery room, right ventricular failure, cardiogenic shock, and mental deepening occurred. After stabiliz-ing vital signs, milrinone, doxapram was administered. We report on the effective use of milrinone for acute right ventricular failure and the active use of doxapram for reduced consciousness and hypoventilation.