Measurement of bone mineral density(BMD) of the spine may be affected by the presence of various factors such as osteophytes, osteosclerosis and spinal deformity, particularly in elderly persons. Therefore the accurate evaluation for osteoporosis is difficult in osteoarthritic spine and until now no technique can evaluate true mineral density of the osteoarthritic spine. So we performed this study to evaluate the effect of osteoarthritic changes of the spine on the BMD and various BMD values such as young-adult% and age-matched%. Additionally we evaluated the diagnostic value of the Singhs index in the advanced osteoporotic spine. We reviewed 50 patients with advanced osteoporosis of the spine retrospectively and they were divided into two groups; one consisted of 22 patients with osteoporosis alone and the other consisted of 28 patients with osteoporosis and osteoarthritic change on the spine. The measured mean BMD value in AP plane and that expressed in relation to reference data for young adults(young-adult%) of the patients with arthritic and osteoporotic spine were significantly higher than those of the patients with osteoporosis alone. On the other hand, values expressed in relation to the age and sex matched mean reference data(age-matched%) were not significantly higher in group of patients with osteoporosis and osteoarthritic change, and Singh s index was not diagnostic for the osteoporosis of the spine. But young-adult% were significantly lower than agematched% even in the osteoarthritic group. We concluded that young-adult% is mare useful value for diagnosis of the advanced osteoporosis in the osteoarthritic spine.
Aged ; Bone Density* ; Congenital Abnormalities ; Diagnosis ; Hand ; Humans ; Osteoarthritis* ; Osteophyte ; Osteoporosis ; Osteosclerosis ; Retrospective Studies ; Spine*

No abstract available.

No abstract available.
Cytomegalovirus Infections* ; Cytomegalovirus*

No abstract available.
Meconium* ; Peritonitis*

BACKGROUND: A stenosis of left main coronary artery has critical prognostic importance. Recent reports on successful left main stenting are now challenging traditional treatment patterns for this lesion. We evaluated recent four-year trends in incidence, clinical, angiographic findings and treatment modalities in patients with left main coronary artery stenosis(LMS). METHODS: Patients who were diagnosed as a significant LMS at Yonsei cardiovascular hospital between 1996 and 1999 were analyzed retrospectively. RESULTS: The incidence of LMS during the period of 1996 to 1999 was 3.3%(n=24) and it was significantly higher than that of previous 15 years before 1996(p<0.01). The incidence of isolated ostial lesion was 0.28% and this lesion was more prevalent in young female patients with less risk factors compared with other types of LMS(p<0.01). After exclusion of the patients with an isolated ostial lesion, patients were grouped according to the lesion site: ostium, shaft, and shaft lesion extended to distal vessels. There were no differences in clinical and hemodynamic findings among these groups. Coronary artery bypass graft was performed in 141 patients(63%) and stent implantation in 16 patients(14%). CONCLUSION: The incidence of LMS has been increased. There was no difference in clinical and hemodynamic findings according to the types of LMS. Surgery is still a standard treatment, but in selected patients percutaneous coronary intervention can be another treatment option.
Constriction, Pathologic ; Coronary Artery Bypass ; Coronary Stenosis* ; Coronary Vessels* ; Female ; Hemodynamics ; Humans ; Incidence ; Percutaneous Coronary Intervention ; Retrospective Studies ; Risk Factors ; Stents ; Transplants

BACKGROUND: The use of a low-dose naloxone infusion concomitant with intravenous morphine PCA (patient-controlled analgesia) attenuates opioid-related side effects without reducing analgesic effects. The authors compared the incidence of morphine-related side effects and the quality of analgesia in adding low-dose naloxone, normal saline or droperidol to an IV fentanyl PCA regimen. METHODS: One hundred eight patients undergoing ocular plastic surgery were enrolled in the study. General anesthesia was induced and maintained with propofol TCI (target controlled infusion), vecuronium or pancuronium and nitrous oxide. After intubated, they received intravenous fentanyl as PCA. They were randomized to receive normal saline, droperidol or low-dose naloxone concomitant with IV fentanyl PCA. Verbal rating scores for pain, the degree of patients' satisfaction (1-4), nausea, vomiting, requests for antiemetics, urinary retention, pruritus and respiratory depression were recorded after 24 hours. RESULTS: There was no difference in the VRS (verbal rating score) for pain, degree of the satisfaction and the incidence of nausea, vomiting and requests of antiemetics among the three groups. There was no incidence of pruritus or respiratory depression. One subject developed urinary retention in the control group, and three cases in the droperidol group, but none was developed in the low-dose naloxone group. CONCLUSIONS: There was no difference in the prevention of postoperative nausea, or vomiting among the normal saline, droperidol, and naloxone groups with an IV fentanyl PCA. Low-dose naloxone, however, had a reducing effect on urinary retention; it may become an alternative choice according to the anesthesiologist's preference.
Analgesia ; Analgesia, Patient-Controlled* ; Anesthesia, General ; Antiemetics ; Droperidol ; Fentanyl* ; Humans ; Incidence ; Morphine ; Naloxone* ; Nausea ; Nitrous Oxide ; Pancuronium ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Propofol ; Pruritus ; Respiratory Insufficiency ; Surgery, Plastic ; Urinary Retention ; Vecuronium Bromide ; Vomiting

OBJECT: It is to evaluate the priority area for effective eye care service to the aged population of rural comniunity at present and in future. METHOD: Number of aged group surveyed on 60 and over 60 years age that, counted 531 among the total 580 patients. Visual acuity was tested and refractive error was measured by Retinornax (Nikon, Japan) . Ocular examination was performed to determine the causes of visual impairment. This survey was conducted under the auspices of the Korean Foundation for Prevention of Blindness with assistance of the Seoul National University Postgraduate School of Public Health from 1994 to 1996 at the Public Health Center of Chun-Cheon, Kang-Won Do(Province). RESULTS: Age distribution showed the sixties (60-69) 49,3%, the seventies (70-79) 33.9%, and the eighties (80) 16.8%. Proportion of visual acuity of 0.7 or upper in the better eyes constituted 32.2% and of 0.2 or worse 19.4%. Causes of visual impairnnente consisted of refractive errors 35. 9%, cataract 35. 9%, macular degeneration 7, 4%, and corneal opacity 3.9% in order. Contributed modes of care were spectacles 27.9%, surgeries 23.9% (cataract, operation, pterygium removal etc.), and medical treatment 23.9%. DISCUSSION: Surgery of the aged population in rural comrnunity of Chun-Cheon revealed the most. prevalent. causes of visual impairment as the refractive errors and cataract. It is suggested that. the most effective eye care would be provided systemically based 0 the result of the epidemiological study on the various ocular disorders.
Age Distribution ; Blindness ; Cataract ; Corneal Opacity ; Epidemiologic Studies* ; Eyeglasses ; Gangwon-do ; Humans ; Macular Degeneration ; Pterygium ; Public Health ; Refractive Errors ; Seoul ; Vision Disorders ; Visual Acuity

BACKGROUND: Optimal control for the management of the length of stay in the postanesthesia care unit (PACU) following general anesthesia in adults is an important strategy for surgical patients' care. A model to predict the results of the PACU stays could be used to improve the utilization of the PACU and resources of the operating room through a more efficient arrangement. The purpose of this study was to evaluate the performance of the decision tree based analysis using clinical sets of data from adult patients undergoing general anesthesia. METHODS: The decision tree was trained with 351 clinical sets (86% in 409 data sets) using a Chi-squared automatic interaction detection (CHAID) algorithm and validated through independent testing of 58 cases (14%). Twenty-two independent variables were used to find determinant variables and to predict categorical dependent values (lengths of stay in the PACU). RESULTS: The decision tree based analysis correctly predicted in 68% of real situations and identified influencing variables as intubation state, complication in the PACU, and intraoperative transfusion. CONCLUSIONS: We concluded that the decision tree based analysis could provide a useful predictive and classifying model for the optimization of limited resources of the PACU. The decision tree based analysis is an alternative way of classifying, and a predicting method for developing a model for lengths of stay in the PACU with easy interpretation and clear graphical displays of the structure of variables.
Adult ; Anesthesia, General ; Decision Trees ; Humans ; Intubation ; Length of Stay* ; Operating Rooms

PURPOSE: To report the results of preschool vision screening in South Korea in 2003. METHODS: Nation wide, population-based vision screening tests were conducted in preschool children over the age of 3 years from March to September 2003. The first step involved home-screening using picture cards. The children who did not pass the first test were sent to public health care centers, where their visual acuity was re-tested. After the re-tests, some children were referred to ophthalmologists. The referral criteria for visual acuity were: age 3, less than 0.5 visual acuity; age 4 or older, less than 0.63 visual acuity in at least one eye. RESULTS: Among 56,836 subjects who had been enrolled, 2,637 (4.6%) children were referred to ophthalmologists. Refractive error was found in 1,746 (66.2%) children. Amblyopia was discovered in 480 (18.2%) children. Anterior segment abnormalities were detected in 269 (10.2%) children, manifest strabismus was detected in 169 (6.4%) children, and fundus abnormalities were found in 17 (0.6%) children. Myopic astigmatism (31.0%) was the most common type of refractive error. Refractive error (87.9%) was the most common cause of amblyopia and exodeviation (63.9%) was the most common type of strabismus. CONCLUSIONS: From the results of the 2003 Preschool Vision Screening, we collected data about the ophthalmic abnormalities that can affect visual development in children. This information will foster improvement in the overall quality and design of preschool vision screening systems.
Amblyopia ; Astigmatism ; Child ; Child, Preschool ; Exotropia ; Humans ; Korea* ; Public Health ; Referral and Consultation ; Refractive Errors ; Strabismus ; Vision Screening* ; Visual Acuity

Two hundred sixty two patients of the essential blepharospasm and hemifacial spasm were treated with Botulinum toxin A (Oculinum(R)). A total of 620 treatments was given injections over a 3-year period. A reduction in spasm intensity was noted in most patients, and the mean response time of the essential blepharospasm and hemifacial spasm were 144.2 days and 172.3 days, respectively, There was no clear relationship between age, sex, toxin dose or preinjected spasm intensity, the amount of spasm reduction, and the mean response time. The mean respone time had no difference from the first through the fourth treatments; but in hemifacial spasm, the mean response time of the second treatment was longer than that of first, third and fourth treatments. The lagophthalmos and superficial punctate keratitis were the most frequent complications. As a result of the injection to avoid the center of the upper and lower eyelids, the frequency of complications could be minimized. There was no clear difference in the beneficial effect and the mcidence of complication (lagophthalmos) between toxin stored in the vaccum and in the non-vaccum state. Patients who were treated with lidocaine mixed toxin had a less effective result than those with saline-mixed toxin.
Blepharospasm* ; Botulinum Toxins* ; Eyelids ; Hemifacial Spasm* ; Humans ; Keratitis ; Lidocaine ; Reaction Time ; Spasm