No abstract available.
Child* ; Humans ; Visual Acuity*

Segmental Spinal Instrumentation(S.S.I.) is more effective means of managing unstable thoraco-lumbar spine fractures than traditional Harrington Rod Instrumentation as an operative procedure which afforded rigid internal fixation with stability and needed minimal external immobilization. Early return to normal activity and successful rehabilitation are facilitated by efficient stabilization with S.S.I. Fifty-nine patients with fractures and fracture-dislocations of thoraco-lumbar spine were treated by Harrington Rod Instrumentation (29 patients) and S.S.I. (30 patients) at this hospital from June 1979 to July 1984. We have analysed the results of these treatment and obtained following conclusions: 1. S.S.I. is more rigid internal fixation than Harrington Rod Instrumentation. a) no or minimal external immobilization b) early ambulation and rehabilitation c) lowered complications 2. There was no significant difference in correction rate, loss of correction, and neurologic recovery between Harrington Rod Instrumentation and S.S.I.
Early Ambulation ; Humans ; Immobilization ; Rehabilitation ; Spine ; Surgical Procedures, Operative

Tracheobronchial rupture following tracheal intubation with double-lumen endobronchial tube (DLT) is a rare complication, but may result in a massive air leakage with resultant pneumothorax, mediastinal emphysema and extensive subcutaneous emphysema in the postoperative period. We report a case of sustained laceration of the posterior membranous part of the trachea possibly due to overinflation of the double-lumen endobronchial tube. A 76-year-old, 45 kg, female was scheduled for a repair of her bronchopleural fistula. Following induction of anesthesia, intubation was performed with Robertshaw's DLT, and a tracheal cuff was inflated with 6 ml of air, but the sound of an air leak was heard coming from the patient's mouth during controlled ventilation. A further 5 ml of air was added 1 ml at a time into the tracheal cuff but the air leak sound continued. At that point, the sound was considered to originate from the bronchopleural fistula rather than from lack of sufficient air. After a thorough deflation of the tracheal cuff, 6 ml of air was reinjected and the operation was resumed. A 4 cm split was unexpectedly noticed in the posterior wall of the trachea during the operation and was repaired without complication.
Aged ; Anesthesia ; Female ; Fistula ; Humans ; Intubation ; Lacerations ; Mediastinal Emphysema ; Mouth ; Pneumothorax ; Postoperative Period ; Rupture* ; Subcutaneous Emphysema ; Trachea ; Ventilation

No abstract available.
Mercury Poisoning*

BACKGROUND: Because of improvement of economic state and eating habit changes in Korea, 60-70% of gallbladder stones are cholesterol stones. As ultrasonography was used increasingly, detection of asymptomatic gallstone were increased. There has been few studies about asymptomatic gallstone in Korea. So, this study was designed to obtain associated factor of prevalence of asymptomatic gallstone. METHODS: We screened adults over 20 years who were visited the health Promotion Center in a university hospital from May 1995 to May 1999. Subjects were defined as case group(584 subjects) who were diagnosed gallstone by abdominal ultrasonogaphy by radiologist. Control group(1153 subjects) were selected by random sampling from visitors of the Health Promotion Center. Every subjects were assessed with respect to gender, age, height, weight, fasting blood glucose, serum total cholesterol, high density lipoprotein-cholesterol, triglyceride. Social-Economic state, smoking were assessed by self-administered questionnaires. Associated factor of prevalence of asymptomatic gallstone were analyzed by Chi-square test and multiple logistic regression. RESULTS: Age, BMI(Body Mass Index), fasting blood glucose were associated with gallstone by Chi-square test(P<0.05). Multiple logistic regression showed that prevalence of asymptomatic gallstones was increased by age(>40 years old) and were associated with BMI(>25 kg/m2), fasting blood glucose. CONCLUSION: Associated factors of prevalence of asymptomatic gallstone were increased by age(>40 years old) and were associated with BMI(>25 kg/m2), fasting blood glucose, and were not different from those in West countries. further studies will be needed about associated factors according to the composition of gallstone and developing from asymptomatic gallstone to asymptomatic gallstone.
Adult ; Blood Glucose ; Cholesterol ; Eating ; Fasting ; Gallbladder ; Gallstones* ; Health Promotion ; Humans ; Korea ; Logistic Models ; Prevalence* ; Smoke ; Smoking ; Triglycerides ; Ultrasonography ; Surveys and Questionnaires

BACKGROUND: Though the mivacurium is the short acting nondepolarizing neuromuscular blocking agent, the action duration of it is not prospected in condition of hepatic failure owing to its being metabolized by serum cholinesterase and other esterase produced in liver. The purpose of this study is to evaluate neuromuscular effect of the mivacurium in cats with acute hepatic failure. METHODS: Six cats administrated only mivacurium are the control group, and six cats with acute hepatic failure by galactosamine hydrochloride are the experimental group. The force of the anterior tibialis muscle in response to supramaximal common peroneal nerve stimulations were recorded, the time intervals from mivacurium administration to attain 100% twitch depression (onset time), from mivacurium administration to recovery of 25% twitch tension (duration) and from 25% to 75% of twitch recovery (recovery index) were compared between the control group and the experimental group. RESULTS: In experimental group, SGOT and SGPT prior to administration of galatosamine were 28.8+/-5.6 (IU/L) and 43.0+/-7.9 (IU/L), respectively, SGOT and SGPT in acute hepatic failure were 5004.0+/-8113.2 (IU/L) and 3763.0+/-5416.4 (IU/L), respectively, and there were significant differences between the control group and the experimental group. The action duration{47.6+/-18.0 (min)} and the recovery time{7.7+/-3.7 (min)} of mivacurium in the experimental group were more prolonged than the action duration{21.9+/-5.0 (min)} and the recovery time{4.4+/-0.7 (min)} of mivacurium in the control group. CONCLUSIONS: These results indicate that the hepatic failure can prolong the action duration and the recovery index of mivacurium, but the other factors affecting the action of mivacurium must be studied.
Alanine Transaminase ; Animals ; Aspartate Aminotransferases ; Cats* ; Cholinesterases ; Depression ; Galactosamine* ; Liver ; Liver Failure ; Liver Failure, Acute* ; Neuromuscular Agents ; Neuromuscular Blockade* ; Peroneal Nerve

BACKGROUND: The number of illegal migrant workers has been increasing in Korea since late 1997 in what was called the IMF era. This study was conducted to evaluate and to recognize the medical utilization and health Status for migrant workers in Korea. The goal of this study was to understand the epidemiological characteristics of the migrant workers and family physician's role as a health provider and gate keeper to them and to provide basic data for public health policy. METHODS: In September 1999, self-administered questionnaires were distributed to the migrant workers in Seoul, Sung-Nam, Pucheon and An-Yang. We classified the reasons for clinical encounters and the prescribed drugs by reviewing the medical records of all patients who visited a clinic of shelter for migrant workers in Sung-Nam from January to December 1998 and analysed the report according to death certification of the shelter for migrant workers in Sung Nam from 1994 to September 1999 RESULTS: The major distribution of nationality were from China, Mongo, and Bangladesh (86.9 %). They were mostly between 30 and 39 years old, males are, and unmarried. Most had high school education. The average income was 756,700 won and the average working hours were 11.5 hours per day in migrant workers being in worse condition than those of Korean workers. Classified according to systems, the respiratory(21.2%), musculoskeletal (20.6%), digestive(15.8%), and cardiovascular(12.5%) symptoms were common. Repayment for death was different between before (87.7%) and after IMF era (13.0%), in late 1997. Average medical expenditure was 43,552 won comprising 5% of the total income of subjects only. Most of them did not benefit from medical insurance. CONCLUSION: Migrant workers' situation seemed poor. The patterns of the disease' were similar to those who visit family medicine clinics in general. Family physicians should take more interest in providing a more effective and better care to migrant workers.
Adult ; Bangladesh ; Certification ; China ; Education ; Ethnic Groups ; Gyeonggi-do ; Health Expenditures ; Humans ; Insurance ; Korea* ; Male ; Medical Records ; Physician's Role ; Physicians, Family ; Public Health ; Seoul ; Single Person ; Transients and Migrants* ; Surveys and Questionnaires

No abstract available.
Thorax*

OBJECTIVE: This study was performed to elucidate the technical and patient-specific risk factors for postoperative ischemia in patients undergoing temporary arterial occlusion (TAO) during the surgical repair of their aneurysms. METHODS: Eighty-nine consecutive patients in whom TAO was performed during surgical repair of an aneurysm were retrospectively analyzed. The demographics of the patients were analyzed with respect to age, Hunt and Hess grade on admission, Fisher grade of hemorrhage, aneurysm characteristics, timing of surgery, duration of temporary occlusion, and number of temporary occlusive episodes. Outcome was analyzed at the 3-month follow-up, along with the occurrence of symptomatic and radiological stroke. RESULTS: In overall, twenty-seven patients (29.3%) had radiologic ischemia attributable to TAO and fifteen patients (16.3%) had symptomatic ischemia attributable to TAO. Older age and poor clinical grade were associated with poor clinical outcome. There was a significantly higher rate of symptomatic ischemia in patients who underwent early surgery (p = 0.007). The incidence of ischemia was significantly higher in patients with TAO longer than 10 minutes (p = 0.01). In addition, patients who underwent repeated TAO, which allowed reperfusion, had a lower incidence of ischemia than those who underwent single TAO lasting for more than 10 minutes (p = 0.011). CONCLUSION: Duration of occlusion is the only variable that needs to be considered when assessing the risk of postoperative ischemic complication in patients who undergo temporary vascular occlusion. Attention must be paid to the patient's age, grade of hemorrhage, and the timing of surgery. In addition, patients undergoing dissection when brief periods of temporary occlusion are performed may benefit more from intermittent reperfusion than continuous clip application. With careful planning, the use of TAO is a safe technique when used for periods of less than 10 minutes.
Aneurysm ; Brain Ischemia ; Craniotomy ; Demography ; Follow-Up Studies ; Hemorrhage ; Humans ; Incidence ; Intracranial Aneurysm ; Ischemia ; Reperfusion ; Retrospective Studies ; Risk Factors ; Stroke ; Troleandomycin

No abstract available.
Humans