BACKGROUND: The elderly is known to have many different clinical laboratory data compared with the young adults. But, in Korea, such study is lacking. METHODS: We gathered 98 healthy elderly cases and 98 healthy young adult controls who have taken periodic health examination from January 1993 to May 1996 at one hospital and we compared the mean of various clinical laboratory data between the two groups. RESULTS: In both sexes, cholesterol, ESR, glucose were significantly higher in the elderly t,han in the controls and direct bilirubin was significantly lower in the elderly than in the controls(P<0.05). In men, albumin, calcium, hemoglobin were significantly lower in the elderly than in the controls and MCV was significantly higher in the elderly than in the controls(P<0.05). In women, alkaline phosphatase, LDH, triglyceride, GOT, GPT, T3,TSH, phosphate were significantly higher in the elderly than in the controls and total bilirubin, protein, uric acid were significantly lower in the elderly than in the controls(P<0.05). WBC count, platelet count, neutrophil count(%), lymphocyte count(%), eosinophil count (%), monocyte count(%), MCH, MCHC, BUN, creatinine, HDL were not significantly different between two groups. CONCLUSIONS: Many clinical laboratory data are different between the elderly and the young adults, and some clinical laboratory data have sexual differences.
Aged* ; Alkaline Phosphatase ; Bilirubin ; Calcium ; Cholesterol ; Creatinine ; Eosinophils ; Female ; Glucose ; Humans ; Korea ; Lymphocytes ; Male ; Monocytes ; Neutrophils ; Platelet Count ; Triglycerides ; Uric Acid ; Young Adult*

In our series with old electrical burn around the the wrist, there are several characteristics: for example, bad scarring in palm and volar aspect of wrist and distal forearm, large multiple defects of the flexor tendons, low median and ulnar nerve palsy, and occasionally insufficient blood supply. Between 1992 and 1995, we treated 8 cases of 7 patients with staged reconstruction. 4 patients with bilateral involvements had below-elbow amputee of contralateral upper extremity. The common approachs in each were soft tissue coverage, staged tendon reconstructiuon, and opponensplasty. The length of time between the injury and tendon reconstruction was 9 months on an average. Soft tissue coverage consisted of: 1. free tissue transfer (n=3), 2. abdominal (n=3) or groin (n=2). Total numbers of flexor tendon reconstruction were 26. Among them, staged reconstruction using silicone prosthesis were done in 18 tendons and primary tendon graft following tenolysis were done in 8 tendons. The time between first and second stage tendon reconstruction was 4.13 months. In all cases, opponen-splasty using extensor indicis proprius (n=4), extensor pollicis longus (n=2), and extensor digiti mini- mi (n=l), were performed. Good functional improvement of the hand were obtained in all cases. Patient s satisfaction were much better than the degree of functional improvement of the hand.
Amputees ; Burns* ; Cicatrix ; Forearm ; Groin ; Hand ; Humans ; Prostheses and Implants ; Silicones ; Tendons ; Transplants ; Ulnar Neuropathies ; Upper Extremity ; Wrist*

The study examined the effects of San-Yin- Jiao(SP-6) acupressure treatment on labor pain, length of delivery and anxiety for women in the labor. The effects of using SP-6 acupressure were evaluated by comparing two groups, a SP-6 acupressure group (22) and a control group (17), for a total of 39 women in labor who had a normal vaginal delivery. Data were collected using a structured questionnaire which included general characteristics, a subjective labor pain scale, measurement of duration of delivery time and a subjective anxiety scale. Data were collected before treatment (pre) and after treatment (post). The results of this study are summarized as follows : 1. The post-scores for total labor pain increased over the pre-scores but the difference between the two groups was not statistically significant(p=0.219). Wilcoxon signed rank test of the difference in pre-post labor pain scores for the SP-6 acupressure group was not statistically significant (p=0.081) but the increase for the control group was statistically significant (p=0.001).2. The length of time for the delivery in the group which had the SP-6 acupressure was shorter (143.91+/-67.77) than the control group (197.94+/-89.64). The difference between the two groups was statistically significant (p=0.028).3. The post-scores for anxiety increased over the pre-scores but the difference between the two groups was not statistically significant (p=0.426). The scores of SP-6 acupressure group did not show a significant increase by the Wilcoxon signed rank test (p=0.194) but in the control group showed a significant increase (p=0.008).This study showed that SP-6 acupressure was effective in relation to labor pain, length of time for delivery and anxiety for labor women. But it is necessary to replicate the study with a larger number of participants to generalize the results.
Acupressure* ; Anxiety* ; Female ; Humans ; Labor Pain* ; Pilot Projects* ; Pregnancy ; Surveys and Questionnaires

Acinetobacter species encounters frequently with clinical specimens and now accounts for a substantial proportion of endemic nosocomial infections in Korea. Recent trends indicate that the antimicrobial resistant strains of Acinetobacter species are increasing. Sixty-one strains were isolated from specimens of patients suspected of nosocomial infections during 1991 to 1996. At present, phenotypic identification of Acinetobacter using biochemical test may not be reliable and resulted in the difficulty to clarify the source of infections and epidemiological study of hospital-acquired infections. Aware of the importance of rational taxonomic proposal for these isolates, correct species identification of these organisms by molecular typing method was carried out. A total of fifty-four strains of A. calcoaceticus-A. baumannii complex species which were identified to genospecies 2 and 13 by biochemical characteristics was subjected to identify by ribotyping using restriction endonuclease EcoRI, ClaI, and SalI. Of fifty-four strains, twenty-five strains were identified as A. baumannii (genospecies 2) and twenty-one strains as genospecies 13, and six strains changed to genospecies 3, and the rest two strains were confirmed as A. haemolyticus (genospecies 4). This result suggests that the ribotyping may be of value for identification of genospecies and epidemiological information of Acinetobacter strains.
Acinetobacter baumannii* ; Acinetobacter calcoaceticus* ; Acinetobacter* ; Cross Infection ; DNA Restriction Enzymes ; Humans ; Korea ; Molecular Typing ; Ribotyping*

Lipoprotein(a) [Lp(a)] is considered an additional, independent and largely genetically determined risk factor for the development of premature coronary heart disease. Furthermore abnormal plasma lipoprotein patterns have been associated with increased risk for developing coronary heart disease. Among these lipoproteins, an increased concentration of serum Apo B and decreased level of Apo A are considered as major risk factors. together with elevated serum cholesterol and decreased HDL cholesterol. The aim of this study is to assess serum Lp(a) levels in newborns and to observe their evolution between brith, 7 days and 1 month in 64 healthy newborns by using ELISA method, Other lipid profiles were also measured and compared with feeding formula methods. The results obtained were as follows: 1) There were no significant changes from birth to 7 days, but was increased significantly after 7 days to 1 month of serum Lp(a) concentrations. 2) There were dramatic increases between birth and 7 days for Apo B and did not change between 7 days and 1 month, while Apo A-I was already present in significant levels at birth and was changed continuously between 7 days and 1 month. 3) There were marked increases between birth and 7 days for total cholesterol and triglycerides, while after 7 days the cholesterol levels only progressively increased until month. 4) There were continuous increases between birth and 7 days and 1 month for HDL-C, while LDL-C was markedly increased between birth and 7 days. 5) There were no significant correlations between serum Lp(a)concentrations and other lipid profiles neither age, sex and feeding formulas. In conclusion, our data suggest that the adequate timing for the screening test of Lp(a) in newborns is around 1 month after birth and there are no statistically significant correlations between Lp(a) and other lipid profiles.
Apolipoprotein A-I ; Apolipoproteins B ; Cholesterol ; Cholesterol, HDL ; Coronary Disease ; Enzyme-Linked Immunosorbent Assay ; Humans ; Infant, Newborn* ; Lipoprotein(a)* ; Lipoproteins ; Mass Screening ; Parturition ; Plasma ; Risk Factors ; Triglycerides

Conjugative R plasmids derived from 74 clinical isolates of Serratia marcescens were epidemiologically analyzed for antimicrobial resistance, EcoRI restriction endonuclease analysis and Southern hybridization with DHFR, TEM and SHV probe. 1. Resistance frequency of isolates against various B-lactam antibiotics was changed by year. 2. Twenty (27%) resistant strains transferred 32 R plasmids to E. coli or Klebsiella by mixed culture. Most strains isolated from 1994 to 1996 transferred only trimethoprim resistance but most strains isolated from 1997 did resistances against gentamicin (Gm) and B-lactams including ampicillin (Ap), carbenicillin (Cb), cefazolin (Cz), cefaloridine (Cl), cefamandole (Cn). 3. Ten plasmids of GmApCbCzC1Cn or GmApCbCzC1 pattern and 3 plasmids of TcSuGmTbApCbCzC1 pattern respectively showed identical EcoRI restriction endonuclease digestion patterns and hybridized fragment patterns with TEM-1 probe by Southern hybridization. These results indicate that the epidemic plasmids carrying blamM gene were present in this hospital in 1997 and molecular genetic analysis of R plasmids can be used to discriminate S. marcescens isolates for epidemiologic studies.
Ampicillin ; Anti-Bacterial Agents ; Carbenicillin ; Cefamandole ; Cefazolin ; Cephaloridine ; Digestion ; DNA Restriction Enzymes ; Epidemiologic Studies ; Epidemiology* ; Gentamicins ; Klebsiella ; Molecular Biology ; Plasmids ; R Factors ; Serratia marcescens* ; Serratia* ; Trimethoprim Resistance

BACKGROUND: The effects of various concentration (20, 50, 100? M) of mepivacaine were studied in isolated guinea pig and rat right ventricular papillary muscles by measuring the effects on myocardial contractility and electrophysiological parameters. METHODS: Isometric force of isolated guinea pig ventricular papillary muscle was studied in modified normal and 26 mM K+ Tyrode's solution. Rat papillary muscle was used to evaluate the effect on Ca2+ release from the sarcoplasmic reticulum (SR) at low stimulation rates. Normal and slow action potentials (APs) were evaluated by using conventional microelectrode technique. Rapid cooling contractures (RCCs), an index of SR Ca2+ content, which are known to be activated by Ca2+ released from the SR were performed. RESULTS: Mepivacaine caused dose-dependent depression of peak force from 0.5 to 3 Hz stimulation rates in guinea pig papillary muscles. Conduction block was frequently noted especially at higher stimulation rates (2 and 3 Hz) at all concentration ranges. In rat, ~20% depression of peak force was shown at rested state contraction. Shortening of AP duration and rate-dependent depression of dV/dt max could be observed at 100 M mepivacaine. In 26 mM K+ Tyrode's solution, 50 and 100 M mepivacaine caused dose-dependent depression of early and late force development. In slow APs, neither shortening of AP duration nor changes of dV/dtmax were not shown at 100 M mepivacaine. ~30% depression of RCC after 2 Hz stimulation rate was shown at 100 M mepivacaine. CONCLUSION: It may be concluded that the direct myocardial depressant effects of mepivacaine may partly be related to inhibition of Ca2+ release from the SR. Shortening of AP duration in normal APs seems to be partly related by blockade of TTX-sensitive ""window"" Na+ current.
Action Potentials ; Anesthetics ; Animals ; Contracture ; Depression* ; Guinea Pigs ; Mepivacaine* ; Microelectrodes ; Myocardium* ; Papillary Muscles ; Rats ; Sarcoplasmic Reticulum

Vascularized fibular graft is one of the treatment option for avascular necrosis of femoral head (ANFH) and has been known as providing a strut mechanical support and new vascular bed. It is very important to evaluate a healing process in femoral head after vascularization procedure. But a plain radiographic finding has a problem to assess pathological changes of ANFH treated with vascularized fibular graft. Authors analyzed chronogical changes of Tc-99m-HDP bone scan in 31 cases of ANFH treated with vascularized fibular graft from April, 1991 to May, 1994 and following results were obtained. l. Until 2 months after surgery, no change in size of cold defect area and no significant change in extent of RI uptake in reactive zone were noted. 2. During 2 months and 6 months after surgery, slight decrease in size of cold defect area and minimal changes in extent of RI uptake in reactive zone were observed. 3. During 6 months and 12 months after surgery, size of cold defect area decreased to 1/2 and changes in extent and degree of RI uptake in reactive zone were observed. 4. During 1 year and 2 years after surgery, size of cold defect area were minimal and sometimes faded away. RI uptake with decreased density in reactive zone broadened and moved to subchondral area. 5. After 2 years after surgery, cold area faded away and small increased RI uptake were observed in same site. In conclusion, Tc-99m-HDP bone scan which is economic and easily applicable in a patient is very useful for follow up study in ANFH treated with vascularized fibular graft.
Follow-Up Studies ; Head* ; Hip ; Humans ; Necrosis* ; Transplants*

Plate fixation is being regarded as one of the reliahle fixation method in the management of tibial fractures. But this technique may leave many complications including infection. However, delayed local infection which developed several weeks after open reduction on the tibia has been rarely described as a complication in the literatures. The purpose of this study is to evaluate the contributing factors to the delayed locaI infection in tibial fracture treated with plate fixation. Authors reviewed and analyzed the 60 cases of tihial fracture that were treated with plate and screws from 1989 to 1996. Analyses dealt with fracture classification, laboratory and radiographic findings and the site of plate application. We defined a delayed local infection as a condition in which patient has infection signs on Jaboratory and physical examination at or over 8 week post-operation without any evidence of osteomyelitis on plain radiographs. We found 7 cases of delayed local infection out of 60 tibial fractures from 8 to 21 weeks postoperatively with an average of 14.1 weeks. All the 7 cases that had been treated with plate on medial aspect of tibia were treated by administration of antibiotics without surgery such as debridement or removal of hardwares. Authors concluded that the medial plating was the most important factor of the development of delayed local infection(Z=1.78).
Anti-Bacterial Agents ; Classification ; Debridement ; Humans ; Osteomyelitis ; Physical Examination ; Tibia ; Tibial Fractures*

BACKGROUND: Nonimmune hydrops fetalis has become an important perinatal problem since it was first described in 1943. Although recent advances in antenatal ultrasound have made it possible to detect and manage nonimmune hydrops fetalis in early pregnancy, the perinatal mortality is still high. OBJECTIVE: To obtain clinically useful data regarding antenatal diagnosis, management, and perinatal outcomes of nonimmune hydrops fetalis, and to assist clinicians offer proper antepartum counseling and obstetric management which may be able to improve prognosis. Study design: We retrospectively reviewed 33 cases of nonimmune hydrops fetalis delivered in our hospital over a 4-year period. RESULTS: The antenatal diagnosis was possible by ultrasonography in all cases. Accumulation of fluid in fetal serous cavity and generalized skin edema were observed in all cases. A probable etiology was found in 23 (69.7%) cases through ultrasonography, various laboratory studies including fetal karyotyping, and autopsies. These were cardiovascular (4), respiratory (6), chromosomal (4), skeletal (1), and others (8). Despite extensive diagnostic studies, no definite etiology was found in 10 (30.3%) cases. Excluding the ten fetuses delivered after induced abortion, eight infants were born alive and six died in the neonatal period. The mortality rate was 91.3% (21/23). CONCLUSION: Nonimmune hydrops fetalis represents a very poor perinatal outcome. It is suggested that to improve the prognosis, various antenatal and postnatal approaches to find associated etiologic factors should be performed, and intensive perinatal cares are needed.
Abortion, Induced ; Autopsy ; Counseling ; Edema ; Female ; Fetus ; Humans ; Hydrops Fetalis* ; Infant ; Karyotyping ; Mortality ; Perinatal Mortality ; Pregnancy ; Prenatal Diagnosis ; Prognosis ; Retrospective Studies ; Skin ; Ultrasonography