BACKGROUND: The purpose of this clinical study was to evaluate the Incentive Spirometry (IS) and Deep Breathing Exercises (DBE) to prevent postoperative pulmonary complications after abdominal surgery in patients over 60 years of age. METHODS: We prospectively randomized 90 patients into 1 of 3 groups: the control group (30 patients) received no respiratory treatment, the IS group (30 patients) was treated with incentive spirometry 4 times daily and DBE group (30 patients) carried out deep breathing exercises under supervision for 15 min 4 times daily. ABGA was taken at ward, PR (preop.room), RR (recovery room), POD1 day and POD2 day. Roentgenographic changes observed at 24 h. and 48 h. after surgery. Pulmonary complications were defined as the development of 3 or more of 6 new findings: cough, sputum, dyspnea, chest discomfort, temperature greater than 38oC, pulse rate more than 100 beats/min. RESULTS: PaO2 in the DBE group and IS group at PR were significantly increased than the values at ward, and the values of the PaO2 in the DBE group at RR and POD1 day, and those of IS group at PR and POD2 day were significant higher than those of the control group (p<0.05). The frequency of development of pulmonary complications (43.3% in the control group, 20% in the DBE group, 20% in the IS group) and roentgenographic changes were comparable in the 3 groups (26.7%, 16.7%, 20% respectively). The DBE group showed the different incidence of postoperative pulmonary complications between upper and lower abdominal surgery (upper: lower= 35.7: 6.3%). CONCLUSIONS: We concluded that DBE and IS were effective in preventing postoperative pulmonary complications after abdominal surgery and lower abdominal surgery causes lesser postoperative pulmonary complications than upper abdominal surgery.
Breathing Exercises ; Cough ; Dyspnea ; Heart Rate ; Humans ; Incidence ; Motivation* ; Organization and Administration ; Prospective Studies ; Respiration* ; Spirometry* ; Sputum ; Thorax

Allergic contact dermatitis from aroma oils has long been recognized and with increasing frequency. Contact dermatitis of the allergic type of fragrances used for aromatherapy has been reported rarely, and only in patients exposed due to their occupation. We report herein a case of allergic contact dermatitis to aroma oils in an aroma therapist. A 25-year-old woman, an aroma therapist, had been treated with topical steroids under the impression of contact dermatitis. She had had pruritic erythematous maculopapules on the arms extending to the hands for the previous 6 months. Patch tests showed strong reactions to aroma oils(3% fennel and 3% juniper). The skin lesions were cleared after she stopped her job. However, re-exposure to aroma oils caused eczematous lesions repeatedly at the sites previously involved. We predict that increasing popularity of aromatherapy will lead to increasing number of patients developing allergic contact dermatitis from aroma oils. This has to be taken into consideration when testing patients with suspected contact dermatitis.
Adult ; Arm ; Aromatherapy ; Dermatitis, Allergic Contact* ; Dermatitis, Contact ; Female ; Foeniculum ; Hand ; Humans ; Oils ; Patch Tests ; Skin ; Steroids

Sensation is the key element that allows the fingertip to participate effectively in virtually all hand functions. Therefore, it is very important to restore sensation as well as well padded, durable skin coverage following severe fingertip injuries. Many ingenious operations have been described to provide the fingertip with sensate coverage. Among them, the innervated cross-finger flap, reported by Cohen et al. in 1983, is very effective and successful in reconstruction of severe fingertip injuries, We report five cases of severe fingertip injuries treated with innervated cross-finger flap. The results are as follows : 1. The level of sensory return and the functional result is excellent in those fingertips reconstructed with the innervated cross-finger flap. 2. Mean time for flap detachment is 16 days post operative and local anesthesis at outpatient department is sufficient. 3. Four of five treated patients achieved excellent sensibility with measurable two-point discrimination(mean 5.0 mm) and ability to recongnize textures and objects.
Fingers ; Hand ; Humans ; Outpatients ; Sensation ; Skin

No abstract available.
Brain Neoplasms* ; Brain* ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: This study was attempted to investigate the prevalence of the expression of c-fos protein, TGF-alpha and -beta, PCNA , DNA ploidy pattern and histopathological parameters of giant cell tumor (GCT) of bone and to correlate with prognosis and to extend our understanding on tumorigenesis of GCT. MATERIALS AND METHODS: Twenty eight cases of paraffin-embedded tissue were studied, classified as recurrent (5 cases) and non-recurrent group (12cases) within the limits of the cases which afforded surgical material on first operation. RESULTS: No significant difference was observed in cellularity of stromal cells, atypia of stromal and giant cells, presence of hemorrhage and necrosis between recurrent and non-recurrent group. However, presence of more than 10 mitotic figures in 10 high power fields in recurrent group was significantly higher than non-recurrent group (p<0.05). The immunoreactivity for PCNA was seen only in nuclei of stromal cells, whereas nuclei of giant cells showed negative staining. The positivity of PCNA revealed no significant difference between non-recurrent (mean; 40.9%) and recurrent group (34.4%). The expression of c-fos oncogene was seen in 5 cases (100%) in recurrent group, and 8 cases (66.7%) in non-recurrent group, and no significant difference was seen. No significant difference of expression of TGF-alpha was seen in 5 cases (100%) in recurrent group and in 11 cases (91.7%) in non-recurrent group. The expression of TGF-beta in stromal cells was significantly higher in non-recurrent group (80%) compared to recurrent group (100%) (p<0.05). In DNA analysis out of 18 cases, 4 cases (22.2%) were aneuploidy and 14 cases (77.8%) were diploidy. Among 4 aneuploidy cases, 3 cases (75%) had no recurrence, and 1 case (25%) had metastasis to lung and expired. No significant difference of DNA ploidy pattern was seen between the recurrent and non-recurrent group. CONCLUSION: Presence of more than 10 mitotic figures in 10 high power fields and less expression of TGF-beta are related to higher possibility of recurrence and it is suggested that the number of mitotic figure (more than 10/10HPF) and expression of TGF-beta could be helpful parameters in predicting recurrence of GCT.
Aneuploidy ; Carcinogenesis ; Diploidy ; DNA* ; Giant Cell Tumor of Bone* ; Giant Cell Tumors* ; Giant Cells* ; Hemorrhage ; Lung ; Necrosis ; Negative Staining ; Neoplasm Metastasis ; Oncogenes ; Ploidies ; Prevalence ; Prognosis ; Proliferating Cell Nuclear Antigen* ; Recurrence ; Stromal Cells ; Transforming Growth Factor alpha ; Transforming Growth Factor beta ; Transforming Growth Factors*

BACKGROUND: There has been no statistical study of dermatoses in the Ganganm area of Seoul which has been rapidly developing in the last 10 years. OBJECTIVE: We evaluated the recent distributions of dermatoses in the Gangam area of Seoul and compared them with the previous reports in Seoul and other provinces of Korea. METHODS: 47,015 new outpatients who visited the Yongdong Severance Hospital from 1983 to 1992 were analyzed statistically RESULTS: The study results are summarized as follows: 1. Among the 47,015 outpatients, the total number of number of male patients were 20,180(42.9%) and female patients 26,835(57.1%). 2. In age distribution, the most frequent age groups were the 3rd decade(21.3%), the lst decade(19.5%), and the 4th decade(19.2%) amounting to 60% of the total outpatients. 3. The most common 15 dermatoses were dermatophytosis, atopic dermatitis, urticaria, irritant contact dermatitis, acne vulgaris, allergic contact dermatitis, seborrheic dermatitis, other eczemas, warts, vitiligo, drug eruption, herpes zoster, psoriasis, bacterial infection, and syphilis. 4. Those dermatoses which showed an increasing tendency annually were seborrheic dermatitis, warts, vitiligo, and syphiiis. Dermatophytosis and bacterial infection showed a decreasing tendency. 5. Seasonal distribution showed that those diseases occurring most frequently during the summer were dermatophytosis, urticaria, allergic contact dermatitis, vitiligo, herpes zoster, and bacterial infection. The incidence of atopic dermatitis and psoriasis increased during the winter season. 6. In sexual distribution, acne, allergic contact dermatitis, and irritant contact dermatitis were more frequent in females, and the remainding common dermatoses did no show any difference. 7. In age distribution, atopic dermatitis and bacterial infection were most frequent in the lst decade. Urticaria, allergic contact dermatitis, acne, drung eruption, psoriasis, and syphilis were most frequent in the 3rd decade, with warts and vitiligo in the 2nd decade, and herpes zoster in the 6th decaded. 8. The distributions of dermotoses as disease groups were eczema(24.9%), urticaria-drug eruption (13.2%), dermatophytosis(10.7%), skin appendage disorder(10.1%), viral infection(10.1%), pigmentary disorders(4.5%), and papulosquamous diseases(4.0%) which constituted 78% of the total. 9. In patients dwelling in apartments, atopic dermatitis and molluscum contagiosumn showed a more frequent tendency in comparison to those living in house. 10. The most common 10 dermatoses among children were atopic dermatitis, urticaria, contact dermatitis, molluscum contagiosum, bacterial infection, dermatophytosis, vitiligo, other viral infections, and nevo-cellular nevi. On the other hand, the most common 10 dermatoses among the elderly were drmatophytosis, other eczemas, urticaria, herpes zoster, pruritus, contact dermatitis, drug eruption, lichen simplex chronicus, seborrheic dermatitis, and vitiligo. CONCLUSION: In contrast to earlier published report from Seoul, the infectous dermatoses, especially parasitic infestation, showed a decreasing tendency. The distribution pattern of the skin diseases did not differ fro other provinces of Korea in general.
Acne Vulgaris ; Age Distribution ; Aged ; Bacterial Infections ; Child ; Dermatitis, Allergic Contact ; Dermatitis, Atopic ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Drug Eruptions ; Eczema ; Female ; Hand ; Herpes Zoster ; Humans ; Incidence ; Korea ; Male ; Molluscum Contagiosum ; Neurodermatitis ; Nevus ; Outpatients ; Pruritus ; Psoriasis ; Seasons ; Seoul* ; Skin ; Skin Diseases* ; Statistics as Topic* ; Syphilis ; Tinea ; Urticaria ; Vitiligo ; Warts

No abstract available.
Adrenal Hyperplasia, Congenital*

No abstract available.
Guillain-Barre Syndrome* ; Plasmapheresis*

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an effective resuscitative modality to temporize noncompressible truncal hemorrhage. Confirming the proper position of the balloon catheter in the target aortic zone is vital. Currently, there is a need for nonradiographical methods. This would overcome the drawbacks of conventional imaging modalities, such as fluoroscopy. Several studies have suggested ultrasound-guided visualization via subxiphoid, transperitoneal, or transesophageal views as an alternative to conventional imaging methods. However, such views are easily obscured in emergency settings. Herein, we report the case of a 70-year-old patient who was successfully resuscitated by REBOA under the guidance of transsplenic ultrasound. REBOA was safely performed using transsplenic visualization without fluoroscopy.

No abstract available.
Apoptosis* ; Female ; Hypertension, Pregnancy-Induced* ; Placenta* ; Pregnancy*