This survey was conducted from January 1991 to May 1991. Two hundred and eight residents in 4 government supported homes for the aged and hundred and eleven living in the community in Taegu, Korea, were examined to evaluate the depression and the anxiety of the aged with combined anxiety and depression scale (CADS) and somatization symptom check list (SCL). There are no significant differences between residents in the home for the aged and those living in the community on the total scores of CADS and SCL. However, in the case of the total score of CADS of the female subjects in the home for the aged were significantly higher than those of the community residents. The elderly in the home for the aged tended to have pure depression, while community residents were likely to have anxiety and depression. Fifty-two subjects of home for the aged and sixty-nine of the community scored over 50 points of CADS, which indicates considerable depression or anxiety. In psychosocial factors, the subjects who in the following situations had statistically significant higher scores than others. The results were as follow. Poor health, unhappiness, unsatisfaction to the past occupation, pessimistic thought in future view for both group and unsatisfaction of the relationship with familiar people for the elderly in the community. The SCL scores of two groups subgrouped by under 49 and 50 on CADS showed significant differences between each subgroup on all of the SCL items. It could be suggested that somatic symptoms for the aged is a sign of depression.
Aged* ; Anxiety* ; Daegu ; Depression* ; Female ; Homes for the Aged ; Humans ; Korea ; Occupations ; Psychology

No abstract available.

A retrospecive clinical observation was done on 325 cases of hypertension admitted to Department of internal Medicine of Seoul Red Cross Hospital from January, 1979 to December, 1982. The following results have been obtained. 1) The observed patients were 157 males and 168 females, and the prevalence rate of malignant hypertension among 325 hypertensions was 16 cases (4.9 percent). Among 16 cases of malignant hypertension 9 cases were male and 7 cases were female. Most frequently in 50, 60 and 40 years of age in this order each sex. 2) The average admitted dates are 7 days. 27 cases (8.3percent) were readmitted above 2 times after one discharged. 3) The most freqeuntly observed duration of Known hypertension 37.9 percent was 6-10 years and the next frequently observed duration 37.4 percent was 3-5 years. 4) The highest percentage of malignant hypertension had systolic blood pressure between 190-209mmHg and diastolic blood pressure between 150-169mmHg. 5) The highest percentage of seasonal number was spring (31.1 percent) and the next autumn, summer, winter in this order and the prevalence rates of hypertention are increased average 1.9% of each year. 6) The 78.5 percent of the patients were found that their blood pressure were abnormaly high when they were examined with related symptoms on admission, and they major symptorms were headache and dizziness. 7) The physical examination on admission, tachycardia (56percent), tachypnea (15.1percent), semicoma to coma (12.9 percent) in this order. 8) The status of treatment in hypertension on admission was as follows; imtermittent treatment 54.5 percent, no treatment 31 percent and continuous treatment 14.5 percent in this order. 9) In the chest X-ray on admission, the most frequent finding was cardiomegaly, and normal finding was the next frequency. The pulmonary Tbc was noted in 12.6 percent. 10) According to the degree of fundoscopic abnormality by K-W classification stage III was 68.8 percent and stage IV was 31.2 percent. 11) Electrocardiogram abnormalities were 44.9 percent, and 87.5 percent of malignant hypertension revealed electrocardiographic abnormalities and left ventricle hypertrophy was observed in 70.5 percent. 12) Hypercholesterolemia 78 percent, Hypernatremia 69.8 percent, Hypokalemia 22.8 percent, serum chloride 34.5 percent (<95m Eg/l), BUN 53.8 percent (>20mg/dl) and creatinine 45.8 percent (>3mg/dl) on admission. 13) Proteinuria was observed in 87.5 percent of malignant hypertension. 14) Marked improved for clinically was 24 percent and mortality rate was 5.2 percent, most common cause of death are cardiovascular accident (64.7percent) and renal failure (23.5percent).
Blood Pressure ; Cardiomegaly ; Cause of Death ; Classification ; Coma ; Creatinine ; Dizziness ; Electrocardiography ; Female ; Headache ; Heart Ventricles ; Humans ; Hypercholesterolemia ; Hypernatremia ; Hypertension ; Hypertension, Malignant ; Hypertrophy ; Hypokalemia ; Internal Medicine ; Male ; Mortality ; Physical Examination ; Prevalence ; Proteinuria ; Red Cross ; Renal Insufficiency ; Seasons ; Seoul ; Tachycardia ; Tachypnea ; Thorax

PURPOSE: The infected diabetic foot patients were reviewed to analyze the result of new dressing methods using a wall-suction instruments. MATERIALS AND METHODS: Eighteen patients treated with wall-suction assisted vacuum dressing were included. After debridement under local anesthesia, a sponge pad, a drain, and a surgical drape were used to seal the wound. Negative pressure applied by the wall-suction at around 200 mmHg and dressing were repeated in every two to three days. The results of repeated wound cultures, growth of granulation tissues, and CRP level were closely observed on the regular basis. RESULTS: Rapid growth of granulation tissues was noticed around the wound in 16 cases. No organism was obtained in an average 5 days and wound coverage was possible in an average 18 days. The CRP level returned to normal in an average 4 weeks. Two patients with end stage renal disease, who were regularly hemodialised, underwent major amputation. CONCLUSION: New dressing method has the following advantages: a rapid wound improvement in the patients with infected diabetic foot, less expensive, less painful, impediment of bacterial contamination in the hospital room. However, further study will be needed for the end stage renal disease patients.
Amputation ; Anesthesia, Local ; Bandages ; Debridement ; Diabetic Foot* ; Granulation Tissue ; Humans ; Kidney Failure, Chronic ; Porifera ; Surgical Drapes ; Ulcer* ; Vacuum* ; Wounds and Injuries

Popular use of intravascular catheterization of both diagnostic and therapeutic purposes led to increase in iatrogenic intravascular foreign bodies for which percutaneous removal has been accepted as the treatment of choice. The majority of percutaneously removed intravascular foreign bodies are located in the right side of the heart, large veins, and pulmonary arteries and intraarterial foreign body is rare. We recently experienced a case of intraarterial fragmented catheter which was removed with a basket percutaneously without any complication.
Catheterization ; Catheters ; Foreign Bodies* ; Heart ; Pulmonary Artery ; Veins

STUDY DESIGN: Retrospective comparative study. OBJECTIVES: The aim of this study was to compare the efficacy of prophylactic antibiotics in spinal surgery for the occurrence of postoperative surgical site infection (SSI) and host immune reactions depending on various administration regimens and protocols. SUMMARY OF LITERATURE REVIEW: The superiority of one regimen or protocol of prophylactic antibiotics over others for SSI in spinal surgery has not been clearly demonstrated. We designed a controlled clinical trial to compare the occurrence of SSI with the changes of hematologic results depending on prophylaxis regimens and protocols. MATERIALS AND METHODS: Between January 2007 and February 2011, two hundred consecutive patients who had undergone thoracolumbar/lumbar surgery for degenerative or traumatic disease were included. Postoperative protocol was altered for each group of fifty consecutive patients; 1st generation cephalosporins for 5-days (group A), 2nd generation cephalosporins for 5-days (group B), 1st generation cephalosporins for 3-days (group C), and 2nd generation cephalosporins for 3-days (group D). Preoperative antibiotic prophylaxis was administrated within 1 hour prior to surgical incision with the same trial antibiotics. Intraoperative bacterial culture was performed from the surgical site. The occurrences of SSI were evaluated as either incisional or organ/space SSI. Serial changes in hematologic inflammatory markers (WBC, ESR, CRP) and DIC markers (fibrinogen, FDP, D-dimer) were compared until postoperative 2 weeks. RESULTS: The study groups were homogeneous regarding age, sex, body mass index, estimated blood loss, diabetes mellitus, smoking, diagnosis, baseline laboratory values, and type of surgery including instrumentation. Overall, 13 cases of incisional SSI (6.5%) and 3 cases (1.5%) of organ/space SSI occurred. There was no difference in the occurrence of incisional and organ/space SSI among the 4 groups (P=0.690, 0.799). Laboratory results revealed that postoperative changes in hematologic inflammatory markers and DIC markers were not influenced by prophylaxis regimens and protocols (all P>0.05). CONCLUSIONS: The occurrences of SSI and host immune responses were not influenced by postoperative antibiotics regimens and protocols. Hematologic investigation revealed that host immune responses did not depend on the type of prophylactic antibiotics.
Anti-Bacterial Agents ; Antibiotic Prophylaxis ; Body Mass Index ; Cephalosporins ; Dacarbazine ; Diabetes Mellitus ; Formycins ; Humans ; Retrospective Studies ; Ribonucleotides ; Smoke ; Smoking

No abstract available.
Injections, Intralesional ; Isotretinoin ; Triamcinolone ; Triamcinolone Acetonide

Resuscitation bag (RB) is widely used for artificial ventilation and adequate ventilation during resuscitation, or for patient transport, when high concentration of inspired oxygen (70-100%) must be supplied. The purpose of this study was to investigate the effect of oxygen flow and the length of corrugated tube as a reservoir on the oxygen concentration in the adult type and pediatric type resuseitation bag. Each 24 mm corrugated tube (0, 20,40, 60, 80, 100 cm) was attached to the inlet valve, oxygen flow of 1, 3, 5, 7, 9, 11, 13 or 15 L/min was delivered to oxygen inlet site of RB. and oxygen concentration was measured for 10 times. To eliminate the possibility that ventilatory pattern affect the oxygen concentration, RB was manually handled with normal ventilatory pattern ; in advlt type, tidal volume was 800 cc, respiratory rate was 10/min and 1:E ratio was 1:2, in pediatric type, tidal volume was 100 cc, respiratory rate was 20/min and 1:E ratio was 1:2. In adult RB, a 15 L oxygen flow without reservoir delivered less than 50% oxygen. To get more than 70% oxygen, one must administer more than a 15 L oxygen flow with reservoir of 60 cm corrugated tube, oxygen flow of 9 L/min with 80 cm corrugated tube or a 7 L flow of oxygen with 100 cm corrugated tube. And to provide more than 80%, oxygen of more than a 11 L flow with reservoir of 100 cm should be delivered. In pediatric RB, a 15 L oxygen flow without reservoir get more than 70% oxygen. A 20 cm corrugated tube as a reservoir increased abruptly oxygen concentration, and A 40 cm tube with more than a 7 L flow delivered more than 95% oxygen, but above 60cm tube there is little increase in the oxygen concentration. These results indicated that to get more than 70% oxygen, 60 cm and 40 cm corrugated tube is required in adult type RB and pediatric type RB respectively as an oxygen reservoir.
Adult ; Bays ; Humans ; Oxygen* ; Respiratory Rate ; Resuscitation* ; Tidal Volume ; Ventilation

No abstract available.
Nails

When anesthesiologists encounter conditions in which intubation is not possible using a conventional direct laryngoscope, they can consider using other available techniques and devices such as fiber optic bronchoscope (FOB)-guided intubation, a laryngeal mask airway (LMA), intubating LMA (ILMA), a light wand, and the Combitube. FOB-guided intubation is frequently utilized in predicted difficult airway cases and is generally performed when the patient is awake to enable easier access to the trachea. An LMA can be introduced to ventilate the patient with relative ease, while an ILMA can be used for definite endotracheal intubation. However, occasionally, an endotracheal tube (ETT) cannot pass through the larynx, despite successful introduction of a FOB into the trachea and placement of an ILMA by the anesthesiologist. Therefore, we initially introduced an ILMA for emergent ventilation, followed by successful insertion of an ETT under FOB guidance. In this report, we describe three cases of difficult intubation using a FOB and ILMA combination approach.
Bronchoscopes* ; Humans ; Intubation* ; Intubation, Intratracheal ; Laryngeal Masks* ; Laryngoscopes ; Larynx ; Nerve Fibers, Myelinated* ; Trachea ; Ventilation