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

BACKGROUND: An intensive and ongoing surveillance program is effective for preventing the hospital infections. but it is time-consuming to detect all cases of hospital infections. So, labratory-based surveillance was performed with the aid of personal computer. The software 'MICRO' that coded and used privately was written in FoxPro 2.0 code. METHODS: All results of the microbiologic culture were stocked in the software and hospital infections were detected by review d an positive microbiology reports and daily ward rounds with examination of patient progress notes. If there was any suggestion or evidence of outbreak of hospital infections the data were analyzed by the 'MICRO' and reported to hospital infections control committee. RESULTS: We detected the outbreak of nosoccmial pneumonia due to a putative single species of methicillin-resistant Staphylococcus aureus in the neurosurgical ward at May, 1996. The suggestive outbreak of wound infections in the 7th ward at April, 1966 was denied by the 'MICRO'. The possible outbreak of 10th ward at May, 1996 was detected. CONCLUSIONS: We describe a surveillance method that identifies excessive rates of positive culture on patient location culture site, and organism indentification using the 'MICRO'. We were able to monitor patient-to-patient cross-infections and possible breakdowns in proper technique, and expect suggestive outbreak of infections early. These results demonstrate that computer analysis of positive culture rates by 'MICRO' is a sensitive and time-efficient method for detecting potentially preventable hospital infections.
Cross Infection* ; Humans ; Methicillin-Resistant Staphylococcus aureus ; Microcomputers* ; Pneumonia ; Wound Infection

No abstract available.
Dysentery, Bacillary*

No abstract available.
Occupational Diseases*

Five cases of cerebral arteriovenous malformation(AVM) are presented, which underwent total extirpation using the operating microscope. The following are considerations which favor the total extirpation of AVM and the advantages of using the operating microscope, including the rationale for non-use of hypotensive anesthesia or mannitolization which is commonly used in intracranial aneurysm surgery: 1) Relatively small sized AVMs are found to show a high rate of large intracerebral hematoma, including that the degree of bleeding from the malformed vessels is not related to the size of the AVM. 2) The operating microscope facilitates the following procedures: a) determination of the extent of the malformed vessels. b) clipping feeders. c) identification of red vein and laminar flow. d) preservation of normal brain tissue.
Anesthesia ; Brain ; Hematoma ; Hemorrhage ; Intracranial Aneurysm ; Intracranial Arteriovenous Malformations* ; Mannitol ; Veins

The brief report of Zeisler (1922) of a pregnant woman with scattered telangiectasia in a unilateral distribution is perhaps the first recorded case of this syndrome. The syndrome has been described in association with pregnancy, puberty, alcoholisrn and cirrhosis, hormonal therapy and congenital status. The authors observed in a 17-year-old male unilateral telangiectatic lesions over the left C, C, C, Tl and T, dermatomal regions. The lesions developed at first at his puberty on the anterior part of the chest as speckled bright red discoloration. Thereafter, the lesion has been progressed to involve the left upper extremity, sholder, upper middle part of the chest, eventually. Family history was negative and physical, lahoratory and X-ray examination were all negative or within normal limit. No mucous membrane involvement was observed. On histopathologic examination of the skin lesion, thin walled ectatic vessels lined with single layer of endothelial cells were observed in the upper dermis. The lesions were partly dermabrased with favorable result.
Adolescent ; Dermis ; Endothelial Cells ; Female ; Fibrosis ; Humans ; Male ; Mucous Membrane ; Pregnancy ; Pregnant Women ; Puberty ; Skin ; Telangiectasis* ; Thorax ; Upper Extremity

No abstract available.
Humans ; Primary Health Care*

We present a patient who developed a pseudolymphoma after ear piercing. A patch test showed gold sensitivity. Therefore, long standing dermal exposure to gold from a pierced-type earring might have produced the patient's disease. This patient did not respond to an intralesional steroid injection and was finally treated with a complete resection of the lesion. It is proposed that every patient with a hyperplastic lesion in the ear lobe should be taken a biopsy in order to rule out the possibility of a pseudolymphoma. When a pseudolymphoma develops in the ear lobe, a complete surgical excision could be the treatment of choice, especially for the prevention of recurrence.
Biopsy ; Body Piercing* ; Ear* ; Humans ; Patch Tests ; Pseudolymphoma* ; Recurrence

No abstract available.
Humans

Nickel is widely known throughout the world as a common source of contact dermatitis. Korea is one of the rapidly developing countries where the use of nickel and nickel by-products is on the rise. Lacking in ore, Korea imports most of its nickel. In the last ten years, in relation to rapid industrial development, the amount of nickel imported has increased over 1, 000 times. Nickel dermatitis is becoming an increasing problem in the patch test clinic. With regards to this, we have tried the dimethylglyoxime spot test to all materials mentioned in the textbooks which are regarded as nickel sources in other industrialized societies, so as to make an up-to-date list of nickel sources applicable to Korea. In addition, we have also included traditional nickel sources such as acupuncture needles, fire pot, old and new coins and chest of drawers etc. We also have analyzed data concerning nickel imports to Korea during the past 10 years.
Acupuncture ; Dermatitis ; Dermatitis, Contact ; Developing Countries ; Fires ; Korea* ; Needles ; Nickel* ; Numismatics ; Patch Tests ; Thorax