OBJECTIVES: Over the last 30 years, despite the increasing sophistication in medical care, the mortality of acute renal failure(ARF) has remained virtually unchanged at 40-50%, but the reasons remain unknown. This study intend to identify prognostic risk factors influencing survival and predict the mortality in ARF patients. METHODS: We retrospectively analyzed 152 patients with ARF who required renal replacement therapy, or whose serum creatinine level above 5 mg/dl, from Jan. 1988 to May. 1995. Multiple factors which may influence mortality were evaluated by univariate and multivariate analysis. RESULTS: 1) Of the 152 patients, 97 were male and 55 were female. The mean age was 47 years and the overall mortality was 36.8%. 2) Based on the univariate analysis, age>60 years, cause of ARF, APACHE II score, number of failing organs, peak serum creatinine level, PaO2, coma, hypotension, ARDS, GI bleeding, ventilatory support, need for antiarrhythmics, DIC, cardiovascular failure, pulmonary failure, neurological failure, and gastrointestinal failure were all significant factors discriminating between survivors and nonsurvivors(p<0.05) 3) By multivariate analysis, hypotension, coma, ventilatory support, and age over 60 years were significant independent predictors influencing survival in ARF patients and logistic equation and logit score were as follows : z=-2.04+1.32(age over 60)+2.18(hypotension)+2.88 (ventilatory support) + 3.28(coma) P=ez/(1+ ez) 4) In ROC(receiver-operating characteristic)curve, when the cutoff point was 0.2, maximum sensitivity was 75% and maximum specificity was 82%. CONCLUSION: In ARF, prognostic risk factors for mortality were age over 60 years, hypotension, assisted ventilation and coma. The logit score by multiple analysis is a reliable predictor of mortality in ARF patients, however the further studies are required to confirm these results.
Acute Kidney Injury* ; APACHE ; Coma ; Creatinine ; Dacarbazine ; Female ; Hemorrhage ; Humans ; Hypotension ; Male ; Mortality* ; Multivariate Analysis ; Renal Replacement Therapy ; Retrospective Studies ; Risk Factors* ; Sensitivity and Specificity ; Survivors ; Ventilation

No abstract available.
Polyarteritis Nodosa*

No abstract available.
Colposcopy* ; Early Diagnosis* ; Uterine Cervical Neoplasms*

Acute bacterial infection of bone and joint presents a real challenge to orthopedist because early diagnosis and treatment are difficult and also essential. In almost all practices, fever and erythrocyte sedimentation rate(ESR) are widely used for monitoring the course, for estimating the effectiveness of treatment, and for the recovery of such illnesses. However, interpreting body temperature is difficult and ESR is nonspecific, is not not sensitive, normalizes slowly. Otherwise, C-reactive protein(CRP) is very sensitive and normalizes fast. CRP, body temperature, and ESR were sequentially measured until a normal value was reached in twenty seven patients in whom acute osteomyelitis (17 patients), acute exacerbation of chronic osteomyelitis(4 patients), and septic arthritis(6 patients) had been diagnosed by positive bacterial culture at Kyungpook National University Hospital from June 1984 to May 1985. The results were as follows: 1. CRP normalized within 8.8 days on average. 2. Fever lasted 4.5 days on average. 3. ESR normalized within 41.6 days on average. 4. Initial mean value of CRP was 4.2 positive in acute in acute osteomyelitis and septic arthritis and 3.5 positive in acute exacerbation of chronic osteomyelitis, therefore CRP can be considered as a very sensitive indicator for early detection of acute bacterial infection of bone and joint. Also sequential CRP determination can be used for monitoring the course, for estimating the effectiveness of treatment, and for the recovery of such illnesses.
Arthritis, Infectious ; Bacterial Infections ; Blood Sedimentation ; Body Temperature ; C-Reactive Protein ; Early Diagnosis ; Fever ; Gyeongsangbuk-do ; Humans ; Joints ; Osteomyelitis ; Reference Values

OBJECTIVE: To evaluate the clinical and histopathological features, treatment and prognosis of borderline ovarian tumors (BOT). METHODS: Thirty nine cases of BOT were treated between January 1985 and December 2001 at Maryknoll Hospital. All of BOT were classified in accordance with the WHO criteria for histological typing and clinical staging according to the FIGO system. The clinical records of all patients were reviewed retrospectively. RESULTS: The incidence of BOT was 21.0% (39/186) of epithelial ovarian malignancies and patients with these tumors tended to present at younger age (36.6 years old) than those with invasive carcinoma (53.6 years old). Fourteen patients (35.9%) were nullipara. The most common chief complaint was palpable mass (28.2%). Serous type (17.9%) occurred less frequently than mucinous type (76.9%). The positive ratio of CA 125 was 45%. Stage I was 37 cases (94.8%), stage II, 1 case (2.6%), and stage III, 1 case (2.6%). The mean size of mucinous tumors was larger than that of serous types (18.7 cm vs 10.0 cm). Twenty three (59%) cases were managed by conservative surgery (unilateral salpingo-oophorectomy) and sixteen cases (41%) by extirpative operation. Post-operative adjuvant chemotherapy was given to seven patients (17.9%). Median follow-up period was 30 months. One patient expired in case of mucinous tumor and seven cases lost during follow-up. Overall survival rate was 96.9%. CONCLUSION: Borderline ovarian tumors constitute approximately 21.0% of epithelial ovarian malignancy and occur in younger patients than those with invasive cancer. It is mostly seen serous and mucinous types and most of them are diagnosed at early stage making definite treatment possible.
Chemotherapy, Adjuvant ; Female ; Follow-Up Studies ; Humans ; Incidence ; Mucins ; Ovary* ; Prognosis ; Retrospective Studies ; Survival Rate

We evaluated the antihypertensive effect of amlodipine, a calcium channel bloker, in 35 cases of essential hypertention. After 12 weeks' administration(5~10mg q.d.), the following results were obtained : 1) The systoloic and diastolic blood pressure were decreased significantly(170.3+/-12.2mmHg vs 143.7+/-13.0mmHg p<0.01 and 104.7+/-5.9mmHg vs 87.8+/-6.5mmHg, p<0.01, respectively) but the heart rate was independant of amlodipine administration. 2) The systolic blood pressure was lowered by 20mmHg or more in 26(76.5%) of 34 patients and the diastolic pressure was lowered by 10mmHg or more in 26(76.5%) of 34 patients at 12 weeks after amlodipine administration. 3) The adverse effects of amlodipine were dizziness in 5, edema in 5, indigestion in 3, constipation in 2, headache, flushing, insomnia in 1 patient respectively and only one of them discontinued amlodipine administration due to severs facial flushing and skin eruption.
Amlodipine* ; Blood Pressure ; Calcium Channels ; Constipation ; Dizziness ; Dyspepsia ; Edema ; Flushing ; Headache ; Heart Rate ; Humans ; Skin ; Sleep Initiation and Maintenance Disorders

PURPOSE: This study was performed to evaluate the usefulness of propofol in radiology studies by comparing propofol sedation with midazolam for patients who do not comply with their doctor's requests and need an injection of a sedative to be treated for a safe and quick recovery without complications. METHODS: Among adult patients who were admitted and checked using CT and MRI in our emergency medical center from February 2001 to August 2001, the patients who required sedation because of the lack of cooperation with ER doctors were studied. Of 49 patients, 23 patients (Group M) were injected with midazolam, and 26 patients (Group P) were injected with propofol. RESULTS: In both groups, the systolic BP and the diastolic BP decreased, but group P's BP decreased more than group M's (p<0.05). In group M, the decrease of SPO2 w a s statistically significant, but neither of the groups required emergency care. Although, Group M didn't require emergency care for SpO2, they did require more emergency care for apnea than Group P did. Group P's time required for an examination to be performed was shorter than group M's. Group P's duration for occurrence of movement was shorter than Group M's, but this difference was not statistically significant. Regardless of which sedative was used, there was no difference in the satisfaction of the radiology technician with regards to group M and group P. CONCLUSION: When the patients were injected with a lowdosage of propofol, they showed effects similar to those observed in patients in injected with midazolam, and there were no complications that required emergency care. The usage of propofol is thought to be a good choice, except for contraindications, for short-time radiology examinations.
Adult ; Apnea ; Emergencies* ; Emergency Medical Services ; Humans ; Magnetic Resonance Imaging ; Midazolam* ; Propofol*

No abstract available.
Pulmonary Artery*

OBJECTIVE: The results of the excision of both outer and inner membranes with fenestration to the basal and parasellar cisterns for symptomatic primary middle cranial fossa arachnoid cysts are presented. METHODS: Twenty-three symptomatic cases of middle cranial fossa arachnoid cyst treated by excision with fenestration from 1993 to 2001 at our hospital were analyzed retrospectively. RESULTS: There was no significant morbidity and mortality after surgery and no recurrence of cyst during the follow-up period(mean 40.8 months). We observed reduction of the cyst with expansion of the surrounding brain and clinical improvement in most of the patients. All cases of type III by Galassi classification, 83% of type II cases and half of type I cases were belonged to the excellent group(reduction of the cyst size over 50% during follow-up period). Seventeen cases(74%) were belonged to the excellent group and 6 cases(26%) were the good group(reduction of the cyst size under 50% during follow-up period). CONCLUSION: The results of this study suggest that the excision and fenestration procedure may be considered as the primary shunt-independent procedure in patients with symptomatic middle cranial fossa arachnoid cyst.
Arachnoid Cysts ; Arachnoid* ; Brain ; Classification ; Cranial Fossa, Middle* ; Follow-Up Studies ; Humans ; Membranes ; Mortality ; Recurrence ; Retrospective Studies

A rare case of chronic pain of entrapment neuropathy of the sciatic nerve successfully relieved by surgical decompression is presented. A 71-year-old male suffered a chronic right buttock pain of duration of 7 years which radiating to the right distal leg and foot. His pain developed gradually over one year after underwenting drainage for the gluteal abscess seven years ago. A cramping buttock and intermittently radiating pain to his right foot on sitting, walking, and voiding did not respond to conventional treatment. An MRI suggested a post-inflammatory adhesion encroaching the proximal course of the sciatic nerve beneath the piriformis as it emerges from the sciatic notch. Upon exploration of the sciatic nerve, a fibrotic tendinous scar beneath the piriformis was found and released proximally to the sciatic notch. His chronic intractable pain was completely relieved within days after the decompression. However, thigh weakness and hypesthesia of the foot did not improve. This case suggest a need for of more prompt investigation and decompression of the chronic sciatic entrapment neuropathy which does not improve clinically or electrically over several months.
Abscess ; Aged ; Buttocks ; Chronic Pain ; Cicatrix* ; Decompression* ; Decompression, Surgical ; Drainage ; Foot ; Humans ; Hypesthesia ; Leg ; Magnetic Resonance Imaging ; Male ; Muscle Cramp ; Pain, Intractable ; Sciatic Nerve* ; Thigh ; Walking