BACKGROUND: The population is aging and life expectancy is increasing. It is important to evaluate the functional ability of elderly for optimal care for elderly. This study was conducted to assess functional disability of elderly and to find out the factors having an effect on the disability. METHODS: It surveyed 1,541 individuals aged 65 years and older in Cluing-Yang province. Six ADL categories (bathing, dressing, feeding, transferring, toileting, and walking) were assessed and related factors were analyzed. RESULTS: ADL was independent in 85.2% of elderly and dependent in 14.8% of elderly. 55.1% of dependent elders were living without family. Bathing was the most common disable AI)L category. The factors having an effect on the disability of ADL were brain disease, self-rated health status, dyspnea, constipation, heart disease, diabetic mellitus, and living status. CONCLUSION: In a rural area, special prevention programs for brain disease, heart disease, and diabetic mellitus and a rehabilitation health service may improve ADL status of elders.
Activities of Daily Living* ; Aged* ; Aging ; Bandages ; Baths ; Brain Diseases ; Constipation ; Dyspnea ; Health Services ; Heart Diseases ; Humans ; Life Expectancy ; Rehabilitation

It is well known that intracranial pressure (ICP) and mean arterial pressure (MAP) are increased by laryngoscopy and endotracheal intubation during induction of general anesthesia, and it may be very dangerous in neurosurgical patients who had increased ICP. Therefore, this study was performed to know the range of ICP increase during induction of the conventional general anesthesia with intubation following thiopental and succinylchohne injections. Intracranial pressure and MAP were measured in 13 patients who underwent craniotomy. All the patients were monitored cerebral epidural ICP and intraarterial pressure preoperatively. The results were as follow: 1. Intracranial pressure was increased of 7.1±7.23 mmHg. 2. Arterial pressure was increased of 43.5±25.46 mmHg. 3. Cerebral perfusion pressure was increased of 33.3±27.53 mmHg. It is stressed that certain procedures are necessary to prevent from further increase of ICP due to induction of general anesthesia in patients with increased ICP.
Anesthesia, General ; Arterial Pressure ; Cerebrovascular Circulation ; Craniotomy ; Humans ; Intracranial Pressure* ; Intubation ; Intubation, Intratracheal* ; Laryngoscopy* ; Thiopental

This study was performed to guide the effective utilization of blood and optimal blood ordering schedule for various elective surgeries, based on the analysis of 1,462 transfused surgical procedures and 5,933 blood units transfused during operation in the period of two years through January, 197 to December, 1988 at Yeungnam University Hospital. The frequency of transfusion, and mean transfused units were evaluated and recommended blood unit for each surgical procedure was proposed. We assure that the successful establishment of this guideline can lead to substantial monetary saving, reduced blood outdating, and a decreased blood bank workload with a more appropriate allocation of the technician's time and effort.
Appointments and Schedules ; Blood Banks

The results of hepatic portojejunostomy performed in 34 patients with biliary atresia between May 1989 and December 1997 were analyzed. These patients were divided into three groups based on age of surgery; group 1 (< or =60 days, n = 11); group 2 (61~90 days, n = 14), and group 3 (>90 days, n = 9). Jaundice was cleared in 22 cases (64.7%). There was no significant difference of jaundice-free rate according to the age at operation between group 1, 2, 3. After a mean follow-up period of 33.9 month (range 18days-105.7 month), there were eleven deaths from hepatic failure(6), esophageal varix bleeding even though anicteric(2), sepsis by cholangitis(1), heart failure(1) and renal failure(1). Two of group 1 and 3 had received liver transplantation. With follow-up of average 33.9 months (18days-106months, one follow-up loss), 5-year cumulative survival rate by Kaplan-Meier method was 65.9%. The 5-year survivals of group 1, 2, 3 were 63.6%, 77.9%, 41.4%. There was no significant difference of survival rates according to the age at operation between group 1, 2, 3. Moreover, two cases of group 3 survived more than 5 years. Therefore, hepatic portojejunostomy can be considered as a primary surgical modality for biliary atresia in a patient of 90 days or more. Early detection of esophageal varix and possible sclerotherapy is necessary for long term survival.
Biliary Atresia* ; Chungcheongnam-do* ; Esophageal and Gastric Varices ; Follow-Up Studies ; Heart ; Hemorrhage ; Humans ; Jaundice ; Liver Transplantation ; Sclerotherapy ; Sepsis ; Survival Rate

The prevalence of low serum urea nitrogen concentrations (<6 mg/dL) in our patient population was 3.8% (452 per 11,911 determinations), representing 372 individual cases. Of these, 323 of the patients' charts were located, reviewed, and classified into disease groups. Malignant tumor was found in 25.1% of the 323 patients, the remaining patients without malignant tumor had various clinical conditions; pregnancy (19.5%), infectious diseases (12.1%), trauma (10.2%), cerebrovascular accident (6.2%), hepatopathy (5.3%), and miscellaneous conditions (21.6%). The prevalence in female and young aged patients under 5 years was considered due to the lower reference range in these groups than in that of female adult groups, and moreover pregnancy in another superimposing factor in the former group. In regards to the causes of this condition, our study corresponded well to the textbook cited etiology of the low serum nitrogen concentration, although malnutrition and hepatopathy were inverted in their incidental order. We postulated, through the present study, that the low serum urea nitrogen concentration is not pathognomonic findings to suggest specific disease or conditions, but rather to reflect patient's general conditions such as hydration, nutrition, or administration of certain drugs.
Adult ; Communicable Diseases ; Female ; Humans ; Malnutrition ; Nitrogen* ; Pregnancy ; Prevalence ; Reference Values ; Stroke ; Urea*

No abstract available.

Neurotoxicity in the workplace may occur with exposure to scores of chemicals. Although large acute outbreaks of the occupational neurological disease are rare, the incidence of occupational neurotoxicity in its subtler aspects is unknown. A working knowledge of both the major occupational neurotoxic solvents and the tools used by clinical neurologists and neurotoxicologists to evaluate neurotoxicity in working population is a necessity for the occupational physician. To investigate the effects of carbon disulfide(CS2) on the peripheral nerve system using the nervous conduction study, 105 male workers working in the spinning room of a viscose rayon factory were examined and compared with a sex and age matched, unexposed 105 male controls using t-test analysis. 72.4% of CS2-exposed workers complained of neurological symptoms, and the abnormal cases in nerve conduction study were 48.6%. The abnormal cases of nerve conduction study increased in number according as the age and duration of exposure increased. In this study, asymptomatic workers were confirmed to have subclinical neuropathy by nerve conduction study. Also as there were abnormal cases even in its duration of exposure below 4 years, nerve conduction study turned out to be ways of discovering of early peripheral neuropathy. In nerve conduction study, the amplitude, velocity, F-wave latency and H-reflex of the motor and sensory nerves in both upper and lower extremities were significant different between CS2-exposed workers and the controls. From the pathological viewpoint, both segmental and axonal degenerations were assumed in this study.
Axons ; Carbon Disulfide* ; Carbon* ; Disease Outbreaks ; H-Reflex ; Humans ; Incidence ; Lower Extremity ; Male ; Neural Conduction ; Peripheral Nerves ; Peripheral Nervous System Diseases* ; Solvents

Since rupture of the Achilles tendon was first reported by Pare in 1575, various caues and diagnostic and therapeutic methods have been described by many workers. Almost all these workers agree that with early diagnosis and early treatment the prognosis is good. But the incidence of misdiagnosis by the physician as well as the patient's own neglect of his condition is disconcertedly high one. Nevertheless, negiected rupture of the Achilles tendon may lead to good results by proper selection of tbe operative method. In this report 16 cases of neglected ruptures of the Achilles tendon, in which treatment had been delayed more than 3 weeks were reviewed. A follow-up study of more than 6 months was made on 14 of these cases treated during the 5 year period from February 1973 to August 1977. The results are summarized as follows: 1. The causes responsible for the neglected ruptures were misdiagnosis by the physician in 62.5% and the patient's own neglect of his condition in 25% of the cases. The patient, in many cases, failed to seek medical treatment because of the rapid disappearance of pain, the absence of an open wound, ability of mild ankle plantar flexion, and the ability to walk. 2. Neglected rupture of the Achilles tendon occured most commonly in man of 4th decade. 3. Left side injuries were more common than right side injuries with a ratio of 9:7. 4. Ruptures by indirect injury were more common than by direct injury with a ratio of 9:7, and were most common during recreation and sports activities. 5. The most frequent site of rupture was 2 to 6 cm above the insertion of the tendon with 81% of the cases. 6. The end-to-end suture with pull-out wire method and Lindholm's operative method gave good (Excellent or Satisfactory) results in neglected rupture of the tendon as well. 7. Even in cases of neglected Achilles tendon rupture, normal function can be regained in approximately 6 months post-operatively if proper method of treatment is selected.
Achilles Tendon ; Ankle ; Clinical Study ; Diagnostic Errors ; Early Diagnosis ; Follow-Up Studies ; Humans ; Incidence ; Methods ; Prognosis ; Recreation ; Rupture ; Sports ; Sutures ; Tendons ; Wounds and Injuries

Today, the exact causal relationship between prolapsed intervertebral disk and sciatica remains unclear. Murphy has proposed that inflammation rather than mechanical pressure is the basis of back pain and sciatica, and that causal irritant is likely to be a chemical product of disk degeneration. The administration of steroids into the epidural space reduces the inflammatory process of the neural structure is well known. We have studied the effect of injection of methylprednisolone acetate (Depomedrol) comparing with the effect of operative treatment. One hundred and eleven cases suffuring from diskogenic low back pain had been treated at Wallace Memorial Baptist Hospital during 2.5 years period from May 1979 to Nov. 1981. The results were as follows: 1. Sixteen patients (14%) stated that they had no relief from the injection, 24(22%) were moderately improved, 52(47%) were markedly improved and 19(17%) were completely relieved of symptoms. 2. The candidates for laminectomy which were confirmed by myelogram had complete improvement in 12%, marked improvement in 39%, moderate improvement in 21%, no relief in 28%.
Back Pain ; Epidural Space ; Humans ; Inflammation ; Intervertebral Disc ; Intervertebral Disc Degeneration ; Laminectomy ; Low Back Pain ; Methylprednisolone ; Protestantism ; Sciatica ; Steroids

Recently, accumulation of knowledge on cerebrovascular microanatomy and its hemodynamics and advances in interventional equipments, especially microcatheters, could make superselective embolization as well as for an adjunctive preoperative procedures The authors performed superselective angiography and embolization with Tracker microcatheter in 25 procedures out of 15 patients with brain arteriovenous malformations (AVMs). Complete embolization was done in 7 prtients (46.7%), nearly complete embolization in 6 patients(40.4%), and partial embolization in 2 patients (13.3%). The overall curative success rate of embolization was 86.7%. Five patients showed no complication at all. Mild complications, however, were observed in 7 patients (46.8%). Severe complications such as AVM or Tracker rupture were observed in 3 patients (20%). In conclusion, superselective embolization is and effective method for the treatment of brain AVMs, and multiple session embolizations could reduce the complication rate and increase the success rate.
Angiography ; Arteriovenous Malformations* ; Brain* ; Hemodynamics ; Humans ; Methods ; Preoperative Care ; Rupture