BACKGROUND: One of the factors that affect the anesthetic risk is preoperative status especially in geriatric patients. So we studied about followings; 1) Can we use APACHE scoring index when we assess the physical status of geriatric patients preoperatively? 2) Is it meaningful in saying the risk of anesthesia? 3) Which one is more significant in predicting the morbidity and mortality: acute physiologic status vs chronic health status? METHOD: Preoperative status of the geriatric patients (above 65 years old), who were received operation from June 1994 to March 1996 at Hanil General Hospital, were assessed by APACHE scoring index and ASA classification. Age, sex, type of operation, emergency or elective, method of anesthesia, duration of procedure, APACHE scoring index, ASA classification, perioperative complication, postoperative complication is coded by grading or type. RESULT: Perioperative complication was showed statistically significant with acute physiologic score (APS) and duration of procedure. Postoperative complication was showed statistically significant with APACHE score or ASA class. Total complication was affected by duration of procedure and APS score. There was also correlation between ASA class and total complication. Among 265 cases, 1 case expired during operation and 7 cases expired after operation. Causes of postoperative death were pneumonia, hemorrhagic shock etc. CONCLUSION: In geriatric patients, 1) APACHE scoring index is available for preoperative assessment. 2) APACHE scoring index is meaningful in predicting the risk of anesthesia. 3) Perioperative complication was more correlated with acute physiologic status than chronic health evaluation.
Anesthesia ; APACHE* ; Classification ; Emergencies ; Hospitals, General ; Humans ; Mortality ; Pneumonia ; Postoperative Complications ; Shock, Hemorrhagic

Congenital lingual cyst is rare and there has been no prior case report about prenatally detected lingual cyst in Korea. When a huge oral cyst is observed at prenatal period and can cause life-threatening airway obstruction at birth, ex utero intrapartum treatment (EXIT) procedure is needed to secure the airway. Herein we present a baby with a prenatally detected huge oral cyst. He was delivered safely assisting EXIT procedure and underwent an operation for resection of the cyst from his tongue. The oral cyst was diagnosed as a lingual cyst with rare histologic type consisting mixed gastrointestinal and respiratory epithelium.
Airway Obstruction ; Korea ; Mouth ; Parturition ; Respiratory Mucosa ; Tongue

Purpose: The purpose of this study was to identify the knowledge and attitudes of oncology nurses towards clinical trials and to provide evidence for the development of clinical trial education programs for oncology nurses. Methods: The study was conducted on 142 nurses who had more than six months of nursing experience working with cancer patients at a tertiary hospital in Seoul, Korea. A structured questionnaire was used to measure the knowledge and attitudes of oncology nurses towards clinical trials. Results: The participants scored an average of 15.03±3.52 out of 19 in terms of knowledge about clinical trials. In terms of attitudes towards clinical trials, the participants scored an average of 5.91±1.37 out of 8. There was a significant positive correlation between the knowledge and attitudes of the participants towards clinical trials (r=.23, p=.007). Conclusion This study found that there was a relationship between the knowledge and attitudes of oncology nurses towards clinical trials. To improve the competency of oncology nurses and provide high-quality care to patients participating in clinical trials, more systematic and sustainable education is needed.

Mostly of the sudden deaths, except in-hospital death and death within 48 hours of discharge, are declared in the emergency department by emergency physician. The purpose of this study is to review the protocol of cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest by understanding the cause of sudden death from autopsy results. A retrospective analysis was performed by 48 months of medical records from emergency department of a tertiary hospital. The analysis was made from the patient group which gone through autopsy in the main office of National Institute of Scientific Investigation. In the emergency department, 1913 patients were declared death and 43 patients have received autopsy and 19 (1.0%) were natural death. 14 partients received CPR in the natural death group, and 13 were specified as cardiovascular disease. Result of this study represents the importance of prehospital CPR in case of unexpected cardiac arrest patients. However to generalize this result, all dead patients must go through autopsies for medical purpose which the frequency alse should be increased.
Autopsy ; Cardiopulmonary Resuscitation ; Cardiovascular Diseases ; Death, Sudden ; Emergencies ; Heart Arrest ; Humans ; Medical Records ; Out-of-Hospital Cardiac Arrest ; Retrospective Studies ; Tertiary Care Centers

BACKGROUND: Osteoarthritis (OA) is a chronic disease that commonly afflicts the elderly. This disease reduces the health-related quality of life (HRQoL) and causes a significant social burden. Whether the effect of coexisting chronic conditions on HRQoL varies according to the presence of OA remains unclear. Therefore, this study aimed to investigate this notion. METHODS: A total of 13,395 participants were identified from the 2009–2013 Korean National Health and Nutrition Examination Survey for analysis. HRQoL was assessed using the European quality of life-5 dimensions (EQ-5D) index. Patients with OA were defined as those diagnosed by a physician or those who displayed both, symptoms and radiological findings consistent with OA at the time of the survey. Associations between OA and 8 chronic conditions were tested using regression analysis. RESULTS: The EQ-5D index was lower in patients with OA than in those without (mean difference, −0.145; 95% confidence interval [CI], −0.138 to −0.151; P<0.001). Most patients with OA and chronic conditions showed a lower score than those without. EQ-5D was particularly lower in OA patients with hypertension, dyslipidemia, stroke, and renal failure. The estimated β coefficient for the interaction term was significant in renal failure (−0.034; 95% CI, −0.055 to −0.012), after adjusting for demographic and socio-economic variables. CONCLUSION: OA significantly affects HRQoL of Korean elderly individuals alone or when combined with other conditions. OA combined with renal failure is particularly detrimental. These results indicate the importance of managing OA, which is an underestimated disease in public health surveys.
Adult* ; Aged ; Chronic Disease* ; Comorbidity ; Dyslipidemias ; Humans ; Hypertension ; Korea* ; Nutrition Surveys ; Osteoarthritis* ; Public Health ; Quality of Life* ; Renal Insufficiency ; Stroke

Background: Regeneration of soft tissue defects is essential for adipose tissue pathologies and disease, trauma, or injury-induced damage. Here, we show that umbilical cord blood-derived mesenchymal stem cells could potentially be tailored and used for the reconstruction of specific damaged sites. Adipogenesis can be exploited in soft tissue reconstruction. Also, primary cilia play a role in the control of adipogenesis. Methods: The adipogenic differentiation capacity of mesenchymal stem cells (MSCs) was shown to influence ciliogenesis. MSCs transfected with intraflagellar transport 88 (IFT88) small interfering RNA (siRNA), which blocks the assembly and maintenance of cilia, were examined to confirm the relationship between adipogenesis and ciliogenesis. Also, 1,2-Bis(2-aminophenoxy) ethane-N,N,N′,N′-tetraacetic acid tetrakis(acetoxymethyl ester) (BAPTA-AM), calcium chelator, inhibited the ciliogenesis of MSCs in adipogenic differentiation. Results: IFT88-knockdown led to decreased cilia formation and limitation of cilia elongation in adipogenesis. Additionally, intracellular calcium triggered cilia formation in MSCs adipogenesis. Interestingly, intracellular calcium cannot overcome the inhibition of adipogenesis caused by low numbers of cilia in MSCs. Conclusion Our data suggested that ciliogenesis was negatively regulated by Wnt5a/β-catenin signaling during adipogenesis. Thus, we suggest that calcium induction triggers adipogenesis and ciliogenesis.

Percutaneous mitral balloon valvuloplasty (PMBV) is the treatment of choice for mitral stenosis. Only a few reported cases have been reported in PMBV patients worldwide. In this study, a case of a 34 year-old female with infective endocarditis a year after PMBV is presented. The patient presented with fever, and peripheral vascular symptoms. Transthoracic echocardiography showed vegetation on the anterior mitral leaflets and Staphylococcus Viridans was isolated from blood cultures. The patient was successfully treated with Amoxicillin + Clavulate and Gentamicin. Further studies on the correlation between PMBV and infective endocarditis are needed.
Amoxicillin ; Balloon Valvuloplasty* ; Echocardiography ; Endocarditis* ; Female ; Fever ; Gentamicins ; Humans ; Mitral Valve Stenosis ; Staphylococcus

Transfer of large quantities of fetal blood across the placental barrier to the maternal circulation is a rare occurrence which results in severe anemia in the newborn infants. This phenomenon is believed to occur most often during labor and delivery and apparently, is more frequent when abnormal obstetric conditions are present. However, fetal erythrocytes have been identified in the naternal circulation throughout most of pregnancy indicating some degree of constant or intermittent transplacental transfusion. We experienced a case of stillbirth due to large amount of fetomaternal transfusion. Acid elutionl test of maternal blood was positive and direct and indirect Coombs test was negative. Ultrasonographic finding on abdomen and cranium to rule out the internal hemorrhage was normal. We report a case of stillbirth due to fetomaternal transfusion with a brief review of related literatures.
Abdomen ; Anemia ; Coombs Test ; Erythrocytes ; Female ; Fetal Blood ; Fetomaternal Transfusion* ; Hemorrhage ; Humans ; Infant, Newborn ; Pregnancy ; Skull ; Stillbirth*

BACKGROUND AND OBJECTIVES: Metabolic syndrome and high sensitivity C-reactive protein (hs-CRP) are known to be strong predictors of coronary atherosclerosis. Even though there have been many observations and much research concerning the association of coronary atherosclerosis with CRP and metabolic syndrome, certain problems still need to be resolved in order to produce clear mechanistic illustrations. Therefore, the correlations of metabolic syndrome, hs-CRP and the severity of coronary atherosclerosis were evaluated herein. SUBJECTS AND METHODS: 271 patients, aged between 29 and 87, who had undergone diagnostic coronary angiograms at the National Medical Center, between January, 2004 and June, 2006 were evaluated. Coronary angiograms were performed in patients who complained of typical chest pain and had risk factors associated with coronary atherosclerosis. The correlations of metabolic syndrome, hs-CRP and coronary atherosclerosis were analyzed in these patients. RESULTS: Positive relationships were found between the metabolic syndrome risk factor clustering and an increased level of hs-CRP (p<0.01). The severity of coronary atherosclerosis increased with the increasing number of metabolic syndrome risk factors. As metabolic syndrome risk factor clustering increased, the quantity of 1, 2 and 3 vessel diseases also increased (Odd ratios 1.61, 1.83 and 2.50; p=0.001, <0.001 and <0.001, respectively). In contrast to metabolic syndrome risk factor clustering, no definite relationship between the hs-CRP level and the severity of coronary atherosclerosis was observed. CONCLUSION: The more metabolic syndrome risk factors clustered, the greater the severity of coronary atherosclerosis. The extension of coronary atherosclerosis maybe predicted using evaluation of metabolic syndrome risk factor clustering in patients with angina.
C-Reactive Protein ; Chest Pain ; Cluster Analysis* ; Coronary Angiography ; Coronary Artery Disease* ; Humans ; Metabolic Syndrome X ; Risk Factors*

OBJECTIVE: This study was designed to define the Korean norm values for the Ricketts analysis. METHODS: In this longitudinal study, lateral cephalograms of 31 subjects with normal occlusion were taken biennially from ages 9-19 years. Cephalometric measurements were performed. Parameters for which the 10-year change did not exceed one standard deviation were defined as unchanged. The means and standard deviations for the measured parameters were determined for each age group. RESULTS: No significant changes in growth were observed in the molar relationship, incisor overjet, incisor overbite, mandibular incisor extrusion, interincisor angle, lower incisor tip (B1) to A point-Pogonion (A-PO) plane, upper incisor tip (A1) to A-PO plane, B1 inclination to A-PO, A1 inclination to A-PO, B1 inclination to Frankfurt plane (FH), convexity, lower facial height, facial axis, maxillary depth, maxillary height, palatal plane to FH, cranial deflection, ramus Xi position, or porion location. Continual changes over the 10 years of growth were observed in the maxillary first molar distal position to pterygoid true vertical plane, facial depth, mandibular plane to FH, anterior cranial length, mandibular arc, and corpus length. CONCLUSIONS: Clinicians can apply the Korean norms at age 9 as determined in this study when using the Ricketts analysis. The patient's age at the beginning of treatment and their sex should be taken into consideration when drawing visual treatment objectives.
Axis, Cervical Vertebra ; Growth and Development ; Humans ; Incisor ; Longitudinal Studies ; Molar ; Overbite