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 absence of nails usually occur as a rare isolated anomaly or combined with other ectodermal defects. This anomaly is regarded as an inherited disorder either dominantly or recessively but quite a few cases were reported as sporadically developed. The patient was a 2-month-old girl who had no nails on both her 2nd, 3rd toes but had rudimentary nails on her left big toe and both 4th toes at birth. We could not find any other congenital deformity, any family history of inherited diseases related to anonychia. Radiological findings revealed no visualization of both 4th distal phalanges, only. We report this case as congenital anonychia of a sporadic type which may have developed independently from an underlying bone abnormality. We also review other reported cases in the literature.
Congenital Abnormalities ; Ectoderm ; Female ; Hallux ; Humans ; Infant ; Parturition ; Toes*

No abstract available.

OBJECTIVES: This study was performed to investigate the relationship between age of onset in late-life depression and T2 hyperintensities observed in the brain MRI, we tried to see part of pathophysiology of late-life depression. METHOD: The subjects consisted of 18 patients whose first depressive episode occurred before age 50, and 20 patients whose first depressive episode occurred after age 50 years, and 20 agematched controls. Depressive patients were diagnosed according to DSM-IV. Established hyperintensity rating systems were used to analyse the T2 weighted images and blood pressure, cholesterol level, DM, EKG were measured to compare the relationships. RESULTS: 1) Signal hyperintensities on T2 weighted image were more severe in late-life depressive patients whose first depressive episode after age 50 (p<0.05) and there is no significant difference between patients whose first episode before age 50 and age-matched control subjects. 2) Mild signal hyperintensities were observed in all elderly depressed patients and control subjects, but severe hyperintensities were observed in late-onset depression. 3) Signal hyperintensities were related to age, hypertension, blood cholesterol level (p<0.05). CONCLUSION: The late onset depressive patients had more white matter hyperintensities on T2 weighted image than early onset depressive patients. this results support previous hypothesis that white matter change is the important biological factor of late-onset elderly depression and old age, hypertension, hypercholesterolemia may be associated with signal hyperintensities.
Age of Onset ; Aged ; Biological Factors ; Blood Pressure ; Brain* ; Cholesterol ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Electrocardiography ; Humans ; Hypercholesterolemia ; Hypertension ; Magnetic Resonance Imaging*

The VATER syndrome is a group of congenital anomalies with a nonrandom tendency for concurrence. Defects include vertebral, anorectal malformation, tracheoesophageal fisutla with esophageal atresia, radial-limb, vascular, and renal abnormalities. The critical period of organogenesis is at or before the sixth or seventh week of gestation. We experienced one case of VATER syndrome in a 1 day old male neonate having vertebral anomalies, esophageal atresia with tracheoesophageal fistula to the distal esophageal segment, imperforated anus, left renal dysplasia with hydronephrosis of the right kidney and both hydroureter, patent ductus arteriosus. We report a case of VATER syndrome with brief review of related literature.
Anal Canal ; Critical Period (Psychology) ; Ductus Arteriosus, Patent ; Esophageal Atresia ; Humans ; Hydronephrosis ; Infant, Newborn ; Kidney ; Male ; Organogenesis ; Pregnancy ; Tracheoesophageal Fistula

No abstract available.
Head* ; Neck*

OBJECTIVES: The aim of the present study was to evaluate the effect of fluoride mouthrinse with low pH on the surface microhardness of artificial incipient carious enamel. METHODS: Firstly, the concentration of sodium fluoride and pH values were measured in commercially available mouthrinse. Secondly, DOCTOR Clean & Fresh(R) (Jang In Pharm, co., LTD. KOREA) with 0.02% sodium fluoride and pH value below pH 4.0 was selected as the experimental group, 0.02% sodium as the positive control group and distilled water as the negative control group. Enamel samples of n vine teeth (n=36) were divided into the three groups respectively and treated with the mouthrinse solutions for 3 and 20 minutes. The surface microhardness (Vickers hardness number, VHN) was measured with microhardness tester before and after the treatments. RESULTS: The average pH of DOCTOR Clean & Fresh(R) was 3.45+/-0.00, and it was acidic enough to cause tooth erosion. The difference of surface microhardness (DeltaVHN) before and after the 20 minute treatment was statistically significant among the groups: DOCTOR Clean & Fresh(R) (12.77+/-2.25 DeltaVHN), distilled water (0.24+/-0.75 DeltaVHN), 0.02% sodium fluoride solution (-0.62+/-1.62 DeltaVHN) (P<0.05). The DOCTOR Clean & Fresh(R) group with low pH showed greater changes on the surface microhardness of the carious enamel than those of other groups (P<0.05). CONCLUSIONS: It is suggested that the mouthrinse with low pH can reduce the surface microhardness of incipient carious enamel.
Dental Enamel ; Fluorides ; Hardness ; Hydrogen-Ion Concentration ; Sodium ; Sodium Fluoride ; Tooth ; Tooth Erosion ; Water

Formaldehyde is a colorless irritating gas of pungent odor, which is used as a disinfectant, antiseptic, deodorant, tissue fixative and embalming fluid, It is used in the formation of resins, alcohols and acids, and in permanent press processes in the textile industry. If formaldehyde is swallowed, severe abdominal pain and vomiting is immediately noted. Corrosive gastritis can follow with diffuse ulceration, fibrosis and contracture of the stomach, resembling linitis plastica, which may be severe enough to require gastrectomy. We report a case of cicatricial contracted stomach due to the ingestion of formalin.
Abdominal Pain ; Alcohols ; Contracture ; Deodorants ; Eating* ; Embalming ; Fibrosis ; Formaldehyde* ; Gastrectomy ; Gastritis ; Linitis Plastica ; Odors ; Stomach* ; Textile Industry ; Ulcer ; Vomiting

Allopurinol is one of the causative drugs that induce fixed drug eruption (FDE). The lymphocyte transformation test (LTT) is a safe and reliable diagnostic procedure for drug allergy, but is reported to be rarely positive in patients with FDE. In the current case, we performed an LTT and successfully confirmed allopurinol as the offending drug. This case report suggests that an LTT should be an optional diagnostic tool for FDE or delayed reaction due to allopurinol.
Allopurinol ; Drug Eruptions ; Drug Hypersensitivity ; Humans ; Lymphocyte Activation ; Lymphocytes

It is said that respiratory failure as an initial manifestation is extremely rare in adult polymyositis. Respiratory failure has been reported in the terminal stage of polymyositis and usually unresponsive to steroid therapy. We experienced two cases of polymyositis presenting with respiratory failure at onset due to respiratory muscle weakness. On admission they had only short history of increasing dyspnea and mild limb weakness before respiratory failure. Diagnosis of polymyositis was established by muscle enzyme, electromyography and muscle biopsy. Oral steroid therapy was initiated with assisted ventilation which resulted in good recovery. Although respiratory failure due to preferential respiratory muscle involvement is very rare, polymyositis should be considered as one of underlying diseases causing severe respiratory failure.
Adult ; Biopsy ; Diagnosis ; Dyspnea ; Electromyography ; Extremities ; Humans ; Polymyositis* ; Respiratory Insufficiency* ; Respiratory Muscles ; Ventilation