PURPOSE: To identify age, gender, medication, seasons and place of fall, and areas of the fractures from the fall among the hospitalized elderly patients in order to provide the basic data for future fall prevention program for the elderly. METHODS: This study was conducted for 106 elderly patients admitted into a university hospital by fractures from the fall during the period from January 1, 1999 to December 31, 1999. Data on the age, gender, medication, season and place of the fall, areas of the fracture were collected based on their medical records. RESULT: The age range of the subjects were from 60 to 96 years old. The subjects were aged between 60-69 years old 49(46.2%), between 70-79 years old 31(29.2%), between 80-89 years old 24(22.6%), and over 90 years old 2(1.9%). Male patients comprised was 34(28.3%), while female patients comprised 76(71.7%). The fall occurred in Winter most frequently 34(32%). The place of the fall included room 81(76.4%), streets 13(12.3%), bathroom 6(5.7%), stair 4(3.8%), and mountain 2(1.9%). Twenty-two subjects (20.8%) had medication regularly, while 84 subjects (79.2%) had no medication. The areas of the fracture from the fall included upper extremities 20(18.9%) and lower extremities 86(81.1%). Radius fracture (7.5%) was the area where the fracture occurred most frequently in upper extremities and femur fracture (52.8%) was the area where the fracture occurred most frequently in lower extremities. A significant difference was found in the fracture area by age, season and place of the fall (p<.05). No significant difference was found in the fracture area by gender and medication. In all age groups, seasons and places of the fall, occurrence of fracture in lower extremity was significantly higher than that in upper extremity.
Aged* ; Aged, 80 and over ; Female ; Femur ; Humans ; Lower Extremity ; Male ; Medical Records ; Radius Fractures ; Seasons ; Upper Extremity

Although excessive arteriovenous fistula blood flow may be a factor in the development of high-output cardiac failure, this diagnosis is easily over-looked. Surgical reduction of fistula blood flow can improve the condition. We here report a case of high-output cardiac failure due to excessive arterio-venous fistula blood flow in a hemodialysis patient. A 51-year-old man who had been treated with hemodialysis since 5 years ago was admitted for increasing cardiac failure. Echocardiographic evaluation of cardiac output and duplex measurement of the fistula confirmed the diagnosis of high-output cardiac failure due to excessive arteriovenous fistula blood flow. After surgical closure of the fistula, the signs and symptoms of cardiac failure subsequently subsided and both systolic and diastolic dimension of left ventricle much decreased.
Arteriovenous Fistula* ; Cardiac Output ; Diagnosis ; Echocardiography ; Fistula ; Heart Failure* ; Heart Ventricles ; Humans ; Middle Aged ; Renal Dialysis*

A 55-year-old woman was referred to our hospital with a 6-month history of dyspnea (NYHA II-III). The physical examination revealed a grade 2/6 "tumor plop," i.e., a low-pitched sound heard during early or mid-diastole. The chest X-ray showed mild cardiomegaly with lung congestion in both lower lung fields. Two-dimensional echocardiogram showed a large myocardial mass, prolapsing into the left ventricle during diastole. Chest computed tomography showed a multi-lobulated mass (6.8x4.1 cm) attached to the interatrial septum during systole and prolapsing into the left ventricle during diastole. Coronary angiography demonstrated large tumor vessels arising from and surrounding the posterior lateral branch of the right coronary artery. The mass was excised and the patient recovered uneventfully.
Cardiomegaly ; Coronary Angiography ; Coronary Vessels ; Diastole ; Dyspnea ; Estrogens, Conjugated (USP) ; Female ; Glycosaminoglycans ; Heart Atria ; Heart Ventricles ; Humans ; Lung ; Middle Aged ; Myxoma ; Physical Examination ; Systole ; Thorax

Laparoscopic sleeve gastrectomy has become a standard procedure in bariatric surgery owing to its efficacy and simplicity. However, this procedure can cause life-threatening complications such as a gastric staple-line leak. A 24-year-old woman was transferred to the emergency department for evaluation of epigastric pain. Nine days prior to transfer, she underwent laparoscopic sleeve gastrectomy at another institution. Abdominal computed tomography (CT) revealed fluid collection with air density along the left subphrenic space and gastrosplenic ligament area. Intravenous antibiotics and total parenteral nutrition were initiated. She underwent percutaneous catheter drainage. On postoperative day 18, an esophagogastroduodenoscopy was performed to assess the site and size of the leak, and revealed a leak at the proximal staple line just below the gastroesophageal junction. A newly designed, fully covered antimigratory esophageal stent was placed to cover the leak from the distal esophagus to gastric midbody. Follow-up abdominal CT demonstrated improvement of the fluid collection at the location of the previous gastric leak. The stent was removed 3 weeks after insertion, and a barium study confirmed no more leakage. In this case, we experienced that the newly designed esophageal stent was safe and effective for preventing migration in the management of leak after laparoscopic sleeve gastrectomy.
Anastomotic Leak ; Anti-Bacterial Agents ; Bariatric Surgery ; Barium ; Catheters ; Drainage ; Emergency Service, Hospital ; Endoscopy, Digestive System ; Esophagogastric Junction ; Esophagus ; Female ; Follow-Up Studies ; Gastrectomy ; Humans ; Ligaments ; Obesity ; Parenteral Nutrition, Total ; Stents ; Tomography, X-Ray Computed ; Young Adult