No abstract available.
Schizophrenia*

PURPOSE: The purpose of this study is to investigate the relative surgical risk and problems in hip hemiarthroplasty for treatment of an unstable intertrochanteric fracture in elderly patients over 80 years old. MATERIALS AND METHODS: Between April 2005 and May 2010, 58 patients whose age was over 80 years were available for inclusion in this study. They were divided into two groups: group 1 included 30 patients with femoral neck fracture and group 2 included 28 patients with intertrochanteric fracture. No significant differences in average age, concomitant disease, and walking ability before development of fracture were noted between the two groups. The following factors, including interval from development of fracture to operation, operation time, amount of blood loss, start time of walking after operation, duration of hospital stay, complications, revision rate, and walking ability were compared between the two groups. RESULTS: Operation time was an average of 85.2 minutes in group 1 and 97.5 minutes in group 2(P=0.03). The amount of bleeding was an average of 483 cc in group 1 and 695 cc in group 2(P=0.006). Similar results for walking start and recovery of walking ability after operation were observed in the two groups. No significant differences were observed in duration of hospital stay, complications, and revision rate. While 25 patients in group 1(83.3%) showed restoration of walking ability after operation to the same level of walking before injury, 19 patients in group 2(67.8%) showed restoration of walking ability postoperatively. CONCLUSION: Even though patients in group 2 showed a longer operation time and a higher amount of blood loss, compared with those in group 1, patients in group 2 had similar surgical risk and complications, compared with those in group 1. Therefore, primary hip hemiarthropalsty could be a good treatment option for intertrochanteric fracture in elderly.
Aged ; Femoral Neck Fractures ; Femur Neck ; Hemiarthroplasty ; Hemorrhage ; Hip ; Hip Fractures ; Humans ; Length of Stay ; Walking

No abstract available.
Management Information Systems* ; Occupational Health Services* ; Occupational Health*

The purposes of this study was to analyze the operational difference of foodservice center for homebound elderly by the presence of the dietitian. The questionnaire was developed to measure all variables for menu management and distributed to 103 meal service centers in charge of congregate meal service program and 57 centers for home-delivered meal service program. The data of 160 centers in charge of congregate meal service and home-delivered service centers were usable for analysis. Statistical data analysis was completed using the SAS 8.1 package program for descriptive analysis and chi-square test. Only 21.9% meal service centers had dietitians, what is more, they were not professionals who did menu management but foodservice managers, volunteers, cook or social workers. The current foodservice programs for the homebound elderly were operated without professional. In the part of menu managemet, dietitians were more actively involved in menu planning in the elderly foodservice center in the presence of the dietitians. The performance level of healthcare service was not significantly different, but the nutrition education in the elderly foodservice center with the dietitians was more frequently performed than that without the dietitians(p<0.05). In the food purchasing and food production management, the significant differences were shown that in the elderly foodservice centers in the presence of the dietitians, the proportion of the contract purchasing was significantly higher than that of direct purchasing(p<0.01). In food sanitary management, the significant differences were not shown in the part of management of keeping meal for identifying the cause of food-borne illness and left-over, but the sanitation education for the foodservice employees was performed more frequently by the presence of the dietitians(p<0.01). In conclusion, the foodservice management was more systematically conducted in the elderly foodservice centers in the presence of the dietitians than that without dietitians. The elderly foodservice program has offered the health-related support for homebound elderly. Although there were several problems in elderly foodservice management, the program delivered well-targeted, effective, and efficient nutrition services and wide range of supportive service to the at-risk older population. It needs to be managed by professional for the improvement in the elderly foodservice.
Aged* ; Data Interpretation, Statistical ; Delivery of Health Care ; Education ; Humans ; Meals ; Menu Planning ; Nutritionists* ; Surveys and Questionnaires ; Sanitation ; Social Workers ; Volunteers

The purposes of this study was to analyze the operational difference of foodservice center for homebound elderly by the presence of the dietitian. The questionnaire was developed to measure all variables for menu management and distributed to 103 meal service centers in charge of congregate meal service program and 57 centers for home-delivered meal service program. The data of 160 centers in charge of congregate meal service and home-delivered service centers were usable for analysis. Statistical data analysis was completed using the SAS 8.1 package program for descriptive analysis and chi-square test. Only 21.9% meal service centers had dietitians, what is more, they were not professionals who did menu management but foodservice managers, volunteers, cook or social workers. The current foodservice programs for the homebound elderly were operated without professional. In the part of menu managemet, dietitians were more actively involved in menu planning in the elderly foodservice center in the presence of the dietitians. The performance level of healthcare service was not significantly different, but the nutrition education in the elderly foodservice center with the dietitians was more frequently performed than that without the dietitians(p<0.05). In the food purchasing and food production management, the significant differences were shown that in the elderly foodservice centers in the presence of the dietitians, the proportion of the contract purchasing was significantly higher than that of direct purchasing(p<0.01). In food sanitary management, the significant differences were not shown in the part of management of keeping meal for identifying the cause of food-borne illness and left-over, but the sanitation education for the foodservice employees was performed more frequently by the presence of the dietitians(p<0.01). In conclusion, the foodservice management was more systematically conducted in the elderly foodservice centers in the presence of the dietitians than that without dietitians. The elderly foodservice program has offered the health-related support for homebound elderly. Although there were several problems in elderly foodservice management, the program delivered well-targeted, effective, and efficient nutrition services and wide range of supportive service to the at-risk older population. It needs to be managed by professional for the improvement in the elderly foodservice.
Aged* ; Data Interpretation, Statistical ; Delivery of Health Care ; Education ; Humans ; Meals ; Menu Planning ; Nutritionists* ; Surveys and Questionnaires ; Sanitation ; Social Workers ; Volunteers

Epstein's syndrome is a rare disease whish is characterized by the association of thrombocytopenia, macrothrombocytopathia, nephritis and deafness. We experienced a case of Epstein's syndrome in a 12 years old male patient who was presented with a life long history of bleeding, usually as epistaxis, bilateral sensorineural deafness and hematuria with proteinuria starting in late childhood. Hematologic studies showed thrombocytopenia with giant platelets and anemia. A bone marrow aspirate revealed the megakaryocytes to be adequate in number and many giant size platelets. Platelet do not respond to addition of A and epinephrine; collagen and ristocetin induced agglutination response is decreased. It is difficult to be certain the association of thrombocytopenia with giant platelets, nephritis and deafness constitutes a new hereditary disease with a distinct pathogenesis or if it is an expansion of the well recognized Alport's syndrome of hereditary nephritis deafness. We report a case of Epstein's syndrome syndrome with brief review of related literatures.
Agglutination ; Anemia ; Blood Platelets ; Bone Marrow ; Child ; Collagen ; Deafness ; Epinephrine ; Epistaxis ; Genetic Diseases, Inborn ; Hematuria ; Hemorrhage ; Humans ; Male ; Megakaryocytes ; Nephritis ; Nephritis, Hereditary ; Proteinuria ; Rare Diseases ; Ristocetin ; Thrombocytopenia

BACKGROUND: Portable devices for measuring peak expiratory flow(PEF) are now of proved value in the diagnosis and management of asthma and many lightweight PEF meters have become available. However, it is necessary to determine whether peak expiratory flow rate(PEFR) measurements measured with peak flowmeters is accurate and reproducible for clinical application. The aim of the present study is to define accuracy, agreement, and precision of mini-Wright peak flow meter(MPFM) against standard pneumotachygraph. METHODS: The lung function tests by standard pneumotachygraph and PEFR measurement by MPFM were performed in a random order for 2 hours in 22 normal and 17 asthmatic subjects and also were performed for 3 successive days in 22 normals. RESULTS: The PEFR measured with MPFM was significantly related to the PEFR and FEV1 measured with standard pneumotachygraph in normal and asthmatics(for PEFR, r=0.92 p<0.001; for FEV1, r=0.78 ; p<0.001). The accuracy of MPFM was within 10%(limits of accuracy recommeded by NAEP) in all the subjects or 22 normal, mean difference from standard pneumotachygraph being I 6.5L/min(percentage of difference being 2.90%) or 1 0.6L/min(percentage of difference being 1.75%), respectively. According to the method proposed by Bland and Altman, the 95% limits of the distribution of differences between MPFM and standard pneumotachygraph after correction of PEFR using our regression equation were +38.2 and -71.5L/min in all the subjects or -20.49~ + 9.49L/min in 22 normal and was similar to the intraindividual agreements for 3 successive days in normal. There was no statistically significant difference of PEFR measured with MPFM and standard pneumotachygraph among three days(p>0.05) and the coefficient of variation(2.4 1.2%) of PEFR measured with MPFM was significantly lower than that( 5.2 3.5%) with standard pneurnotachygraph in normal (p<0.05). CONCLUSION: This results suggest that the MPFM was as accurate and reproducible as standard pneumotachygraph for monitoring of PEFR in the asthmatic subjects.
Asthma ; Diagnosis ; Flowmeters ; Peak Expiratory Flow Rate ; Respiratory Function Tests

The pseudolymphoma syndrome that may mimic malignant lymphoma clinically and histopathologically has been described as a hypersensitivity reaction to anticonvulsant drugs. It consists of the triad of a fever, generalized rash and lyrnphadenopathy. In some cases, varying degrees of malaise, hepatosplenornegaly, abnormal liver function tests, arthralgias, eosinophilia and blood dyscriasias may also be present. We report a case of pseudolymphoma syndrome due to carbamazepine in a 47-year-old man. He had a diffuse edematous and erythematous patches, papules and vesicles associated with high fever, hepatosplenomegaly and lymphadenopathy. The histopathologic finding slowed a dense atypical mononuclear cell infiltrate of the upper dermis associated with Pautriers microabscess like structures and severe dermal edema. Laboratory findings revealed leukocytosis and an abnormal liver function test. Three weeks after the withdrawal of carbamazepine and treatment with oral prednisolone, his skin lesion and general condition markedly improved.
Anticonvulsants ; Arthralgia ; Carbamazepine* ; Dermis ; Edema ; Eosinophilia ; Exanthema ; Fever ; Humans ; Hypersensitivity ; Leukocytosis ; Liver Function Tests ; Lymphatic Diseases ; Lymphoma ; Middle Aged ; Prednisolone ; Pseudolymphoma* ; Skin

Many factors are thought to be affecting to the graft and patient survival. We have analyzed our surgical 200 renal transplantation performed at Kosin Medical Center. Pusan, Korea from December l984 to May 1990. Overall 1 and 3 years graft and patient survival rates were 91.9%, 94.2% 83.6%. and 93.0% respectively. Arterial spasm was occurred in four cases but the difference of occurrence or acute tubular necrosis and graft survival rate were not significant statistically. End to side arterial anastomosis was performed in four cases. Polar artery was ligated in four cases. Average total ischemic time was 50.7 minutes There was no loss of graft loss due to urological complications. We found that there was no notable significance of these selected surgical factors which influencing patient and graft survival at our Medical Center.
Arteries ; Busan ; Graft Survival* ; Humans ; Kidney Transplantation* ; Korea ; Necrosis ; Spasm ; Survival Rate ; Transplants*

BACKGROUND: Laryngoscopy and tracheal intubation for general anesthesia are potent stimuli to the cardiovascular system due to sympathetic stimulation. The aim of this study was to compare the hemodynamic responses with different administration routes of lidocaine on blood pressure and heart rate changes associated with tracheal intubation. METHODS: Sixty patients were randomly assigned to spray group (Group 1, n=20) received 10% lidocaine 1.5 mg/kg spray to intratracheally immediately before tracheal intubation, IV group (Group 2, n=20) received 2% lidocaine 1.5 mg/kg intravenously before 90 sec tracheal intubation and control group (Group 3, n=20). Anesthesia was induced with thiopental 5 mg/kg IV, vecuronium 0.1 mg/kg and 50% N2O-O2- 2vol % enflurane. After 5 minutes, tracheal intubation was performed. Mean arterial pressure and heart rate were measured at preintubation and immediately postintubation, 1, 3, 5 mins after tracheal intubation. RESULTS:The differences of mean arterial pressure which were measured at preintubation and immediately postintubation and 1 minute after intubation in group 1 were significantly lower than those in other group (p<0.05). The differences of heart rate which measured at preintubation and 1 minute after intubation were lower than those in group 3 (p<0.05). CONCLUSIONS: For the suppression of sympathetic stimulation following tracheal intubation, 10% lidocaine spray to the laryngotrachea is an effective method to suppress cardiovascular response.
Anesthesia ; Anesthesia, General ; Arterial Pressure ; Blood Pressure ; Cardiovascular System ; Enflurane ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Intubation* ; Laryngoscopy ; Lidocaine* ; Thiopental ; Vecuronium Bromide