No abstract available.

BACKGROUNDS: As life expectancy is increasing, it is necessary to evaluate the health and nutritional status in elderly, especially in tube-fed elderly patients whose malnutritional status is related to the increase in mortality. This study was conducted to improve the nutritional status in tube-fed elderly patients. METHODS: Effects of nutritional support on tube-fed elderly patients(> or =65years) for 8 weeks were investigated by biochemical assessment and weight. RESULTS: When comparing the biochemical changes of the control group(n=8) with those of the case group(n=8), it showed significant differences in total protein, serum albumin and TLC(p<0.05), not in serum transferrin, serum iron, hemoglobin, hematocrit and weight(p>0.05). CONCLUSION: This study suggests the in tube-fed elderly patients can be improved if nutritional support is properly administrated.
Aged* ; Hematocrit ; Humans ; Iron ; Life Expectancy ; Mortality ; Nutritional Status ; Nutritional Support* ; Serum Albumin ; Transferrin

There are many difficult problems and various methods in the treatment of difficult fractures of the femur. We reviewed the records of twelve patients who had been managed with circular external fixation using the llizarov apparatus for difficult fractures of the femur at Keimyung University. Dongsan rnedical center from October 1993 to April l996. There were ten males and two females with an average age of 42 years (range, 16-74 years). Si.x of twelve patients were severely comminuted supracondylar and intercondylar fractures of the femur associated with severe soft tissue injury (including four open fractures). These patients were treated initially by closed reduction with Ilizarov external fixator and followed by compression-distraction techniques. Four of the remaining six ptients developed infected non-unions after internal fixation of the femur without shortening or bone defect. These infected non-unions were treated by curettage, irrigation and Ilizarov application. After the control of infection, compression - distraction techniques were applied. One of the remaining two patients had severe open comminuted fracture of the supra-intercondyle region of femur associated with diaphyseal segmental bone defect (5cm in length). This patient was treated with closed reduction and internal bone transportation usipg llizarov external fixator. One patient with varus deformity (20 degree) was treated by correction of the deformity and simple compression technique. In three patients, additional autogenous cancellous iliac bone graft was done. The union of the fracture site was obtained in ten patients and the duration of llizarov external fixation was an average of 10 months (range 6-14 months). We experienced several complications; there were twelve patients of limitation of motion of knee, ten patients of pin tract infection, one patient of fracture site non-union, one patient of re-fracture and one patient of femoral artery injury. We concluded that the Ilizarov external fixation technique is one of the effective methods for the treatment of difficult fractures of the femur in spite of its complexity and high incidence of complications.
Congenital Abnormalities ; Curettage ; External Fixators* ; Female ; Femoral Artery ; Femur* ; Fractures, Comminuted ; Humans ; Incidence ; Knee ; Male ; Soft Tissue Injuries ; Transplants ; Transportation

This study was performed to investigate the biochemical properties of Acanthamoeba proteinase, its role in the pathogenesis of Acanthamoeba keratitis and the therapeutic effect of the homogenate of amniotic membrane as a proteinase inhibitors. Acanthamoeba castellanii isolated from the keratitis patient was cultured in PYG medium, in which the excretory and secretory products were analysed. The secretory proteinases of A. castellanii wre identified using in vitro azocasein assay, activity-PAGE, and various protein substrate degradation assays, and one of them was purified and characterized. The pruified secretory proteinase was a kind of serine proteinase. Its molecular weight was 105 kDa and optimal pH was 8.5. It was able to degrade the various protein substrates such as fibronectin, IgA, IgG, fibrinogen. The various proteinase ingibitors and the amniotic membrane homogenates were tested in vitro against the purified seirne proteinase. The amniotic membrane homegenates markedly showed the inhibitory effect against the enzyme activity and this inhibitory effect was also revealed in animal study. In vivo study, this purified proteinase was infected into 14 pigmented rabbit corneas, pretreated with steroids. The corneal lesions induced by both of the purified proteinase and A. castellanii, showed similar clinical findings each other, in which the stromal infiltration and opacity with epithelial defect was revealed. These corneal lesions were significantly inhibited without any side effects of the amniotic membrane homogenates. Conclusively, Acanthamoeba proteinase was closely associated with the pathogenesis of Acanthamoeba keratitis. This study provides a successful animal model of Acanthamoeba keratitis using pigmented rabbit. And the fact that Acanthamoeba-induced corneal lesions were inhibited by the amniotic membrane homogenate, suggested that the amniotic membrane homogenate have the ability of the serine protinase inhibition further investigative studies are also necessary.
Acanthamoeba castellanii ; Acanthamoeba Keratitis* ; Acanthamoeba* ; Amnion* ; Animals ; Cornea ; Fibrinogen ; Fibronectins ; Humans ; Hydrogen-Ion Concentration ; Immunoglobulin A ; Immunoglobulin G ; Keratitis ; Models, Animal ; Molecular Weight ; Peptide Hydrolases ; Serine ; Serine Proteases ; Steroids

Aneurysm of the pulmonary artery is a rate entity. A neonate was seen with cyanosis and tachypnea. There was a grade 4/6 systolic murmur along the left sternal border. The chest X-ray showed a round mass shadow in the left parahilar region. Echocardiogram showed large Ventricular Septal Defect and mild Pulmonary Stenosis. The cardiac angiogram showed giant aneurysm of pulmonary artery. Surgical intervention was advised. However, the patient was discharged against operative plan. And the patient died two weeks later.
Aneurysm* ; Cyanosis ; Heart Septal Defects, Ventricular* ; Humans ; Infant, Newborn ; Pulmonary Artery ; Pulmonary Valve Stenosis* ; Systolic Murmurs ; Tachypnea ; Thorax

BACKGROUND: Assessing and securing airway is the beginning of the treatment for emergency patients. Rapid Sequence Intubation is a technique that uses sedatives and neuromuscular blockers to perform endotracheal intubation. This is a basic technique that all emergency physicians must master. Therefore, we investigated the recent circumstance of Rapid Sequence Intubation in patients at the emergency department. METHODS: Ten-item surveys were mailed to the board certified emergency physicians in the emergency department of 45 hospitals. Among the 45 surveys, 37 surveys were returned. The rate of reply was 82.2%. RESULTS: Throughout the hospital, 35/37 of the endotracheal intubation was performed in the emergency department. Anesthesiologists were not called for endotracheal intubation in 34/37 emergency department, and anesthesiologists were not called for the use of neuromuscular blockers in 36/37 emergency departments. 35 emergency departments used sedatives. The sedatives used were as follows : midazolam(48.6%), diazepam(25.7%), thiopental sodium(22.9%), and ketamine(2.9%). 30 emergency departments used neuromuscular blockers. The neuromuscular blockers used were as fallows : succinylcholine(46.7%), vecuronium(43.3%), and pancuronium(10.0%). The rate of Rapid Sequence Intubation was 33.8%. Various monitoring devices were used during Rapid Sequence Intubation ; cardiac monitors 90.5%, pulse oximeters 80.4%, noninvasive blood pressure monitors 64.9% and ETCO2/ 12.8%. Only 6 of 37 hospitals had the assessment program far endotracheal intubations and 60% was the assessment rate in these hospitals, however, there was no proctocol for the quality assurance assessment. CONCLUSION: Emergency endotracheal intubation was performed independently by the physician of the emergency department. The Rapid Sequence Intubation was effective and had low adverse effect. We recommended that Rapid Sequence Intubation should be used more aggressively in patients. Also, applying these assessment proctocol in patients, we could improve the quality of assurance assessment.
Blood Pressure Monitors ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Hypnotics and Sedatives ; Intubation* ; Intubation, Intratracheal ; Neuromuscular Blockade ; Neuromuscular Blocking Agents ; Postal Service ; Thiopental

To investigate the effect of hyperoxia on EKG findings and to evaluate the applicability of EKG as noninvasive monitoring index of oxygen toxicity, 38 rabbits were continuously exposed to 6 different conditions-3 hyperbaric oxygenations (HBO-2.5, 3.5 and 5ATA, 100% O2), normobaric oxygenation (NBO, 100% O2), hyperbaric aeration (HBA-5ATA, 21% O2) and normobaric aeration (NBA, 21% O2)-for 120 minutes and their EKG and time to dyspnea and convulsion were recorded. Dyspnea and death were observed in exposure conditions of HBO-3.5 and HBO-5 (Positive rate of dyspnea; 10%, 100%, death; 10%, 25%, respectively) only, and convulsion in 4 oxygenation groups (NBO; 20%, HBO-2.5; 20%, HBO-3.5; 20%, HBO-5; 88%). Abnormal EKG findings included arrhythmia and ST-T changes and the incidences was increasing with doses(partial pressure of oxygen). In addition to EKG change, findings observed during exosure were dyspnea and convulsion in the order of appearence and when non specific ST-T change was accepted as positive (abnormal) finding, the frequency of abnormal EKG was statistically significant(p<0.01), but when it was excluded from positive results, the frequency of EKG change was not significant(p>0.05). These results suggest that the effect of hyperoxia on heart is myocardial ischemia and arrhythmia, that oxygenation more than 3.5ATA causes myocardial damage in 120 minutes exposure, and that EKG is valuable as monitoring index of oxygen toxicity.
Arrhythmias, Cardiac ; Dyspnea ; Electrocardiography* ; Heart ; Hyperbaric Oxygenation ; Hyperoxia* ; Incidence ; Myocardial Ischemia ; Oxygen ; Rabbits* ; Seizures

No abstract available.
Korea

No abstract available.
Humans ; Ulsan*

BACKGROUND: The fire victims are affected not only by bum and trauma but also carbon monoxide(CO) and hypoxia. It may be useful to triage mass casualties of fire field that preestimate the victim's injury sevrrities by experiments of measuring the concentration of CO and oxygen according to time progression. METHOD: We prepared one house of apartment as like usual residental environment. The mesuring of concentrations of CO and oxygen was started from firing. RESULT: 3.8 Min. after firing: CO concentration(0.007%) was reached to the level that can give rise to spontaneous headache. 5 Min.: The concentration of CO was incerased. At this level(0.012%), the victims of fire may be suffered severe headache inspite of mild movement. 5.5 Min.: At this time,0.02% of CO concentration that the victims can't escape by themselves was checked. 6 Min.; 0.08% was measured, almost patients may be unconscious and the symptoms will be more severe at this CO concentration because of hypoxia.6.4 Min.: It was absolutly impossible to be survival at this time due to incresing of CO concentration(0.195%) and decreasing of O2 concentration(5%). CONCLUSION: It is within 5.5 Min. that the patient can escape by themselves, and impossible to be survival more than 6.5 Min. in fire field. Rescuers and EMTs must consider time factor as well as sysmtoms of patients.
Anoxia ; Carbon* ; Fires* ; Headache ; Humans ; Mass Casualty Incidents ; Oxygen ; Time Factors ; Triage ; United Nations