No abstract available.
Pancreaticoduodenectomy*

BACKGROUND: Good documentation of electrical injuries at the time of presentation is very important to emergency management, so this study was designed to investigate the clinical characteristics and the outcomes of patients with electrical injury. METHODS: A review of 75 cases of electrical injuries admitted to our hospital via the emergency department over a 4 year period from 1996 to 1999 was conducted. RESULTS: There were 49 patients with high-voltage injuries and 19 patients with low-voltage injuries. All but 4 patients were males, with a mean age of 29.5 years. The most common type of injury was 14.5% TBSA in the high-voltage group and 2.5% in the low-voltage group. Forty-nine(72.1%) of the injuries were work related. The number of patient with compartment syndrome was 19, and fasciotomies were performed in all but one patient. Myoglobinuria was noted in 22 patients, but no patient developed acute renal failure due to myoglobinuria. In the high-voltage group, 10 limb amputations were performed. Complication were observed in 12 patients. The most common complication was neurological injury. The average length of hospital stay was 50.7 days in the high-voltage group and 13.8 days in the low-voltage group. The overall mortality rate was 4.3%. CONCLUSION: Prevention of electrical injuries is very important. Education and compliance with safety measures, as well as basic knowledge and precaution in dealing with electricity, are essential to avoid these injuries.
Acute Kidney Injury ; Amputation ; Burns* ; Compartment Syndromes ; Compliance ; Education ; Electricity ; Emergencies ; Emergency Service, Hospital ; Extremities ; Humans ; Length of Stay ; Male ; Mortality ; Myoglobinuria

Clostridium difficile infection (CDI) has become a significant threat to public health. Although broad-spectrum antibiotic therapy is the primary treatment option for CDI, its use has evident limitations. Probiotics have been proved to be effective in the treatment of CDI and are a promising therapeutic option for CDI. In this study, 4 strains of lactic acid bacteria (LAB), namely, Lactobacillus rhamnosus (LR5), Lactococ-cuslactis (SL3), Bifidobacterium breve (BR3), and Bifidobacterium lactis (BL3) were evaluated for their anti-C. difficile activity. Co-culture incubation of C. difficile (106 and 1010 CFU/ml) with each strain of LAB indicated that SL3 possessed the highest antimicrobial activity over a 24-hr period. The cell-free supernatants of the 4 LAB strains exhibited MIC50 values between 0.424 mg/ml (SL3) and 1.318 (BR3) mg/ml. These results may provide a basis for alternative therapies for the treatment of C. difficile-associated gut disorders.
Bacteria ; Bifidobacterium ; Clostridium ; Clostridium difficile ; Coculture Techniques ; Complementary Therapies ; Lactic Acid ; Lactobacillus rhamnosus ; Probiotics ; Public Health ; Pyridines ; Sprains and Strains ; Thiazoles

PURPOSE: The purpose of this study was to evaluate the risks of undergoing intramedullary nailing with minimum surgical optimization (fast-track) for geriatric trochanter fracture due to fall from a standing height. MATERIALS AND METHODS: From May 2006 to August 2013, 48 fractures were enrolled in fast-track, and were an average age of patients was 77.6 years (range, 62-97 years). They underwent primary testing for anesthesia, including basic body fluid test, arterial blood, electrocardiography, and chest radiographs. The time from visit to surgery was 28.9 hours (range, 1-96 hours). RESULTS: During hospitalization, there was one case of stress-induced cardiac arrest; however, other complications, infection, and 30-day mortality did not occur. According to preoperative classic test, the average albumin was 3.45 g/dl, blood sugar, 169 mg/dl, blood urea nitrogen, 20.5 mg/dl, Cr, 1.5 mg/dl, Na, 135.3 mEq/L, and K, 4.21 mEq/L. The average PaCO2 of arterial blood was 37.6 mmHg. CONCLUSION: We found that the fast-track for trochanteric fracture due to slip-down was relatively safe, and could be considered as a therapeutic approach.
Aged* ; Anesthesia ; Blood Glucose ; Blood Urea Nitrogen ; Body Fluids ; Electrocardiography ; Femur* ; Fracture Fixation, Intramedullary ; Heart Arrest ; Hospitalization ; Humans ; Mortality ; Osteoporotic Fractures ; Prospective Studies* ; Radiography, Thoracic

BACKGROUND: The aim of this study was to confirm the risk factors for low back pain and injury to improve the prevention and treatment of lower back pain. MATERIALS AND METHODS: An epidemiologic study of low back pain and injury was performed with questionnaires distributed to 471 women working at Yeungnam university hospital. The differences in low back pain and injuries among various hospital departments were analyzed by a one-way analysis of variance (ANOVA), and the relevant factors included in the questionnaire were determined by a factor analysis. RESULTS: The frequency of low back pain in women in the department of diet and in the maintenance department was higher than among the other departments. The frequency of low back pain was mainly related to the frequency of psychosomatic symptoms. In addition, the low back pain was partially related to the frequency of psychosomatic symptoms and partially related to the frequency of pushing during the workday. The degree of disability from low back pain was increased by lifting and hard physical work and was related to the frequency of psychosomatic symptoms and the degree of work dissatisfaction. The frequency of low back injury was increased by increased standing time during work and hard physical work. The frequency of low back injury was related to advancing age and in part to psychosomatic symptoms. CONCLUSION: Lower back pain and its associated complications are related to psychosomatic factors and type of work. Lower back injury is related to physiological factors such as age. For the prevention and treatment of lower back pain, a multidisciplinary approach is required.
Back Injuries ; Diet ; Epidemiologic Studies* ; Female ; Hospital Departments ; Hospitals, General* ; Humans ; Lifting ; Low Back Pain* ; Surveys and Questionnaires ; Risk Factors

No abstract available.
Surgery, Oral* ; Transplants* ; Veins*

BACKGROUND: During the orthognathic surgery, it is important to know the exact anatomical location of the mandibular foramen to achieve successful anesthesia of inferior alveolar nerve and to prevent damage to the nerves and vessels supplying the mandible. METHODS: Cone-beam computed tomography (CBCT) was used to determine the location of the mandibular foramen in 100 patients: 30 patients with normal occlusion (13 men, 17 women), 40 patients with skeletal class II malocclusion (15 men, 25 women), 30 patients with skeletal class III malocclusion (17 men, 13 women). RESULTS: The distance from the anterior border of the mandibular ramus to mandibular foramen did not differ significantly among the three groups, but in the group with skeletal class III malocclusion, this distance was an average of 1.43 +/- 1.95 mm longer in the men than in the women (p < 0.05). In the skeletal class III malocclusion group, the mandibular foramen was higher than in the other two groups and was an average of 1.85 +/- 3.23 mm higher in the men than in the women for all three groups combined (p < 0.05). The diameter of the ramus did not differ significantly among the three groups but was an average of 1.03 +/- 2.58 mm wider in the men than in the women for all three groups combined (p < 0.05). In the skeletal class III malocclusion group, the ramus was longer than in the other groups and was an average of 7.9 +/- 3.66 mm longer in the men than women. CONCLUSIONS: The location of the mandibular foramen was higher in the skeletal class III malocclusion group than in the other two groups, possibly because the ramus itself was longer in this group. This information should improve the success rate for inferior alveolar nerve anesthesia and decrease the complications that attend orthognathic surgery.
Anesthesia ; Cone-Beam Computed Tomography ; Female ; Humans ; Male ; Malocclusion* ; Mandible ; Mandibular Nerve ; Orthognathic Surgery

BACKGROUND: Phadiatop test has been introduced as a single test for screening the atopics who were sensitized to common inhalant allergens. MATERIAL AND METHOD: We compared the clinical efficiency of Phadiatop test and total IgE level for defining presence of atopy in 136 asthmatic subjects. The presence of atopy was defined by skin prick test done with 10 common inhalant allergens. More than 2+ skin reactivity was defined as having atopy. Phadiatop test and total IgE level in serum were measured using Pharmacia CAP systems. RESULT: 109 out of 136 subjects had more than 2+ skin reactivity to at least one allergen and another 27 subjects had 1+ or negative skin reactivity to allergens. The performance characteristics of Phadiatop test for screening atopy was superior than total IgE level, with sensitivity(91.7% vs. 82.6%), positive predictive value(94.3% vs. 86.5%) and concordance rate(89.0 % vs. 75.7% ). Specificity and negative predictive value of the Phadistop test were acceptable and higher than that of total IgE level. CONCLUSION: These results suggested that Ph adiatop may be simple and useful for screening atopic status in Korean asthmatic subjects.
Allergens ; Hydrogen-Ion Concentration ; Immunoglobulin E ; Mass Screening* ; Sensitivity and Specificity ; Skin

The sensitivity and specificity of ST segment change on ECG for detection of coronary artery disease(CAD) by pacing stress test were assessed. Among 28 cases with chest pain(mean age 52, M/F : 21/7), 10 patients had normal coronary angiographic finding(Group I), and 18 had coronary artery disease(Group II). Pacing stress test showed high specificity(100%), but low sensitivity(61%) for the diagnosis of CAD. Especially in patients with 1 vessel disease, the sensitivity was only 50%, and positive results were not attained unless there was at least 90% or more stenosis in any of the major branches(LAD, RCA or LCX). But in patients with multivessel disease, the sensitivity was much higher(83%). Lateral(V4-6) or inferior leads(2, 3, aVF) showed ischemic ST segment depression most commonly. Therefore one of the inferior lead and V5 may be a minimum requirement for monitoring pacing-induced ST segment changes. Time constant during isovolumic relaxation showed statistically significant prolongation after pacing only in CAD patient group, suggesting pacing-induced impairment of early left ventricular relaxation.
Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Depression ; Diagnosis* ; Electrocardiography ; Exercise Test ; Humans ; Relaxation ; Sensitivity and Specificity ; Thorax

The prevalence of epilepsy and psychosis in 22q11.2 deletion syndrome (22q11.2DS) is higher than in the general population. Recent study on adults with 22q11.2DS reported that the most common trigger for provoked seizures was the use of antipsychotics and antidepressants. In this paper, blonaserin was used because aripiprazole, quetiapine, paliperidone were not effective. The patient had convulsion on the fourth day of taking blonaserin. Neurological and cardiac examination was carried out, and lamotrigine was added at the advice of neurologist. Than the patient didn’t have any convulsions and the symptoms gradually improved. When treating patients with 22q11.2DS, the medicine should be chosen carefully, and the patient should be observed closely, paying attention to the possibility of convulsions.