BACKGROUND: In previous our retrospective study, we concluded that administered fluid volume, duration of operation, operative procedures and anesthetic techniques were the major factors of postoperative urinary retention. However, the administered fluid volume, age, types and duration of the operation confined to hemorrhoidectomy was questioned as a precipitating factor. The high retention rate in spinal anesthesia is also questioned. METHODS: We investigated these possible precipitating factors of urinary retention in healthy patients (n=154) undergoing hemorrhoidectomy. The patients were randomly divided into three different anesthetic techniques: caudal (2% lidocaine 300 mg with 1 : 200,000 epinephrine), spinal (0.5% tetracaine 5 mg with epinephrine 0.1 mg or 5% lidocaine 40 mg) and general (enflurane, N2O, vecuronium). Urinary retentin was searched according to above factors following surgery. RESULTS: The overall urinary retention rate was 46.1%. The retention rate in patients with spinal anesthesia was higher than that in those with other anesthetic techniques (p<0.05). There was no significant difference between patients with lidocaine and tetracaine spinal anesthesia in urinary retention rate. The administered fluid volume in patients with urinary retention was significantly higher than that of patients without retention (p<0.05). Age, duration and types of hemorrhoidectomy did not significantly affect urinary retention rate. CONCLUSIONS: Restriction of fluid administration and avoidance of spinal anesthesia are necessary in reducing postoperative urinary retention following hemorrhoidectomy.
Anesthesia, Spinal ; Epinephrine ; Hemorrhoidectomy* ; Humans ; Lidocaine ; Precipitating Factors ; Retrospective Studies ; Surgical Procedures, Operative ; Tetracaine ; Urinary Retention*

For the rapidly growing elderly population, the achievement and maintenance of good nutritional status is critical to health, functioning and quality of life. Elderly women living alone have been identified as a group associated with poor nutrition. The purpose of this study was to assess dietary intakes of elderly women living alone as compared to those of elderly women living with family in a rural area and to examine seasonal variation. The subjects are 49 elderly women living alone and 41 elderly women living with family who reside in Goryeong-gun, Gyeongbuk, and their food intakes were assessed once each time in summer 2005, winter 2005-2006, and spring 2006. The average ages were 74.7 years for living alone and 72.8 years for living with family. Education level was not different between the two groups. Height, weight, body mass index, systolic and diastolic blood pressures, and fasting blood glucose were not significantly different between the two groups. Average intakes of major nutrients, nutrient adequacy ratio, mean adequacy ratio and index of nutritional quality were lower in the elderly women living alone compared with the elderly women living with family in summer, but the differences in intakes of most nutrients became insignificant both in winter and in spring. High carbohydrate and low fat diet was prevalent and intakes of carbohydrate and fat in summer deviated from macronutrient acceptable distribution ranges. Percentages of the subjects who consumed energy less than 75% of the estimated energy requirement and nutrients less than the estimated average requirement were higher than those reported by the Third National Health and Nutrition Examination Survey. In summer, the percentage of the subjects who consumed energy less than both 75% of the estimated energy requirement and 4 nutrients less than estimated average requirements was 58.5% of the elderly women living alone, which was higher than 26.5% of the elderly women living with family and that of National Nutrition Survey. Therefore, nutrition policies including nutrition education and support are necessary to improve nutritional status of elderly, especially elderly women living alone and should reflect regional and seasonal characteristics.
Aged* ; Blood Glucose ; Body Weight ; Diet ; Education ; Fasting ; Female ; Gyeongsangbuk-do* ; Humans ; Nutrition Policy ; Nutrition Surveys ; Nutritional Status ; Nutritive Value ; Quality of Life ; Seasons*

No abstract available.
Child* ; Cough* ; Humans ; Maxillary Sinus* ; Maxillary Sinusitis*

PURPOSE: This study was to verify the effects of a fluid therapy education program for aged stroke patients for preventing dehydration, pyuria and bacteriuria. METHODS: The study employed a non-equivalent control group pretest-posttest design in quasi experimental basis. Subjects were 38 stroke patients (20 in the experimental group and 18 in the control group) older than 65, hospitalized in a senior care center in S city, Korea. RESULTS: The amount of daily average fluid intake, normal ratio of blood urea nitrogen-creatinine ratio, serum Na+ and urine white blood cells were increased significantly in the experimental group. Normal ratio of bacteriuria increased in the experimental group, but not significantly. CONCLUSION: The education program is considered to be an effective nursing intervention tool for preventing dehydration and urinary tract infections which related to the secondary wellness of aged stroke patients. However, longer term study is necessary for better quality of nursing and developing more specific education programs for aged stroke patients usually hospitalized for a long period of time.
Bacteriuria ; Dehydration ; Education* ; Fluid Therapy* ; Humans ; Korea ; Leukocytes ; Nursing ; Pyuria ; Stroke* ; Urea ; Urinary Tract Infections

The purpose of this study was to assess dietary habits and seasonal variation and diversity of food intakes of elderly women living alone as compared to those of elderly women living with family in a rural area. Forty nine elderly women living alone and forty one elderly women living with family who reside in Goryeong-gun, Gyeongbuk, were interviewed using questionnaires in summer 2005, and their food intakes were assessed secondly in winter and thirdly in spring 2006. The average ages were 74.7 years for elderly living alone and 72.8 years for elderly living with family. Tooth status and bone fracture experience were similar between the groups. The prevalence of musculoskeletal disease was 61.2% and that of circulatory disease was 32.7% of the subjects. Average of total score of mental depression of the subjects was 5.94 out of 12 points, and it was not significantly different between the two groups. Skipping meals was more frequent and mealtime was more irregular in the elderly women living alone as compared with the elderly women living with family. Consumption of dietary supplements was also less in the elderly women living alone. Food intakes by the elderly women living alone tended to be lower than those by the elderly women living with family. Dietary diversity score was significantly lower with the elderly women living alone as compared with the elderly women living with family only in summer (p < 0.01). Percentages of the subjects who have taken meat group and vegetable group were significantly lower in the elderly living alone compared with the elderly living with family during summer. Therefore, it is necessary to develop food assistance or supporting program suited for the season within a community for elderly women living alone.
Aged ; Depression ; Dietary Supplements ; Eating ; Female ; Food Assistance ; Food Habits ; Fractures, Bone ; Humans ; Meals ; Meat ; Musculoskeletal Diseases ; Prevalence ; Seasons ; Tooth ; Vegetables

We present here the case of a 13-year-old male patient with Alexander's disease who underwent surgical correction of a femur fracture. Alexander's disease is a rare and fatal disorder that affects the white matter in the brain and it causes developmental delay, psychomotor regression, spasticity, megaloencephaly and seizure. The patient had the possibility of a seizure attack during the perioperative period. We discuss the anesthetic management of a patient with Alexander's disease and we review the relevant literature.
Adolescent ; Alexander Disease ; Anesthesia ; Brain ; European Continental Ancestry Group ; Femur ; Humans ; Male ; Muscle Spasticity ; Perioperative Period ; Seizures

Long QT Syndrome is characterized by syncope and fatal ventricular arrhythmia. Monotherapy with beta blockers is the first-line therapy. In patients with recurrent syncope despite therapy with beta blockers, combinations of the following modalities of treatment may be considered: pacemakers, left cervicothoracic sympathectomy, and implantable cardioverter defibrillators. Recently, we anesthetized a patient with Long QT Syndrome who underwent thoracoscopic left upper ganglionectomy for recurrent episodes of syncope and ventricular arrhythmia despite aggressive use of propranolol. Because of the increased risk of developing fatal ventricular arrhythmias during anesthesia and surgery, we performed a left stellate ganglion block prior to induction of anesthesia to prevent the ventricular arrhythmia that may be triggered by stimulation of the sympathetic nervous system and to assess the effect of surgical ganglionectomy on the QT interval. Following the block, the QT interval was shortened, and anesthesia and surgery was uneventful though anesthetic induction caused serious sympathetic responses. We recommend a left stellate ganglion block prior to induction of anesthesia in patients with Long QT Syndrome resistant to beta blocker to prevent fatal arrhythmia and to predict the efficacy of the surgical sympathectomy on the QT interval.
Anesthesia* ; Arrhythmias, Cardiac ; Defibrillators, Implantable ; Ganglionectomy ; Humans ; Long QT Syndrome* ; Propranolol ; Stellate Ganglion* ; Sympathectomy* ; Sympathetic Nervous System ; Syncope

A 25-year-old male patient was received emergency operation, open reduction and tenorrhaphy owing to degloving injury on the dorsum of his left hand, under axillary brachial plexus block using a transarterial approach. Following operation, he revealed the signs and symptoms of brachial plexus injury such as weakness, sensory deficit and tingling sensation on his left forearm and hand. The finding on electromyography (EMG), performed on the 16th postoperative day (POD), was indicative of left incomplete brachial plexus injury, mainly in medial cord and ulnar nerve, and partially median and radial nerve at/above the axillary level. The signs and symptoms were improved slightly on POD 8 and a lot on POD 23. The complete recovery of symptoms and regeneration of injured nerve on EMG were confirmed 3 months following operation. In this case, the causative factors of brachial plexus injury were suggested in stretching of the brachial plexus due to improper positioning of injured arm during or after operation, combined with or without injury due to nerve block or tourniquet compression.
Adult ; Arm ; Brachial Plexus* ; Electromyography ; Emergencies ; Forearm ; Hand ; Humans ; Male ; Nerve Block ; Radial Nerve ; Regeneration ; Sensation ; Tourniquets ; Ulnar Nerve

BACKGROUND: In vitro serum allergen-specific IgE tests have been routinely used in the clinical diagnosis of allergic diseases. We evaluated the clinical usefulness of a newly introduced multiple antigen screen test, Advansure Allergy Screen (LG Life Science, Korea) (LG-Screen) for the detection of allergen specific IgE. METHODS: A total of 180 sera (80 for inhalant and 100 for food panels) were tested by LG-Screen and RIDA Allergy Screen (R-biopharm, Germany) (RIDA-Screen) assays. According to the 58-60 specific allergens or allergen groups, the positive rates and agreement rates were analyzed using the cut off levels of class 2. For the quantitation of total IgE and specific IgE, nephelometry and ImmunoCAP test were performed in the sera showing discrepant results between the two allergy screen assays. RESULTS: The agreement rate and kappa value (k) of total IgE between the two allergy screen assays was 73.9% and 0.333. LG-Screen showed higher agreement rate with nephelometry than RIDA-Screen. The positive rates to common outdoor inhalant and food allergens were significantly higher in RIDA-Screen. Overall agreement rate of specific IgE between the two allergy screen assays for 58 allergens was 86.7% (6,086/7,020) (k, 0.293). In samples showing discrepant results between the two allergy screen assays, concordance rate of allergy screen assay with ImmunoCAP assay was 70.9% (449/633) for LG-Screen (k, 0.585) and 29.1% (184/633) for RIDA-Screen (k, -0.303). CONCLUSIONS: LG-Screen showed a favorable agreement with RIDA-Screen and ImmunoCAP assays, and it could be used for the detection of allergen specific IgE in the clinical laboratory.
Adolescent ; Adult ; Aged ; Allergens/diagnostic use/*immunology ; Child ; Child, Preschool ; Female ; Humans ; Hypersensitivity, Immediate/diagnosis ; Immunoglobulin E/*blood ; Immunologic Tests/methods ; Infant ; Male ; Middle Aged ; Reagent Kits, Diagnostic

OBJECTIVE: The measurement of liver size can be used for the diagnosis of the fetal growth abnormality (FGR, macrosomia etc.). The purpose of this study was to evaluate a mathematical relationship between the fetal liver size(liver length or volume) and the gestational age in the normal pregnancies. Brief comparisons were also tried on the base of the degree of the correlation between liver length and its volume. METHODS: We collected 54 singleton pregnancies of 20 to 36weeks of gestation for measuring fetal liver length and 57 singleton pregnancies for measuring fetal liver volume. We used Combison 530 utrasonic machine(Kreztechnik AG, Zipf, Austria). RESULTS: There was significant correlation between liver size( length and volume) and gestation age. And the liver volume better correlated with gestational age than liver length(r=0.93 : r=0.78, p<0.0001, p<0.0001). CONCLUSION: Ultrasonic measurement of fetal liver size is a reliable indicator of fetal growth, especially liver volume. Therefore these data may have a potential value for the prediction of abnormal fetal growth(FGR, macrosomia).
Diagnosis ; Fetal Development ; Gestational Age* ; Liver* ; Pregnancy* ; Ultrasonics