No abstract available.
Dentures*

No abstract available.
Humans ; Infant, Very Low Birth Weight* ; Critical Care*

Computed Tomograms of 45 patients with or without lung mass were reviewed to determine the characteristics of the major and minor fissures. Also pulmonary vascular distibutions were analyzed to localize each pulmonary lobe. The results were as follows; 1. Each major fissure area was imaged frequently as lucent band, less frequently dense band. 2. The minor fissure areas were imaged as oval or triangular lucent zones. The oval or triangularlucent zones were as same frequency. 3. Avascular planes without above mentioned lucent zones were also correspond to minor fissure areas. 4. Slices of avascular zones were observated between pulmonary arteries to posterior segment or apicoposterior segment of upper lobe and to superior segement of lower lobe on both lungs.
Humans ; Lung ; Pulmonary Artery

It is supposed in Korea that institutional care for the elderly would increase while their home care would decrease. Assessment of the functional status is of much importance for effective caregiving for the institutionalized people. The functional status was evaluated in 89 elderly residents of an institution in Taegu, using the Korean version of the mini-mental state examination, the Blessed Dementia Rating Scale, the Barthel Activities of Daily Living, and the Motoricity Index. Vision and hearing were also examined. Based on scores of the Korean version of mini-mental state examination, 45% were found to have definite cognitive impairment and further 25% to have questionable cognitive impairment. About 35% of the subjects possibly had mild or more severe dementia on the Blessed Dementia Rating Scale. Fifty-seven percent had impairment in activities of daily living, and 66% had impairment in motor power. Sixteen percent and 20% had poor vision and hearing difficulty, respectively, to the degree of impairment in daily activities. These findings indicate that more than half of elderly people in institutional care may need either partial or total help from others.
Activities of Daily Living ; Aged* ; Daegu ; Dementia ; Hearing ; Home Care Services ; Humans ; Korea

No abstract available.
Humans

PURPOSE: In the treatrnent of respiratory distress syndrome, Infants are often exposed to hyperoxia. It can generate oxygen free radical, damage to lung and bronchi, and inactivate pulmonary surfactant(PS). Antioxidant therapy in animal and human models has been tried to overcome this detrimental effects. We hypothesized that the addition of oxygen free radical such as hydrogen peroxide(H) could compromise surface active properties(SAP) of PS and that further addition of antioxidant such as catalaseR(CAT, Sigma chemical, St. Louis) could recover SAP. METHODS: We prepared combinations of mixtures with SurfactenR(S-TA, Tokyo Tanabe, Japan), H202 and CAT. 1)0.625mgPL(phospholipids)/ml or 1.25mgPL/ml S - TA and H202 were mixed to the final concentrations of 0.1 and 1mM H respectively, and incubated at 37C for one hour. 2) 0.625mgPL/rnl S - TA, H202 and CAT 10U were mixed to the final concentrations of lmM H202, and incubated at 37 degree C for one hour. We used Pulsating Bubble Surfactometer (Electronetics, NY) measure in vitro minimum and maximum surface tensions(ST) and area-surface tension relationship. RESULTS: 1) For 0.625mgPL/ml S-TA and 1mM H mixture minimum. ST after 5 min of pulsation increased significantly(P=0.007) and the area-surface tension curve was deformed. But they were comparable to control levels for 1.25mgPL/ml S-TA. 2) When CAT was added to 0.625mgPL/ml S-TA and 1mM H mixture, the resultant minimum ST after 5 min of pulsation dropped to the control levels with recovery of hysteresis curve(P=0.0001). CONCLUSION: PS could be inactivated by addition of high concentrations of H but SAP can be recovered either by increasing PS concentration or by further addition of antioxidant CAT. Therefore, we suggest that in case of suspected surfactant inactivation an increase in surfactant concentration or administration of antioxidant must be considered.
Animals ; Bronchi ; Catalase* ; Cats ; Humans ; Hydrogen Peroxide* ; Hydrogen* ; Hyperoxia ; Infant ; Lung ; Oxygen

This study includes 19 cases of complicated low extremity injury to whom underwent microvascular free-tissue transfer in cases of open comminuted fracture, osteomyelitis, and vascular compromise or extensive soft tissue defect from Nov. 1994 to July 1997. The average time after injury to coverage was 25 days. The nineteen patients underwent a total of nineteen free tissue transfers primarily, and eighteen (94.7 per cent) of the transfers survived. Major complications were encountered recurrent failure of the free tissue transfer in one patient and partial necrosis in the other flap, which were successfully treated by flow-through radial forearm free flap and distally based superficial sural artery flap respectively. Two patients were sustained below knee amputation, one above knee amputation, despite of survival of flaps. This reveals limb salvage in 84 percent. The microvascular reconstruction is a versatile and reliable methods in complicated cases after severe trauma. Free tissue transplantation should be considered as a primary treatment in such complicated cases.
Amputation ; Arteries ; Extremities ; Forearm ; Fractures, Comminuted ; Free Tissue Flaps ; Humans ; Knee ; Limb Salvage ; Lower Extremity* ; Necrosis ; Osteomyelitis ; Tissue Transplantation ; Transplants

Severe neurologic complication after epidural anesthesia is very rare. We experinced a case of cauda equina syndrome following epidural anesthesia with 2% lidocaine 20 ml, alkalinized with sodium bicarbonate and 1: 200,000 epinephrine added in female patient underwent abdominal hysterectomy. She complained hypoesthesia of buttock, perineum, left leg and weakness of left leg. She also suffered from urinary retension and defecation difficulty and abdominal discomfort 2 days after epidural block. In MRI taken 4 days after block, spinal stenosis (L4-5) and mild disc bulging (L3-4) were noted. She was treated with medication, bladder training and physical therapy and recovered slowly but gradually, finally discharged 2 months after block with mild weakeness of left leg. We suggest the causative factors are the temporary neural compression due to spinal stenosis and the spinal cord ischemia due to vascular spasm because of added epinephrine.
Anesthesia, Epidural* ; Buttocks ; Cauda Equina* ; Defecation ; Epinephrine ; Female ; Humans ; Hypesthesia ; Hysterectomy ; Leg ; Lidocaine ; Magnetic Resonance Imaging ; Perineum ; Polyradiculopathy* ; Sodium Bicarbonate ; Spasm ; Spinal Cord Ischemia ; Spinal Stenosis ; Urinary Bladder

PURPOSE: To evaluate the usefulness of CT for the diagnosis and treatment planning of mechanical intestinal obstruction. MATERIALS AND METHODS: We retrospectively reviewed 38 patients who were clinically suspected of mechanical intestinal obstruction and had undergone abdominal CT. The CT scans were evaluated for the absence or presence, severity, cause and site of intestinal obstruction. CT findings were compared with the results of laparotomy, barium study and clinical course. The absence or presence and severity of intestinal obstruction were classified into no obstruction, partial obstruction, complete obstruction. Diagnosis was estabilished by means of laparotomy in 20 cases, barium study in 9 cases and clinical course in 9 cases. RESULTS: Of 38 cases, 7(18.4%) showed no obstruction, 22(57.9%) showed partial obstruction, and 9(23.7%) showed complete obstruction. The presence or absence and severity on CT scans were corretly predicted in 36 of 38 cases (sensitivity 95%, specificity 97%, accuracy 96%) (in case of no obstruction:sensitivity 100%, specificity 94%, accuracy 95%;in case of partial obstruction:sensitivity 91%, specificity 100%, accuracy 95%;in case of complete obstruction:sensitivity 100%, specificity 100%, accuracy 100%). All 9 cases with complete obstruction underwent prompt and immediate laparotomy. 13 cases, excluding those with mass around the site of transition and adhesion with strangulation, with partial obstruction improved with conservative treatment without laparotomy. The causes of obstruction were adhesion in 13, hernia in 6, primary cancer in 5, metastatic cancer in 3, abscess in 2, intestinal tbc in 1, and Crohn's disease in 1. The cause of obstruction on CT scans were correctly predicted in 27 of 31 cases (87.1%). The sites of obstruction on CT scans were correctly predicted in 22 of 26 cases (84.6%). CONCLUSION: CT is valuable in the evaluation of absence or presence, severity, cause and site of intestinal obstruction, and is considered to be helpful in treatment planning for the patients with intestinal obstruction.
Abscess ; Barium ; Crohn Disease ; Diagnosis ; Hernia ; Humans ; Intestinal Obstruction* ; Laparotomy ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed

BACKGROUND: During craniotomy operations, the PaCO2 has therapeutic implications because hyperventilation is often used to lower intracranial pressure. PETCO2 is often used as an estimate of PaCO2, with the assumption that P(a-ET)CO2 is relatively constant. To clarify the relationship between PaCO2 and PETCO2, sixty patients undergoing elective craniotomies were studied. METHODS: Arterial blood gases were measured from 30 minutes after endotracheal intubation to skin closure at an interval of 30 minutes in thirty patients, and at random interval in another thirty patients. PETCO2 was simultaneously determined with infrared capnography(Datex AS/3TM, Filand). RESULTS: The PaCO2 was 31.7+/-3.0 mmHg and PETCO2, 26.3+/-2.5 mmHg, with a P(a-ET)CO2 of 5.5+/-2.7 mmHg(n = 431, range between 0-13.5). There was a significant positive correlation between PaCO2 and PETCO2(r = 0.537, slope = 0.440, P<0.001) and between P(a-ET)CO2 and PaCO2(r = 0.625, slope = 0.555, P<0.001). Although changes in the pooled data of PaCO2 and PETCO2 correlated statistically, comparisons in 43 of 60(71.6%) individuals were not correlated. On comparisons of subsequent measurements, 17.0% of changes in PaCO2 and PETCO2 were in opposite directions. P(a-ET)CO2 had a tendency to increase with time during surgery(slope = 0.0082), but there was no statistically significant difference between the measurements. CONCLUSION: The PETCO2 measured with infrared capnography does not provide a stable reflection of PaCO2 in many patients undergoing craniotomy. Therefore, we concluded that capnography must be used in conjuction with arterial blood gas measurements for monitoring the respiratory acid-base status of mechanically ventilated neurosurgical patients undergoing craniotomy.
Capnography ; Carbon Dioxide* ; Carbon* ; Craniotomy* ; Gases ; Humans ; Hyperventilation ; Intracranial Pressure ; Intubation, Intratracheal ; Skin