We conducted a retrospective study of 104 patients to examine the efficacy of two methods of urinary bladder management after total hip arthroplasty under spinal anesthesia. Patients who had total hip replacement was randomly assigned either to Group I, in which indwelling catheters were placed during the operation and removed the next morning, or Group II, in which urinary retention was managed by intermittent catheterization as needed. After the removal of the indwelling catheter, the patients in Group I had a lower incidence of urinary retention than those in Group II. Bladder distention(volume above 700ml) was more common in Group II and was associated with an increased need for subsequent long-term catheterization. There was no significant difference between the groups in the rates of urinary tract infection. We conclude that the short-term use of an indwelling catheter after extended surgery, such as joint replacement, reduces the incidence of urinary retention and bladder overdistention, without increasing the rate of urinary tract infection.
Anesthesia, Spinal* ; Arthroplasty, Replacement, Hip* ; Catheterization ; Catheters ; Catheters, Indwelling ; Humans ; Incidence ; Joints ; Retrospective Studies ; Urinary Bladder* ; Urinary Retention ; Urinary Tract Infections

This is a follow up study on consecutive series 50 patients of total hip arthroplasty to assess for transient leg-length inequality. The authors report a clinical experience of 50 patients who have been pelvis tilt before total hip replacement. Retrospectively reviewed for the presence of pelvic obliquity preoperative and at the 1, 3 and 6 months follow-up visits. The results were as follows. Fourty-eight patients(96%) with functional leg length inequality related pelvic obliquity were improved within 6months postoperative follow up period after total hip arthroplasty. Two patients(4%) had persistent functional leg length inequality that affected factors-old age, female and soft tissue tightness due to pelvic obliquity. We believe that in most of these patients, the transient functional leg length inequality has a self-limited course, whereas in a small number, the profoud sense of inequality remains.
Arthroplasty, Replacement, Hip ; Female ; Follow-Up Studies ; Humans ; Leg Length Inequality* ; Leg* ; Pelvis ; Retrospective Studies ; Socioeconomic Factors

The treatment of frozen shoulder should initially be conservative, with the emphasis on passive stretching of the capsular structures. If the patient's clinical progress stalls or the condition worsens, and his or her life style is disturbed enough, manipulation under gerneral anesthesia is indicated. The Authors practiced the passive manipulation under the general anesthesia on 7 patients of frozen shoulder, who had been treated at the Department of Orthopaedic Surgery, Yonsei University, Wonju College of Medicine, from March 1988 to April 1989. The results obtained were as follows:l. All seven patients achieved nearly full range of motion with minimal or no pain. 2. After 3 months of follow-up, all seven patients showed neither signs of readhesions nor recurrence of pain. 3. There were no complications, such as humerus shaft fracture and dislocation of shoulder.
Anesthesia ; Anesthesia, General ; Bursitis ; Dislocations ; Follow-Up Studies ; Gangwon-do ; Humans ; Humerus ; Life Style ; Muscle Stretching Exercises ; Range of Motion, Articular ; Recurrence ; Shoulder

The metallic failure is one of the annoying problems after fracture surgery. The seventeen cases of metallic failures after compression plate fixation were treated at the Department of Orthopaedic Surgery. Yonsei University Wonju College of Medicine between January, 1980 and December, 1988. The results were summerized as follows: l. Among 17 cases, 12(70.5%) were under 40 years of age and 14(80%) were male patients. 2. The sites of fracture of the seventeen cases; 12 femurs, 3 tibiae, and 2 radii. Of the cases, there were breakage of plates in 13 cases, bending 1 case and failure of screw in 3 cases. 3. The pattern of fracture: communited fracture
Femur ; Fractures, Bone ; Fractures, Open ; Gangwon-do ; Humans ; Incidence ; Male ; Osteoporosis ; Radius ; Tibia ; Transplants ; Weight-Bearing

OBJECTIVES: This study is for developing the prediction model of outpatient's revisit in target hospital. Using this model, hospital managers can make efficient customer relationship. METHODS: This is based on the medical record data of patients in target hospital (with 967 beds). They are divided into two groups, which are used each for different purpose. One(raw data) is used to make the prediction model of revisit and the other(test data) is used to evaluate the model. For raw data were used the 4,273 outpatient cases, where patients visited the first time between august and september in 2000, and visited till december in 2003. For the test data were used 9,392 outpatient cases, where patients visited the first time between august and september in 2003, and visited till december in 2006. That is, each data was selected from the outpatient's medical records for three-years. RESULTS: The decision tree model is better than the logistic regression model as prediction model of outpatient's revisit in target hospital. The decision tree model is evaluated more excellent in ROC curve and classification accuracy in test data. For predicting the outpatient's revisit, it is more useful to have 4 variables - non-insured expenses, special medical service, cooperation service with oriental medicine and visit via ER. We can predict the revisit of outpatients over 39.5% rate by these variables. CONCLUSIONS: By using decision tree model, target hospital can make more accurate prediction of outpatient's revisit and make good customer relation management. So, target hospital can use some CRM program including 4 variables. To make more useful model for other hospitals in Korea, each hospital managers need to understand more their hospital environment and patient's characteristics.
Data Mining ; Decision Trees ; Humans ; Korea ; Logistic Models ; Medical Records ; Medicine, East Asian Traditional ; Outpatients ; ROC Curve

No abstract available.
Alcoholism* ; Memory*

BACKGROUND: Even though there were developments in various treatment techniques for acute arterial occlusion this disease still has high rate of mortalities and limb amputations. We investigated the combined diseases symptoms location of occlusion type of treatment complication and prognosis in our patients. MATERIAL AND METHODS: This study recruited 48 patients (42 men, 6 women, mean age 57.7 years) who received the operation from January 1995 toDecember 1998. We investigated the post-operation course via medical record review or telephone interview with patients or their family members. RESULT: The most common combined diseases were atherosclerosis in 30 patients. other diseases were 17 diabetes mellitus 16 hypertension and 12 atrial firillation. Pain and clod sensation were noticed in all patients paresthesia in 5 patients fibrillation. Pain and cold sensation were noticed in all patients paresthesia in 5 patients and lower extremity paralysis in 11 patients. In 29 patients the time interval from the onset of symptom to admission was over 72 hours and 15 patients were admitted within 24 hours. The distribution of arterial occlusion location was at 28 femoral arteries 14 popliteal arteries and 6 iliac arteries. All the patients were received embolectomy and 5 patients were received additional bypass grafting. Postoperative complications were 12 reocclusions. 6 compartment syndromes 6 skin necrosis and 2 acute renal failure. The mortality rate was 16.7% (8/48) and the amputation rate was 25%. CONCLUSION: This study revealed 25% reocclusion 25% limb amputation and 16.7% mortaliyt. To improve the prognosis of acute lower extrements arterial occlusion early diagnosis and understand the underlying diseases prompt treatment and operation additional operation including interventional radiologic examination and thorough postoperative care would be appreciated.
Acute Kidney Injury ; Amputation ; Atherosclerosis ; Compartment Syndromes ; Diabetes Mellitus ; Early Diagnosis ; Embolectomy ; Extremities ; Female ; Femoral Artery ; Humans ; Hypertension ; Iliac Artery ; Interviews as Topic ; Lower Extremity ; Male ; Medical Records ; Mortality ; Necrosis ; Paralysis ; Paresthesia ; Popliteal Artery ; Postoperative Care ; Postoperative Complications ; Prognosis ; Sensation ; Skin ; Transplants

Total anomalous pulmonary venous return(connection) is a congenital heart disease. Especially, the reports of the patients with double connections of all pulmonary veins were rare. An infant who underwent operation for total anomalous pulmonary venous return had double drainge of all pulmonary veins to both left vertical vein and anomalous descending vein. This second lesion was not diagnosed preoperatively, but in operative field. Operative treatments were performed by ligation of left vertical vein and central pulmonary vein-to-left atrium anastomosis without ligation of the descending anomalous vein. For these less common variants fo total anomalous pulmonary venous return,a more detailed and precise understanding of morphology can facilitate accurate surgical repair. And also, early detection of the disease is an another issue for a good prognosis.
Heart Defects, Congenital ; Humans ; Infant ; Ligation ; Prognosis ; Pulmonary Veins ; Scimitar Syndrome* ; Veins

No abstract available.
Myasthenia Gravis* ; Thymectomy*

Acquired tufted angioma is a benign, progressive vascular lesion that has a distinctive histopathologic appearance. We report a 31-year-old man with acquireed tufted angioma. Several reddish papules and plaque were present on the neck. The lesion had been present for 6 months. They had enlarged slowly, and were slightly tender. Histopathologic examination of the biopsy specimen showed round to ovoid cellular tufts of capillaries, most prominent in the middle to lower dermis.
Adult ; Biopsy ; Capillaries ; Dermis ; Hemangioma* ; Humans ; Neck