No abstract available.

No abstract available.
Diaphragm* ; Ultrasonography*

PURPOSE: The postoperative morbidity and mortality for acute gangrenous cholecystitis (AGC) are higher than for acute nongangrenous cholecystitis (ANGC). However, preoperative predictive factors for the outcome of gangrenous cholecystitis have not been identified. The goal of this study was to determine the preoperative clinical predictive factors for the outcome of surgical treatment for acute gangrenous cholecystitis. METHODS: From January 2005 to December 2006, the medical records of 173 patients who underwent laparoscopic cholecystectomy for acute cholecystitis were reviewed and analyzed retrospectively. RESULTS: Among 173 patients with acute cholecystits, 57 (32.9%) had pathologically confirmed gangrenous cholecystits. Six variables were found to be associated with gangrenous cholecystits by univariate analysis: an age > or = 55 years, the presence of associated diseases, hypertension, fever (> or =37 degrees), an increased white blood cell count (> or = 15,450/mm3) and glucose. Four variables were identified that were associated with gangrenous cholecystits by multivariate analysis: an age > or = 55 years, the presence of associated diseases, hypertension, and an increased white blood cell count (> or =15450/mm3). CONCLUSION: The results of this study suggest that patients with an age > or = 55 years, the presence of associated diseases, hypertension, and an increased white blood cell count (> or =15450/mm3) have an increased risk of gangrenous cholecystitis and require immediate surgery.
Cholecystectomy, Laparoscopic ; Cholecystitis* ; Cholecystitis, Acute ; Fever ; Glucose ; Humans ; Hypertension ; Leukocyte Count ; Medical Records ; Mortality ; Multivariate Analysis ; Retrospective Studies

Authors observed many cases of vertical deviation in the patients complaining of marked asthenopia. Of 1275 cases who had refraction, there were 183 cases of vertical deviation (13.54%) in our clinic, during the last 2 years from July 1, 1973 to August 31, 1975. In the series of our observation, the females were much more frequent than the males in numbers, especially after 30 years of age group. The right hyperphoria was more frequent than the left. In the most of the vertical deviation, the degrees of deviation were less than one prism diopter and associated with low grade of refractive errors (less than +/- 0.5 diopter). If the marked refractive error was corrected without correction of vertical deviation, the headache appeared to be increased in the cases of marked refractive error associated with vertical deviation. In the majority of the cases who had vertical deviation, the headache (marked asthenopia) was complained of and in the many cases of them the head was tilted slightly to one shoulder. 1) In the many cases, the headache was occipital in character. 2) The headache seemed to be marked in looking the moving picture or on walking the streets (by the looking of moving objects). 3) The headache started easily by looking out of door in the railway journey or driving. 4) The headache occured usually by the exercise or home work and increased in the afternoon while they were comfortable early in the morning.
Asthenopia ; Female ; Head ; Headache* ; Humans ; Male ; Refractive Errors* ; Shoulder ; Walking

OBJECTIVES: To reexamine the association between air pollution and daily mortality in Seoul, Korea using a method of meta-analysis with the data filed for 1991 through 1995. METHODS: A separate Poisson regression analysis on each district within the metropolitan area of Seoul was conducted to regress daily death counts on levels of each ambient air pollutant, such as total suspended particulates (TSP), sulfur dioxide (SO2), and ozone (O3), controlling for variability in the weather condition. We calculated a weighted mean as a meta-analysis summary of the estimates and its standard error. RESULTS: We found that the p value from each pollutant model to test the homogeneity assumption was small (p<0.01) because of the large disparity among district-specific estimates. Therefore, all results reported here were estimated from the random effect model. Using the weighted mean that we calculated, the mortality at a 100 microgram/m3 increment in a 3-day moving average of TSP levels was 1.034 (95% CI 1.009-1.059). The mortality was estimated to increase 6% (95% CI 3-10%) and 3% (95% CI 0-6%) with each 50 ppb increase for 3-day moving average of SO2 and 1-hr maximum O3, respectively. CONCLUSIONS: Like most of air pollution epidemiologic studies, this meta-analysis cannot avoid fleeing from measurement misclassification since no personal measurement was taken. However, we can expect that a measurement bias be reduced in a district-specific estimate since a monitoring station is better representative of air quality of the matched district. The similar results to those from the previous studies indicated existence of health effect of air pollution at current levels in many industrialized countries, including Korea.
Air Pollution* ; Bias (Epidemiology) ; Developed Countries ; Epidemiologic Methods ; Epidemiologic Studies ; Humans ; Korea ; Mortality* ; Ozone ; Seoul* ; Sulfur Dioxide ; Weather ; Information Storage and Retrieval

PURPOSE: The present study investigates the seasonal variations of acute angle-closure glaucoma in patients visiting the hospital. METHODS: Eighty-seven patients (94 eyes) who underwent laser iridotomy were retrospectively analyzed over 5 years. Monthly and seasonal variations were investigated and the difference in seasonal variations according to sex, age, and inhabited area were inspected. RESULTS: When evaluating monthly variations, acute angle-closure glaucoma occurred mostly in January (13.8%). Incidence of glaucoma was the highest in winter (29.9%), decreased in spring and summer (26.4%) and was lowest in autumn (17.2%). In big cities, the incidence trend was highest in spring (31.8%), lowest in autumn (19.7%) and slightly elevated in winter (27.3%). However, in small cities and rural areas, the incidence was highest in summer (42.9%) and winter (38.1%). There were significant differences between inhabited areas. CONCLUSIONS: Among the patients, seasonal incidence of acute angle-closure glaucoma was the highest in winter and decreased as autumn approached. There were differences of incidence between inhabited areas.
Glaucoma ; Glaucoma, Angle-Closure ; Humans ; Incidence ; Retrospective Studies ; Seasons

PURPOSE: Active prevention is an essential component in reducing the development of pressure sores. For the high-risk patient group, following the certified pressure sore screening scale as well as educating the patient and the nurses who care for them can lead to optimal management of these patients. Applying a risk assessment scale along with a prevention strategy can reduce medical costs and length of stays at the hospital. The purpose of this study is to evaluate the efficacy of a new pressure sore risk assessment scale based on the universally recommended Braden scale and our prevention program. METHODS: From June to August, 2003, our pressure ulcer risk assessment scale was applied to a total of 1882 patients admitted to the experimental group (intensive care unit, neurosurgery, general surgery, and oncology units). It was based on Braden scale. We analysed sensitivity, specificity, positive and negative predictive value and ROC curve to evaluate its efficacy. Pressure ulcer prevention program was composed of patient's education using protocol and specific nursing care. The incidence of pressure ulcers was also measured during the 3 months period, and those were compared to the control group of 1789 patients from March to May, 2002. RESULTS: 118(6.27%) of the experimental group were high-risk with an incidence of pressure ulcers measuring 4 (0.21%). Sensitivity, specificity, positive and negative predictive value of our scale were 100%, 94%, 4%, 100%, respectively, and AUC(area under the curve) was 0.992. In the control group, the incidence of pressure ulcers was 11(0.61%). Statistical analyses using chi- squared tests with a significance level of 5%, the results were such that chi-square=3.6482(p=0.0561). The results proved to be statistically significant in borderline. CONCLUSION: The results from this study proved that pressure sore risk assessment scale based on Braden scale has an excellent efficacy, and shows that our pressure ulcer prevention program is partially effective in reducing pressure ulcer incidence.
Education ; Humans ; Incidence ; Mass Screening ; Neurosurgery ; Nursing Care ; Pressure Ulcer* ; Risk Assessment* ; ROC Curve ; Sensitivity and Specificity

OBJECTIVE: Stenosis or herniated nucleus pulposus (HNP) occupying lumbar intracanal and foraminal area is an important cause of double radicular symptoms. Using the combined interlaminar and paraisthmic approach, we performed decompression surgery in patients with co-existing intracanal and foraminal lesions. The objective of this study is to describe usefulness and outcome of combined interlaminar and paraisthmic approach surgery and to analysis the cause of poor outcome. METHODS: Between Apr 2009 and Apr 2014, 78 patients (42 males and 36 females) with intracanal and foraminal lesions were enrolled in this study. Patients with a vacuum disc, spondylolisthesis, instability or an isthmic defect on the preoperative dynamic view radiograph were excluded from this study. All patients underwent surgery through a combined approach for discectomy and decompression. The outcome of surgery was evaluated and classified into excellent, good, fair and poor. RESULTS: The results were excellent in 53 patients, good in 9, fair in 6 and poor in 10 during the follow-up. The outcome of the combined approach was excellent to fair in 87% (68 of 78) patients in our study. In the poor outcome group, three patients complained of early-onset relapsed pain (<1 month) and another seven patients complained of delayed-onset pain (>3 months). CONCLUSION: Combined approach for both intracanal and foraminal area lesions may be useful if selectively performed on patients whose facet joint is relatively intact, and that it is worthy of consideration as an alternative to fusion surgery; however, further studies are needed.
Constriction, Pathologic ; Decompression ; Diskectomy ; Follow-Up Studies ; Humans ; Male ; Radiculopathy ; Spinal Stenosis ; Spondylolisthesis ; Vacuum ; Zygapophyseal Joint

An 18-year-old man collapsed at his workplace while putting desiccant into a cylindrical mixer, 2 m x 1 m in dimension, which contained rubber powder. His coworker found him collapsed, and he was transported to a hospital by a 119 rescue team, where he died. Prior to the incident, liquid nitrogen had been placed into the mixer to lower the temperature of the rubber powder. There were no injuries or disease that could have caused death. Analysis of the gas in the mixer revealed that the O2 concentration had dropped to 3.7% in 2 minutes following addition of the liquid nitrogen. Therefore, it was concluded that the cause of death was asphyxia due to oxygen deficiency caused by liquid nitrogen evaporation.
Adolescent ; Anoxia* ; Asphyxia* ; Autopsy ; Cause of Death ; Humans ; Nitrogen* ; Oxygen* ; Rubber

Ovarian pregnancy is an uncommon form of ectopic gestation that is often difficult to diagnose. The diagnostic criteria were described in 1878 by Spiegelberg, which comprise that the pregnancy is in the ovary and does not involve the tube. Primary ovarian pregnancy results in maternal hemorrhage early in the first trimester, and is usually accompanied by rupture of ovary with hemoperitoneum to require emergency operation. Misdiagnosis is common because it is confused with a ruptured corpus luteum. One case of ovarian pregnancy was presented with a brief review of literatures.
Corpus Luteum ; Diagnostic Errors ; Emergencies ; Female ; Gestational Age* ; Hemoperitoneum ; Hemorrhage ; Humans ; Ovary ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy, Ectopic* ; Rupture