An accurate and relatively simple method for estimating the amount of acute blood loss is essential in the hemorrhagic shock patients. Conventional physiologic parameters, blood pressure, pulse rate and CVP, could not serve for evaluation of the adequate oxygen transport in the tissue. Pulmonary artery catheter is a best tool for evaluating the cardiopulmonary function and the oxygen transport system, and mixed venous oxygen saturation(SvO2) monitoring have made a great advances for early detection of cardiovascular dysfunction and the changes in peripheral tissue oxygenation. But pulmonary artery catheterization is complicated procedure in emergency setting. Although the central venous oxygen saturation(ScvO2) cannot completely replace the SvO2 value, it has a close relation with SvO2 change in variable clinical situations. We testify the usefulness of ScvO2 monitoring in 24 patients of the hemorrhagic shock. Initial resuscitation was performed with ATLS standard and continuous ScvO2 was monitored. Systolic blood pressure and pulse rate were recorded for one hour from initial resuscitation in each 15 minutes. Nineteen patient was traumatic hemorrhagic shock and five was non traumatic. Twelve of 19 patients was blunt trauma, and remains were stab in injury mechanism. Mortality rate was 29.2%. Initial ScvO2 of nonsurvivor was 43.6%, and 51.3% in survivor groups(p>0.05). In the group of stab wound and non-traumatic hemorrhage, the ScvO2 was gradually increase by time. But ScvO2 in survivors of blunt trauma was increased first 30 minutes and decrease afterthen. Continuous monitoring of ScvO2 may by partly useful in resuscitation for hemorrhagic shock. It is more valuable in the blunt trauma than in the penetrating injury or non-traumatic hemorrhage.
Blood Pressure ; Catheterization, Swan-Ganz ; Catheters ; Emergencies ; Heart Rate ; Hemorrhage ; Humans ; Mortality ; Oxygen* ; Pulmonary Artery ; Resuscitation ; Shock, Hemorrhagic* ; Survivors ; Wounds, Stab

No abstract available.
Animals ; Interleukin-4* ; Mice*

In this article neuroanatomical and verbal developmental process were introduced, followed that disorders and assessment of language function were reviewed. Finally, the causes and assessment of developmental dyslexia as a childhood disorder related to verbal function were reviewed.
Dyslexia ; Neuropsychology

BACKGROUND: The growth of elderly population increased the need for oral health care. Elderly patients with poor teeth alignment needs more attention with orthodontic treatment METHODS: Elderly patients visiting department of orthodontics, Kangdong Sacred Heart Hospital between 2000-2004 were treated with fixed appliances in one or both dental arches. Treatment plans were different from than that of younger patients and included uncommon and strategic removals of teeth and prosthesis. RESULTS: There was decrease in orthodontic treatment forces with increasing age, and the observation made from this study was favorable in the patients' as well as in the orthodontist's, point of view. It was possible to move the remaining teeth considerably, and the retention was made with various fixed appliances. CONCLUSIONS: Orthodontic treatment is not limited by patient age. However, it is wise not to extend treatment goals too far beyond the patients' objective needs
Aged* ; Dental Arch ; Heart ; Humans ; Oral Health ; Orthodontics ; Prostheses and Implants ; Tooth

We have applied the intraoperative use of Perfluorophenanthrene (C14F24) liquid in 19 eyes of complicated retinal detachment surgery in 19 patients since November 1990 to October 1991. The vast majority of case of retinal detachment was trauma (9 eyes) and uveitis including pars planitis (6 eyes) remainders were juvenile retinoschisis, cataract surgery, myopIa, diabetes one eye each. The grade-D of proliferative change was found in 9 eyes (D1 3 eyes, D2 3 eyes, D3 3 eyes) and 8 eyes belong to over grade-C2 (C2 4 eyes, C3 4 eyes). Multiple anterior retinal tears were found in two. Giant retinal tear was noticed in 5 eyes and the other one was made on therapeutic purpose. Intraoperative reattachment was obtained in all eyes. The follow-up periods were 6 or more (mean 9.1) months. At last follow-up, the retina was attached in 12 eyes (63%), partially attached in 2 (10%) and redetached in 5 (26%). Visual acuity was improved or same in 12 eyes (63%), became worse in 7(37%). Visual acuity of 0.02 or better was obtained in 12(63%) eyes and 3(16%) saw 0.1 or better. Perfluorophenanthrene liquid was thought as non-toxic, heavy biomaterial and effective to treat the complicated retinal detachments.
Cataract ; Follow-Up Studies ; Humans ; Myopia ; Pars Planitis ; Retina ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Retinoschisis ; Uveitis ; Visual Acuity ; Vitrectomy

In spite of vigorous efforts to enhance appropriateness of blood usage in surgery, it is recognized that there are still not a few overuse and misuse of blood products in Korean hospitals. To assure appropriate use of blood, continuous monitoring and controlfling blood orders, particularly for surgical operations, should be implemented. The indicator of 'ratio of crossmatching to transfusion' (C/T ratio) has been focalized on in this regard. The authors investigated C/T ratio for eight hospitals, evenly distributed in their geographical location as well as size. Only elective surgeries operated from March 1 to May 31, 1995 were included for analysis. Standardized survey format was distributed, and retrospective reviews of medical records were performed by volunteer surveyors from each hospital after two sessions of pre- survey education. The results were as follows. Average C/T ratio, for all hospitals and all surgeries, was 1.76. Differences in C/T ratio by sex, months, clinical departments, blood components were not significant. However, the ratio showed increasing tendency with ages. The C/T ratio on the average was not higher, compared with the recommended guideline. However, due to study' s limitations ini standardization of survey method and verification of data, we could not conclude that current status of appropriateness of blood use is satisfactory. In addition, to pervasively use the C/T ratio as a quality indicator for blood use management, supplementary measures, such as standardization of data, should be adopted.
Surveys and Questionnaires ; Education ; Medical Records ; Quality Indicators, Health Care* ; Retrospective Studies ; Volunteers

Retinal toxicity secondary to intravitreal injection of gentamicin for the purpose of prophylaxis or treatment of endophthalmitis was reported infrequently and it was thought to be caused by an error in the intravitreal injection technique or by faulty dilution of gentamicin. After vitrecotomy, we experienced two cases of ischemic retinopathy secondary to intravitreal injection of gentamicin for prevention of endopthalmitist.
Endophthalmitis ; Gentamicins* ; Intravitreal Injections ; Retinaldehyde ; Vitrectomy*

PURPOSE: This study is aimed to investigate perceptions of caregivers and medical staff toward do not resuscitate (DNR) and advance directives (AD). METHODS: Participants were 141 caregivers and 272 medical staff members from five general hospitals. A questionnaire used for the study consisted of 20 items: 14 about DNR perceptions, three about AD, one each for age, gender and employment. RESULTS: Both medical staff and caregivers strongly recognized the need for DNR and AD, and the level of recognition was higher with medical staff than caregivers (DNR chi2=44.56, P=0.001; AD chi2=16.23, P=0.001). The main reason for the recognition was to alleviate sufferings of patients in the terminal phase. In most cases, DNR and AD were filled out when patients with terminal conditions were admitted, and patients made the decisions by consulting with their guardians. Medical staff better recognized the need and for growing demand for guidelines for the DNR and AD decision making process than caregivers (chi2=7.41, P=0.0025). CONCLUSION: This study showed that patients highly rely on their caregivers when making decisions for DNR and AD. Thus, it is important that patients and caregivers are provided with objective information about the decisions. Since participants' strong support for DNR and AD was mainly aimed at alleviating patients' suffering, further study is needed in the association with hospice care. Medical staff also needs to understand the different views held by caregivers and fully consider the disparity when informing patients/caregivers to make the DNR and AD decisions.
Advance Directive Adherence ; Advance Directives ; Caregivers* ; Decision Making ; Employment ; Hospice Care ; Hospitals, General ; Humans ; Medical Staff* ; Personnel, Hospital ; Resuscitation Orders ; Surveys and Questionnaires

STUDY DESIGN: The authors retrospectively analysed the difference of clinical natures in contained vs. ruptured HIVD. OBJECTIVE: To compare contained HIVD with ruptured HIVD in respect of clinical symptoms, signs and the result after surgery. SUMMARY OF LITERATURE REVIEW: In contained disc herniation, the disc material remains beneath tile intact outer annulus. But, once disc material penetrates through the limit of posterior annulus, it is a ruptured herniation or disc extrusion/sequestration. There is few report concerning the clinical characteristics related to type of herniation. MATERIALS AND METHODS: Forty-six patients, treated by open discectomy from March 1990 to December 1994, were followed up for minimum two years. The clinical symptoms and signs including SLR, motor deficit, sensory deficit, change of DTR, and severity of radiating pain were periodically followed up on the predesigned protocol. Result: Twenty patients had contained disc and remaining 26 had ruptured disc. The mean age of contained disc was 31.4 years and that of ruptured disc was 43.3 years. In preoperative examination, 18/26 cases of patients with ruptured discs, developed pain in less than 3 months, compared with 7/20 cases of does with contained ones. Motor deficit was positive in 25/26 cases (96.2%) of ruptured discs and 12/20 cases (60%) of contained ones. 23/26 cases (80.8%) of patients with ruptured discs, had sensory deficit compared with 12/20 cases (60%) of those with contained ones. There was no significant difference in SLR and DTR change between ruptured and contained disc. CONCLUSIONS: Factors such as age, motor and sensory deficits and duration of symptoms had correlation with the type of herniation, but SLR and DTR change showed no statistical difference in this study. Clinical outcome showed no significant difference between two groups, but in ruptured group, the results were getting worse with the time goes. On the basis of this study, we concluded that the clinical symptoms and signs were different between the two groups, but surgical results showed no statistical difference.
Diskectomy ; Humans ; Retrospective Studies

No abstract available.
Hernia*