Using the APCHE III tool, this study was about the factors related to the death of ICU-patients. From 1999. 12. 1 to 2000. 9. 30, the 284 patients admitted to ICU at P university who were over 15 years of age were selected for the subjets. The data was analyzed through SPSS WIN program for frequency, percentile, x2-test, t-test and logistic regression. The results are summarized as follows: 1) Of the 284 patients, 88died. The mortality is 31.0 percent. The average APACHE III point was 48.62 +/- 32.32. The average point of non-survivors was higher than that of survivors. 2) There are the significant difference between APACHE III marks and mortality. The mortality rate were over 50 percent 60 points of the mark. When the marks were over 100 points, the mortality were over 90 percent. Below 40 points, the mortality was below 10 percent. Among the variables in the APACHE III, the most significant variables in explaining death were neurologic abnormalities, pulse, PaO2/ AaDO2, creatinine, sodium, glucose, chronic health state and age. According to the variables, the models explained the 42.43 percent of the variance in patient's death. In conclusion, the APACHE III tool can be used to predict the progress of ICU patients, and can also be used for the selection of patients for ICU admission/discharge criteria.
APACHE* ; Creatinine ; Glucose ; Humans ; Logistic Models ; Mortality ; Sodium ; Survivors

The deformed and rigid spine presenting moderate to severe kyphosis and scoliosis results in a restriction of function of the lung best characterized spirographically by a reduction in vital capacity. When the lesion involves the thoracic spine, restriction of function is more marked. Spinal deformities such as kyphosis and scoliosis develop from various causes. Tuberculous spondylitis, a main cause of kyphosis and scoliosis, is increasingly found in Korea. Cardiorespiratory dysfunction caused by spinal deformity poses another problem besides the spinal deformity perse. To perform therapeutic measures such as Harrington instrumentation, with or without preoperative localizer cast and halofemoral traction, as well as anterior interbody fusion, evaluation of pulmonary function and arterial gas analysis preoperatively is helpful to prevent and reduce postoperative cardiorespiratory failure or complications. The authors have reviewed the results of arterial gas analyses and pulmonary function tests on 35 cases of scoliosis and 60 cases of kyphosis done at the Department of Orthopedic Surgery, Seoul National University Hospital, from January 1975 to February 1978. The results were as follows: 1. Average degree of scoliosis in 35 cases was 89; vital capacity 60% of normal, and maximum breathing capacity 72%. Average degree of dorsal spine kyphosis in 38 cases was 93.5; vital capacity 38%, and maximum breathing capacity 73% Average degree of lumbar spine kyphosis of 22 cases was 79; vital capacity 77%, and maximum breathing capacity 84%. 2. Static values for pulmonary function such as vital capacity and dynamic values such as maximum breathing capacity hed a significant negative correlation with the severity of scoliosis and kyphosis. 3. Decrease in vital capacity due to scoliosis and kyphosis correlated positively with decrease in maximum breathing capacity. 4. Arterial oxygen saturation had a significant negative correlation with the severity of scoliosis and kyphosis.
Congenital Abnormalities ; Korea ; Kyphosis ; Lung ; Orthopedics ; Oxygen ; Respiration ; Respiratory Function Tests ; Scoliosis ; Seoul ; Spine ; Spondylitis ; Traction ; Vital Capacity

This is to report the histo-pathologic findings of the degenerated inferior alveolar nerves(IAN) causing uncontrollable neuralgia persisted for over 3 years. The patients had sufferred from frequent attack of unbearable pain along the mandibular branches of the Vth nerve. The pain arised spontaneously 5-10 times a day and lasted for 2-5 minutes. The medications including Tegretol were neither so effective to alleviate the pain level, nor enough to keep free from pain all days. The peripheral neurectomies were preceded by diagnostic nerve block, and partial resection of the IAN in the mandibular canals were approached by sagittal split osteomy of the ramus. The histopathologic findings of the resected IAN were as follows ; 1. Special staining with Luxol Fast Blue (LFB) and Masson Trichrome (MT) disclosed marked degeneration of the axons, decreased in number and fibrosis between the nerve fibers. 2. EM study revealed destruction of myelin continuity surrounding axons, degeneration of Schwann cell and endoneureal sheath, and coarse collagen between the destructed axons. 3. The 3 of 6 patients presented again with recurred pain in 2-3 years after the peripheral neurectomies. Excisional biopsy of the retromolarpterygomandibular softtissues disclosed the collateralization neuropathy beside the long-buccal nerves and their neuromatous findings.
Axons ; Biopsy ; Carbamazepine ; Collagen ; Fibrosis ; Humans ; Mandibular Nerve* ; Myelin Sheath ; Nerve Block ; Nerve Fibers ; Neuralgia ; Trigeminal Neuralgia*

No abstract available
Constriction, Pathologic* ; Stents*

Fat embolism is one of a rare catastrophic complication after multiple fraetures and extensive soft tissue injury. Many hypothesis on its pathogenesis has been postulated by many writers, still its exact pathogenesis, definite diagnostic criteria and treatment is not established. Nowadays fat embolism is considered as a respiratory insufficiency syndrome, even disseminated intravascular coagulation rather than isolated phenomena after extensive trauma of musculoakeletal system. Respiratory failure associated with fat embolism is a major cause of death, but is usually seIf-limited and is responsive to intensive treatment. Monitoring of blood gas is required for early diagnosis and respiratory supportive treatment with continued monitoring is necessary until resolution. The writers experienced six cases of fat embolism, at the Department of Orthopedic Surgery, Seoul National University Hospital for the period of three years from June 1974 till May 1977. Respiratory support, parenteral steroid and low molecular weight dextran with other supportive measure was a mainstay of treatment. Of six cases, five was recovered without sequalae and one was expired four days after trauma.
Cause of Death ; Dextrans ; Disseminated Intravascular Coagulation ; Early Diagnosis ; Embolism, Fat ; Molecular Weight ; Orthopedics ; Respiratory Insufficiency ; Seoul ; Soft Tissue Injuries

A case of hypertrophic interstitial neuropathy in a 32 years old man developed in the median nerve is reported. This is a rare disease characterized by thickened peripheral nerves which may be palpable and visible. This case was treated by excision of transverse carpal ligament and external and internal neurolysis.
Hereditary Sensory and Motor Neuropathy ; Ligaments ; Median Nerve ; Peripheral Nerves ; Rare Diseases

Little is known of the clearance mechanism of blood in the joint and it is still controversial. In order to clarify the possible mechanism of the clearance, rabbits own venous blood was injected into their own right knee joints of twenty-four normal adult rabbits and the opposite left knee joints served as control. The animal were killed at 12 hours, 1, 2, 3, 4, 7, 14 and 21 days after intra-articular injection of autologous blood. For histological and histochemical studies, the fresh synovial tissues were obtained from infrapatellar regions. The sections were stained by the alcian-blue (pH 2.5) for mucopolysaccharides and methylgreen pyronin for ribonucleic acid (R.N.A.). And finally, for metachromasia the sections were stained with toluidine blue (pH 2.5). In hematoxylin-eosin stained preparation, the synovial cells did not show any gross alterations in the early stages of experiment, but there was an increasing infiltreation of some inflammatory cells into the synovial and subsynovial tissues. Many erythrocytes were found lying free between the synovial cells, in the synovial matrix and subsynovial tissues. Any synovial change that shows a patchy thickening of the synovium due to increase in both the size and number of synovial cells and villous proliferation, became marked at the fourth day after experiment. On the seventh day villous proliferation were still seen but persist in an attenuated form. These changes converted to nearly normal from two weeks after experiment. With methyl-green pyronin stain for R.N.A., the synovial cell showed a definite increase in number in pyroninophilic granules and in intensity of staining reaction at two days of hemarthrosis and these findings were seen even in the third week specimens. After 12 hours of experiment, the synovial cells and the matrix showed a quite clear positive reaction with alcine-blue. And these changes showed a most strong positive reactions at 24 hours of experiment. But after 24 hours the synovial cells gradually showed a decreasing tendensy in intensity of staining reaction to alcian-blue. Since the fourth day of experiment the synovial and subsynovial tissues were closer to normal with alcian-blue. Toluidine blue gave only faint metachromasia to the very rarely in the deeper layer of synovium. We confirmed some of the injected erythrocytes escaped from the joint into the synovium and were cleared from the joint, and blood cells are clears from the joint by phagocytosis of synovial cells. It is suggested that these changes correlates with various histological and metabolic changes of the synovial membrane following a experimental hemarthrosis.
Adult ; Animals ; Blood Cells ; Deception ; Erythrocytes ; Glycosaminoglycans ; Hemarthrosis ; Humans ; Injections, Intra-Articular ; Joints ; Knee Joint ; Knee ; Phagocytosis ; Rabbits ; RNA ; Synovial Membrane ; Tolonium Chloride ; United Nations

Diffuse tremendous thickening of gastric wall caused by excessive proliferation of the mucosa of unknown causewas first decribed by Menetrier in 1888. The disease is highly uncommon, but the exact preoperative diagnosis iscrucial because of the more excellent prognosis than other malignant lesions including gastric lymphoma andinfiltrative gastric carcinoma. The authors recently experienced a case of Menetrier's disease which had beendiagnosed as gastric lymphoma preoperatively. Radiologic differentiation is not impossible between this extermelyrare disease and other mimicking malignant lesions, that is the reason why we introduce radiographic findings ofthe case by comparison with gastric lymphoma of giant rugal type and infiltrative gastric carcinoma. Typical upperG-I series findings of the case are: 1) Enlarged tortuous proximal gastric rugal folds only along the greatercurvature, 2) Perpendicular lines of barium spicules trapped by apposed folds with clubbed or forked appearance,3) Abrupt transition of transion to normal stomach, 4) No luminal narrowing and retained but sluggish peristalsis.Thus radiologists can diagnose Menetrier's disease scrupulously based on critical application of enlarged foldspattern and extent of the lesion in association with other radiologic features and clinial history of fairly longduration. Brief review of clinical and pathologic features about Menetrier's disease is included.
Barium ; Diagnosis ; Diagnosis, Differential ; Gastritis, Hypertrophic ; Hypertrophy ; Lymphoma ; Mucous Membrane ; Phenobarbital ; Prognosis ; Stomach

After extensive studies of the regenerated meniscus, most of authors believe that newly replaced meniscus completely consisted of fibrous connective tissue Instead of forming fibrocartilaginous tissue. This experiment was planned to investigate the chronological effect on the normal menisci and replaced one which formed after meniscectomy In rabbits knees. Total meniscectomy was performed on the medial menlsci of both knee joints of the 40 young rabbits (5 weeks old), weighting from 300 to 400 gm and 40 adult rabbits weighting from 1800 to 2200gm. In both groups, meniscal specimens were obtained from medial area of both knee joints 3,5, 12,24 and 48 weeks following meniscectomy respectively. Medlcal meniscl of normal 5,12,24 and 48 weeks old rabbits were used as control. Each specimen was examined grossly and histologically. Serial histological sections were cut at 6um and stained with hematoxylin and eosin for the histological examination and Safranln-0 fast green Iron hematoxylin for the histochemical examination. The result obtained were as follows: 1. Macroscopically all regenerated meniscl were less shlny and smaller than normal. Its margin was blunt shaped and completely connected with synovial membrane. 2. The meniscus, at 5 weeks after birth was composed with flbroblast and flbrocyte without cartilage cells. At 12 weeks after birth, In 2 out of 4 menisci flbrocytes were transformed with round oval shaped cells with lacunae and they looked Immature cartilage cells and Iightly stained with Safranin-O. 3. In young experimental rabbits, cartilage cells were found in one out of 14 regenerated meniscl at 12 weeks after meniscectomy while in mature rabbits cartilage cells were found in 2 out of 13 regenerated meniscl at 24 weeks after meniscectomy and newly formed 3 menlsci were strongly stained with Safranin-0. Mean rate of cartilage transformation of regenerated meniscl was 10.6% in young rabbits and 8.1% In adult rabbits without much difference in Incidence of transformation rate. Cartilagenous transformation in the small area of regenerated menlscus was found In 10% of cases. It ls summarized from the result that regenerated meniscl firstiy composed with fibrous tissue, but later on regenerated meniscus partiy transforms Into cartllage cells but not entirely. It is speculated that this cartllaginous transformation is due to adaptive metaplasia.
Adult ; Cartilage ; Connective Tissue ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans ; Incidence ; Iron ; Knee ; Knee Joint ; Metaplasia ; Parturition ; Rabbits ; Synovial Membrane

No abstract available.
Arteries* ; Head* ; Necrosis*