Purpose: The purpose of this study was to evaluate the mortality of patients over eighty years old with femoral neck fractures that have been treated with bipolar endoprostheses. Materials and Methods: We retrospectively studied 37 patients out of a total of 83, who suffered from hip fractures and were treated with surgery from 2000 through December 2004. We attempted to distinguish the differences between the 8 patients who died (Group A) and the 29 patients who lived (Group B). The variables that we analyzed, were: age, sex, operative time, the time period from admission to surgery, the time period from admission to discharge, the ASA score, and any medical comorbidities. Results: In Group A, 2 patients died within 1 month, 2 died between 1 and 6 months, 1 died between 6 and 12 months, and 3 died after 1 year. There were statistical differences between Group A and Group B with respect to two variables: the time period from admission to, and medical comorbidities. Conclusion: There were significant correlations with an increase in the mortality rate among patients with lung disease, female patients in general, and delays in surgery. Therefore, particular care should be paid to patients with these variables.
Comorbidity ; Female ; Femoral Neck Fractures ; Hip Fractures ; Hip* ; Humans ; Lung Diseases ; Mortality* ; Operative Time ; Retrospective Studies

BACKGROUND: The automated border detection(ABD) echocardiography has the ability of recognizing the endocardial-blood interface, and therefore, on-line estimation of the left ventricular(LV) volume every cardiac cycle. Compared with the off-line conventional 2-dimensional echocardiographic method that requires tracing the endocardial border manually, the ABDd system can be a convenient and objective method in the estimation of the LV volume and the ejection fraction(EF). The purpose of this study is to compare the LV volume and EF between the on-line ABD system and the convertional off-line echocardiographic method. METHODS: In two weeks, 83 adult patients older than 16 years of age were referred to our echocardiographic laboratory. Among these 83 patients, 64 patients who had a normal sinus rhythm were included to our study. Using the Hewlett-Packard SONOS 1500, a 2.5 MHz transducer was placed dat the cardiac apex. Patients with an apical 4 chamber view of the LV in which at least 75% of the endocardium was clearly seen were selected for study. On that view, the ABD system was turned on, and the reansmit power and the time-gain compensation controls were adjusted in order to approximate the automated border to the visually apparent endocardial surface. The LV end-diastolic volume(LVESV) and LV end-systolic volume(LVESV) were calculated by the method of disc. LVEDV, LVESV, and EF were displayed every cardiac cycle. Also the off-line estimation of the LV volume was performed by the method of disc, after manually tracing the endocardial border on the apical 4 chamber view. RESULTS: 44 patients(69%) of 64 patients had > or =75% of the LV endocardium visualized. LVEDV, LVESV, and Ef with the ABD system were highly correlated with those with the off-line, manually traced method(r=0.95, 0.8, respectively), but LVEDV and EF with toe ABD system were significantly less than those with the latter(p<0.01). The limits of agreement between tow methods(off-line, manually traced method-ABD system) were somewhat wide. Those of LVEDV, LVESV and EF were +22~-10ml(mean 6ml), +15~-14ml(mean 0.1ml), and +19~-12%(mean 3.8%), respectively. CONCLUSION: LVEDV,LVESV, and EF measurements by the ABD system and the off-line manually traced methods thve a strong correlation, The ABD system should habe clinical applications in setting, in which measurements of LV volume and Ef are important, But, the comparison with a more reliable method is necessary.
Adult ; Compensation and Redress ; Echocardiography* ; Endocardium ; Humans ; Toes ; Transducers

PURPOSE: To reduce the side effects and improve the effectiveness of standard chemoradiation therapy, many complementary or alternative medicines have been tried. However, little is known about its immunologic effects in breast cancer patients. The aim of this study was to assess the immunologic effects of mistletoe extract (Viscum album L., VAE) in patients with early breast cancer after surgery followed by standard adjuvant chemoradiation therapy. METHODS: A total 20 patients with early breast cancer treated with breast conserving surgery followed conventional chemoradiation therapy. Ten of these patients received subcutaneous injections of VAE for 7 weeks. IL-2, IL-4, IL-6, IL-10, TGF-beta, and IFN-gamma levels in serum samples were measured in all patients. RESULTS: The concentrations of IL-2, IL-4, IL-10, and TGF-beta were not significantly changed between before and after VAE treatment in both test and control group. The concentration of IL-6 in the test group was increased from 8.19+/-1.75 pg/mL to 9.86+/-1.46 pg/mL after treatment (p=0.013). The concentration of IFN-gamma in the test group was remarkably increased from 91.76+/-17.16 pg/mL to 167.42+/-66.61 pg/mL after treatment (p=0.009). CONCLUSION: Significant increases in the concentration of IL-6 and IFN-gamma were observed after VAE treatment. These results suggest that VAE treatment can stimulate immune responses, especially cell-mediated immunity in immune-compromised patients received the chemoradiation for breast cancer.
Breast ; Breast Neoplasms ; Humans ; Immunity, Cellular ; Injections, Subcutaneous ; Interleukin-10 ; Interleukin-2 ; Interleukin-4 ; Interleukin-6 ; Mastectomy, Segmental ; Mistletoe ; Transforming Growth Factor beta

There have been many reports stating that halperidol premedication has been used for sefative and antiemetic effects. Therefore we utilized haloperidol as a premedicant for the purpose of obtaining the above effects. Over a period of one year from march 1978 to February 1979, 0.1mg haloperidol per kilogram of body weight was given to 747 patients. The results were as follows. 1)The extrapyramidal symptioms appeared in children, especially in the 10-year old group. 2) Large doses of haloperidol were more likely to cause to extrapyramidal symptoms than smaller doses(over 0.1mg/kg) 3)The effects of haloperidol lasted for a considerable duration of time after administration, (about 24-48 hous).
Antiemetics ; Body Weight ; Child ; Haloperidol* ; Humans ; Premedication*

No abstract available.
Family Practice* ; Hospitals, Community* ; Humans

Pre-anesthetic assessment of laboratory findings in proposed operative patients is one of the most important procedures in evaluating the patients condition. The more diffuse and minutely the findings are carried out, the better the results are in controlling the patients during and after anesthesia. The serum electrolytes are the most essential laboratory findings in ascertaining whether or not the body components deviate beyond the norm. If there should be a severe deterioration of the major electrolytes for any cause, the physiological response of the various mechanisms of the body tissue will attempt to restore the normal status. At times, it is impossible to obtain normal conditions because of too serious impairment of the cellular functions due to severe electrolyte imbalance. The authors studied the pre-anesthetic major serum electrolytes in elective operative cases retrospectively and the results were classified into two groups of GI diseases and others. These results were compared with the normal values and ranges. Although most of the mean values of our data shifted to the lower level of the normal, the deviations were still within the normal range. Even though the lower levels were observed in a few more incidents in the GI diseases than in the other disease group, still these were of no great significance.
Anesthesia ; Electrolytes* ; Humans ; Reference Values ; Retrospective Studies*

During the past two years, we had 80 cases of intravenous lidocaine anesthesia for upper limb operations. Per kilogram of body weight, we usually used 1.0~3.0mg of 0,5~0.8% lidocaine and a pressure of 200~300 mmHg(about 100 mmHg higher than the patients systolic blood pressure) by means of an Inflato-Matic dual cuff tourniquet which was also connected with an Inflato-Matic 2, 000 Tourniquet Regulator and oxygen tank. Analgesia occurred about 5 10 minutes after injection with relative satisfaction and, fortunately, no kind of serious complications ensued after releasing the tourniquet. It is not only a simple technique and of low cost to give the anesthesia to the patient(in-patient or out-patient), but also it is possible to perform anywhere and at any time without serious complications or complexities of any other method of anesthesia.
Analgesia ; Anesthesia ; Body Weight ; Humans ; Lidocaine* ; Methods ; Oxygen ; Tourniquets ; Upper Extremity*

No abstract available.
Carcinoma, Transitional Cell*

An anesthetic experience with bilateral adrenalectomy for pheochromocytoma in an 18 year old male has been reported. We chose fluothane as a primary anesthetic agent for the management of anesthesia 'with relative satisfaction. The patient was treated with phenoxybenzamine for a long time (about 40 days) and also with propranolol for a few days intermtteently before induction of anesthesia. During anesthesia and operation, the highest systolic blood pressure was 180 mmHg, the lowest was 80 mmHg and some variable arrhythmias with extrasystoles were present. But these were well controlled immediately after administration of regitine and propranoloL Recently some reviews of the literature on the anesthetic management of pheochromocytoma suggest that the selection of an anesthetic agent is not as important as the adequate management of the characteristics of those agents which affect the anesthetic procedures. Conclusively, we prefer to recommend that it is important to manage the patients with alpha & beta adenergic blocking agents for at least several weeks pre-operatively, and to use the anesthetic agents as far as possible which do not have the sensitizing effects to catecholamine on myocardium.
Adolescent ; Adrenalectomy* ; Anesthesia ; Anesthetics ; Arrhythmias, Cardiac ; Blood Pressure ; Cardiac Complexes, Premature ; Halothane ; Humans ; Male ; Myocardium ; Phenoxybenzamine ; Phentolamine ; Pheochromocytoma ; Propranolol

Cardiac arrest is the most serious problem during anesthesia and surgery. Whether the heart is in ventricular fibrillation, in asystole or in EMD, the ABCDS of CPR must always be used. The authors have experience with cardiac arrest obviously due to the complexities of vagovagal reflexs and severe electrolyte imbalance, especially in potassium ions. After the diagnosis of ventricular fibrillation in our case by continuous ECG monitoring, immediate closed chest cardiac massage was carried out and the essential drugs and a DC defibrillator were used. At the first attempt, the normal sinus rhythm was restored immediately after 100 joules of DC countershock were given. We then gave another 200 J. of a second shock for recurrent VF. Thereafter, complete normal sinus rhythm was restored without dysrhythm of any kind. Simultaneously the authors also several times observed changes of arterial blood gases and pH. About ten hours later the patient regaineded consciousness completely without complications. If possible, continuous ECG monitoring during anesthesia is highly recommended because various dysrhythmias can be detected by this system.
Anesthesia ; Cardiopulmonary Resuscitation ; Consciousness ; Defibrillators ; Diagnosis ; Drugs, Essential ; Electrocardiography ; Gases ; Heart ; Heart Arrest ; Heart Massage ; Humans ; Hydrogen-Ion Concentration ; Ions ; Potassium ; Reflex ; Shock ; Thorax ; Ventricular Fibrillation*