BACKGROUND: Patients receiving an elective total knee replacement (TKR) are frequently older and immobilized. The related decline in respiratory function and structural changes may place these patients at an increased risk of perioperative pulmonary complications. METHODS: This study reviewed the data of 239 consecutive procedures performed by a single surgeon. The data examined included the patient's characteristics (age, gender, height, weight and body mass index [BMI]); concurrent pulmonary comorbidity (presence vs. absence); anesthetic techniques (general vs. spinal); types of operation (unilateral vs. bilateral); duration of operation (< 4 vs. > or = 4 hr); duration of tourniquet inflation (< 2 vs. > or = 2 hr); number of perioperative transfusions (< or = 4 vs. > or = 5 units); and American society of anesthesiologists (ASA) physical status. Pulmonary complications were grouped together as a single outcome. A Chi-square test and multiple logistic regression analysis were used to identify the risk factors. A P value < 0.05 was considered significant. RESULTS: Pneumonia, pulmonary edema, pulmonary congestion, atelectasis and pulmonary embolism were the pulmonary complications (n = 28; 11.7%) examined. Age, gender, BMI, pulmonary comorbidity, type and duration of surgery, duration of tourniquet inflation, anesthetic technique and ASA physical status were not associated with pulmonary complications. Only the number of packed cells transfused (> or = 5 units) was found to be associated with the pulmonary complications (odds ratio 5.21; P = 0.015). In particular, transfusions were related to pneumonia, pulmonary edema, pulmonary congestion and pulmonary embolism (P < 0.01). However, atelectasis was not related to any of the potential risk factors including the anesthetic technique. CONCLUSIONS: Transfusion requirements may be an important risk factor of the early postoperative pulmonary complications in patients receiving a TKR.
Arthroplasty, Replacement, Knee* ; Body Mass Index ; Comorbidity ; Estrogens, Conjugated (USP) ; Humans ; Inflation, Economic ; Logistic Models ; Pneumonia ; Pulmonary Atelectasis ; Pulmonary Edema ; Pulmonary Embolism ; Risk Factors* ; Tourniquets

Cutaneous metastases from internal carcinomas are relatively rare, especially from pancreatic carcinoma. Pancreatic carcinomas are usually adenocarcinomas which arise in the head of the gland, and are known to rapidly metastasize to the lymphatic system by permeation and embolization. We report a case of cutaneous metastasis from pancreatic adenocarcinoma. in 74-year-old male patient who have two pea sized, slight erythematous nodules on the lower abdomen and posterior side of the neck.
Abdomen ; Adenocarcinoma* ; Aged ; Head ; Humans ; Lymphatic System ; Male ; Neck ; Neoplasm Metastasis* ; Peas

No abstract available.
Drug Therapy* ; Lung*

No abstract available.
Blood Platelets* ; Humans ; Platelet Aggregation* ; Plateletpheresis* ; Tissue Donors*

BACKGROUND: When one of family members must be treated, the others are required to get various forms of changes including modification of their proper roles in the family. Particularily when he or she can not perform his or her activities of daily living(ADL) owing to functional impairment by himself or herself, there seems to be greater dependence upon his or her family. Accordingly, we tried to give help in the treatment of patients through the comparative analysis concerning functional impairment in both groups on the assumption that there is difference of family function between two family groups which have a patient in family, or not. METHODS: This study was carried out to 83 inpatients in Sun Hospital in Dae Jeon and local rehabilitation clinics in Iksan from 1. July. 1995 to 31. Jun. 1996. We evaluated activites of daily living by using modified Barthel Index(MBI) and classified them into dependent group with 60 points or less(6roup I ), and independent group with more than 60 points(Group II). We also used Family APGAR score and FACES III to evaluate their family functions. RESULTS: MBI scores to evaluate ADL were 42.9+/-15.6 in Group I and 82.1+/-17.9 in Group II. Family APGAR scores were 6.93+/-2.52 in Group I and 7.24+/-17.9 in Group II but there was no significance between two groups. Types of family according to Family APGAR score were highly functional, morderate dysfunctional, and severly dysfunctional one in order of frequency in both groups, but there was no significance in their frequencies in both groups. Types of Family in view of cohesion was disengaged, separated, connected, and enmeshed one in order of frequency in Group I, and separated, disengaged, connected, and enmeshed one in order of frequency in Group II but there was no significance between two groups. Types of family in view of adaptability were rigid, chaotic structured,and flexible one in order of frequency in Group I, and were flexible, structured, rigid, and chaotic one in orders in Group II, which showed significance between two groups. Extremal types of family structure were large in numbers in Group I, but it didnt show significance. CONCLUSIONS: Assuming that there were large numbers of rigid and chaotic family in Group I, it is considered that tne family which has a patient with severely impaired function seems to have weaker adaptability to their family stresses than otherwise. Therefore, it is desirable that physicians who take charge of such patients provide continuous and comprehensive medical care for them including their family with greater concerns and through analysis and assessment of their family functions.
Activities of Daily Living ; Apgar Score ; Daejeon ; Humans ; Inpatients* ; Jeollabuk-do ; Rehabilitation* ; Solar System

PURPOSE: Neonatal hyperbilirubinemia has benign courses in most cases, but the possibility of toxicity of hyperbilirubinemia required courses examination of every newborn infant to identify the severity of hyperbilirubinemia progress. This study aims to see how the body surface area of newborns influences the decline rate of serum bilirubin level in conventional phototherapy. METHODS: Based on the charts of the Pediatrics Department, Dae-Dong Hospital from January 2003 to December 2006, we analyzed 168 neonates diagnosed as neonatal hyperbilirubinemia (serum bilirubin > or =15 mg/dL) in retrospective way. We excluded newborn infants under 37 weeks of gestation and under 2,500 g birth weight and classified neonates into four groups by the calculation results of body surface area:males above 75 percentile (group A), males below 25 (group B), females above 75 (group C), and females below 25 (group D). RESULTS: Out of 168 samples, the number of group A, B, C, D was 30, 20, 20, 15 respectively. In conventional phototherapy, the mean decline rates of serum bilirubin of group B and D recording 2.09 mg/dL/day and 1.77 mg/dL/day, were significantly faster than those of group A and C recording 1.63 mg/dL/day and 1.41 mg/dL/day (P<0.01). No significant differences were found in different duration of phototherapy between groups below 25 percentile and those above 75 in both genders. CONCLUSION: In conclusion, body surface area influences of infants the decline rate of serum bilirubin level in conventional phototherapy.
Bilirubin* ; Birth Weight ; Body Surface Area* ; Female ; Humans ; Hyperbilirubinemia ; Hyperbilirubinemia, Neonatal ; Infant ; Infant, Newborn ; Male ; Pediatrics ; Phototherapy* ; Pregnancy ; Retrospective Studies

No abstract available.
Animals ; Mucous Membrane* ; Rats*

PURPOSE: To investigate the difference in healing of the corneal epithelial cells between in LASEK and in PRK and the factor to induce the difference. METHODS: The rate of corneal epithelial recovery was measured after mechanical removal of corneal epithelium (PRK) or after removal with alcohol (LASEK) in rabbits. PCNA (proliferating cell nuclear antigen) staining was performed to compare the degree of cellular proliferation. Immunocytochemical staining was also carried out to examine the expressions of fibronectin and EGFR (epidermal growth factor receptor), which were known as the factors participating in corneal epithelial regeneration. In cultured porcine corneal epithelial cells, the degree of epithelial proliferation was compared between the control group (group I without alcohol treatment) and alcohol treated groups with various alcohol concentrations (groups II, III, IV and V) after cell culture for 2 weeks. RESULTS: The rate of epithelial healing was faster in LASEK group than in PRK group. These epithelial cells recovered to normal cells faster in LASEK group than in PRK group according to light and electron microscopic findings. PCNA expression and fibronectin expression were higher in LASEK group than in PRK group, whereas no difference was seen in the expression of EGFR. Although the proliferation of corneal epithelial cells increased, it was not proportional to the amount of added alcohol-treated epithelial cells. CONCLUSIONS: We showed that the corneal epithelia recovered to normal shape faster in LASEK than in PRK group when alcohol treated corneal epithelial cells were treated to the site of the wound. Higher expression of fibronectin in LASEK group suggest that fibronectin could be a factor promoting corneal epithelial cell regeneration.
Cell Culture Techniques ; Cell Proliferation ; Epithelial Cells* ; Epithelium, Corneal ; Fibronectins ; Keratectomy, Subepithelial, Laser-Assisted* ; Proliferating Cell Nuclear Antigen ; Rabbits* ; Regeneration ; Wounds and Injuries

No abstract available.
Adrenocortical Carcinoma* ; Stomach Neoplasms*

PURPOSE: Tacrolimus (FK506) has been widely used as an immunosuppressant in organ transplanted recipients to suppress organ rejection phenomenon. We investigated the role of oxidative stress and heme oxygense-1 by FK506 on human Jurkat T cells. METHODS: The cells viability was examined by DAPI stain, enzyme activity of caspase family proteins, and western blotting for Baks, PUMA, iNOS, HO-1. Cells were cultured in the absence or presence of CoPPIX or ZnPPIX and the fluorescence intensity was analyzed using a flow cytometry. RESULTS: Treatment with FK506 increased the generation of reactive oxygen species (ROS), including hydrogen peroxide and superoxide anion, and NO in Jurkat cells in a dose-dependent manner. Immunohistochemistry and Western blot analysis data revealed the hemoxygenase-1 (HO-1) was induced by the addition of FK506 in Jurkat cells. Induction of CoPP, HO-1 inducer, resulted in decreased intracellular H2O2 and NO concentrations. Instead ZnPP, an HO-1 competitive inhibitor did it reversely. In addition, ZnPP regulates iNOS protein synthesis by inhibition of HO-1. CONCLUSION: Increase of HO-1 expression would induce to decrease the intracellular H2O2 and NO concentrations. Also, HO-1 would regulate iNOS protein synthesis. Consequently, we can expect the regulation of HO-1 expression with concomitants use of FK506 to suppress organ rejection phenomenon by enhancing apoptosis.
Apoptosis ; Blotting, Western ; Flow Cytometry ; Fluorescence ; Heme ; Heme Oxygenase-1 ; Humans ; Hydrogen Peroxide ; Immunohistochemistry ; Indoles ; Jurkat Cells ; Lymphocytes ; Oxidative Stress ; Proteins ; Puma ; Reactive Oxygen Species ; Rejection (Psychology) ; Superoxides ; T-Lymphocytes ; Tacrolimus ; Transplants