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

No abstract available.
Drug Therapy* ; Lung*

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

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

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

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

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

No abstract available.
Adrenocortical Carcinoma* ; Stomach Neoplasms*

The combination of an intradermal nevus with epidermal cyst or other adnexal tumors has often been described since 1952. Most of these reports have involved the coexistence of common epidermal cysts and melanocytic nevi. Herein, we report a 21-year-old Korean male, who initially presented to our department with a rapidly enlarging preexisting nevus on his back. The mass was surgically excised and histopathologically showed intradermal nevus combined with epidermal cyst.
Epidermal Cyst ; Humans ; Male ; Nevus ; Nevus, Intradermal ; Nevus, Pigmented ; Young Adult

The size of the cisterna magna is still detatable. Robertson13) stated that the cisterna magna varies greatly in capacity and described the large cisterna magna as a separate entity. He also found that in most cases the cisterna magna extended approximately 2.5cm above the foramen magnum and was usually 5mm deep with a variable width. Liliequist8) proposed a mean heigh of 28mm for the normal cisterna magna with a wide variation of 15 to 60mm, and a depth of 6mm at the foramen magnum with a variation of 2 to 10mm:however, he did not quote measurements for the width. Gonsette, et al.5) reported 28 cases of enlarged cisterna magna diagnosed by ventriculography and coined the phrase "mega grande citerne" or mega cisterna magna. All of these cases, however, had symptoms of posterior fossa disease. Our study of the syndrome of the mega cisterna magna without specific syndrome is presented nystagmus, transient syncope in the first & third cases were operated under suboccipital craniectomy and was confimed the large cisterna magna. This paper presents the clinical diagnosis with vertebral angiogrraphy, pneumoencephalography and computed tomography.
Cisterna Magna* ; Diagnosis ; Foramen Magnum ; Numismatics ; Pneumoencephalography ; Syncope