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

Doxorubicin(Adriamycin(R)) is effective in the treatment of various solid tumors and hematologic malignancies. Because of dose-related cardiotoxicity, however, early inappropriate discontinuation of doxorubicin therapy may minimize its therapeutic efficacy in many patients. Consequently, clinically sensitive tests are needed to select patients in whom treatment must be stopped early. Various techniques have been used for early detection of subclinical doxorubicin-induced cardiotoxicity, including electrocardiography, systolic time intervals, echocardiography, radionuclide angiography and endomyocardial biopsies. Most studies of doxorubicin cardiotoxicity have dealt with systolic function of the left ventricle and effects on diastolic function have not been reported. In order to determine whether impaired diastolic function may be an early sign of doxorubicin cardiotoxicity, a retrospective study was performed in 12 patients who had undergone serial radioangiography and were found to have left ventricular ejection fractions(LVEF)> or =55% prior to doxorubicin treatment and during follow-up. Average rapid filling velocity(RFV) and slow filling velocity(SFV) were both significantly reduced after doxorubicin treatment. RFV fell from 5.17+/-1.52 units/second to 4.18+/-0.96(P<0.01) and SFV fell from 2.20+/-1.32 units/second to 1.42+/-0.62(P<0.05). There were no significant changes in filling volume ratio, total diastolic time and diastolic time ratio. Since a change in left ventricular diastolic function can occur before ejection fraction falls to subnormal levels, diastolic function as well as systolic function should be examined in the early detection of doxorubicin cardiotoxicity.
Biopsy ; Doxorubicin* ; Echocardiography ; Electrocardiography ; Follow-Up Studies ; Heart Ventricles ; Hematologic Neoplasms ; Humans ; Radionuclide Angiography ; Retrospective Studies ; Systole

In the orthopedic Department of Jeonbug National University Hospital, twenty-five open tibial shaft fractures were reviewed and analyzed with osteomedullography and bone scanning with radioactive isotopes from June 1981 to October 1983. The results are as follows. 1. The cases of injury were mostly traffic accident(70.8%) and majority was found between second decade and third decade. Males were 11 times more frequent than females. 2. In the shape and location of fractures, comminuted fracture(60%) was most common, and fracture of middle one third(48%), lower one third(28%) were in order. 3. In the open tibial fractures, Grade I. of soft tissue injury was most frequent(64%). As inthe plate fixation was required, we should it placed atypically on the posterior surface of the tibia. 4. In the osteomedullography at 3 months after treatment, the rate of positive finding was 80 and intraosseous crossing vein(Kaski sign 1) was observed most frequently. 5. In the profile of the bone scanning with radioactive isotopes, the rate of single-peak uptake was 76% and twin-peak uptake was 24%. 6. In the negative Osteomedullogram and twin-peak uptake on the profile of the bone scanning, bone graft was necessary. 7. In the case of difficult diagnosis for union process of tibia fracture, osteomedullography and bone scanning with radioactive isotopes were considered useful method of early diagnosis.
Diagnosis ; Early Diagnosis ; Female ; Fractures, Comminuted ; Fractures, Open ; Humans ; Jeollabuk-do ; Male ; Methods ; Orthopedics ; Radioisotopes ; Soft Tissue Injuries ; Tibia ; Tibial Fractures ; Transplants

PURPOSE: This study was performed to find out the role of routine lumbar puncture in children presented with their first seizure with Fever. METHODS: This study included 220 children, over a 5 year period, from April 1999 to March 2003, who visited or were admitted at Dae Dong Hospital with their first febrile convulsion. Lumbar puncture was performed in all children. We analyzed their age, family history, type of seizure, duration of seizure, cause of fever, and the results of lumbar puncture. RESULTS: In the sex distribution, males(58.6%) outnumbered females(41.4%) and the ratio was 1.2:1. 81.7% of the patients had febrile convulsion from 6 months- to 3 years of age(P<0.05). 30.5% also had family history of febrile convulsion. The types of seizure were generalized tonic-clonic(72.7%), generalized tonic(17.7%), and generalized clonic(6.4 %). For the duration of seizure, 90.4% of the patients were estimated less than 15 minutes(P<0.05). The causes of fever were pharyngotonsilitis(40.5%), gastroenteritis(19.1 %), pneumonia or bronchitis(13.2%), meningitis(11%), otitis media, urinary tract infection, and exanthem subitum. However, 9.1% of the patients were diagnosed meningitis, with 18 of 20 patients under 3 years of age. CONCLUSION: In the first seizure with fever, lumbar puncture is a useful method for meningitis, especially under 3 years of age.
Child* ; Exanthema ; Fever* ; Humans ; Meningitis ; Otitis Media ; Pneumonia ; Seizures* ; Seizures, Febrile ; Sex Distribution ; Spinal Puncture* ; Urinary Tract Infections

Retroperitoneal fibrosis (RPF), although rare, can lead to significant intestinal obstruction. A case of RPF resulting in obstruction of the rectosigmoid colon is presented. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) revealed a characteristic fibrotic mass impinging on the rectosigmoid colon.
Colon ; Intestinal Obstruction ; Magnetic Resonance Imaging ; Retroperitoneal Fibrosis*

No abstract available.
Hemorrhage* ; Hemorrhoids*

No abstract available.
Prolapse*

No abstract available.
Prolapse*

The antihypertensive effect and side reactions of perdipine were evaluated in 30 patients with essential hypertension. The results were as follows; 1) Before medication and after 2, 4, 5 and 8 weeks of medication, the over all average systolic and diastolic blood pressure were 170+/-13/104+/-7, 152+/-13/93+/-6, 146+/-11/91+/-6, 143+/-9/90+/-7, and 141+/-10/89+/-7mmHg, respectively. In 89% of all cases, marked or moderate degree of antihypertensive effect was observed. 2) There were no significant changes in heart rates before and after treatment. 3) In 83% of all cases, improvement of symptoms were observed. 4) The side reactions of oral perdipine were mild constipation, anorexia, facial flushing, dizziness, and headache, respectively one case. but there were no side reactions which required discontinuing the treatment, except 1 case which discontinued the medication because of severe bradycardia and dizziness.
Anorexia ; Blood Pressure ; Bradycardia ; Constipation ; Dizziness ; Flushing ; Headache ; Heart Rate ; Humans ; Hypertension ; Nicardipine*

Anhidrotic ectodermal dysplasia is a rare genetic disorder characterized by absence or diminished numbers of structures derived from the ectoderm, and it is reported to be inherited as an x-linked recessive trait. It is recognized clinically by anhidrosis, hypotrichosis, anodontia or reduced numbers of teeth with deformed shape and characteristic facial features. In addition, otolaryngological manifestations include atrophic rhinitis, sensorineural hearing loss, and conductive hearing loss and satyr ear, among others. Early diagnosis of anhidrotic ectodermal dysplasia can prevent fatal hyperpyrexia and appropriate genetic counseling can be followed to make a reasonable future plans for the pediatric patient. A 2-month-old infant was referred with symptoms of intermittent nasal obstruction and crust formation in both nasal cavities. The nasal endoscope demonstrated atrophic changes of nasal mucosa and radiologic study showed an unerupted conical shaped tooth. The diagnosis of anhidrotic ectodermal dysplasia was confirmed with the finger impression test that revealed deficiency of sweat pores. We report a case of anhidrotic ectodermal dysplasia with a review of the literature.
Anodontia ; Diagnosis ; Ear ; Early Diagnosis ; Ectoderm ; Ectodermal Dysplasia* ; Endoscopes ; Fingers ; Genetic Counseling ; Hearing Loss, Conductive ; Hearing Loss, Sensorineural ; Humans ; Hypohidrosis ; Hypotrichosis ; Infant ; Nasal Cavity ; Nasal Mucosa ; Nasal Obstruction ; Rhinitis, Atrophic* ; Sweat ; Tooth