Anesthesia consent was requested by our anesthesiology department when the patient condition was found to be critical during the preanesthetic visit. To evaluate the trend, one hundred and five anesthesia consent cases among the 6,430 anesthetics from January 1977 to December 1978 at the department of anesthesiology, St. Mary's hospital, Catholie Medical College, were analyzed according to the anesthetic method, age, sex, surgical department, anesthetic agent, physical status, site of operation, diagnosis, preanesthetic problem and cause of death. The results were as follows; 1) Fifteen cases(14%) died among the 105 cases of anesthesia consent during and/or after .surgery, within the first 7 days. 2) Physical status was class ll E in 43% and the ratio of elective to emergency surgery was 1 to 1.4. 3) Upper abdominal surgery was performed in 52 cases(50%), urogenital surgery in 21 cases (20%), head and neck surgery in 18 cases(17%), surgery on extremities in 12 cases(11%) and thoracic surgery in 2 cases(2%), accordingly. 4) Cardiovascular problems were found in 27 cases(26%), hematologic disorders in 13 cases (12%), respiratory problems in 13 cases(12%), sepsis in 9 cases (9%), problems of central nervous system in 9 cases(9%), hepato-renal disorders in 8 cases(8%) and endocrine disorders in 5 cases(5%), respectively, 5) Postanesthetic cause of death was cardiopulmonary disturbance(33%), sepsis(27%) cerebral edema(20%) and hemorrhage(13%).
Anesthesia* ; Anesthesiology ; Anesthetics ; Cause of Death ; Central Nervous System ; Diagnosis ; Emergencies ; Extremities ; Head ; Humans ; Methods ; Neck ; Sepsis ; Thoracic Surgery

No abstract available.
Carcinoma, Renal Cell* ; Colon* ; Colonic Neoplasms*

Osteoporosis represents a reduced amount of bone tissue as compared with controls of same age and sex, and common feature of osteoporosis is a state of skeletal fragility leading to various fractures such as Colles' fracture, vertebral compression fracture, femur neck fracture, generally due to an inadequate amount of normally mineralized bone tissue, making the skeleton incapable of supporting normal mechanical demand. However it is difficult to quantify precisely its magnitude because of the variety of techniques used and the many bone sampling sites concerned. In 1970, Singh and associates(24.25) developed a method for grading the trabecular structure of the proximal end of the femur and reported that the femoral trabecular pattern index can clearly separate persons with osteoporosis from normal individuals. Cameron and its associstes developed an accurste method of determining bone mineral content by means of I-125 photon absorptiometry(5. 28). This method is consistently reproducible at the 98% level and has demonstrated agreement with ash measurement of cadaver bones at the 97% level. A comparative study of the usefulness of the femoral trabecular pattern index(Singh Index) and rsdial bone mineral content measurement by photon absorption was performed in 75 Kroean persons above forty years old. 25 of 75 persons were fracture patients due to osteoporosis. The results were as follows. 1. A significant difference in Singh index was noted between the fracture group snd control group. 2. A significant difference in bone mineral density was noted between the fracture group and control group. 3. A positive correlation was noted between the bone mineral denisty and Singh Index. 4. A significant difference in bone mineral density was noted between the fracture group and the control group which have same grade of Singh Index. So, we believe that bone mineral density is more objective and accurate than Singh Index. 5. We believe that both Singh Index and bone densitometer is useful in diagnosis and grading of osteoporosis.
Absorption ; Bone and Bones ; Bone Density ; Cadaver ; Colles' Fracture ; Diagnosis ; Femoral Neck Fractures ; Femur ; Fractures, Compression ; Humans ; Methods ; Miners ; Osteoporosis ; Skeleton

BACKGROUND: Tumor necrosis factor-alpha(TNF-alpha) has been thought to play a major role in neurological injury during global brain ischemia and subsequent reperfusion following resuscitation in cardiac arrest. So, we hypothesized that the elevation in TNF-alpha was dependent upon the duration of the global brain ischemia, and related to delayed neuronal damage. METHODS: Fourteen rats were divided two groups ; 1 minute-cardiac arrest group(n=7) and 3 minute-cardiac arrest group(n=7). we induced cardiac arrest by chest compression and damping of tracheal tube for 1 minute and 3 minutes respectively. And then, resuscitation was initiated. To measure the plasma activity of TNF-alpha, blood samples were drawn before and at the end of cardiac arrest, and 30, 60, 90, and 120 minutes after initiation reperfusion. At 72 hours after resuscitation, the ND(neurologic deficit) score was determined and the histopathologic outcome of hippocampal CA1 neuron was observed by the percent dead hippocampal CA1 neurons. RESULTS: 1. TNF-alpha level during the early reperfusion period(<2h) was significantly increased in 3 min-cardiac arrest group compared with 1 min-cardiac arrest group(p=0.0001). 2. There was a no significant difference of neurologic deficit score between 1 min- and 3 min-cardiac arrest. 3. Percent dead hippocampal neurons were significantly increased in 3 min-cardiac arrest group compared with 1 min-cardiac arrest group(9.1+/-1.2% vs 1.2+/-0.9%, p<0.05). CONCLUSION: The results suggest that longer duration of global brain ischemia causes a more profound increase in plasma TNF-alpha level during the early reperfusion period(<2h) and more delayed neuronal damage than lessor duration of global brain ischemia, and that increase in TNF-alpha level during the early reperfusion period(<2h) is related to delayed neuronal damage.
Animals ; Brain Ischemia ; Brain* ; Heart Arrest* ; Heart Arrest, Induced ; Necrosis ; Neurologic Manifestations ; Neurons ; Plasma ; Rats* ; Reperfusion ; Reperfusion Injury* ; Resuscitation ; Thorax ; Tumor Necrosis Factor-alpha*

Our study surveded 418 obese first grade elementary school children(279 male and 139 female), in seoul, and measured levels of serum total cholesterol, HDL cholesterol, LDL cholesterol, triglyceride were measured in addition to the measurement of body weight and height. The following results were obtained. 1) Obesity index was catergorized into mild, moderate, and severe, and the percentage of mild was 6.8%, moderate 48%, severe 45.7% respectively in surveyed children. 2) The average level of total cholesterol was 1.66.60 27.63mg/dl, HDL cholesterol 50.22+/-0.68mg/dl, LDL cholesterol 82.23+/-1.26mg/dl. 3) Atherogenic index was calculated, and obtained value was 2.45+/-0.48. It showed higher statstical significance in boys than in girls(p<0.05). 4) There was no significant difference in average level of total cholesterol, LDL cholesterol, and triglyceride in accordance of the severity of obesity. 5) Statistical significance was found in different average ievels of HDL cholesterol and atherogenic index according to obesity index (p<0.05). 6) There was a statistical significance in the average values of Kaup index and Rohrer index in accordance with obesity index (p<0.000). 7) There was no correlation between abnormal levels of total cholesterol, HDL cholesterol, and LDL cholesterol and the severity of obesity. 8) Abnormal levels of triglyceride, atherogenic index, Rohrer index and Kaup index had a statistical significance since their levels. 9) There was a correlation between atherogenic index and body measurement. Total cholesterol level showed correlation with obesity index, and HDL cholesterol with Kaup index and arm circum ference.
Arm ; Body Weight ; Child ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Humans ; Male ; Obesity ; Seoul* ; Triglycerides

We report a rare case of subepithelial hematoma of the renal pelvis (AntopoI-Goldman Lesion). A 55-year-old women visited our hospital because of gross hematuria. Ultrasonogram showed a 4cm well-defined solid mass of the left renal pelvis. Intravenous pyelography revealed compression of the left upper pelvicocalyceal system by the mass with contrast filling within the mass. CT scan revealed Iobulated well defined mass in the left renal pelvis extending into renal parenchyme. A transitional cell carcinoma or renal cell carcinoma was suspected radiologically, and the patient underwent left total nephrectomy. In pathology, the lesion turned out to be a subepithelial hemaroma. In the differential diagnosis of renal malignancy, a subepithelial hematoma of the renal pelvis may be included.
Carcinoma, Renal Cell ; Carcinoma, Transitional Cell ; Diagnosis, Differential ; Female ; Hematoma* ; Hematuria ; Humans ; Kidney Pelvis* ; Middle Aged ; Nephrectomy ; Pathology ; Tomography, X-Ray Computed ; Ultrasonography ; Urography

No abstract available.
Body Weight* ; Cholesterol*

Purpose: The aim of this study was to identify factors affecting pressure ulcers among cognitive impairment inpatients with long term care facilities. Methods: In this secondary data analysis of the two long-term care facilities, 162 patients with mild or more cognitive impairment were analyzed. Patients with a pressure ulcer of stage 2 or higher that developed after the first day of hospitalization were defined as the pressure ulcer group, while the other patients comprised the non-pressure ulcer group. Demographic characteristics were compared between the two groups. Initially, a univariate analysis was conducted. Subsequently, risk factors were identified through logistic regression analysis using the variables that exhibited statistically significant differences in the univariate analysis. Results: Thirty-three patients had hospital-acquired pressure ulcers. Age (odds ratio [OR]=0.92, 95% confidence interval [CI]=0.87~0.98), albumin levels (OR=0.25, 95% CI=0.08~0.77), Charlson comorbidity index (OR=1.57, 95% CI=1.14~2.18), and Mini-Mental State Examination for Koreans score (OR=0.90, 95% CI=0.81~0.99) were identified as risk factors for pressure ulcer occurrence. Conclusion Our data analysis supports independent associations between certain clinical characteristics and pressure ulcer occurrence in long-term care facility patients with cognitive impairment. To reduce the risk of pressure ulcers in long-term care facilities, health professionals should implement appropriate prevention measures.

Phenobarbital is a long-acting barbiturate causing generalized depression of neuronal activity in the brain. Its effect is primarily achieved through enhanced GABA-mediated synaptic inhibition. Its use as an antiepileptic agent was first described in 1912. Before the introduction of phenytoin, phenobarbital is used as sedative-hypnotics. It is used for the treatment of epilepsy and status epilepticus. All barbiturates, including phenobarbital, have a high potential far abuse. They were frequently used for suicide attempts in the past, but they have in large part been replaced by benzodiazepines. the onset of symptoms depends on the drug and the route of administration. Mild to moderate barbiturate intoxication resembles ethanol inebriation with slurred speech, ataxia, and lethargy. Severe acute barbiturate intoxication is life threatening. Early deaths are generally cardiovascular-related. Hypotension, shock, pulmonary edema, and cardiac arrest that occurs with large doses are caused by depression of central sympathetic tone and as well as by direct depression of cardiac contractility. The potentially fatal oral dose of phenobarbital is 6-l0g. We describe an 23-year-old woman with pulmonary edema and cardiac arrest after ingestion of 18 grams of phenobarbital. She was completely recovered by successful cardiopulmonary resuscitation and hemoperfusion. We report a case with literature review.
Ataxia ; Barbiturates ; Benzodiazepines ; Brain ; Cardiopulmonary Resuscitation ; Depression ; Eating ; Epilepsy ; Ethanol ; Female ; Heart Arrest* ; Hemoperfusion ; Humans ; Hypotension ; Lethargy ; Neurons ; Phenobarbital* ; Phenytoin ; Pulmonary Edema* ; Shock ; Status Epilepticus ; Suicide ; Young Adult

No abstract available.
Addison Disease*