No abstract available.
Arm* ; Foot Injuries* ; Foot* ; Free Tissue Flaps* ; Hand*

No abstract available.
Free Tissue Flaps* ; Hand Injuries* ; Hand*

PURPOSE: Delirium in the elderly is common in the postoperative period but there are only few reports on detailed studies of this condition. Number of urologic patients with postoperative delirium was increas ed in our hospital for recent 24 months. The clinical characteristics of patients with postoperative delirium was analyzed retrospectively. MATERIALS AND METHODS: We selected the patients with postoperative delirium from 1010 patients who had undergone urological surgery under general or spinal anesthesia in the period from Jan. 1997 to Dec. 1999. Diagnosis of postoperative delirium was established with Diagnostic and Statistical Manual of Mental Disorders(DAM-III-R) by psychiatric clinicians. Onset and recovery of symptoms, risk factors, previous psychiatric clinicians. Onset and recovery of symptoms, risk factors, previous psychiatric disorder, relationship with anesthesia, drugs, and surgical procedures, concomittant medical conditions, and complications were retrospectively reviewed. RESULTS: Postoperative delirium was observed in 13 patients (1.3%). All patients were male and mean age was 70.4 years (46-86 years). Surgical procedures included TURP(8 patients), cystectomy (3 patients), nephroureterectomy (1 patient), and bladder rupture repair (1 patient). Delirium became apparent between one day and two days after the operation (mean 32.2 hours) and lasted for up to 7 days (mean 53 hours). Several factors such as older age (>65 years), male patient, longterm medication, past history of CVA, memory impairment, hearing difficulty, traumatic brain contusion, and obsessive personality were thought to be risk factors of postoperative delirium. Treatment with Haloperidol(R) intramuscular injection (2.5-5mg, every 30 minutes, 2-4 times until symptom resolution was achieved) with or without Ativan(R) intravenous injection (2mg) were effective. Complete symptom recovery was seen in 92.3% (12/13) of patients. One patient (7.7%) with previous history of dementia had persistent memory disturbance and disorientation during follow-up periods. CONCLUSIONS: Generally, postoperative delirium is an acute transient confusional state without considerable sequeles. Treatment is sedation and prevention of inadvertent accident associated with confusional state. Urologic surgeon must be attentive to the development of this illness especially when high risk factors were present.
Aged ; Anesthesia ; Anesthesia, Spinal ; Brain Injuries ; Cystectomy ; Delirium* ; Dementia ; Diagnosis ; Follow-Up Studies ; Hearing ; Humans ; Injections, Intramuscular ; Injections, Intravenous ; Male ; Memory ; Postoperative Period ; Retrospective Studies ; Risk Factors ; Rupture ; Urinary Bladder

No abstract available.
Ankle*

As times go by, the objects and subjects of researches have changed. Forensic medicine and science can not be escaped. To overview the international changes and trend of forensic medicine and science, we gathered abstracts of 3,354 articles from 5 outstanding international journals, those are (1) Forensic Science International, (2) Journal of Forensic Science, (3) American Journal of Forensic Medicine and Pathology, (4) Medicine, Science and the Law, (5) International Journal of Legal Medicine. There were 1,226 articles (36.6%) on forensic pathology, followed by forensic genetics (902 articles, 26.9%), toxicology (549 articles, 16.4%), forensic sciences (445 articles, 13.3%) and medical law & criminal psychology (232 articles, 6.9%). Corresponding authors from 4 countries (USA, Great Britain, Germany and Japan) took more than half of total corresponding authors. And there were 27 articles (0.8%) from Korea. This article will introduce us an overview of international trend of forensic researches.
Criminal Psychology ; Forensic Genetics ; Forensic Medicine ; Forensic Pathology ; Forensic Sciences ; Germany ; Great Britain ; Jurisprudence ; Korea ; Pathology ; Toxicology ; United Nations

The Widmark formula has been widely used in forensic fields since the early decades of 20 the century. When the calculation of blood-alcohol concentrations (BAC) from given quantities of alcoholic beverages consumed was required, Widmark equation has been applied. However, some modern experimental results have reported that the Widmark factor, r showed discrepancy between individuals. Furthermore, Widmark equation was derived from Caucasian to the calculation of blood alcohol concentration. To estimate and compare Widmark factor of blood with breath ethanol metabolism in Koreans, we performed the controlled drinking study for 50 healthy male. All subjects are classified into three groups considering alcohol-drinking history (frequency and quantity in the past year). Group A subjects (n=20) consumed 0.5 g ethanol per kilogram of body weight, group B subjects (n=18) 0.8 g, and group C subjects (n=12) 1.0 g in fast state, respectively. Biological specimens of blood and breath were obtained for alcohol experiment from 60 minutes to 6 hour every 30-60 minutes after the alcohol intake. Concentration-time profiles of alcohol were plotted for each subject and the Widmark values (C0 and r0) from blood and breath were extrapolated using linear regression analysis. We determined the practical factors, rpeak at peak blood alcohol concentration. The evaluated data of Widmark factor for Korean male are 1.19 (group A), 1.06 (group B), and 0.75 (group C), respectively, showing the unreliability and inaccuracy of Widmark formula to the male Korean population. Our findings suggest that Widmark equation could be applied only for gross approximation, and no accuracy must be offered.
Alcoholic Beverages ; Body Weight ; Drinking ; Ethanol ; Humans ; Linear Models ; Male* ; Metabolism

The operative technic for the correction of hydronephrosis due to obstruction at ureteropelvic junction has been discussed. There are two different types of technics in pyeloplasty ; 1st. nondismembered pyeloplasty molds and restructures the obstructed ureteropelvic junction without completely dismembering it and 2nd. dismembered pyeloplasty interrupts the continuity of the transport system of the obstructed ureteropelvic junction. Since Andereon-Hynes reported the technics which belongs to dismembered pyeloplasty for retrocaval ureter in 1949, many articles with satisfactory result have been published. We report Anderson-Hynes pyeloplasty for hydronephrosis secondary to obstruction of the ureteropelvic Junction in 7 cases. Advantages of Anderson-Hynes pyeloplasty are as follows. 1. Complete excision of the obstructive segment. 2. Reduction of the dead space. 3. Excision of a good part of the sick pelvis. 4. Activation of latent pacemaker P cells.
Fungi ; Hydronephrosis ; Pelvis ; Retrocaval Ureter

Penile amputation is quite rare and requires emergency reimplantation by using microvascular surgery. Herein we report a case of an 8-year-old boy who accidentally has his penis amputated during circumcision. Emergency reimplantation was performed by using microvascular surgery. Thereafter partial necrosis of glans penis and distal penile skin was noted So penoplasty by using scrotal skin was done to restore normal shape penis. After 6 months later, normal erection and sensation were restored.
Amputation ; Child* ; Circumcision, Male ; Emergencies ; Female ; Humans ; Male ; Necrosis ; Penis* ; Replantation* ; Sensation ; Skin

Hyperkeratosis of the nipple and areola is a rare condition. We report a case of hyperkeratosis of the nipple and areola occurrinp in man with no underlying endocrirop thy or synthetic estrogenic drug therapy. The patient was not associated with epidermal nevus orichthyosis and so fitted into the nevoid form of hyperkeratosis of the nipple and areola. The clinical appearance and histological findings of the lesion were the same as those reported before. He showed a slight improvement in the color and hyperkeratcsis of the nipple and areola with 6 months use of a topical keratolytic agent and corticosteroid crearn.
Drug Therapy ; Estrogens ; Humans ; Nevus ; Nipples*

Desquamative gingivitis is characterized by a diffuse erythema of the free and attached gingiva associated with areas of vesiculation, erosion, and desquamation. Desquamative gingivitis is not a distinct disease entity but represents a reaction pattern of the gingiva to various stimuli. Pemphigus vulgaris, cicatricial pemphigoid, and lichen planus may presents as desquamative gingivitis. We observed 3 patients whose disease was limited to the gingiva, and studied them by light and direct immunofluorescence microscope. We classified them according to clinical, histologic, and immunopathologic observations. Identification of the underlying causes of desquamative gingivitis is of utmost importance and is dependent upon clinical, histologic, and immunologic criteria.
Diagnosis, Differential ; Erythema ; Fluorescent Antibody Technique ; Fluorescent Antibody Technique, Direct ; Gingiva ; Gingivitis* ; Humans ; Lichen Planus ; Pemphigoid, Benign Mucous Membrane ; Pemphigus