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

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

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

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

OBJECTIVES: Radiofrequency(RF) ablation is an effective and low risk curative treatment for supraventricular arrhythmias. Catheter ablation produced cardiac lesions primarily through formation of coagulation necrosis. We evaluated the degree of myocardial injury after RF catheter ablation by means of serial measurement of myocardial enzyme. METHODS: Fifty-one patients with symptomatic supraventricular tachycardia were included. There were 32 men and 19 women(mean age. 39.5+/-15.4 years)All patients underwent electrophysiologic study to detect accessary pathway and ablation with radiofreguency current. A mean of 18.3+/-14.2 radiofrequency pulses were delivered. The pulses were at a power of 50 to 60 Volts for a duration of 20 to 30 seconds. Unipolar method and a 6F or 7F catheter with a 4 mm tip electrode was used. LDH, CPK and Ck-MB as a kind of cardiac enzyme were measured before and after ablation. RESULTS: 1) The concentration of LDH and CPK were elecated at 8 hours and 16 hours after ablation (p<0.05). 2) The concentration of CK-MB was elevated at 8 hours, 16 hours, 24 hours and 72 hours after ablation(p<0.05). 3) There was no correlation between the number of applications and amounts of radiofrequency current and rise in LDH, CPK, CK-MB concentration. CONCLUSION: The concentration of LDH, CPK and CK-MB were elevated after ablation but they were within normal limits. RF catheter ablation produced myocardial damage inevitably but were within normal limits. RF catheter ablation produced myocardial damage inevitably but minimally, then RF ablation is an effective and safe therapeutic modality for patients with symptomatic tachyarrhythmias.
Arrhythmias, Cardiac ; Catheter Ablation* ; Catheters ; Electrodes ; Humans ; Male ; Necrosis ; Tachycardia ; Tachycardia, Supraventricular*

No abstract available.
Meconium* ; Peritonitis*

No abstract available.
Animals ; Ethanol* ; Rats*

Accelerated acute rejection(AAR) is a rare condition and has a poor prognosis in graft survival following renal transplantation. To elucidate its characteristics, we analysed 14 cases(5.0%) of AAR among 279 renal transplantation. AAR is defined as a condition in which immediate postoperative urine output is good followed by decreased urine output and increase of serum creatinine level within 7 days after transplantation. The incidence of AAR was more prevalent in cadaveric donors than living donors. One year graft survival was inferior in AAR, namely 8 out 14 cases(57%), than that of the patients without AAR(95.1%). Among the factors affecting graft survival in AAR, age and sex of both donor and recipient, donor condition such as living or cadaveric donor, and preoperative HLA matching had no relevance to a graft survival. Time of onset of AAR has no effect on graft survival either. Postoperative donor lymphocytotoxic test showed positive result in one out of 3 patient despite of all negative findings in the preoperative crossmatching test. Histologic finding such as vasculitis on renal biopsy was related to graft survival. Response of treatment was 55% in initial solumedrol pulse therapy and 20% in secondary OKT3 treatment, with an overall effect of 57%. Rerejection developed in 4 out of 8 cases of graft survival group while all cases showed a good function at post operative two years. Graft survival following AAR remains low and AAR is one of the main cause of graft loss following renal transplantation. To illustrate its characteristics, more clinical analysis are required.
Allografts* ; Biopsy ; Cadaver ; Creatinine ; Graft Survival ; Humans ; Incidence ; Kidney Transplantation ; Living Donors ; Methylprednisolone Hemisuccinate ; Muromonab-CD3 ; Prognosis ; Tissue Donors ; Transplants ; Vasculitis