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*

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

We investigated the effects of panretinal photocoagulation (PRP)on macular microcirculation in diabetic retinopathy. PRP using argon blue green laser was performed in 23 eyes of 15 patients with early proliferative diabetic etinopathy and very severe nonproliferative diabetic retinopathy without significant macular edema. The changes in volume, flow, velocity of macular microcirculation were measured before PRP, 1 hour, 1 day, 1 week, and 1 month following PRP, using Heidelberg Retina Flowmeter(HRF). Mean volume, flow, velocity of macular microcirculation decreased to a maximal degree 1 hour following PRP, from 14.87+/-0.40, 387.45 +/-101.40, 1.40+/-0.28(before PRP)to 12.44+/-1.39, 347. 33+/-100.39, 1.27+/-0.34(p<0.05). From 1hour to 1 month after PRP, macular microcirculation gradually increased. However, throughout this period, all parameters of macular microcirculation remained lower than pre-PRP level(p<0.05). Our study suggests that panretinal photocoagulation reduces the macular microcirculation in diabetic retinopathy.
Argon ; Diabetic Retinopathy ; Humans ; Light Coagulation* ; Macular Edema ; Microcirculation* ; Retina ; Retinaldehyde*

No abstract available.
De Lange Syndrome*

Idiopathic thrombocytupenic purpura is known as an autommune t,hrombocytopenic purpura. It is characterized by either an acute or gradual onset of petechiae or ecchymoses in the skin and mucous membranes, especially in the mouth. Epistaxis, conjunct.ival hemorrhage, hemorrhagic bullae in the mouth, gingival bleeding, melena, and hematemesis may occur. We report a case of idiopathic thrombocytopenic purpura in a 10-year-old male, who showed multiple petechiie and ecchymoses on both lower extremities, and hemorchagic bullae in the mouth. Periheral blood smear showed decreased platlet count, and in the bone marrow megakeyocytes were incraesed. Bleeding time was increased, but coagulation time was normal.
Bleeding Time ; Bone Marrow ; Child ; Ecchymosis ; Epistaxis ; Hematemesis ; Hemorrhage ; Humans ; Lower Extremity ; Male ; Melena ; Mouth ; Mucous Membrane ; Purpura ; Purpura, Thrombocytopenic, Idiopathic* ; Skin

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