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Fistula*

BACKGROUND: The prevalence of cognitive impairment in the elderly has been increasing in recent years with the growing of the aged population. Clinical assessment of cognitive function and mood is very important because cognitive impairment and depression commonly coexist in the elderly. The elderly interacts with the other family members, so cognitive impairment of the elderly influence family function. The objectives of this study were to delineate the factors correlated with cognitive function and to explore the relationship of depression and family function with cognitive function. METHODS: This study was done during 20 day period from July to August, 1996. The subjects were home residents aged 60 years or more living in a subcounty of Kyungpook Province, Korea. The final analysis included 195 subjects(male 95, female 100). The questionnaire included sociodemographic data, MMSE-K(Korean version of Mini Mental State Examination) for evaluation of cognitive function, BDI for evaluation of depression and family APGAR score for evaluation of family function. The results were analyzed by descriptive, comparative and correlative analysis. RESULTS: Mean MMSE-K score was 25.3+/-4.3 with female subjects(23.9+/-4.8) having significantly higher cognitive impairment when compaired to male subjects(26.6+/-3.2)(P<0.001). MMSE-K score was associated with gender, age, year of education(P<0.001), BDI and APGAR score(P<0.05). Religion, smoking and alcohol use were not associated with MMSE-K score. The prevalence of dementia by MMSE-K was 9.7% in definite dementia (MMSE-K<_19) and 23.1% with questionable dementia(20<_MMSE-K<_23). In male, the prevalence was 1.1% and 20.0% respectively. In female, the prevalence was 18.0% and 26% respectively, indicating difference between male and female subjects(P<0.001). CONCLUSIONS: In the elderly, female gender, older age and lower educational level were associated with cognitive function impairment. There was a positive correlation between cognitive function and family function. The group with impaired cognitive function had more depression than the normal group.
Aged* ; Apgar Score ; Dementia ; Depression* ; Female ; Gyeongsangbuk-do ; Humans ; Korea ; Male ; Prevalence ; Smoke ; Smoking ; Surveys and Questionnaires

BACKGROUND: Baricity differences between spinal anesthetic solutions are thought to produce differences in distribution of anesthetics within the subarachnoid space. We evaluated the influence of baricity of bupivacaine on the quality of the block and the incidence of side effects obtained following intrathecal injection of bupivacaine 8 mg with fentanyl 20 microgram. METHODS: Thirty healthy term parturients scheduled for a cesarean section under combined spinalepidural procedures were randomly allocated into Group I, hyperbaric bupivacaine (n = 15); or Group II, isobaric bupivacaine (n = 15). The dose of both groups was bupivacaine 8 mg combined with fentanyl 20 microgram. The maximum level of sensory blockade, time to reach T4 level and maximum level, time to get complete motor recovery and perioperative complications were assessed. RESULTS: Time to sensory block T4, motor block Bromage scale 3, complete resolution of motor block and sensory regression time to T10 was significantly delayed in Group II compared to Group I. Maximal block height, and time to maximal block had no significant differences between the two groups. There were no significant clinical advantages of one preparation over the other. CONCLUSIONS: The data from this study suggests that intrathecal injection of either hyperic or isobaric bupivacaine produces satisfactory anesthesia with similar side effects.
Anesthesia ; Anesthetics ; Bupivacaine* ; Cesarean Section* ; Female ; Fentanyl ; Incidence ; Injections, Spinal ; Pregnancy ; Subarachnoid Space

PURPOSE: The purpose of this study is to evaluate the effect of polylactide resorbable film in preventing epidural fibrosis after lumbar laminotomy. MATERIALS AND METHODS: Thirty-six New Zealand male rabbits about fifteen month old, weighing 3.5 kg in average, were used. Uniform laminotomy windows measuring 7x7 mm were made on the left side of the spine at three lumber locations (L2, L3 and L4). The laminotomy window at second lumbar spine was left untreated and used as control group (Group 1). The lanimotomy window of 3rd lumbar spine was covered with free fat tissue (Group 2), and polylactide ( Surgi-Wrap(R)) resorbable film was inserted on the laminotomy window of 4th lumbar spine (Group 3). Twelve rabbits were euthanized at 4, 8 and 12 weeks each after operation for biochemical analysis of hydroxyproline content and histologic examination. RESULTS: 1. There was considerable reduction in the total collagen, ranging from 40~48% in the Group 2 or the Group 3 compared to the Group 1. There was no statistical difference between the Group 2 and the Group 3. 2. The extent of fibrosis and fibroblast density was significantly lower in the Group 2 or the Group 3 than in the Group 1. However, the extent of fibrosis and fibroblast density did not differ statistically between the Group 2 and the Group 3. 3. No significant statistical differences of the collagen content and the histologic findings in each group was demonstrated during experimental period. CONCLUSION: These results suggest that polylactide (Surgi-Wrap(R)) resorbable film may be a useful method for reduction of epidural fibrosis after lumbar laminotomy.
Collagen ; Fibroblasts ; Fibrosis* ; Humans ; Hydroxyproline ; Laminectomy* ; Male ; New Zealand ; Rabbits ; Spine

Sclerosing encapsulating peritonitis (SEP), or abdominal cocoon, is generally recognized as a rare complication of continuous ambulatory peritoneal dialysis (CAPD), and the prognosis is very poor. The causes of SEP are multifactorial, including acetate in dialysate, recurrent peritonitis and dialysate con tamination with antiseptics containing chlorhexidine. Patients experience the characteristic symptoms and signs of nausea, vomiting, abdominal pain, and partial or intermittent bowel obstruction, and weight loss and malnutrition develop in severe case. We performed bowel resection on two patients with SEP, one idiopathic, and the other from CAPD. We briefly review the literature, and discuss the pathophysiology and the management of SEP.
Abdominal Pain ; Anti-Infective Agents, Local ; Chlorhexidine ; Humans ; Malnutrition ; Nausea ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis* ; Prognosis ; Vomiting ; Weight Loss