BACKGROUND: Induced hypotension is effective in decreasing blood loss and providing better visibility in the surgical field. Extensive epidural block to T4 with intravenous infusion of low-dose epinephrine allows mean arterial pressure to 50 mmHg. We investigated the effects of hypotensive epidural anesthesia comparing with normotensive epidural anesthesia during total hip arthroplasty. METHODS: 40 patients scheduled for total hip arthroplasty under epidural anesthesia were randomly divided into two groups. In hypotensive group, 0.5% bupivacaine 20cc was injected into L1-2 epidural space and if sensory block reached to T4, then epinephrine 1~5 g/min was intravenously injected with continuous infusion pump. As a result, mean arterial pressure was maintained 50 mmHg, and heart rate, 55~80bpm. In normotensive group, 0.5% bupivacaine 20cc was injected into L4-5 epidural space, and sensory block reached to T8. Therefore blood pressure was maintained within 20% of preoperative baseline. RESULTS: There was apparent difference in blood loss between two groups (hypotensive group: 259 +/- 75 ml, normotensive group: 803 +/- 144*ml) (*:p<0.05). In addition, in the case of hypotensive epidral group, transfusion was not required and CVP, heart rate were not changed postoperatively. Cardiac, renal, and cerebral function were preserved too. CONCLUSIONS: Hypotensive epidural anesthesia with low dose of epinephrine infusion is safely lowering mean arterial pressure to 50 mmHg. This technique is associated with low blood loss, reduction in perioperative transfusion requirements, and has no side effects on CNS, liver, kidney and heart function.
Anesthesia, Epidural* ; Arterial Pressure ; Arthroplasty, Replacement, Hip* ; Blood Pressure ; Bupivacaine ; Epidural Space ; Epinephrine ; Heart ; Heart Rate ; Humans ; Hypotension ; Infusion Pumps ; Infusions, Intravenous ; Kidney ; Liver

The carpal scaphoid is the commonest of the carpal bones to be fractured, and this injury is the commonest to befall the wrist of working man. There is still some disaggrement as to the optimum treatment and as to how long immobilization should be maintained. The twenty seven cases of the carpal scaphoid were treated at department of orthopaedic surgery, Maryknoll Hospital. They were analyzed in regared to the clinical and radiological aspects. The results were summarized as follows. l. Of 27 cases 24 cases were in the age group 20 to 39, and all cases were male patients. 2. In 17 cases, the fracture was found in right side. 3. In 19 cases (70.4%), the fracture was found on the middle 1/3 of the carpal scaphoid and in 18 cases(66.8%), the fracture line was transverse. 4. The union rate of fracture was 100% in the distal 1/3 fracture, 89.5% in the middle 1/3 fracture and 66.3% in the proximal fracture. The average period of immobilization were 10.3, 14.9 and 15.3 weeks respectively. 5. By Maudsley's assessment, the end result was good in all cases of the distal 1/3 fracture, 84.2% in the middle 1/3 fracture and 66.7% in the proximal 1/3 fracture. 6. Traumatic arthritis developed in 3 cases, avascular ncerosis in 7 cases, nonunion in 4 cases.
Arthritis ; Carpal Bones ; Humans ; Immobilization ; Male ; Wrist

No abstract available.
Neck* ; Talus*

No abstract available.

BACKGROUND: The purpose of this study was to analyze the endotracheal intubation cases performed in the emergency department. METHODS: We investigated retrospectively 326 cases of endotracheal intubation performed in the emergency department of a tertiary care center from April 1, 1998 to March 31, 1999. We focused on operators, medications used, its success rate and immediate complications, and the relationship between its success rate and medications. RESULTS: Of 326 consecutive intubations, 193 patients(59.2%) were done by emergency medicine residents or attending physician. While 320 patients(98.2%) were successfully intubated, 6 patients could not be intubated and 2 patients underwent tracheostomy. Of 50 cases of intubations(15.3%) attempted with paralyzing agents, 48 cases were done with succinylcholine and 46 cases underwent by emergency physicians. Intubations with neuromuscular paralysis resulted in high success rates at the first attempt. Of 55 immediate adverse events were encountered in 47 patients(desaturation=17, bronchial intubation=15, hypotension=8, bradycardia=4, cardiac arrest=2, others=5). CONCLUSION: At this institution, paralyzing agents were used infrequently, but almost all of them were used by emergency physicians.
Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Humans ; Intubation ; Intubation, Intratracheal* ; Paralysis ; Retrospective Studies ; Succinylcholine ; Tertiary Care Centers* ; Tertiary Healthcare* ; Tracheostomy

No abstract available.
Humans ; Male ; Prostate* ; Prostate-Specific Antigen*

No abstract available.
Humans ; Male ; Prostate* ; Prostate-Specific Antigen*

In order to survey the reality of anxiety and depression among the Koreans residing in china, a study was conducted between January and March of 1991, on the residents of Yun-Kil city, with subjects of 472 Koreans and 479 Chinese. The evaluation was based on the questionnaires, named Combined self-rating anxiety depression scale (CADS), distributed among the subjects. ANOVA and t-test were applied for data processing. The results were as follows: There was not significant difference in the mean of total scores between the two groups. The scores of Koreans were 29.70±7.03, while those of Chinese were 29.45±9.01. The score of the CADS above 50 (clinically significant level) was seen in 12 (2.54%) Koreans and 21 (4.38%) Chinese. The anxiety-depression scores relating to the items of indigestion and decreased appetite, sleep disturbance, apprehension, decreased libido were relatively high among the Koreans. The items appeared low in scores among the Koreans were faintness, fear, suicidal rumination, hopelessness, paresthesias. The highs among the Chinese were facial flushing, anxiousness, dissatisfaction, suicidal rumination. The items appeared low among the Chinese were fear, faintness, paresthesias, weight loss, suicidal rumination. In the compatison of evaluation by items between the two groups, the items placing the Koreans significantly higher over the Chinese are indigestion & decreased appetite, sleep disturbance, apprehension, decreased libldo. The Chinese marked significantly higher in facial flushing, anxiousness, dissastisfaction, suicidal rumination. Those in the case of female (p<0.01 respectively), less than twenty years old (p<0.01 respectively), dissatisfied with family relationship (p<0.01 respectively), with past history of psychiatric hospitalization (Koreans p<0.01, Chinese p<0.05), pessimistic toward future, present, past self image (p<0.01 respectively) had significantly higher scores in both groups. In religion, neither group showed significant difference. In religion, neither group showed significant difference. In marital status, the Koreans showed a higher degree of divorce and separation and the Chinese in singleness (p<0.01 respectively). The Korean were higher in illiteracy and the Chinese had more college education (p<0.01 respectively). In place of growth, The Koreans showed not much difference in the areas while more Chinese grew up un large cities (p<0.01). More Koreans lived in the dormitory while the Chinese were engaged more in self-cooking (p<0.01 respectively), In pocket money per mouth, more Koreans were less than 1 dollar while the Chinese were between 7 and 10 dollars (p<0.01 respectively). There were no significant difference between two groups about religion.
Anxiety* ; Appetite ; Asian Continental Ancestry Group ; China* ; Depression* ; Divorce ; Dyspepsia ; Education ; Ethnopsychology ; Family Relations ; Female ; Flushing ; Hospitalization ; Humans ; Libido ; Literacy ; Marital Status ; Mouth ; Paresthesia ; United Nations ; Weight Loss

Fordyce's disease is a condition known as ectopically located sebaceous glands on the vermilion borders of the lips and oral mucosa. Clinically, it is groups of minute, yellowish, globoid macules and papules. Histologically, it is characterized by sebaceous glands not associated with hair follicles. We report on a 40-year-old man with Fordyce's disease showing particularly wide distribution on the buccal mucosa and upper lip.
Adult ; Hair Follicle ; Humans ; Lip ; Mouth Mucosa ; Sebaceous Glands

Trichilemmal horn(trichilemmal keratosis) is a rare keratinizing tumor that resembles a cutaneous horn. Histologically, it is characterized by an abrupt maturation of keratinocytes into lamellar keratin without the formation of a granular layer. We describe a case of a trichilemmal horn on the right cheek of a 78-year-old woman.
Aged ; Animals ; Cheek ; Female ; Horns* ; Humans ; Keratinocytes