No abstract available.
Child* ; Humans ; Humerus*

OBJECTIVES: Over the last 30 years, despite the increasing sophistication in medical care, the mortality of acute renal failure(ARF) has remained virtually unchanged at 40-50%, but the reasons remain unknown. This study intend to identify prognostic risk factors influencing survival and predict the mortality in ARF patients. METHODS: We retrospectively analyzed 152 patients with ARF who required renal replacement therapy, or whose serum creatinine level above 5 mg/dl, from Jan. 1988 to May. 1995. Multiple factors which may influence mortality were evaluated by univariate and multivariate analysis. RESULTS: 1) Of the 152 patients, 97 were male and 55 were female. The mean age was 47 years and the overall mortality was 36.8%. 2) Based on the univariate analysis, age>60 years, cause of ARF, APACHE II score, number of failing organs, peak serum creatinine level, PaO2, coma, hypotension, ARDS, GI bleeding, ventilatory support, need for antiarrhythmics, DIC, cardiovascular failure, pulmonary failure, neurological failure, and gastrointestinal failure were all significant factors discriminating between survivors and nonsurvivors(p<0.05) 3) By multivariate analysis, hypotension, coma, ventilatory support, and age over 60 years were significant independent predictors influencing survival in ARF patients and logistic equation and logit score were as follows : z=-2.04+1.32(age over 60)+2.18(hypotension)+2.88 (ventilatory support) + 3.28(coma) P=ez/(1+ ez) 4) In ROC(receiver-operating characteristic)curve, when the cutoff point was 0.2, maximum sensitivity was 75% and maximum specificity was 82%. CONCLUSION: In ARF, prognostic risk factors for mortality were age over 60 years, hypotension, assisted ventilation and coma. The logit score by multiple analysis is a reliable predictor of mortality in ARF patients, however the further studies are required to confirm these results.
Acute Kidney Injury* ; APACHE ; Coma ; Creatinine ; Dacarbazine ; Female ; Hemorrhage ; Humans ; Hypotension ; Male ; Mortality* ; Multivariate Analysis ; Renal Replacement Therapy ; Retrospective Studies ; Risk Factors* ; Sensitivity and Specificity ; Survivors ; Ventilation

Acute bacterial infection of bone and joint presents a real challenge to orthopedist because early diagnosis and treatment are difficult and also essential. In almost all practices, fever and erythrocyte sedimentation rate(ESR) are widely used for monitoring the course, for estimating the effectiveness of treatment, and for the recovery of such illnesses. However, interpreting body temperature is difficult and ESR is nonspecific, is not not sensitive, normalizes slowly. Otherwise, C-reactive protein(CRP) is very sensitive and normalizes fast. CRP, body temperature, and ESR were sequentially measured until a normal value was reached in twenty seven patients in whom acute osteomyelitis (17 patients), acute exacerbation of chronic osteomyelitis(4 patients), and septic arthritis(6 patients) had been diagnosed by positive bacterial culture at Kyungpook National University Hospital from June 1984 to May 1985. The results were as follows: 1. CRP normalized within 8.8 days on average. 2. Fever lasted 4.5 days on average. 3. ESR normalized within 41.6 days on average. 4. Initial mean value of CRP was 4.2 positive in acute in acute osteomyelitis and septic arthritis and 3.5 positive in acute exacerbation of chronic osteomyelitis, therefore CRP can be considered as a very sensitive indicator for early detection of acute bacterial infection of bone and joint. Also sequential CRP determination can be used for monitoring the course, for estimating the effectiveness of treatment, and for the recovery of such illnesses.
Arthritis, Infectious ; Bacterial Infections ; Blood Sedimentation ; Body Temperature ; C-Reactive Protein ; Early Diagnosis ; Fever ; Gyeongsangbuk-do ; Humans ; Joints ; Osteomyelitis ; Reference Values

OBJECTIVES: This study aimed to investigate differences in unmet dental care needs according to employment status and if factors have relevance to unmet dental care needs due to "economic burden" and "no time to spare for visiting". METHODS: Multivariate logistic regression analysis was performed to examine the factors that affected the prevalence of unmet dental care needs due to "economic burden" and "no time to spare for visiting" in an economically active population comprised of subjects aged 20-64 years. RESULTS: Compared to regular workers, part-time workers experienced 1.28-times more unmet dental care needs, while students experienced 0.64-times fewer unmet dental care needs. With regard to reasons related to "economic burden", the rate of experiencing unmet dental care needs was 1.37-times higher for part-time workers than for regular workers. Regarding reasons related to "no time to spare for visiting", the rate of experiencing unmet dental care needs was 0.51-times lower in part-time workers compared with regular workers. In economically inactive people, these values were 0.51-times lower in the unemployed, 0.37-times lower in students, 0.23-times lower in house workers, 0.20-times lower in subjects with disease and injury, and 0.20-times lower in early retirees compared to regular workers. CONCLUSIONS: Part-time workers experienced more unmet dental care needs compared with regular workers. With regard to "economic burden", a significant difference in unmet dental care needs was observed between regular workers and part-time workers. Additionally, regarding "no time to spare for visiting", people who were economically inactive because of unemployment, student or house-worker status, diseases and injury, and retirement experienced fewer unmet dental care needs compared with regular workers.
Dental Care* ; Employment* ; Humans ; Logistic Models ; Prevalence ; Retirement ; Unemployment

BACKGROUND: Compared with conventional routes of delivering potent analgesics to postoperative patients, transdermal administration of fentanyl offers the advantages of simplicity and noninvasiveness. The analgesic efficacy and safty of transdermal fentanyl patch (TDFP) were evaluated postoperatively. METHOD: TDFP releasing 25 mcg/hr (Group 1) or placebo (Group 2) were applied to 40 women 6 hours before total abdominal hysterectomy under the general anesthesia. Postoperatively, self-administered intravenous fentanyl was maintained with a 20-mcg incremental dose and a 10-min. locking interval. Each group was assessed following 48 hours with respects to vital signs, VAS pain scores, hourly-used fentanyl doses, satisfaction scores and side effects. RESULT: VAS observed 24 hours, 36 hours after operation were significantly lower in group 1 than group 2. Hourly-used fentanyl doses were significantly lower in group 1 than group 2 at 2 hours, 6 hours, 12 hours and 24 hours after operation. The incidence of side effects were similar between group 1 and group 2. CONCLUSION: TDFP-25 mcg applied 6 hours before operation provides supplementary analges-ia after the postoperative period without significant side effects such as respiratory depression.
Administration, Cutaneous ; Analgesics ; Anesthesia, General ; Female ; Fentanyl* ; Humans ; Hysterectomy* ; Incidence ; Postoperative Period ; Respiratory Insufficiency ; Vital Signs

PURPOSE: To study the efficacy of unilateral rectus resection in the surgical treatment of undercorrected or recurrent strabismus. METHODS: A retrospective chart review of patients who had undergone a unilateral rectus resection with at least 6 months (mean 35.6 months) of postoperative follow-up was performed. RESULTS: A resection of a single rectus muscle was undergone by 92 patients: 70 underwent a unilateral resection of the medial rectus and 22 underwent a unilateral resection of the lateral rectus. The mean preoperative deviations of patients were 23.6+/-5.9 prism diopters (PD). The amount of unilateral medial rectus resection ranged from 3 to 7 mm and unilateral lateral rectus resection ranged from 5 to 10 mm. The satisfactory surgical result was considered to be any deviation within 8 PD. The success rates were 81.4% in the unilateral medial rectus resection group and 72.7% in the unilateral lateral rectus resection group. The satisfactory surgical result of the group of preoperative deviation less than or equal to 20 PD was 93.2%, the group of greater than 20 PD and less than or equal to 25 PD was 65.6% and the group of greater than 25 PD was 68.8%. This difference in results between three groups was statistically significant (p=0.006). CONCLUSIONS: The unilateral rectus resection is an effective procedure for the treatment of undercorrected or recurrent strabismus with small to moderate preoperative deviations.
Follow-Up Studies ; Humans ; Reoperation* ; Retrospective Studies ; Strabismus*

Operative repair of mallet fracture is a technically difficult operation because fracture of fragment and the difficulty in visualizing the articular congruity. The problems with these methods include soft tissue scar formation and subsequent joint stiffness. From January 1993 to April 1994, eight cases of mallet fingers with displaced large fracture fragment and/or subluxed distal phalanx were treated by closed reduction using extension-block Kirschner wire. The follow-up evaluation took place after a mean of 6 months. The results according to Crawford's criteria were four excellent, two good and two fair. This technique is simple, and easier than other techniques for reduction of mallet fractures, and is associated with a low morbidity.
Cicatrix ; Fingers ; Follow-Up Studies ; Joints

Primary malignant lymphoma of the appendix is an unconnnon neoplasm although the gastrointestinal tract is the most common extranodal site of malignant lymphoma. We report a case of primary malignant lymphoma of the appendix in a 54-year-old male, who presented with pain in the right lower abdomen. An appendectomy was performed. The appendix measured 9.5 cm in length and 5.5 cm in diameter. Cut sections showed a solitary circumferential mass in the appendiceal lumen. Light microscopic features were compatible with malignant lymphoma of diffuse large cell type(Working Formulation) and the immunophenotype was B cell type.

No abstract available.
Colposcopy* ; Early Diagnosis* ; Uterine Cervical Neoplasms*

Proliferations of the endometrial glands form a continuum from focal glandular crowding through simple hyperplasia, complex hyperplasia and atypical hyperplasia to frank adenocarcinoma. But objective criteria to distinguish these proliferative endometrial lesions are not clear-cut and terminology is confusing. The p53 protein is a nuclear phosphoprotein that can regulate cell proliferation and suppress tumor growth. Mutation in the p53 gene have been reported in a variety of human tumors, and in selected malignancies overexpression of p53 has been associated with poor prognosis. In this study we examined a series of endometrial proliferative lesion, including hyperplasia, adenocarcinoma, and adenomyosis to determine whether or not p53 is overexpressed in these lesions. In the result, p53 immunoreactivity was observed in 3 of 17 (17.6%) simple hyperplasia, one of 6 (16.6%) complex hyperplasia, none of 3 (O%) atypical hyperplasia, 6 of 13 (46.1%) adenocarcinoma and none of 10 (O%) adenomyosis. In conclusion, p53 mutation seems to play a role in oncogenesis of endometrial adenocarcinoma in early phase but there was no significant relationship between p53 overexpression and histologic grade of adenocarcinoma.
Adenocarcinoma* ; Adenomyosis ; Carcinogenesis ; Cell Proliferation ; Crowding ; Endometrial Hyperplasia* ; Female ; Genes, p53 ; Humans ; Hyperplasia ; Prognosis