Background: The continuous brachial plexus block brings about the prolongation of surgical anesthesia, postoperative pain relief, and sympathectomy. Methods: The twenty-five patients scheduled for upper extremity operations had been taken the continuous axillary brachial plexus block procedure to relief postoperative pain and, to get the sympathetic block effect. We used local anesthetics less than maximum recommended dose, 0.125% bupivacaine continuously infused at 4 ml/hour via catheter. We adopted the faces pain rating scale to evaluate postoperative pain degree. The faces pain rating scale composed of six faces, based upon the degree of pain. The patients has been asked to choose these rating scale according to their painfulness three times a day for five days. Results: Clinically, we have found the effective decrease in the degree of pain. Systemic toxic reactions, hematoma and infection sign at injected site were not found. Conclusion: The pain of upper extremity after operation was controlled by continuous infusion of 0.125% bupivacaine, 4 ml/hr, usually.
Anesthesia ; Anesthetics, Local ; Brachial Plexus* ; Bupivacaine ; Catheters ; Hematoma ; Humans ; Pain, Postoperative ; Sympathectomy ; Upper Extremity*

No abstract available.
Hemifacial Spasm*

In microscopical survey of clinically normal skin, P. orbiculare was found to be present on scalp, face, anterior chest, back, arm and leg in 68.2%, 68.3%, 90.2%, 86.4%, 28.6% and 16.7% respectively, and P. ovale was present in scalp, face, anterior chest, back, arm and leg in 84.1%, 56.1%, 51.2%, 38.6%, 19.0% and 7.1%. P. ovale was dominant species in scalp, on the other hand P.orbiculare was dominant species in anterior chest and back. The large number of spore of P. ovale was present on scalp, on which P. ovale was dominant species, and on anterior chest and back, the number of spore of P. orbiculare was more increased than the numbers of P. ovale. The hyphae, identical in size and shape with those of Malassezia furfur, were found on scalp in one subject. In cultural survey, the pcsitive culture rate in P. orbiculare was showed in over all from 87.5% to 80.8% and in P. ovale from 33.3% to 88.2%. Germ tube formation on culture was found in 3 subjects on anterior chest and in one subject on back.
Arm ; Hand ; Hyphae ; Incidence* ; Leg ; Malassezia* ; Scalp ; Skin* ; Spores ; Thorax

The purpose of this study was to compare the corrosion characteristics between implant fixture and two types of abutment screw; gold screw, titanium screw. The anodic polarization behavior, the galvanic corrosion behavior, and the crevice corrosion behavior of prepared samples were investigated using potentiostat and scanning electron microscope. The results were as follows : 1. Anodic polarization behavior of samples: The primary passivation potential of implant fixture was -420mV, implant abutment was -560mV, titanium screw was -370mV and gold screw was -230mV. All samples were shown to have a high corrosion potential and good formation of passive film. The critical passive current density of gold screw was higher than of other samples and the sample of gold screw showed a unstable passive film formation at passive region. 2. Galvanic corrosion behavior of samples: Contact current density between implant fixture and titanium screw showed 8.023x 10-5C/cm2. Contact current density between implant fixture and gold screw showed 5.142x 10-5C/cm2. 3. Crevice corrosion behavior of samples : The crevice corrosion resistance of sample using titanium screw was higher than that of sample using gold screw, and a severe corrosion morphologies were observed at the fixture-screw interface by the scanning electron microscope.
Corrosion* ; Titanium

To assess the adequacy of medical manpower and medical fee for the newborn nursery care, the author visited 20 out of 24 hospitals with the pediatric training program in Youngnam area between July 29 and August 14, 1991. Total number of newborn, both normal and sick, admission and discharge in 1--30 June 1991 was obtained from the logbook of nursery. Head nurse and staff pediatrician of the nursery were interviewed to get the current staffing for the nursery and their subjective opinion on the adequacy of nursery manpower and the difficulties in recruiting manpower. Average medical fee charged for the maternity and normal newborn nursery care was obtained from the division of self-audit of medical insurance claim of each hospital. Average minimum requirement of nursing care time for one normal newborn per day was 179.5 (+/-58.6) minutes; 2023(+/-50.7) minutes for the university hospitals and 164.2(+/-60.5) minutes for the general hospitals. The ratio of minimum requirement of nursing care time and available nursing time was 1.42 on the average. Taking the additional requirement of nursing care for the sick newborns into consideration, the ratio was 2.06. The numbers of R. N. and A. N. in the nurserys of study hospitals were 31%, and 17%, respectively, of the nursing manpower for the nursery recommended by the American Academy of Pediatrics. These findings indicate that the nursing manpower in newborn nursery is in severe shortage. Ninety percent of the head nurses and 85% of the staff pediatrician stated that the newborn nursery is short of R.N. and 75% of them said that the nurse's aide is also short. Major reason for not recruiting R.N. was the financial constraint of hospital. For the recruitment of nurse's aide, short supply was the second most important reason next to the financial constraint. However, limit of quarter in T.O. was the major reason for the national university hospitals. Average total medical fee for the maternity and newborn nursery cares of a normal vaginal delivery who stayed two nights and three days at hospital was 219,430Won. Out of the total medical fee, 20,323Won(9.3%) was for the newborn nursery care. In case of C-section delivery six nights and seven days, who stayed otal medical fee was 732,578Won and out of the total fee 76,937Won (12.0%) was for the newborn care. Cost for a newborn care per day by cost accounting was 16,141Won for the tertiary care hospitals and 14,576Won for the all other hopitals. The ratio of cost and the fee schedule of the medical insurance for a newborn care per day was 5.0 for the tertiary care hospitals and 4.9 for the all other hospitals. Considering the current wage level of the medical personnel, capital investment for the hospital facilities and equipments, and the cost for hospital maintenance, it is hard to expect adequate quality care in the newborn nursery under the current medical insurance fee schedule.
Education ; Fee Schedules ; Fees and Charges ; Fees, Medical* ; Hospitals, General ; Hospitals, University ; Humans ; Infant, Newborn* ; Insurance ; Investments ; Maintenance and Engineering, Hospital ; Nurseries* ; Nursing ; Nursing Care ; Nursing, Supervisory ; Pediatrics ; Salaries and Fringe Benefits ; Tertiary Healthcare

We have retrospectively analyzed the clinical and radiological outcome in 22 cervical spondylotic myeloradiculopathy patients who underwent combined front anterior decompression and fusion) and back (open door laminoplasty) surgery between Mar. 1991 and Jan. 1995. Clinical symptoms were evaluated by Japanese Orthopaedic Association(JOA) score and the recovery rate. Plain radiogram and MIR were taken before and after surgery, and then the cervical curvature, change of body to canal ratio and the A-P compression ratio of the cord were measured and compared to the clinical symptoms. Results : The mean JOA score increased from 10.1±3.3 preoperatively to 14.7±1.4 at the final follow-up with a mean recovery rate of 64.4%. No patients deteriorated as a result of the combined procedure. Post-op. radiograms showed an increasement of body to ratios (average 0.69±0.09 pre-op. to 1.0±0.13 post-op.) and maintenance or recovery of cervical Lordosis. On MRI, the A-P compression ratios of the cord were increased with recovery of subarachnoid space after the operation in most cases (average 38.4±7.6 pre-op. to 55.7±7.2 post-op.). Conclusion : This combined procedure safely and effectively resulted in decompression of the spinal cord and good functional recovery in patients with 1) anterior and posterior pathology, 2) narrow spinal canal and large spondylotic bar or herniated disc encroaching the spinal canal more than 5mm, 3) narrow spinal canal and kyphotic deformity, 4) narrow spinal canal and segmental instability, 5) multisegmental cord compression and severe radiculopathy.
Animals ; Asian Continental Ancestry Group ; Congenital Abnormalities ; Decompression ; Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; Lordosis ; Magnetic Resonance Imaging ; Pathology ; Radiculopathy ; Retrospective Studies ; Spinal Canal ; Spinal Cord ; Subarachnoid Space

No abstract available.
Porphyrias, Hepatic*

BACKGROUNDS: When measuring lung function and response to bronchodilator, MDI(metered-dose inhaler) is commonly used but unfamiliarity of its use and cold sensation by the puffed gas decrease reliability of the result. Spacer can reduce the cold freon effect and undesired oropharyngeal deposition caused by the rapid evaporation of the propellant and there are many studies which showed more effectiveness of spacer on the treatment of children with asthma but no study whether it is effective on the bronchodilator response test in the first medical examination of old age. Therefore, we tested whether the use of spacer can reduce the cold freon effect and improve the bronchodilator response in the first medical examination of old age. METHODS: Two hundred of elderly patients( 65years) who had never used MDI were measured the bronchodilator response. Subjects were randomised to either spacer-user or spacer-nonuser. Twenty minutes after 400 g fenoterol was administered, FEV1 (forced expiratory volume in one second) was measured. Bronchoconstriction was defined as a decrease in FEV1 by 10% or greater after bronchodilator inhalation. We further devided each group into normal or obstructive group, obstructive group was defined as FEV1<80% of predicted and FEV1/FVC<70%. RESULTS: In normal group, spacer-user(n=83) showed greater bronchodilator response than spacer-nonuser(n=66), 6.43% vs 3.81% respectively(p<0.05) and two case of bronchoconstriction occured only in spacer-nonuser. In obstructive group, there is no significant difference in bronchodilator response between spacer-user(n=18) and spacer-nonuser(n=33), 12.32% vs 11.16% respectively(p>0.05) but brochoconstriction(n=1) occured only in spacer-nonuser. CONCLUSION: Spacer improved bronchodilator response and prevented bronchoconstriction, in the first medical examination of old age.
Aged ; Asthma ; Bronchoconstriction ; Child ; Chlorofluorocarbons ; Fenoterol ; Humans ; Inhalation ; Lung ; Sensation

Complete patent urachus is a congenital anomaly that remains Open by fistulous tract extending from the bladder to umbilicus even after birth and rarely observed in literatures. We have experienced a case of complete patent urachus and reported with review of some literatures.
Parturition ; Umbilicus ; Urachus* ; Urinary Bladder

Intracerebral hemorrhage secondary to vitamin K deficiency is presented in three newborn infants: 4 days, 28 days and 21 days of age respectively. After the administration of vitamin K(5-10 mg) either intravenously or intramusculary, prolonged prothrombin time(PT) and partial thromboplastin time(PTT) were corrected promptly. Vitamin K dependent coagulation factor deficiency due to vitamin K deficiency is accounted for the pathogenesis of hemorrhage. The possible causes of vitamin K deficiency, diagnostic methods and treatment of this disease entity are reviewed. Neurosurgeons as well as pediatricians should remain alert for the development of intracerebral hemorrhage caused by vitamin K deficiency in neonatal period.
Blood Coagulation Factors ; Cerebral Hemorrhage* ; Hemorrhage ; Humans ; Infant, Newborn* ; Partial Thromboplastin Time ; Prothrombin ; Prothrombin Time ; Thromboplastin ; Vitamin K Deficiency* ; Vitamin K* ; Vitamins*