BACKGROUND: Unexpected cancellation of the elective operation on scheduled day is stressful event to both of patients and doctors, especially when there is little explanation and understanding. Above all, it is against cost-saving policies in hospital management. Thus the author investigated the rate, distribution and causes of cancelled cases to get help to make plans to reduce the cancellation rates. METHODS: From March 1st in 1996 to February 28th in 1997, all operation schedules were reviewed and cancelled cases on scheduled day were analyzed. All the elective operations except emergency operations under general, regional or local anesthesia were included in this analysis. Total cancellation rate was analyzed according to surgical departments, month, week day, age and causes. In statistical analysis, SAS program was used. RESULTS: Total number of cancellation was 424 cases and mean cancellation rate was 8.47%. In analysis of cancellation rate by months, it was highest in October and lowest in November. In August, October and December the cancellation rates were higher than the other months. It was higher on Tuesday and Thursday. Most common causes of cancellation was the problems related patient's condition, especially related to coexisting diseases. Among these, cardiac disease was predominant. Non-medical causes were predominant than medical causes in most cancelled cases. CONCLUSION: Trying to reduce the cancellation rates is suggested as one of methods that will make the quality and quantity of medical services better. Careful preoperative evaluation of patient and consultation of abnormal findings or laboratory data before hospitalization, appropriate scheduling of operation, complete preparation of operation apparatus, through all these, firm establishment of doctor-patient rapport are core element of reducing of cancellation rate. So, attention and support by not only anesthesiologist but surgeons and hospital managers are needed to achieve these goals of reducing of cancellation rate.
Anesthesia, Local ; Appointments and Schedules ; Emergencies ; Heart Diseases ; Hospitalization ; Humans ; Life Change Events

Sonographic detection of ureteral jets entering the urinary bladder is a well-known procedure. Color Doppler ultrasound was used to image the ureteral jets in 28 patients with unilateral ureteral calculi proved by intravenous urography. Three major findings of ureteral jets were obtained in the affected ureter with a stone: less frequency (26 patients), weak reflection (20 patients), and lower grade in length (27 patients) that were significantly different from the unaffected side in the same patient. No significant differences were found between the ureteral jets and the degree of hydronephrosis or the location of a stone. In conclusion, these results suggest that ureteral jets should be checked routinely during the procedure of color Doppler ultrasonogram in patients with possible unilateral ureteral obstruction. Color Doppler examination of ureteral jets may be a important adjunct in routine pelvic ultrasonogram especially in patients who have absolute or relative contraindications of intravenous urography.
Humans ; Hydronephrosis ; Ultrasonography ; Ultrasonography, Doppler, Color* ; Ureter* ; Ureteral Calculi* ; Ureteral Obstruction ; Urinary Bladder ; Urography

Sonographic detection of ureteral jets entering the urinary bladder is a well-known procedure. Color Doppler ultrasound was used to image the ureteral jets in 28 patients with unilateral ureteral calculi proved by intravenous urography. Three major findings of ureteral jets were obtained in the affected ureter with a stone: less frequency (26 patients), weak reflection (20 patients), and lower grade in length (27 patients) that were significantly different from the unaffected side in the same patient. No significant differences were found between the ureteral jets and the degree of hydronephrosis or the location of a stone. In conclusion, these results suggest that ureteral jets should be checked routinely during the procedure of color Doppler ultrasonogram in patients with possible unilateral ureteral obstruction. Color Doppler examination of ureteral jets may be a important adjunct in routine pelvic ultrasonogram especially in patients who have absolute or relative contraindications of intravenous urography.
Humans ; Hydronephrosis ; Ultrasonography ; Ultrasonography, Doppler, Color* ; Ureter* ; Ureteral Calculi* ; Ureteral Obstruction ; Urinary Bladder ; Urography

No abstract available.
Dermatitis, Contact*

No abstract available.
Animals ; Dietary Fats* ; Rats*

Eccrine chromhidrosis(colored sweating), resulting from the contamination of the sweat by dyes, pigment from microorganisms such as those of Piedraia or Corynebacterium, or other chernicals, is a very rare disease. We report a case of eccrine chromhidrosis which revealed dark-brown colored pigmented spots analyzed by energy dispersive X-ray microassay and scanning electron microscopy, which were thought to be composed of silver iodide(AgI) formed by the conjugation of silver components from outside and iodide components of eccrine sweat, on the face, postauricular area, legs, and finger tips.
Coloring Agents ; Corynebacterium ; Fingers ; Leg ; Microscopy, Electron, Scanning ; Rare Diseases ; Silver* ; Sweat

BACKGROUND: Various kinds of methods had been tried to reduce pain on injection of propofol. In this study, the effect of lidocaine pretreatment and that of temperature controlled injections were compared and evaluated its clinical utility. METHODS: One hundred and twenty patients were randomly allocated into 4 groups after permission. Room temperature propofol was used as induction agent in group P,. In group C, cooling (4 degrees C) propofol was used and warming propofol (37 degrees C) in group H. And room temperature propofol following lidocaine (1 mg/kg) was used in group L. Injection dosage of propofol was 2 mg/kg and injection speed was 2 ml/sec in all groups. In each patients, pain score and visual analog scale were measured and tested by ANOVA or Kruskal-Wallis test. RESULTS: There were no statistical significant difference in pain score among the 4 groups. But in visual analog scale analysis, group L markedly reduced values than the other groups by statistically significant manner (in Duncan grouping). CONCLUSION: The alleviating effect of lidocaine pretreatment on painful injection was better than that of changing temperature of propofol itself. More over effectiveness, in view of simplicity, we recommend lidocaine pretreatment.
Humans ; Lidocaine ; Propofol* ; Visual Analog Scale

No abstract available.
Somatoform Disorders*

From January 1985, to June 1986, 7 cases in which supracondylar and intercondylar fractures of the femur were treated at our orthopaedic department using the Extensile Approach for an anatomical reduction and firm internal fixstion, show successful results in follow up stuides. l. All 7 cases were type III fractures of Neers classification. 2. Among the 7 cases treated surgically using the Extensile Approach, 5 cases showed excellent and good results and the remaining 2 csses showed one fair and one failed results. 3. Probably due to the additional open proximal tibia and patella fracture and delayed surgery from trauma one case had a fair results. The case which failed wss due to ipsilsteral ligamentous injuries and a nerve injury in addition to the femur fracture and slso the impossibility of early knee joint exercise due to associated injuries. 4. None of the results of the 7 csses had any relationship with the patients age. 5. One case of postoperative skin necrosis developed around the tibial tuberosity and was treated successfully by a cross leg flap. 6. In comminuted supracondylar and intercondylar fractures of the femur, the Extensile Approach is thought to be an excellent surgical technique by means of a wide surgical field for an anatomical reduction and firm internal fixation with the repair of associated ligamentous injuries.
Adult ; Classification ; Femur ; Follow-Up Studies ; Humans ; Knee Joint ; Leg ; Ligaments ; Necrosis ; Patella ; Skin ; Tibia

Congenital pseudarthrosis of the tibia was accepted as one of the most difficult disease in respect of the frequency and treatment for the orthopaedists. Since April, 1984, we experienced 3 cases of congenital pseudarthrosis of the tibia, one 2 year-old boy involved left tibia only and the other 4 year-old female involved bilaterally, obtained solid bony union in all which were treated by massive surgical management that contained vascularized bone graft and electric stimulation. Several complications were faced such as refracture, valgus deformities of the ankle, skin irritation sign, angular deformities. But refracture was healed without delayed or nonunion by simple plaster cast immobilization. The vascularized bone graft snd electric stimulation is thought to be more improved methods for the treatment of congenital pseudarthrosis of the tibia. Althought solid bony union was obtained in congenital pseudarthrosis of the tibia, periodic follow-up and adequste management must be mandatory up to the end of the bony growth.
Ankle ; Casts, Surgical ; Congenital Abnormalities ; Electric Stimulation ; Female ; Follow-Up Studies ; Humans ; Immobilization ; Male ; Pseudarthrosis ; Skin ; Tibia ; Transplants