No abstract available.
Humans ; Mental Health* ; Paresis* ; Rehabilitation* ; Stroke*

STUDY DESIGN: A retrospective study was made of patients undergoing posterolateral fusion of the lumbar spine. OBJECTIVES: To compare the clinical outcomes of the patients who underwent posterolateral fusion of the lumbar spine with commercially available allogeneic bone graft with those patients in a similar consecutive control group who underwent posterolateral fusion of the lumbar spine with autogenic bone graft and to determine whether the commercially available allogeneic bone is useful for postero-lateral fusion of the lumbar spine. SUMMARY OF LITERATURE REVIEW: Major differences exist in the ability of an allogeneic bone graft to regenerate a viable cellular network as compared to an autogenic bone graft. This is related to the immunologic response of the host to the foreign bone. The fusion rate of deep freezing allogeneic bone graft was reported as 80-100%. MATERIALS AND METHODS: Seventy-nine patients with spondylolisthesis treated with decompression, fixation with pedicle screws and posterolateral fusion were retrospectively reviewed. Nineteen patients (group 1) were treated with commercially available allogeneic bone (Tutoplast) graft mixed with autogenic bone and the remaining 60 patients (group 2) were treated with autogenic bone graft. Operating time, amount of transfusion, duration of hospital stay, symptom improvement, fusion rate, duration of fusion, and complications were studied. RESULTS: There were no significant differences between the two groups in terms of duration of hospital stay, amount of transfusion, symptom improvement, and complications . However, there were significant differences between the allogeneic and autogenic groups in terms of operating time (212.3 versus 230.9 minutes), fusion rate (36.8% versus 98.3%), and duration of fusion (10.2 versus 6.4 months), respectively. CONCLUSIONS: Commercially available allogeneic bone is less useful for posterolateral fusion of the lumbar spine.
Decompression ; Freezing ; Humans ; Length of Stay ; Retrospective Studies ; Spine* ; Spondylolisthesis ; Transplants

Acute osteomyelitis is usually shown as a localized area of increased activity (hot uptake) in the infectious focus on bone scintigraphy. In our patient, absence of radioactivity (cold lesion) was noted in the distal metaphyseal and diaphyseal regions of his right femur. Initial x-ray was interpreted as normal except for mild soft tissue swelling in the right thigh. The lesion was confirmed as an acute osteomyelitis with subperiosteal abscess on surgery. Staphylococcus aureus was the etiologic organism. We describe a case of acute osteomyelitis in a one-year-old boy shown as a cold lesion on bone scan.
Abscess ; Femur ; Humans ; Male ; Osteomyelitis* ; Radioactivity ; Radionuclide Imaging ; Staphylococcus aureus ; Technetium Tc 99m Medronate ; Thigh

Kasabach-Merritt syndrome is the association of thrombocytopenia, disorder of coagulation, spontaneous bleeding and enlargement of a hemangima or extensive hemangiomatosis, which can be often life threatening. We experienced a three years-old girl with suddenly enlarging hemangioma of right cheek, complicated by severe thrombocytopenia, consumptive coagulopathy and hemorrhagic cystitis. Generalized petechia and ecchymosis were noted on the overlying skin of hemangioma, trunk and extremities. But the study of MRI and angiography, hypevascular was located within the right masseter muscle extending to temporalis muscle and anterior to parotid gland. So selective embolization with PVA (polyvinyl alcohol) was performed through the distal branch of internal maxillary artery and facial artery. She was medicated with oral corticosterioid for 3 weeks. After embolizationn, blood flow to hemangioma and facial swelling were markedly decreased. Patient was followed up for 7 years and she showed normal contour of face and no bleeding diathesis.
Angiography ; Arteries ; Cheek ; Cystitis ; Disease Susceptibility ; Ecchymosis ; Extremities ; Female ; Hemangioma ; Hemorrhage ; Hemorrhagic Disorders* ; Humans ; Kasabach-Merritt Syndrome* ; Magnetic Resonance Imaging ; Masseter Muscle ; Maxillary Artery ; Parotid Gland ; Skin ; Thrombocytopenia

PURPOSE: This study was to evaluate the effects of visiting nursing intervention on self care behavior and blood pressure with high risk of cerebrovascular diseases. METHOD: A one-group pretest-posttest was designed. Data collection was done in 150 participants from March, 2003 to November, 2003 at a public health center. Self care behavior was assessed by the scores of smoking, alcohol, diet, exercise, stress and medication compliance. The scores of knowledge related cerebrovascular diseases, blood pressure, blood glucose were estimated. The Participants were intervened in with basic assessment, emotional support, education. This program took a period ranging from 3 months to 7 months depending on the cerebrovascular risk level. The mean number of visiting times was 1.67 per month. RESULT: 1. Knowledge level was improved(t=-2.542, p=.012). 2. Systolic and diastolic pressure were lower(t=5.439, p<.001; t=4.966, p<.001). 3. Self care level was higher (t=-12.981, p=.001) after the intervention. CONCLUSION: The visiting nursing intervention was found to have an effect on the scores of knowledge, self care behavior and blood pressure with high risk of cerebrovascular diseases. The results provided evidences for the importance of visiting nursing intervention in the high risk factor of cerebrovascular disease for self care.
Blood Pressure* ; Data Collection ; Diet ; Education ; Glucose ; Hematologic Diseases ; Humans ; Medication Adherence ; Nursing* ; Public Health ; Risk Factors ; Self Care* ; Smoke ; Smoking

We report an autopsy case of secondary hemochromatosis associated with multiple frequent blood transfusion for the treatment of aplastic anemia. A 23-year-old man had been diagnosed as having aplastic anemia at the age of 13. He received a whole blood transfusion, about 1280 ml, every month during the past 10 years. Recently he developed diabetes mellitus and a congestive heart failure. The autopsy revealed that multiple organs were affected by secondary hemochromatosis, including the liver, heart, pancreas, spleen, bone marrow, stomach, thyroid gland, adrenal glands, and testes. The lungs and liver showed gross and microscopic findings consistent with a congestive heart failure in addition to hemochromatosis. The details are presented. This is a case of rare secondary hemochromatosis occurring in a young man and presenting the classic histopathologic changes indistinguishable from those of primary hemochromatosis.
Adrenal Glands ; Anemia ; Anemia, Aplastic* ; Autopsy* ; Blood Transfusion ; Bone Marrow ; Diabetes Mellitus ; Heart ; Heart Failure ; Hemochromatosis* ; Humans ; Liver ; Lung ; Pancreas ; Spleen ; Stomach ; Testis ; Thyroid Gland ; Young Adult

No abstract available.
Moyamoya Disease*

STUDY DESIGN: A retrospective study was performed in obese and nonobese patients undergoing lumbar spine surgery. OBJECTIVES: To report perioperative complications and surgical outcomes in obese patients who underwent lumbar surgery compared with a similar consecutive control group to determine whether obesity is a predictor of poor outcome as well as a factor associated with perioperative complications in lumbar spine surgery. SUMMARY OF LITERATURE REVIEW: Perioperatiye challenges in managing the obese patient include anesthesia considerations related to impaired preoperative cardiac and respiratory function, technical difficulties associated with incubation, positioning, and gaining venous and arterial access for monitoring and administering medications. Obesity has also been implicated in delayed wound healing and thrombophlebitis. MATERIALS AND METHODS: One hundred twenty seven patients with spondylolisthesis treated with decompression and fusion were retrospectively evaluated. Forty four patients were obese and remaing eighty three patients were nonobese. The operation time, amount of transfusion, duration of hospital stay and clinical outcomes were studied. RESULTS: There were no significant differences between the obese and control groups in terms of duration of surgery (224 versus 200 min), amount of transfusion (2.6 versus 2.2 pint), duration of hospital stay (21.3 versus 19.7 days), and symptom improvement (74fo versus 73fo). CONCLUSIONS: Obesity is not a predictor of poor outcome as well as a factor associated with high perioperative complication rate in lumbar spine surgery.
Anesthesia ; Decompression ; Humans ; Length of Stay ; Obesity* ; Retrospective Studies ; Spine* ; Spondylolisthesis ; Thrombophlebitis ; Wound Healing

High output heart failure due to congenital arteriovenous fistula is a rare disease and is difficult to treat. A 27 year old man, suffering from dyspnea, palpitation, lower extremity edema, and abdominal distension admitted May, 1987. At admission there were continuous thrill and bruit at left supraclavicular and infraclavicular area. The heart sound was irregular and rapid, and grade IV/VI pansystolic murmur was audible at the apex. Chest PA showed marked cardiomegaly with pleural effusion and notching at superior aspect of left 2nd rib. Selective left subclavian artery angiogram showed extensive congenital arteriovenous fistula at the area of left subclavian artery and its branches. After setrial feeding artery embolization and palliative operation, the fistula size decreased much with clinical improvement.
Adult ; Arteries ; Arteriovenous Fistula* ; Cardiomegaly ; Dyspnea ; Edema ; Fistula ; Heart Failure ; Heart Sounds ; Humans ; Lower Extremity ; Pleural Effusion ; Rare Diseases ; Ribs* ; Subclavian Artery* ; Thorax

PURPOSE: The purpose of this study was to understand the meaning of experiences in home visiting nursing service among the elderly in community provided by nursing students. METHOD: This is a phenomenological study to investigate the experience of community-based patients. Data were collected through in-depth interviews from the 4th of March to the 15th of December 2003. Individual interviews were conducted with 8 patients on subjective experiences. Data were analyzed through Colaizzi's method, in which meaningful statements were extracted. RESULT: Four categories were identified from nine theme clusters. The four categories were 'thankfulness', 'dependence', 'sorrowfulness' and 'the sense of being'. CONCLUSION: These results show the importance of visiting nursing service for the elderly in community.
Aged* ; House Calls* ; Humans ; Life Change Events ; Nursing Services* ; Qualitative Research ; Students, Nursing