In modern society we have been gradually interested in the elderly and easily come into contact with many medical favors to enhance the quality of life, and the elderly are gradually increasing owing to the development of the basic science such as new diagnostic machinery, operative technique and development of the therapeutics. However, the variation of the environment has increased the possibility to be exposed to the dangerous factors, and it has given rise to the problems about the quality of the elderly life. It has also greatly enlarged in medical as well as social. Therefore, the frequency of the elderly reconstructive surgery to increase the quality of the elderly life by operation without life or death has increased in plastic surgery. So authors thought that the safe operative study is necessary. We reviewed the case of 102 elderly patients (65 years of age), who were operated during the period from 1988 to 1995, and analyzed the age & sex distribution, classification & distribution of diseases in elderly, operation of plastic & reconstructive surgery in elderly, anesthetic, methods, underlying diseases, and postoperative complications through the patient records. We also examined postoperative function, aesthetic improvement, progression of the quality of life by telephone and analyzed the elderly classification and elderly plastic & reconstructive surgery. The results are as follows : 1. There were benign neoplasm, facial bone fracture, aesthetic surgery, skin and soft tissue defect, complicated diabetic mellitus, malignant ulcer, malignant neoplasm, pressure sore in elderly diseases of plastic & reconstructive surgery. 2. We mainly performed skin graft, flap surgery, ORIF, aesthetic surgery. 3. The recovery rate after postoperative evaluation shows that ; 1) 52% of total interviewee feel that their QOL has improved. 2) 24% of total interviewee feel that their QOL has not changed. 3) 24% of total interviewee feel that their QOL has deteriorated. We report the point at issue and statistical examination with record investigation.
Aged* ; Classification ; Dermatologic Surgical Procedures ; Facial Neoplasms ; Fractures, Bone ; Humans ; Postoperative Complications ; Pressure Ulcer ; Quality of Life ; Sex Distribution ; Skin ; Surgery, Plastic* ; Telephone ; Transplants ; Ulcer

Ischemia results when the decrease in tissue perfusion exceeds the tissues ability to increase an oxygen extraction from the blood. Brain edema has been defined as an abnormal accumulation of fluid within brain parenchyma associated with a volumetric enlargement of the brain tissue. In most instances, the labelling of edema as vasogenic or cytotoxic is only relative. For cerebral protection, there were many possible techniques which could increase or maintain cerebral perfusion and reduce cerebral metabolic demand for oxygen. This study was carried out the effect of mild
Brain Edema* ; Brain Ischemia* ; Brain* ; Edema ; Ischemia ; Oxygen ; Perfusion ; Tissues

No abstract available.
Arthritis* ; Tendon Entrapment*

Caudal anesthesia appears to be a safe and reliable techniuqe for surgical anesthesia as well as an alternative to narcotics for postoperative analgesia for procedures below the umbilicus. The caudal anesthesia might be particularly helpful in infants and children to avoid repetitive injections of narcotics to control postoperative pain. Advantages of caudal anesthesia for pediatric surgery i.e. clearly defined anatomic landmarks, a simplicity of the technique and high success rate have been reported. However, it has not been popular in clinical practice due to several reasons. First of all, small children do not cooperate with technical procedures. Therfore, an additional measure to provide a cooperative state is needed, such as pentothal or ketamine injection, or general anesthesia induced beforehand. Secondly, there is no clear determination or unanimity in anesthetic dosage according to the patient's age or body weight. Lastly, clinical experience and reports have not been enough for clinical practice. The aim of this study was to determine whether commonly accepted dosages used in infants produce blood levels within a safe range. This study was undertaken to measure changes of plasma concentration of lidocaine in patients with pediatric caudal anesthesia, and to check pain and motor scores and analgesic level at the recovery room. The time courses of the plasma concentration were observed in 29 healthty children(0.5-13 yr) to whom were caudally injected with 1% lidocaine mixed 1: 200,000 epinephrine(10 mg/kg). The plasma concentrations were measured by immunofluoresence assay at the intervals of l5, 30, 45, and 60 minutes. The values of plasma concnetration were 1.67+/-0.41, 1.85+/-0.61, 1.73+/-0.46, 1.75+/-0.29mcg/ml(MEAN+/-SD). The peak plasma concentration was 1.85+/-0.61mcg/ml at 30 minutes. However, there no significant differences during the first hour. No data exceeded 5 mcg/ml which is plasma toxic level of lidocaine, nor children had an experience of toxic complications. When the pain and motor scores were checked in the recovery room, most children had no pain and were not ahle to stand but movalble. Sensory levels were checked up to T9 which were suitable for lower abdominal and perineal surgery. These results indicate that the injection of l% lidocaine 10 mg/kg with epinephrine in children is considered to be safe because plasma concentration dose not exceed the toxic levels.
Analgesia ; Anatomic Landmarks ; Anesthesia ; Anesthesia, Caudal* ; Anesthesia, General ; Body Weight ; Child ; Epinephrine ; Humans ; Infant ; Ketamine ; Lidocaine* ; Narcotics ; Pain, Postoperative ; Plasma* ; Recovery Room ; Thiopental ; Umbilicus

Gram-negative sepsis is the most common setting in which the constellation of abnormalities in lung function, is clinically called the adult respiratory distress syndrome(ARDS). There is a considerable clinical interest in measuring pulmonary microvascular filtration pressure in patients with acute respiratory failure. Pulmonary capillary pressure(Pc) influences the rate of edema formation in the injured lung, and an understanding of how Pc is altered by the disease is important to improve our treatment of acute respiratory failure, We infuesd E. Coli endotox-in, 3 mg/kg, intravenously into anesthetized dogs and measured the hemodynamics and pulmonary capillary pressure, which was derived from the pressure transient recorded while the pulmonary artery catheter was rapidly wedged. Dogs were given fluids to restore cardiac filling pressure to baseline levels. This resulted in a low resistance shock in all animals. 3 hours after the endotxin infusion experimental ARDS developed. The data report that mean pulomanary artery pressure, pulmonary capillary pressure, and pulmonary vascular resistance(PVR) are increased in experimental ARDS(P<0.1), and there is uneuqal, variable partitoning of the PVR. The Gaar estimation of Pc and measured Pc were highly correlated(r=0.915). These data suggest that measuring Pc will alow the clinician to learn if vasoactive agents infused in the management of acute respiratory failure can reduce the microvascular filtration pressure. In this manner, clinicians may directly reduce the rate of edema formation in the acutely injured lung.
Adult ; Animals ; Arteries ; Capillaries* ; Catheters ; Dogs ; Edema ; Filtration ; Hemodynamics* ; Humans ; Lung ; Pulmonary Artery ; Respiratory Insufficiency ; Sepsis ; Shock ; Shock, Septic

Gram-negative sepsis is the most common setting in which the constellation of abnormalities in lung function, is clinically called the adult respiratory distress syndrome(ARDS). There is a considerable clinical interest in measuring pulmonary microvascular filtration pressure in patients with acute respiratory failure. Pulmonary capillary pressure(Pc) influences the rate of edema formation in the injured lung, and an understanding of how Pc is altered by the disease is important to improve our treatment of acute respiratory failure, We infuesd E. Coli endotox-in, 3 mg/kg, intravenously into anesthetized dogs and measured the hemodynamics and pulmonary capillary pressure, which was derived from the pressure transient recorded while the pulmonary artery catheter was rapidly wedged. Dogs were given fluids to restore cardiac filling pressure to baseline levels. This resulted in a low resistance shock in all animals. 3 hours after the endotxin infusion experimental ARDS developed. The data report that mean pulomanary artery pressure, pulmonary capillary pressure, and pulmonary vascular resistance(PVR) are increased in experimental ARDS(P<0.1), and there is uneuqal, variable partitoning of the PVR. The Gaar estimation of Pc and measured Pc were highly correlated(r=0.915). These data suggest that measuring Pc will alow the clinician to learn if vasoactive agents infused in the management of acute respiratory failure can reduce the microvascular filtration pressure. In this manner, clinicians may directly reduce the rate of edema formation in the acutely injured lung.
Adult ; Animals ; Arteries ; Capillaries* ; Catheters ; Dogs ; Edema ; Filtration ; Hemodynamics* ; Humans ; Lung ; Pulmonary Artery ; Respiratory Insufficiency ; Sepsis ; Shock ; Shock, Septic

No abstract available.
Antibody Formation* ; Child* ; Hepatitis B* ; Hepatitis* ; Humans ; Vaccination*

Authors experienced the cases like to Muco-Cutaneous Lymph node Syndrome (MCLS) admitted to the department of Pediatrics, St. Benedict Hospital from Jan. 1978 to Dec. 1979. Here Authors presented the clinical datas of twenty cases simulating this syndrome as reported by Kawasski. 1. The peak age group was from 1 to 2 years of age and the youngest case was 3 months old infant. Most of them (95%) was under 3 yesrs old. The ratio of male and female was 13 to 7. The seasonal incidence was higher in May to June and November to February. The annual incidence of 1979 was more than 2 times as that of 1978. 2. The clinical symptoms on admission were as follow : fever (100%), cough (70%), diarrhea (65%), vomiting (45%), irritability (40%), So, on admission, Authors had used to overlook as respiratory disease or acute gastroenteritis. 3. The 70% of them showed at least 5 items of the principal symptoms of MCLS. At acute phase, 14 cases (70%) also showed the erythematous desquamation of anogenital region, and 2 cases (10%) showed a transitory hydrocele. The appearance of rashes was observed in 10 cases (50%), and 7 cases of the remainder showed the desquamation of digits during convalescent phase. 7 of 15 cases (46.7%) showed only the desquamation of fingertips. 4. 8 cases (40%) had sinus tachycardia, and I case had gallop rhythm. Most of them showed normal EKG, and 4 cases (20%) showed low voltage of limb leads. 5. In the laboratory findings, most of them had leucocytosis, elevated ESR, positive CRP, normal ASO, and 5 cases (25%) had slight increase of serum transminase. Hepatomegaly was observed in 7 cases (35%). 6. In spite of the intensive treatment, fever was continued for about 5 days in 5 cases (25%).
Cough ; Diarrhea ; Electrocardiography ; Exanthema ; Extremities ; Female ; Fever ; Gastroenteritis ; Hepatomegaly ; Humans ; Incidence ; Infant ; Lymph Nodes* ; Male ; Pediatrics ; Seasons ; Tachycardia, Sinus ; Vomiting

We report 1 case of Fanconi's anemia which has severe pancytopenia, PDA, hypoplatic right thumb and cryptorchism with a brief review of related literature and references.
Cryptorchidism ; Fanconi Anemia* ; Male ; Pancytopenia ; Thumb

Calcific tendinitis of the shoulder joint is common disease causing acute pain, mainly involving the supraspinatus or infraspinatus muscle, and less frequently the teres minor or subscapularis muscle. This study reports on the satisfactory arthroscopic removal of calcium deposits as well as infraspinatus and supraspinatus muscle repair without relapse via minimal incision using suture anchors. This was a case of atypically extensive calcific tendinitis involving the infraspinatus muscle, with a bursal side partial rupture of the supraspinatus muscle in a 61-year-old female whose chief complaint was chronic pain of the right shoulder exacerbated by limited movement.
Acute Pain ; Calcium ; Chronic Pain ; Female ; Humans ; Middle Aged ; Recurrence ; Rupture ; Shoulder Joint ; Shoulder* ; Suture Anchors ; Tendinopathy*