BACKGROUND: According as old aged people have an increased interest in early detection of disease and health promotion, old aged people who take health examinations are increased. So this study is aimed to survey common problems about geriatric health in community and their frequency by way of investigation on diagnosis in health examination data and to evaluate the effects of health risk factors on each disease patterns. METHODS: The medical records of the clients who have taken health examinations for the first time from March 1995 to February 2000 at a health examination center of a university hospital in Seoul were reviewed. The category and number of judged diagnosis, sociodemographic factors are compared and analyzed. RESULTS: The selected medical records accounted to 22,393. The study subjects consist of 11,544(51.6%) male. Mean age is 52.0+/-10.5 years(range 16~90). 65 years or more old aged people of them are 2,612(11.7%), the number of judged diagnosis per one old person is 4.84+/-2.22(range 0~9) and young people took less diagnosis is 35.7%, functional diagnosis is 7.9%. The common diagnoses are liver disease(7.07%), decreased physical strength(6.68%), hyperlipidemin(6.53%),obesity(5.90%), osteoporosis or postmenopausal syndrome(4.72%), need for immunization against viral hepatitis(4.69%), hypertension(4.20%) functional gastrointestinal disease(3.93%). The number of total diagnosis and organic diagnosis is larger in older age, no exercise, female,smoker, no-spouse, lower education(p<0.05). The number of other diagnosis is larger in no exercise, smoker, female, younger age(p<0.05). CONCLUSION: According to health examination, total diagnosis and organic diagnosis are more in old aged group than in young. Functioinal diagnosis and other diagnosis is less in old aged group than in young.
Diagnosis* ; Early Diagnosis ; Female ; Health Promotion ; Humans ; Immunization ; Liver ; Male ; Medical Records ; Osteoporosis ; Risk Factors ; Seoul

PURPOSE: The objective of this study was to define the Os Submedialis Malleolare (OSM) as an any ossicles below medial malleolus of tibia and to determine the characteristics of clinical and radiological characteristics and to evaluate results of surgical treatment of OSM. MATERIALS AND METHODS: Twenty-six patients with OSM were identified between November 1, 1998 and June 30, 2002. RESULTS: The mean age was 18.3 years. All patient except one were male and soccer players comprised 71% (20 cases). Associated disease were 8 cases (29%) of chronic ankle instabilities, one case (4%) of anterior impingement syndrome and one (4%) of plantar fascitis. The most common clinical symptom was pain during walking and sports activity and sign was tenderness around medial malleolus. Only simple radiograph could reveal presence of ossicle and differentiate with acute fracture. If symptom and sign obscured , Bone scan (7 cases) and MRI (3 cases) identify causes of pain and tenderness. As a surgical treatment, all bony fragment caused symptom and sign were eliminated and medial collateral ligament was reattached meticulously. Associated chronic ankle instability were present, modified Brostrom procedure was done simultaneously. On follow-up, The symptomatic pain were wholly disappeared at average 2.2 months (1-6 months) after operation. On one year follow-up, all patients have been daily life without any complaints and all soccer players go back to the game within three months. CONCLUSION: Os Submedialis Malleolare have relatively rare incidence and most common clinical symptom and sign is tenderness on medial malleolar area of ankle, can be diagnosed both physical examination and plain X-ray film. As a treatment, Removal of ossicle and meticulous repair or reattachment of deltoid ligament could obtain excellent or good results.
Ankle ; Collateral Ligaments ; Fasciitis ; Follow-Up Studies ; Humans ; Incidence ; Ligaments ; Magnetic Resonance Imaging ; Male ; Physical Examination ; Soccer ; Sports ; Tibia ; Walking ; X-Ray Film

No abstract available.

No abstract available.
Autoantibodies* ; DNA*

BACKGROUND: In patients with limited cervical spine movement, equipment for orotracheal intubation should achieve sufficient laryngeal exposure with the least cervical spine movement. This study was designed to compare movement of the cervical spine during the orotracheal intubation with various intubating equipment. METHODS: Twelve emergency physicians & residents with a total experience of >50 cases of endotracheal intubation in two emergency centers were assigned to perform orotracheal intubation with four different airway devices, including the Macintosh laryngoscope (ML), DCI video laryngoscope (DCI), Airway Scope (AWS) and Levitan Scope (LS), using the same manikin (Ambu(R) airway management trainer) in random sequences. Movement of the C-spine was examined by measuring the angle formed by two lines which are parallel to the anterior surface of the C2 and C7 vertebrae bodies. The angle was measured when Cormack-Lehane grade II glottis exposure was achieved during intubation. RESULTS: Mean cervical spine movements were 37.6 +/- 9.2degrees, 32.2 +/- 14.2degrees, 32.2 +/- 6.45degrees and 17.4 +/- 10.0degrees with the ML, DCI (p = 0.347), AWS (p = 0.094), and LS (p < 0.001), respectively, compared to that of ML. Cervical spine movement by LS was 54% less than that by ML. LS produced less cervical spine movement in comparison to DCI (p = 0.013) and AWS (p = 0.001). CONCLUSIONS: The Levitan Scope produced less movement of the cervical spine when compared to the Macintosh laryngoscope, DCI video-laryngoscope and Airway Scope during orotracheal intubation in a single airway training manikin model.
Airway Management ; Emergencies ; Glottis ; Humans ; Intubation ; Intubation, Intratracheal ; Laryngoscopes ; Manikins ; Pilot Projects ; Spine

BACKGROUND: According as people have an increased interest in early detection of disease and health promotion, people who take health examinations are increased. So this study is aimed to survey common problems about health in community and their frequency by way of investigation on diagnosis in health examination data and to evaluate the effects of health risk factors on each disease patterns. METHODS: The medical records of the clients who have taken health examinations for the first time from March 1995 to February 2000 at a health examination center of a university hospital in Seoul were reviewed. The category and number of judged diagnosis, sociodemographic factors are compared and analyzed. RESULTS: The selected medical records accounted to 22,393. The study subjects consist of 11,544(51.6%) male. Mean age is 52.0+/-10.5 years(range 16~90). Mean number of judged diagnosis is 4.04+/-2.13(range 0~9) per one person and female took more diagnosis than male on an average(4.09+/-2.17 Vs 3.99+/-2.09). The organic diagnosis(56.4%) is most in total and other diagnosis is 35.7%, functional diagnosis is 7.9%. The common diagnoses are liver disease(7.07%), decreased physical strength(6.68%), hyperlipidemia(6.53%), obesity(5.90%), osteoporosis or postmenopausal syndrome(4.72%), need for immunization against viral hepatitis(4.69%), hypertension(4.20 %), functional gastrointestinal disease(3.93%). The number of total diagnosis and organic diagnosis is larger in older age, no exercise, female, smoker, no spouse, lower education(p<0.05). The number of functional diagnosis is larger in female, younger age, non smoker, lower education(p<0.05). The number of other diagnosis is larger in no exercise, smoker, female, younger age(p<0.05). CONCLUSION: According to health examination, total diagnosis and organic diagnosis are influenced by age, exercise, sex, smoking, spouse, education, functional diagnosis is influenced by sex, age, smoking, education and other diagnosis is influenced by exercise, smoking, sex, age.
Diagnosis* ; Early Diagnosis ; Education ; Female ; Health Promotion ; Humans ; Immunization ; Liver ; Male ; Medical Records ; Osteoporosis ; Risk Factors ; Seoul ; Smoke ; Smoking ; Spouses

Recently, interest has been increased on the role of catecholamines in extrarenal potassium homeostasis. This study has undertaken to investigate the effects of epinephrine added to lidocaine for axillary block in HR, MAP, ABG, blood sugar and electrolytes (Na+, K+), and the effects of propranolol, beta-adrenergic blocker, on the data. The patients admitted to our hospital for operation of upper extremities were divided into three groups. Group I was 10 patients blocked with lidocaine 30 ml. Group II was 14 patients blocked with lidocaine 30 ml with epinephrine 0.3 mg(1:100,000). Group III was 10 patients pretreated with propranolol (10u/kg) and blocked with lidocaine 30 ml with epinephrine. After block, the results were as follows. 1) MAP decreased in all group and group III decreased more than group I. 2) HR increased all group and group III decreased more than group I. 3) ABG showed hypoventilatory pattern due to sedative effect by diazepam (0.15mg/kg). 4) Blood sugar value was increased in group I and II, showed increasing tendency in group III, but this tendency was not significant. 5) Blood K+ concentration decreased significantly and the maximal decrease was 0.5 mEq/L in 30 min after block, but there was not significant decrease in group III. This results indicate that clinical dose of epinephrine(1;100,000) decrease blood K+ concentration significantly and propranolol (10u/kg) pretreatment prevent K+ decreasing effect of epinephrine. In clinical practice, it is suggested that much care must be paid to use of local anesthetics with epinephrine to hypokalemic patients.
Anesthetics, Local ; Blood Glucose ; Brachial Plexus* ; Catecholamines ; Diazepam ; Electrolytes ; Epinephrine* ; Homeostasis ; Humans ; Hypnotics and Sedatives ; Lidocaine* ; Potassium ; Propranolol* ; Upper Extremity

Recently, interest has been increased on the role of catecholamines in extrarenal potassium homeostasis. This study has undertaken to investigate the effects of epinephrine added to lidocaine for axillary block in HR, MAP, ABG, blood sugar and electrolytes (Na+, K+), and the effects of propranolol, beta-adrenergic blocker, on the data. The patients admitted to our hospital for operation of upper extremities were divided into three groups. Group I was 10 patients blocked with lidocaine 30 ml. Group II was 14 patients blocked with lidocaine 30 ml with epinephrine 0.3 mg(1:100,000). Group III was 10 patients pretreated with propranolol (10u/kg) and blocked with lidocaine 30 ml with epinephrine. After block, the results were as follows. 1) MAP decreased in all group and group III decreased more than group I. 2) HR increased all group and group III decreased more than group I. 3) ABG showed hypoventilatory pattern due to sedative effect by diazepam (0.15mg/kg). 4) Blood sugar value was increased in group I and II, showed increasing tendency in group III, but this tendency was not significant. 5) Blood K+ concentration decreased significantly and the maximal decrease was 0.5 mEq/L in 30 min after block, but there was not significant decrease in group III. This results indicate that clinical dose of epinephrine(1;100,000) decrease blood K+ concentration significantly and propranolol (10u/kg) pretreatment prevent K+ decreasing effect of epinephrine. In clinical practice, it is suggested that much care must be paid to use of local anesthetics with epinephrine to hypokalemic patients.
Anesthetics, Local ; Blood Glucose ; Brachial Plexus* ; Catecholamines ; Diazepam ; Electrolytes ; Epinephrine* ; Homeostasis ; Humans ; Hypnotics and Sedatives ; Lidocaine* ; Potassium ; Propranolol* ; Upper Extremity

No abstract available.
Emergencies* ; Emergency Service, Hospital* ; Hospitals, Teaching* ; Korea* ; Medical Records*

BACKGROUND: Laryngeal microscopic surgery is stressful as a result of the intubation and suspension laryngoscopy during the short operation time. Therefore, the objectives of the anesthesiologist are to maintain sufficient anesthetic depth, promote rapid awakening, and return the protective airway reflexes. This study compared the hemodynamic responses and recovery patterns between propofol-N2O and sevoflurane-N2O anesthesia. METHODS: Sixty outpatients undergoing laryngeal microscopic surgery were randomly divided into three groups: Endotracheal intubation with the effect-site concentration of propofol fixed at 3 ug/ml (Group P3), 4 ug/ml (Group P4) or endotracheal intubation with sevoflurane anesthesia (Group S). In all groups, the anesthesia was supplemented with up to 50% of N2O. The hemodynamic responses during intubation and suspension laryngoscopy were compared. In addition, extubation time, emergence time and the state of recovery (Steward score) were compared. RESULTS: After intubation and suspension laryngoscopy, the mean arterial pressure was significantly higher in Group S than in Groups P3 and P4 (P < 0.05). The heart rate was significantly higher in Group S than in the Group P4 (P < 0.05). The extubation times were not significantly different. However, the time for responding to a verbal command was significantly faster in Groups P3 (7.8 +/- 2.3 min) and P4 (8.8 +/- 1.9 min) than in Group S (10.6 +/- 1.8 min). The Steward score 1 min after extubation was significantly higher in Group S (P < 0.05). CONCLUSIONS: Propofol-N2O anesthesia can be useful in laryngeal microscopic surgery.
Anesthesia* ; Arterial Pressure ; Blood Pressure ; Heart Rate ; Hemodynamics ; Humans ; Intubation ; Intubation, Intratracheal ; Laryngoscopy ; Outpatients ; Propofol ; Reflex