OBJECTIVE: The authors conducted this study to investigate the safety and efficacy of decompressive surgery alone in the treatment of lumbar spinal stenosis in the elderly population. METHODS: All charts and records of 323 patients aged 65 years or older who underwent lumbar spinal decompressive surgery without fusion for lumbar spinal stenosis in the period from September 2003 to August 2007 were reviewed. RESULTS: A total of 323 patients were identified. Mean age among patients were 72.6years. 197 patients(60.9%) underwent wide decompression, 95 patients(29.4%) had microscopic partial decompression, and 31 patients(9.5%) underwent bilateral decompression via unilateral approach. Perioperative morbidity seen was among 16 patients(4.9%). There were 5 patients(1.5%) reoperated for hematoma formation. Another 5 patients(1.5%) developed wound infection. Cerebrospinal fluid(CSF) leakage were noted among 3 patients(0.9%). 2 patients(0.6%) had urinary difficulty, and Steven Johnson syndrome developed in one patient(0.3 %). Clinical outcome was evaluated using Macnab's classification. 40 patients(12.4%) had excellent results, 241 patients(74.8%) had good results, 34 patients(10.3%) had fair results and 8 patients(2.5%) had poor outcome. CONCLUSION: Decompressive laminectomy alone is a relatively safe and effective treatment option for the elderly.
Aged ; Decompression ; Hematoma ; Humans ; Laminectomy ; Spinal Stenosis ; Wound Infection

No abstract available.
Herpes Zoster* ; Psoriasis*

No abstract available.
Head* ; Neck* ; Neurilemmoma*

This research has been done in order to improve quality of nursing and medical service. In order to improve those qualities the study has been done to know inpatient perception of kindness and meaning of kindness which patients receive from nurse and also what effect inpatient have when they experience kindness from nurse. The subjects were 454 people who admitted in K Hospital. Time period was from October to December 1995. This survey has been done by personal interview with a written questionnaire. Analysis of data has been done by X2-test and percentage. The results of the research may be summarized as follows. 1. The inpatients perception of kindness on nurse were explanation(26.8%), tolerance(16.3%), warm-heartedness(12.8%), interest(9.5%), ability(8.4%), confidence(6.4%), respect(4.0%), support(2.65%). 2. In order to find out general meaning of kindness, study classified by age, sex, education, job, experience of hospitalization, inpatient ward. As a result of X2-test, no special meaning of kindness was presented in inpatient perception of kindness. 3. Contents kindness which inpatient experienced were, warm-heartedness(23%), understanding(18.1%), interest(17.8%), ability(12.8%), tolerance(5.7%), confidence(2.6%). 4. Over half of subjects(59.1%) answered stability to effect on kindness of Nurse. Next are self-confidence(7.9%), respect(5.3%), confidence(4.6%), warm-heartedness(3.5%), understanding(2.6%). According to above results inpatient feels that meaning of kindness were explanation, tolerance, warm-heartedness. This meaning has no distinctive difference other than consistent meaning. Likewise, inpatient experience about contents of kindness is similar to meaning of kindness. As a result of this research, which show that kindness of nurse gives patient stability, respect and confidence, we would kindness is important for recovery of inpatient. Therefore, this research outcome could be able to help to improve quality of nursing and medical service.
Education ; Hospitalization ; Humans ; Inpatients* ; Nursing ; Surveys and Questionnaires

No abstract available.
Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia, Mycoplasma*

The Purposes of this study were to understand the types of appellations used by nurses and doctors for patients in a hospital and to analyze satisfaction and reason about appellation for patient. This would enable us to provide basic data on culturally suitable appellations for admitted patients. 454 Patients at K University hospital in Seoul were subjects for this study. Subjects were interviewed individually using a questionnaire and frequency X2-test. Results are as follows. 1. The most frequently used type of appellations in hospitals was '-ssi ; -sir' used by 88.1% of the nurses and 83.9% of the doctors. About 3 quaters of the medical staff used '-ssi' while none used job position. 2. 93.2% of the patients were satisfied with the appellations used by nurses and 93.0% of the patients were satisfied with the appellations used by the doctors 43.7% didn't think appellations were important and 44.3% thought it natural to use the appellation. The most satisfactory form of appellation used by nurses was '-ssi' to 93.3% of patients. All were satisfied with '-nim ; -sir', '-teacher' and there was no statistically significance. On the other hand, the level of satisfaction and the appellation used by doctors showed a relationship(X2=19.72, p=.000). Every patient was satisfied with '-nim' and '-teacher' but 19.9% were dissatisfied with the others of appellations. 3. Most patients preferred to be called '-ssi' by nurses(77.3%) and doctors(78.7%) respectively. The dominant reason being accuracy(45.8%), naturalness(33.9%) for nurses and 43.8% and 45.4% respectively for doctors. 4. The relationship between the type of appellations requested of nurses and general characteristics showed that age(X2=83.91% p=.000), level of education(X2=33.35 p=.000), and occupation(X2=38.22 p=.033) were related to the type of appellation. The type of appellation requested of doctors was related to the age(X2=72.56 p=.000), level of education(X2=30.01 p=.000), and occupation(X2=42.90 p=.010). Generally, '-ssi' was requested of doctors and nurses, but lower age group or higher age group(over 61), those in elementary schools or elementary school graduates and students preferred being called by their first names or grandfather, grandmother. From the results above, we can see that the most general type of appellation used for patients by the medical staff is '-ssi' and most patients were satisfied with the appellation but, the reason being that such appellations were accepted without concern. This shows that most are not adequately satisfied with the appellation. Only a small number of people use '-nim' and '-teacher' but is the preferred and frequently used types of appellation. Therefore, a continuous research of appellations used for patients with patients using '-nim' and an investigation with nurses' opinions of appellations for patients as the subject are required.
Hand ; Humans ; Medical Staff ; Surveys and Questionnaires ; Seoul

OBJECTIVE: Using the standardization of disease diagnosis of disease, and surgical procedures, the authors have made a clinical application for the analysis of inpatient data with the ability to search for information pertinent for writing of clinical articles. METHODS: A client-server system and database software was developed for networking. For clinical application, a computerized daily report has been developed. Data from Neurosurgical patients admitted at Soonchunyang University Hospital from January to December 1998 were analyzed with this system. Data for clinical articles was obtained using the search mode, information such as orbital infarction syndrome following intracranial aneurysm surgery and epidemiological analysis or geriatric neurosurgical patients. RESULTS: For the daily report it takes approximately 10 minutes to input the patients demographic information, name of disease, diagnosis and surgical procedure. The daily report also numbers and sorts the inpatients according to large categories of diagnosis, reports the ratio between inpatients and operative patients. The annual report that was obtained was very accurate and gave rapid statistics for the one year. By retrospective study for the past 18 years, we calculated the incidence of orbital infarction syndrome following intracranial aneurysm surgery as 1.4%, and also estimated the population of geriatric inpatients as 18.3% by retrospective study. CONCLUSIONS: It has been found to be most useful to make a daily and annual report for tracking and research purposes. For use in clinical articles, it can be possible to do a search of the patients using the standardized disease, diagnosis and neurosurgical procedures application and obtain pertinent information in a timely manner.
Diagnosis ; Epidemiology* ; Humans ; Incidence ; Infarction ; Inpatients ; Intracranial Aneurysm ; Neurosurgical Procedures* ; Orbit ; Retrospective Studies ; Writing

OBJECTIVE: The the international classification of disease and surgical procedure has been found to be a lengthy and time-consuming text for use by neurosurgeons. A more subject matter related classification system is needed for use by this specialty. The author has developed a more comprehensive and standardized classification system specified for diagnosis of neurological disease and neurosurgical procedures. METHODS: Standardization of disease was completed by modifying the name of disease according to that which was used for daily report past 10 years, and from textbook of neurosurgery. The fields of international coding are continued in each. Neurosurgical procedures were designated and modified according to Current Procedure Terminology 96. Client-server system will be used for networking and database software applications have been developed. RESULTS: Disease was classified in 14 large categories and 379 subcategories. Diagnosis was classified in 12 large categories and 43 subcategories. Neurosurgical procedure has 20 large and 202 subcategories. The international coding system such as ICD-10 and ICD-9CM is maintained for the diagnosis and procedures to each category. CONCLUSIONS: It could be possible to make and use a standardized database model of disease, diagnosis and neurosurgical procedures to be used by physician.
Classification ; Clinical Coding ; Diagnosis ; Epidemiology* ; International Classification of Diseases ; Neurosurgery ; Neurosurgical Procedures*

BACKGROUND: We compared elderly and adult patients and tried to find a way to make an early diagnosis and proper management for elderly patients with altered mental status in the emergency department(ED). METHODS: During one year, two groups -123 elderly patients over 65 years and 127 adult patients from 20 to 64 years who visited ED in National Police Hospital(NPH)-were selected. Sex, age, arrival time after symptom onset, means of transportation, underlying diseases, causative disease, time of notification to other departments, and pattern of discharge of two groups were analyzed. RESULTS: The average age of the elderly and the adults were 76.43+/-9.51 and 42.12+/-15.0(yrs), respectively. As for the means of transportation, 84% of the elderly used a 911 ambulance service, and 11% used other emergency services. The average times from symptom onset to arrival for two groups were 124 minutes and 69 minutes, respectively. 86.99% of the elderly and 68.38% of the adults had underlying diseases. As for final diagnosis, cerebrovascular disease for the elderly and cardiovascular disease for the adults were the main causes. When patients left the hospital, rate of transfer to other hospital was higher in the elderly(60.2%), and rate of discharge was higher in the adults(15.8%). CONCLUSION: The elderly patients had more intracranial causes and needed longer time for diagnosis than the adult patients. In the case of the patients with intracranial cause who needed an emergency care, they were usually diagnosed at the secondary medical facility and then transferred to the other hospitals for proper treatment causing bad effect on the prognosis of the treatment due to time delay.
Adult ; Aged ; Ambulances ; Cardiovascular Diseases ; Early Diagnosis ; Emergencies ; Emergency Medical Services ; Humans ; Police ; Prognosis ; Transportation

In connective tissue diseases, autoantibodies cause pulmonary interstitial inflammation and fibrosis, and patients require treatment with an immunosuppressive agent such as a steroid. Dermatomyositis is an incurable, uncommon form of connective tissue disease that occasionally causes diffuse pulmonary inflammation leading to acute severe respiratory failure. In such cases, the prognosis is very poor despite treatment with high-dose steroid. In the present case, a 46-year-old man was admitted to our hospital with dyspnea. He was diagnosed with dermatomyositis combined with cryptogenic organizing pneumonia (COP) with respiratory failure and underwent treatment with steroid and an immunosuppressive agent, but the COP was not improved. However, the respiratory failure did improve after treatment with intravenous immunoglobulin, which therefore can be considered a treatment option in cases where steroids and immunosuppressive agents are ineffective.
Autoantibodies ; Connective Tissue Diseases ; Cryptogenic Organizing Pneumonia* ; Dermatomyositis* ; Dyspnea ; Fibrosis ; Humans ; Immunoglobulins* ; Immunosuppressive Agents ; Inflammation ; Lung Diseases, Interstitial ; Middle Aged ; Pneumonia ; Prognosis ; Respiratory Insufficiency ; Steroids