This article is being retracted as a part of the manuscript was a 'duplicate publication' from an earlier publication.

PURPOSE: The purpose of this study was to identify risk factors of fall and to examine its results among patients aged 60 and over diagnosed with osteoporosis. METHODS: A retrospective descriptive survey was conducted with 91 patients admitted in a university hospital in a city. Data were collected using an interview method with a structured questionnaire, and were analyzed using descriptive statistics and multiple logistic regression. RESULTS: In patients with osteoporosis, the intrinsic risk factors of falls were aging (OR = 3.742), gait disturbance (OR = 12.565), taking one or fewer medicine (OR = 7.873), and having two or more diseases (OR = 5.173). The extrinsic risk factors included the use of a bed (OR = 3.093), slippery floors (OR = 12.130), bathroom mat without anti-slip rubber backing (OR = 3.564), and presence of a night light on the passage from the bedroom to the bathroom (OR = 2.980). CONCLUSION: For the elderly aged over 70 who are most vulnerable to falls, screening tests such as bone mineral density (BMD) should be conducted in health examinations and the risk of fracture caused by osteoporosis should be communicated to the vulnerable elderly. Besides, development of new exercise programs combining weightbearing exercise is needed to prevent bone loss and increase functional activities.
Aged ; Aging ; Bone Density ; Floors and Floorcoverings ; Gait ; Humans ; Light ; Logistic Models ; Mass Screening ; Osteoporosis ; Retrospective Studies ; Risk Factors ; Rubber ; Weight-Bearing ; Surveys and Questionnaires

Reflex sympathetic dystrophy is a common posttraumatic pain syndrome for which no relia- bly effective method of therapy has been found. Oral therapy has been attempted with steroid, tricyclic antidepressant, beta-blocker, and antiseizure medications, none of which are predictably helpful. Multiple invasive treatment, including sympathetic blockade and intravenous regional local anesthetic, reserpine, or guanethidine blocks, have been employed, but again with inconsistent success. Transcutaneous nerve stimulation is effective in some patients but aggravates symptoms in others. Following a report of the use of subarachnoid block in the treatment of reflex sympathetic dystrophy, a symptom that is characterized by vasospasm and cold intolerance, we experienced the ability of subarachnoid block to relieve the symptoms of reflex sympthetic dystrophy.
Guanethidine ; Humans ; Reflex Sympathetic Dystrophy* ; Reflex* ; Reserpine ; Transcutaneous Electric Nerve Stimulation

PURPOSE: The purpose of this study was to identify the features, risk scores and risk factors for deep vein thrombosis in critically ill patients who developed deep vein thrombosis in their lower extremities. METHODS: The participants in this prospective descriptive study were 175 adult patients who did not receive any prophylactic medication or mechanical therapy during their admission in the intensive care unit. RESULTS: The mean age was 62.24 (+/-17.28) years. Men made up 54.9% of the participating patients. There were significant differences in age, body mass index, and leg swelling between patients who developed deep vein thrombosis and those who did not have deep vein thrombosis. The mean risk score was 6.71(+/-2.94) and they had on average 4.01(+/-1.35) risk factors. In the multiple logistic regression, body mass index (odds ratio=1.14) and leg swelling (odds ratio=6.05) were significant predictors of deep vein thrombosis. CONCLUSION: Most critically ill patients are in the potentially high risk group for deep vein thrombosis. However, patients who are elderly, obese or have leg edema should be closely assessed and more than one type of active prophylactic intervention should be provided.
Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Body Mass Index ; *Critical Illness ; Female ; Humans ; Leg/*blood supply ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Predictive Value of Tests ; Prospective Studies ; Risk Factors ; Venous Thrombosis/diagnosis/*etiology ; Young Adult

Because operationg room time is one of the most expensive hospital resources, cancellation of a planned surgery is a wasteful expenditure of specialized human manpower and other medical resources. To decrease the rate of cancellation, we performed this prospective study about patients who planned elective surgery under general or regional anesthesia frome September 1, 1990 to December 31, 1990 in the operating room of Yeungnam University Hospital. Daily, the total number of planned surgeries and cancelled patients were recorded, and the most important reasons for cancelling by an individual patient were also recorded. The results were as follows: 1)The total number of planned elective surgeries was 3,102 patients and total number of cancelled patients was 502 patients. Thus the mean rate of cancellation was 16.2%. 2)The highest rate of cancellation was in October(21.2%), and the departmental variation was hte highest rate in dental(37.5%) and the lowest rate in the ophthalmic department(8.6%). 4) The reason of cancellation were as follows: combined systemic diseases or abnormal laboratory findings(42.4%) were most common, and the next was no admission(14.5%), heavy schedule or deficinecy of operating room(10.3%), refusal of operation(8.6%), insufficinet patient preparation(7.8%), and affairs of operator or department(7.4%), and others. As a result of this study, there are several ways to decrease the cancellation rate in operating room of yeungnam University Hospital. The first is a careful preoperative evaluation of patient's physical status and results of labaratory examination before hospitalization, and then the common practice of outpatient surgery, appropriate plan of overall elective operation, reasonable management of an operating room, and good relationships between the individual department, especially surgeons and concultant. If we follow the above mentioned ways, disruptions of the surgical schedules may be avoided and a more economical management of the operationg room is possible.
Ambulatory Surgical Procedures ; Anesthesia, Conduction ; Appointments and Schedules ; Disulfiram ; Health Expenditures ; Hospitalization ; Humans ; Operating Rooms ; Prospective Studies

OBJECTIVES: Gastrectomy with lymph node dissec tion is the standard treatment for early gastric can cer(EGC). However, patients who have high risks demand modifications in surgical treatment for EGC. Recently, endoscopic mucosal resection(EMR) has become accepted in many institutions as a treatment for cancerous mucosal lesions of the stomach. Thus we investigated the efficacy and safety of EMR prospectively in the patients with EGC who have high risks in surgery and those with premalignant lesions. METHOD: Twenty-five patients were treated with EMR, thirteen were EGC and twelve were premalignant lesions such as tubular adenoma, severe dysplasia. We used standard snare method and endoscopic mucosal resection using a band ligation kits(EMRL). RESULTS: The complete resection rate at the first step of EMR was 100%(12/12) in premalignant lesions, 76.9%(10/13) in EGC. Of three EGC resected incomple tely at the first step, one patient was treated by surgery and two patients underwent the third step of EMR. The final complete resection rate was 92%(23/25) and it was 100%(12/12) in the premalignant lesions, 84.6%(11/13) in EGC. The final complete resection rate in according to the methods was 100%(5/5) by standard snare method, 75%(6/8) by EMRL. As pathologic results, all cases of EGC were limited to the mucosa. No serious complications such as perforation, major bleeding were encountered. CONCLUSION: We consider that EMR is effective and safe in treatment of the patients with EGC who have high risks in surgery and those with premalignant lesions.
Adenoma ; Gastrectomy ; Hemorrhage ; Humans ; Ligation ; Lymph Nodes ; Mucous Membrane ; Prospective Studies ; SNARE Proteins ; Stomach ; Stomach Neoplasms*

We report a patient suffering from Marie Unna's hypotrichosis. A 24-year-old man presented with a progressive hair loss. Since puberty, he had experienced a loss of hair on the scalp, eyebrow and eyelash, and the hair was coarse and twisted. On physical examination and laboratory studies, there were no associated abnormalities in the patient. The scanning electron microscopic examination of the affected hair demonstrated cuticular peeling, and twisting or angulation of hair shaft, which showed the typical clinical manifestations of Marie Unna's hypotrichosis.
Adolescent ; Eyebrows ; Hair ; Humans ; Hypotrichosis* ; Physical Examination ; Puberty ; Scalp ; Young Adult

Although spontaneous bacterial peritonitis is a frequent complication in the childhood nephrotic syndrome, it is very rare in adults with nephrotic syndrome. It frequently develops when the patients are either in relapse or receiving steroid therapy at the time peritonitis is diagnosed. We report an unusual case of a spontaneous bacterial peritonitis as the presenting feature in a 15-year-old male patient with nephrotic syndrome. He presented with diffuse abdominal pain and distension for 15 days. Abdominal paracentesis revealed the diagnostic laboratory findings of peritonitis, and the bacterial culture of the ascites showed a mixed growth of Escherichia coli and Pseudomonas aeruzinosa. His serum albu- min level was 1.6gldL and the amount of 24 hours proteinuria was 21.0g/day. Although he was treated with adequate antibiotics for 3 weeks, the peritonitis was more aggravated. We decided to insert a catheter into the peritoneal cavity for continuous drainage of the intractable ascites. Two weeks after drainage, the peritonitis improved as the peritonitis subsided, the proteinuria disappeared completely without a steroid therapy. Six months after spontaneous remission, the proteinuria have recurred, and the kidney biopsy then showed focal segmental glomerulorsclerosis.
Abdominal Pain ; Adolescent ; Adult ; Anti-Bacterial Agents ; Ascites ; Biopsy ; Catheters ; Drainage ; Escherichia coli ; Humans ; Kidney ; Male ; Nephrotic Syndrome* ; Paracentesis ; Peritoneal Cavity ; Peritonitis* ; Proteinuria ; Pseudomonas ; Recurrence ; Remission, Spontaneous

Iodinated contrast-induced acute renal failure is estimated to occur in 0.15 to 2% of all patients undergoing contrast imaging studies. Incidence is higher in patients with renal insufficiency, diabetes mellitus, dehydration, multiple myeloma, congestive heart failure, advanced age. We here report successful vascular interventional procedure by using gadopentetate dimeglumine(Gd-DTPA) as a contrast agent in a patient with chronic renal insufficiency and right superficial femoral artery stenosis. The patient had a history of iodinated contrast-induced acute renal failure. Gd-DTPA(0.17mmoVkg) diluted 1: 1 with 0.9% norrnal saline was used as contrast agent for the interventional procedure. Percutaneous transluminal angioplasty was successfully performed and there was no evidence of contrast material- induced acute renal failure after the procedure. Gd- DTPA is an alternative contrast agent for patients with chronic renal insufficiency.
Acute Kidney Injury ; Angioplasty* ; Constriction, Pathologic ; Dehydration ; Diabetes Mellitus ; Femoral Artery ; Gadolinium DTPA* ; Heart Failure ; Humans ; Incidence ; Multiple Myeloma ; Pentetic Acid ; Renal Insufficiency ; Renal Insufficiency, Chronic*

BACKGROUND: This study was performed to evaluate the effects of intercostal nerve block added in intravenous patient-controlled analgesia (IV-PCA; PCA) on pain, pulmonary function and the movement of the ipsilateral arm after a thoracotomy. METHODS: Forty five patients undergoing elective thoracotomy were randomly allocated into one of three groups. The groups were divided as follows: PCA, ICB-PCA (PCA and intercostal nerve blocks by direct injection of 5 ml of 0.2% bupivacaine into the intercostal spaces of two upper and two lower segments around the surgical incision) and IM groups. For the PCA, the patients that received PCA, were administered IV bolus of 0.1 mg/kg of nalbuphine followed by PCA with 0.1% nalbuphine (basal rate 0.5 ml/hr, bolus dose 1 mg and lockout interval 8 minutes). In each group, VAS score, the inspiratory capacity and the movement of the ipsilateral arm were checked postoperatively at 6, 24, 48 and 72 hours. RESULTS: Inspiratory capacity was decreased less in ICB-PCA group (P<0.05) at 6 hour, but after 24 hour, there were no differences between the groups. The analgesic effect was significantly better in ICB-PCA group as compared to the PCA or IM groups (P<0.05). Furthermore, arm motion limitation after operation was the least in ICB-PCA group (P<0.01). CONCLUSION: Intraoperative intercostal nerve blocks added in PCA has a transient improvement of pulmonary function, and also provide better analgesia and improved ipsilateral arm motion after a thoracotomy than in PCA or IM analgesia. The authors recommend adding intercostal nerve block for patients undergoing thoracotomy who receive IV-PCA.
Analgesia ; Analgesia, Patient-Controlled ; Arm ; Bupivacaine ; Humans ; Inspiratory Capacity* ; Intercostal Nerves* ; Nalbuphine ; Passive Cutaneous Anaphylaxis ; Thoracotomy*