OBJECTIVES: Over the last 30 years, despite the increasing sophistication in medical care, the mortality of acute renal failure(ARF) has remained virtually unchanged at 40-50%, but the reasons remain unknown. This study intend to identify prognostic risk factors influencing survival and predict the mortality in ARF patients. METHODS: We retrospectively analyzed 152 patients with ARF who required renal replacement therapy, or whose serum creatinine level above 5 mg/dl, from Jan. 1988 to May. 1995. Multiple factors which may influence mortality were evaluated by univariate and multivariate analysis. RESULTS: 1) Of the 152 patients, 97 were male and 55 were female. The mean age was 47 years and the overall mortality was 36.8%. 2) Based on the univariate analysis, age>60 years, cause of ARF, APACHE II score, number of failing organs, peak serum creatinine level, PaO2, coma, hypotension, ARDS, GI bleeding, ventilatory support, need for antiarrhythmics, DIC, cardiovascular failure, pulmonary failure, neurological failure, and gastrointestinal failure were all significant factors discriminating between survivors and nonsurvivors(p<0.05) 3) By multivariate analysis, hypotension, coma, ventilatory support, and age over 60 years were significant independent predictors influencing survival in ARF patients and logistic equation and logit score were as follows : z=-2.04+1.32(age over 60)+2.18(hypotension)+2.88 (ventilatory support) + 3.28(coma) P=ez/(1+ ez) 4) In ROC(receiver-operating characteristic)curve, when the cutoff point was 0.2, maximum sensitivity was 75% and maximum specificity was 82%. CONCLUSION: In ARF, prognostic risk factors for mortality were age over 60 years, hypotension, assisted ventilation and coma. The logit score by multiple analysis is a reliable predictor of mortality in ARF patients, however the further studies are required to confirm these results.
Acute Kidney Injury* ; APACHE ; Coma ; Creatinine ; Dacarbazine ; Female ; Hemorrhage ; Humans ; Hypotension ; Male ; Mortality* ; Multivariate Analysis ; Renal Replacement Therapy ; Retrospective Studies ; Risk Factors* ; Sensitivity and Specificity ; Survivors ; Ventilation

BACKGROUND: The aim of this study is to evaluate the therapeutic effect of splenectomy in children with chronic idiopathic thrombocytopenic purpura(ITP) who do not respond to corticosteroids and intravenous immunoglobulin(IVIG). METHODS: Fifteen patients(7 boys and 8 girls) who were admitted to St. Mary's Hospital under the diagnosis of ITP from December 1990 to February 1997 were enrolled In this study. All had chronic forms(more than 6 months after diagnosis) and were refractory to corticosteroids(prednisolone 1~2mg/kg) and IVIG(400mg/kg for 5 days or 1 g/kg for 2 days). We you-finely employ pneumococcal vaccine in 13 patients before splenectomy slnce 1992. Antiplatelet antibody was examed in 10 patients. We measured platelet count at preoperative time, postoperative 1 day, 1 month, and 3 months or more. Hematologic results were analyzed according to Berchtold and McMillan's criteria (1) complete response(CR) >120 x 10(9)/l; (2) partial response(PR) >50 x 10(9)/l (3) no response(NR) < 50 x 10(9)/l. RESULTS: The median age at operation was 10 yr(6~16). The median time interval between diagnosis and splenectomy was 2 yr 2 mo(6 mo~5 yr 5 mo). Antiplatelet antibody was positive in 2 cases of 10 cases(20%). Of 15 cases, 12 cases were corticosteroid resistant and 3 cases were corticosteroid dependent. The postsplenectomy platelet count(median 407 x 10(9)/l of 1 day; 254 x 10(9)/l of 1 month; 227 x 10(9)/l of 3 months or more) was significantly higher than presplenectomy platelet count(median 9 x 10(9)/l)(P<0.05). All patients showed complete or parial response throughout the follow up period. Accessory spleen was found in 1 case and removed during operation. There were no serious complications following splenectomy except mild fever in 2 cases(14%). CONCLUSION: Splenectomy appears to be an effective and relatively safe treatment for patients with chronic ITP who have had inadequate response to conventional therapies.
Adrenal Cortex Hormones ; Blood Platelets ; Child ; Diagnosis ; Fever ; Follow-Up Studies ; Humans ; Platelet Count ; Purpura, Thrombocytopenic* ; Spleen ; Splenectomy*

No abstract available.
Humerus*

In the orthopedic Department of Jeonbug National University Hospital, twenty-five open tibial shaft fractures were reviewed and analyzed with osteomedullography and bone scanning with radioactive isotopes from June 1981 to October 1983. The results are as follows. 1. The cases of injury were mostly traffic accident(70.8%) and majority was found between second decade and third decade. Males were 11 times more frequent than females. 2. In the shape and location of fractures, comminuted fracture(60%) was most common, and fracture of middle one third(48%), lower one third(28%) were in order. 3. In the open tibial fractures, Grade I. of soft tissue injury was most frequent(64%). As inthe plate fixation was required, we should it placed atypically on the posterior surface of the tibia. 4. In the osteomedullography at 3 months after treatment, the rate of positive finding was 80 and intraosseous crossing vein(Kaski sign 1) was observed most frequently. 5. In the profile of the bone scanning with radioactive isotopes, the rate of single-peak uptake was 76% and twin-peak uptake was 24%. 6. In the negative Osteomedullogram and twin-peak uptake on the profile of the bone scanning, bone graft was necessary. 7. In the case of difficult diagnosis for union process of tibia fracture, osteomedullography and bone scanning with radioactive isotopes were considered useful method of early diagnosis.
Diagnosis ; Early Diagnosis ; Female ; Fractures, Comminuted ; Fractures, Open ; Humans ; Jeollabuk-do ; Male ; Methods ; Orthopedics ; Radioisotopes ; Soft Tissue Injuries ; Tibia ; Tibial Fractures ; Transplants

No abstract available.
Lymphadenitis*

No abstract available.
Dinoprostone* ; Membranes* ; Rupture* ; Suppositories*

Gastritis cystica polyposa (GCP) is a lesion characterized by all the histological features described for hyperplastic polyps, And there is s marked proliferation of muscular elements and entrapment of numerous epithelial cysts. These lesions have been described at gastroenterostomy stomas, at peptic ulcer edges, and in association with carcinoma. It is rare that GCP presenting as a submucosal tumar-like lesion develops in the absence of above mentioned associated conditions. We had experienced a 69 year-old man with GCP. Barium X-ray and endoacopic findings showed submucosal tumor in antrum, and endoscopic ultrasonograpic findings showed markedly thickened mucosal layer with scattered hypoechoeic areas and the submucosal layer well preserved. GCP was confirmed by histological examination of resected stomach.
Aged ; Barium ; Gastritis* ; Gastroenterostomy ; Humans ; Peptic Ulcer ; Polyps ; Stomach

No abstract available.
Female ; Fetal Heart* ; Hearing* ; Heart Rate, Fetal* ; Pregnancy ; Pregnancy*

Osteochondromas are common and typically arise from the metaphyseal ends of long bones. An osteochondral neoplasm of the soft tissue, which is a lesion of uncertain pathogenesis, is uncommon and usually arises from the synovial tissue in joints and tendon sheaths. Rarely, extraskeletal osteochondromas also arise outside of synovial compartments. Most of the reported cases were presented in the hands and feet, especially in the fingers. Here we describe a 44-yr-old female patient who presented with a pain in the left buttock. A well-defined osseous mass was detected in the buttock. It consisted of sharply demarcated, mature hyaline cartilage that was covered with a fibrous capsule, which changed gradually into cancellous bone, more pronouncedly at the center. The diagnosis of an extraskeletal osteochondroma should be considered when a discrete, ossified mass is localized in the soft tissues. A case of pathologically proven extraskeletal osteochondroma of the buttock is presented with a literature review, magnetic resonance imaging, and radiological findings.
Accidental Falls ; Adult ; Buttocks* ; Diagnosis, Differential ; Female ; Human ; Myositis Ossificans/diagnosis ; Osteochondroma/complications ; Osteochondroma/diagnosis* ; Osteochondroma/radiography ; Osteochondroma/surgery ; Pain/etiology ; Sarcoma/diagnosis ; Soft Tissue Neoplasms/complications ; Soft Tissue Neoplasms/diagnosis* ; Soft Tissue Neoplasms/radiography ; Soft Tissue Neoplasms/surgery

PURPOSE: The purpose of this study was to identify the effects of a BeHaS exercise program on pain, health status, body weight in middle-aged women who have osteoarthritis in their knees. METHOD: The participants in this study were eighteen women whose mean age was 56.22years and who had osteoarthritis in the knees. The BeHaS exercise program consists of approximately one and half hour of exercise, two days per week, for twelve weeks. Data were gathered from September 2005 to December 2005 using a questionnaire and measuring VAS for pain, KWOMAC for health status, body weight for scale. Data were analyzed with the SPSS Win 11.0 using frequency and paired t-test for differences between pre-exercise and post-exercise. RESULTS: The results of this study are as follows: Scores for pain on post test were statistically lower than pre test(t=4.202, p=0.001), health status was statistically improved after exercise program (t=3.479, p=0.002). But body weight did not change(t=-.774, p=0.222). CONCLUSION: From these results, it is concluded that the BeHaS exercise program can be effective in decreasing pain and increasing health status in middle-aged women with knee osteoarthritis.
Body Weight ; Female ; Humans ; Knee* ; Middle Aged* ; Osteoarthritis* ; Osteoarthritis, Knee ; Surveys and Questionnaires