This study consisted of 66 peritrochanteric fractures which were treated by the modified Gamma nail (Asian Pacific nail) from August 1993 to October 1995. Sixty-one intertrochanteric fractures and five subtrochanteric fractures were treated in our institution. Average length of follow-up was 15.0 months. Four patients died during follow-up. The results were as follows; Lag screws were ideally introduced in 55 (83%) cases. The mean length in lag screw sliding was 4.3 mm in stable trochanteric fractures and 5.7 mm in unstable ones. Fifty-one out of 62 patients (82%) were returned to their previous ambulatory status. Intraoperative complications were as follows; distal crack (3 cases); rotation of femoral head (2 cases); entry point crack (I case); medialization of proximal fragment (7 cases); and missing of the interlocking screw (1 case). All of these complications did not affect the outcome. All medial cortical gaps were closed after sliding of lag screws. Three distal cracks did not propagate to the shaft. Postoperative complications were a case of superior cut-out, and two second fractures after falls. Callus formed more early in the stable trochanteric fractures (5+/-2.1 weeks) than unstable fractures (7.3+/-2.1 weeks). It was statistically significant. Union time between stable and unstable trochanteric fractures was not statistically significant. In conclusion, the Asian Pacific (AP) nail could appropriately fix the osteoporotic peritrochanteric fractures in elderly patient. It could offer early rehabilitation to these patients and decrease the mortality and morbidity.
Aged ; Asian Continental Ancestry Group ; Bony Callus ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary* ; Head ; Hip Fractures ; Humans ; Intraoperative Complications ; Mortality ; Postoperative Complications ; Rehabilitation

PURPOSE: This study is designed to verify affecting variables to turnover intention of nurses in general hospital. METHODS: The data were from the self-reported questionnaire responses of 168 nurses in five general hospitals 300-400 beds in Seoul and Gyungi province and analyzed by frequency and percentage, t-test, ANOVA and Scheffe's test and stepwise multiple regression. RESULTS: The means of turnover intention were 3.14+/-0.87, job overload, 3.54+/-0.67, role ambiguity, 2.87+/-0.71 and burnout, 2.68+/-0.72. A significant correlation was found among turnover intention and job overload (r=.24, p<.001), role ambiguity (r=.30, p<.001), and burn out (r=.58, p<.001). The factors that affect turnover intention from the result of multiple regression by the stepwise selection, were burn out, role ambiguity. CONCLUSION: Based on the results, to reduce turnover intention of nurses, emotional support should be provided and also range of roles be clearly defined. In addition, it is needed to improve the working conditions for nurses to get a sense of accomplishment.
Burns ; Hospitals, General ; Intention ; Surveys and Questionnaires

The author observed clinical study and response of -interferon treatment of 43 cases of chronic hepatitis who were admitted to Department of Pediatrics Pusan National University College of Medicine during the period of 4 year 6 months from Jenuary, 1988 to Jun, 1992. The results were as follows: 1) Of 43 patients with chronic hepatitis, CPH was 17 cases (39.5%) and CAH was 26 cases (60.5%). 2) Of 43 patients, chronic hepatitis caused by HBV was 37 cases (86.0%) 2 cases were by Wilson's disease, 1 case was by glycogen storage disease and in the 3 cases, the cause was undetermined and CPH by HBV and CAH were 14 cases (82.4%), 23 cases (88.5%) respectively. 3) A peak frequency (46.5%) of chronic hepatitis occurred between 6 to age and male predominated in a propotion of 3.5:1. 4) On the clinical manifestation, jaundice and hepatomegaly was higher frequency on CAH than on CPH. 5) On the laboratory findings, CAH had higher serum ALT and direct bilirubin level than CPH. 6) On effect of -interferon treatment for patients of CAH, serum ALT and AST levels normalized in 81.8% of patients, negative conversion of HBeAg was 38.5%, Anti-HBe serocoversion was 7.7%, negative conversion of HBsAg was 7.7% and the clearnce of HBV-DNA from seum showed 60.0%. 7) The HBeAg seroconversion (28.6%) on children of HBsAg(+) mother showed lower reponse than HBeAg seroconversion (50.0%) of HBsAg(-) mother after -interferon treatment for patients of CAH.
Bilirubin ; Busan ; Child* ; Glycogen Storage Disease ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Hepatolenticular Degeneration ; Hepatomegaly ; Humans ; Jaundice ; Male ; Mothers ; Pediatrics

Alveolar Process ; Bone Marrow ; Equipment and Supplies ; Mandible ; Maxilla ; Skin ; Titanium ; Transplants ; Vestibuloplasty

Metabolic acidosis (MA) is associated with increased proteolysis, increased osteoclast activity and blunted cardiac muscle response, but the effect of MA on various clinic al parameters in CAPD patients is not well known. To evaluate the effects of MA on serum albumin level and other nutritional parameters in CAPD patients, we studied 106 CAPD patients retrospectively who have had monthly biochemical measurement and urea kinetic studies every 6 months for more than 2 years. The patients were divided into three groups according to their mean total CO2 (tCO2) level of the 2-year follow-up (Group l; mean tCO2 < 22mM/L, Group ll; 22mM/L < or = mean tCO2 < 26mM/L, and Group lll; mean tCO2 > or = 26mM/L), and the clinical, biochemical, and urea kinetic data were compared among the three groups. 1)The mean age of the subjects was 46.9+/-12.2 years with a sex ratio of 1.2:1, the mean CAPD duration 28.3+/-21.8 months, mean body weight (Bwt) 59.0+/-8.9kg, %Bwt/IBW 104.1+/-11.5%, %LBM/Bwt 75.5+/-11.1% and well-nourished patients by subjective global assessment (SGA) were 65%. 2)The mean BUN, creatinine, total protein and albumin of all patients were 55.6+/-13.6mg/dL, 12.3+/-3.5mg/dL, 6.6+/-0.7g/dL and 4.0+/-0.4g/dL, respectively. In urea kinetic study, the mean NPCR, weekly Kt/ Vurea, SCCr and RRF were 0.96+/-0.16g/kg/day, 2.02+/-0.37, 63.7+/-18.4L/week/1.73m2, and 0.99+/-1.32ml/ min, respectively. 3)The mean age was significantly higher in group l (51.0+/-10.8) than those of group ll (47.0+/-12.4) and lll (42.6+/-11.4) (P<0.05). %Bwt/IBW of group l (114.4+/-15.8%) was also significantly higher than those of group ll (104.6+/-12.6%) and lll (103.5+/-13.7 %) (P<0.05), but there were no significant differences in sex ratio, CAPD duration, %LBM/Bwt, and SGA among the three groups. 4)The mean tCO2 in group l, group ll, and group lll were 20.6+/-1.2mM/L, 23.9+/-1.1mM/L, and 27.3+/-0.8mM/L, respectively. Compared to group lll, group l had significantly higher BUN (61.1+/-14.3 vs. 46.1+/-7.2mg/dL, P<0.05) and serum albumin (4.04+/-0.31 vs. 3.75+/-0.39g/dL, P<0.05), in spite of comparable dialysis dose and albumin loss into dialysate. 5)NPCR (1.02+/-0.21g/kg/day vs. 0.88+/-0.14g/kg/ day, P<0.05) and ultrafiltration volume (1.4+/-0.4 vs. 1.0+/-0.3, P<0.05) were significantly higher in group l than those of group lll. But there were no significant differences in Kt/Vurea, SCCr, RRF, and 24-hour dialysate loss of protein/albumin among the three groups. 6)No differences were observed among the three groups in the changes of body weight, %Bwt/IBW, %LBM/Bwt, BUN, albumin, NPCR, and RRF from the baseline values after the 2-year follow-up. 7)There were significant inverse correlations between the mean tCO2 level and NPCR (r=-0.33, P<0.001), %Bwt/IBW (r=-0.32, P<0.001), RRF (r=-0.29, P<0.005), and serum albumin level (r=-0.24, P<0.05). But, creatinine, %LBM/Bwt, and Kt/Vurea did not show any correlation with the mean tCO2 level. 8)Using stepwise multiple regression analysis, NPCR (beta=-0.3491, P<0.001), %Bwt/IBW (beta=-0.046, P<0.001), and ultrafiltration volume (beta=-0.0012, P< 0.005) were independent factors affecting the mean tCO2 level. In conclusion, low total CO2 level in long-term CAPD patients may reflect increased protein intake and mild to moderate degree of metabolic acidosis may not affect the nutritional status of well-dialyzed CAPD patients.
Acidosis* ; Body Weight ; Creatinine ; Dialysis ; Follow-Up Studies ; Humans ; Myocardium ; Nutritional Status ; Osteoclasts ; Peritoneal Dialysis, Continuous Ambulatory* ; Proteolysis ; Retrospective Studies ; Serum Albumin* ; Sex Ratio ; Ultrafiltration ; Urea

No abstract available.
Humans ; Hypertension* ; Perindopril*

The study was undertaken to evaluate the effect of major blood components on the CT number. The CT numbers according to the various levels of hematocrit, total protein and cholesterol were checked and analysed by the dilution of pack cell, plasma and 184 complete blood cell count samples under same scanning conditions. In case of normal protein and cholesterol level(33 samples), the CT number was increased about 5.5 hounsfield unit according to 10% increase of hematocrit level: and In case of normal hematocrit and cholesterol level(39 samles), the CT number was increased about 3.5 hounsfield unit according to 1gm% increase of protein level. CT number changes were not predictable according to the changes of cholesterol level(34 samples). From these results, we concluded that major blood components should be considered in the CT number analysis of tissue.
Blood Cell Count ; Cholesterol ; Hematocrit ; Plasma Cells

BACKGROUND: This study was undertaken to evaluate the effect of plasma concentration of vitamin C is on the plasma total antioxidant status(TAS) in patients with paraquat intoxication. METHODS: As a preliminary research for this study, we measured plasma vitamin C levels, uric acid, TAS, and bilirubin from 100 healthy Koreans aged between 25-55 years. Various concentrations of vitamin C were constructed in vitro with normal pooled plasma between 1mg/dl and 100 mg/dL and TAS was measured. Both vitamin C concentrations and TAS were measured from the blood samples, taken at 0.5, 1, 2, 3, 5, 7, 9 hours after a bolus injection of vitamin C(50 mg/kg) from 7 volunteers who had been recruited from medical students at our hospital. Various amounts of vitamin C were given to 10 patients with paraquat intoxication for 5 consecutive days in the morning : first day ; 100 mg single dose, second day; 500 mg single dose, third day ; 1,000 mg single dose, fourth day : 3,000 mg single dose, and fifth day ; 3,000 mg three times every 8 hours. RESULTS: The mean value of TAS and vitamin C measured in 100 healthy Korean adults was 2.22 +/-0.16 mmol/L and 0.48+/-0.10 mg/dL. Age and sex do not influence these levels(p> 0.05, data are not presented). A direct correlation was observed between TAS and vitamin C concentrations of 1 mg/dL and 100 mg/dL both in vivo and vitro. As the vitamin C concentration was increased gradually 5 consecutive days, the TAS values increased in the same way as follows : first day(vitamin C 100 mg) 2.26+/-0.98 mmol/L, second day(vitamin C 500 mg) 2.76+/-0.78 mmol/L, third day(vitamin C 1.000 mg) 2.81+/-0.68 mmol/L, fourth day(vitamin C 3.000 mg) 3.18 mmol/L. On the fifth day when 3.000 mg of vitamin C was given by bolus intravenous injection 3 times(every 8 hours for a day), the TAS values measured one hour after the injection was 3.58+/-0.37 mmol/L. CONCLUSION: When vitamin C is used as a free radical scavenger, the loading dose and maintenance dose should be around 2278 mg intravenous bolus and 146 mg/hour. High doses of vitamin C are effective and safe for patients with acute paraquat intoxication.
Adult ; Ascorbic Acid* ; Bilirubin ; Free Radical Scavengers ; Humans ; Injections, Intravenous ; Paraquat* ; Plasma* ; Pulmonary Fibrosis ; Students, Medical ; Uric Acid ; Vitamins* ; Volunteers

No abstract available.
Humans

PURPOSE: We intended to decrease late CNS reaction after radical radiotherapy for an intracranial germinoma by using combined neoadjuvant chemotherapy and involved-field radiotherapy. The efficacy in terms of its acute toxicity and short-term relapse patterns was analyzed. MATERIALS AND METHODS: Eighteen patients were treated with combined neoadjuvant chemotherapy and radiotherapy between 1995 and 2001. The chemotherapy regimen used was the Children's Cancer Group (CCG) 9921A (cisplatin, cyclophosphamide, VP-16, vincristine) for 5 patients younger than 16 years, BEP (bleomycin, VP-16, cisplatin) for 12 patients, and EP (VP-16, cisplatin) for 1 patient. The radiotherapy covered the whole craniospinal axis for 5 patients, the whole brain for 1, and the partial brain (involved field) for 12. the primary lesion received tumour doses between 3,960 and 5,400 cGy. RESULTS: The male to female ratio was 16:2 and the median age was 16 years old. The tumors were located in the pineal gland in 12 patients, in the suprasellar region in 1, in the basal ganglia in 1, in the thalamus in 1. Three patients had multiple lesions and ventricular seedings were shown at MRI. In 3 patients, tumor cells were detected in the cerebrospinal fluid and MRI detected a spinal seeding in 2 patients. The response to neoadjuvant chemotherapy was complete remission in 5 patients, partial remission in 12, and no response in 1. However, after radiotherapy, all except 1 patient experienced complete remission. The toxicity during or after chemotherapy greater than or equal to grade III was remarkable; hematologic toxicity was observed in 11 patients, liver toxicity in none, kidney toxicity in none, and gastrointestinal toxicity in one. One patient suffered from bleomycin-induced pneumonitis. Radiotherapy was therefore stopped and the patient eventually died of respiratory failure. The other 17 are alive without any evidence of disease or relapse during an average of 20 months follow-up. CONCLUSION: A high response rate and disease control was experienced, which was the same as observed other studies and the morbidity from chemotherapy-induced toxicity was similar. With these results, the results from adjuvant chemotherapy and involved-field radiotherapy cannot be concluded to be equal to those from extended-field radiotherapy. The long term follow-up study on later complications are required in order to draw definite conclusions on the optimal management with minimum side effects.
Adolescent ; Axis, Cervical Vertebra ; Basal Ganglia ; Brain ; Cerebrospinal Fluid ; Chemotherapy, Adjuvant ; Cyclophosphamide ; Drug Therapy* ; Etoposide ; Female ; Follow-Up Studies ; Germinoma* ; Humans ; Kidney ; Liver ; Magnetic Resonance Imaging ; Male ; Pineal Gland ; Pneumonia ; Radiotherapy* ; Recurrence ; Respiratory Insufficiency ; Thalamus