Upper gastrointestinal(UGI) bleeding was critical disease that was commonly found in emergency department and needed more early diagnosis and rapid treatment for decreasing mortality and morbidity. It's causes and frequencies here affected by many factors, but the majorities were caused by peptic ulcers and esophageal-gastric varices. With development of economy and medical services, new drugs and endoscopic interventions, the treatment of patients with UGI bleeding was more improved. So I would like to evaluate the change of causes and frequencies of UGI bleeding and the associated clinical findings. A total of 1,546 patients presented with UGI bleeding in emergency department of Yeungnam university hospital during the five years from Jan. 1991 to Dec. 1995 were clinically reviewed by charts and compared with previous seven years report from Jan. 1984 to Dec. 1990 in the same hospital. The ratio of male to female was 6.1:1 and slightly increased in comparison with previous seven years. The incidences in 6th and 5th decades were highest(54.4%) as like as previous seven years. Age distribution of duodenal ulcer bleeding, Mallory-Weiss tear and acute gastric mucosal lesion were developed in lower decades than the others. The causes of UGI bleeding were caused by esophageal varix(45.4%), peptic ulcer(38.8%), Mallory-Weiss tear(4.3%), gastric cancer(3.8%), others(3.1%), acute gastric mucosal lesion(2.7%), undetermined causes(1.8%) in defending order of frequencies. The proportion of esophageal varices was increased from 36.6% to 45.4%, but that of peptic ulcer was relatively decreased from 47.6% to 38.8%. And the annual distribution of varices was increased, however the annual distribution of peptic ulcers was increased. Although the ranking of annual distribution of gastric ulcers and duodenal ulcers were not changed compared to previous study and the frequency of gastric ulcers was increased since 1992, but additional follow-up was needed. Seasonal variations were found that upper gastrointestinal bleeding was increased in fall and peptic ulcer bleeding was increased significantly in summer and fall, however, varix bleeding was less frequent in summer time as like as previous seven years. Emergency endoscopic examination was performed within 6 hours far 54.5%, 24 hours for 90.8% and this reacts were to be like previous results, 57.5% and 90.7% respectively. Findings of emergency endoscopic examination were active bleeding focus(21.2%), blood clot(7.9%), exposed vessels(13.3%), flat blood spot(6.4%) and lesion without evidence of bleeding(51.3%). Endoscopic findings of active bleeding were easily seton when examination was perfomed within 24 hours. Blood transfusion was performed in 67.3% with average 2.1 units. When the causes of bleeding were due to varix and marginal ulcer, more amounts of blood were transfused than the others. In previous seven years, blood transfusions were performed in 71.2% with average 5 units and more amounts of blood were transfused in gastric cancer and varix bleeding.
Age Distribution ; Blood Transfusion ; Duodenal Ulcer ; Early Diagnosis ; Emergencies ; Emergency Service, Hospital ; Esophageal and Gastric Varices ; Female ; Follow-Up Studies ; Hemorrhage* ; Humans ; Incidence ; Male ; Mallory-Weiss Syndrome ; Mortality ; Peptic Ulcer ; Seasons ; Stomach Neoplasms ; Stomach Ulcer ; Varicose Veins

Diastasis of the ankle joint was associated with extensive ligamentous rupture and resulted from external rotation or abduction injuries at the ankle. It might occur without associated fracture but was more frequently seen in cases of bimalleolar fracture in which there was fracture of the medial malleolus or rupture of the deltoid ligament with fracture of the lower third of the fibula. Thirty patients of diastasis of the ankle joint were admitted and treated by internal fixation with screw and bolt from January 1978 to December 1981. The following results were obtained: 1. The main cause of the injuries was falling from a height and the other causes were slipping down and sports injury in order. 2. The most common type by Lauge-Hansen classification was supination-external rotation type (20 cases, 67%). 3. Partial diastasis of the ankle joint or anterior type was 14 cases (47%) and complete diastasis or total type was 16 cases (53%). 4. In all cases, mixed oblique fibular fracture and medial instability were seen. 5. The good results were achieved in 24 patients (80%).
Accidental Falls ; Ankle Fractures ; Ankle Joint ; Ankle ; Athletic Injuries ; Classification ; Clinical Study ; Fibula ; Humans ; Ligaments ; Rupture

No abstract available.
Mucocutaneous Lymph Node Syndrome*

Cardiovascular respons follwing ethanol ingeation was conapared in two groups of male college studenta; 20 who ahowed visble facial flushing and 25 whe showed on flushing. Ethanol was administered as 25% Korean liquor (Kumbokju) a dose of 2ml per kg body weight, the heart rate, blood pressure and respiratory rate were measured. The reaults areas follows. The heart rate after ethanol ingestion increased significantly in both flushing and non-flushing groups. However, the degree of the heart rate increased in the flushing group was aignificantly higher than that in the non-flushing group. The blood pressure was decreased significantly from 40minutes after ethanol ingestion in both groups. Howyer, the flushing group showed higher systolic pressure, and lower diastalic pressure and mean arterial pressure than the non-flushing group. The reapiratory rate following ethanol administration was increased in the flushing group but decreased in the non-flishing group when compared with the resting respiratory rate. The results clearly indicate that a signifcant difference in cardiovascular resoponrses to ethanol exists the flushing and non-flushing groups. The flushing group shows a greater tachycardia and greater fall in. mean arterial pressure followig ethanol ingestion than the non-flushing group.
Male ; Humans

To elucidate the funcion of arachidonic acid as a secondary brain edema facotr, the infusion edema model was constucted using adult cats with studies of somatosensory evoked potentials, regional cerebral blood flow of white matters, brain water contents, magentic resonance images and histological findings. Among 50 cats, 6 cats were used as sham poerated group without infustion and in 45 cats solutions of various concentrations of arachidonic acid and physiologic saline were infused into the left and right frontal white maters respectively. According to the different concentrations of arachidonic acid, three groups were named as group A(0.1mg/ml), group B(1mg/ml), group C(10mg/ml). During 4 hours of slow infusion of the infusates(average 0.5ml in each side totally) central conduction time(CCT) was measured every an hour with contralateral median nerve stimulation bilaterally and cerebral blood flow(CBF) of white matter was measured by hydrogen clearance method every 2 hours. Finally the cats were sacrificed and specimens of edematous white matter obtained bilaterally at the coresponding points. Water contents were measured with vacuum freeze drying method. T2-weighted magnectic resonance images(MRI) and light microscopic studies were performed in a cat of each groups. The results were as followed ; 1) MRI and histologic findings showed that the infusion brain edema technique was efective in inducing interstitial edema, but the differences in the degree of edema formation between the right and the left sides were not siginificant in all groups. 2) There were no statistically significant difference between the water contents of the right and that of left in all groups. 3) Either infusion of arachidonic acid or physiologic saline in the white matter did not change regional white matter CBF in all groups. 4) The I-N1 interpeak latency was labelled as central conduction time(CT), and the baseline CCT was 5.83+/-0.52msec. 5) The differences of CCT between infusion group and noninfusion group were statistically significant in group C at 2, 3, 4hours(p>0.01) and the differerences of cct between arachidonic acid and physiologic saline infustion sites were statistically significant in group B at 4 hors, group C at 1 hour(p>0.05) and group C at 2, 3, 4hours(p>0.01) after eginning of infusion and the differences increased with time in group C(p>0.01). The results indicate that arachidonic acid does not have edemogenic properties during 4 hours infusion but may induce neurologic dysfunction as to increase the CCT in somatosensory evoked potential studies if it exists in the edema fluid of brain white matter.
Adult ; Animals ; Arachidonic Acid* ; Brain Edema ; Brain* ; Cats ; Edema ; Evoked Potentials, Somatosensory* ; Freeze Drying ; Humans ; Hydrogen ; Magnetic Resonance Imaging ; Median Nerve ; Neurologic Manifestations ; Vacuum

OBJECTIVES: The aim of this study is to determine the risk factors related to musculoskeletal disorders in shipyard workers. METHODS: A questionnaire survey was performed on 2,140 shipyard workers in a shipyard in Ulsan city. The questionnaire consisted of questions on the general characteristics, the health behavior, work type and duration, physical burden, job control, type of instruments used, posture, and musculoskeletal symptoms. Definition of musculoskeletal disorders was based on either NIOSH criteria and Kim's criteria. RESULTS: Positive rate of musculoskeletal disorders in any one part of the body was 77.2% by NIOSH criteria and 60.7% by Kim's criteria. Positive rate of the symptoms increased in workers with longer work hours, with a severe physical burden, and without any control over their job. Work with a more frequent unstable posture and for longer hours was also associated with increased musculoskeletal symptoms. Multiple logistic regression analysis showed that unstable posture and physical burden is closely related to the positive rate of musculoskeletal symptoms after controlling for age, smoking, drinking, exercise, duration of work, and job control; showing a good dose-response relationship. CONCLUSION: Inadequate posture and physical burden were the most significant factors affecting musculoskeletal disorders in shipyard workers in this study. Therefore, it will be necessary to make efforts to reduce the prevalence of musculoskeletal disorders related to a specific job, instrument, physical burden, and posture. Workers should be educated on the types and prevalence of musculoskeletal disorders, how to improve the ergonomic occupational environment and to set up preventive measures against the risk factors during work.
Cumulative Trauma Disorders ; Drinking ; Health Behavior ; Logistic Models ; National Institute for Occupational Safety and Health (U.S.) ; Posture ; Prevalence ; Questionnaires ; Risk Factors* ; Smoke ; Smoking ; Ulsan

OBJECTIVES: This study was conducted to develop a model describing the interaction between lifestyle, job, and postural factors and parts of the upper extremities in shipyard workers. METHODS: A questionnaire survey was given to 2,140 workers at a shipyard in Ulsan City. The questionnaire consisted of questions regarding the subjects' general characteristics, lifestyle, tenure, physical burden, job control, posture and musculoskeletal symptoms. The overall relationship between variables was analyzed by a structural equation model (SEM). RESULTS: The positive rate of upper extremity musculoskeletal symptoms increased in employees who worked longer hours, had severe physical burden, and did not have any control over their job. Work with a more frequent unstable posture and for longer hours was also associated with an increased positive rate of musculoskeletal symptoms. Multiple logistic regression analysis showed that unstable posture and physical burden were closely related to the positive rate of musculoskeletal symptoms after controlling for age, smoking, drinking, exercise, tenure, and job control. In SEM analysis, work-related musculoskeletal disease was influenced directly and indirectly by physical and job stress factors, lifestyle, age, and tenure (p < 0.05). The strongest correlations were found between physical factors and work-related musculoskeletal disease. CONCLUSION: The model in this study provides a better approximation of the complexity of the actual relationship between risk factors and work-related musculoskeletal disorders. Among the variables evaluated in this study, physical factors (work posture) had the strongest association with musculoskeletal disorders.
Drinking ; Humans ; Life Style ; Logistic Models ; Male ; Musculoskeletal Diseases ; Posture ; Surveys and Questionnaires ; Risk Factors ; Smoke ; Smoking ; Upper Extremity

Wilms' tumor is the most common intra-abdominal malignant tumor of childhood. There has been a progressive improvement in the over all survival rate of children with Wilms' tumor since the introduction of radiotherapy and nephrectomy. Survival has continued to improve with the addition of chemotherapy, initially actinomycin D, and later vincristine. This paper reviewed 34 patients with Wilms' tumor seen between 1965 and 1979 with special references to the significant factors in diagnosis as well as the influence of age, stage of disease and treatment on the prognosis. The usefulness of three modalities of treatment was discussed. A cure rate of 64.9% in the intensive multimodaliy treatment group was calculated by the Life Table Method.
Child ; Dactinomycin ; Diagnosis ; Drug Therapy ; Humans ; Life Tables ; Nephrectomy ; Prognosis ; Radiotherapy ; Survival Rate ; Vincristine ; Wilms Tumor*

Percutaneous catheter drainage of pancreatic pseudocyst is an effective and safe method of treatment. Various approaches to the pseudocyst have been used. We experienced one case of successful treatment of pancreatic pseudocyst with percutaneous catheter drainage through the kidney without complication.
Catheters* ; Drainage* ; Kidney* ; Pancreatic Pseudocyst*

BACKGROUND: Irbersatan, an orally active antihypertensive agent, effectively reduce blood pressure by directly blocking angiotensin II receptors without any significant adverse effects. The purpose of this study is to evaluate the efficacy and safety of irbesartan in patients with mild to moderate hypertension. METHODS: This study enrolled 83 patients who had diastolic pressure above 95 mmHg and below 110 mmHg on two measurements. Sixty eight patients were administered 150mg of irbesartan, an angiotensin II receptor blocker, daily for four weeks as an initial dosage. If the sitting diastolic pressure was equal to or greater than 90 mmHg after a 4 week treatment period, the dosage was doubled until the end of 8 weeks. Baseline pressures, antihypertensive effect, side effects, laboratory findings were compared before and after treatment. RESULTS: Fourty two patients out of 53 patients having completed this study showed decreased blood pressure equal to or more than 5 mmHg of the sitting diastolic pressure (response rate=79%). Twenty one patients out of 53 patients showed normalized blood pressure below 90 mmHg of the sitting diastolic pressure (normalization rate=40%). The extent of decrease in diastolic and systolic blood pressure after eight week treatment was an average 11.7+/-10.1 mmHg and 16.3+/-18.9 mmHg, respectively (p<0.05). Nineteen ontoward side effects was observed in 17 patients out of 68 patients with medication (frequency of ontoward effects=25%). Only one case with headache was considered to be related to the medication. Abnormal laboratory findings were observed in eight patients, and only one case with elevation of bilirubin and ALT levels was considered to be related to the medication. CONCLUSION: In conclusion, irbesartan is a safe and effective antihypertensive drug in patients with mild to moderate hypertension with tolerable side effects.
Bilirubin ; Blood Pressure ; Headache ; Humans ; Hypertension* ; Receptors, Angiotensin