Evaluation of several antihypertensive regimens involving reserpine, hydrochlorothiazide (Esidrex(R)) and clonidine (Catapres(R)) was conducted on 230 subjects with mild to severe hypertension. Chlordiaxepoxide (Librium(R)) which is a sedative was also administered to observe the effect in patients with mild labile hypertension. The results obtained were as follows; 1. All five regimens of chlordiazepoxide, reserpine, hydrochlorothiazide, hydrochlorothiazide plus reserpine and hydrochlorothiazide plus clonidine produced a significant decrease in average mean arterial pressure (systolic+diastolicc pressure/2) compared to control values (p<0.01). 2. Hydrochlorothiazide plus clonidine was the most effective pressure lowering regimen, resulting in an average fall of 39.3 mmHg in average mean arterial pressure and obtaining excellent result in 28.6% of the cases. 3. The order in the pressure lowering effect was hydrochlorothiazide plus clonidine, hydrochlorothiazide plus reserpine, hydrochlorothiazide, reserpine, and chlordiazide 4. There was no significant difference between hydrochlorothiazide plus clonidine and hydrochlorothiazide plus reserpine (p>0.1). 5. More reduction in diastolic pressure than systolic was observed with hydrochlorothiazide plus clonidine. 6. The results of hydrochlorothiazide alone, hydrochlorothiazide-reserpine and hydrochlorothaizide-clonidine were better than those of chlordiazepoxide and reserpine alone in patients with fundoscopic findings of Keith-Wagener Grade II. 7. There was difference in pressure lowering effect with hydrochlorothiazide plus clonidine between the group with and without albuminuria. 8. Hydrochlorothiazide plus clonidine were extremely effective in patients with severe hypertension, hydrochlorothiazide plus reserpine in patients with moderately severe hypertension, and reserpine and hydrochlorothiazide alone in patients with mild hypertension.
Albuminuria ; Antihypertensive Agents* ; Arterial Pressure ; Blood Pressure ; Chlordiazepoxide ; Clonidine ; Humans ; Hydrochlorothiazide ; Hypertension ; Reserpine

No abstract available.
Breast Neoplasms* ; Breast* ; Drug Therapy*

Acute digitalization with ouabain were performed 28 times in 20 intact Mongrel dogs, who were devided into four groups : i.e. 1) Control group; Acute digitalizations were performed to observe the changes of the plasma potassium and sodium concentrations and the concomittent electrocardiographic findings. 2) Group 1;-Electrolyte solution, either KCl or NaCl, was infused during acute digitalization to observe the influences of these ions on the actions of cardiac glycoside, especially arrhythmia producing action. 3) Group 2 ; -The K depleted group and the Na depleted group was each made by the measure of diet control and the usage of oral diuretics to observe the influences of the state of depleted electrolyte (K or Na) on the action of cardiac glycoside during acute digitalization. 4) Group 3 ; -The intravenous infusion of either KCl or NaCl solution was introduced as the cardiac arrhythmia by the ouabain was produced to observe the effects of these ions on the digitalis induced arrhythmia. The results obtained were summarized as follows. (1) The arterial plasma concentration of potassium was increased during acute digitalization. The rise occurred at early stage, and the maximal increase of potassium was observed at the ventricular tachycardia. The average increase was 0.65 mEq/L as compared to control value (p<0.05). The arterial plasma concentration of sodium was reduced during acute digitalization. The fall occurred following the rise of plasma K level. The maximal reduction of sodium was observed after ventricular tachycardia, and the average decrease was 5.2 mEq/L as compared to control value (p<0.05). (2) Rapid increase up to toxic level of the plasma potassium concentration occurred occasionally during acute digitalization in the group with KCl infusion. This result was best explained due to the inhibitory action of cardiac glycoside on the K transport. (3) The interesting change was on T wave, which showed the peaking at late portion. This change occured in 60.6% during digitalization with ouabain, and paralleled mostly, but not consistently and even sometimes inversely, with the shift of plasma potassium concentration. It is tempting to assume that the change of T wave was resulted from an altered potassium gradient across the myocardial cells rather than a ssuming the changes of the plasma K level. (4) Just prior to intoxication, the marked prolongation of PR interval and ST depression were observed in about 70~80% of the cases studied. These changes might be applicable to a clue of the cardiac glycoside overdosage. (5) The intravenous infusion of KCl suppressed markedly the arrhythmia producing action of the cardiac glycoside, and resulted in prompt and dramatic abolishing, of digitalis induced arrhythmia. The intravenous infusion of KCl solution, however, produced A-V block or dissociation occasionally. This finding would be likely resulted from the additive or synergistic action of K and cardiac glycoside in suppressing A-V conducting system. (6) The NaCl infusion affected nothing to the arrhythmia producing action of cardiac glycoside. (7) The K depletion reduced markedly the threshold of the heart to the toxic effects of cardiac glycoside. (8) Potent diuretics in the state of deficient diet would produce clinically significant hypopotassemia and hyponatremia or both. The inducced hypopotassemia may provoke serious cardiac arrhythmia in the digitalized patients or animals.
Animals ; Arrhythmias, Cardiac ; Depression ; Diet ; Digitalis ; Diuretics ; Dogs ; Electrocardiography ; Electrolytes* ; Heart ; Humans ; Hypokalemia ; Hyponatremia ; Infusions, Intravenous ; Ions ; Ouabain ; Plasma ; Potassium ; Sodium ; Tachycardia, Ventricular

BACKGROUND: The purpose of this clinical study was to evaluate the Incentive Spirometry (IS) and Deep Breathing Exercises (DBE) to prevent postoperative pulmonary complications after abdominal surgery in patients over 60 years of age. METHODS: We prospectively randomized 90 patients into 1 of 3 groups: the control group (30 patients) received no respiratory treatment, the IS group (30 patients) was treated with incentive spirometry 4 times daily and DBE group (30 patients) carried out deep breathing exercises under supervision for 15 min 4 times daily. ABGA was taken at ward, PR (preop.room), RR (recovery room), POD1 day and POD2 day. Roentgenographic changes observed at 24 h. and 48 h. after surgery. Pulmonary complications were defined as the development of 3 or more of 6 new findings: cough, sputum, dyspnea, chest discomfort, temperature greater than 38oC, pulse rate more than 100 beats/min. RESULTS: PaO2 in the DBE group and IS group at PR were significantly increased than the values at ward, and the values of the PaO2 in the DBE group at RR and POD1 day, and those of IS group at PR and POD2 day were significant higher than those of the control group (p<0.05). The frequency of development of pulmonary complications (43.3% in the control group, 20% in the DBE group, 20% in the IS group) and roentgenographic changes were comparable in the 3 groups (26.7%, 16.7%, 20% respectively). The DBE group showed the different incidence of postoperative pulmonary complications between upper and lower abdominal surgery (upper: lower= 35.7: 6.3%). CONCLUSIONS: We concluded that DBE and IS were effective in preventing postoperative pulmonary complications after abdominal surgery and lower abdominal surgery causes lesser postoperative pulmonary complications than upper abdominal surgery.
Breathing Exercises ; Cough ; Dyspnea ; Heart Rate ; Humans ; Incidence ; Motivation* ; Organization and Administration ; Prospective Studies ; Respiration* ; Spirometry* ; Sputum ; Thorax

In the fractures and dislocations of the carpus, prompt and accurate diagnosis is the prime prerequisite for restoring function to this most complicated joint in the body. And then, early precise reduction and continuous maintenance of the reduced position until ligamentous and bone healing is complete provide the best chance of achieving a satisfactory restoration of function. We analysed forty five cases of fractures and dislocations of the carpus which were treated for 5 years from Jan. 1984 to Dec. 1988 at the Department of Orthopedic Surgery, College of Medicine, Hallym University. The following results were obtained; l. Of the total 45 injuries, scaphoid fractures were seen in 32(71.1%), other carpal bone fractures except scaphoid in 13 patients(28.9%), and carpal bone dislocation and fracture- dislocations in 11 patients(24.4%). 2. Carpal scaphoid fracture 1) 19 of the 32 patients(59.4%) had an associated ipsilateral upper extremity injury. 2) This fracture was common in the young male. 3) A union rate(95.6%) was achieved using a usual conservative treatment for undisplaced racture(14), operative treatment for displaced(18). 4) The mean time to radiological union for all fractures was 11.1 weeks. Old fracture by SotoHall classification took the longest time to union(18.2 weeks), subacute fracture 13 weeks, and acute fracture 9 weeks. 5) 10 cases were treated for nonunion, 5 of 10 nonunions were classified as type (50%). 2 cases showed ultimately nonunion in spite of various sorts of treatment, which belonged to waist fracture. 3. Other carpal bone fractures except scaphoid were seen in 13(15 bones) of 45 injuries, and pisiform(4) and triquetrum(4) fractures were common. 4. Carpal dislocation and fracture-dislocations were seen in 11 of the 45 injuries and dorsal transscaphoid perilunate dislocations(4) were common. These were treated by C.R. and cast immobilization or O.R. and K-wire fixation relatively good results were obtained.
Carpal Bones ; Classification ; Clinical Study ; Diagnosis ; Dislocations ; Humans ; Immobilization ; Joints ; Ligaments ; Male ; Orthopedics ; Upper Extremity

No abstract available.
Arthroplasty* ; Bone Resorption* ; Hip* ; Thigh*

No abstract available.
Arthroplasty, Replacement, Hip* ; Venous Thromboembolism*

Although several histopathological changes have been developed in frozen shoulder, frozen shoulder is mostly accompanied by the changes of the rotator cuff which has the most important function in movement and has a role in stabilizing the shoulder joint. The changes of the rotator cuff in frozen shoulder have not been reported in Korea yet, but Simon reported that there was an attenuation of the rotator cuff in frozn shoulder. Accordingly, we observed the changes of the rotator cuff in frozen shoulder by ultrasonography, which has no rsdiation exposure and is non-invasive. The authors practiced the shoulder ultrasonography on 36 patients with a pain and limitation of motion in shoulder at the Dept. of Orthopedic Surgery, Hangang Sacred Heart Hospital, Hallym University, from March in 1988 to August in 1988. The results are as follows ;1) Ultrasonography is thought to contribute a great deal in detection of the changes of the rotator cuff, especially of the thickness of the rotstor cuff. 2) Among 36 patients, the thickness of the rotator cuff of 35 patients was 6.494+1.008 mm (M+SD) in the affected shoulder and 6.475+1.052 mm(M+SD) in the unaffected shoulder. In only one pstient, the thickness of the rotator cuff was 1.68+0.58 mm(M+SD) in the affected shoulder and 553+1.16mm(M+SD) in the unaffected shoulder. Theres no significant change in the thickness of the rotator cuff measured by ultrasonography in frozen shoulder. 3) Ultrasonography is an excellent diagnostic method in detecting the rupture of the rotator cuff in frozen shoulder.
Bursitis ; Heart ; Humans ; Korea ; Methods ; Orthopedics ; Rotator Cuff ; Rupture ; Shoulder ; Shoulder Joint ; Ultrasonography

Plaster of Paris is an effective ancillary treatment in the surgery of infected cavities in bone. It is well tolerated and spontaneously absorbed over the period of weeks to months, being replaced by bone of normal architecture. When the antibiotics incorporated into plaster of Paris, the antibiotics are capable of prolonged local release in bactericidal concentrations. Therefore it is proposed that antibiotics loaded plaster of Paris might be a simple adjuvant technique after good surgical debridement for the treatment of bone infection. The authors carried out an experiment to study the effect of plaster of Paris containing antibiotics for a prevention of experimental osteomyelitis, using 45 rats, which were divided into 3 groups. In the Group 1, a defect was made at the proximal metaphysis of the tibia, inoculated by Staphylococcus aureus sensitive to Cephradine and Tobramycin and then filled with plaster of Paris pellet. In the Group 2, a defect was filled with Cephradine loaded plaster of Paris pellet. In the Group 3, a defect was filled with Tobramycin loaded plaster of Paris pellet. Then we observed the healing process of the bone defect in the point of view of the gross findings, radiologic findings and histologic findings at 4th, 8th and 12th week after operation. The results of this study were as follows:l. In the control Group;all 30 cases were infected. 2. In the Group 2;only 4 of 30 cases were infected. 3. In the Group 3;all 30 cases were not infected. 4. The plaster of Paris filled into the defect was absorbed continuously and stimulated the new bone formation.
Animals ; Anti-Bacterial Agents ; Calcium Sulfate ; Cephradine ; Debridement ; Osteogenesis ; Osteomyelitis ; Rats ; Staphylococcus aureus ; Tibia ; Tobramycin

Various kinds of bone cements mixed with antibiotics have been widely used for treatment and prevention of infections, especially combined with bone defects. But bone cements have some disadvantages in that they are rather expensive and capable of incurring some complications such ss fibrosis of surrounding soft tissue or local erosion of bone, and furthermore, they must be removed after infection is controlled for bone graft to fill up the defects because they do not have properties of osteoconduction or osteoinduction. So we have come to the idea of using theoretically advantageous plaster of paris to take place of bone cements, and performed in-vitro experiment upon the effectiveness of plaster of paris pellets containing antibiotics, then obtained good results comparable to those from many experimental studies using bone cements. By this, we think that it would be possible in the future to treat and prevent infections supervening bone defects with plaster of paris mixed up with antibiotics. The results are as follows : 1. Sustained release of large amount of antibiotics from plaster of paris enough to exert inhibitory activity on abcterial growth, and there was a direct relationship between concentrations of eluted antibiotics and diameters of inhibitory zones. 2. Tobramycin was capable of inhibiting the growth of S. aureus, E. coli, and Ps. aeruginosa for 7 days at maximum. 3. Cephradine inhibited the growth of S. aureus and E. coli but did not affect that of Ps. aeruginosa. 4. The maximum antibacterial activity wss reached within first 24 hours from the start of elution of antibiotics from plaster of paris.
Anti-Bacterial Agents ; Bone Cements ; Bone Regeneration ; Calcium Sulfate ; Cephradine ; Fibrosis ; Tobramycin ; Transplants