PURPOSE: In young male patients who suffered several kinds of trauma with subsequent suspicious reflex sympathetic dystrophy syndrome, we performed three-phasic bone scan in order to investigate its usefulness. MATERIALS AND METHODS: Patients with narrow range of age (21-25. mean 22.8+/-1.3, all male) were included with suspicious reflex sympathetic dystrophy syndrome of 12 feet and 5 hands. Only one was bilateral feet case and 16 were ipsilateral (Rt:13, Lt:3). The etiologic traumas were 4 fractures, 4 sprains, 3 blunt trauma, 2 cellulitis, 1 tendon tear, 1 crush injury, 1 overexercise, and 1 unknown. Radiologically 3 showed osteoporotic changes. Three-phasic bone scans were performed 21.2+/-7.3wks after trauma. RESULTS: According to symptom complex, confirmatory reflex sympathetic dystrophy syndrome 4 cases and suspicious 13 were analyzed. All confirmatory cases (100%) showed increased uptake at delay phase with periarticular accentuation. Of confirmatory 4 cases, 2 showed increased uptake in all three phases (perfusion: P, blood pool: B, and delay: D), and other 2 revealed decreased P but, both increased B and D. Of suspicious 13 cases, 9(69.2%) had increased D (4 periarticular and 5 focal), 2 decreased D, and 2 symmetric D. In 12 foot cases, so-called weight bearing patterns - increased contralateral sole at P and B - were revealed in 7(58.3%). CONCLUSION: Diffuse periarticular increased uptake at delay phase of three-phasic bone scan was a compatible finding to reflex sympathetic dystrophy syndrome in young male patients whose symptom complex strongly designated post traumatic reflex sympathetic dystrophy syndrome.
Cellulitis ; Foot ; Hand ; Humans ; Male* ; Reflex Sympathetic Dystrophy* ; Reflex* ; Sprains and Strains ; Tendons ; Weight-Bearing

A 38 year old woman presented with two week history of cough, progressive dyspnea, orthopnea and pedal edema. She had previously been in excellent health with the exception of surgery five years ago for tumor of the right thigh. The histopatihologic diagnosis was chondrosarcoma. Her clinical course was characterized by rapid aggrevation of dyspnea and eddema unresponsive to conventional managements for congestiove heart failure. Transesophageal echocardiogram showed dleft atrial mass growing from pulmonic vein. To our knowledge, cardiac metastasis from chondrosarcoma is rare and we report this is the first case of chondrosarcoma metastatic to the heart in Korea.
Adult ; Chondrosarcoma* ; Cough ; Diagnosis ; Dyspnea ; Edema ; Female ; Heart Failure ; Heart* ; Humans ; Korea ; Neoplasm Metastasis ; Thigh ; Veins

We report a case of Holt-Oram syndrome associated with tetralogy of Fallot. Right thumb was digitalized, and left thumb was hypoplastic and dislocated at metacarpopharygeal joint. Thrombocytopenia in peripheral blood and megakaryocytic hypoplasia in bone marrow was accompanied. Brief review was done with emphasis on embryologic pathogenesis.
Bone Marrow ; Joints ; Tetralogy of Fallot ; Thrombocytopenia ; Thumb

The coronary arteriovenous fistula (CAVF) is a rare congenital anomaly but constitutes the most common hemodynamically significant coronary artery anomaly. Transcatheter embolization is as an effective alternative to surgery even though procedure may be complicated by migration of the coil into peripheral vessels or pulmonary arteries. To our knowledge, the association of CAVF with Turner syndrome was not reported. We report a case of successful coil embolization of CAVF using a complex, helical-fibered platinum coil in patient with Turner phenotype with 46,XX.
Arteriovenous Fistula* ; Coronary Vessels ; Embolization, Therapeutic* ; Humans ; Phenotype* ; Platinum ; Pulmonary Artery ; Turner Syndrome

BACKGROUND: The purpose of this study is to evaluate the immediate survival, complication and follow-up results of aortic dissection and to analyze the risk factors that determine the prognosis after aortic dissection. METHODS: 29 patients(M : 12, Age : 59.0+/-11 yrs) with aortic dissection were reviewed retrospectively. Any dissection involving the ascending aorta was classified as proximal dissection and the dissection was considered to be acute if time from clinical onset of the dissection to admission was less than 2 weeks. The immediate survival rate and follow-up results of aortic dissection was compared by type, onset and mode of treatment. RESULTS: 1) The studied patient were 29(Acute onset : 24, Proximal type : 14) and 17 patients(Proximal type : 14) were surgically treated. 2) Five of 10 patients with proximal dissection and 4 of 12 patients with distal dissection, who were managed by medical treatment, died, and 1 of 4 patients with proximal dissection and none of 3 patients with distal dissection, who were managed by surgical treatment, died at hospital. There was no significant statistical difference in mortality according to type, onset and mode of treatment. 3) Nine of 14 patients with proximal dissection and 8 of 15 patients with distal dissection had one or more complications. 4) The cause of death could be established in 10 patients. The most frequent cause of death was aortic rupture including cardiac tamponade(4 of 6 patients for proximal dissection, 2 of 3 patients for distal dissection). 5) The most of death, 8 of 10 deaths occurred within 2 weeks of onset of disease. there was a good life expectancy for the discharged patient regardless of type, onset and mode of treatment. CONCLUSION: These data showed that there was equivalent outcomes in patients with aortic dissection regardless of type, onset and mode of treatment. But these data would not be applied to general population with aortic dissection because of limited number of the study.
Aorta ; Aortic Rupture ; Cause of Death ; Follow-Up Studies* ; Humans ; Life Expectancy ; Mortality ; Prognosis ; Retrospective Studies ; Risk Factors ; Survival Rate

BACKGROUND: A clinical trial was done to evaluate the antihypertensive efficacy and side effects of amlodipine, a new long-acting calcium antagonist, in patients with mild to moderate essential hypertension. METHODS AND RESULTS: 1) The study patients consisted of 18 men and 12 women, and the mean age was 49 years. Amlodipine monotherapy (5-10mg) was continued for 12 weeks. 2) Blood pressure dropped significantly in 4 weeks and in 8 weeks, and well maintained throughout the study period. The mean-pressure drop was 32.9/20.8mmHg after 12 weeks. 3) Heart rate did not change significantly with amlodipine therapy. 4) Optimal dose for effective pressure-drop was 10mg in 57% of patients. Overall good antihypertensive effect was achieved in 83% of patients. 5) All of the laboratory parameters including blood chemistry, glucose, lipid and electrolytes did not change significantly after 12 weeks. 6) Side effects were mild in nature(gastrointestinal discomfort in 3, dry mouth in 1, weakness in 1, dizziness in 1 and headache in 1 patient). CONCLUSION: Amlodipine monotherapy with 5 to 10mg once a day regimen is effective and well tolerated in the patients with mild to moderate essential hypertension.
Amlodipine ; Blood Pressure ; Calcium ; Chemistry ; Dizziness ; Electrolytes ; Female ; Glucose ; Headache ; Heart Rate ; Humans ; Hypertension* ; Male ; Mouth

BACKGROUND: Follow-up angiographic study was performed in patients who underwent successful coronary artery stenting(Palmaz-Schatz) to native coronary arteries, to evaluate the restenosis rate and angiographic features. METHOD: Follow-up angiography was done in 6 months after coronary arteries stenting in 16 of 22 patients(follow-up rate : 73%) regardless of symptom recurrence or the result of exercise treadmill test. RESULTS: 1) Total 26 Palmaz-Schatz stents were implanted in 26 patients with coronary stenosis : primary, elective stenting in 19, bail-out procedure in 4 and restenosis after prior coronary angioplasty(PTCA) in 4 patients. The morphological characteristic of the leisons were type A in 1, type B in 20 and type C in 5. 2) Coronary stenting was successful in all patients and no significant procedure-related cardiac event occurred. Subacute closure in the stent and bleeding complication developed in minority of patients. 3) The overall restenosis rate in six months was 31%. 4) The diameter stenosis of the lesion in the patients without restenosis was 94% before stenting, 6% immediately after stenting and 26% in 6 months. CONCLUSION: Coronary artery stenting is a safe and useful interventional procedure which can be done with low risk even in the complicated leison. The restenosis rate is comparable to conventional PTCA. The long-term outcome of coronary stenting might be more favorable and promising with more selective and strict application of this procedure.
Angiography* ; Constriction, Pathologic ; Coronary Stenosis ; Coronary Vessels* ; Exercise Test ; Follow-Up Studies* ; Hemorrhage ; Humans ; Recurrence ; Stents

BACKGROUND: Although coronary bypass grafting has been shown to prolong life and to relieve symptoms in the early patients with symptomatic coronary artery disease, the operative mortality and morbidity are higher than in younger patients. For this reason percutaneous transluminal coronary angioplasty(PTCA) is a potentially attractive and less invasive alternative to bypass surgery in elderly patients. This study was done to evaluate the feasibility and the initial success rate of PTCA in patients over 70 years of age compared to younger patients group. METHODS: Patients were selected and grouped as I (age 50~69) and II (age over 70) from the consecutive patients who underwent coronary angioplasty at Asan Medical Center from July 1989 to October 1991. Coronary angioplasty was performed at 121 lesions in group I (92 patients) and at 44 lesions in group II (24 patients). RESULTS: Clinically unstable angina and angiographically multivessel disease were more frequent in the elderly patients than in younger patients.The overall initial success rate of PTCA for the elderly and younger patients group were 95.5% and 82.6% respectively. The rate of major complications of PTCA in the elderly patients was not different from that of younger patients:Acute myocardial infarction in 1, energency coronary bypass operation in 1 and cardiac tamponade in 1 patients. There was no difference in the rate of angiographic restenosis between elderly (27.8%) and younger patients group (35.7%). CONCLUSION: PTCA may be appropriate therapeutic modality in the selected group of elderly patients, with high initial success and low cpmplication rate, and follow-up study would be necessary to evaluate the rate of long-term survival and event-free survival after PTCA.
Aged* ; Angina, Unstable ; Angioplasty ; Angioplasty, Balloon, Coronary* ; Cardiac Tamponade ; Chungcheongnam-do ; Coronary Artery Disease ; Disease-Free Survival ; Follow-Up Studies* ; Humans ; Mortality ; Myocardial Infarction ; Transplants

OBJECTIVES: To examine whether the nursing practice environment at the hospital-level affects the job satisfaction and turnover intention of hospital nurses. METHODS: Among the 11 731 nurses who participated in the Korea Health and Medical Workers' Union's educational program, 5654 responded to our survey. Data from 3096 nurses working in 185 general inpatient wards at 60 hospitals were analyzed using multilevel logistic regression modeling. RESULTS: Having a standardized nursing process (odds ratio [OR], 4.21; p<0.001), adequate nurse staffing (OR, 4.21; p<0.01), and good doctor-nurse relationship (OR, 4.15; p<0.01), which are hospital-level variables based on the Korean General Inpatients Unit Nursing Work Index (KGU-NWI), were significantly related to nurses' job satisfaction. However, no hospital-level variable from the KGU-NWI was significantly related to nurses' turnover intention. CONCLUSIONS: Favorable nursing practice environments are associated with job satisfaction among nurses. In particular, having a standardized nursing process, adequate nurse staffing, and good doctor-nurse relationship were found to positively influence nurses' job satisfaction. However, the nursing practice environment was not related to nurses' turnover intention.
Adult ; Female ; Humans ; *Job Satisfaction ; Logistic Models ; Male ; Middle Aged ; Nursing Staff, Hospital/*psychology ; Odds Ratio ; *Personnel Turnover ; Questionnaires

OBJECTIVES: To examine whether the nursing practice environment at the hospital-level affects the job satisfaction and turnover intention of hospital nurses. METHODS: Among the 11 731 nurses who participated in the Korea Health and Medical Workers' Union's educational program, 5654 responded to our survey. Data from 3096 nurses working in 185 general inpatient wards at 60 hospitals were analyzed using multilevel logistic regression modeling. RESULTS: Having a standardized nursing process (odds ratio [OR], 4.21; p<0.001), adequate nurse staffing (OR, 4.21; p<0.01), and good doctor-nurse relationship (OR, 4.15; p<0.01), which are hospital-level variables based on the Korean General Inpatients Unit Nursing Work Index (KGU-NWI), were significantly related to nurses' job satisfaction. However, no hospital-level variable from the KGU-NWI was significantly related to nurses' turnover intention. CONCLUSIONS: Favorable nursing practice environments are associated with job satisfaction among nurses. In particular, having a standardized nursing process, adequate nurse staffing, and good doctor-nurse relationship were found to positively influence nurses' job satisfaction. However, the nursing practice environment was not related to nurses' turnover intention.
Adult ; Female ; Humans ; *Job Satisfaction ; Logistic Models ; Male ; Middle Aged ; Nursing Staff, Hospital/*psychology ; Odds Ratio ; *Personnel Turnover ; Questionnaires