We evaluate the effects of diltiazem in 19 patients with ischemic heart disease (15 patients) of classical anginal pectoris & 4 patients of variant angina) by means of clinical status & electrocardiographic changes and obtain the results as follows: 1. The pulse rate & blood pressure were decreased by diltiazem slightly but these decreases were not significant in statistical meaning. 2. Diltiazem administration of 4 weeks duration normalized EKG completely in 4 patients & partially in 3 patients among the 13 patients who showed abnormal resting EKG initially. 3. All 19 patients who received diltiazem showed clinical improvement; 9 patients had excellent responses, 7 patients good responses & 3 patients fair responses. 4. Diltiazem had side effects in 3 patients, drowsiness, mild euphoria & possibly tolerance respectively in each patients.
Angina Pectoris* ; Blood Pressure ; Diltiazem ; Electrocardiography ; Euphoria ; Heart Rate ; Humans ; Myocardial Ischemia ; Sleep Stages

The effects of muscle relaxants and intravenous anesthetics on intraocular pressure(IOP) were studied in 40 patients ranging in age from 12~63 years and undergoning elective non-ophthalmic surgery. IOP was measured with the PErkins Applanation Tonometer before induction, 1 minute and 2 minutes after intravenous anesthesia, 1 minute after succinylcholine and 1 minute after intubation. The patients were divided into 4 groups: thiopental+succinylcholine+intubation (group A, control group) : pnacuronium pretreatment+thiopental+succinylcholine+intubation (group B): ketamine+succinylcholine+intubation (group C): and, pancuronium+ketamine+succinylcholine+intubation(group D). The results were as follows: 1) In group A, IOP changes following thiopental (5mg/kg) administration showed a highly significant decrease (p<0.01) after 1 minute and significant decrease(p<0.05) after 2 minutes compared with the control value. In group B, IOP changes following thiopental admistration decreased significantly(p<0.05) after 1 minute and 2 minutes compared with the control value. 2) The IOP changes following ketamine(2mg/kg) administration in group C and D showed mild increases or decreases and were not statiscally significant(p>0.05). 3)IOP changes after 1 minute following succinylcholine(1mg/kg) administration showed significant increases(p<0.05) in group A, C and highly significant increases(p<0.01) in group D. IOP changes after 1 minute of endotracheal intubation showed highly significant increases (p<0.01) compared with the control value in group A, C and D. 4) Pretreatment with a mondepolarizing muscle reaxant could not prevent the increase in IOP following succinylcholine administration.
Anesthesia, Intravenous ; Anesthetics, Intravenous* ; Humans ; Intraocular Pressure* ; Intubation ; Intubation, Intratracheal ; Succinylcholine ; Thiopental

Combid is a compound of Compaxine, which is a phenothiazine derivative, and Darbid that is a long acting anticholinergic synthetic. This medicant was originally intended for use in physical and emotional peptic ulcer cases. Because of it's pharmacological action, writers decided to consider the medicant as a preanesthetic medication. From a record of 2800 patients in the hospital for the year 1975 was administered as a premedicant at random, even though some contraindication did occur and is discussed later in this article, the following results were observed. 1. Because of the characteristics of a long acting effect of Combid Spansule, it can be administered orally with sips of water, 2~3 hours prior to operation, eliminating needless preanesthetic shots, without affecting the N.P.O. rule. 2. Sedative and antisialogue effects of the drug have been also satisfactory, therefore it is recommended to use as a premedicant especially in Korea because ether is commonly used. 3. The drug has an additional antiemetic effect to prevent vomiting from ether anesthesia. 4. Some side effects were observed such as dry mouth, tachycardia, fever and extrapyramidal action that occur from overdosage. 5. The contraindications to be considered when using Combid Spansule as a premedicant include dehydration, fever, tachycardia and parkinsonism. 6. Please note the writers do not recommend this application for short procedure such as closed reduction of Colles fracture and simple spinal anesthesia due to the long lasting drying effect.
Anesthesia ; Anesthesia, Spinal ; Antiemetics ; Colles' Fracture ; Dehydration ; Ether ; Fever ; Humans ; Korea ; Mouth ; Parkinsonian Disorders ; Peptic Ulcer ; Preanesthetic Medication ; Tachycardia ; Trimeprazine* ; Vomiting ; Water

Many cases have been reported indicating that postspinal headache can be relieved immediately by an epiduralinjection of saline: also autologous blood has recently been used successfully instead of saline. C.S.F. changes in 20 cases were observed in the support of the concept; that a continuous leakage in association with hypovolemia and hypotension of C.S.F is the primary cause of postspinal headache. Subarachnoid pressure increased immediately with Xylocaine injection into lumbar epidural space. A spinal needle was inserted into the subarachnoid space at the level Ll-L2 and opening pressure of C.S.F. was read, epidural Tuohy needle was inserted at the 4~5. Twenty-five ml of Xylocaine was injected into epidural space and C.S.F. pressure changes were observed. This procedure was performed on 10 patients in lateral position and another 10 patients were tested in the sitting position. Sitting position: Condition Highest pressure change Lowest pressure change Average pressure change Average opening pressure Horizontal position: Highest pressure change Lowest pressure change Average pressure' change Average opening pressure .Pressure rise 350 mm H2O 60 mm HO 191 mm H2O 369 mm H2O .290 mm H2O 40 mm H2O 14Z mm H2O 165 mm H2O .These pressure changes responded almost simultaneously as xylocaine was injected. The immediate relief of postspinal headache by injecting fluid into epidural space is simultaneous with the increase of C.S.F. pressure. In summary, the direct cause of postspinal headache is probably hypotension of C.S.F. pressure resulting from continuous leakage from spinal tap.
Epidural Space* ; Headache ; Humans ; Hypotension ; Hypovolemia ; Intracranial Pressure ; Lidocaine* ; Needles ; Spinal Puncture ; Subarachnoid Space

The purpose of our study was to compare the clinical results between arthroscopic bone fixation on intertubercular groove using suture anchor and soft tissue fixation at the rotaor interval for biceps tenodesis when partial tear or instability of biceps tendon accompanied with rotator cuff tear. From January 2010 to January 2012, 34 cases who were performed biceps tenodesis for partial tear or instability were enrolled in our study. Mean follow-up period was 30.2 months. Bone fixation using suture anchor was performed in 18 cases, and soft tissue fixation was performed in 16 cases. Clinical result was evaluated by pain visual analogue scale (VAS), Speed test, Yergason test, muscle strength, and Constant score. Pain VAS of cases with soft tissue fixation was significantly higher than that of cases with bone fixation at 6 months and final follow-up. Positive results for the final follow-up Speed and Yergason test were checked in 4 cases (25%) with soft tissue fixation and 1 (5.6%) with bone fixation. The Popeye deformity was seen in 4 cases (25%) with soft tissue fixation and 2 (11%) with bone fixation. Constant score was improved 47 to 78 in cases with soft tissue fixation and 48 to 86 in cases with bone fixation. In patient with partial tear or instability of biceps tendon accompanied with rotator cuff tear, biceps tenodesis using soft tissue fixation showed worse result compared with bone fixation because of long duration of the pain. Therefore, when performing the biceps tenodesis, bone fixation will be recommended.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Muscle Strength ; Rotator Cuff ; Shoulder ; Suture Anchors ; Tendons ; Tenodesis* ; Tissue Fixation

To report the association of a unilateral serous macular detachment with severe postoperative pain. A 71-year-old woman presented with a sudden decrease in vision in the right eye, seven days after a total knee replacement arthroplasty. The patient's history was unremarkable except for a severe pain greater than the visual analog scale of 8 points for about 2 days after surgery. Retinal examination showed a well differentiated serous detachment that was about 3.5 disc diameter in size and located in the macular area. Fluorecein angiography and indocyanine green angiography showed delayed perfusion of the choriocapillaris without leakage points in the early phase and persistent hypofluorescence with pooling of dye in the subretinal space in the late phase. There was a spontaneous resolution of the serous detachment and the choroidal changes with residual pigment epithelial changes. Severe postoperative pain may influence the sympathetic activity and introduce an ischemic injury with a focal, choroidal vascular compromise and secondary dysfunction of overlying RPE cells in select patients.
Aged ; *Arthroplasty, Replacement, Knee ; Choroid/*blood supply ; Coloring Agents/diagnostic use ; Female ; Fluorescein Angiography ; Humans ; Indocyanine Green/diagnostic use ; Ischemia/diagnosis/*etiology ; Pain Measurement ; *Pain, Postoperative ; Retinal Detachment/diagnosis/*etiology ; Serum ; Vision Disorders/etiology

No abstract available.
Pneumonia*

The main trend moves towards early excision and skin grafting as treatment for the deep second degree burns and the third degree burns. The ability to excision & skin grafting. This study prospectively evaluated the ability of laser doppler flow measurements obtained within 72 hours after burn injury to predict the depth of burn wounds. A Periflux system 4001 laser doppler flowmetry had been used to measure cutaneous microflow circulation of 100 selected points of burn wounds in 44 admitted patients from March 1993 to February 1994. The mean value of superficial second degree burn checked by laser doppler was 194.6 perfusion unit(PU). The deep second degree burn was 59.7 PU and third degree burn was 5.1 PU. The blood flow of more than 100 PU reliably predicted the superficial second degree burn with 90.2 percents accuracy. The blood flow between 100 PU and 10 PU predict the deep second degree dermal burn with 96.2 percents accuracy. That of less than 10 PU predict the third degree burn with 100 percents accuracy. There was also a significant correlation between initial flow measurements and the depth of burn wounds. We conclude that laser doppler flow measurements performed early after burn injury are useful in predicting the depth of burn wounds. The laser doppler flowmetry has the advantage of being easy to use, noninvasive, provide immediate result for early determination of burn depth. The laser doppler flowmetry is useful in selecting patients for early excision and grafting of burn wounds.
Burns* ; Humans ; Laser-Doppler Flowmetry* ; Perfusion ; Prospective Studies ; Skin Transplantation ; Transplants ; Wounds and Injuries

Non-Hodgkin's malignant lymphoma is a relatively frequent lymphoreticular malignancy, and has been reported to constitute up to 5.2% of all malignant tumors in Korean patients. Various morphologic classifications of non-Hodgkin's lymphoma have been proposed, and among them, the Rappaport's classification has been most widely accepted. In 1982, a National Cancer Institute sponsored study on classification led to the creation of the Working Formulation in an attempt to resolve the controversy anddebate regarding the various classifications of non-Hodgkin's lymphoma. Angioimmunoblastic lymphadenopathy with dysproteinemia and polymorphic reticulosis are lymphoreticular proliferative disorders which have reported to transform to malignant lymphoma. The purpose of the present study is to reclassify non-Hodgkin's lymphomas according to the Working Formulation and to investigate the histopathological and immunocytochemical characteristics of angioimmunoblastic lymphadenopathy with dysproteinemia and polymorphic reticulosis. This study reviewed 300 cases of nodal and extranodal non-Hodgkin's lymphoma, 26 cases of polymorphic reticulosis, and 7 cases of angioimmunoblastic lymphadenopathy with dysproteinemia examined in the Departments of Pathology, Yonsei University College of Medicine, Youngdong Severance Hospital and Yonsei University Wonju College of Medicine from January 1977 to December 1986. In non-Hodgkin's lymphoma, each case was classified according to the Working Formulation and the Rappaport classification. All angioimmunoblastic lymphadenopathy with dysproteinemia and polymorphic reticulosis cases were subjected to histopathological analysis and a review of the clinical records. Immunocytochemical studies were done using kappa and lambda chains for B-cell markers and alpha-1-antichymotrypsin for histiocytic marker. The results obtained were as follows; 1) Among 300 cases of non-Hodgkin's lymphoma, the primarily involved tumor sites were the lymph nodes (141 cases), the gastrointestinal tract (67 cases), and the tonsils (32 cases) in descending order of frequency. 2) Using the Working Formulation, intermediategrade lymphomas occurred in 66.4% of the patients, and the most common subtype was "diffuse, large cell" (32.7%). By the Rappaport classification, 3 patients had nodular lymphomas, and "diffuse, histiocytic" was the most common subtype. 3) Infarction was present in 32 cases in which the "diffuse, lagre cell" type was most frequently associated. 4) In immunoperoxidase stains of 7 cases of angioimmunoblastic lymphadenopathy with dysproteinemia, proliferating immunoblasts revealed a polyclonal positivity for kappa and lambda chains. Atypical reticulocytes present in 26 cases of polymorphic reticulosis revealed a negativity for kappa, lambda and alpha-1-antichymotrypsin.

Non-Hodgkin's malignant lymphoma is a relatively frequent lymphoreticular malignancy, and has been reported to constitute up to 5.2% of all malignant tumors in Korean patients. Various morphologic classifications of non-Hodgkin's lymphoma have been proposed, and among them, the Rappaport's classification has been most widely accepted. In 1982, a National Cancer Institute sponsored study on classification led to the creation of the Working Formulation in an attempt to resolve the controversy anddebate regarding the various classifications of non-Hodgkin's lymphoma. Angioimmunoblastic lymphadenopathy with dysproteinemia and polymorphic reticulosis are lymphoreticular proliferative disorders which have reported to transform to malignant lymphoma. The purpose of the present study is to reclassify non-Hodgkin's lymphomas according to the Working Formulation and to investigate the histopathological and immunocytochemical characteristics of angioimmunoblastic lymphadenopathy with dysproteinemia and polymorphic reticulosis. This study reviewed 300 cases of nodal and extranodal non-Hodgkin's lymphoma, 26 cases of polymorphic reticulosis, and 7 cases of angioimmunoblastic lymphadenopathy with dysproteinemia examined in the Departments of Pathology, Yonsei University College of Medicine, Youngdong Severance Hospital and Yonsei University Wonju College of Medicine from January 1977 to December 1986. In non-Hodgkin's lymphoma, each case was classified according to the Working Formulation and the Rappaport classification. All angioimmunoblastic lymphadenopathy with dysproteinemia and polymorphic reticulosis cases were subjected to histopathological analysis and a review of the clinical records. Immunocytochemical studies were done using kappa and lambda chains for B-cell markers and alpha-1-antichymotrypsin for histiocytic marker. The results obtained were as follows; 1) Among 300 cases of non-Hodgkin's lymphoma, the primarily involved tumor sites were the lymph nodes (141 cases), the gastrointestinal tract (67 cases), and the tonsils (32 cases) in descending order of frequency. 2) Using the Working Formulation, intermediategrade lymphomas occurred in 66.4% of the patients, and the most common subtype was "diffuse, large cell" (32.7%). By the Rappaport classification, 3 patients had nodular lymphomas, and "diffuse, histiocytic" was the most common subtype. 3) Infarction was present in 32 cases in which the "diffuse, lagre cell" type was most frequently associated. 4) In immunoperoxidase stains of 7 cases of angioimmunoblastic lymphadenopathy with dysproteinemia, proliferating immunoblasts revealed a polyclonal positivity for kappa and lambda chains. Atypical reticulocytes present in 26 cases of polymorphic reticulosis revealed a negativity for kappa, lambda and alpha-1-antichymotrypsin.