BACKGROUND: As an antihypertensive drug, Nifedipine, a calcium channel blocker was introduced recently, which also has antianginal effect. But due to the relatively short duration of action, another antihypertensive agents having longer duration of action and stronger hypertensive effect were under investigation. Nilvadipine, a new calcium channel blocker, was introduced to have more prologned duration of action and to act more specifically on vascular smooth muscle. So the efficacy and safety of oral Nilvadipine on essestial hypertension was investigated and represented by our institute. METHODS: In order to investigate the efficacy and safety of oral Nilvadipine, daily doses of 4mg twice a day were administered in 30 hypertensive patients whose states were compatible to the criteria : 1) severity of hypertension rated in Stage I and Stage II according to the classification by WHO, 2) ages ranging from 30 to 74 years regardless of sex, 3) blood pressure with 95mmHg or higher but less than 115mmHg in diastolic pressure which was the mean in a sitting position at the last two out of not less three consultations in the 2 week observation period, 4) outpatients with informed consent for 6 weeks. Blood pressure and heart rate were measured every 2 weeks. The complete with blood count with platelet, uronalysis and the electrocardiography were performed at the beginning period and the 6th weeks of therapy. And kinds of side effects were questioned by examining physicians. RESULTS: The following results were obtained : 1) Blood pressure fell significantly in 6 weeks of treatment with Nilvadipine(Mean pressure+/-S.D., 6.00mmHg vs 108.90+/-9.68mmHg p<0.05), 2) There was no significant change in EKG in 6 weeks of treatment with Nilvadipine, 3) Pulse rate was decreased in 6 weeks of treatment with Nilvadipine(80.14+/-11.90/min vs 75.39+/-6.47/min, p<0.05). 4) No significant chsange in body weight was observed(64.50+/-8.7kg vs 63.50+/-10.25kg, p<0.05). 5) There were no significant changes in blood chemistry including blood sugar, cholesterol, electrolytes, serum creatinine and alkaline phosphatase values, 6) Hematologic findings and urinalysis findings reamained unchanged, 7) Total 10 patients(33.30%) had various side effects;facial flushing 30.00%, palpitation 23.33%, headache 20.00%, nausea 10.00%, drowsiness 3.33%, heaviness 3.33% and indigestion 3.33%. But there was no serious side effect that requires to discontinue the medication of the test drug. And there was no need to reduce the dosage due to the side effect, 8) The antihypertensive effect was judged to decrease markedly in 76.70%, decrease 20.00%, unchange 3.30% and increase 0.00%, 9) The utility which was assessed with the data from the overall safety and antihypertensive effect, the drug was judged to be very useful in 60.00%, useful 33.30%, useless 6.67% and inhibited 0.00%. CONCLUSION: From the above results, Nilvadipine in doses of 4mg twice a day was effective and useful in most cases without severe side effects in essential hypertensive patients with diastolic blood pressure of 95 to 115mmHg.
Alkaline Phosphatase ; Antihypertensive Agents ; Blood Glucose ; Blood Platelets ; Blood Pressure ; Body Weight ; Calcium Channels ; Chemistry ; Cholesterol ; Classification ; Creatinine ; Dyspepsia ; Electrocardiography ; Electrolytes ; Flushing ; Headache ; Heart Rate ; Humans ; Hypertension* ; Informed Consent ; Muscle, Smooth, Vascular ; Nausea ; Nifedipine ; Outpatients ; Referral and Consultation ; Sleep Stages ; Urinalysis

No abstract available.

No abstract available.
Craniocerebral Trauma* ; Disseminated Intravascular Coagulation* ; Head* ; Humans ; Latex*

No abstract available.
Female ; Humans ; Hysterosalpingography* ; Laparoscopy*

No abstract available.
Bone Marrow*

Eighty-three cases with severe blepharoptosis were treated by the superiorly based muscle flaps around eye including orbicularis oculi muscle, frontalis muscle, levator muscle. The selection of the muscle flaps were done in accordance with the levator function of patients. The orbicularis oculi muscle flap technique in 32 patients who have 2-5 mm levator function, 21 cases of the interdigitated orbicularis oculi-frontalis muscle flap for 1-3 mm levator function, frontalis muscle flap technique for less than 2 mm levator function, 22 cases of levator muscle resection for 2-8 mm levator function, 7 cases of levator plication for 5-9 mm levator function. The majority of patients recorded as satisfactory results. There has been no complete failure but there were 14 cases of undercorrection, 4 cases of overcorrection, 2 cases of exposure keratitis, 3 cases of corneal erosion, 2 cases of sensory loss, hematoma loss of wrinkle and a few cases of eyelid deformity such as notching, entropion, fading or unnatural fold. The orbicularis oculi muscle technique or the interdigitated orbicularis oculi-frontalis muscle flap technique offers several advantages over conventional frontalis muscle flap technique such as being a simple with a good operative field, single incision or supratarsal fold, no depression on the forehead, no risk of neurovascular injury and relatively easy technique with less complication. The levator resection or levator plication could offer good results by careful selection of patients. In conclusion, we would like to say that the interdigitated frontalis orbicularis oculi muscle flap technique is best in cases with less than 2 mm levator function, orbicularis oculi muscle flap technique in 2-4 mm levator function, levator resection in 4-8 mm levator function, levator plication in more that 8 mm levator function.
Blepharoptosis* ; Congenital Abnormalities ; Depression ; Entropion ; Eyelids ; Forehead ; Hematoma ; Humans ; Keratitis

Pulmonary embolism is a serious complication, which is well known in patients undergoing total hip or total knee arthroplasty or lower extremity fracture surgery. But, there are few literatures concerning pulmonary embolism after upper extremity surgery. Pulmonary embolism after minor upper extremity fracture surgery is extremely rare. We report a case of 66-year-old female patient that developed pulmonary embolism after percutaneous cannulated screw fixation for a greater tubercle fracture of the proximal humerus with literature review.
Aged ; Arthroplasty ; Female ; Fracture Fixation ; Hip ; Humans ; Humerus* ; Knee ; Lower Extremity ; Pulmonary Embolism* ; Shoulder Fractures ; Upper Extremity

BACKGROUND: After closed reduction, patients are sometimes concerned that their external nasal shapes have changed. The aim of this study was to investigate and explain changes in nasal shape after surgery through objective photogrammetric anthropometry measurements taken through three-dimensional (3D) reformed computed tomography (CT) images. METHODS: Our study included 100 Korean patients who underwent closed reduction of isolated nasal bone fracture from January 2016 to June 2017. Using the ruler tool in Adobe Photoshop CS3, we measured preoperative and postoperative nasal base heights, long nostril axis lengths, both nasal alar angles, and amount of nasal deviation through the 3D reformation of soft tissue via CT scans. We then compared the dimension of nose. RESULTS: The amount of postoperative correction for nasal base height was 1.192 mm. The differences in nostril length between each side were found to be 0.333 mm preoperatively and 0.323 mm postoperatively. The differences in the nasal alar angle between each side was 1.382° preoperatively and 1.043° postoperatively. The amount of nasal deviation was found to be 5.248 mm preoperatively and 1.024 mm in postoperatively. CONCLUSION: After the reduction of nasal bone fractures, changes in nasal dimensions were noticeable in terms of nasal deviation but less significant in nasal tips, except for changes in nasal alar angles, which were notable.
Anthropometry ; Humans ; Nasal Bone ; Nose ; Tomography, X-Ray Computed

Objective: To compare preventable trauma death rates (PTDRs) in patients with traumatic brain injury before and after the establishment of a regional trauma center (RTC) at a single center. Methods: Our institution established an RTC in 2014. A total of 709 patients were enrolled from January 2011 to December 2013 (before RTC) and 672 from January 2019 to December 2021 (after RTC). The revised trauma score, injury severity score, and trauma and injury severity score (TRISS) were evaluated. Definitive preventable (DP), possibly preventable (PP), and non-preventable deaths were defined as TRISS >0.5, TRISS 0.25–0.5, and TRISS <0.25, respectively. PTDR was the proportion of deaths from DP+PP out of all deaths, and the preventable major trauma death rate (PMTDR) was the proportion of deaths from DP+PP out of all DP+PP. Results: The overall mortality rates before and after the establishment of RTC were 20.3 and 13.1%, respectively. PTDR was lower after the establishment of RTC than before (90.3% vs.79.5%). The PMTDR was also lower after the establishment of RTC than before (18.8% vs.9.7%). The ratio of direct hospital visits was higher in patients before the establishment of RTC than in those after (74.9% vs. 61.3%, p<0.001). Conclusion Establishing the RTC reduced PTDRs. Additional studies on factors associated with PTDR reduction are required.

PURPOSE: The aim of this study was to determine the risk factors for rhabdomyolysis in patients with carbon monoxide (CO) poisoning. METHODS: This was a retrospective study on patients with CO poisoning who visited the emergency department from January 1, 2014 to December 31, 2015. We compared clinical variables between patients with and without rhabdomyolysis. RESULTS: Among 120 patients who were included to this study, 108 patients exhibited normal value of CPK (creatine phosphokinase), and 12 patients were diagnosed as rhabdomyolysis. Sources of CO, duration of CO exposure, initial GCS (Grasgow coma scale), initial systolic and diastolic blood pressure, initial body temperature and AKI (Acute kidney injury) were showed significant difference between patients who developed rhabdomyolysis and patients who did not. In addition, initial white blood cell counts, troponin I level and carboxyhemoglobin (COHb) level were more higher in rhabdomyolysis group. pH and initial bicarbonate level were more lower. Duration of CO exposure (Odds ratio, 1.011; 95% confidence interval, 1.002∼1.020, P=0.021)was found to be only risk factor for rhabdomyolysis by logistic regression analysis. CONCLUSION: Duration of CO exposure is potential risk factor of rhabdomyolysis development in CO poisoning.
Blood Pressure ; Body Temperature ; Carbon Monoxide Poisoning* ; Carbon Monoxide* ; Carbon* ; Carboxyhemoglobin ; Coma ; Emergency Service, Hospital ; Humans ; Hydrogen-Ion Concentration ; Kidney ; Leukocyte Count ; Logistic Models ; Poisoning ; Reference Values ; Retrospective Studies ; Rhabdomyolysis* ; Risk Factors* ; Troponin I