BACKGROUND: To evaluate depressure effect and safety of delapril, a new ACE inhibitor, in Korea. METHOD: Thirty three patients, aged 37-69, with mild to moderate essential hypertension were first observed for 2 weeks with placebo followed by administration of 15mg of delapril twice daily for 2 weeks, then doubled dosage to 30mg b.i.d. and combined with 25mg of dihydrochlorothiazide if optimal BP were not obtained at the end of 4th week, continued the same dose until the end of 10 week's trial period. RESULT: BP dropped 15/9mmHg inaverage at the end of 10th week rewarding 70% of cumulative effectiveness. Most frequent side reaction was dry cough, occurred in 9% of patients followed by chest tightness, headache, constipation and transient elevation of GPT. CONCLUSION: Delapril 15-30mg twice daily as monotheraphy or combined with diuretics is well tolerated and effective in the treatment of mild to moderate essential hypertension.
Constipation ; Cough ; Diuretics ; Headache ; Humans ; Hydrochlorothiazide ; Hypertension* ; Korea ; Reward ; Thorax

The present study was performed in order to test the effects of diphenylhydantoin (DPH) and two central nervous system (CNS) stimulants, intermittent light stimulation(ILS) and pentylenetetrazol (Metrazol) on body temperature (Tb) during cold exposure in the bat DHP delayed the onset of entry into hibernation in both the oriental discoloured bats and the little brown bats and formed long and prominent plateaus that were not found in the normal and the controls. The responses of body temperature to the ILS were sensitive and the body temperature fell dramatically in the big brown bats. Metrazol effects on body temperature were obvious but; seemed dose-dependent. The experimental results further support the hypothesis that hibernation is an epileptic fit as suggested by serveral researchers.
Animal ; Body Temperature/drug effects ; Body Temperature Regulation ; Chiroptera/physiology* ; Female ; Hibernation* ; Light ; Male ; Pentylenetetrazole/pharmacology ; Phenytoin/pharmacology

Arytenoid subluxation or recurrent laryngeal nerve paralysis may result from injury to the larynx following endotracheal intubation or blunt laryngeal trauma. Early diagnosis is important for appropriate treatment and better prognosis. A 62-years-old man was admitted for cholecystectomy. He was intubated without any difficulty and nasogastric tube was inserted with the help of laryngoscope and Magill forcep before surgery. He had a weak voice and hoarseness after atraumatic extubation and those symptoms did not improve even 2 days after. Indirect laryngoscopy, videolaryngotelescopy, electromyography(EMG) and computed tomographic findings revealed anterior, inferior subluxation of left cricoarytenoid cartilage associated with left thyroarytenoid muscle denervation and resultant unilateral vocal cord palsy. Conservative treatment for 40 days after the operation and follow-up examination was done. The voice quality was improved and indirect laryngoscopy examination showed that right vocal cord crossed midline in a attempt to meet its paralyzed counterpart on phonation.
Anesthesia, General* ; Cartilage ; Cholecystectomy ; Denervation ; Early Diagnosis ; Follow-Up Studies ; Hoarseness ; Intubation, Intratracheal ; Laryngeal Muscles ; Laryngoscopes ; Laryngoscopy ; Larynx ; Paralysis* ; Phonation ; Prognosis ; Recurrent Laryngeal Nerve* ; Surgical Instruments ; Vocal Cord Paralysis ; Vocal Cords ; Voice ; Voice Quality

OBJECTIVE: Transpedicular screw fixation has some disadvantages such as postoperative back pain through wide muscle dissection, long operative time, and cephalad adjacent segmental degeneration (ASD). The purposes of this study are investigation and comparison of radiological and clinical results between interspinous fusion device (IFD) and pedicle screw. METHODS: From Jan. 2008 to Aug. 2009, 40 patients underwent spinal fusion with IFD combined with posterior lumbar interbody fusion (PLIF). In same study period, 36 patients underwent spinal fusion with pedicle screw fixation as control group. Dynamic lateral radiographs, visual analogue scale (VAS), and Korean version of the Oswestry disability index (K-ODI) scores were evaluated in both groups. RESULTS: The lumbar spine diseases in the IFD group were as followings; spinal stenosis in 26, degenerative spondylolisthesis in 12, and intervertebral disc herniation in 2. The mean follow up period was 14.24 months (range; 12 to 22 months) in the IFD group and 18.3 months (range; 12 to 28 months) in pedicle screw group. The mean VAS scores was preoperatively 7.16+/-2.1 and 8.03+/-2.3 in the IFD and pedicle screw groups, respectively, and improved postoperatively to 1.3+/-2.9 and 1.2+/-3.2 in 1-year follow ups (p<0.05). The K-ODI was decreased significantly in an equal amount in both groups one year postoperatively (p<0.05). The statistics revealed a higher incidence of ASD in pedicle screw group than the IFD group (p=0.029). CONCLUSION: Posterior IFD has several advantages over the pedicle screw fixation in terms of skin incision, muscle dissection and short operative time and less intraoperative estimated blood loss. The IFD with PLIF may be a favorable technique to replace the pedicle screw fixation in selective case.
Back Pain ; Follow-Up Studies ; Humans ; Incidence ; Intervertebral Disc ; Muscles ; Operative Time ; Skin ; Spinal Fusion ; Spinal Stenosis ; Spine ; Spondylolisthesis

No abstract available.
Osteogenesis Imperfecta* ; Osteogenesis*

Creutzfeldt-Jakob disease (CJD) is presumably caused by a slow infectious pathogen or prion. The principal clinical features of Creutzfeldt-Jakob disease are dementia, pyramidal and extrapyramidal symptoms and signs, cerebellar dysfunction, and myoclonus. The patient rapidly deteriorates, declines to a vegetative state, becomes comatous, and is ultimately dead within several months. The authors present a case of Creutzfeldt-Jakob disease, proved by clinical findings, typical serial EEG, and pathologic features.
Creutzfeldt-Jakob Syndrome/*diagnosis/pathology/radiography ; Electroencephalography ; Female ; Humans ; Middle Aged ; Tomography, X-Ray Computed

To obtain wider versatility and greater reach in microsurgical lumbar discectomy, modified procedure has been performed on 263 patients in 1979-1983. It consisted of a smaller midline incision, removal of lateral half of the spinous process, partial but sufficient microdrilling of the lamina, use of a modified slender Taylor retractor, flavotomy, preservation of epidural adipose-areolar tissue etc. Particularly a slender Taylor-Chung retractor offered yielding surgical opening and therefore secured free of pituitary forceps to every direction. The microsurgical results including 72 bisegmental and 8 trisegmental discectomies were compared with those of standard operations of same number performed by same surgeon in 1972-1979, for the good contrast. Mean blood loss per operation was 94 ml with the standard discectomy and 46 ml with microsurgery. Dural tear occured in 17 cases undergoing standard operation and in 3 undergoing microsugery. The mean time until return to duty was 8.6 weeks with standard, compared with 4.2 weeks. In the microsurgical group, 3 patients had postoperative discitis while 2 had in the standard. In this series, the results of microsurgery surpasses the standard in the convalescent phase. Major advantages of this modified microsurgical technique were its ability to secure the greater reach to remove disc material as much as possible and to preserve the integrity of normal tissue better.
Discitis ; Diskectomy* ; Humans ; Microsurgery ; Surgical Instruments

The surgical approach to the lower cervical lesions, especially in traumatic injuries, has been controversial. Some authors advocated posterior fusion for such lesions, while others disagreed and reported good operative results with anterior approach using several types of cervical plates. We analysed 28 patients with lower cervical spine traumatic as well as pathological lesions who underwent 32 anterior surgical interventions with cervical plates during the period of August, 1991 and December, 1993. A successful postoperative vertebral stability was obtained in 5 patients(89.3%) and in 19 patients(87.5%) who had predominent posterior ligamentous injuries. Serious complications such as esophageal perforation and postoperative angulation were seen in 5 patients(17.3%) that were related to the process of reduction. With our clinical experiences, we support anterior fusion with cervical plates particularly for lower cervical lesions even though posterior fusion has ben preferred for traumatic posterior ligamentous complex injuries.
Esophageal Perforation ; Humans ; Ligaments ; Spine

PURPOSE: The purpose of this study is to compare and analyze the results of primary and secondary patency rates and limb salvage rates in DM (Diabetes Mellitus) and Non-DM patients with atherosclerosis in the lower extremity after arterial reconstruction. METHODS: A retrospective study was done by reviewing admission notes and follow up records of 95 atherosclerotic limbs which had infrainguinal arterial reconstruction due to claudication induced severe impediment and limb threatening ischemia (reat pain, minor and major tissue loss). Kaplan-Meier survival analysis was used in the comparison of the primary, secondary patency rates and limb salvage rates, and statistical examination was handled by the Log-Rank significance test. RESULTS: 1 and 3 year primary patency rates were 76.0% and 65.6% each in the DM group and 63.9% and 56.5% each in the Non-DM group. 1 and 3 year secondary patency rates were 80.0% and 69.7% in DM patients and 81.1%, 73.9% each in Non-DM patients. The 1 and 3 year limb salvage rates of DM patients were 83.8% and 72.6% while Non-DM patients revealed a 84.9% and 77.8%. CONCLUSION: Aggressive arterial reconstruction is recommended as well, in DM patients with atherosclerosis in the lower extremity, considering the insignificant differences in the risk of surgery as well as the primary, secondary patency rates and limb salvage rates.
Atherosclerosis ; Extremities* ; Follow-Up Studies ; Humans ; Ischemia ; Limb Salvage* ; Lower Extremity ; Retrospective Studies ; Transplants*

BACKGROUND/AIMS: A lymph-node dissection around the abdominal esophagus, vagotomy, and dissection to the phrenoesophageal membrane performed during a radical subtotal gastrectomy result anatomical changes and may result functional changes in the lower esophageal sphincter. We performed this study to define the changes of the esophageal reflux and motility in the development of these complications. METHODS: We performed this study before and after the radical subtotal gastrectomy with the esophageal manometry and 24hour ambulatory esophageal pH monitoring in 16 gastric cancer patients. RESULTS: There were no significant changes of the length, resting pressure of the lower esophageal sphincter, and the velocity of peristalsis in the lower esophageal area after the radical subtotal gastrectomy (3.94+/-0.66 vs. 3,85+/-0.61, 24.93+/-8.68 vs. 24.21+/-9.43, 3.99+/-0.95 vs. 3.79+/-1.01, respectively). There were no significant changes of the number of reflux episodes >or= 5 min (0.56+/-0.96 vs. 0.44+/-1.03), the duration of longest reflux episodes (5.19+/-6.84 vs. 4.25+/-7.22), and the total reflux time of pH below 4 (11.13+/-14.32 vs. 12.19+/-19.11) after the radical subtotal gastrectomy. CONCLUSION: This study suggests that acid reflux and esophageal motility after the radical subtotal gastrectomy might not be affected by anatomical derangement due to the surgical procedure itself.
Esophageal pH Monitoring ; Esophageal Sphincter, Lower ; Esophagus ; Gastrectomy* ; Gastroesophageal Reflux ; Humans ; Hydrogen-Ion Concentration ; Manometry ; Membranes ; Peristalsis ; Stomach Neoplasms ; Vagotomy