BACKGROUND: The acute effect, of ethanol (EOH) include lowered blood pressure through peripheral vasodilation and decreased circulating blood volume. This study was aimed at examing the effects of EOH on the hemodynamic response to up and down head tilts. METHODS: Ten 21 to 23 year old male adults served as subjects. Each subject participated in both control and EOH experiments. In the EOH experiment, 3 mls of 25% EOH per liter of total body water was administered orally, 35 min were allowed for the blood EOH level to reach maximum before the tilt protocol was initiated. The tilt protocol consisted of 5 stages, each stage was 3-min in duration : supine (0 degrees)-head down tilt (HDT, 15 degrees)-supine (0 degrees)-head up tilt (HUT, 25 degrees)-supine (0 degrees). Hemodynamic parameters were measured with an impedance cardiograph (NCCOM3-R7, BoMed) with two electrodes placed around the neck and two around the thorax. Blood pressure (BP) was measured with an automatic sphygmomanometer (DATEX). Data was collected during every second half-minute throughout the duration of the protocol. RESULTS: In the control, HDT produced an increase in the end-diastolic index (EDI), the stroke index (SI), the cardiac index (CI), and the peak flow index (PFI) ; there were no significant changes in heart rate (HR), the systemic vascular resistance index (SVRI), and BP. In contrast, HUT resulted in a decrease in EDI, SI, EF, CI, and PFI and an increase in HR, SVRI, and BP ; the latter changes sugges a sympathetic overactivation. In the EOH experiment, the basal EDI, SI, and systolic BP were lower and HR was higher than in control. HDT and HUT caused similar changes as in control experiments. CONCLUSIONS: There results indicate that EOH cause volume depletion to result in reduced central blood volume and compensatory tachycardia. These EOH-induced changes were not altered by 15 degreeshead-down and 25 degreeshead-up tilts.
Adult ; Blood Pressure ; Blood Volume ; Body Water ; Cardiography, Impedance ; Eating* ; Electric Impedance ; Electrodes ; Ethanol* ; Gravitation ; Head ; Heart Rate ; Hemodynamics* ; Humans ; Male ; Neck ; Sphygmomanometers ; Stroke ; Tachycardia ; Thorax ; Vascular Resistance ; Vasodilation ; Young Adult

BACKGROUND: The present study was performed in order to identify the possible future location of the Department of Emergency Medicine and future demand for and supply of manpower through a survey of the heads of Kwangju City and Chollanam-do hospitals. The survey covered the degrees of recognition and understanding, the necessity, the future prospects, and the direction of development of the Department of Emergency Medicine. METHODS: A total of 33 large-scale general hospitals were selected in county districts having more than 200 sickbeds as of November 1999. Among them, the heads of 29 hospitals responded to the survey. The survey had a total of 31 questions, including 6 questions on the status of the emergency room. Six(6) questions concerned the degree of recognition of the Department of Emergency Medicine. Six(6) questions concerned the degree of understanding of the Department of Emergency Medicine. Six(6) questions concerned the necessity for the Department of Emergency Medicine, and 7 questions concerned the future prospects and direction of development. The results of the survey were analyzed. RESULTS: 1) As to the question of the degree of recognition, the Department of Emergency Medicine was known to all. That is, 50% of the respondents were well aware of the department, and 50% a little. Nineteen(19) respondents(65%) answered that it was convenient to have the Department of Emergency Medicine in a university hospital, among which 16 respondents(55%) answered that it was because of the rapid treatment of emergency patients. 2) As to the question of the degree of understanding, particularly, the areas of medical examination and treatment by the Department of Emergency Medicine, 15 respondents answered that it was for the treatment of patients who needed to receive emergency treatment, while 12 respondents answered that it was for the diagnosis and treatment of all patients who visited the emergency room. Only 7 respondents(24%) answered positively as to the possibility of the Department of Emergency Medicine using thrombolysis medicine. 3) All except for one respondent had a positive view on the necessity for the Department of Emergency Medicine, and all except for 3 respondents wanted to have specialized doctors in emergency medicine work at the corresponding hospital. As to the type of schedule, 10 hospitals(34%) wanted to have only night shifts, and 11 hospitals(38%) wanted to have both day and night shifts. Most hospitals, needed two or more workers in the field. 4) As to the question of the direction of development, many respondents were of the opinion that the hiring of specialized doctors in emergency medicine would not be of greatly help to the finances of the hospital due to increased labor costs. It seems that improvement of the medical system to improve hospital financing is a required prerequisite for the development of the Department of Emergency Medicine. Also, 21 respondents(83%) were of the opinion that it would take a considerable amount of time to activate the Department of Emergency Medicine with respect to the future prospects of the department. CONCLUSION: It was shown in the present survey that the heads of hospitals in Kwangju City and Chollanam-do recognized the Department of Emergency Medicine in a positive way, but it was necessary to establish both a delivery system for emergency medicine and collaboration with and support by other medical areas for its future development. It was estimated that in the future, more than 55 doctors specializing in emergency medicine would be needed as medical manpower for the general hospitals in the districts.
Appointments and Schedules ; Cooperative Behavior ; Surveys and Questionnaires ; Diagnosis ; Emergencies* ; Emergency Medicine* ; Emergency Service, Hospital ; Emergency Treatment ; Gwangju* ; Head ; Hospitals, General ; Humans ; Jeollanam-do*

No abstract available.
Angiomyoma* ; Mucous Membrane*

No abstract available.
Hand ; Hyperplasia

Colorectal carcinoma in patients under 40 years and over 70 years of age is unusual but not rare. The prognosis of these two groups, compared with remainder of patients, is thought to be unfavorable. From Jan. 1981 to Dec. 1997, 541 patients with primary colorectal cancer who were treated by surgical resection were analyzed retrospectively. They were divided into three age groups according to the age at admission, i.e. under 40 years, over 70 years and between 40 and 69 years(control group). Among three age groups, sex ratio, tumor characteristics(size, location , depth of invasion, lymph node metastasis, liver metastasis, peritoneal metastasis, histopathologic classification, stage, DNA ploidy pattern), serum CEA level and survival were compared and analyzed. The results were as follows: 1) In the young patient group(52 cases), female predominence, large tumor size, high proportion of mucinous adenocarcinoma in histopathologic classification, more frequent metastasis to regional lymph node, frequent peritoneal metastasis and high incidence in tumor location at transverse colon were noted(p<0.05). 2) In the elderly group(69 cases), deep invasion of tumor(T4) was noted (p<0.05). In addition, among them, concomittent diseases were presented in 25 patients(36%). They were diabetes(8), cardiac arrhythmia(4), old myocardial infarction(2), liver cirrhosis(5), COPD(3), previous cancer(3). 3) The 5-year survival rates of the young patient group and that of elderly patient group were lower than that of the other(p<0.01). 4) There was no significant differences in liver metastasis, tumor stage, DNA ploidy pattern, serum CEA level among three age groups.
Adenocarcinoma, Mucinous ; Aged* ; Classification ; Colon, Transverse ; Colorectal Neoplasms* ; DNA ; Female ; Humans ; Incidence ; Liver ; Lymph Nodes ; Neoplasm Metastasis ; Ploidies ; Prognosis ; Retrospective Studies ; Sex Ratio ; Survival Rate

Twelve patients with inflammatory bowel disease had been operated at the department of surgery, Chonnam University Hospital during the period from March 1988 to February 1997. In this study, we report on the operative cases regarding age, sex, symptoms, duration of disease, location of disease, preoperative diagnosis, operative indication, frequency of operation, histopathologic findings and follow up. The results were as follows: 1) The male to female ratio in ulcerative colitis was 1 : 1, and the mean age was 54.5 years. In Crohn's disease, male to female ratio was 2.3 : 1 and the mean age was 42.1 years. 2) The mean duration of symptoms in ulcerative colitis was 39 months and in Crohn's disease was 13.9 months. The common symptoms in ulcerative colitis were abdominal pain, bloody diarrhea, indigestion, weight loss and in Crohn's disease abdominal pain, palpable mass, weight loss, indigestion. Extraintestinal symptoms in Crohn's disease were cholelithiasis like symptom, anal fistula, anal fissure. 3) The involvement site in ulcerative colitis was large bowel only, but in Crohn's disease small bowel (50%), large bowel (20%), small and large bowel (30%) were involved. 4) Preoperative diagnosis in ulcerative colitis was accurate, but in Crohn's disease accurate diagnosis was made only in 20% and the other cases were operated under the impression of different diseases or conditions (intestinal tuberculosis (50%), bowel perforation (20%), mechanical ileus (10%)). 5) The indication of surgery in ulcerative colitis was intractability to medical treatment, on the other hand, in Crohn's disease most operative cases were made under the emergentconditions (bowel perforation, bowel obstruction, enterocutaneous fistula, abdominal mass). The frequency of operation in ulcerative colitis were two times in one case, three times in one cases. In Crohn's disease half of cases experienced two or three times of surgery. The method of operation in ulcerative colitis was total proctocolectomy with J-pouch ileoanal anastomosis. In Crohn's disease resection of diseased bowel segment was performed.
Abdominal Pain ; Cholelithiasis ; Colitis, Ulcerative ; Colonic Pouches ; Crohn Disease ; Diagnosis ; Diarrhea ; Dyspepsia ; Female ; Fissure in Ano ; Follow-Up Studies ; Hand ; Humans ; Ileus ; Inflammatory Bowel Diseases* ; Intestinal Fistula ; Jeollanam-do ; Male ; Rectal Fistula ; Tuberculosis ; Weight Loss

This study was aimed to elucidate the effect of intracerebroventricular losartan administration on arterial pressure regulation during hemorrhage in rats by power spectral analysis of blood pressure and heart rate variability. Nineteen male Sprague-Dawley rats weighing 240-300g were divided into losartan-administered(n=10) and control(n=9) groups. Hemorrhage was induced with a withdrawal pump from the femoral artery at 3ml/kg/min for 5min. Arterial presure was measured with a pressure transducer connected to the contralateral femoral artery for 5min before, during and after hemorrhage. The blood pressure signal digitized at 500 Hz through a data acquisition system was analyzed with fast Fourier transform algorithm to yield power spectra of systolic(SP) and diastolic(DP) blood pressure and instantaneous heart rate(HR). Powers of very low frequency (VLF, 0.02-0.26 Hz), low frequency(LF, 0.26-0.75 Hz) and high frequency(HF, 0.75-5.00 Hz) band were obtained. Basal systolic and diastolic blood pressure was 149+/-9 and 99+/-2mmHg, respectively, and was not changed by hemorrhage in control rats. Basal blood pressure in losartan group was 143+/-9 and 97+/-6mmHg and was significantly lowered to 116+/-13 and 77+/-9mmHg, respectively. HR was significantly increased during and after hemorrhage in both groups. Total power of SP variability in losartan group was 13.9+/-3.2mmHg2 before hemorrhage and was significantly increased to 66.6+/-25.3mmHg2 during hemorrhage. VLF, LF and HF powers of SP variability were 7.3+/-2.0, 3.8+/-1.1 and 2.8+/-0.7mmHg2, respectively, in losartan group and 5.5+/-1.4, 3.7+/-1.5 and 2.8+/-0.8mmHg2 in control rats. VLF and HF powers of SP were increased to 33.0+/-15.2 and 20.3+/-6.4mmHg2 in losartan group, and VLF power was increased to 7.9+/-1.5mmHg2 in control group. VLF power of DP variability increased from 3.3+/-0.9 before hemorrhage to 5.9+/-1.0mmHg2 during hemorrhage in control group. Powers of DP variability in losartan group and those of HR variability in both groups were not changed by hemorrhage. The above results suggested that losartan aggravated the arterial pressure fall during hemorrhage by impairing the sympathetic nerve activation by central angiotensin II.
Angiotensin II ; Animals ; Arterial Pressure ; Blood Pressure* ; Femoral Artery ; Fourier Analysis ; Heart Rate* ; Heart* ; Hemorrhage* ; Humans ; Lateral Ventricles* ; Losartan* ; Male ; Rats ; Rats, Sprague-Dawley ; Transducers, Pressure

No abstract available.
Breast Neoplasms* ; Breast*

OBJECTIVE: Weight gain and DM can be serious side effects in the use of atypical antipsychotics (AAP), although conventional antipsychotics (CAP) have also been implicated. Also weight gain & DM are the adverse effects that are often associated with noncompliance and medical problems. The relationship between weight gain, dyslipidemia and DM is well established. Patients with schizophrenia are not only at risk of DM, but also taking antipsychotic medication further increases the chance of developing non-insulin-dependent hyperglycemia. Thus, this pilot study was conducted to investigate the risk of hyperlipidemia & DM in Korean patients taking antipsychotic medications. METHODS: After receiving informed consent, demographic data and history of medication were collected from medical records of 174 inpatients (92 male, 82 female). For the laboratory tests blood sampling was done at 7 A.M. before the meal and medication. RESULTS: For all subjects, the mean age was 41.10+/-9.56 years (range 14-65 years); 88% were diagnosed with schizophrenia. Of these, 55% were treated with antipsychotics alone (Monotherapy) and 45% were treated with combination therapy (such as antipsychotics plus a mood stabilizer). The mean age of onset of illness was 24.8+/-47.25 years old and mean duration of admission was 45.44+/-133.84 months. In the monotherapy group, the duration & dosage of each medications were 42.1+/-60.5 weeks and 12.2+/-8.22 mg/day of haloperidol (N=35), 6.95+/-9.52 weeks & 5.03+/-1.88 mg/day of risperidone (N=19), 9.1+/-11.1 weeks & 13.9+/-6.5 mg/day of olanzapine (N=8), 10.2+/-6.3 weeks and 287.6+/-62.9 mg/day of lodopine (N=4), 15.7+/-9.54 weeks and 335+/-172.8 mg/day of clozapine (N=5), 20+/-22.23 & 620+/-265.9 mg/day of chlorpromazine (CPZ; N=5). Mean weight gains of CAP group and AAP group, which was divided by the main therapeutic drug, were 0.18+/-5.99 and 2.18+/-6.38 kg in total subjects, however, there was no statistical significance between the groups. Moreover, there was no statistically significant difference in weight gain between groups when comparing each individual monotherapy (haloperidol, risperidone, olanzapine, lodopine, clozapine, CPZ: ANOVA; df=5, f=1.12, p=0.35). In the laboratory test results of total subjects abnormality of total cholesterol was 23.6%, triglyceride was 50.6%, fasting blood sugar (FBS) 1.7%, hemoglobin A1c (HbA1c) 27.6%, insulin 3.4%. There were statistical significances of correlations between HbA1c & FBS (r=0.489, p<0.01), total cholesterol (r=0.286, p<0.01), low density lipid (LDL; r=0.299, p<0.01) and triglyceride (TG; r=0.277, p<0.05), high density lipid (HDL; r= -0.192, p<0.05), original weight (r=0.154, p<0.05). With ANOVA for the evaluations of drug effect in monotherapy groups, the level of ALT (SGPT; p=0.04) was higher in olanzapine group, TG was higher in clozapine & CPZ group (p=0.03). HDL was lower in lodopine, clozapine & CPZ group (p=0.01). LDLwas highr in olanzapine & lodopine group (p=0.01). Abnormalities of ALT in olanzapine & clozapine group were 37.5% & 40%, those were statistically significant (p=0.02). Although there was no statistical significance (p=0.05), clozapine (60%), CPZ (60%) & olanzapine (37.5%) groups revealed more abundant abnormalities than haloperidol (11.4%) & risperidone (21%) groups in total cholesterol. CPZ (100%), clozapine (80%), lodopine (75%), olanzapine (75%) groups revealed more abundant abnormalities than haloperidol (48.6%) & risperidone (57.9%) groups in TG, however, there was no statistical significance. And the abnormality of HbA1c was 62.5% in olanzapine group and 40% in CPZ group, those were more abundant than other groups (20-25.1%), even though no statistical significance. CONCLUSION: In the cases of Korean patients taking antipsychotic medication, the tentative risk rate of hyperlipidemia might be 18.3% and hyperglycemia might be 27.6%. CPZ, clozapine and olanzapine, as compared with haloperidol and risperidone, may be associated with more adverse changes in total cholesterol and TG. Olanzapine and CPZ, as compared with haloperidol, risperidone and clozapine, may be more risky in the development of hyperglycemia. HbA1c may be an indicator to detect the risk of hyperlipidemia and hyperglycemia in patients taking antipsychotic medications.
Age of Onset ; Antipsychotic Agents* ; Blood Glucose ; Chlorpromazine ; Cholesterol ; Clozapine ; Dyslipidemias ; Fasting ; Haloperidol ; Humans ; Hyperglycemia* ; Hyperlipidemias* ; Informed Consent ; Inpatients ; Insulin ; Male ; Meals ; Medical Records ; Pilot Projects ; Prevalence* ; Risperidone ; Schizophrenia ; Triglycerides ; Weight Gain

Low-grade endometrial stromal sarcoma (LGESS) with intravascular extension is very rare, with only 26 cases having been reported. We experienced a case of LGESS with inferior vena cava (IVC) extension. A 60-year-old female presented with left leg edema. She had a history of total hysterectomy, and was diagnosed of leiomyoma at that time. On imaging study, tumor masses were located around both common iliac veins (CIV), and within the CIV and IVC. The pelvic masses on both side and IVC mass were resected, and then the patient received adjuvant hormonal therapy and radiotherapy over the remnant pelvic masses. LGESS with IVC extension is difficult to distinguish from intravascular leiomyomatosis. LGESS is a malignant disease and commonly recurs, even in early stages. Accurate diagnosis, complete resection, proper adjuvant therapy and close follow-up are very important.
Diagnosis ; Edema ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Iliac Vein ; Korea ; Leg ; Leiomyoma ; Leiomyomatosis ; Middle Aged ; Radiotherapy ; Sarcoma, Endometrial Stromal* ; Vena Cava, Inferior*