BACKGROUND : Heart rate variability informed us to diagnose impairment of autonomic nervous system in patient with diabetes, hypertension, ischemic heart disease, chronic renal disease, arrhythmia. Change of autonomic nervous system is related to circadian rhythm, stress, physical activity, age and so on. Especially, impairment of vagal nervous system with age help us to expect sudden cardiac death, myocardial infarction, arrhythmia. So we survey heart rate variability by using 24 hours Holter monitoring to expect impairment of autonomic nervous system in elderly hypertensive patients. METHODS : In order to assess 24 hours heart rate variability, we used Del Mar Avionics 563 Holter monitoring on 15 older hypertensive patient (>or=65 years), 15 older hypertensive patient(<64 years), 15 younger healthy subjects (<64 years), and 15 older healthy subjects (>or=65 years). The following frequency domain variables were considered: low frequency(LF), high frequency(HF) power spectral parameter, and LF/HF ratio. Results : 1) There was significant decrease in LF power spectral parameter in older groups compared with younger groups 394.0+/-237.8 vs 127.7+/-96.3, p<0.05, 171.8+/-173.5 vs 40.8+/-33.8, p<0.05). 2) In hypertensive patients, there was significant decrease in HF power spectral parameter compared with healthy subjects(989.2+/-553.8 vs 526.0+/-364.7, p<0.05, 804.2+/-404.5 vs 368.8+/-241.2, p<0.05). 3) Although there was no significant difference, L/H ratio decreased in older groups compared with younger gourps. 4) In circadian rhythm, control subjects had low HF power spectral parameter at morning. LF/HF ratio was high at morning in younger groups. CONCLUSION : L/H ratio was depressed in older groups. HF was blunted in hypertensive groups. Thus, impairment of autonomic nervous system was accelerated by age and hypertension.
Aged ; Arrhythmias, Cardiac ; Autonomic Nervous System ; Circadian Rhythm ; Death, Sudden, Cardiac ; Electrocardiography, Ambulatory ; Heart Rate* ; Heart* ; Humans ; Hypertension ; Motor Activity ; Myocardial Infarction ; Myocardial Ischemia ; Nervous System ; Renal Insufficiency, Chronic

The authers had diagnosed and treated 560 upper gastrointestinal polys by endoscopy on 479 patients who had visited to the gastraeaterologic department of Hae Wha hoapital, Medical College of Korea University from January, l980 to June, l991. The results were as follows; 1) The incidence of upper gastrointestinal polyps among 52,031 endoscopy cases was 0.92% with no sexual difference and increased after 5th. decade. 2) The moet prevalent location of upper gastrointestinal polypes was stomach(90.0%), among which antrum occupied 52.9%. 3) The main symptoms of patients with upper gastrointestinal polyp were epigastric pain(77.7%), indigestion(57.0%) and acid belching(26.5%). 4) Histopathologic examination of 504 polyps in stomach revealed that 411(81.5%) were hyperplastic polyp and 80(15.9%) were adenomatous polyp. In duodenum, 35(68.6%) polyps were hyperplastic and 7(l3.7%) were adenomatous. All of 5 esophageal polyps were hyperplastic.
Adenomatous Polyps ; Duodenum ; Endoscopy ; Humans ; Incidence ; Korea ; Polyps* ; Stomach

Diffuse neonatal hemangiomatosis (DNH) is a rare entity with the distinctive features of multiple hemangiomas of the skin and internal organs, which may result in a fatal outcome if wide-spread involvement of the internal organs. We report a case of DNH with cutaneous and hepatic involvement. The significant regression in the vascular lesions was achieved with systemic corticosteroid therapy.
Fatal Outcome ; Hemangioma ; Skin

To establish the hematological reference values in the healthy adults visited our hospitals, following examination were done on 2823 persons by Coulter Counter Model S-plus II ; white blood cell count (WBC), red blood cell count (RBC), hemoglobin (Hb), hematocrit (Hct), meant corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW), platelet, plateletcrit, mean platelet volume (MPV) and platelet distribution width (PDW). The following results are obtained. 1) Male, mean value of WBC; 6,800±2,680 (2SD)/µl Female, mean value of WBC; 5,950±2,380 (2SD)/µl 2) Male, mean value of RBC; 428±60 (2SD)x104/µl Female, mean value of RBC; 415±56 (2SD)x104/µl 3) Male, mean value of Hb; 15.4±1.8 (2SD) g/dL Female, mean value of Hb; 13.0±1.6 (2SD) g/dL 4) Male, mean value of Hct; 45.3±5.0 (2SD)% Female, mean value of Hct; 38.2±4.6 (2SD)% 5) Male, mean value of MCV; 93.8±5.8 (2SD) fL Female, mean value of MCV; 92.2±7.4 (2SD) fL 6) Male, mean value of MCH; 31.8±2.2 (2SD) pg Female, mean value of MCH; 31.4±2.8 (2SD) pg 7) Male, mean value of MCHC; 34.0±1.2 (2SD)% Female, mean value of MCHC; 33.9±1.2 (2SD)% 8) Male, mean value of RDW; 12.7±1.0 (2SD)% Female, mean value of RDW; 12.6±1.4 (2SD)% 9) Male, mean value of Platelet; 242.9±87.8 (2SD) X103/µl Female, mean value of Platelet; 242.2±89.0 (2SD) X103/µl 10) Male, mean value of Plateletcrit; 0.201±0.076 (2SD)% Female, mean value of Plateletcrit; 0.204±0.076 (2SD)% 11) Male, mean value of MPV; 8.20±1.70 (2SD) fl Female, mean value of MPV; 8.36±1.82 (2SD) fl 12) Male, mean value of PDW; 16.1±0.8 (2SD)% Female, mean value of PDW; 16.0±0.8 (2SD)%
Adult* ; Blood Platelets ; Erythrocyte Count ; Erythrocyte Indices ; Female ; Hematocrit ; Humans ; Leukocyte Count ; Male ; Mean Platelet Volume ; Reference Values*

The goal of total knee replacement is to relieve pain, to stabilize joint movement and to correct deformity. It is indicated for patients with rheumatoid arthritis, osteoarthritis and severe post-traumatic arthritis. The author analyzed 71 patients(106 cases), who received the PFC type of total knee replacement from August 1992 and the results were as follows; 1. Among the 71 patients, male was 8 patients and female was 63 patients whose average age was 56 years and average follow up period was 24 months, ranged from 8 months to 3 years 8 months. 2. Rheumatoid arthritis was the most common cause with 31 patients(56 cases) followed by osteoarthritis with 39 patients(49 cases). There was also one patient(1 case) that showed bony union of the knee due to old tuberculosis. The average duration of the illness was 12 years and the average weight of the patients was 57.7kg. 3. Flexion contracture decreased from an average of 21 degrees to 5 degrees after the operation. The range of motion increased from an average of 92 degrees before the operation to 117 degrees afterwards in cases of rheumatoid arthritis and decreased slightly from 108 degrees to 106 degrees in cases of osteoarthritis. 4. The tibiofemoral angle was corrected from an average 1.5 degrees varus before the operation to an average 6.7 degrees valgus after operation. Eighty seven percent of patients with rheumatoid arthritis showed valgus deformity and seventy eight percent of degenerative osteoarthritis patients showed varus deformity preoperatively. 5. Radiographically, the joint line position shifted an average 2.3mm in rheumatoid arthritis and an average 0.3mm in osteoarthritis. The component position, the femoral flexion was an average 89.6 degrees in the anteroposterior view, an average 87 degrees in the lateral view. 6. The thickness of the patella measured in the operating room of 61 cases was an average 21mm and after resection of patella, the remaining bone measured an average of 13.6mm. 7. To achieve soft tissue balance, 29 patients(33 cases) underwent medial stripping and 23 patients(30 cases) had patella lateral release. 8. The Insall Knee Rating Score was used to evaluate the results. The results were 69 cases excellent, 33 cases good, 3 fair and 1 poor. Ninety two percent of the patients had good or excellent results in average 24 months follow-up. 9. The complications consisted of one case of delayed deep infection, one case of patellar subluxation and one case of supracondylar fracture of the femur.
Arthritis ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Knee ; Congenital Abnormalities ; Contracture ; Female ; Femur ; Follow-Up Studies ; Humans ; Joints ; Knee ; Male ; Operating Rooms ; Osteoarthritis ; Patella ; Range of Motion, Articular ; Tuberculosis

Subungual exostosis is a solitary fibrus nodule on the inner border of the terminal phalanx of the great toe. Rarely, the terminal phalanges of other toes, particularly the little toe, or even the fingers are involved. The first appearance is a small pinkish growth projecting slightly beyond the inner free edge of the nail, which pushes upward and backward. A case of Subungual exostosis affecting 20 year old man, who has been suffering from bean sized nolule on subungual area of terminal phalanx of left 5th toe. The skin iesion developed 1 year ago, and increased size insidiously and tendemess on pressure or tight shoes was noted. Diagnosis was confirmed by histopathologic and radiologic studies, and treated witb complete excision of tumor mass.
Diagnosis ; Exostoses* ; Fingers ; Humans ; Shoes ; Skin ; Toes ; Young Adult

BACKGROUND: There is increasing concern in many countries about the problem of drug-resistant tuberculosis. Prevalence of primary drug-resistant tuberculosis is the optimal epidemiological indicator for long term monitoring of national tuberculosis control program. Our purpose was The purpose of our study is to assess clinical characteristics and socioeconomic status of patients with drug-resistant tuberculosis. METHODS: We studied 68 cases with durg-resistant Mycobacterium tuberculosis infection diagnosed at the Ewha Womans University Mokdong Hospital from March, 1995 to February, 2000. RESULTS: Patients with primary drug-resistant tuberculosis(PDR) were younger(39.6±16.3 years vs. 48.2±16.5 years; p<0.05), had more population of less than more were under the age of 40 years aged-group(62.9% vs. 36.4%; p<0.05) and were more highly educated than those with acquired drug-resistant tuberculosis(ADR)(38.9% vs. 11.1%; p<0.05). In patients with ADR, the rates of familial history of tuberculosis and living in a rented house residence in a rented house were increased higher than compared with to those of patients with PDR. Patients with ADR had more involved lobes(2.0±0.8 vs. 1.4±0.7; p<0.01) and longer treatment duration than those with PDR(18.3±7.2 months vs. 10.6±6.3 months; p<0.05). Patients with ADR showed larger numbers of resistant were resistant to more number of drugs, lower hospitalization rate and higher rate of self-interruption of medication than those with PDR. In patients with PDR, mono-drug resistance was increased, whereas poly-and multi-drug resistances were decreased compared with those with ADR. Resistance to isoniazid was the highest among antituberculosis drugs, and resistance to isoniazid in patients with ADR was higher than that in patients with PDR(90.9% vs. 71.4%; p<0.05). CONCLUSIONS: Patients with ADR were more likely to include more population be of lower socioeconomic class, and patients with PDR seem seemed to be young and socially active population. For control of drug-resistant Mycobacterium tuberculosis infection, proper isolation and prevention of patient with drug-resistant tuberculosis are needed.
Female ; Hospitalization ; Humans ; Isoniazid ; Mycobacterium tuberculosis ; Prevalence ; Social Class ; Tuberculosis ; Tuberculosis, Multidrug-Resistant*

The authors report our experience of digital pulp reconstruction by free great toe pulp transfer. Twelve patients were treated with lateral great toe hemipulp. Twelve cases of digital pulp defect were reviewed, including 2 thumbs and 10 indices. There were 11 primary cases and 1 case of secondary reconstruction. We noted no necrosis and 5 patients suffered from cold intolerance. The flap sensibility, according to ASSH criteria, was excellent in 1 case, good in 10 cases, fair in 1 case and poor in no cases. The range of the stationary two-point discrimination test was between 4 and 15mm (mean S2-PD value; 7.2mm). The subjective evaluation found in 11 patients was satisfactory and dissatisfactory in 1. Performing this procedure during the acute phase may improve the management of trauma by reducing the time needed for cicatrisation and the length of disability. Furthermore, the principal advantages of this procedure are minimal donor site morbidity, as well as excellent functional and cosmetic gain.
Discrimination (Psychology) ; Humans ; Necrosis ; Thumb ; Tissue Donors ; Toes*

BACKGROUND: The blunted tip of a reusable with multiple uses can cause problems with the passing procedure in arthroscopic Bankart repair. This study assessed the advantage of Scorpion with a 70° arthroscope in arthroscopic Bankart repair compared to hook typed suture passer. METHODS: Scorpion in 19 patients, the hook type suture passer (conventional group) in 18 patients were used. All patients underwent the same procedure except for the type of suture passer used. Another different point of the procedure were telescopes and the number of portals used; three arthroscopic portals (posterior, anterorsuperiorlateral, and mid-anterior) and a 30° arthroscope in the conventional group, but two portals and a 70° arthroscope as well as the 30° one in the Scorpion group. The surgery time and the surgical complications including an iatrogenic axillary nerve injury were recorded. RESULTS: The Scorpion group showed a significant decrease in surgery time compared to the conventional group. In contrast to the conventional group, Scorpion provided an easy estimation of the exit of suture passing, no iatrogenic labral injury during the passing procedure with straight movement and the sharp tip of the knife installed. Iatrogenic supraspinatus injuries could be avoided when making an accessory anteosuperiorlateral portal due to the 70° arthroscope. CONCLUSIONS: In arthroscopic Bankart repair, the use of the Scorpion suture passer and a 70° arthroscope can reduce the surgery time, avoid unnecessary supraspinatus injury, and avoid iatrogenic axillary nerve damage through the relatively easy and precise suture passing and saving of the anterosuperior portal.
Arthroscopes* ; Arthroscopy ; Humans ; Scorpions* ; Sutures* ; Telescopes

Recently, a benign variant of scleroderma, called the C.R.S. T, syndrome, has ben ibed by Winterbauer. Patients with this disorder have skin changes such as Cermal and subr,utaneous calcinosis, Raynauds phenomenon, sclerodactyly, and te1angiectasia. With the passible exception. of the gastroirgestinal syaterh, involvernent of other organs is uncommon, and affected. individuals have a Iong clinical cgurse. A case of C.R.S.T. syndrome in 25-year-old femala in reported with brief reviev of literatures. The patient showed miultiple pea sized nodular depoaits on dermal and subcuta.neous layers of both elbow and. knee joints, Rayaauds phenamenon, sclerrodactyly with acroselerosis and sclerodermatous change on both hands and forearm and telangiectasia on face and both palms On eeophagogram, slight disturhance of passage at the cardioesophageal junetion area was noted.
Adult ; Calcinosis ; Elbow ; Forearm ; Hand ; Humans ; Knee Joint ; Peas ; Skin ; Telangiectasis