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

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

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

No abstract available.
Snake Bites* ; Snakes*

Leiomyoma is a benign solitary tumor which is originated from a smooth muscle cell and grows slowly. It is most commonly found in the uterus and can develop anywhere that smooth muscle is present, including esophagus, lower extremity, stroma of GI tract, and pleura. However, the occurrence of leiomyoma in the hand is so uncommon. We present one case of solid type leiomyoma found in the right 4th finger of a young woman.
Esophagus ; Female ; Fingers ; Gastrointestinal Tract ; Hand ; Humans ; Leiomyoma ; Lower Extremity ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Pleura ; Uterus

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*

No abstract available.
Rectal Neoplasms*

BACKGROUND: With the number of cancer survivors increasing, follow-up care to deal with problems related to their original cancer is needed. One of these is screening for a second primary cancer as cancer survivors are one of the high-risk groups for cancer occurrence. The purpose of this study was to assess the screening rates of major cancers in patients with a history of cancer in Korea. METHODS: Our data were from the 4th Korea National Health and Nutrition Examination Survey. We narrowed the data to include 11,169 adults aged 40 and 80 years. Participants were grouped according to their history of cancer and the time since cancer diagnosis into no cancer group (no cancer diagnosis), cancer survivor group (cancer diagnosis > or =5 years ago), and cancer follow-up group (cancer diagnosis <5 years ago). We estimated the screening acceptance rates of major cancers according to the cancer history and assessed the relationships between them. RESULTS: The cancer screening rates of stomach, breast, cervix, and colon were 42.4+/-4.9%, 45.5+/-5.6%, 42.1+/-6.4%, and 24.1+/-3.8% for the cancer survivor group and 45.6+/-5.2%, 61.9+/-6.2%, 48.8+/-7.0%, and 20.8+/-4.3% for the cancer follow-up group. A history of cancer diagnosis was not related to the acceptance rate of stomach and cervical cancer screening. Breast cancer screening (odd ratio [OR], 1.783; 95% confidence interval [CI], 1.044-3.048) increased only in the cancer follow-up group. At 5 years after a cancer diagnosis, only the screening rate for colon cancer (OR, 1.701; 95% CI, 1.119-2.588) persistently increased compared to individuals without a history of cancer. CONCLUSIONS: The screening for breast cancer was the only screening examination whose rate increased in the cancer follow-up group, with the significance disappearing in the cancer survivor group. Our results demonstrate that the screening rate for secondary cancers is below optimal in cancer patients in Korea.
Adult* ; Breast ; Breast Neoplasms ; Cervix Uteri ; Colon ; Colonic Neoplasms ; Diagnosis* ; Early Detection of Cancer ; Female ; Follow-Up Studies ; Humans ; Korea* ; Mass Screening* ; Neoplasms, Second Primary ; Nutrition Surveys ; Stomach ; Survivors ; Uterine Cervical Neoplasms

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

No abstract available.
Appendicitis* ; Child* ; Humans