A total of 4757 apparently healthy aged persons over 65 years of age was surveyed for geriatric hypertension. A single blood pressure measurement was taken in the sitting position. Mean systolic blood pressure rose significantly with age in female but didn't in male and mean diastolic blood pressure didn't change with age in both sex. The prevalence of pure systolic hypertension, i.e., a systolic blood pressure greater than or equal to 160 mmhg and a diastolic blood pressure less than 95mmhg, increased with age. The prevalence was slighty lower for female than it was for male, being 7.0% for female and 8.0% for male. The prevalence of classical hypertension-defined as diastolic blood pressure greater than or equal to 95mmhg - was 42.7% for female and 48.2% for male and it rose with age in female. The prevalence of both pure systolic and classical hypertension was 49.7% for female and 56.1% for male.
Blood Pressure ; Epidemiologic Studies* ; Female ; Humans ; Hypertension* ; Korea* ; Male ; Prevalence

Since Sicard, Cathlin and Tuffier performed the first sacral extradural anesthetic technique in 1901, surprisingly increased interest in this technique and basic investigation has been done concerning the anatomy, the physiology, and the fate of the local anesthetic in the body, after in jection in the epidural space. Recently, a decreasing interest in peridural anesthesia and nerve block thechniques have resulted from the availability of more efficacious and more safe volatile anesthetics. However in case of contraindication of both general and spinal anesthesia, this caudal anesthesia should be available and very usefull. Authers have undertaken to evaluate the circulatory effect of caudal anesthesia with the injection of lidocain into the epidural space through the sacral hiatus. Ten cases were selected and observed the change of the cardiovascular system before and after caudal anesthesia. The changes of the heart rate and systolic blood pressure between pre-and post anesthesia were insignificant statistically.
Anesthesia ; Anesthesia, Caudal* ; Anesthesia, Epidural ; Anesthesia, Spinal ; Anesthetics ; Blood Pressure ; Cardiovascular System ; Epidural Space ; Heart Rate ; Lidocaine* ; Nerve Block ; Physiology

One hundred and ten patients with carcinoma of the nasopharynx were treated by radiation therapy in Deoartment of Therapeutic Radiology, Seoul National University Hospital between 1979 and 1985. Among these, one hundred and five patients were treated with curative intent and 5 patients with palliative aim. Excluding 16 patients who did not receive a full coarse of radiation therapy, the remaining 89 patients were reviewed for this analysis. Minimum follow-up period of survivors was 36 months. Forty-three percent of the patients had T4 primary lesions and 72% had stage IV disease. The histology was squamous cell carcinoma in 46% of the patients. undifferentiated carcinoma in 49%, and lymphoepithelioma in 5%. Total radiation dose to the primary site averaged 6,500 cCY for T1, T2 lesions and 7,500 cCY for T3, T4 lesions. Neck node were given boost treatment to a maximum 7,500 cCY depending on the extent of disease. Early primary lesion(T1, T2) and neck nodes were successfully controlled in most cases when dose of greater than 6,500 cGy was delievered. Forty two patients(47%) had recurred, 16 of whom(38%) recurred at the primary site and 24(57%) developed distant metastases. Of these, 9 patients received re-irradiation with or without chemotherapy and local control was obtained in 2 patients(22%). Actuarial overall survival and disease-free survival rate was 42% and 38% at 5 years. T-stage and histotogic subtype were not correlated with survival. However, N-stage was related to survival significantly(p=0.043).
Carcinoma ; Carcinoma, Squamous Cell ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Humans ; Nasopharynx ; Neck ; Neoplasm Metastasis ; Radiation Oncology ; Seoul ; Survivors

PURPOSE: To understand the morphologic and molecular changes in carcinogen-induced breast tissues, DMBA (10-dimethy1-1,2 benzanthracene) was administrated in Sprague- Dawley female rats. MATERIALS AND METHODS: At 50 days of age, all experimental rats were given 20 mg DMBA by gastric intubation. Until the seventh week after DMBA administration, six rats were sacrificed every week, thereafter all tumors found during 20 weeks were removed every week. The morphologic changes were evaluated in routinely processed sections stained with H-E and with anti-smooth muscle actin antibody. Mutation of Ha-ras codons 12 and 61 was examined by ARMS (amplification refractory mutation system) method in frozen tissues. RESULTS: The epithelial cell proliferation of terminal end buds began 2 weeks after DMBA treatment and progressed to the 6th week, resulting in microscopic malignant tumor in one of the 7th weeks rats. The tumors were developed in 43 of 62 rats (69.4%); 8 benign lesions in 4 rats and 72 malignant tumors in 39 rats. Mutations in the 12th and 61th codon of Ha-ras gene were respectively found in 29.7% and 2.7% of preneoplastic breasts, 25% in benign lesions, 2.6% and 31.6% of malignant tumors. CONCLUSION: DMBA treatment in rats induced epithelial proliferation, then benign and malignant tumors through Ha-ras gene mutation, especially in codon 61 leading to cancer.
9,10-Dimethyl-1,2-benzanthracene* ; Actins ; Animals ; Arm ; Breast ; Codon ; Epithelial Cells ; Female ; Genes, ras ; Humans ; Intubation ; Rats*

OBJECTIVES: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder showing many neuropsychological deficits. Many environmental risk factors have been thought to increase the risk for the disorder. We examined blood iron levels in children with ADHD and a control group to find an association between iron deficit and diagnosis, neuropsychological characteristics and clinical features. METHODS: An ADHD group (n=50) and control group (n=45) of children 6-12 years of age were recruited. Both groups were diagnosed by semi-structured interview, and they were evaluated using the Korean version of the ADHD Rating Scale (K-ARS), Korean version of IOWA Conner's Rating Scale (K-IOWA), intelligence quotient (IQ), and neurocognitive function tests (continuous performance test, children's color trails test, Stroop color-word test). Iron levels in blood were determined using the inductively coupled plasma mass spectrometry instrument. Independent t-test and correlation were used to determine the relation of blood iron levels with symptom ratings and neurocognitive function. Logistic regression was performed to determine the diagnostic value of blood iron levels. RESULTS: Blood iron levels were significantly lower in ADHD than in control and showed negative correlation with K-ARS and K-IOWA scores. Blood iron levels showed positive association with IQ and Stroop color-word test results and negative association with results of continuous performance testing. Low blood iron levels predicted the diagnosis of ADHD. CONCLUSION: Lower levels of blood iron were associated with ADHD symptom severity, IQ, and frontal lobe-mediated neurocognitive function. As blood iron levels may influence ADHD, measurement of iron levels in blood may be useful for evaluation of symptoms and neurocognitive function in ADHD.
Child* ; Diagnosis ; Humans ; Intelligence ; Iowa ; Iron* ; Logistic Models ; Mass Spectrometry ; Plasma ; Risk Factors

A central vacuum scavenger modified by the authors, was used to control the atmospheric contamination of the operating room by anesthetic gases and vapours. Air pollution was monitored by measuring the concentrations of halothane vapour in the air of the operating room with the gas chromatograph. Under endotrachal intubation, the semi-colsed circle absorber system was used for anesthetic administration and maintained with 0.8~1.2% Halothane. Total gas flow rates were 4 liter/min with 50% oxygen in nitrous oxide for daily work. Air sampling was taken early in the morning at 10cm high from the floor before anesthesia. After daily work, they were also done at 10cm, 120cm, and 140cm high from the floor and at the corridor of the operating room. We investigated the differences of halothane concentration according to each sits by the changing central vacuum pressure. Results are followings: The atmospheric halothane concentration of the operating room before anesthesia were 0.27+/-0.12, 0.22+/-0.11 and 0.15+/-0.06 ppm.The atmospheric halothane concentration of the operating room after daily work were 7.94 +/- 1.30 ppm without the active central vacuum pressure.The atmospheric halothane concentration of the operating room after daily work were 1.41 +/-0.48ppm of 20mmHg of central vacuum pressure.The tmospheric halothane concentration of the operating room after daily work were 0.49+/-0.18ppm of 40mmHg of central vacuum pressure. The atmospheric halothane concentrations at the corridor of the operating room after daily work were 1.09+/-0.19, 0.77+/-0.11n and 0.36+/-0.17ppm when each vacuum pressure was 0mmHg, 20mmHg and 40mmHg. A significant reduction (p<0.01) in atmospheric halothane concentration of the operation room was obtained by the use of the central vacuum pressure with the scavenger. The higher the vacuum pressure, the greater reduction of the operating room air pollution was observed.
4-Acetamido-4'-isothiocyanatostilbene-2,2'-disulfonic Acid ; Air Pollution* ; Anesthesia ; Anesthetics, Inhalation ; Halothane* ; Intubation ; Nitrous Oxide ; Operating Rooms* ; Oxygen ; Vacuum*

The authors retrospectively analized the radiographs and medical records of 135 consecutive patients who underwent minimaly invasive spinal surgery from January, 1990 to December, 1994 at our institution. Among these, 72 patients have had chemonucleolysis and others percutaneous automated lumbar discectomy(PALD). The success rate was similar in both groups, ie, 75% in chemonucleolysis and 74.6% in PALD by Macnab's criteria. The higher success rate could be obtained in 1) younger age below 30, 2) predominant sciatica than lower back pain, 3) eccentric bulged disc with minimal degeneration, 4) abscent or minimal neurologic deficits. In conclusion, provided patients are carefully screened, minimal invasive spinal surgery is more preferable over conventional surgery, providing a safe and effective therapeutic alternative to many patients suffering from herniated lumbar disc.
Diskectomy* ; Humans ; Intervertebral Disc Chemolysis* ; Low Back Pain ; Medical Records ; Neurologic Manifestations ; Retrospective Studies ; Sciatica

We analyzed 20 cases of traumatic carotid cavernous fistula(CCF) during the recent 10 years The results are summarized as follows: 1) In 18 cases(90%), the clinical symptoms & signs of CCF occurred within 2 months after trauma. 2) The sites of fistulae were common in horizontal segment(40%) and at the junction(30%) between horizontal segment and posterior ascending segment of cavernous portion of internal carotid artery. 3) The main draining veins of CCF were the superior ophthalmic vein(90%) and the inferior petrosal sinus(70%). 4) The methods of treatment were occlusion of fistula with balloon(9 cases), occlusion of cavernous ICA with balloon(2 cases), ligation of cervical ICA with Poppen's clamp(4 cases) and trapping(2 cases). Two patients were not treated and another patient was healed spontaneously. 5) The frequency and severity of complication was significantly decreased in cases treated by detachable balloon occlusion than by direct cervical ICA ligation or trapping procedures. 6) The procedure using the self-sealed goldvalve balloon was simple, but had a risk of premature separation and premature deflation.
Balloon Occlusion ; Carotid Artery, Internal ; Fistula* ; Humans ; Ligation ; Veins

OBJECTIVES: The aim of this study was to investigate the gender differences of direct aggression and relational aggression in Korean elementary and middle school students. METHODS: Parents of 946 elementary school students(age 9.54±1.72 years, 485 boys, 461 girls) completed the Child Behavior Checklist(CBCL). Six-hundred-and-three middle school students(age 13.98±0.93 years, 301 boys, 302 girls) completed the Youth Self-Report(YSR). Independent t-test, chi-square test, and Fisher's exact test were used. RESULTS: Boys had significantly higher direct aggression scores than girls in elementary school students(p<0.001). There was no significance gender difference of relational aggression in elementary school students(p=0.235). In middle school students, boys had significantly higher direct aggression than girls(p=0.017), and girls had significantly higher relational aggression compared to the boys(p<0.001). CONCLUSION: Our results suggest the presence of gender differences in manifestation of aggression subtypes in Korean elementary and middle school students. These gender differences should be taken into account in prevention and intervention approaches of aggression in children and adolescents.
Adolescent* ; Aggression* ; Child Behavior ; Child* ; Female ; Humans ; Parents

BACKGROUND: An important metabolic feature of acromegaly is a reduced action of insulin on hepatic gluconeogenesis and peripheral glucose disposal which mediated by growth hormone hypersecretion. Octreotide, a synthetic octapeptide somatostatin analogue exerts complex effects on hormonal and metabolic regulations affecting glucose homeostasis. This study was designed to ascertain the shorterm effect of octreotide on glucose tolerance in acromegaly. METHODS: 10 patients (five men and five women, age 47.9+/-11.8) were injected subcutaneously with octreotide, 100 micrograms for 24 hours. Patients were assessed with respect to growth hormone, glucose, and insulin response to a standard 100 g oral glucose tolerance test (OGTT) before and during the last 2 hour of octreotide infusion. RESULTS: During the therapy, there was significant decrease in mean blood glucose response to OGTT (678.4+/-51.9 vs 581.9+/-47.3 mg/dL/2hr: mean areas under the glucose curve, p=0.01) and mean serum insulin response to oral glucose load was significantly reduced in all patients (339.2+/-106.2 vs 256.7+/-111.3 U/mL/2hr: mean areas under the insulin curve, p=0.01). Using glucose tolerance test criteria three patients of 10 had normal glucose tolerance, four and three had impaired glucose tolerance and diabetes, respectively, at base line. While on octreotide these composition was changed to six patients of NGT, three of IGT and one diabetes. CONCLUSION: We conclude that insulin resistance mediated by GH hypersecretion was improved by shorterm octreotide treatment.
Acromegaly* ; Blood Glucose ; Female ; Gluconeogenesis ; Glucose Tolerance Test ; Glucose* ; Growth Hormone ; Homeostasis ; Humans ; Infusions, Subcutaneous* ; Insulin ; Insulin Resistance ; Male ; Octreotide* ; Social Control, Formal ; Somatostatin