No abstract available.
Helicobacter pylori* ; Helicobacter*

Since opening of the Yeungnam University Hospital in June 1983 till end of 1984, total 30 cases of cerebral thrombosis were analyzed clinically. Among the 30. 17 cases were given Urokinase from 60,000 to 240,000 units daily for 2-46 days. The interval from the onset to the inititiation of therapy varied from 1 hour to 17 days. Ten cases showed marked recovery and 6 cases moderate improvement. One case, in which only 120,000 units daily were administered, showed stationary course. The interval of the Urokinase untreated 13 cases was from 3 days to 18 months. Six cases were sationary, whereas 7 cases showed mild improvement. Age, sex, past history, associated diseases, and the laboratory findings are shown in the tables. Conclusion is that the earlier the therapy started, the higher the dosage used, the better of the results is obtained.
Intracranial Thrombosis* ; Urokinase-Type Plasminogen Activator*

Peroneal nerve palsy after total knee arthroplasty is rare. Its etiology is multifactorial. Among them, stretching of the nerve by correction of severe preoperative valgus or flexion deformities, compression of the vascular supply of the nerve by the fascia, direct pressure on the nerve from the dressing are the well known factors which appear to cause development of peroneal nerve palsy. We experienced a case of the peroneal nerve palsy in infected total knee arthroplasty, which was accompanied with subsidence of the tibial prosthesis and report with review of the literature.
Arthroplasty ; Bandages ; Congenital Abnormalities ; Fascia ; Knee ; Paralysis* ; Peroneal Nerve* ; Prostheses and Implants

OBJECTIVE: To evaluate the efficacy of laparoscopic surgery in the treatment of deep endomtriosis, we have studied 30 cases of deep endometriosis. Endometriosis is classified into superficial(<1mm), intermediate(2-4mm), deep(>5mm) and very deep(>10mm) endometriosis by the infiltration depth from the peritoneal surface. In the treatment of deep endometriosis, medical hormonal therapy is not effective, so surgical treatment is required. There are many difficulties in surgiacal treatment ; hard lesion to excise, ditsorted pelvic anatomy after excision, easy to damage to ureter and uterine artery, and limitation for potentially morbid procedure to whom wants to conceive. Especially laparoscopic surgery in the treatment of deep endometriosis is very difficult because it is impossible to know the depth by palpation. In deep endometriosis type II, the lesion is concealed due to rectal adhesion to cul de sac, uterosacral ligament and in type III, the lesion is regarded as a small lesion or missed due to invagination into pelvic floor. The authors compared the laparoscopic surgery with laparotomy to evaluate the efficacy of laparoscopic surgery in the treatment of deep endomtriosis. METHODS: Deep endometriosis, 30 cases out of 102 cases, which were histologically comfirmed as endometriosis were studied. The authors compared the laparoscopic surgery(15 cases) with laparotomy(15 cases) in the surgical treatment of deep endometriosis for operation procedure, operation time, hospital stay and symptoms improvement. RESULTS: The mean operation time of laparoscopic surgeries in deep endometriosis was 178.7(+/-43.1)min while type I, II and III in deep endometriosis took 148.5(+/-21.2)min, 162.0(+/-30.7)min and 245.0(+/-36.1)min respectively and took a little more time than laparotomy. Mean hospital stay in laparoscopic surgeries was 5.7(+/-1.8)days and laparotomy took 10.0(+/-2.3)days that was statistically significant. CONCLUSION: If patients are chosen adequately and operator's skills are satisfactory, laparoscopic surgery is very valuable in the treatment of deep endometriosis. More datas will be required to confirm the efficacy.
Endometriosis* ; Female ; Humans ; Laparoscopy* ; Laparotomy ; Length of Stay ; Ligaments ; Palpation ; Pelvic Floor ; Ureter ; Uterine Artery

The Diltiazem hydrochloride is a new calcium antagonist of which effect on angina pectoris has been reported. Authors studied the clinical effect of Diltiazem in 18 cases of angina pectoris including stable and unstable angina. The 14 cases were male and 4 cases were female with ages ranging 46 to 72 years. All cases had typical anginal attack on 1-6 times in everyday with transient improvement by sublingual nitroglycerin. After coutine physical and laboratory work-up, Diltiazem 30mg tablet was given 3 times a day for 3 consecutive weeks and checked the response of angical pain for first 3 times visit with 3 days interval and thereafter with one week interval. In 13 cases of 15 cases, the Diltiazem alone was medicated. There was considerable improvement of anginal attack in 13 cases of 15 cases with Diltiazem alone, namely complete subsidence of anginal attack throughout 3 weeks in 2 cases, only minimal substernal discomfort on effort once a week in 4 cases and in 7 cases the frequency and severity of anginal pain reduced to about 50% of control state. In 2 of 15 cases there were no effect on anginal pain until one week, subsequently a beta-blocker was added and the anginal attack improved considerably in both cases. In 3 cases of 18 cases, the anginal attacks were so severe and frequent that the Diltiazem with beta-blocker were given from the beginning. In one case the anginal pain disappeared completely and in two cases there were good effect. The effect of Diltiazem usually started to occurs in 3 days to one week after medication. The overall effectiveness of Diltiazem in angina pectoris was 87% with excellent effect in 40%, good effect in 27% and fair effect in 20%. In 5 cases of good response to Diltiazem, the stress exercise test by bicycle ergometer was carried out before and after one week medication with programs of 30 wt, 50 wt, 75 wt, and 100 wt loading for 4 minutes in each stage. The exercise tolerance improved about 25-50 wt, the ST depression by exercise became less by 1-2mm and the maximal heart rate increased by 4-9/min. These data showed marked improvement of exercise tolerance in angina pectoris by Dltiazem objectively. There were macular skin rash, diarrhea and mild dizziness in one case respectively which were improved without treatment. These data showed that Diltiazem was highly effective in angina pectoris except few very severe cases. In severe cases, the combined therapy of Diltiazem and beta-blocker was more effective.
Angina Pectoris* ; Angina, Unstable ; Calcium ; Depression ; Diarrhea ; Diltiazem* ; Dizziness ; Exanthema ; Exercise Test ; Exercise Tolerance ; Female ; Heart Rate ; Humans ; Male ; Nitroglycerin

Antihypertensive and untoward effects of atenolol were studied in 20 cases of essential hypertension with their average pre-treatment systolic and diastolic blood pressures of approximately 160mmhg and 100mmhg, respectively. All patients were assigned to a single dose of 50mg atenolol once daily for a period of four weeks, and a weekly complete history and physical examination. Besides routine blood counts and urinalysis, blood chemistry relating to hepatic and renal functions, and electrolytes balance as well as fasting blood sugar levels were checked before and at the end of medication. In addition, in 10 cases, pulmonary function was studied before and after one week of treatment. With the therapy, the diastolic blood pressure fell to 90mmHg or below in 17 out of 20 cases(85%), and the pre-treatment diastolic blood pressure in the remaining three cases who responded poorly was 108mmHg or above. However two cases of the 17, who responded well and whose blood pressure became normal, had an initial diastolic pressure of 110mmHg each. The hypotensive effect of atenolol on both systolic and diastolic blood pressures was essentially similar, and the effect appeared during the first week with its peak effect occurring during the third week. There was no significant difference during treatment between recumbent and sitting blood pressures, both systolic and diastolic; thus no postural hypotension was observed. The comparison of the results of post-treatment laboratory tests with pre-treatment data revealed no significant changes. These suggest that atenolol can be used in patients with diabetes mellitus, chronic obstructive pulmonary disease or cerebral sclerosis, which are frquently associated with essential hypertension. Also a once-daily dose with satisfactory hypotensive response is one of very practical advantages of atenolol, particularly from the patient's point of view, in the treatment of hypertension, in which a life-long therapy is needed in most cases. Thus atenolol seems to be one of the most attractive choices of drugs for the treatment of mild to moderate hypertension.
Atenolol* ; Blood Glucose ; Blood Pressure ; Chemistry ; Diabetes Mellitus ; Electrolytes ; Fasting ; Humans ; Hypertension* ; Hypotension, Orthostatic ; Physical Examination ; Pulmonary Disease, Chronic Obstructive ; Tuberous Sclerosis ; Urinalysis

Observation of changing pattern of blood pressure and pulse rate of enflurane anesthesia for 200 cases operations, performed during the past 4 years (1983~1986) in Yeungnam University Hospital have been evaluated clinically. In order to observe the influence of enflurane upon the blood pressure and pulse rate during general anesthesia, the authors prepared a formula, expressing changing of blood pressure and pulse rate by time series and analyzed the types and distribution pattern in the experiment. The results obtained were as follows: 1. Blood pressure and pulse rate were increased at the time of intubation. 2. Generally, blood pressure and pulse rate were increased at the time of intubation and then stabilized within 20 minutes. 3. Most common patterns were identified. ADEE type was 73~74%, which is most common type and AEEE type was about 40%.
Anesthesia* ; Anesthesia, General ; Blood Pressure* ; Enflurane* ; Heart Rate* ; Intubation

Adult Wilms' tumor, unlike that of childhood, is a rare disease. Microscopically, the tumor is fundamentally characterized by triplastic embryonal renal tumor composed of variable amounts of metanephric blastema and its epithelial and stromal derivatives but rarely a small group of tumors composed virtually entirely of differentiated epithelial derivatives, the abundance of tubular structures. These monomorphous epithelial type of Wilms' tumor tended to have an early onset and benign course. Grossly, classic Wilms' tumor is a solid tumor, but very rarely shows cystic change and may lead to misinterpretation as a polycystic kidney or multicystic nephroma. Here, we reports a case of primary renal tumor, grossly very similar to a multicystic kidney but histologically represent a tubular monomorphous epithelial variant of Wilms' tumor occured in 63 year old male adult.
Child ; Adult ; Male ; Female ; Humans

Since the development of cardiac monitoring, Holter ECG monitoring, His Bundle electrogram and cardiac pacemaker, the cardiac conduction defect has been diagosed more precisely. Also SA block and sick sinus syndrome were well investigated recently. Author reviewed 10,084 cases of electrocardiograms for recent 3 years which were examined at korea University Hospital and analyzed the incidence of conduction defect, type of SA block, conduction defect in myocardial infarction and the relation of SA and AV conduction defect and Q-T(c). There were 5,390 cases of male and 4,694 cases of female with age range of 10 months to more than 80 years. In 60 cases, 24 hour Holter ECG monitoring were also carried out. The data were as follows; 1. There were 568 cases of cardiac conduction defect out of 10,084 cases and the incidence was 5.64% as a whole. Among the conduction defects, there was SA block in 0.36%, AV block in 2.12%(1st degree in 1.86%, Mobitz type I in 0.11%, Mobitz type II in 0.08%, complete block in 0.07%), bundle branck block in 2.52%(RBBB in 2.13%, LBBB in 0.39%), intraventricular conduction defect in 0.20%, left bundle hemiblock in 0.07%, bifascicular block in 0.05%, 1st degree AV block with BBB in 0.18%, W-P-W syndrome in 0.1% and L-G-L syndrome in 0.04%. 2. There were 36 cases of SA block among 10,084 cases(0.36%). In 26 cases, there were one case of Mobitz type I 2nd degree SA block, Mobitz type II in 20 cases, no P wave with nodal escape in 13 cases and 2 cases of transient sinus arrest associated with syncopal attack which were diagnosed by 24 hour Holter ECG monitoring. 3. There were 45 cases of conduction defect in 122 cases of acute or subacute myocardial infarction(36.9%). Among the 45 cases, there were 2 cases of SA block, 15 cases of 1st degree AV block, 2 cases of 2nd degree AV block, 2 cases of complete AV block, 10 cases of RBBB, 3 cases of LBBB, 4 cases of intraventricular conduction defect and 7 cases of left bundle hemiblock. These data showed lower incidence of critical conduction defect such as Mobitz type II and complete AV block in Korea than in United States. 4. The Q-T(c)interval were measured in 207 cases of SA block and AV block without BBB or IVCD. The values of Q-T(c)in cases of conduction defect were within normal limits. In cases of myocardial infarction, there were mild prolongation of Q-T(c)interval, however there was no difference of Q-T(c)interval between infarction with conduction defect and those without conduction defect. There was no correlation between P-R interval prolongation and Q-T(c)interval. These data suggested that the cardiac conduction defect is a specific involvement of conduction system by various causes rather than diffuse myocardial changes.
Atrioventricular Block ; Electrocardiography* ; Electrocardiography, Ambulatory ; Electrophysiologic Techniques, Cardiac ; Female ; Heart* ; Humans ; Incidence ; Infarction ; Korea ; Male ; Myocardial Infarction ; Sick Sinus Syndrome ; United Nations ; United States

Clonidine, α2-adrenergic agonist, applied spinally or epidurally has been shown to be effective in blocking noxious stimuli in human applications. The purpose of this study is to evaluate the analgesic effect of epidurally administered clonidine. In 40 patients undergoing hemorrhoidectomy or anal fistulectomy, 1.33% lidocaine 15ml (Group I) or 1.33% lidocaine mixed with 75µg clonidine (Group II) administered epidurally through sacral hiatus. Intraoperative changes of vital signs and duration of postoperative analgesic effects were observed. The results were as follows: 1) In the group I, average analgesic duration was 2.42 hours. 2) In the group II, average analgesic duration was 7.32 hours. 3) After epidural clonidine injection, the decrease in heart rate and blood pressure was not significant without sedation. 4) Postoperatively, any complaints related clonidine were not reported. In conclusion, postoperative pain control with epidural clonidine was effective.
Blood Pressure ; Clonidine* ; Heart Rate ; Hemorrhoidectomy ; Humans ; Lidocaine ; Pain, Postoperative ; Vital Signs