No abstract available.
Femoral Neck Fractures* ; Femur Neck* ; Femur* ; Fracture Fixation, Intramedullary*

BACKGROUND: Effective oral loading of carbamazepine (CBZ) is very important as it is the most often administered drug for partial and generalized seizures. The pharmacokinetics and tolerability of a single oral loading of controlled-release form of carbamazepine (CBZ-CR) were assessed in 38 adult patients at risk for seizure. METHODS: CBZ-CR was administered to 38 adults (22 had had CBZ just before entry into the study and 16 had not) at a dosage of 20 mg/kg as a single loading. Side effects and serum levels of CBZ and CBZ-10,11-epoxide (CBZ-E) were evaluated at 0, 2, 4, 6, 8, 12, 18, 24 h after the loading. Correlations between the frequency of side effects and other parameters (maxium serum concentration : Cmax, time to maximum concentration Tmax and area under the concentration time curve (AUC) of CBZ and CBZ-E) were also assessed. RESULTS: Mean CBZ serum levels (percentage of subjects with level > 4 Mg/ml shown in parenthesis) were 0.0 (0%), 3.2 (30%), 6.1 (79%), 7.2 (92%), 7.7 (95%), 7.7 (95%), 7.7 (95%) and 7.1 Mg/ml (95%) at 0, 2, 4, 6, 8, 12, 18 and 24 h after loading. Cmax and Tmax were 8.42 Mg/ml and 13.2 h respective-ly. Although side effects developed in 15 patients (39%), there were no significant neurotoxic side effects. The frequen-cy of the history of CBZ use was not different (p<0.05) in the two groups (one had side effects, another had not). Cmax, Tmax, and AUC of CBZ and CBZ-E were also not different (p<0.05). CONCLUSIONS: A single oral loading dose of CBZ-CR provides therapeutic serum concentrations quickly (in most patients within 6h) and is well tolerated. Rapid loading with CBZ-CR appears to be a useful alternative for the management of patients with a high risk of seizures.
Adult ; Anticonvulsants ; Area Under Curve ; Carbamazepine* ; Humans ; Pharmacokinetics ; Seizures

BACKGROUND AND OBJECTIVES: The growing implantations of electrophysiological devices in the context of increasing rates of chronic antithrombotic therapy in cardiovascular disease patients underscore the importance of an effective periprocedural prophylactic strategy for prevention of bleeding complications. We assessed the risk of significant bleeding complications in patients receiving anti-platelet agents or anticoagulants at the time of permanent pacemaker (PPM) implantation. SUBJECTS AND METHODS: We reviewed bleeding complications in patients undergoing PPM implantation. The use of aspirin or clopidogrel was defined as having taking drugs within 5 days of the procedure and warfarin was changed to heparin before the procedure. A significant bleeding complication was defined as a bleeding incident requiring pocket exploration or blood transfusion. RESULTS: Permanent pacemaker implantations were performed in 164 men and 96 women. The mean patient age was 73+/-11 years old. Among the 260 patients, 14 patients took warfarin (in all of them, warfarin was changed to heparin at least 3 days before procedure), 54 patients took aspirin, 4 patients took clopidogrel, and 25 patients took both. Significant bleeding complications occurred in 8 patients (3.1%), all of them were patients with heparin bridging (p<0.0001). Heparin bridging markedly increased the length of required hospital stay when compare with other groups and the 4 patients (1.5%) that underwent the pocket revision for treatment of hematoma. CONCLUSION: This study suggests that hematoma formation after PPM implantation was rare, even among those who had taken the anti-platelet agents. The significant bleeding complications frequently occurred in patients with heparin bridging therapy. Therefore, heparin bridging therapy was deemed as high risk for significant bleeding complication in PPM implantation.
Anticoagulants ; Aspirin ; Cardiovascular Diseases ; Female ; Hematoma ; Hemorrhage ; Heparin ; Humans ; Length of Stay ; Male ; Ticlopidine ; Warfarin

The causes of blindness may be related to a person's life style, social status, age, sex, place of residence and era. To investigate the general aspects of the causes of blindness, authors reviewed clinical records of 16,671 patients who visited the Ophthal mology Department of Chonnam University Hospital in the years 1977, 1980, 1985, and 1989. After reviewing records of patients who had corrected vision below 0.1, we have obtained following results. 1. In the studied sample, 1,696 patients were identified as blind. The blind males(11.0%) were more prevalent than the blind females(9.3%) with a significant difference(p<0.05) and the blininess occurred most frequently in the sixtieth age group. 2. The leading etiologic factors of the blindness were cataract(43.0%) followed by trauma(19.4%), general eyeball dise~ses etc. In 1977 the main cause of blindness was general eyeball diseases. Thereafter, cataract was the leading cause of the blindness. 3. Visual acuities of studied samples were in the order of hand motions, 0.02-0.06, counting fingers, and light perception. The most common causes of absolute blindness were trauma and general eyeball diseases. In the case of visual acuity of better than hand motions, cataract was the leading cause. Cataracts were more prevalent in the age group above fiftieth, while trauma was the chief cause in those under thirtieth. 4. Suggested etiology of disease which directly cause blindness included unknown etiology(54.8%), trauma, undetermined and systemic diseases. In the unknown etiology group, cataract and glaucoma were distributed in high proportion while in the trauma group corneal diseases were the chief cause.
Blindness* ; Cataract ; Corneal Diseases ; Fingers ; Glaucoma ; Hand ; Humans ; Jeollanam-do ; Life Style ; Visual Acuity

PURPOSE: To report two cases that showed clinical findings of recurrent keratoconus following penetrating keratoplasty. METHODS: A 39 year-old male and a 34 year-old female developed clinical signs of recurrent keratoconus in his left and her right eye 3 and 8 years after keratoplasty, respectively, and he underwent successful corneal regrafting. RESULTS: We confirmed recurrence of keratoconus histopathologically through the examination of the cornea of the recipient who underwent corneal regrafting and chromosomal study showed mosaicism, 47,XXY/46,XY. CONCLUSION: We report the histopathologic feature of one case of recurrent keratoconus for the first time in Korea.
Adult ; Cornea ; Corneal Transplantation ; Female ; Humans ; Keratoconus* ; Keratoplasty, Penetrating ; Korea ; Male ; Mosaicism ; Recurrence

A 29-year-old man was referred to the emergency department with a complaint of abdominal pain and dizziness. He had experienced two previous syncopal episodes. His family history revealed that his mother and his two uncles had received permanent pacemaker implantation. His initial heart rate was 49 beats per minute. The electrocardiography (ECG) showed atrial flutter and right bundle branch block (RBBB) with left anterior fascicular block (LAFB). On admission, 24-hour Holter showed ventricular pause up to 16 seconds during syncope. Radio frequency catheter ablation (RFCA) of atrial flutter was performed. The ECG revealed bifascicular block (RBBB and LAFB) and first-degree atrioventricular block. He received a permanent pacemaker implantation. His brother's and his sister's ECGs also showed trifascicular block and the pedigree showed autosomal dominant inheritance. This patient was diagnosed with a progressive familial heart block (PFHB) type I. This would be the first report of a PFHB type I case documented in Korea.
Abdominal Pain ; Adult ; Atrial Flutter ; Atrioventricular Block ; Bundle-Branch Block ; Catheter Ablation ; Dizziness ; Electrocardiography ; Emergencies ; Heart ; Heart Block ; Heart Rate ; Humans ; Korea ; Mothers ; Pedigree ; Syncope ; Wills

BACKGROUND: Exercise testing is a standard noninvasive method used in the evaluation and management of patients with suspected coronary artery disease. However, patients with lower limb impairment are unable to undergo a standard bicycle or treadmill test. Alternative methods of exercise testing are needed for patients with vascular, orthopedic or neurologic conditions who cannot perform leg exercise. This study was aimed to determine the diagnostic accuracy of arm exercise thallium-201 SPECT for evaluating chest pain in patients unable to perform leg exercise. METHOD: Twenty-five anginal patients performed arm ergometry testing in conjunction with thallium-201 SPECT. Thereafter all underwent coronary angiography. RESULT: Significant coronary artery disease (> or =50% stenosis) in at least one vessel was present in 22 (88%) of the 25 patients. The sensitivity of thallium-201 SPECT for detecting coronary artery disease was 91%, which was significantly higher than the 32% sensitivity found with the electrocardiographic response alone (p <0.001). Thallium-201 SPECT yielded a sensitivity of 88, 86 and 100% for one, two, and three vessel diseases, respectively, and an 84% sensitivity and 81% specificity for detecting individual vessel stenosis. CONCLUSION: Arm exercise thallium-201 SPECT is useful for detecting coronary artery disease in patients unable to perform leg exercise. In addition, it provides an information regarding exercise tolerance. Therefore, this test appears to be reliable and useful and should be considered in the detection of coronary artery disease in nonambulatory patients.
Angina Pectoris ; Arm* ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Electrocardiography ; Exercise Test ; Exercise Tolerance ; Humans ; Leg ; Lower Extremity ; Orthopedics ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Aminophylline* ; Humans* ; Ritodrine* ; Uterus*

BACKGROUND: Laser therapy is generally postponed until scar maturation. We speculated that the use of laser therapy at the beginning of the wound healing process might minimize discomfort and problems at an early stage. METHODS: From January 2013 to May 2014, we conducted a study of 50 patients who underwent primary closure or scar revision procedures due to facial scarring. Within 1 to 2 weeks after the removal of all stitches, we performed laser treatments with a 532-nm neodymium-doped yttrium aluminium garnet (Nd:YAG) laser. To assess the improvement of the scars, we evaluated the scars using the Vancouver Scar Scale (VSS) and conducted a photo analysis using a computer graphics program. RESULTS: The mean score on the VSS decreased from 5.99 to 1.49 after the laser treatment. The score for each evaluation item decreased, meaning that the scars improved. The differences showed statistical significance. In the photo analysis that was conducted using Adobe Photoshop, the mean brightness of the pixels located within the scar territory increased from 61.54% to 69.42% after laser treatment, and the mean chroma decreased from 50.65% to 43.12%. These changes were statistically significant. CONCLUSIONS: We used a 532-nm Nd:YAG laser at an early stage of scar formation and confirmed improvements in the redness, hyperpigmentation, and hypertrophy of the scars shortly after treatment.
Cicatrix* ; Computer Graphics ; Humans ; Hyperpigmentation ; Hypertrophy ; Laser Therapy ; Wound Healing ; Yttrium

BACKGROUND: Laser therapy is generally postponed until scar maturation. We speculated that the use of laser therapy at the beginning of the wound healing process might minimize discomfort and problems at an early stage. METHODS: From January 2013 to May 2014, we conducted a study of 50 patients who underwent primary closure or scar revision procedures due to facial scarring. Within 1 to 2 weeks after the removal of all stitches, we performed laser treatments with a 532-nm neodymium-doped yttrium aluminium garnet (Nd:YAG) laser. To assess the improvement of the scars, we evaluated the scars using the Vancouver Scar Scale (VSS) and conducted a photo analysis using a computer graphics program. RESULTS: The mean score on the VSS decreased from 5.99 to 1.49 after the laser treatment. The score for each evaluation item decreased, meaning that the scars improved. The differences showed statistical significance. In the photo analysis that was conducted using Adobe Photoshop, the mean brightness of the pixels located within the scar territory increased from 61.54% to 69.42% after laser treatment, and the mean chroma decreased from 50.65% to 43.12%. These changes were statistically significant. CONCLUSIONS: We used a 532-nm Nd:YAG laser at an early stage of scar formation and confirmed improvements in the redness, hyperpigmentation, and hypertrophy of the scars shortly after treatment.
Cicatrix* ; Computer Graphics ; Humans ; Hyperpigmentation ; Hypertrophy ; Laser Therapy ; Wound Healing ; Yttrium