BACKGROUND: Recently, it is substituted automatic sphygmomanometer for mercury sphygmomanometer. But it seems to be insufficient for data of its accuracy. A sample accurate automatic sphygmomanometer could have an important role in the management of hypertension. The aim of this study is to assess the accuracy of the automatic sphygmomanometer that is used common practice and at home. METHODS: We collected 247 patients who visited the department of Famiiy Practice of Taegu medical center from April to August 1996. BP was measured sequentially same arm by standard device(mercury. sphygmomanometer), test device A(A&D TM-2650), test device B(seine SE-2000). We assessed the automatic sphygmomanometer according to the standards set out by the British Hypertension Society(BHS) protocol and the American Association for the Advancement of Medical Instrumentation(AAMI). These data were analysed using pearson' correlation and paired t-test. RESULTS: Test device A was highly correlated to mercury sphygmomanometer in systolic and diastolic BP(r=0.90, r=0.88). Also test device B was highly correlated to that(r=0.90, r=0.87). The mean difference between BP value obtained by the standard device and those obtained by the test device A were 0.59+/-7.66mmHg systole(mean+/-SD) and 3.83+/-6.43mmHg diast.ole, whereas the difference between the former and those obtained by the test device B were 1.70+/-7.99mmHg systole.and 5.58+/-6.38mmHg diastole. Comparing to standard device, there were a signifioant difference except systolic BP of test device A(P<0.05). According to the criteria of the AAMI, the diastolic BP of test device B was not enough and according to the criteria of the BHS, the diastolic BP of both test device were not enough. CONCLUSIONS: Both test device were highly correlated to mercury sphygmomanometer. But according to the criteria of the BHS and AAMI, there were not enough. Because the use of automatic sphygmomanometer was popularized, I think that further study will be required to assess of accuracy.
Arm ; Blood Pressure* ; Daegu ; Diastole ; Humans ; Hypertension ; Sphygmomanometers*

PURPOSE: To evaluate the clinical characteristics of pseudophakic retinal detachment(RD) as RD is the most common sight-threatening complication after cataract surgery. METHODS: We analysed retrospectively the clinical characteristics of 22 pseudophakic RD patiens(23 eyes) which had been operated from January 1993 to December 1997 and followed for 6 months or longer at the Gyeongsang National University Hospital. RESULTS: The average age of the patients was sixty-three and male predominated 19 eyes(82.6%). According as types of IOL implantation included 14 eyes with posterior chamber IOL, 7 eyes with sclera-fixated IOL, 2 eyes with anterior chamber IOL, and 16 eyes(70%) occurred the posterior casule rupture. The interval between IOL implantation and the development of RD was 9.6 months on average and 78% of eyes developed RD within 1 year. In eyes with sclera-fixated IOL, the interval was shorter than others, In cases with ruptured posterior capsule, RD occurred earlier than those with intact posterior capsule. Retinal breaks were principally located in the upper quadrants in 12 eyes(63%) and horseshoe tear was most commmonly encountered. RD involving 3 or more quadrants was observed in 12 eyes(51%) of patients, and macular detachment in 18 eyes(78%). Anatomic success achieved in 83%. The most common cause of the failure was the development of proliferative vitreoretinopathy. Visual results in eyes with ultimate anatomic success of RD repair improved 0.5 or more in 80% if the macula was not involved and in 14.2% if the macula was involved. CONCLUSION: We thought that thorough fundus examination is neccessary during the follow-up of pseudophakic eye with posterior capsule rupture and sclera-fixated IOL after cataract surgery.
Anterior Chamber ; Cataract ; Follow-Up Studies ; Humans ; Male ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Retrospective Studies ; Rupture ; Vitreoretinopathy, Proliferative

PURPOSE: To report a case of moyamoya disease initially presenting transient visual loss in a healthy young subject. CASE SUMMARY: A 20-year-old male with no history of systemic disease or trauma visited our clinic due to sudden onset visual loss in the right eye. There were no accompanying symptoms, including headache, seizure, paresis, or paresthesia. Best corrected visual acuity at the first visit was hand movement in the right eye and 20/20 in the left eye. No abnormal finding was revealed in the anterior segment. On fundus examination, whitening at post pole was found in the right eye. In fluorescein angiography, a choroidal and retinal artery filling delay in the posterior pole was noted. The patient's visual acuity began to improve gradually and was recovered to 20/20 by the next day. Moyamoya disease was diagnosed based on magnetic resonance angiography of the brain and transfemoral cerebral angiography as well as stenosis of the internal carotid artery and middle cerebral artery with collateral vessel networks. CONCLUSIONS: Moyamoya disease should be considered as a possible cause of transient visual loss in healthy young subjects.
Brain ; Carotid Artery, Internal ; Cerebral Angiography ; Choroid ; Constriction, Pathologic ; Eye ; Fluorescein Angiography ; Glycosaminoglycans ; Hand ; Headache ; Humans ; Magnetic Resonance Angiography ; Male ; Middle Cerebral Artery ; Moyamoya Disease ; Paresis ; Paresthesia ; Retinal Artery ; Seizures ; Visual Acuity ; Young Adult

No abstract available.
Breast Neoplasms* ; Breast* ; Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy*

BACKGROUND: Mannitol is widely used in neurosurgical patients and may induce an increase in serum potassium concentration according to doses and administration rates with unknown mechanism. The treatment of hyperkalemia is aimed at eliminating the causes and includes calcium, sodium bicarbonate, glucose with insulin, loop diuretics and hyperventilation. This study was undertaken to observe the effects of hyperventilation on the serum potassium concentration following infusion of mannitol (2.0 gm/kg). METHODS: We studied 30 patients who were operated brain aneurysm clipping surgery and were divided into 3 groups (n=10). In control group, mild hypocapnia was maintained (PaCO2, 32 2 mmHg) before and after mannitol infusion. In group I, moderate hypocapnia was maintained (PaCO2, 27 2 mmHg) before and after mannitol infusion. In group II, mild hypocapnia (PaCO2, 32 2 mmHg) was maintained before 30 minutes of mannitol infusion and moderate hypocapnia (PaCO2, 27 2 mHg) after mannitol infusion. We started infusion of 20% mannitol with a dosage of 2.0 gm/kg, 15~20 min after cranium was opened. RESULTS: The changes of serum potassium were as follows (Mean SD mEq/l) (just before and 15min, 30min, 60min after mannitol infusion): 3.79 0.48, 4.66 0.60, 4.44 0.48, 4.13 0.40 (Control group), 3.62 0.18, 3.63 0.42, 4.14 0.51, 3.95 0.33 (Group I), 3.76 0.20, 3.91 0.15, 4.11 0.30, 4.04 0.23 (Group II). After 15 minutes of mannitol infusion, the serum potassium levels of group I and II were lower than that of control group (p<0.05) and there was no significant difference between group I and II. CONCLUSIONS: These results suggest that hyperventilation may blunt the increase in serum potassium concentration following rapid infusion of high dose mannitol.
Calcium ; Glucose ; Humans ; Hyperkalemia ; Hyperventilation* ; Hypocapnia ; Insulin ; Intracranial Aneurysm ; Mannitol* ; Potassium* ; Skull ; Sodium Bicarbonate ; Sodium Potassium Chloride Symporter Inhibitors

BACKGROUND: A reliable, well-validated home blood pressure(BP) self measurement device could have an important role in the management of hypertension. Rigorous assessment of such a device have not performed well, particularly in the hypertensive range. METHODS: We assessed the National EW274W device(oscillometric) for home messurem of BP according to the standards set out by the British Hypertension Society protocol and American Association for the Advancement of Medical Instrumentation(AAMI). The device was compared with sequential measurements using a standard mercury sphygmomanometer in the same arm in 105 patients aged 16-79 years. The BP of subjects was measured three times at least a week apart. These data were analysed using Pearson's correlation and paired t-test. RESULTS: The device was highly correlated to mercury sphygmomanometer in mean systolic BP(SBP) and mean diastolic BP(DBP) (r=0.93, r=0.93, P<0.05). The device was satisfactory over the whole BP range(SBP 106-182mmHg, DBP 56-116mmHg), with a B grade for SBP and a A grade for DBP(British Hypertension Society protocol) and a PASS for both SBP and DBP(AAMI). Sensitivity and specificity are 84.2%, 93.0%(mean SBP) and 100%, 96.9% (mean DBP). CONCLUSIONS: We concluded the wrist blood pressure meter(National EW274W) for home BP measurement is highly satisfactory and is suitable for clinical use.
Arm ; Blood Pressure* ; Humans ; Hypertension ; Sensitivity and Specificity ; Sphygmomanometers ; Wrist*

Simulated Brown syndrome is a term applied to a myriad of disorders that cause a Brown syndrome-like motility. We encountered a case of acquired simulated Brown syndrome in a 41-year-old man following surgical repair of fractures of both medial orbital walls. He suffered from diplopia in primary gaze, associated with hypotropia of the affected eye. We performed an ipsilateral recession of the left inferior rectus muscle as a single-stage intraoperative adjustment procedure under topical anesthesia, rather than the direct approach to the superior oblique tendon. Postoperatively, the patient was asymptomatic in all diagnostic gaze positions.
Adult ; Anesthesia, Local ; Diplopia/*etiology/surgery ; Eye Movements ; Humans ; Male ; Ocular Motility Disorders/*etiology/radiography/surgery ; Oculomotor Muscles/surgery ; Ophthalmologic Surgical Procedures ; Orbital Fractures/radiography/*surgery ; *Postoperative Complications ; Strabismus/etiology/surgery ; Tomography, X-Ray Computed ; Vision, Binocular

Superior sagittal sinus thrombosis (SSST) is an uncommon cause of stroke, whose symptoms and clinical course are highly variable. It is frequently associated with a variety of hypercoagulable states. Coagulation abnormalities are commonly seen in patients with hyperthyroidism. To the best of our knowledge, there are few reports on the association between hyperthyroidism and cerebral venous thrombosis. We report on a 31-year-old male patient with a six-year history of hyperthyroidism who developed seizure and mental deterioration. Findings on brain computed tomography (CT) showed multiple hemorrhages in the subcortical area of both middle frontal gyrus and cerebral digital subtraction angiography (DSA) showed irregular intra-luminal filling defects of the superior sagittal sinus. These findings were consistent with hemorrhagic transformation of SSST. Findings on clinical laboratory tests were consistent with hyperthyroidism. In addition, our patient also showed high activity of factors IX and XI. The patient received treatment with oral anticoagulant and prophylthiouracil. His symptoms showed complete improvement. A follow-up cerebral angiography four weeks after treatment showed a recanalization of the SSS. In conclusion, findings of our case indicate that hypercoagulability may contribute to development of SSST in a patient with hyperthyroidism.
Adult ; Angiography, Digital Subtraction ; Brain ; Cerebral Angiography ; Follow-Up Studies ; Hemorrhage ; Humans ; Hyperthyroidism ; Male ; Seizures ; Stroke ; Superior Sagittal Sinus ; Thrombophilia ; Thrombosis ; Venous Thrombosis

OBJECTIVE: We compared the radiological and clinical outcomes between patients who underwent posterior fixation alone and supplemented with fusion following the onset of thoracolumbar burst fractures. In addition, we also evaluated the necessity of posterolateral fusion for patients treated with posterior pedicle screw fixation. METHODS: From January 2007 to December 2009, 46 consecutive patients with thoracolumbar burst fracture were included in this study. On the basis of posterolateral fusion, we divided our patients into the non-fusion group and the fusion group. The radiological assessment was performed according to the Cobb's method, and results were obtained at immediately, 3, 6, 12 months after surgery. The clinical outcomes were evaluated using the modified Mcnab criteria at the final follow-up. RESULTS: The demographic data and the mean follow-up period were similar between the two groups. Patients of both groups achieved satisfactory clinical outcomes. The mean loss of kyphosis correction showed that patients of both groups experienced loss of correction with no respect to whether they underwent the posterolateral fusion. There was no significant difference in the degree of loss of correction at any time points of the follow-up between the two groups. In addition, we also compared the effect of fixed levels (i.e., short versus long segment) on loss of correction between the two groups and there was no significant difference. There were no major complications postoperatively and during follow-up period. CONCLUSION: We suggest that posterolateral fusion may be unnecessary for patients with thoracolumbar burst fractures who underwent posterior pedicle screw fixation.
Follow-Up Studies ; Humans ; Kyphosis

The changes of arterial carbon dioxide partial pressure considerably influence cerebral blood flow and different anesthetic agents have different effects on cerebrovascular physiology. However the importance of these differences in neuroanesthetic practice are unclear. Transcranial Doppler ultrasonography allows the noninvasive direct measurements of cerebral blood flow velocity and direction in the basal brain arteries. The authors performed transcranial Doppler ultrasonography to measure the blood flow velocity of middle cerebral artery in 12 patients who were anesthetized with 10 mcg/kg of fentanyl and 66 % nitrous oxide in oxygen(fentanyl group) and 12 patients with 1.0 vo1% isoflurane and 66 % nitrous oxide in oxygen(isoflurane group) during normocapnia(P(ET)CO(2)=38 mmHg) and hypocapnia(P(ET)CO(2)=28 mmHg)state. The carbon dioxide reactivity was expressed as the changes in mean blood flow velocity per unit changes in endtidal carbon dioxide partial pressure(P(ET)CO(2)). Mean blood flow velocity of middle cerebral artery decreased from 46.6+/-8.9 cm/s to 30.0+/-5.3 cm/s in the fentanyl group and 42.7+/-5.6 cm/s to 32.5+/-4.6 cm/s in the isoflurane group as the P(ET)CO(2) decreased from 38 mmHg to 28 mmHg. There was a significant difference between the CO2 reactivity of fentanyl group(1.7+/-0.7 cm/s/mmHg) and isoflurane group(1,0+/-0,2 cm/s/mmHg) (p<0.05). It is concluded that hyperventilation is more likely to affect cerebral blood flow during fentanyl-nitrous oxide anesthesia than during isoflurane-nitrous oxide anesthesia.
Anesthesia ; Anesthetics ; Arteries ; Blood Flow Velocity ; Brain ; Carbon Dioxide ; Fentanyl* ; Humans ; Hyperventilation ; Isoflurane* ; Middle Cerebral Artery ; Nitrous Oxide ; Partial Pressure ; Physiology ; Ultrasonography, Doppler, Transcranial