Antihypertensive and beta-adrenoceptor blocking effect of long-acting propranolol were observed in the outpatient department, Department of Internal Medicine, National Medical Center during the period between December, 1981 and May, 1982. The clinical effects of long-acting propranolol were compared with those of conventional propranolol and following results were obtained. 1) Direct cross-over from conventional propranolol 20mg three times a day for several days to long-acting propranolol 160mg once daily was not accompanied by appreciable side effect and there was fairly good antihypertensive effect either in systolic or diastolic pressure. 2) Antihypertensive and bata-adrenoceptor blocking effect of long-acting propranolol 160mg once daily were comparable to those of conventional propranolol 40mg three or four times a day. The compliance of the patients to long-acting propranolol once daily was naturally better than that to conventional propranolol which must be taken three to four times daily. 3) In several cases of trial, the patients who tolerated the long-acting propranolol 160mg per day also well tolerated the regimen of long-acting propranolol 320mg per day, 4) The regimen of long-acting propranolol once daily was recommendable to those patients who were on beta-blocking agents for prolonged period of time for their indications such as hypertension and other chronic cardiovascular diseases, in view of the aspects of good patient compliance, good antihypertensive and beta-blocking effect.
Blood Pressure ; Cardiovascular Diseases ; Compliance ; Humans ; Hypertension ; Internal Medicine ; Outpatients ; Patient Compliance ; Propranolol*

No abstract available.
Leiomyosarcoma ; Vena Cava, Inferior

A 52-year-old woman with esential mixed cryoglobulinemia (type II ), which was confirmed by cryoglobulin elcct,rophoresis and immunofixation elect,rophoresis, had purpuric skin lesions on the legs. The lesions had a tendency of recurrence for the past 2 years, and moderate degrees of arthralgia and myalgia were accompanied in each time. However, the patient had not been suffered from any internal organ distress caused by the disease proress. Histological examinations of a skin lesions revealed a feature of leukocytoclatic vasculitis, and deposits of IgM, IgG and C; were also recognized. A regimen of small doses of prednisolone was effective for the cutaneous lesions in this patient for 4 months follow-up until this writing. It, seems that the patient has had a mild form of the disease among the clinical spectrum of mixed cryoglobulinemia, with a cryocrit value of 2.4% at the time of her initial visit..
Arthralgia ; Cryoglobulinemia* ; Female ; Follow-Up Studies ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Leg ; Middle Aged ; Myalgia ; Prednisolone ; Recurrence ; Skin ; Vasculitis ; Writing

INTRODUCTION: The purpose of this study was to investigate the changes in the concern and attitudes of Nursing students toward the disabled before and after the disability experience program. METHOD: 151 Nursing students with clinical practice in National rehabilitation hospital were conveniently selected as the subject. All subjects had experience the disability program, and their attitudes toward the disabled were measured before and after the 3hours' program. Collected data were analyzed by SPSS 11.0 with paired t-test. RESULTS: 1. The concern toward the disabled after their disability experience program was more positive than before(t= -4.930, p= .000). 2. The attitudes toward the disabled after their disability experience program was more positive than before(t=5.892, p=.000). 3. The appreciation of daily life after their disability experience program was higher than before(t=- -8.563, p= .000). CONCLUSION: In summary, the disability experience program should be effective in order to promote the positive attitude toward the disabled. Therefore expansion of this program is of profound significant.
Humans ; Nursing* ; Rehabilitation ; Students, Nursing*

OBJECTIVE: Fetal heart rate in embryos(6-8 gestational weeks) have been significantly related to fetal outcome, but have rarely been studied. We attempted to identify fetal heart rate during 6-8 gestational weeks. Our purpose was to determine the lower limit of the heart rate associated with a favorable outcome and to evaluate the prognosis for those embryos with slow heart rates in early period. METHODS: We prospectively studied 798 singleton pregnancies between Jul. 1997-Dec. 1999 visiting our hospital. Gestational age was calculated from the beginning of the last menstrual period in the case of regular cycle and was confirmed by the crown-rump length. Other cases were measured by crown-rump length or mean gestational sac diameter. Color doppler sonography was used to calculate the fetal heart rate in beats per minute as the mean of 3 waves. RESULTS: Mean fetal heart rate (+/-SD) were 114.08+/-15.40 bpm for group 1, 126.49+/-18.78 for group 2, 139.83+/-19.92 for group 3, and 149.58+/-23.34 for group 4(p<0.001). Prognosis in the first trimester improved as heart rate increased to 100 bpm in group 1 and 120 bpm in group 2. In group 3 and 4, most of fetus with heart rates below 110 bpm died. CONCLUSIONS: The fetal heart rate during 6-8 gestational weeks is associated with fetal outcome at the end of the first trimester and we can identify the fetuses that are in risk.
Crown-Rump Length ; Embryonic Structures ; Female ; Fetal Heart* ; Fetus ; Gestational Age ; Gestational Sac ; Heart Rate ; Heart Rate, Fetal* ; Humans ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy* ; Prognosis ; Prospective Studies ; Ultrasonography*

We evaluated MR imaging of spondylolytic spondylolisthesis degenerative spondylolisthesis and retrolisthesis in 14, 9 and 20 patients respectively. Sagittal and axial spin echo and gradient echo images were obtained with 25-30cm FOV and 5mm/0.5mm thickness/gap by using spine surface coil. Sagittal images showed defects of pars interarticularis just inside of the pedicles of spines in all the cases of spondylolytic spondylolisthesis with relatively variable signal intensity. Displaced vertebrae were commonly observed at L5 (8/14) in spondylolytic spondylolisthesis, at L4 (5/9) in degenerative spondylolisthesis and at variable locations in retrolisthesis. The mean length of displacement of vertebrae in spondylolytic spondylolisthesis was about 7mm and less displacement was onserved in degenerative spondylolisthesis and retrolisthesis. Seven, four and six cases of pseudobulging of disk at displaced level were observed in cases of spondylolytic spondylolisthesis, degenerative spondylolisthesis and retrolisthesis respectively. Seven, five and 14 cases of true disk lesions were onserved in cases of spondylolytic spondylolisthesis, degenertive spondylolisthesis and retrolisthesis respectively. Grade II neural foraminal stenoses (obliteration of one half epidural fat of neural foramen) were commonly (8/14) seen in spondylolytic spondylolisthesis, however the other two types showed less severe neural foraminal stenosis. In conclusion, MR imaging is a highly accurate method for the diagnosis and evaluation of spondylolisthesis and associated lesions of spine and disks.
Constriction, Pathologic ; Diagnosis ; Humans ; Magnetic Resonance Imaging* ; Methods ; Spine ; Spondylolisthesis*

No abstract available.
Accidents, Traffic*

PURPOSE: Colorectal surgery, there are many important prognostic factors---depth of invasion, lymph node metastasis and distant metastasis. In there, the involvement of the lymph nodes by metastatic colorectal carcinoma may depends on several factors such as the sex, the age of the patient, tumor site and size, the symptomatic duration of the disease, tumor cell differentiation, and operating methods. In that point of view, we want to know how many lymph nodes are dissected for enough to determine statistically considerated Dukes C stage. METHODS: We had studied 128 operation cases of colorectal adenocarcinoma from our hospital admission during the period of May, 1988 to October, 1997 to determine to provide an accurate assessment of the presence of nodal metastases. Patients status, tumor site and size, symptomatic duration of disease, tumor cell differentiation, and operating methods of 128 cases were analyzed. We calculated the probability to find at least one positive node in Dukes C, by binomial distribution from SPSS (version 7.5). RESULTS: Eighty-three specimens (65%) were classified as Dukes B. Forty-five specimen (35%) had lymph node metastases (Dukes C) with a mean of 4.1+/-4.1 positive lymph nodes per specimen. The mean total number of lymph nodes identified per specimen was 11.6+/-7.4 (range 1~41), Dukes B was 10.9+/-7.1 (range 1~29) and Dukes C was 12.8+/-7.9 (range 3~41). Applying Students t-test to compare two independent average means, the result was the absence of significant differences in the number of nodes for the specimens defined as Dukes B and Dukes C, sex, age, symptom duration, and operationmethods whereas significant differences did exist for the specimen depending on the tumor differentiation, tumor size, and location. Poorly differentiation cancer was more prominent meaning than well or moderately differentiation in Dukes B (p<0.05). In stage Dukes C, if tumor size was below 2cm it was differences in other sizes (p<0.05). In tumor location, if tumor sited ascending colon was more prominent than sigmoid and rectum (p<0.05). According to our result, minimum 6 lymph nodes per specimen were optimal Dukes C staging assessment. CONCLUSION: The minimum 6 lymph nodes provided an accurate assessment of the presence of nodal metastases (95 percent confidence interval) in Dukes C stage.
Adenocarcinoma ; Cell Differentiation ; Colon, Ascending ; Colon, Sigmoid ; Colorectal Neoplasms* ; Colorectal Surgery ; Humans ; Lymph Nodes* ; Neoplasm Metastasis ; Rectum

No abstract available.
Technetium Tc 99m Dimercaptosuccinic Acid*

BACKGROUND: The Cobas(R) Integra is a new automated chemistry analyzer with continuous and random-access features for routine chemistries, specific proteins, electrolytes, therapeutic drugs and drugs of abuse. The system maintains 68 test-specific reagent cassettes on board and have test principles of absorbance photometry, immunoturbidometry, fluorescence polarization and ISE measurements. We evaluated the usefulness of Cobas(R) Integra in the aspect of accuracy, precision, linearity, comparison study, test speed and general performance. METHODS: We evaluated the analytical performance of the Cobas(R) Integra for T. bilirubin, CRP, BUN, creatinine, sodium, potassium, chloride, valproic acid, phenytoin and carbamazepine according to NCCLS guidelines (EP5-T2, EP6-P, EP9-T and GP10-T). RESULTS: In accuracy study, error ranges(%) of most test items, except sodium and chloride, were within analytic goals. In within-run and between-run precision study, Coefficient of variation (CV, %) of most items, except sodium, were lower than limits suggested by College of American Pathologists Survey 1991. The linearities were maintained well in the range of medically significant levels and were statistically acceptable (p<0.001). The comparison study for most items, except sodium and chloride, indicated good correlation with Hitachi 747 and TDx FLx(TM) and correlation coefficients (r) were above 0.98. Throughput was about 450 tests/hr. CONCLUSIONS: Cobas(R) Integra showed satisfactory accuracy, precision, linearity, good correlation with other analyzers and high throughput. So, we concluded that Cobas(R) integra is highly suitable for not only routine use but also emergency tests in medium to large-sized hospitals because of its high productivity and reliability.
Bilirubin ; Carbamazepine ; Chemistry* ; Creatinine ; Efficiency ; Electrolytes ; Emergencies ; Fluorescence Polarization ; Phenytoin ; Photometry ; Potassium ; Sodium ; Street Drugs ; Valproic Acid