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.
Pulmonary Atelectasis*

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*

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

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

No abstract available.
Accidents, Traffic*

No abstract available.

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

To avoid unnecessary transfusions of blood products, a patient's current hematologic and hemodynamic status must be evaluated thoroughly by assessing on-going and anticipated bleeding using a pre-determined transfusion threshold, and overall physiological conditions should be monitored using various parameters. A large, randomized investigation of critically ill pediatric patients demonstrated that a restrictive approach, with a lower hemoglobin transfusion threshold of 7.0 g/dl, was not harmful during the immediate postoperative period, compared to a liberal hemoglobin policy of 9.0 g/dl. Subgroup analyses supported a restrictive policy in patients with more serious conditions. Furthermore, packed red blood cell transfusion was related to adverse postoperative outcomes, such as prolonged mechanical ventilation. Therefore, a "restrictive" policy can be adopted for intraoperative transfusion in otherwise healthy patients. However, more investigations are needed to replace the conventional "liberal" approach in patients with compromised oxygenation, such as cyanotic congenital heart disease or pulmonary insufficiency. There is no "universal" transfusion threshold for all pediatric patients.
Blood Transfusion ; Critical Illness ; Erythrocyte Transfusion ; Heart Defects, Congenital ; Hemodynamics ; Hemorrhage ; Humans ; Oxygen ; Postoperative Period ; Respiration, Artificial

Among the postoperative complications of ptosis surgery, lagophthalmos and lid lag have been significant and untolerable problems. In this study, progressive change of lagophthalmos and lid lag following external levator resection was examined in 109 eyes of 74 patients from November 1988 through March 1996. Lagophthalmos and lid lag were measured at postoperative 1 month, 3 to 9 months and 12 to 18 months. The relations of lagophthalmos and lid lag according to preoperative MRD, levator function, resection amount of the levator muscle were analyzed. Lagophthalmos measured average 1.11mm and lid lag revealed average 4. 73mm at postoperative 11 to 84 months (mean 22.2 months). At the postoperative 1 year, lagophthalmos and lid lag were significantly decreased and decreasing amount measured 1.17mm and 0.90mm, respectively. Seventy eyes showed lagophthalmos less than 1mm at mean 13 months postoperatively. The postoperative change of lagophthalmos and lid lag had relation to the preoperative levator function.
Humans ; Postoperative Complications