To assess the role of multiple factors in influencing occurrence of ventricular premature complexes after acute myocardial infarction twenty-four hour Holter electrocardiographic tape recording were made in 40 survivors of an acute myocardial infarction 10 to 20days after attack. Ventricular premature complexes in the early post infarction period were not correlated with left ventricular function, age, sex, smoking, diabetes mellitus, previous angina, and previous myocardial infarction. The occurrence of ventricular premature complexes showed a positive correlation with the occurrence of ST-T change. The occurrence of ventricular premature complexes during sleep hours was compared to the awake state. In 22 patients, the incidence of ventricular premature complexes are excluded from analysis, the 22 of patients, or in 76 percent, sleep was associated with a lowered occurrence of ventricular extrasystoles.
Diabetes Mellitus ; Electrocardiography ; Humans ; Incidence ; Infarction ; Myocardial Infarction ; Smoke ; Smoking ; Survivors ; Tape Recording ; Ventricular Function, Left ; Ventricular Premature Complexes*

No abstract available.
Adenocarcinoma*

Fewer than one half of patients with acute myocardial infarction is a candidate for thrombolytic therapy. Current data revealed that primary coronary stenting may be useful alternative to intravenous thrombolytic therapy for acute myocardial infarction in these subset of patients. We experienced a patient presenting with acute myocardial infarction and acute promyelocytic leukemia in whom thrombolytic therapy was thought be not eligible due to hemorrhagic tendency. Primary coronary stenting was performed successfully without complications. Follow-up angiography revealed no evidence of restenosis or stent occlusion.
Angiography ; Follow-Up Studies ; Humans ; Leukemia, Promyelocytic, Acute ; Myocardial Infarction ; Stents* ; Thrombolytic Therapy

The hemostatic effect of endoscopic microwave coagulation method for upper gastrointestinal bleeding was evaluated clinically. Hemostasis over 72 hours was achieved in 18 of 20 cases (90%) with upper gastrointestinal bleeding by the endoscopic microwave coagulation method. It is noteworthy that this method was effective in all 4 cases of pulsatile bleeding from exposed vessels. We conclude that this method is useful for emergency endoscopic hemostasis on upper gastrointestinal bleeding, especially bleeding from exposed vessels.
Emergencies ; Hemorrhage* ; Hemostasis ; Hemostasis, Endoscopic ; Microwaves*

Chronic osteomyelitis continue to be a therapeutic challenge. The osteomyelitis also implies chronic ischemia of the diseased bone ; thus systemic antibiotic treatment may not be as effective as we want. In 1972, Klemm developed a new procedure to supplement saucerization in the treatment of chronic osteomyelitis, alternative to irrigation and suction-drainage, i.e., Gentamicin-PMMA Beads. The authors analysed 35cases of the chronic osteomyelitis which were admitted and treated by sauceriztion and Gentamicin-PMMA Beads in Department of Orthopaedic Surgery, Korea Veterans Hospital from Aug. 1984 to Jan. 1988.
Gentamicins ; Hospitals, Veterans ; Ischemia ; Korea ; Osteomyelitis ; Polymethyl Methacrylate

BACKGROUND: The purpose of the current study is to investigate anatomical relationships between the muscle overlying the distal transverse carpal ligament (TCL) and the thenar motor branch of the median nerve. METHODS: Of the 192 wrists that underwent open carpal tunnel release, a muscle belly overlying the TCL was observed on the distal margin of TCL in 25 wrists and ligament exposure could not be achieved without transection of it. We recorded surgical findings of these 25 wrists. The origin of the recurrent motor branch arising from the major median nerve was marked on the axial and coronal section diagrams of the wrist. RESULTS: The presence of muscle overlying the TCL was seen in 25 wrists (21 patients, 13%). The locations of origin were distributed not only on the radial side but anterior or ulnar side of the major median nerve. Abnormal branches originated from the unusual side in 14 cases (56% of those with a muscle overlying the TCL): central-anterior side in eight cases, ulnar-anterior side in five cases, and ulnar side in one case. These anomalous branches were frequently associated with the muscle belly overlying the TCL in our study regardless of the origin site. The branches were prone to cut if careless midline incision along the third web space was performed. Unusual origin and aberrant pathway of the recurrent thenar motor branch were associated with the presence of a muscle overlying the TCL. CONCLUSIONS: A thorough knowledge of the standard and variant anatomy of the muscle belly and recurrent motor branch in the carpal tunnel is fundamental to prevention of complications such as muscle wasting or atrophy by iatrogenic motor branch injury during carpal tunnel release.
Atrophy ; Carpal Tunnel Syndrome ; Humans ; Ligaments* ; Median Nerve* ; Muscles* ; Wrist

OBJECTIVES: Psychiatric patients had less access to psychiatric care due to a stigma associated with psychiatric care. However there have been numerous efforts to break down the stigma. One of them was to change the name of the discipline to Mental Health Medicine, which was established nationwide in August, 2011. Authors try to understand the change of concepts by according to the change of the name of psychiatry. Subjects consisted of undergraduate and graduate students, and university faculty members. METHODS: The survey was conducted by the Kyung Hee University mass e-mail system. Mails were delivered to the undergraduate and graduate students, and university faculty members. The contents of the survey consisted of questions regarding awareness of the name change (psychiatry-->mental health medicine), positive or negative impressions of the name change, psychiatric history, and eligibility of access to the psychiatric clinic. RESULTS: Most respondents were not aware of the name change (90.8%), however they generally responded to the changed name positively (92.7%). Also they responded that by changing the name, the possibility of the easy access to psychiatric treatment would be expected. The undergraduate students group, the graduate students group, and the below 22 year old group responded more favorably to the name change compared to the faculty group and the above 22-year-old group. They also responded positively to the improvement of easy access to psychiatric treatment. However, regarding the effects of the name change on deciding to receive the psychiatric treatment, only small numbers were agreed to accept treatment. CONCLUSION: This survey showed that the less-than-22-year-old group, undergraduate students group, and graduate students group thought more positively to the name change (psychiatry->mental health medicine) compared to the group of more than the 22 years old and the faculty group. However, only small numbers of those groups answered that they can visit and receive psychiatric treatment when they are needed. One of the reasons they are reluctant to receive psychiatric care is due to the concern of the discrimination in employment and insurance coverage. Campaigns against stigmas for the psychiatric care via the proper method and time are needed nationwide, and should be enhanced. Practical policy should be re-established.
Surveys and Questionnaires ; Discrimination (Psychology) ; Electronic Mail ; Employment ; Humans ; Insurance Coverage ; Mental Health ; Postal Service ; Young Adult

The syndrome of inappropriate ADH secretion is a disorder characterized by hyponatremia which results from water retention attributable to ADH release. The hallmark of SIADH is hyponatremia due to water retention, in the presence of urinary osmolality above plasma osmolality. The SIADH was initially described by Schwartz et al (1957). This syndrome, first recognized in patients with bronchogenic carcinoma, has now been observed in a variety of other illnesses. Recently, we encountered a 59 year-old female with small cell lung cancer, also she had SIADH. Thus, we present a case and review the literature on the subject.
Carcinoma, Bronchogenic ; Female ; Humans ; Hyponatremia ; Inappropriate ADH Syndrome* ; Osmolar Concentration ; Plasma ; Small Cell Lung Carcinoma* ; Water

BACKGROUND AND OBJECTIVES: Benign paroxysmal positional vertigo (BPPV) is one of the most common peripheral vestibular disorders. It constitutes the most common vestibular disorder in the elderly with vertigo. Purpose of this study to assess the clinical characteristics and treatment outcome of BPPV in elderly patients. MATERIALS AND METHODS: We reviewed the medical records of 380 patients above age 60 who were treated for BPPV. Collated data of the elderly BPPV patients in terms of involved canals, number of canalith repositioning procedures and their underlying disease were analyzed and compared with the data of national health report in 2008 that represented the general population. RESULTS: Number of BPPV patients was increased along with age. Three hundred and eighty patients (44.9%) of 847 BPPV patients were over 60. Most commonly involved canal was posterior semicircular canal. Lateral semicircular canal was involved much more frequently (46.8%) compared with previous reports. Along the age, involvement of lateral semicircular canal, frequency of multiple canal involvement and cupulolithiasis increased. In patients older than 60, treatment response was worse than younger ages. More canalith reposition procedures were needed in the elderly than younger patients with BPPV. Between patients with BPPV and normal population, no difference was found in prevalence of co-morbities, such as diabetes, cerebrovascular disease, cardiovascular disease, other otologic disease, and psychiatric disease. CONCLUSION: We suggest that more careful diagnosis and intervention should be considered in BPPV of old age due to its complicated natures and lower treatment response.
Aged ; Cardiovascular Diseases ; Ear Diseases ; Humans ; Medical Records ; Prevalence ; Semicircular Canals ; Treatment Outcome ; Vertigo

Ehlers-Danlos syndrome (EDS) is a very rare genetic disorder characterized by defects in the production of connective tissue. Among them, vascular EDS is the subtype known to have the worst prognosis due to fragile blood vessels. Accordingly, we would like to report a case report of a patient with vascular EDS with a review of the literature on possible massive transfusion and anesthesiological problems. Patients with vascular EDS have very weak blood vessels and tissues that are easily broken. So there is a high possibility of unexpected massive bleeding during emergency surgery in these patients. Therefore, the anesthesiologist should be fully prepared for the possibility of massive blood loss, keeping in mind the possibility of damage to large blood vessels. The central vein must be secured using ultrasound, sufficient blood and fluids must be prepared, and equipment capable of rapid administration must be perfectly prepared before the start of operation.