An analysis of echocardiograms was made in 50 patients with pericardial effusion of various origins, diagnosed by clinical and M-mode echocardiographic examinations. In these cases the estimated volume of pericardial effusion ranged between 40 ml and 999 ml. The width of echo-free space behind the left ventricular wall which reflect the amount of effusion showed a significant positive correlation with the systolic excursion and the diastolic mean velocity of both right and left ventricular epicardial surfaces. The echocardiographic patterns of so-called pseudo-mitral valve prolapse and a notch on the right ventricular epicardial surface during systole were found more frequently in patients with large pericardial effusion. Thus, in pericardial effusion, and echocardiographic examination is useful for the visualization of the abnormal motions of cardiac structures as well as for its diagnosis.
Diagnosis ; Echocardiography* ; Humans ; Pericardial Effusion* ; Prolapse ; Systole

The treatment of acetabular fractures is composed of operative and conservative methods, however, they are still controversial. Generally, because the acetabular fracture involves the joint surface and one sequalae such as post-traumatic arthritis can follow treatment, therefore an accurate reduction and postoperative early mobilization to obtain the prevenation of joint stiffness and arthritis are required. In order to achieve these purposes, we have studied and done a comparative survey between conservative and operative treatment on 55 patients with acetabular fractures, who were treated at our department from Jan. 1982 to Dec. 1988. Results were obtained as follows. 1. The prevalent age was the third decade and the cause of injury was traffic accidents in the majority. 2. The most common type of fracture was a posterior wall by Letournel classification. 3. Satisfactory results of operative treatment were 76% and conservative treatment 47%. 4. The complications were post-traumatic arthritis, ectopic ossification, peroneal nerve palsy and skin infection. 5. In the majority of displaced acetabular fractures, ORIF was recommended.
Accidents, Traffic ; Acetabulum ; Arthritis ; Classification ; Early Ambulation ; Humans ; Joints ; Ossification, Heterotopic ; Paralysis ; Peroneal Nerve ; Skin

Simple posterior hip dislocations requiring open reduction is very few and reported approximately 3% of all posterior hip dislocations and we have little comments of the various causes preventing or blocking a concentric reduction following traumatic posterior hip dislocation. In a review of eleven cases of posterior dislocation requiring open reduction, we divided two groups, one is a failed closed reduction group, the other is a nonconcentric reduction group. A concentric reduction was prevented from an inverted limbus or an osteocartilagenous loose body from acetabulum or femoral head.
Acetabulum ; Dislocations ; Head ; Hip Dislocation ; Hip

A sepsis or multiple organ dysfunction occurs frequently in the intensive care unit and causes a significant number of mortality and morbidity. Somtimes polyneuropathy of varying severity occurs in association with a sepsis or critical illness. Since the clinical evaluation is often difficult, electrophysiologic studies are employed to reveal a definitive evidence for polyneuropathy. The purpose of this study was to investigate the frequency of polyneuropathy and to determine the electrophysiologic features of critically ill patients. The subjects were 23 patients between ages of 42 and 72 with a sepsis or systemic inflammatory response syndrome combinded with the multiple organ failure. The results revealed reductions in the amplitude of compound motor action potential and sensory nerve action potential, as the most marked abnormality. Needle EMG revealed the signs of denervation of limb muscles. Approximately 65.3% of adult patient with sepsis or multiple organ dysfunction has an axonal polyneuropathy. We suspect that the axonal polyneuropathy is related to the severity of multiple organ dysfunction.
Action Potentials ; Adult ; Axons ; Critical Illness* ; Denervation ; Extremities ; Humans ; Intensive Care Units ; Mortality ; Multiple Organ Failure ; Muscles ; Needles ; Polyneuropathies* ; Sepsis ; Systemic Inflammatory Response Syndrome

The antihypertensive effect of trimazosin was studied in 24 cases of essential hypertension, which include 9 cases with pretreatment diastolic pressure of 114mmHg or more, for a period of 4 weeks. The average pretreatment systolic and diastolic blood pressures were approximately 175mmHg and 114mmHg, respectively. The treatment was started with 100mg of trimazosin daily in 2 divided doses and and the drug was titrated upward at weekly interval by 100mg up to 400mg/day depending on the response of the blood pressures. Routine blood counts, urinalyses, liver and kidney function tests, electrolyte balance, total serum cholesterol and triglyceride were determined before and at the end of treatment. The diastolic blood pressure fell 10mmHg or more in 20 out of 24 cases(83.3%), and in 12 cases out of 20 favorable responders it fell to 90mmHg or below. The pretreatment diastolic blood pressure in 4 nonresponders was all 115mmHg or more. The antihypertensive effect appeared during the first week of therapy and progressively increased until the end of treatment week without causing postural hypotension. Unpleasant symptoms appeared in 12 cases during treatment, which include dizziness, headache, numbness in the extremities and tinnitus in the decreasing order of frequency. However, these symptoms were mild and transient in all cases disappearing spontaneously despite continued medication. No significant biochemical changes in the blood were recorded after treatment. We conclude that trimzosin seems to be a safe and effective antihypertensive drug particularly useful for the treatment of mild to moderate hypertension.
Blood Pressure ; Cholesterol ; Dizziness ; Extremities ; Headache ; Hypertension* ; Hypesthesia ; Hypotension, Orthostatic ; Kidney Function Tests ; Liver ; Tinnitus ; Triglycerides ; Urinalysis ; Water-Electrolyte Balance

The cardiac dimensions and functions were studied by analyzing simultaneously recorded M-mode echocardiograms and phonocardiograms in 24 cases of essential hypertension with no evidence of heart faliure, and also in 20 healthy adults for comparison. Thirteen hypertensives out of 24 had findings consistent with left ventricular hypertrophy on either routine chest roentgenograms or electrocardiograms or both(group II) and the remaining 11 had no such findings(group I). The posterior wall and septal thickness, and isovolumic relaxation time were significantly was increased even in the group I as well as in the group II. The isovolumic relaxation time was correlated well with the septal thickness in both groups. In contrast, a significant increase in left atrial and left ventricular systolic dimensions was noted only in the group II, and so was a significant reduction in the fractional shortening and mean velocity of circumferential fiber shortening. These findings suggest that the echocardiographic examination is useful in patients with essestial hypertension for the early dagnosis of the increased thickness of the posterior wall and the septum, and the abnormality during early diastolic relaxation of the left ventricle, prior to the appearance of the ventricular hypertrophy on the routine chest films amd/or electrocardiograms, and also that echocardiograms enable early detection of the systolic dysfunction of the hypertrophied left ventricle in the absence of apparent failure.
Adult ; Echocardiography* ; Electrocardiography ; Heart ; Heart Ventricles ; Humans ; Hypertension* ; Hypertrophy ; Hypertrophy, Left Ventricular ; Relaxation ; Thorax

Synovial chondromatosis is a rare monoarticular disorder which often involves the knee, hip and the elbow but the shoulders are less frequently affected. The diagnosis depends on the important radiographic and operative findings as well as histopathological criteria. We have experienced the synovial chondromatosis developed in the left shoulder of a 37 year-old male who was diagnosed by CT scan, axillary angiography and microscopic findings and treated at Chonbuk National University Hospital.
Angiography ; Chondromatosis, Synovial ; Diagnosis ; Elbow ; Hip ; Humans ; Jeollabuk-do ; Knee ; Male ; Shoulder ; Tomography, X-Ray Computed

Effects of thoracentesis on thoracic impedance and cardiac performance were studied in patients with uncomplicated unilateral tuberculous pleural effusion. The speed of the removal of the pleural effusion in thoracentesis was essentially similar to that of a generally used for therapeutic purpose in daily practice. Thoracic impedance was measured in 23 cases before, 4 and 10 minutes after thoracentesis to the amount of pleural effusion aspirated was observed. In 11 cases out of 23, the changes in cardiac performance as assessed by stroke volume, cardiac output, heart rate, heather index and ratio of pre-ejection period to left ventricular ejection time(PEP/LVET) were observed 4 minutes after 150 ml to 1,000 ml of thoracentesis. In these cases, stroke volume, cardiac output, and Heather index were determined from impedance cardiograms, and PEP/LVET from mechanocardiograms recorded simultaneously with the former. A significant increase in thoracic impedance was observed both 4 and 10 minutes after thoracentesis. There was a slight but a significant correlation between the changes in thoracic impedance and the amount of pleural fluid aspirated only 4 minutes after thoracentesis. Thoracentesis showed no consistent influence on cardiac performance as reflected to stroke volume, cardiac output, heart rate, heart index and PEP/LVET. These facts suggest that measurement of thoracic impedance may be a useful method reflecting alterations in pleural fluid volumes, particularly when it occurs in a relatively short period of time, and the effects of thoracentesis of less than one liter on the cardiac functions as determined by the above-mentioned parameters were variable.
Cardiac Output ; Electric Impedance* ; Heart ; Heart Rate ; Humans ; Pleural Effusion ; Stroke Volume

No abstract available.
Fever*

This study was conducted to identify a effect of the comprehensive self-regulation program for hypertensives as a nursing intervention on self-care performance and the physiologic parameters in rural areas. For this purpose, a nonequivalent control group and a pre and post-test quasi- experimental design was used. Fifty-four were evaluated subjects from two Community Health Practitioner Posts in the suburbs of Taejon City. The subjects of the control and experimental groups were matched for age and sex. The self-regulation program developed by author given to the experimental group. The program consisted of group education on hypertension and self-care, self-regulation including the blood pressure self-monitoring, recording of self-care activities, and encouraging and reinforcing self-efficacy. The whole program was carried out from September to November of 1999. The data were analyzed by repeated measure ANCOVA, t-test, and ANCOVA. The results were as follows; There was significant improvement in the scores on knowledge (F=.68, P=.004), perceived self-efficacy (F=26.39, P=.000), self-care performance (F=26.11, P=.000) of the experimental group compared with those of the control group. There was no significant change on the score of locus of control, perceived benefits and perceived barrier, blood cholesterol level, body weight between two groups (P>.05). From these results, it can be concluded that the self-regulation program is an effective nursing strategy to promote self-care performance of hypertensives in rural area.
Blood Pressure ; Body Weight ; Cholesterol ; Daejeon ; Education ; Hypertension ; Internal-External Control ; Nursing ; Research Design ; Self Care