BACKGROUND: Coronary artery spasm plays an important role in the pathogenesis of not only variant angina but also other forms of angina,acute myocardial infarction, and sudden death. However precise mechanisms by which coronary spasms occur remains unknown. The role of increased coronary artery tone as a part of pathogenesis of conary spasm and relation to the severity of coronary artery disease are still controversial. Thus we underwent this study to investigate the role of increased coronary artery tone as a part of pathogenesis of conary spasm and realtion to the severity of coronary artery disease. METHODS: Intracoronary acetylcholine and isosorbide dintrate were used as a spasm-provocative agent and vasodilator respectively. We analyzed 176 vessels(69 right coronary artery, 58 left anterior descending coronary artery, 49 left circumflex coronary artery) of 75 patients admitted for evaluation of chest pain syndrome. Among the 176 vessels, spasm occurred in 39 vessels of 25 patients. RESULTS: 1)Coronary artery spasm occured in 30.4%(21/69), 17.2%(10/58), 16.3%(8/49) of right coronary artery, left anterior descending coronary artery, left circumflex coronary artery respectively. 2) There is no relationship between angiographically visible minimal coronary artery disease and occurrence of spasm provoked by acetylcholine. 3) There was no significant difference of coronary risk factor predicting coronary spasm between two groups. 4) There is more significant % vasodilation by isosorbide dintrate(ISDDN) occurred din both the spastic and nonspastic arterial segment of vasospastic angina group than no spasm group(30.2%, 28.4% vs 14.2%, p<0.05). 5) Degree of % vasodilation by ISDN was more significantly larger in vasospastic angina group than no spasm group despite the presence of same amount of angiographically visible minimal coronary artery disease(38.3% vs 12.5%, p<0.05). CONCLUSION: These findings suggests that the occurrence of conronary artery spasm is not related to minimal coronary artery disease. Increased coronary artery tone observed only in vasospastic angina group may be part of pathogenesis of coronary spasm.
Acetylcholine* ; Arteries ; Chest Pain ; Coronary Artery Disease ; Coronary Vessels* ; Death, Sudden ; Humans ; Isosorbide ; Muscle Spasticity ; Myocardial Infarction ; Risk Factors ; Spasm ; Vasodilation

Pacemaker malfunctions are secondary to alterations of the preset pacing rate, irregular pacing failure of sensing, failure of cardiac capture or depolarization, and various combinations of these events. A 76 years old male patients was admitted due to pacemaker malfunction. 2 years ago, he was diagnosed as complete atrioventricular block. And then bipolar permanent pacemaker was implanted. Since then syncopal attack developed repetitivly. 12 lead ECG and 24 hour holter moniter monitoring, revealed pacing and sensing failure, thus we converted bipolar system into unipolar system. since then syncopal attack did not developed again.
Atrioventricular Block* ; Electrocardiography ; Humans ; Male

A 63-year-old woman had pronounced pincer nail of her big toenails. Her nail condition was markedly painful and associated with the underlying osteophyte. Under digital anaesthesia the nail plate was completely avulsed and the lateral portions of the matrix were destroyed by electrodessication. Then a longitudinal incision of the distal nail bed was made to separate it from the underlying structure and to expose the osteophyte. The exposed osteophyte was removed and the nail bed was sutured. Tie-under sutures were used to hold the bed in the appropriate transverse curvature. With this surgical correction, the treated nail showed a normal shape at 18 months of follow-up.
Female ; Follow-Up Studies ; Humans ; Middle Aged ; Nails ; Osteophyte* ; Sutures

To evaluate the characteristics of violent behavior of psychiatric inpatients, the authors reviewed clinical records of psychiatric patients who had admitted at UiJong Bu St. Mary's Hospital from January 1994 to lune 1995. We divided the 287 subjects into violent and nonviolent group according to the presence of violent behaviors in psychiatric ward. We assessed demographic variables, clinical characteristics and violent behaviors using Overt Aggression Scale and compared these variables of violent group with nonviolent group. The results were as follows: 1) The number of violent patients was 72(25.1% of the total). 2) In terms of demographic variables, the differences between two groups in education and occupation were significant(p<.05). 3) In psychiatric diagnoses, violent group were more likely to have mania, schizophrenia and organic rental disorder in sequence but there were no differences between violent and nonviolent group. 4) The history of violent behavior was greater in violent group(p<.001) and the mode of admission was significantly different between two groups(p<.005). 5) In cluster of psychopathology on admission, more frequently found clusters of psychopathology in violent group were agitation-excitement and hostile- suspiciousness and there were significant differences between two groups(p<.001). 6) The length of stay in violent group(59.3 days)was significantly longer than nonviolent group(38.4 days)(p<.001). 7) The types of violent behavior were verbal aggression, physical aggression against objects and physical aggression against other people in frequency sequence. 8) The most frequent type of behavioral clue before violent behavior was hyperactive, loud, verbally abusive, angry, hostile(68.1%). 9) Most of violent behaviors were presented between midday and 6 pm. in resting time. 10) 62.3% of total violent behaviors were occurred within first week following admission. 11) The variables which showed significant effects on total aggression score were religion, educational status, occupation, mode of admission, psychiatric diagnosis, psychopathology on admission and history of violent behavior before admission. In summary, these results showed similar trends compared to previous studies on characteristics of psychiatric inpatients. And we fecund that more important predictors of violent behavior in practice were likely to be history of violent behavior, psychopathology on admission and behavioral cue before violent behavior.
Aggression ; Bipolar Disorder ; Cues ; Diagnosis ; Education ; Educational Status ; Humans ; Inpatients* ; Length of Stay ; Mental Disorders ; Occupations ; Psychopathology ; Schizophrenia

PURPOSE: The objective of this prospective study is to assess changes in body mass index(BMI, weight in kilograms/height in meters2) according to age and dosage on epileptic children treated with topiramate. METHODS: From January 2006 to December 2008, prospective studies have been performed on 63 children with epilepsy aged below 15 old who had been treated with topiramate. Patients were classified into 3 groups according to age: 2-5 years as a group 1; 6-10 years as a group 2; 11-15 years as a group 3;, and classified into 2 groups according to dosage: from 2 to 5 mg/kg/day as group A, more than 5 mg/kg/day to 8 mg/kg/day as group B. We have checked BMI of patients four times and evaluated the changes in BMI of each group. RESULTS: BMI at initial presentation and follow-up periods of 6, 12, and 24 months is as follows: 16.3+/-1.25, 14.3+/-1.8, 14.2+/-2.4, and 15.7+/-2.1 in the group 1, 18.5+/-1.23, 15.2+/-1.24, 14.8+/-2.27, and 16.8+/-2.5 in the group 2, 21.6+/-2.31, 16.5+/-2.17, 15.4+/-2.56, and 15.1+/-1.3 in the group 3. Comparing with group A and B is as follows: 19.3+/-2.35 and 18.1+/-1.89 at initial presentation, 15.5+/-2.45 and 15.1+/-1.15 at 6 months, 14.9+/-2.15 and 14.7+/-1.91 at 12 months, 15.9+/-1.28 and 16.0+/-1.12 at 24 months. CONCLUSION: The effect of topiramate on changes of BMI shows difference according to age. In groups of 2-10 years old, BMI was rebounded from lowest value after 12 months, however, in the group of 11-15 years old, BMI kept decreasing at 24 months. And dosage of topiramate does not affect to BMI significantly.
Aged ; Body Mass Index ; Child ; Epilepsy ; Follow-Up Studies ; Fructose ; Humans ; Prospective Studies

Although halothane is generally anesthetic of choice for asthmatics due to its bronchodilatory action, its combined use with aminophylline should be discouraged. This report is a 43-year-old male who had primary closure and open reduction internal fixation (ORIF) for facial avulsion injury and zygomatic tripod fracture under N2O-O2-halothane anesthesia. About 90 minutes after the procedure, the patient who had aminophylline infusion for an acute bronchospasm developed a sudden cardiac arrest. The immediate cardiopulmonary resuscitation was applied and the patient was recovered without any neurological deficit. At the time, the serum theophylline concentration of the patient was 16 microgram/ml which was in the range of normal therapeutic dose. The cause for this cardiac arrest by halothane is unknown, but possibly a drug interaction between halothane and aminophylline might have contributed, since halothane sensitizes the heart to exogenous catecholamines.
Adult ; Aminophylline* ; Anesthesia ; Bronchial Spasm ; Cardiopulmonary Resuscitation ; Catecholamines ; Death, Sudden, Cardiac ; Drug Interactions* ; Halothane* ; Heart ; Heart Arrest* ; Humans ; Male ; Theophylline

Mandible fractures have recently been managed by rigid internal fixation with miniplate and screws more often than by traditional interosseous wiring methods. The purpose of this paper was to compare traditional interosseous wiring with miniplate fixation in open reduction of mandible fracture, especKweonially in operative results and costs. From June of 1989 to June of 1998, there were 142 patients, admitted to the department of Plastic and Reconstructive Surgery, Chun-Cheon Sacred Heart Hospital, Hallym University. Of those, 101 patients were managed by open reduction, and among them, 83 patients were treated with miniplate fixation, but 18 patients had recently been treated with interosseous wiring methods. No significant difference was noted between the two groups in terms of complications, but the overall cost of miniplate and screws was higher than interosseous wiring, while the mean operative time was longer in the group treated with miniplate fiation. The authors recommend interosseous wiring technique for patients with mandible fractures requiring open reduction and fixation, except for absolute indications of rigid internal fixation.
Gangwon-do ; Heart ; Humans ; Mandible* ; Operative Time ; Plastics

OBJECTIVES: Tyrosine hydroxylase(TH) is a rate-limiting enzyme in the synthesis of catecholamines, and could be a candidate gene for causing the bipolar disorders. Therefore, we designed this study to investigate the association of the VNTR(variable number of tandem repeats) polymorphic locus in the first intron of the TH gene with bipolar disorders. METHODS: We typed VNTB polymorphic region of the TH gene using PCR in 115 bipolar patients and 85 normal controls. Four types of alleles(A, B, C, D) were typed according to the difference of the repeat(TCAT)6-9 number. The frequencies of allele and genotype were compared between patients and normal controls, and in patients and normal controls allelic frequencies were compared respectively in terms of family history of affective disorders and age of onset. RESULTS: 1) The allelic frequencies were significantly lower in type A, and significantly higher in type D in patient group compared to control group. The genotype frequencies were significantly higher in type BD in patient group than in control group. 2) In comparing the allelic frequencies among patient group with and without family history and control group, there were no significant differences between groups with and without family history, whereas patient group with family history showed lower significance in type A and higher significance in type D compared to control group. 3) In comparing the allelic frequencies among patient groups with early onset and late onset and control group, patient group with early onset showed higher significance in type D than patient group with late onset and showed lower significance in type A and higher significance in type D compared to control group. CONCLUSIONS: The authors conclude that the VNTR polymorphic region of the TH gene might be associated bipolar disorders, and type A and type D alleles might be susceptibility genes of bipolar disorder.
Age of Onset ; Alleles ; Bipolar Disorder ; Catecholamines ; Genotype ; Humans ; Introns ; Mood Disorders ; Polymerase Chain Reaction ; Tyrosine 3-Monooxygenase* ; Tyrosine*

PURPOSE: This study evaluated the results of acetabular medial wall osteotomy to reconstruct the acetabulum in dysplastic hip during total hip arthroplasty. MATERIALS AND METHODS: We clinically and radiologically evaluated 30 hips of 30 patients with secondary hip osteoarthritis caused by congenital hip dislocation or acetabular dysplasia who underwent total hip arthroplasty (THA) between March 1999 and October 2002. The average age of subjects was 46.5 years(17 to 73 years), and the mean follow-up period was 5 years(5.3 to 8.7 years). In 26 cases, a cementless hemispherical acetabular cup was inserted in the true acetabulum; in 4 cases a reinforced ring was inserted. Only 2 hips needed structural bone grafting. RESULTS: The average Harris hip score improved from 56.3 points preoperatively to 93.2 points at the last follow up. Radiographic analysis revealed no aseptic loosening or radiolucent line, and showed stable bony fixation at the true acetabulum. The mean thickness of the medial acetabular wall postoperative was 20.5 mm(10 to 36 mm). Bone union of the medial wall was observed at a mean of four months postoperatively. CONCLUSION: Acetabular medial wall osteotomy can maintain the integrity of the acetabular medial wall while achieving enhanced acetabular coverage and more normal hip biomechanics.
Acetabulum ; Arthroplasty ; Biomechanics ; Bone Transplantation ; Displacement (Psychology) ; Follow-Up Studies ; Hip ; Hip Dislocation, Congenital ; Humans ; Osteoarthritis, Hip ; Osteotomy

OBJECTIVE: The purpose of this study was to examine the strength of the knee and pulmonary function comparing collegians and hockey players in college. METHOD: KINdegreeCOM isokinetic dynamometer and medigraph were used to evaluate strength of the right lower extremity and pulmonary function to 30 male students comprising 15 hockey players and 15 collegians with no significant difference in age, weight, and height between the two groups. All subjects used their right lower limb as dominant limb. RESULTS: 1) The significant differences between collegians and hockey players were found in the peak torque at 60o/sec,180o/sec. 2) The siginficant differences between collegians and hockey players were found in forced vital capacity, forced expiratory volume in one second and expiratory reserve volume on the pulmonary function. 3) The significant correlation between isokinetic strength and pulmonary function were found in peak torque. CONCLUSION: It is turned out that hockey players in college have much better isokinetic strength and pulmonary function than collegians, so it is suggested this result have to be considered in selecting hockey players and exercise prescription.
Expiratory Reserve Volume ; Extremities ; Forced Expiratory Volume ; Hockey* ; Humans ; Knee* ; Lower Extremity ; Male ; Prescriptions ; Torque ; Vital Capacity