Stenosing peroneal tenosynovitis is one of the rather common causes of pain and disability following calcaneal fracture. In practice, however, attention is focused on fracture healing and the development of subtalar degenerative arthritis, and impingement or adhesion of the peroneal tendons within their sheaths due to bony protrusion or distorted anatomy resulting in disability and pain on weight bearing is too frequently overlooked. We diagnosed and treated four cases of stenosing peroneal tenosynovitis, three of which were associates with subtalar arthritis, in a relative short period of time. We proposed that orthopaedists treating calcaneal fractures be aware of this entity as distinct causes of pain.
Arthritis ; Fracture Healing ; Osteoarthritis ; Tendons ; Tenosynovitis ; Weight-Bearing

BACKGROUND: Hypertension is one of the frequent problems for which family physicians are well encountered to manage. Nonpharmacologic measures which include stress relaxation, low salt diet, weight reduction, moderation of alcohol intake, physical activity, tobacco avoidance are used as definitive or adjuvant therapy for hypertension. Family physicians should vigorously encourage their patients to adopt these life style modifications. This study was conducted to know how many nonpharmacologic treat,ment modalities are adopted by hypertensives and to find predicting factors. METHODS: A total of 100 of the hypertensive patients who are followed up via the department of family medicine, Hanyang University Hospital, from September 1995 through November 1995 are included in this study. A trained nurse interviewed patients according to the previously designed structured questionnaire. The overall response rate was 90% and the fill-up rate of the questionnaire was 100%. RESULTS: Sixty three patients were women. The mean age was 57.4 years(range, 20 to 84). Sixty one percent accompanied one or more other diseases, of which diabetes mellitus was the most common disorder. The mean systolic pressure was 143.9 mmHg and the mean diastolic blood pressure was 89.3mmHg. Ninty-three percent of patients received antihypertensives with compliance of 81 to 100%. Twenty four percent of patients adhered to regular exercise, 36 percent weight reduction, 48 percent low salt diet, 79 percent moderate drinking, 81 percent stress relaxation, and 87 percent no smoking. Of those six non-pharmacological treatments, 3.6 behaviors were adhered. Male patients were more attended with the low salt diet. Eleven patients of 2S alcoholics(44.0%) reduced their amount of alcohol intake and 8 of 17 smokers quitted smoking (47.1%) after they were diagnosed as hypertension. The mean BEPSI score was 1.5. Fifty one percent of patients had stress within the last three months, 32 percent had cumulative fatigue. The occupational stress was the most common one. All exercise which patients reported were isotonic. Seventeen percent of the patients took certain herb medicine or folk medicine. CONCLUSIONS: Of those 100 hypertensives who were treated at the department of family medicine, Hanyang University hospital, 24% adhered to regular exercise, 36 per cent weight reduction, 48 percent low salt diet, 79 percent moderate drinking, 81 percent stress relaxation, and 87 percent quit smoking in order. Of those six non-pharmacological treatments, 3.6 behaviors were adhered on the average. Nonpharmacologic treatment should be promoted by family physician as an important strategy for treatment of hypertension.
Antihypertensive Agents ; Blood Pressure ; Compliance ; Diabetes Mellitus ; Diet ; Diet, Reducing ; Drinking ; Fatigue ; Female ; Humans ; Hypertension ; Life Style ; Male ; Medicine, Traditional ; Motor Activity ; Physicians, Family ; Relaxation ; Smoke ; Smoking ; Tobacco ; Weight Loss ; Surveys and Questionnaires

The mechanism of development of pulmonary edema associated with -sympathomimetic agent is still not fully understood. 2-sympathomimetic drugs such as ritodrine, terbutaline, and fenoterol are widely used for the treatment of premature uterine contraction. We describe a case of pulmonary edema that occurred suddenly during Cesarean section in a previously healthy parturient, associated with ritodrine pretreatment for 5 days in an attempt to arrest preterm labor. Pulmonary edema was completely treated with mechanical ventilation and diuretic therapy.
Cesarean Section* ; Female ; Fenoterol ; Humans ; Obstetric Labor, Premature ; Pregnancy ; Pulmonary Edema* ; Respiration, Artificial ; Ritodrine* ; Terbutaline ; Uterine Contraction

BACKGROUND: Blood pressures rneasured by a nurse at reception room as a part of routine physical examination are oft,en used as a indicator of medical care. Blood pressure at reception room and consultation room are, however, often different to each other and these differences are caused by various factors including difference of white coat effect by nurse and doctor. Thus, this study was performed in order to know whether blood pressure difference really exit, and its associated factors. METHODS: Two hundred ninety one patients who visited to one university hospital farnily practice were enrolled in this study. Blood pressure and pulse rate at reception room and consultation room, waiting t,ime, time interval between reception and consultation, smoking status, and intake of coffee and food were collected. Nine patients were excluded, because blood pressure either at reception room or at consulation room was not recorded. This study was performed by one nurse and two doctors. They defined the guideline for method of blood pressure measurement before the study, and used the same kind of indirect cuff sphygmomanometer. RESULTS: Two hundred eighty two patients were analyzed. The number of men was one hundred twenty five. Systolic blood pressure at consultation room was higher than that at reception room by 1.6+/-11.9mmHg (P<0.05). Sixty five cases(65%) in systolic blood pressure and 111 cases(40%) in diastolic blood pressure showed blood pressure differences more than 5mmHg. The group with systolic blood pressure difference between reception room and consultation room(SBP) in more than 5mmHg is more likely to be hypertensive than the group with SBP in less than 5mmHg(P<0.01). More female patients(66%) and hypertensive patients(59%) were belong to the group whose systolic blood pressure at consultation room were 5mmHg higher than at reception room(P<0.01). Twenty four patients(30%) of the group whose systolic blood pressure at reception room were 5mmHg higher than at consultation room had cigarette smoking within 1 hour, and this ratio was significantly higher than the other groups whose systolic blood pressure difference was less than 5rnmHg or systolic blood pressure at consultation room were 5mmHg higher than at reception room(P<0.01). There was relatively good concordance in classifying hypertension and normal blood pressure according to measurement site(Overall kappa, 0.747, P<0.01). CONCLUSIONS: Many patients showed blood pressure differences more than 5mmHg between reception room and consultation room. Systolic blood pressure at consultation room was higher than that at reception room, and there was relatively good concordance in classifying hypertension and normal blood pressure according to measurement site, but the adverse effect by misclassification should not be neglected. The importance as well as the limitation of blood pressure measurement at reception room should be considered in screening and treating hypertensive patient. Every time when blood pressure is taken, physicians should keep in mind to consider patients factors which may influence blood pressure level.
Blood Pressure* ; Coffee ; Female ; Heart Rate ; Humans ; Hypertension ; Male ; Mass Screening ; Outpatients* ; Physical Examination ; Smoke ; Smoking ; Sphygmomanometers

No abstract available.
Child* ; Fagopyrum* ; Humans ; Hypersensitivity*

No abstract available.
17-alpha-Hydroxyprogesterone*

Atrial myxomas are uncommon, but surgical treatment offers a potential cure. Early diagnosis is essential so that tumors can be promptly removed in order to reduce morbidity or mortality from atrioventricular valve dysfunction and embolic complications. They are intracavitary tumors occurring within any of the cardiac chambers, but they have a predilection for the atria, particulary the left atrium. The development of noninvasive, echocardiogaphic technique has made it possible to screen large numbers of patients with atrial myxoma with ease and safty. Recently the development of diagnostic procedure and cardiac surgery increased the accuracy of diagnosis and the opportunity of successful ereatment. We report the two cases of left artial myxomas which were removed successfully by surgery.
Diagnosis ; Early Diagnosis ; Echocardiography ; Heart Atria ; Humans ; Mortality ; Myxoma* ; Thoracic Surgery

In Korea, owing to effective vaccination, occurences of poliomyelitis begen to decrease rapidly from 1964 and in recent years less than 10 cases of acute infection are being reported annually. However, patients crippled with poliomyeltis residua, mainly the legacy of the many epidemics of 1950s, and early 1960s, are many and pose a social and national problem as well as a personal and family ordeal. We reviewed 536 patients with residual poliomyelitis admitted and treated at Seoul National University Hospital during the past 18 years, from 1963 to 1980 They were divided into four chronological groups; the first, 1993 to 1968, the second 1968 to 1973, the third, 1974 to 1977, and the fourth, 1978 to 1980, In each group, based on in-patient records, and out-patient records, epidemology, deformities, and treatment were extensively reviewed. The followings are the outcome of this investigation 1. The male-to-female ratio was 53.7%: 46.3%, The male majority, distinct in the first group with 63. 7%, became less conspicuos in the fouth group with 50. 3%. 2. Average age oe admission, which was 10. 7 years in the first group, had increased decidedly to 17. 8 years in the fourth group. 3. The age of onset was most frequent between 1 to 2 years with 45.8% and next frequent between 7 to 12 months with 23. 5%. The ages below 5 years occupied 97. 6% of the cases. 4. The year of onset was most frequent from 1961 to 1963 with 28.7%. The incidence markedly and steadily decreased thereafter. 5. 94. 5% of the cases were unvaccinated. The remaining cases, except one, had had incomplete vaccination. 6. Fever, with 74. 0% was by far the most frequent initial symptom. Vomiting and diarrhea were the next frequent symptoms. 7. Of the 60% of the patients who had had any previous treatment, 25. 9% had operations and 20. 4% had braces and crutches. 8. Average number of admissions per patient were 1. 7 and average number of operations were l. 9. Average length of hospitalization was 39. 2 days. 9. 23. 6% of the patents had hip deformities, of which flexion defermity was most frequent with 4. 7%. Soutter fasciotomy or Campbell operation was employed in order to correct flexion deformity. In the earlier groups, Mustard operation, Sharrard operation, Ober-Barr operation, and pem-berton osteotmy were commonly practiced, whereas in the later groups, Thomas-Thompson-Straub operation, combined Thomas-Thompson-Straub and Ober-Barr operation, Salter osteotomy, Chiari osteotomy, Steel osteotomy were favored. 10. 45.2% of the patients had knee and leg deformities, of which flexion deformit; was most frequent with 14.5%. Flexion-valgus-external rotation deformity and flexion-valgus deformity with 4.6% and 4.5%, respectively, followed next. 11. 83. 9% of the patients had foot and toe deformities, of which equinovarus deformity occupied 6. 5% equinovalgus deformity 6.8%, and clawing of great toe 25. 2%. Triple arthodesis was done most frequently with 45. 9% of the cases, or 282 feet. Jone's operation or its modification, Tendo Achilles lengthening, plantar fasciotomy, and Peroneal tendon transfer were also frequntly performed. 12. There was leg length inequality in 90%. of the cases, Epiphysiodesis and femoral shortening were carried out, except for 4 cases of stapling in the earliest group, and femoral lengthening was done in 3 cases. 13. Spineal deformity was found in 19.7 % Of the cases, of which scoliosis was most freqent with 11. 5%. 7% of the cases had pelevic obliquity. Lumbodorsal fasciotomy, and postrior spinal fusion with Harrington instrument were carried out in order to ameliorate these deformities. 14. Deformities in the upper extremity were found in 3.6% of the patients. Procedures carried out inclulded shoulder fusion, Saha's operation, Steindler's flexorplasty, sternocleidomastold transfer, wrist fusion and opponensplasty, etc. 15. Generally, there was marked improvement of disability after treatment. The patients having moder.ate to severe limping decreased from 41.3%, preoperatively, to 25% after operation.
Age of Onset ; Animals ; Arterial Switch Operation ; Braces ; Clubfoot ; Congenital Abnormalities ; Crutches ; Diarrhea ; Fever ; Foot ; Hip ; Hoof and Claw ; Hospitalization ; Humans ; Incidence ; Knee ; Korea ; Leg ; Leg Length Inequality ; Male ; Osteotomy ; Outpatients ; Poliomyelitis ; Scoliosis ; Seoul ; Shoulder ; Spinal Fusion ; Steel ; Tendon Transfer ; Toes ; Upper Extremity ; Vaccination ; Vomiting ; Wrist

Congenitial elevation of the scapula, more commonly referred to as Sprengel's deformity, first was described by Eulenberg in 1963. After then, many authors have reported this abnormal condition and many surgical spproaches have been described. When evaluating a patient with congenital elevation of the scapula for surgical correction, cosmetic severity, functional impairment, associated congenital anomalies and the child's age should be consicdered. Since July, 1981, we have tried surgical correction in 8 patients with this deformity, and followed up for more one year except one patient. 6 patients between 3 years and 11 years of age were trested with Green's operation, and 2 patients, 22 years and 26 years of age were treated with supraspinous portion resection only. All of 7 patients, whose follow-up period is more than one year, gained more thsn 1 grade of cosmetic improvement, mean 17 of combined abduction and mean 1.6 cm of acspular lowering. Keloid formation was most common complication and was prevented by meticulous subcutsneous and subcuticular suture. Brschial plexus palsy was most serious complication and was prevented by avoiding overcorrection or by clavicular osteotomy or intraoperative EST.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Keloid ; Osteotomy ; Paralysis ; Scapula ; Sutures

Statistical analysis of 18,211 cases of electrocardiogram which were recorded in Chung-Ang University Hospital from January 1969 to December 162% of total cases(61% of male and 63% of female) and the incidence of normal electrocardiogram was decrease with aging. 2) Abnormal Q-wave was seen in 0.4% of total cases(0.5% of male and 0.3% of female) and the incidence of abnormal Q-wave was more common over 50 years of age. 3) Left axis deviation was seen in 1.1% of total cases(1.4% of male and 0.9% of female) and the incidence of left axis deviation was more common over 50 years of age. Right axis deviation was seen in 0.3% of total cases(0.3% of male and 0.4% of female) and the incidence of right axis deviation was more common under 30 years of age. 4) Left ventricular hypertrophy was seen in 3.6% of total cases(4.8% of male and 2.5% of female) and the incidence of right ventricular hypertrophy was more common under 30 years of age. 5) ST-segment depression was seen in 2.0% of total cases(2.2% of male and 1.9% of female) and the incidence of ST-segment depression was increased with aging. 6) T-wave inversion was seen in 1.6% of total cases (1.5% of male and 1.7% of female) and the incidence of T-wave inversion was increased with aging. 7) Atrioventricular block was seen in 1.4% of total cases(1.8% of male and 1.0% of female) and the incidence of atrioventricular block was more common over 50 years of age. 8) Incidence of complete left bundle branch block was 0.2% and was more common overs 60 years of age. Incidence of complete right bundle branch block was 1.1% and the incidence was more common over 50 years of age. Incidence of incomplete right bundle branch block was 3.0% and the incidence was more common under 40 years of age. 9) The incidence of premature beat was 2.7% of total cases, atrial fibrillation 1.5%, supraventricular tachycardia 0.2%, sinus tachycardia 7.5%, sinus bradycardia 2.2% and sinus arrhythmia 2.3%. 10) Low voltage was ssen in 3.8% of total cases and the incidence of low voltage was more common over 50 years of age.
Aging ; Arrhythmia, Sinus ; Atrial Fibrillation ; Atrioventricular Block ; Axis, Cervical Vertebra ; Bradycardia ; Bundle-Branch Block ; Cardiac Complexes, Premature ; Depression ; Electrocardiography* ; Humans ; Hypertrophy, Left Ventricular ; Hypertrophy, Right Ventricular ; Incidence ; Male ; Tachycardia, Sinus ; Tachycardia, Supraventricular