The palatal fracture results in deformity of the midface, as well as change in occlusion. However, no report was found on the incidence, treatment and results of palatal fracture in Korea. A retrospective review was done over 6 years and 11 patients(6.5%) with palatal fracture were determind out of 168 patients who had midfacial bone fractures without nasal bone fracture. According to the Hendrickson's classification, the number of patients with specific types of palatal fracture was described as follows; sagittal (2 cases), parasagittal (2 cases), para-alveolar (3 cases), transverse(3 cases) and complex(1 case). Le Fort I (6 cases), Le Fort II (7 cases) and mandible (6 cases) fractures were also associated. Open reduction and internal fixation was applied to all patients. Internal fixation consisted of pyriform or alveolar ridge stabilization and maxillary buttress stabilization. The rigid palatal vault stabilization was applied in one patient with midline split of the palate. The duration of intermaxillary fixation was shortened to less than 3 weeks from 4 to 6 weeks with rigid fixation. The palatal splint was used temporarily before internal fixation. All the patients showed good bony union and satisfactoryocclusion postoperatively. Open reduction and internal fixation showed satisfactory results from the aspects of stability, occlusion, patient convenience and final aesthetics. The following treatment model for palatal fracture according to the fracture type is proposed; 1) Alveolar type - close reduction or open reduction and selective alveolar ridge fixation and selective application of palatal splint, 2) Sagittal type - open reduction and internal fixation of the alveolar ridge, maxillary buttress and palatal vault. 3) Parasagittal type - open reduction and internal fixation of the pyriform aperture and maxillary buttress, as well as selective fixation of the palatal vault. 4) Para-alveolar type - open reduction and internal fixation of the alveolar ridge and maxillary buttress. 5) Complex type - open reduction and internal fixation of the alveolar ridge, maxillary buttress, pyriform aperture and continuous use of a palatal splint to bony union. 6) Transverse type - open reduction and internal fixation of the alveolar ridge and maxillary buttress.
Alveolar Process ; Classification ; Congenital Abnormalities ; Esthetics ; Fractures, Bone ; Humans ; Incidence ; Korea ; Mandible ; Nasal Bone ; Palate ; Retrospective Studies ; Splints

To evaluate the hypotensive effect of dilevalol which has a nonselective blocking action on beta receptors with selective beta2 agonist actcvity, We performed a prospective clinical study for 8 weeks in 31 patients with essential hypertension(mean age : 52+/-9, mean sitting blood pressure : 158/101mmHg) without concomitant heart failure, coronary heart disease, conduction disturbance or renal impairment. The daily dose of dilevalol was 200-400mg. The results were as follows ; 1) After 8 weeks of treatment with dilevalol, average sitting systolic and diastolic blood pressures reduced to 138+/-8mmHg(13%), 84+/-5mmHg(17%) respectively(p<0.01, 0.01). 2) After 8 weeks of treatment with dilevalol, 28(90%) out of the 31 hypertensives showed good hypotensive effect ie, : sitting diastolic blood pressure decreased to below 90mmHg. 3) Pulse rate decreased slightly from pretreatment average of 75+/-8 beats per minute to 70+/-6 beat per minute at the end of 6 weeks of treatment but went back to pretreatment value lastly. 4) Average body weight, serum levels of total cholesterol, HDL cholesterol, triglyceride, AST, ALT, BUN, creatinine, sodium and potassium were not significantly changed from the pretreatment values. 5) A few side effects in order of frequency were epigastralgia, fatigue, cold extremities and dizziness. These results suggest that dilevalil may be used as an effective first line monotherapeutic antihypertensive agent in mild to moderate hypertensives without significant limitations.
Blood Pressure ; Body Weight ; Cholesterol ; Cholesterol, HDL ; Coronary Disease ; Creatinine ; Dizziness ; Extremities ; Fatigue ; Heart Failure ; Heart Rate ; Humans ; Hypertension* ; Labetalol* ; Potassium ; Prospective Studies ; Sodium ; Triglycerides

To evaluate the changes of Doppler echocardiographic parameters of left ventricular(LV) filling in hypertensive subjects, 34 patients(M : F=17 : 17) with and without LV hypertrophy and 19 healthy, age-matched control subjects(M : F=10 : 9) were examined by M-mode, 2 dimensional and Doppler echocardiography. From the Doppler recording, A2 D(time from second heart sound to the onset of early diastolic mitral flow), peak velocity at early diastole(E) and late diastole(A), ratio of E to A velocity, diastolic filling times, early diastolic deceleration rate(EDDR) and flow velocity integral(FVI) were measured. In the patients without LV hypertrophy, A2 D only was significantly prolonged(127+/-21 vs 83+/-24 msec P<0.01) as compared with the normal subjects, but the patients with LV hypertrophy had more prolonged A2 D(149+/-31 vs 83+/-24 msec P<0.01), higher late diastolic peak velocity(A : 0.58+/-0.17 vs 0.47+/-0.09m/sec, P<0.01) and lower E/A velocity ratio(0.95+/-0.19 vs 1.24+/-0.29, P<0.01) than the normal subjects. There was a significant correlation between A2 D and LV muscle mass index in entire patients with hypertension(r=0.42P<0.01). These data suggest that A2D is the earliest parameter indicating abnormality of LV diastolic function and E/A ratio is not likely to be a definite index of LV diastolic dysfunction but rather be a reliable index of LV hypertrophy in hypertensive patients with preserved LV systolic funtion.
Deceleration ; Echocardiography* ; Echocardiography, Doppler ; Heart Sounds ; Humans ; Hypertrophy

No abstract available.
Child* ; Diverticulum* ; Humans

To analyze the effects of the characteristics of the systolic anterior motion(SAM) of the mitral valve on the left ventricular outflow pressure gradient and to determine the relation between the anatomical characteristics of the left ventricle and the left ventricular outflow pressure gradient, mitral valve and left ventricular M mode echocardiogram and continuous wave Doppler echocardiogram of the left ventricular outflow tract were recorded in 7 patients with hypertrophic obstructive cardiomyopathy(HOCM), aged 19 to 66 years(mean 37 years). Mitral-septal distance at the closest apposition(S-SAM;1.1+/-2mm), duration of mitral-septal apposition(89+/-20 msec), time interval from the peak of the R-wave to initial apposition of the mitral valve against the interventricular septum(R-SAM interval ; 222+/-32 msec) and left ventricular posterior wall thickness(LVPWT; 1.1+/-0.5mm) were observed on mitral valve and left ventricular M-mode echocardiograms and peak flow velocity in the left ventricular outflow(V-LVOT; 3.5+/-1.5 m/sec) was measured from the Doppler echocardiograms of the left ventricular outflow tract. V-LVOT was correlated significantly with degree of mitral-septal apposition(r=-0.70, p<0.05), duration of mitral-septal apposition(r=0.74, P<0.05), R-SAM interval(r=-0.80, p<0.05) and LVPWT(r=0.78, p<0.05). These results suggest that the closer apposition of mitral valve against interventricular septum, the more prolonged mitral-septal apposition, the earlier onset of SAM of the mitral valve and the thicker the left ventricular posterior wall, the more increase the LV outflow pressure gradient in HOCM.
Cardiomyopathy, Hypertrophic* ; Heart Ventricles ; Humans ; Mitral Valve*

To evaluate the antihypertensive effect, side effects and metabolic changes of arotinolol, a combined alpha and beta blocker, 10-15mg of arotinolol twice a day was administered for 8 weeks in 27 hypertensives (168+/-16/106+/-10mmHg) without heart failure, bradycardia, conduction disturbance, coronary heart disease or renal impairment. Blood pressure decreased to 137+/-10/90+/-6mmHg and average reduction of systolic BP and diastolic BP were 31 mmHg(18%) and 16mmHg(15%) respectively. Pulse rate reduced significantly(p<0.01) after 2weeks' treatment of arotinolol and average reduction of pulse rate was 10 beats/min after 8weeks treatment. There were no significant changes of serum ALP, AST and ALT, BUN, and serum creatinine, Na+, K+, total cholesterol, HDL cholesterol and triglyceride. But in 8 patients(30%), insomina, sleepness, cold extrimities or numbness on extremities developed or aggravated. These results suggest that arotinolol be an useful antihypertensive agent in hypertensives without heart failure, bradyarrhythmais or peripheral vascular disease.
Blood Pressure ; Bradycardia ; Cholesterol ; Cholesterol, HDL ; Coronary Disease ; Creatinine ; Extremities ; Heart Failure ; Heart Rate ; Hypertension* ; Hypesthesia ; Peripheral Vascular Diseases ; Triglycerides

Coronary spasm may be induced by a variety of physiologic and pharmacologic stimuli but specific receptor blockade has not been consistently shown to prevent the attacks. Most patients with variant angina respond well to treatment with calcium antagonists and nitrates. A small proportion of patients are refractory to this therapy. We report a case of the patient with a 9-year-history of variant angina who has been refractory to high doses of calcium antagonists and nitrates. The repeated addition of clonidine was consistently effective in abolishing both symptoms and objective evidence of myocardial ischemia in this particular patient.
Calcium ; Clonidine* ; Humans ; Myocardial Ischemia ; Nitrates ; Spasm

PURPOSE: The purpose of this study was to examine the effects of frozen gauze with normal saline on thirst and the oral health of patients with nasal surgery. METHODS: A quasi-experimental, nonequivalent control group pretest-post test design was used. Participants (n=52) received either gauze frozen with normal saline (n=26), or wet gauze (n=26). The subjective thirst level and oral health of the participants were assessed before the intervention, 30 minutes after the first intervention, 30 minutes after the second intervention, and 30 minutes after the third intervention. RESULTS: After oral hygiene was provided twice, the thirst level was improved in patients receiving the gauze frozen with normal saline. After oral hygiene was provided a third time, the thirst level was improved in patients receiving the gauze frozen with normal saline. CONCLUSION: Gauze frozen with normal saline can be effective for oral hygiene in reducing the thirst level and improving the oral health in nasal surgery patients.
Humans ; Nasal Surgical Procedures* ; Oral Health* ; Oral Hygiene ; Thirst*

BACKGROUND: The diastolic transmitral flow velocity pattern has been commonly used to assess left ventricular(LV) diastolic function. The effects of multiple factors(such as, LV preload, afterload and heart rate, etc.) make difficulties in accurate interpretation. METHODS: In order to investigate the diastolic transmitral filling patterns according to the changes of the proload or heart rate, we studied 27 normal subjects with pulsed Doppler echocardiography after the administration of nitroglycerin(0.6mg/tab.) sublingually or atropine(0.5mg/amp.) intravenously. RESULTS: 1) After nitroglycerin administration, the folowings were obtained. ; The systolic blood pressure and LV diastolic filling time(DFT) decreased by 10.1% and 15.3%, respectively(p<0.001), compared with baseline data. The ratio of peak early to late diastolic transmitral flow velocities (E/A) and time-velocity integrals(TVIE/TVIA) decreased by 10.3% and 14.8%, respectively(p<0.01). The early diastolic filling time(Time E) was unchanged. Therefore, we suggest that time E is helpful, compared with the increments of the preload or the diastolic dysfunction. 2) After atropin administration, the heart rate, peak late diastolic transmitral flow velocity(PA) and percent atrial contribution(%AC) significantly increased by 43.6%, 25.1% and 41.4%, respectively(p<0.001). The E/A, TVIE/TVIA and DFT significantly decreased by 42.9%, 38.9% and 43.0%, respectively(p<0.001) compared to the data before drug administration. 3) The heart rate correlated negatively to the E/A, TVIE/TVIA and DFT. It was correlated positively to %AC(r=+0.63; p<0.001). The normalized E/A ratio by DFT(E/A/DFT) didn't correlate. Therefore, E/A/DFT is helpful on the exclusion of the influences of heart rate by the administration of the atropine. CONCLUSION: The decrement of preload or the increment of heart rate changes the diastolic transmitral flow velocity patterns. Therefore, when the diastolic function is assessed by interpretation of the Doppler transmitral flow velocity pattern with pulsed Doppler echocardiogram, the potential influences of preload and heart rate must be taken into account.
Atropine* ; Blood Pressure ; Echocardiography ; Echocardiography, Doppler* ; Echocardiography, Doppler, Pulsed ; Heart Rate ; Humans* ; Nitroglycerin* ; Time

PURPOSE: The purpose of this study was to evaluate the long term outcome and the factors contributing to treatment outcome for chronic functional constipation in children. METHODS: Sixty three children were enrolled who had chronic functional constipation and could be followed by telephone contact. They were treated at the Bucheon Soonchunhyang Hospital for more than 1 month and observed from March 2001 to June 2005. We analyzed the clinical features, symptoms and signs, as well as the course and results of treatment. RESULTS: The male to female ratio was 35 (55.6%) : 28 (44.4%). The mean age at the onset of symptoms and diagnosis was 21.1+/-23.5 (1.9~84.0) months and 47.1+/-34.2 (6.9~138.0) months, respectively. The mean defecation frequency before treatment was 3.2+/-2.3 (0.5~10.0) times per week. The symptoms associated with constipation were as follows: soiling 34 (54.0%) which was more common in males than females, large stools in 30 (47.6%), decreased bowel movements less than three times a week in 20 (31.7%), straining during defecation in 19 (30.2%) and retentive posturing 19 (30.2%). The mean duration of follow-up was 34.2+/-14.6 (3.6~60.0) months and 44 (69.8%) patients had their symptoms resolve ("success") and 19 (30.2%) were not resloved ("fail") from the constipation. The time for recovery from soiling, straining during defecation and retentive posturing after treatment was 4.3+/-2.4 (1.0~36.0), 5.0+/-1.4 (0.8~36.0) and 5.0+/-3.1 (1.0~36.0) months, respectively. A relapse of the constipation occurred in 15 (23.8%) patients, 9 (60%) boys and 6 (40%) girls. The time to relapse after cessation of treatment was 2.9+/-1.9 (1.0~6.0) months and the only risk factor associated with relapse was the initial duration of treatment. CONCLUSION: Most of the patients had resolution of symptoms within five months after treatment; relapse occurred within three months after the interruption of treatment. The duration of treatment was important for recovery and for the prevention of relapse in the constipated children. Thus a long term maintenance of therapy and follow-up is necessary for chronic functional constipation in children.
Child* ; Constipation* ; Defecation ; Diagnosis ; Female ; Follow-Up Studies* ; Gyeonggi-do ; Humans ; Male ; Recurrence ; Risk Factors ; Soil ; Telephone ; Treatment Outcome ; Withholding Treatment