BACKGROUND: The purpose of this study was to assess the prevalence of orthostatic hypotension(OH) and its associations with demographic characteristics, body mass index, medications, disease and activities of daily living. METHODS: Orthostatic hypotension was assessed at 1 minutes after the patients arose from a supine position among the 183 elderly patients aged 60 years or older in a mental hospital. RESULTS: The prevalence of orthostatic hypotension defined by changes in systolic or diastolic blood pressure was 41.0% and the prevalence of systolicorthostatic hypotension was 13.1%. Body mass index and serum sodium concentration were lower in women with orthostatic hypotension than those without orthostatic hypotension, but there were no differences among men. Orthostatic hypotension was significantly associated with the level of supine systolic and diastolic blood pressure. Through multiple logistic regression analysis, orthostatic hypotension seerned to be associated with factors such as body mass index, supine diastolic blood pressure and serum sodium concentration. There was no association between orthostatic hypotension and factors such as sex, age and medications. CONCLUSIONS: Orthostatic hypotension was common in the long-term hospitalized elderly patients. It was associated with hypertension, hyponatremia and low body weight.
Activities of Daily Living ; Aged* ; Blood Pressure ; Body Mass Index ; Body Weight ; Female ; Hospitals, Psychiatric ; Humans ; Hypertension ; Hyponatremia ; Hypotension ; Hypotension, Orthostatic* ; Logistic Models ; Male ; Prevalence ; Risk Factors* ; Sodium ; Supine Position

BACKGROUND: The purpose of this study was to assess the prevalence of orthostatic hypotension(OH) and its associations with demographic characteristics, body mass index, medications, disease and activities of daily living. METHODS: Orthostatic hypotension was assessed at 1 minutes after the patients arose from a supine position among the 183 elderly patients aged 60 years or older in a mental hospital. RESULTS: The prevalence of orthostatic hypotension defined by changes in systolic or diastolic blood pressure was 41.0% and the prevalence of systolicorthostatic hypotension was 13.1%. Body mass index and serum sodium concentration were lower in women with orthostatic hypotension than those without orthostatic hypotension, but there were no differences among men. Orthostatic hypotension was significantly associated with the level of supine systolic and diastolic blood pressure. Through multiple logistic regression analysis, orthostatic hypotension seerned to be associated with factors such as body mass index, supine diastolic blood pressure and serum sodium concentration. There was no association between orthostatic hypotension and factors such as sex, age and medications. CONCLUSIONS: Orthostatic hypotension was common in the long-term hospitalized elderly patients. It was associated with hypertension, hyponatremia and low body weight.
Activities of Daily Living ; Aged* ; Blood Pressure ; Body Mass Index ; Body Weight ; Female ; Hospitals, Psychiatric ; Humans ; Hypertension ; Hyponatremia ; Hypotension ; Hypotension, Orthostatic* ; Logistic Models ; Male ; Prevalence ; Risk Factors* ; Sodium ; Supine Position

BACKGROUND AND OBJECTIVES: Coronary collateral circulation is known to have beneficial effects in patients with angina pectoris and myocardial infarction. The purpose of this study is to determine the predictors of collateral vessels development, the pathways of collateral circulation and the changes in collateral flow after coronary intervention and its functional significance in patients with total occlusion. MATERIALS AND METHODS: One hundred thirty five patients who underwent coronary angiogram between Jan '97 and Dec '97 in Chonnam University Hospital (out of 3,264 cases) had total occlusion of one coronary artery were classified into two groups: angina pectoris (Group I:50 M, 19 F, 62.4+/-11.0 years) and acute myocardial infarction (Group II: 47 M, 19 F, 62.0+/-9.5 years). RESULTS: Among 135 patients, 123 patients had collateral circulation. Collaterals were more frequently observed and better developed (grade 2 or 3) in Group I than Group II. Proximal and ostial lesions were associated with well developed collaterals. Collateral circulation was more frequently observed and well developed in proportion to the duration of angina in Group I. In 123 patients with collateral circulation, 247 collateral circulations were observed. Right coronary artery (RCA) and Left circumflex coronary artery (LCX) were more frequent recipient arteries than left anterior descending coronary artery (LAD)(RCA:2.20+/-1.02, LCX:1.88+/-0.94, LAD:1.29+/-0.8 respectively, RCA vs. LAD:p<0.001, LCX vs. LAD:p=0.014). Coronary interventions were performed in 50 out of 135 patients, collateral flow of Group II decreased much more than Group I after intervention (Group I: 5/14, Group II: 24/36, p=0.046). The wall motion score was lower in patients with well developed than poorly developed collaterals (20.7+/-4.91 vs. 23.7+/-6.22, p=0.015). CONCLUSION: Proximal or ostial lesion and duration of angina are major predictive factors for the development of collateral circulation. Collateral circulation is associated with preserved myocardial contractility.After coronary intervention in patients with acute myocardial infarction, recruitment of preexisting collaterals may be more important mechanism rather than neoangiogenesis.
Angina Pectoris ; Arteries ; Collateral Circulation* ; Coronary Vessels* ; Humans ; Jeollanam-do ; Myocardial Infarction

No abstract available.
Dementia* ; Primary Health Care*

The goal of reduction mammaplasty is a breast with natural contour and volume, aesthetically situated scars, and a well-placed, sensate nipple and areola. The most successful techniques achieve this through the excision of tissue from the lower part of the breast based on some variation. However, the Mckissock's vertical bipedicle technique is the popular method for reduction mammaplasty. As an alternative modified Mckissock's method, we have found the use of only an inferior dermal flap with a keyhole pattern to be a simple and safe method for obtaining satisfactory aesthetic results. We have used inferior dermal flap for 4 patients recently and obtained the advantages as below compare to the Mckissock's method. 1. Rich blood supply to the broad based inferior flap. 2. More easy transposition of the nipple and areola. 3. More good operation field for resection of breast tissue. 4. Short operation time. 5. Can applied to the gigantomastia.
Breast ; Cicatrix ; Female ; Humans ; Mammaplasty* ; Methods ; Nipples

No abstract available.
Aortic Valve*

A 2-month-old female infant presented with a bluish-black, flat, hairy patch, 1.2cm in diameter, on the posterior aspect of her neck since birth. Histologic sections from the lesion showed numerous diffusely scattered dermal melanocytes throughout the dermis. The histopathologic and clinical findings were not fully oonsistent with any other known dermal melanocytosis. The diagnosis of “hairy blue nevus” was proposed for this unique lesion.
Dermis ; Diagnosis ; Female ; Humans ; Infant ; Melanocytes ; Neck ; Nevus, Blue* ; Parturition

No abstract available.
Cystadenoma*

Epidural hematoma associated with epidural anesthesia is rare. We describe a case of a epidural hematoma after continuous epidural anesthesia and analgesia for arthroscopic patella shaving. Anesthesia was indudced with 8 ml lidocaine, 2.0% with epinephrine, 1:200,000 and surgery proceeded. When additional boluses of bupivacaine were administered later, aspiration of the epidural catheter still yielded no blood. At the end of the operation, an epidural infusion of 0.125% bupivacaine was done 2 ml/hr by two-day infusor. In the third postoperative day, the patient suffered from acute myocardial infarction and then heparin was infused. In the fourth postoperative day, she complained lumbar back pain and developed depressed dorsiflexion (Grade II) of great toe in left foot during the infusion of heparin. Sagittal MRI showed posterior thickened epidural hematoma along the segments of T12-L4. Despite the delayed laminectomy and decompression, which was performed six days after her initial operation, she had a good postoperative response, followed by a complete neurological recovery.
Analgesia ; Anesthesia ; Anesthesia, Epidural* ; Back Pain ; Bupivacaine ; Catheters ; Decompression ; Epinephrine ; Foot ; Hematoma* ; Heparin ; Humans ; Infusion Pumps ; Laminectomy ; Lidocaine ; Magnetic Resonance Imaging ; Myocardial Infarction ; Patella ; Toes

OBJECTIVES: The purpose of this study was to identify the effects of aerobics and aquarobics exercise programs on elders' leg muscle strength, balance and walking ability in elders. The participants of the study were 21 elders; 11 of them participated in the aerobics exercise program and 10 of them participated in the aquarobic exercise program. METHODS: Both of the participants practiced for 10 weeks. The data were analyzed with using two-way ANOVA with repeated measures on the last factor. RESULTS: The results were summarized as follows: First, the main effect of exercise programs(aerobics x aquarobics) and the interaction effect between the exercise programs and the leg muscle strength were not significant. Second, the participants' static balance of the aquarobics exercise program increased more than that of the aerobics exercise program. Third, the participants' dynamic balance of the aquarobics exercise program increased more than that of the aerobics exercise program. Fourth, the main effect of exercise programs and the interaction effect between the exercise programs and the increase in gait speed were not significant. Fifth, the participants' step length of aquarobics exercise group increased more than that of the aerobics exercise program. All of the participants' leg muscle strength, static balance, dynamic balance, gait speed and step length increased after the both of two exercise programs. And, more importantly, the positive effect of the aquarobics exercise program on static balance, dynamic balance and step length was stronger than that of the aerobics exercise program. CONCLUSIONS: These results suggest that the aquarobics exercise program be more effective exercise on elders' balance and walking ability than the aerobics exercise program.
Gait ; Leg* ; Muscle Strength* ; Walking*