Measurements of mitral flow velocity by pulsed Doppler echocardiography are very useful in evaluating left ventricular diastolic filling properties. In hypertensive patients, abnormalities of diastolic function may precede systolic abnormalities and may serve as a more sensitive marker of end organ damage. We estimated left ventricular nass by 2-D echo short axis area-length method and compared with peak mitral flow velocity in early diastole(PFVE)and during atrial systolic(PFVA). There was a significant increase of LV mass and LV mass indices in the hypertensive patients and PFVE/PFVA ratio was decreased in them. Aithough there was no relationship between blood pressure and PFVE/PFVA ratio, a significant relationship was demonstrated between LV mass index and PFVE/PFVA ratio in the hypertensive patients.
Axis, Cervical Vertebra ; Blood Pressure ; Echocardiography, Doppler, Pulsed ; Humans

Early and longterm prognosis depended on the extents of acute myocardial infarction and residual myocardial function. Many clinical methods have been evaluated to determine their ability to estimate the size of myocardial infarcts. But because of many disadvantages simplified QRS scoring system, used with standard 12-lead EKG, was developed, which is noninvasive, inexpensive and easily releatible. Therefore, the correlation between QRS and peak CK,killip classification were evaluated in 55 patients with initial acute myocardial infarction at the Chung-Ang University, Yong-San and Pil-Dong Hospital during the period from January 1983 to December, 1986. The results were as follows : 1) The average QRS score of the anterior wall infarction is 7.1 and that of the inferior wall infarction is 4.5 and there is a statistical significance(p<0.01). 2) In the acute myocardial infarction, the correlation coefficeient between the QRS score and the killip classification is 0.66(p<0.05). 3) In the acute myocardial infarction, the average QRS score is 6.3 and the correlation coefficient between the leak CK and the QRS score is 0.52(p<0.05). 4) In the anterior wall infarction, the average QRS score is 7.1 and the correlation coefficient between the peak Ck and QRS score is 0.48(p<0.05). 5) In the inferior wall infarction, the average QRS score is a 4.5 and the correlation coefficient between the leak CK and QRS score is 0.79(p<0.05).
Classification ; Electrocardiography ; Humans ; Infarction ; Myocardial Infarction* ; Prognosis

PURPOSE: The purpose of this study was to review our clinical experiences of acute mesenteric ischemic disease at the Masan Samsung hospital. METHOD: Retrospectively reviewed the medical records of 20 patients with acute mesenteric ischemic disease from 1998 through 2003 in terms of clinical characteristics, image findings, management and results. RESULT: The mean age of patients was 63.5 years and the male female ratio was 1.5:1. Coexisting diseases were atrial fibrillation (n=10), hypertension (n=9), myocardial infarction (n=2), DM (n=4). The clinical manifestations were abdominal pain, abdominal distension, peritoneal irritation signs, vomiting and melena. The presenting signs were nonspecific. Laboratory findings were nonspecific and not helpful for diagnosis of acute mesenteric ischemia. Abdominal CT and SMA angiography were accurate and sensitive diagnostic tools. Seventeen cases were SMA occlusion (1 case: SMA dissection) and 3 cases were SMV occlusion. Operative procedures were resection of bowel (12 cases) and thromboembolectomy (5 cases). Non operative procedure was anticoagulation (3 cases). One patient refused surgery. CONCLUSION: Both clinical and laboratory data were non-specific and delayed diagnosis was the main cause of the overall mortality rate of 35% (7 cases). The mortality rate for patients undergoing surgery for acute mesenteric ischemic disease was high, but early diagnosis and intensive care may be reduced mortality.
Abdominal Pain ; Angiography ; Atrial Fibrillation ; Critical Care ; Delayed Diagnosis ; Diagnosis ; Early Diagnosis ; Embolism ; Female ; Humans ; Hypertension ; Ischemia* ; Male ; Medical Records ; Melena ; Mesenteric Vascular Occlusion ; Mortality ; Myocardial Infarction ; Retrospective Studies ; Surgical Procedures, Operative ; Thrombosis ; Tomography, X-Ray Computed ; Vomiting

Clinical observarions were done on 616 cases of cerebrovasculae accidents treated as inpatients at the Sung-Sim hospital, Chung-Ang university over a period of 8 years, from January, 1981 to Agust, 1988. The results were as follows; 1) Of 616 cases of cerebrovascular accidents, cerebral hemorrhage was presented in 56.82%, cerebral thrombosis in 28.57%, subarachnoid hemorrhage in 12.66%, cerebral embolism in 1.95%. 2) The ratio of male to female was 1.01:1. 3) The cerebrovascular accidents were most common in the sixth decade and followed by the fifth and fourth in turn. 4) The seasonal incidence was in order of frequency of Spring, Winter, Autumn and Summer. 5) Among disease preceding the onset of cerebrovascular accidents, hypertension was noted at 75% in cases of cerebral hemorrhge, 61% in cerebral thrombosis and 73% in subarachnoid hemorrhge. 6) The mean duration of underlying hypertension was 13.7 years in cerebral emorrhge, 15.3 years in cerebral thrombosis, 12.2 years in subarachnoid hemorrhage and 14.8 years in cerebral embolism. 7) Major precipitating factor in cerebral hemorrhage and subarachnoid hemorrhage was thought to be physical activity, whereas cerebral thrombosis and cerebral embolism frequently occured during sleeping or resting state. 8) The mean cholesterol level were 204.1mg% in cerebral hemorrhage, 214.9mg% in cerebral thrombosis, 211.7mg% in subaraachnoid hemorrhage and 217.0mg% in cerebral embolism. 9) The mortality rate was 12.2% in total, 16.6% in cerebral hemorrhage 2.3% in cerebral thrombosis, 15.45 in subarachnoid hemorrhage and 25% in cerebral embolism.
Cerebral Hemorrhage ; Cholesterol ; Female ; Hemorrhage ; Humans ; Hypertension ; Incidence ; Inpatients ; Intracranial Embolism ; Intracranial Thrombosis ; Male ; Mortality ; Motor Activity ; Precipitating Factors ; Seasons ; Stroke* ; Subarachnoid Hemorrhage

PURPOSE: In general, sinusitis in children is diagnosed by clinical symptom and paranasal sinus x-ray. Sinus plain x-rays in children is simple, inexpensive, and speedy. However, it requires proper interpretative techniques, because different development of each sinus, soft tissues overlying sinuses and bony structure require precise diagnosis. This study was conducted to compare plain x-rays with OMU CT scans. METHODS: From September 1996 through August 1997, thirty nine patients who were diagnosed as sinusitis based on clinical symptoms and plain x-rays at the pediatric department of Seoul Adventist Hospital were studied. Water's view, Caldwell's view and lateral view were taken for the plain x-rays with concurrent OMU CT scans prior to treatments. RESULTS: Ten cases (25.6%) out of 39 patients showed posterior nasal drip and fourteen cases (35.9%) showed nasal obstruction. Twelve cases (30.8%) were related to allergic diseases and seven cases (58.3%) among these 12 cases were bronchial asthma. Sensitivity of plain x-ray were 88.5+/-12.9% for maxillary sinuses, and 59.9+/-13.65% for ethmoidal sinuses. CONCLUSION: When maxillary sinusitis is suspected, plain X-ray for maxillary sinuses is enough to diagnose sinusitis, but for ethmoidal sinuses it may be underestimated or overestimated in comparison with OMU CT scan. Ethmoidal sinusitis requires careful diagnosis and follow-up because it plays important roll for chronic sinusitis due to its structure. Therefore, we recommends OMU CT scan to diagnose paranasal sinusitis of children with plain X-ray.
Asthma ; Child* ; Diagnosis ; Ethmoid Sinusitis ; Humans ; Maxillary Sinus ; Maxillary Sinusitis ; Nasal Obstruction ; Seoul ; Sinusitis* ; Tomography, X-Ray Computed*

PURPOSE: To draw attention to patient safety and increase its awareness among medical students, we developed a program that teaches patient safety based on common medical error cases. The aim of this study is to introduce this program and improve student receptivity to it. METHODS: As part of the "Patient, Doctor, and Society" course, third-year medical students participated in 8 hours of a medical error education program. Students discussed recent, typical medical lawsuits that were generated from internal medicine, surgery, pediatrics, obstetrics and gynecology, neurosurgery, medication, anesthesia, and blood transfusion cases. Students weighed these issues in small groups, using various discussion methods. After finishing the program, students completed a course evaluation questionnaire. RESULTS: The students rated this program as satisfactory, highly motivating, and helpful in preparing their future practices. They responded that although the cases were interesting, some were difficult. They stated that the small group discussion techniques encouraged them to take active part in the discussion and to consider the cases more deeply. CONCLUSION: Small group discussion of medical error cases is an effective method for students to study patient safety.
Anesthesia ; Blood Transfusion ; Group Processes ; Gynecology ; Humans ; Internal Medicine ; Malpractice ; Medical Errors ; Neurosurgery ; Obstetrics ; Patient Safety ; Pediatrics ; Safety Management ; Students, Medical ; Surveys and Questionnaires

PURPOSE: The primary objective of the current study was to investigate the characteristics of synchronous cancers in gastric cancer patients. MATERIALS AND METHODS: We analyzed the 2,237 patients who were diagnosed between December 2000 and December 2003 with gastric cancer and synchronous cancers of organs other than the stomach. RESULTS: 73 (3.3%) of a total of 2,237 gastric cancer patients had synchronous primary cancers. Among these 73 patients, 71 had one synchronous cancer, and two patients had double synchronous cancers. Colorectal cancer (26 patients, 34.7%) was the most frequently encountered synchronous cancer, followed by cancer of the lung (16 patients, 21.3%), esophagus (13 patients, 17.2%), and liver (8 patients, 10.7%). Synchronous can-cers were detected with increased frequency in the elderly, in the patients with multiple gastric cancers, in the patients with differentiated gastric cancer, and in the patients with early gastric cancer, as determined on univariate analysis, but the differentiation of gastric cancers was the only risk factor for synchronous cancers on the multivariate analysis. CONCLUSIONS: The differentiation of gastric cancer cells may be a risk factor for synchronous cancers in gastric cancer patients. Careful surveillance by the physician for synchronous cancer is warranted for the patients suffering from gastric cancer.
Aged ; Colorectal Neoplasms ; Esophagus ; Humans ; Liver ; Lung Neoplasms ; Multivariate Analysis ; Risk Factors ; Stomach ; Stomach Neoplasms*

Experinece in the management of 74 patients with delayed traumatic intracranial hemorrhage(DTICH) of 474 head injury from January 1996 to December 1996 is poresented with emphasis on the incidence, occurring time, risk factors and outcome. The incidence of DTICH was 15.6% of all hospitalized head-injury patients. After an injury, every patient had an immediate computerized tomography(CT) scan to diagnose intracranial pathology and then CT follow-up was carried out according to intial CT finding and reurological deficit. The lesion was almost occurred in patients with initial abnormal CT finding(85.1%). 82.4% of DTICH were noted within 72 hours after injury. The delayed epidural hematoma and intracerebral hemorrhage were almost noted in first 72 hours(>90%), but the delayed subdural hemorrhage was found after a time interval varying from 6 hours to 10 days. So we strongly recommend CT follow-up in 4-8hour, 24-72hour, and then 7th day after head injury, especially in patients with initial abnormal CT findings. The risk factor of the delayed lesion was not hypotension, hypoxia, and consciousness level, but age of patients and the initial CT finding. The development of DTICH was not heralded by neurological deterioration. The prognosis of DTICH was not worse than non-DTICH. The patient with delayed subdural hemorrhage was better than the patient with non-delayed lesion(including hemorrhage and normal CT finding).
Anoxia ; Cerebral Hemorrhage ; Consciousness ; Craniocerebral Trauma* ; Follow-Up Studies ; Head* ; Hematoma ; Hematoma, Subdural ; Hemorrhage ; Humans ; Hypotension ; Incidence ; Intracranial Hemorrhages* ; Pathology ; Prognosis ; Risk Factors

Hyponatremia, well known as a serious medical condition, is the most frequent electrolyte disorder in clinical medicine. The aim of this study is to bring to readers affecting factors in hyponatremia treatment and to suggest effective treatment guideline. We studied general characteristics, associated serum potassium change, relationship of sodium concentration in urine, and affecting factors on serum sodium correction in 76 hyponatremic patients who had admitted Hanyang University Kuri Hospital. These 73 hyponatremic patients were divided into 10 groups according to cause and treatment by retrospective analysis(1 group : G-I origin, 2 group : CRF, 3 group : CHF, 4 group: LC, 5 group : adrenal origin, 6 group : diuretics use, 7 group : CHF with di- uretics use, 8 group : LC with diuretics use, 9 group : polydypsia, 10 group : SIADH). Serum sodium were 124.2+/-6.9mEq/L in initial diagnosis, 125.6 +/-7.7mEq/L after 48 hour, and 129.8+/-6.3mEq/L in final evaluation. Among these hyponatremic patients, thirty patients' (41.1%) sodium correction rate were below 0.5mEq/L/hr during initial 48 hour and fifteen patients(20.5%) were corrected above 135mEq/l in serum sodium Initial serum potassium was average 4,07mEq/L, and 15 patients in 73 hyponatremic patients were hypokalemic feature. Eight patients of 15 hypokalemic patients were corrected to normal potassium level and in addition, four patients of 8 corrected patients were corrected to normal sodium level above 135mEq/L. The disease frequency were highest in GI origin (31.5%), followed by SIADH(20.5%) and LC(12.3%). In our study, hyponatremia correction was not related to patient sex, age, and initial serum sodium concentration. In conclusion, Hyponatremia prognosis was not related to initial serum sodium concentration and corection rate, but related to treatment of underlying disease. And hypokalemia acompanied by hyponetremia was corrected after correction of hyponatremia.
Clinical Medicine ; Diagnosis ; Diuretics ; Humans ; Hypokalemia ; Hyponatremia* ; Potassium ; Prognosis ; Retrospective Studies ; Sodium