Twenty-five patients with cerebrovascular diseases were administered Nicardipine, a calcium antagonist, in daily dose of 60 mg per orally for 8-12 weeks during the year of 1983, to evaluate the efficacy of the drugs clinically. The following results were obtained. 1) General improvement rating was 80%. 2) Marked improvement(88%) were noted in subjective symptoms, especially of tinnitus, paresthesia and headache. significant improvement were noted in psychiatric(74%) and neurologic(71%) symptoms e.g disturbance of sleep, emotion, memory, speech, swallowing and muscle power. 3) In 13 hypertensive patients, average blood pressure lowered from 163/96 to 138/83 mmHg in 4 weeks and maintained thereafter. 4) major adverse effect was facial flushing, noted in 4 patients(16%), which were transient and mild and allowed to contiume medication.
Blood Pressure ; Calcium ; Deglutition ; Flushing ; Headache ; Humans ; Memory ; Nicardipine ; Paresthesia ; Tinnitus

No abstract available.
Arthritis* ; Open Bite*

Strongyloides stercoralis is a nematodes and is prevalent in the tropical regions. In Korea, 6 cases have been reported in which the parasites were identified in feces. We report a case of hyperinfection syndrome with Strongyloides stercoralis confirmed in the tissue sections. A 52-year-old woman was admitted to the hospital because of generalized edema and weakness. She received steroid therapy for 30 years because of rheumatoid arthritis. One year ago, generalized edema and dyspnea were developed and she was diagnosed as minimal change nephrotic syndrome for which she received cyclosporin. On admission, she complained of generalized weakness and edema, multiple arthralgia and abdominal discomfort with nausea. The white-cell count was 14,600 without eosinophilia. A stool specimen was negative for occult blood, ova or parasites. Right lower quadrant abdominal pain and tenderness were developed, and the exploratory laparotomy was done under the impression of the acute appendicitis. An appendectomy with a biopsy of mesenteric lymph nodes was performed. From the 5th day after operation, the patient began to complain of the abdominal pain and constipation. Under the impression of adhesion bad formation, the laparotomy was done and disclosed that the proximal ileum was markedly dilated. On jejunotomy, a great amount of formed stool and barium was noticed in the proximal portion of small bowel. The jejunal tissue was biopsied. Grossly, the appendix was unremarkable. Microscopically, the inflammatory reaction was nearly absent, but in serosa, minute granulomas were found which contain a part of the parasite. Same feature was noted in the mesenteric lymph node. The biopsied jejunum contains numerous adult female, filariform and rhabdidiform larvae and eggs in the mucosa, submucosa and muscle wall. Their morphology was compatible with Strongyloides stercoralis. The patient died 5 days later in the state of multiple organ failure.
Adult ; Male ; Female ; Humans ; Biopsy

BACKGROUND: In 1996, our emergency department(ED) had 148.4 patients per day and an average time for managing simple and uncomplicated patients was 248 minutes. To relieve congestion, delay and conflict in ED, we have developed Fast Track to treat patients with minor illness rapidly and effectively. The Fast Track area is located in a separate area in front to the main department. The efficiency and effectiveness of new system and patients satisfaction were investigated. METHODS: All ambulatory patients(> 15 years of age) were triaged and treated at Fast Track by emergency physicians. Patients, triaged as severe illness, were moved directly to main ED and the other patients with minor illness were managed in Fast Track. We analysed the patients who were managed at Fast Track from Jan. 1st 1997 through Nov. 30th 1997. The total time staying in Fast Track from beginning of trige to final decision such as discharge or admission was recorded retrospectively. A questionnaire was obtained from random patients in the same period to evaluate the patient's satisfaction. RESULTS: The number of patients who were managed in Fast Track was 13,378, and it was 55.8% of all adult patients who visited ED during the period. The average staying time was decreased significantly with time, (140.9+/-2.9 minutes in June, 125.4+/-2.8 minutes in July, and 97.7+/-1.0 minutes after July). The 75 percentile weighted average time was also decreased significantly; 196 minutes in June, 107 minutes in July, 135 minutes from August to November(p<0.01). The questionnaire were obtained from 107 patients. The results were revealed that 90 of 107 patients(84.1%) were satisfied with emergency care at Fast Track, and the remaining patients expressed unsatisfied comments such as long waiting time(4.7%), overcrowding(1.9%), unsatisfactory care(1.9%). CONCLUSION: The Fast Track system could decrease patient's staying time and improve patient's satisfaction. In addition, the efficiency and effectiveness of the acute care in ED would be enhanced by managing minor illness in Fast Track rapidly and effectively.
Adult ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Estrogens, Conjugated (USP) ; Humans ; Surveys and Questionnaires ; Retrospective Studies ; Tertiary Care Centers*

Spinal dysraphism, first described by Lichtenstein in 1940, is a congenital anom- aly due to incomplete fusion or malformation of the midline dorsal embryonic structures including the ectoderm, mesoderm, and neuroectoderm. Spina bifida occulta is a spinal dystraphism and a manifestation of a midline defect of osseous spine and related structures without cyst formation. Spinal dysraphism may be associated with hypertrichosis, lipoma, dimpling, pigmentation, hemangioma, congenital scar, sinus, cyst, or skin defect in the midline dorsal area. We observed a 23-year-old female patient with spina bifida occulta who had a blue scar surrounded by circumscribed hair growth of the lumbosacral area since 1-montb-old age. Histopathologic finding of the blue scar revealed common blue nevus showing intradermal melanocytes and melanophages. Spine X-ray showed hemivertebra of L5 and spina bifida occulta of Sl. There were no abnormal neurologic signs.
Cicatrix ; Ectoderm ; Embryonic Structures ; Female ; Hair ; Hemangioma ; Humans ; Hypertrichosis* ; Lipoma ; Melanocytes ; Mesoderm ; Neural Plate ; Neurologic Manifestations ; Nevus, Blue* ; Pigmentation ; Skin ; Spina Bifida Occulta* ; Spinal Dysraphism* ; Spine ; Young Adult

It is evident that an elevation of airway albumin excreation rate without clinical proteinuria strongly predicts a later progression on diabetic renal disease. So we studied the correlation between Microalbumin checkly RIA & Micral-Test®. We collected urine between 08:00 h and 08:00 h next day and then checked microalbuminuria by radioimmunoassay method and Micral-Test® The results are as follows: 1. There was significant correlation between microalbuminuria checked by RIA & Micral-Test® 2. There was poor correlation between diabetes duration or HV-A1c and maximal change in albumin excreation rate. 3. So we concluded that Micral-Test® can be used in laboratory instead of RIA.
Methods ; Proteinuria ; Radioimmunoassay

No abstract available.
Orthopedics*

No abstract available.

Sensation is the key element that allows the fingertip to participate effectively in virtually all hand functions. Therefore, it is very important to restore sensation as well as well padded, durable skin coverage following severe fingertip injuries. Many ingenious operations have been described to provide the fingertip with sensate coverage. Among them, the innervated cross-finger flap, reported by Cohen et al. in 1983, is very effective and successful in reconstruction of severe fingertip injuries, We report five cases of severe fingertip injuries treated with innervated cross-finger flap. The results are as follows : 1. The level of sensory return and the functional result is excellent in those fingertips reconstructed with the innervated cross-finger flap. 2. Mean time for flap detachment is 16 days post operative and local anesthesis at outpatient department is sufficient. 3. Four of five treated patients achieved excellent sensibility with measurable two-point discrimination(mean 5.0 mm) and ability to recongnize textures and objects.
Fingers ; Hand ; Humans ; Outpatients ; Sensation ; Skin

The bipolar hemiarthroplasty is one of the treatment methods of the avascular necrosis of the femoral head and the fracture of the femur neck. The mechanism of bipolar hemiarthroplasty is intended to distribute the forces at the site of the inner and outer articulation, and theoritically diminish acetabular wear and produce a painless arthroplasty. The authors analyzed motion of two components in 23 cases of the bipolar hemiarthroplasty, performed at the Department of Orthopaedic Surgery, Korea University Hospital, between January, 1985 and January, 1993 with average 47 months follow up(range 24 to 84 months). The results obtained were as follows: 1. In the motion of the two components, inner bearing motion was average 11.5 degrees(from 1 to 29 degrees) and outer bearing motion was average 21.4 degrees(from 3 to 45 degrees). 2. The inner bearing motion was highest at 12 months with average 16 degrees and outer bearing motion was lowest during the same period with average 15 degrees. During the follow up the inner bearing motion was decreased whereas outer bearing motion was increased. 3. The inner or outer bearing motion of bipolar component was no correlation with age, sex and clinical result.
Acetabulum ; Arthroplasty ; Femur Neck ; Follow-Up Studies ; Head ; Hemiarthroplasty ; Korea ; Necrosis