The study was conducted to determine the lateral tibio-articular angle of ankle joint in 100 korean adults(160 cases) ranging from second to eight decades of age. The authors have defined as the lateral tibio-articular angle of ankle joint, that is the sharp angle between the lateral tibial axis which is the lateral longitudinal line through each midpoints of the upper and lower one third of the tibia, and the line to connect the anterior and posterior tips of the tibial articular surface of ankle joint. 1. It was 79.3°±3.4°in all cases. 2. It was 79.2°±3.6°in male and 79.6°±2.7°in female. It was reduced in male approximately 0.4°compared with female. 3. It was 79.1°±3.1°in the left side and 79.5°±3.6°in the right side. It was reduced approximately 0.4°in the left side compared with the right side. 4. It was reduced approximately 0.9°in the left side compared with both sides of the same person.
Adult ; Ankle Joint ; Ankle ; Female ; Humans ; Male ; Statistics as Topic ; Tibia

beta-receptor antagonist as antihypertensive agent has adverse effect such as vasoconstriction, bronchoconstriction and aggravation of atherosclerosis. So beta-receptor antagonist with alpha-receptor blocking property has been studied for avoidance of adverse effects of beta-receptor antagonist. Nipradilol, a new beta-receptor antagonist with alpha-receptor blocking property was administrated in 30 essential hypertensive patients for 10 week in order to evaluate the antihypertensive effects and adverse effects. The results were as follows: 1) Nipradilol was effective in 20 patients(67%) on systolic blood pressure 22 patients (73%) on diastolic blood pressure at the end of 10 weeks treatment. 2)Before medication, mean systolic and diastolic blood pressure in sitting position were 160+/-14mmHg and 102+/-18mmHg,and after 10 weeks of medication, mean systolic and diastolic blood pressure were significantly declined to 143+/-22mmHg and 89+/-12mmHg(p<0.001). 3) There was no significant change in pulse rate, from 78+/-12 beats per minute the beginning of the treatment to 75+/-11 beats per minute after 10 week of treatment. 4) There was no significant changes in sodium, potassium, GOT, GPT, bilirubin, alkalin ephosphatase, BUN, creatinine, LDH, CPK and lipid. 5) The adverse effects of nipradilol were bradycardia(7%), dyspnea(3%), chest discomfort(3%) and headache(3%). In summary, nipradilol seemed to be effective antihyertensive drug in treating mild to moderate hypertension.
Atherosclerosis ; Bilirubin ; Blood Pressure ; Bronchoconstriction ; Creatinine ; Heart Rate ; Humans ; Hypertension ; Potassium ; Sodium ; Thorax ; Vasoconstriction

STUDY DESIGN: A retrospective review of the patients who have a fixation failure of instrumentalion for the spinal fusion in lumbar region. OBJECTIVES: To assess the incidence and different types of the mechanical failure of fixation and to evaluate their managements and their influences on the progression of a spinal fusion and to the clinical outcomes. SUMMARY OF LITERATURE REVIEW: Most of the spine surgeons have been experiencing the mechanical failures after instrumentations for a spinal fusion, eden though the incidence is decreasing with a modification of the implants. Reports on this problem are sporadic in conjunction with the other topics, rarely focusing on their management and their influences on the final outcomes. MATERIALS AND METHODS: 338 consecutive patients who had a lateral fusion in the lumbar region with an instrumentation of pedicle screws and rods, mostly with decompression, were reviewed to analyse the fixation failures of instrumentation after surgery. RESULTS: There were 26 patients (7.7%) who had the fixation failures of instrumentation, in terms of loosening around the pedicle screws in 18 patients (5.3%), the breakage of the pedicle screws in fide patients (1.5%), and the migration of a rod in three patients (0.9%). They were managed by prolonged use of brace and ergonomic back cares. Even with the fixation failures, 19 patients (73.1%) disclosed solid union uneventfully, but one patient had re-operation to obtain solid fusion. The final outcomes were satisfactory in 22 patients (84.6%), including four of six patients who had pseudoarthrosis. CONCLUSIONS: The fixation failure of instrumentation after a spinal fusion in lumbar region was not rare, but the progression of a spinal fusion usually quite well achieved and the final outcomes were not so bad, even with the implant failures and pseudoarthrosi s. Except for the persistently symptomatic pseudoarthrosis, only a prolonged use of brace and the ergonomic back cares are recommended for symptomatic patients.
Braces ; Decompression ; Humans ; Incidence ; Lumbosacral Region* ; Pseudarthrosis ; Retrospective Studies ; Spinal Fusion* ; Spine

Hypertensive encephalopathy is an acute clinical syndrome that shows central nerve dysfunction with sudden and marked elevation in blood pressure. But its pathophysiologic mechanisms, clinical courses and prognosis are still not clear. In order to study clinical manifestations and response to treatment in patients with hypertensive encephalopathy, we reviewed 45 patients with hypertensive encephalopathy who were admitted in Dept. of Internal Medicine, National Medical Center, from January 1975 to December 1984. The following results were obtained: 1) The ratio of male to female was 1.1:1. The peak age of incidence was in the 6th and 7th decade with mean age of 57.5 years. 2) Among 45 patients, only 29 had known history of hypertension and the average duration of hypertension was 8.1+/-3.6 years. 3) The most common sympotm was severe headache (68.9%). And altered consciousness, nausea and/or vomiting, focal neurologic signs and visual disturbance were also common symptoms in decreasing order of frequency. 4) Funduscopic examination showed hypertensive retinopathy in 20 of 24 (91.7%) patients and lumbar puncture revealed increased CSF pressure in 12 of 20 (60%) patients. 5) In most patients, the mean interval to symptomatic improvement was 2.1 days after administration of anti hypertensive agents, but in 6 patients with initial mean arterial blood pressure above 170mmHg, 4 patients showed delayed response and 2 patients were expired.
Antihypertensive Agents ; Arterial Pressure ; Blood Pressure ; Consciousness ; Female ; Headache ; Humans ; Hypertension ; Hypertensive Encephalopathy* ; Hypertensive Retinopathy ; Incidence ; Internal Medicine ; Male ; Nausea ; Neurologic Manifestations ; Prognosis ; Spinal Puncture ; Vomiting

No abstract available.
Hydrothorax*

PURPOSE: To evaluate the characteristics of CT findings in differential diagnosis of cervical lymphadenopathy. MATERIALS AND METHODS: We evaluated CT findings of histopathologically proved 32 cases of tuberculous lymphadenitis, 12 cases of nodal lymphoma, 29 cases of metastasis from March 1986 to Dec. 1992, retrospectively. We analyzed age and sex distribution, location of lymphadenopathy, internal nodal density, feature of contrast enhancement, extracapsular spread and nodal calcification. RESULTS: Tuberculous lymphadenitis was more preponderant in young female (mean;32) and CT showed internal low density(91%) with irregular thick marginal enhancement(46.9%), predilection for spinal accessory node(71.9%), and nodal calcification(5/32). Nodal lymphoma showed predilection for internal jugular chain (100%) and had conglomerated homogeneous internal node structures(83%). Metastasis showed old male preponderance (mean :52 years), predilected at internal jugular chain(89.7%),internal low density(93.3%) with regular thin marginal enhancement(44.8%), extracapsular spread(41.4%), and nodal calcification(2 cases of nodal metastasis of papillary type thyroid cancer). CONCLUSION: We concluded that CT evaluation of the chracteristics of lymphadenopathy is helpful for differential diagnosis of cervical lymphadenopathy.
Diagnosis, Differential* ; Female ; Humans ; Lymphatic Diseases* ; Lymphoma ; Male ; Neoplasm Metastasis ; Retrospective Studies ; Sex Distribution ; Thyroid Gland ; Tuberculosis, Lymph Node

No abstract available.
Breast* ; Glucuronidase* ; Lipase* ; Milk, Human*

No abstract available.
Pulmonary Artery*

A modern development of ambulatory ECG monitoring gave great advances in the diagnosis and evaluation of various cardiac conditions. Fifteen cases of ischemic heart disease, 11 cases of nonischemic heart disease, 5 cases of noncardiac disease and 9 cases of normal healthy subjects were studied from January 1980 to July 1981 in national Medical Center, with the following results: 1) The heart rate was decreased during night time, with less decreasing tendency in patients with ischemic heart disease. 2) Among 30 cases, including 12 patients with ischemic heart disease, who didn't show arrhythmia on routine 12 lead ECG, 12 cases, including 6 patients with ischemic heart disease, showed arrhythmia on Holter monitoring. 3) Among 5 cases with ischemic heart disease who showed premature ventricular contraction on day time monitoring, 2 cases didn't show premature ventricular contraction on nigh time monitoring. 4) The S-T segment and T wave were changed during night time in 2 cases with ischemic heart disease and in 2 normal subjects. From these results, we could assert that Holter monioring or ambulatory ECG tracing would be a good method for diagnosis and evaluation of ischemic heart disease, and other cardiac conditions. Several another studies with this equipment have to be performed and would give more distinctive outcomes.
Arrhythmias, Cardiac ; Diagnosis ; Electrocardiography ; Electrocardiography, Ambulatory* ; Heart Diseases ; Heart Rate ; Humans ; Myocardial Ischemia ; Ventricular Premature Complexes

A clinical review was made on 48 cases with cor pulmonale who were admitted to medical department, National Medical Center, between 1973 and 1982, and the results were as follows : 1) Teh age of subjects ranged from 26 to 88, and their mean was 51. male to female ratio was 1.6:1 and majority of them were in their 6th and 7th decade. 2) COPD was the most common cause of cor pulmonale but pulmonary tuberculosis had also a considerable portion. Less commonly it was caused by chest deformity which was mainly from spine tuberculosis and kyphoscoliosis. 3) Almost all patients were admitted with over heart failure. 4) Laboratory features showed indirect evidence of heart failure and pulmonary hypertension in chest X-ray films, RVH patterns in EKG and hypoxia and hypertcapnea with metabolic compensation in arterial gas analysis. 5) The case fatality rate was one-forth and that from kyphoscoliosis was especially high(80%).
Anoxia ; Compensation and Redress ; Congenital Abnormalities ; Electrocardiography ; Female ; Heart Failure ; Humans ; Hypertension, Pulmonary ; Male ; Mortality ; Pulmonary Disease, Chronic Obstructive ; Pulmonary Heart Disease* ; Spine ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary ; X-Ray Film