No abstract available.
Anemia, Iron-Deficiency* ; Iron*

No abstract available.
Fibrosis* ; Recurrence*

A retrospective clinical observation was done in 90 cases of acute myocadial infarction admitted to Hanyang University Hospital from July 1972 to Dec. 1980. The following results were obtained. 1) The ratio of male to female was 2.3:1. Most patients(63.2%) were in the age groups between the 6th and 7th decades. 2) The main symptoms of acute myocardial infarction were chest pain(76.6%), dyspnea (64.4%), radiating pain(27.7%), epigastric pain(18.8%) and palpitation(15.5%). The painless infarction accounted for 11.1% of all cases. 3) The most common preceding disease was hypertension(38.5%) and other associated diseases were diabetes mellitus(13.2%), C.V.A.(8.8%), angina pectoris(8.8%), previous myocardial infarction(6.6%) and drug intoxication(3.3%). No preceding diseases were found in 12.0% of cases. 4) The anterior wall infarction was 45.5% of 90 cases, inferior wall infarction 22.2%, antero-inferior wall infarction 11.2%, subendocardial infarction 7.7%, posterolateral infarction 2% on ECG. 5) The mortality rate of patients according to the Killip class was 4.2% in class I, 14.3% in class II, 50% in class III and 76.9% in class IV. Group of high Killip class was associated with high mortality. 6) In long term prognosis according to Norris' coronary prognostic index, the highest value was 11.72 with average value of 7.02+/-2.65 in survival group, whereas in death group, the lowest value was 5.08, the highest 16.88 and average value was 10.4+/-3.86. 7) High risk subgroup who complicated within the first 4 admission days, occupied 21.1% and low risk subgroup without complication occupied 46.7%. After the 5th admission days, 2.2% of high risk subgroup was expired, whereas there was no death cases in low risk subgroup. 8) Average duration of hospitalization was 22.4+/-9.5 days in high risk subgroup and 17.3+/-6.8 days in low risk subgroup. In low risk subgroup, 10 cases were discharged within the 7th day of admission and 30 cases after the 8th day of admission. 9) 89.5% of total death occured within the 4th hospitalized day, and 66.7% of cases under systolic BP of 84mmHg were expired. Definite cardiomegaly on chest X-ray and past history of myocardial infarction were associated with high mortality. Half of cases with pulmonary edema were died.
Cardiomegaly ; Dyspnea ; Electrocardiography ; Female ; Hospitalization ; Humans ; Infarction ; Male ; Mortality ; Myocardial Infarction* ; Prognosis ; Pulmonary Edema ; Retrospective Studies ; Thorax

Tracheoesophageal fistula (TEF) occurs in approximately 1 in 3,000 to 5,000 live births. TEF arises from failure of normal division of proximal foregut into separate respiratory and digestive tracts at 4 weeks' gestation. TEF and esophageal atresia are interrelated anomalies, and TEF usually occurs with esophageal atresia. These are usually diagnosed shortly after birth. However, the diagnosis is often delayed in TEF without esophageal atresia, because babies with this anomaly are usually normal in size and seldom have other anomalies. Therefore, sometimes TEF without esophageal atresia is found during operation for an unrelated condition when positive pressure ventilation causes massive inflation of the gastrointestinal tract. We report a case of TEF in adult patient found during general anesthesia for emergency exploratory laparotomy.
Adult ; Anesthesia, General* ; Diagnosis ; Emergencies* ; Esophageal Atresia ; Gastrointestinal Tract ; Humans ; Inflation, Economic ; Laparotomy* ; Live Birth ; Parturition ; Positive-Pressure Respiration ; Pregnancy ; Tracheoesophageal Fistula*

Scaphoid fractures are the most common fracture and early diagnoses are very important because of preventing from serious complications such as nonunion, avascular necrosis, and disability of wrist joint. There are a few reports of clinical survey of scaphoid fractures, but not to be reported the evaluation for the close relation among mechanism, modes of treatment, especially operation and late complications. This paper reports more clear corelationships among them as mentioned as above through clinical study of scaphoid fractures. The authors have surveyed the clinical study of 26 cases of scaphoid fractures from July, 1983 to November, 1989 at Department of Orthopedic Surgery, Haewha hospital of Korea University. The following conclusions were obtained through clinical survey. 1. Among 26 cases, they were 25 males and one female between 20 and 50 years of age, and ocalization was 16 in right and 10 in left. They were 21 fresh fractures and five nonunions. 2. Mechanism of injuries had revealed fall down or slip down in 13 cases, roller injury in five cases, fisting injury in four cases, direct trauma in two cases, and traffic accident in two cases. Fracture loeation was four cases in proximal 1/3, 17 cases in middle 1/3, and five cases in distal 1/3. 3. Operations using volar approachs in 12 cases and dorsal approachs in three cases had been done for ten cases of displaced fresh fractures and five cases of neglected nonunions. 4. Eleven undisplaced fresh fractures were treated with short arm thumb spica cast but one with. long arm cast. Of ten displaced fresh fractures treated by open reduction, seven cases were treated with Herbert screw, two cases with K-wire, and one case with treated by open reduction and bone graft with Herbert screw fixation in three cases, K-wire fixation in one case, and open reduction with bone graft in one case. 5. Unions were obtained at average 11.5 weeks in eight of 11 cases treated with conservative treatment for fresh fractures, 12 weeks in eight of 10 open reduction cases of fresh fractures, and 20 weeks in three of five neglected nonunion cases. 6. Of eleven conservatively treated cases, two cases resulted in nonunion and other one case in avascular necrosis. Of ten treated with open reduction, one complicated in delayed union, other one nonunion. Of five neglected nonunion cases treated by open reduction added with bone graft, one remained in nonunion and other one case complicated with arthritis and nonunion.
Accidents, Traffic ; Arm ; Arthritis ; Clinical Study ; Diagnosis ; Female ; Humans ; Korea ; Male ; Necrosis ; Orthopedics ; Thumb ; Transplants ; Wrist Joint

BACKGROUND: Diabetic ketoacidosis(DKA) is serious acute metabolic complication and the most important cause of high morbidity and mortality of diabetes. The object of this study is to examine the clinical characteristics of patients with DKA who had a prior history of diabetes or not. METHOD: Authors reviewed retrospectively the medical records of 49 cases adimitted to Kyungpook National University Hospital from January 1991 to June 1997 with a diagnosis of DKA and classified cases as type I, type II and newly diagnosed diabetics according to prior history of diabetes. RESULTS: 1. Of 49 cases of DKA, 24(49%) were classified as type I, 17(35%) as type II from data available in the medical records, and 8(16%) had DKA as the initial manifestation of the disease. 2. The male to female ratio was 0.5 : 1 in type I, 1.1 : 1 in type II and 1.7 : 1 in newly diagnosed diabetics, and the mean age was 24.4 in type I, 57.9 in type II and 23.9 years old in newly diagnosed diabetics. 3. The mean duration between initial diagnosis of diabetes and the occurrence of DKA was 2.6 in type I and 6.9 years in type II diabetes. The occurrence of DKA within 2 years of initial diagnosis of diabetes was 54% in type I and 18% in type II diabetes, but the occurrence of DKA after 5 years of initial diagnosis of diabetes was 17% in type I and 47% in type II diabetes. 4. The precipitating factors of DKA were identified in 88% in type I, 76% in type II and 38% in newly diagnosed diabetics, and the most common precipitating factor was omission of treatment in both type I and type II(type I: 56%, type II: 35%). 5. The altered mental status was correlated with increased osmolality (p<0.05), but not with other laboratory values such as pH, bicabonate, glucose, anion gap and dehydration status(p>0.05). CONCLUSION: It is necessary to conduct early aggressive evaluation for early diagnosis and proper treatment of DKA, because DKA occurs in patients with prior history of type II diabetes and without prior diabetic history as well as patients with prior history of type I diabetes.
Acid-Base Equilibrium ; Dehydration ; Diagnosis ; Early Diagnosis ; Female ; Glucose ; Gyeongsangbuk-do ; Humans ; Hydrogen-Ion Concentration ; Male ; Medical Records ; Mortality ; Osmolar Concentration ; Precipitating Factors ; Retrospective Studies

Gangweon-do is known to be highly endemic area of sparganosis more than other provinces in Korea. A seroepidmiologic examination for the detection of anti-Spirometra erinacei plerocercoid IgG in serum was carried out in normal inhabitants in Hongcheon-gun, Gangweon-do. Sere were tested by enzyme-linked immunosrobent assay (ELISA) for the anti-sparganum antibodies. Positive rate for anti-sparganum antibody in 719 adults was 3.3%. Data of the questionnaire for 24 ELISA positive inhabitants revealed that 20 had a history of eating raw meat of snakes, 24 had a history of eating frogs, and 24 had a history of drinking stream water. Two positive cases had a past history of sparganosis. Two positive cases showed current symptoms of sparganosis. The data revealed that ELISA would be useful to find infected cases among normal inhabitants at sparganosis-endemic areas.
Adult ; Aged ; Aged, 80 and over ; Animals ; Antibodies, Helminth/*blood ; Enzyme-Linked Immunosorbent Assay ; Female ; Human ; Immunoglobulin G/*blood ; Korea/epidemiology ; Male ; Middle Aged ; Seroepidemiologic Studies ; Sparganosis/*epidemiology ; Spirometra/*immunology

BACKGROUND: The aim of this study was to compare the cardiovascular changes followed by laryngoscopy with the McCoy laryngoscope blade with those followed by laryngoscopy with the Macintosh laryngoscope blade. METHODS: Forty eight patients were randomly divided into two groups. Following induction with fentanyl 2 mcg/kg and thiopental 5 mg/kg, and muscle relaxation with vecuronium 0.1 mg/kg, the vocal cords were visualized with either the McCoy or the Macintosh laryngoscope blade, then tracheal intubation was performed. Heart rate and arterial blood pressure were measured just before and after laryngoscopy, and 1, 3 and 5 min later. RESULTS: There was a significant increase in both heart rate and arterial blood pressure after tracheal intubation using the Macintosh laryngoscope. Also, use of the McCoy blade resulted in a significant increase in both heart rate and arterial blood pressure. CONCLUSIONS: There was no significant difference on arterial pressure and heart rate to laryngoscopy and tracheal intubation with either the McCoy blade or the Macintosh.
Arterial Pressure ; Blood Pressure* ; Fentanyl ; Heart Rate* ; Heart* ; Humans ; Intubation* ; Laryngoscopes* ; Laryngoscopy ; Muscle Relaxation ; Thiopental ; Vecuronium Bromide ; Vocal Cords

Fungal infection has been observed with increasing frequency in recent years because the use of combinations of broad spectrum antibiotics, immunosuppressive agents, and antineoplastic agents is increasing and the survival rate of premature baby is increasing. We experienced a 3 month old male infant with anuria due to bilateral ureteropelvic fungus balls. He was born at 31 weeks gestation period and had been treated with broad spectrum antibiotics for 5 weeks after birth. We removed fungus balls surgically and made nephrostomy bilaterally. And then irrigation of amphotericn B through nephrostomy and systemic amphotercin B injection had performed for 3 weeks. Thereafter fungus balls completely disappeared.
Anti-Bacterial Agents ; Antineoplastic Agents ; Anuria* ; Fungi* ; Humans ; Immunosuppressive Agents ; Infant* ; Male ; Parturition ; Pregnancy ; Survival Rate

A prospective study had been performed in infants with hydronephrosis due to ureteropelvic junction stenosis to determine adequate management plan. Forty infants (47 renal units) were selected for the study during the period from January 1995 to July 1997 in the Department of Pediatrics, Asan Medical Center. They were diagnosed prenatally or early postnatally (<3 months of age) on the basis of renal ultrasonography and techotium-99m-mercap- toacetyltriglycerine (MAG3) scan. The antero-poste- rior pelvic diameter (APPD) was measured from serial renal ultrasonography and relative renal function and clearance half time (T1/2) were calculated from serial MAG3 scan. Those who had accompanying other urogenital anomalies or vesicoureteral reflux were excluded in this study. Follow-up tests (ultrasonography and MAG3 scan) and surgical corrections, if necessary, were performed according to the predetermined algorithrn. The male to female ratio was 3: 1. Hydronephrosis was involved the left side in 24 renal units, the right side in 9 renal units, and the bilateral sides in 14 renal units. All the hydronephrotic renal units were divided into 2 groups; Group A (19 renal units) those had taken surgical correction, and group B (28 renal units) those revealed spontaneous improvement without surgical correction. The mean follow-up duration was 7.2+/-6.3 months in group A and 14.1+/-12.6 months in group B. The mean APPD in the first postnatal renal ultrasonography was 19.4+6.8 mm in group A and 10.0+/-3.0mm in group B and this was statistically significant (P<0.01). The rela- tive renal function of group A in the first MAG3 scan was under 35% in 7 renal units and over 35M in 12 renal units. In group B, the relative renal function was over 35% in the all 28 renal units. Tl/2 in the first MAG3 scan was longer than 20 minutes in the all 19 renal units in group A. In group B, Tl/2 was shorter than 10 minutes in 15 renal units, between 10 minutes and 20 minutes in 6 renal units, and longer than 20 rninutes in 7 renal units. The mean APPD of the 7 renal units in group B of which Tl/2 was longer than 20 minutes was 12.62.6mm and that of group A was 19.4+/-6.8mrn and this was statistically significant (P<0.01). In conclusion, the renal ultrasonography and MAG3 scan can be used effectively to determine the degree of the stenosis of the ureteropelvic junction in hydronephosis during infancy. When the babies are diagnosed with hydronephrosis due to ureteropelvic junction stenosis in the early infantile period, serial renal ultrasonography and MAG3 scan play an important role in the decision of the management.
Chungcheongnam-do ; Constriction, Pathologic ; Female ; Follow-Up Studies ; Humans ; Hydronephrosis* ; Infant ; Male ; Pediatrics ; Ultrasonography* ; Vesico-Ureteral Reflux