Plasma renin activity (PRA) and aldosterone were measured to evaluate various status of clinical conditions in normal controls and patients with essential hypertension. Fourteen controls and 45 essential hypertensive patients for PRA, and 10 controls and 28 patients with essential hypertension for plasma aldosterone were studied. The results obtained are summarizing as follows. 1. Mean value of PRA of normal subjects was 2.9+/-1.4ng/ml/hr at rest, and 5.9+/-2.3ng/ml/hr by double stimulation, respectively, the latter elevated up to twice the former. 2. Mean value of PRA in the patients with essential hypertension was 3.37+/-3.0ng/ml/hr at rest, and 5.99+/-4.9ng/ml/hr by double stimulation. The latter have increased to 1.8 times the former. 3. The patients with low PRA observed in 33.3%, the normal in 42.2%, and the high in 22.5%, at rest. After double stimulation, the low group was observed in 22.2%, the normal in 60.0%, and the high in 17.8%. 4. Mean age of the patietns with low PRA was 57.2+/-2.6 years. Though it was higher than those of normal and high PRA groups(52.0+/-10.1 years), statistical significances were observed (0.05 Aldosterone* ; Blood Pressure ; Cholesterol ; Electrocardiography ; Furosemide ; Humans ; Hypertension* ; Hypertrophy, Left Ventricular ; Motor Activity ; Plasma* ; Potassium ; Proteinuria ; Renin* ; Sodium ; Triglycerides

Acute digitalization with ouabain were performed 28 times in 20 intact Mongrel dogs, who were devided into four groups : i.e. 1) Control group; Acute digitalizations were performed to observe the changes of the plasma potassium and sodium concentrations and the concomittent electrocardiographic findings. 2) Group 1;-Electrolyte solution, either KCl or NaCl, was infused during acute digitalization to observe the influences of these ions on the actions of cardiac glycoside, especially arrhythmia producing action. 3) Group 2 ; -The K depleted group and the Na depleted group was each made by the measure of diet control and the usage of oral diuretics to observe the influences of the state of depleted electrolyte (K or Na) on the action of cardiac glycoside during acute digitalization. 4) Group 3 ; -The intravenous infusion of either KCl or NaCl solution was introduced as the cardiac arrhythmia by the ouabain was produced to observe the effects of these ions on the digitalis induced arrhythmia. The results obtained were summarized as follows. (1) The arterial plasma concentration of potassium was increased during acute digitalization. The rise occurred at early stage, and the maximal increase of potassium was observed at the ventricular tachycardia. The average increase was 0.65 mEq/L as compared to control value (p<0.05). The arterial plasma concentration of sodium was reduced during acute digitalization. The fall occurred following the rise of plasma K level. The maximal reduction of sodium was observed after ventricular tachycardia, and the average decrease was 5.2 mEq/L as compared to control value (p<0.05). (2) Rapid increase up to toxic level of the plasma potassium concentration occurred occasionally during acute digitalization in the group with KCl infusion. This result was best explained due to the inhibitory action of cardiac glycoside on the K transport. (3) The interesting change was on T wave, which showed the peaking at late portion. This change occured in 60.6% during digitalization with ouabain, and paralleled mostly, but not consistently and even sometimes inversely, with the shift of plasma potassium concentration. It is tempting to assume that the change of T wave was resulted from an altered potassium gradient across the myocardial cells rather than a ssuming the changes of the plasma K level. (4) Just prior to intoxication, the marked prolongation of PR interval and ST depression were observed in about 70~80% of the cases studied. These changes might be applicable to a clue of the cardiac glycoside overdosage. (5) The intravenous infusion of KCl suppressed markedly the arrhythmia producing action of the cardiac glycoside, and resulted in prompt and dramatic abolishing, of digitalis induced arrhythmia. The intravenous infusion of KCl solution, however, produced A-V block or dissociation occasionally. This finding would be likely resulted from the additive or synergistic action of K and cardiac glycoside in suppressing A-V conducting system. (6) The NaCl infusion affected nothing to the arrhythmia producing action of cardiac glycoside. (7) The K depletion reduced markedly the threshold of the heart to the toxic effects of cardiac glycoside. (8) Potent diuretics in the state of deficient diet would produce clinically significant hypopotassemia and hyponatremia or both. The inducced hypopotassemia may provoke serious cardiac arrhythmia in the digitalized patients or animals.
Animals ; Arrhythmias, Cardiac ; Depression ; Diet ; Digitalis ; Diuretics ; Dogs ; Electrocardiography ; Electrolytes* ; Heart ; Humans ; Hypokalemia ; Hyponatremia ; Infusions, Intravenous ; Ions ; Ouabain ; Plasma ; Potassium ; Sodium ; Tachycardia, Ventricular

A clinical observation of 30 cases of pyogenic abscess and 18 cases of tuberculous abscess in the metaphysis of long bones during the past 15 years was carried out and following results were obtained. 1. The highest age incidence was the second decade (53.3%) in pyogenic abscess and the first decade (44.4%) in tuberculous abscess. 2. Average duration of symptoms were 1.6 years in pyogenic abscess and 2.3 years in tuberculous abscess. 3. Chief complaint on admission was pain both in pyogenic abscess (56.7%) and in tuberculous abscess (27.8%). 4. The tibia was the most common site in pyogenic abscess and the femur in tuberculous abscess. 5. Leucocyte count was increased more than 15, 000/mm in 23.3% of pyogenic abscess and 22. 2% of tuberculous abscess. 6. Erythrocyte sedimentation rate was increased more than 21mm/hr in 60.0% of pyogenic abscess and in 44.4% of tuberculous abecess. 7. Epiphysis was involved in 23.3% of pyogenic abscess and 38.9% of tuberculous abscess. 8. The positive result on bacteriologic culture was 46.7% in pyogenic abscess and 22.2% in tuberculous abscess. Coagulase positive staphylococcus aureus was cultured in 12 cases and other organisms were cultured in 2 cases. 9. Differential diagnosis between pyogenic, tuberculous abscess, and cystic tumors was not easy in many cases. Preoperatively, 5 cases of pyogenic abscess were misdiagnosed as tuberculosis and 2 cases as osteod osteoid osteoma. 3 cases of tuberculous abscess were misdiagnosed as pyogenics and 1 case as giant cell tumor. 10. Various methods of surgery including saucerization, curettage and bone graft, resection of bony focus, and arthrodesis were carried out. There was no difference in the end result between them. 11. Shortening or deformity due to epiphyseal plate damage was occurred in 3 cases (10.0%) in pyogenic abscess and 4 cases (22.2%) in tuberculous abscess. Those complications could be minimized with meticulous surgery not damaging the epiphyseal plate.
Abscess ; Arthrodesis ; Blood Sedimentation ; Coagulase ; Congenital Abnormalities ; Curettage ; Diagnosis, Differential ; Epiphyses ; Femur ; Giant Cell Tumors ; Growth Plate ; Incidence ; Osteoma, Osteoid ; Staphylococcus aureus ; Tibia ; Transplants ; Tuberculosis

One hundred patients with 119 curves with idiopathic scoliosis, age ranged from 2 to 32 years, were-treated at Seoul National University Hospital from 1968 to 1979. Of 100 patients, 63 were adolescent type, 20 juvenile, and 17 infantile. The distribution of curve-patterns was 49 right thoracic, 19 double major (Rt. thoracic & Lt. lumbar), 18 left thoracic, 12 thoracolumbar, and 2 left lumbar. Of these patients, 67 with 83 curves were treated with Milwaukee-brace for one to seven years with an average of three and one-half years. Seven patients were treated surgically because of a poor response to the brace or progression of the curve.Sixteen patients with 20 curves followed for average 4. 6 years after the completion of brace treatment showed some loss of correction: 2.8 degrees for thoracolumbar, 3.1 degrees for thoracic, 4.2 degrees for lumbar segments and 4, 9 degrees for thoracic segments of double major curves. The brace was more effective for curves with 6 to 9 involved vertebrae and of less than 40 degrees. Thirty three patients with 36 curves were treated with Harrington instrumentation and posterior spinal fusion and followed from 1 to 12 years with an average of six and one-half years. The initial preoperative curves ranged from 50 to 120 degrees with an average of 75.3 degrees. Immediate postoperative correction ranged from 30 to 70 degrees with an average of 36. 2 degrees (48.1%). The average loss of correction at follow-up was 1.5 degrees (2.8%) for curves of less than 60degrees and 1.4 degrees (1.3%) for those of more than 101 degrees. Varioua methods of preoperative correction were applied. Halofemoral traction was applied for rigid and severe curve in 9 patients, Cotrel traction for less rigid one in 11 patients, Risser localizer cast for flexible one in 9 patients, and no preoperative correction for mild and flexible one in 4 patients.
Adolescent ; Braces ; Follow-Up Studies ; Humans ; Scoliosis ; Seoul ; Spinal Fusion ; Spine ; Traction

No abstract available.
Bone and Bones* ; Dental Implants*

PURPOSE: Epilepsy is generally defined as a chronic condition characterized by recurrent unprovoked seizure. It is still controversial whether the long-term antiepileptic drugs(AED) treatment will be necessary in children with first unprovoked seizure. Cognitive and behavioral side effects of AEDs are especially important in developing children. Therefore the rationale of AED treatment in the children with first unprovoked seizure depends upon the seizure recurrence rate and presence of risk factors related with seizure recurrence. We are going to evaluate the risk of seizure recurrence and risk factors after a first unprovoked seizure in children. METHODS: One hundred fifty eight patients presented with a first unprovoked seizure from July, 1994 to June, 1999 were prospectively followed by regular epilepsy clinic visit or telephone interview for a mean of 27 months. We analyzed overall recurrence risk and risk factors of seizure recurrence(EEG finding, etiology of seizure, seizure type, history of prior febrile convulsions, neurodevelopmental status prior to first seizure, presence of a Todd's paresis, family history of seizures, a seizure occuring while asleep, and duration of seizure) by Cox's proportional hazards model and Kaplan-Meier survival analysis. RESULTS: In 158 patients with first unprovoked seizure, 61 (39%) patients experienced subsequent seizure. The cumulative risk of seizure recurrence was 28.5, 37.6, and 42.3% at 6, 12, and 18 months. The median time to recurrence was 3 months, with 72% of recurrence occurring within 6 months, 92% within 1 year, and 100% within 2 years. On univariate analysis, risk factors for seizure recurrence included an etiology of seizure and abnormal EEG. In idiopathic cases, the risk factor was an EEG abnormality. CONCLUSION: Many of the children with a first unprovoked seizure will not have recurrences. The recurrence risk of a first unprovoked seizure in children have statistically correlated with the etiology of seizure(cryptogenic and symptomatic) and abnormal EEG. Children with an idiopathic first seizure and a normal EEG have a particularly favorable prognosis.
Ambulatory Care ; Child ; Electroencephalography ; Epilepsy ; Humans ; Interviews as Topic ; Paresis ; Prognosis ; Proportional Hazards Models ; Prospective Studies* ; Recurrence* ; Risk Factors ; Seizures* ; Seizures, Febrile

The clinical effect of etafenone on 12 cases of angina pectoris(9 males and 3 females with average age of 58.3 years) were studied and following results were obtained: 1. Anginal chest pains were improved after average 9 days (3~15 days) of medication and the dreug was very effective in 41.7%, moderately effective in 33.3% and slightly effective in 25.0% of cases. 2. The ST segment depression of E.C.G. were reduced in 50.0%, improvement of T waves inversion or enlargement of T waves were observed in 66.7% and E.C.G. improvement either ST segment or T wave observed in 75.0% of cases. 3. No side reactions such as hypotension, palpitation, dizziness, headache or gastrointestinal disturbances were seen during the treatement with etafenone.
Angina Pectoris* ; Chest Pain ; Depression ; Dizziness ; Female ; Headache ; Humans ; Hypotension ; Male

The clinical effect of etafenone on 12 cases of angina pectoris(9 males and 3 females with average age of 58.3 years) were studied and following results were obtained: 1. Anginal chest pains were improved after average 9 days (3~15 days) of medication and the dreug was very effective in 41.7%, moderately effective in 33.3% and slightly effective in 25.0% of cases. 2. The ST segment depression of E.C.G. were reduced in 50.0%, improvement of T waves inversion or enlargement of T waves were observed in 66.7% and E.C.G. improvement either ST segment or T wave observed in 75.0% of cases. 3. No side reactions such as hypotension, palpitation, dizziness, headache or gastrointestinal disturbances were seen during the treatement with etafenone.
Angina Pectoris* ; Chest Pain ; Depression ; Dizziness ; Female ; Headache ; Humans ; Hypotension ; Male

The authors developed a computer program for use in report printing as well as data storage and retrieval for the gastrointestinal endoscopy service. This program used IBM PC XT and was written in dBASE III plus language. We applied the automatic SNOMED coding method, which is one of the most efficient and accurate method of computerization of medical data. The working sheet which contained the results of previous endoscopic studies could be printed during registration. The dBASE word processor enabled issuing of the formal report of endoscopic result, and the data storage was carried out during the typewriting of the report. Two kinds of data files were stored in the hard disk; the temporary file contained full informations and the permanent file contained patients identification data and SNOMED code. Searching of a specific case was performed by chart number, patients name, date of study, or SNOMED code within a second. All the cases were arranged by SNOMED codes of procedure, topography and morphology codes. Every new data was copied to the diskette automatically. with which data could be restored in case of hard disk failure. The main advantages of this program in comparison to the large main frame computer system are low price, flexibility and easy accessibility. Based on our experience (including surgical pathology department, radiology, clinical pathology), we assume that this program may fit every endoscopy room where there are less than 20,000 cases per year.
Information Storage and Retrieval ; Clinical Coding* ; Computer Systems ; Endoscopy ; Endoscopy, Gastrointestinal* ; Humans ; Information Storage and Retrieval* ; Pathology, Surgical ; Pliability ; Systematized Nomenclature of Medicine

Author analysed ECG records of conventional 12 leads of 240 healthy persons (120 males and 120 females of 15-90 years of age) to evaluate the cardiac changes with advancing age and following results were obtained; 1. P-R intervals were not changed significantly with advancing age. The QT, Q-aT, Q-aU, and Q-U intervals were prolonged with advancing age and they were marked in male than female. 2. Mean QRS axis were shifted to the left with advancing age and these were more distinct in male than female. Mean P axis and mean T axis were not changed appreciably with advancing age. 3. The incidences of ECG position of vertical and semivertical heart position were decrease with advancing age and intermediate, horizontal and semihorizontal heart position were increased with advancing age. 4. The transitional zone of precordial leads were not changed with advancing age.
Aging* ; Axis, Cervical Vertebra* ; Electrocardiography* ; Female ; Heart* ; Humans ; Incidence ; Male