The volumetry by cineangiocardiography is known to have the most diagnostic and prognostic value in theevalutaion of various valvular heart diseases and ischemic heart diseases. Athough many authors favor thearea-length method for the voulmetry of left ventricle, 45degrees RAO projection seems to be more simple,inexpensive and acurate technique, considering the positional relationship of cardiac valves and obliquity of thelong axis of left ventricle within the chest cage. Authors present the anatomical, geometrical and radiologicalbasis for the superiority of 45degrees RAO projection by analyzing 20 normal heart specimen and 115cineangiocardiograms of valvular heart disease, and the results as follows; 1. Blood flow and motility of themitral and aortic valves can be more clearly demonstrated by 45degrees RAO projection than by AP view. 2. The longdiameter of left ventricular silhouette made 45degrees RAO projection reflects 90% or more of real diameter. 3. InRAO 45degrees position, patient's left nipple is optimal and convenient level for the ruler offering accuratemagnification coefficient of left ventricle. 4. Ejection fration after the extrasystole is exaggerated regardlessof the left ventricular function, so it is desirable to exclude the 2 or 3 beats after extrasystole.
Aortic Valve ; Cardiac Complexes, Premature ; Heart ; Heart Valve Diseases ; Heart Valves ; Heart Ventricles ; Methods ; Myocardial Ischemia ; Nipples ; Thorax ; Ventricular Function, Left

BACKGROUND: One of the main disadvantages of caudal block is the long latent period before a satisfactory blockade is obtained. Many investigators have used various preparations of local anesthetic solutions to improve the speed of onset. This study was performed to evaluate the effectiveness of prewarming of lidocaine HCl for caudal block. METHODS: Fifty healthy young patients (ASA I) were allocated into two groups, A and B. In group A, the local anesthetic solution were injected at room temperature (25 degrees C), while in group B, they were injected at 37oC. All the caudal block were performed using 2% lidocaine HCl 20 ml with fentanyl 100ug and epinephrine 1:200,000. The onset time was defined as the period from completion of injection until the patient first noticed loss of sensation to pin-prick on perianal region. Assessment of sensory loss was made at 15 seconds interval. We have compared the onset of sensory blockade between groups. The duration of analgesia and any significant side effects were also recorded. RESULTS: The onset of sensory blockade was significantly faster in group B (3.5 +/- 0.5 minutes) than group A (6.2 +/- 0.9 minutes). The duration of analgesia were not significantly changed between groups. Side effects of urinary retention, pruritus and nausea were noted between both groups but the difference was not significant. CONCLUSIONS: We have found that the onset time was 44% faster with warm lidocaine-fentanyl mixture (37 degrees C) than with the room temperature (25 degrees C). The improved clinical usefulness was achieved with no increase in side effects. The technique is a safe and effective method to reduce the latency of onset.
Analgesia ; Epinephrine ; Fentanyl ; Humans ; Lidocaine ; Nausea ; Pruritus ; Research Personnel ; Sensation ; Urinary Retention

We present two cases of linear lichen simplex chronicus. One is a 44-year-old male patient who had a linear licbenified patch on the left upper extremity, and the other is a 45-year-old female patient who had linear pruriginous nodules on the right lower extremity. The one is coincidental with localized lichen simplex chronicus, the other is coincidental with prurigo nodularis histopathologically.
Adult ; Female ; Humans ; Lichens* ; Lower Extremity ; Male ; Middle Aged ; Neurodermatitis* ; Prurigo ; Upper Extremity

A 22-year-old male has had multiple, grouped, asymptomatic, yellowish flat papules, nodules, and plaques on the knees, elbows, butteeks, hands, and feet. Yellowish nodules first appeared on the heels after birth, and gradually increased in size and number and spread to the knees, elbows, buttocks, and hands. Physical examination revealed normaI except for the skin lesions. Gross finding of the serum was clear and paper electrophoresis revealed marked increase in betalipo-protein and mild increase in prebetalipoprotein, suggesting type II hyperlipoproteinemia Serum cholesterol was 510 mg%, and serum triglyceride was 190mg%. Histopathology showed many aggregates of foam cells on H-E stain and many lipid droplets in the dermis on oil red O stain.
Buttocks ; Cholesterol ; Dermis ; Elbow ; Electrophoresis, Paper ; Foam Cells ; Foot ; Hand ; Heel ; Humans ; Hyperlipoproteinemia Type II* ; Knee ; Male ; Parturition ; Physical Examination ; Skin ; Triglycerides ; Xanthomatosis* ; Young Adult

Human sparganosis is not uncommon and over 60 cases are reported in Korea but the case infested with multiple spargana is rare. The case we are reporting here is a 33 year-old Korean male having had an abscess and several bean-sized nodules on the left thigh. The patient had the history of eating frogs as a tonic food 3 years ago. Five spargana were removed from the lesions by surgical excision. Two of them were alive and other three were degenerated or calcified.
Abscess ; Adult ; Eating ; Humans ; Korea ; Male ; Scabies* ; Sparganosis ; Thigh

Urticaria is a common disease and a well known reaction pattern of the skin eharacterized by erythema or wheals and edema, that is the results of a local leakage ef plasma, from minute vessels into the connective tissue of the dermis. Seven hundred and sixty cases of urticaria visited to this department from January 1973 to December 1974 were studied clinically in various ways. Patients were classified as acute and chronic urticaria-acute form when the hives have been present for less than 8 weeks and chronic form when the hives lasted longer. In all patients, a detailed history, a complete physical examination, a total and differential leukocyte count, erythrocyte sedimentation rate and routine stool examination were performed. Foods were incriminated as the exciting causes of urticaria by history, diet elimination test and ingestion test. An ice cube test was done for corroboration of cold allergy. Cholinergic urticaria, was diagnosed by the appearance of small wheals surrounded by erythema after exercise, emotional disturbances or hot drinks. The diagnosis of urticaria due to drug was based on the history of urticaria following the taking of a certain drug. Infection as the inciting cause was determined by history and physical examination. The results: 1. The incidence of urticaria is 4. 6% to total number of dermatologic patients. 2. Among the 760 urticaria patients, acute cases were 498 which were 2 times more than chronic cases, and female patients were 474 cases that revealed marked high incidences than male patients. 3. The age of the patients ranged from 2 months to 87 years, and the patients between 20 and 39 years occupied more than half of the all patients. 4. Abnormal hematologic findings were more marked in acute form; leukocytosis and neutrophilia were dominate in acute form, and lymphocytosis and eosinophilia were more marked in chronic form. 5. Among the etiologic factors, the bacterial infection was the most frequent which occupied 22. 4% of the all urticaria patients. 6. Seven cases of urticaria due to parasites were clonorchis sinensis, in which I had experienced the complete recovery with the treatment of subcutaneous injection of clonorchis sinensis antigen (1: 10,000) 0.01- 0.1ml at the interval of one week. 7. In this study, the inciting or perpetuating causes could not be found in 50.8% of patients-46.2% of acute form and 59.5% of chronic form.
Affective Symptoms ; Bacterial Infections ; Blood Sedimentation ; Clonorchis sinensis ; Connective Tissue ; Dermis ; Diagnosis ; Diet ; Eating ; Edema ; Eosinophilia ; Erythema ; Female ; Humans ; Hypersensitivity ; Ice ; Incidence ; Injections, Subcutaneous ; Leukocyte Count ; Leukocytosis ; Lymphocytosis ; Male ; Parasites ; Physical Examination ; Plasma ; Skin ; Urticaria*

Multidirectional shoulder instability is often difficult to diagnose and treat and can be cause of significant disability. Nonoperative rehabilitations and life tyle modifications are the primary treatments. Hiwever, the inferior capsular shift procedure, performed either from an anterior or posterior approach, as described by Neer and Foster, is recommended for symptomatic multidirectional instability that is unresponsive to nonoperative therapy. Twenty-seven shoulders in twenty-seven patients with inferior and multidirectional instability were managed with Neer s inferior capsular shift, through anterior or posterior approach depending on the direction in which the shoulder is most unstable. All of the patients were followed up for an average of 3 years (range one to seven years). The postoperative range of motion of the shoulders was well maintained except 1 patient. Three patients had recurrence of symptomatic and disabling multidirectional instability, but twenty-four (89%) of the shoulders continued to function well with no instability, no pain, no recurrence and no remarkable limitation of motion.
Humans ; Range of Motion, Articular ; Recurrence ; Shoulder*

No abstract available.
Animals ; Lymphocyte Subsets* ; Lymphocytes* ; Rats*

Background: Lumbar epidural anesthesia is widely used regional blockade method. But postepidural back pain is most common cause that experienced patients refuse epidural anesthesia. We planned this study to evaluate the effect of epidural dexamethasone injection for postepidural back pain. Methods: Adult patients free of back pain were randomly allocated into two groups. In both group anesthesia was induced with 2% lidocaine 20~25 ml mixed with 1:200,00 epinephrine and fentanyl 0.1 mg. After surgery, epidural catheter was removed after epidural dexamethasone injection in one group (group 2). In other group (group 1), catheter was removed without treatment. We visited patients and asked existence of back pain, and the intensity of back pain was measured by visual analogue scale at 24, 48 and 72 hours after surgery. Statistical analysis was done by Student's t-test and Mann-Whitney test. Results: In group 2, there was significant decrease in number of patients suffering from back pain and intensity of back pain. Conclusion: Epidural dexamethasone injection results in decreased number of patients suffering from back pain and also less in intensity of back pain.
Adult ; Anesthesia ; Anesthesia, Epidural* ; Back Pain* ; Catheters ; Dexamethasone* ; Epinephrine ; Fentanyl ; Humans ; Lidocaine

No abstract available.
Vesicovaginal Fistula*