A retrospecive clinical observation was done on 325 cases of hypertension admitted to Department of internal Medicine of Seoul Red Cross Hospital from January, 1979 to December, 1982. The following results have been obtained. 1) The observed patients were 157 males and 168 females, and the prevalence rate of malignant hypertension among 325 hypertensions was 16 cases (4.9 percent). Among 16 cases of malignant hypertension 9 cases were male and 7 cases were female. Most frequently in 50, 60 and 40 years of age in this order each sex. 2) The average admitted dates are 7 days. 27 cases (8.3percent) were readmitted above 2 times after one discharged. 3) The most freqeuntly observed duration of Known hypertension 37.9 percent was 6-10 years and the next frequently observed duration 37.4 percent was 3-5 years. 4) The highest percentage of malignant hypertension had systolic blood pressure between 190-209mmHg and diastolic blood pressure between 150-169mmHg. 5) The highest percentage of seasonal number was spring (31.1 percent) and the next autumn, summer, winter in this order and the prevalence rates of hypertention are increased average 1.9% of each year. 6) The 78.5 percent of the patients were found that their blood pressure were abnormaly high when they were examined with related symptoms on admission, and they major symptorms were headache and dizziness. 7) The physical examination on admission, tachycardia (56percent), tachypnea (15.1percent), semicoma to coma (12.9 percent) in this order. 8) The status of treatment in hypertension on admission was as follows; imtermittent treatment 54.5 percent, no treatment 31 percent and continuous treatment 14.5 percent in this order. 9) In the chest X-ray on admission, the most frequent finding was cardiomegaly, and normal finding was the next frequency. The pulmonary Tbc was noted in 12.6 percent. 10) According to the degree of fundoscopic abnormality by K-W classification stage III was 68.8 percent and stage IV was 31.2 percent. 11) Electrocardiogram abnormalities were 44.9 percent, and 87.5 percent of malignant hypertension revealed electrocardiographic abnormalities and left ventricle hypertrophy was observed in 70.5 percent. 12) Hypercholesterolemia 78 percent, Hypernatremia 69.8 percent, Hypokalemia 22.8 percent, serum chloride 34.5 percent (<95m Eg/l), BUN 53.8 percent (>20mg/dl) and creatinine 45.8 percent (>3mg/dl) on admission. 13) Proteinuria was observed in 87.5 percent of malignant hypertension. 14) Marked improved for clinically was 24 percent and mortality rate was 5.2 percent, most common cause of death are cardiovascular accident (64.7percent) and renal failure (23.5percent).
Blood Pressure ; Cardiomegaly ; Cause of Death ; Classification ; Coma ; Creatinine ; Dizziness ; Electrocardiography ; Female ; Headache ; Heart Ventricles ; Humans ; Hypercholesterolemia ; Hypernatremia ; Hypertension ; Hypertension, Malignant ; Hypertrophy ; Hypokalemia ; Internal Medicine ; Male ; Mortality ; Physical Examination ; Prevalence ; Proteinuria ; Red Cross ; Renal Insufficiency ; Seasons ; Seoul ; Tachycardia ; Tachypnea ; Thorax

BACKGROUND: The concept of myocardial injury after coronary occlusion is changing in recent years. Brief episode of ischemial induces reversible myocardial injury and repeated brief ischemic insults might cause myocardial necrosis due to cummulative damages. Recent observations showed that brief episodes of ischemia have protective effects on the myocardium increasing the myocardial tolerance to a subsequent sustained ischemic insult. This phenomenon is termed ischemic preconditioning and can be noticed after a variety of protocols in multiple species of experimental animals. This study was planned to 1) measure the changes of hemodynamic parameters and the ischemic damage of insulted myocardium during ischemic preconditioning, and 2) compare the infarct sizes with or without preconditioning. METHODS: Using canine model of a single 90 minutes' occlusion of left anterior descending coronary artery and 240 minutes' reperfusion, 14 mongrel dogs were randomized to with(n=7) or without(n=7) ischemic preconditioning such as four 5 minutes' occlusion and 5 minutes' reperfusion, Changes of hemodynamic parameters and extents of the ischemic myocardial damages during preconditioning were observed. And using in vitro myocardial staining with monastral blue and triphenyl tetrazolium chloride, we compared the infarct sizes and risk areas in two groups of occlusion and reperfusion canine model with and without preconditioning. RESULTS: 1) Heart rate was significantly decreased after first 5 minutes' occlusion compared with those of basal control(151+/-27 VS 163+/-25 BPM, p<0.05) without further changes in subsequent ischemic insults. Left ventricular systolic pressure was significantly decreased after first 5 minutes' occlusion(109.0+/-19.9 VS 130.6+/-23.3mmHg, p<0.005), and after first 5 minutes' reperfusion and second 5 minutes' occlusion compared with those of basal control(111.3+/-29.8, 109.9+/-17.2 VS 130.6+/-23.3mmHg respectively, p<0.05), without further changes during remaining ischemia. Left ventricular end diastolic pressure and maximum +dp/dt were not changed. Peak -dp/dt was decreased significantly after first and second 5 min occlusion(943.7+/-294.4, and 962.1+/-281.5) from basal control level(1168.2+/-358.8mmHg, p<0.05). Thereafter no change was noted during remaining preconditioning. The changes in rate-pressure product were same as those of left ventricular systolic pressure(first 5 minutes occlusion ; 17.3+/-3.7 VS 21.2+/-3.5, p<0.005, second 5 minutes' occlusion ; 17.9+/-5.3, 18.1+/-3.4 VS 21.2+/-3.5, p<0.05). 2)Transmyocardial lactate extraction ratio was significantly decreased in early phase of ischemic preconditioning(17.5+/-11.3 VS 25.2+/-9.9%, p<0.05). 3) Hemodynamic parameters such as heart rate, left ventricular systolic pressure, left ventricular end-diastolic pressure, maximum +dp/dt, peak -dp/dt and rate-pressure product were changed similarly in both control and precontioned groups. 4) There was no significant difference of mean myocardial blood flows in infarct zones, which represent collateral blood flow, after 5 minutes' brief occlusion and 60 minutes of sustained occlusion in preconditioned group. 5) The infarct area/risk area ratio was significantly reduced in preconditioned group(27.0+/-9.6 VS 5.6+/-3.1%, p<0.005), but the risk area/left ventricular area ratio showed no difference in the two groups. CONCLUSIONS: These findings suggest that, in the early phase of brief repeated occlusion and reperfusion, myocardial ischemic damage accompaning systolic and diastolic myocardial dysfuctions develops and myocardial protective effect of ischemic preconditioning was obtained at the same time. Ischemic preconditioning group demonstrated reduced infarct sizes compared to those of control group after 90 minutes' sustained ischemia and reperfusion in canine acute myocardial infarction model.
Animals ; Blood Pressure ; Coronary Occlusion ; Coronary Vessels* ; Dogs ; Heart Rate ; Hemodynamics ; Ischemia ; Ischemic Preconditioning* ; Lactic Acid ; Myocardial Infarction ; Myocardial Reperfusion ; Myocardium ; Necrosis ; Reperfusion

BACKGROUND: The purpose of this study was to estimate the economical impacts of surgical site infection (SSI) after general surgeries. METHODS: A prospective study was performed with the surgeries from September to December, 2002 and the SSI cases were collected based on the definitions of Centers for Disease Control and Prevention, The length of stay (LOS) and the hospital charge for the SSI group were compared with the non-SSI (NSSI) group by a matched cohort study for age, sex, operation procedure, and NNIS risk groups. RESULTS: There were 1,007 cases of surgeries and the 52 cases of SSI and the 26 cases have been matched. The LOS of the SSI group was 5.2 days longer than that of the NSSI group (P<0.05) which was significant, The injection and dressing meal, and total hospital charge were \157,562, \72,251, and \2,153,964 more in SSI group than those of NSSI group (P<0,05) for post-operation stay. The charge of medication and room in SSI group were \558,146 and \723,114 more than those of the NSSI group, but there were no significant difference. CONCLUSION: The SSI could increase the LOS and the hospital charge; therefore, this economic loss had an impact on the hospitals as well as the patients. To estimate the economic impacts of SSI precisely, however, further studies are needed to analyze and control other factors for the cost such as a type of surgery. In addition, the scope and setting of cost analysis should be expanded into the aspects of an individual, the hospital, and society.
Bandages ; Centers for Disease Control and Prevention (U.S.) ; Cohort Studies ; Costs and Cost Analysis ; Hospital Charges ; Humans ; Length of Stay ; Meals ; Prospective Studies

Fabella impingement syndrome after total knee arthroplasty (TKA) is a rare condition. However, the location of the inserted prosthesis and the size of the fabella are considered major causative factors. Thus far, a conventional surgical excision of the impinged fabella is recommended treatment for the impingement. A 72-year-old woman was diagnosed with degenerative arthritis of the knee. She complained of fabella impingement due to an incompletely excised bony spur behind the posterolateral femoral prosthesis after TKA. The fabella and remaining bony spur were removed using an arthroscopic procedure. The impingement has not recurred and the range of motion (ROM) of the knee was improved after a 12 months follow-up. Arthroscopic surgery might be an alternative treatment for fabella impingement after TKA.
Aged ; Arthroplasty* ; Arthroscopy ; Female ; Follow-Up Studies ; Humans ; Knee* ; Osteoarthritis ; Prostheses and Implants ; Range of Motion, Articular

Purpose: This study aimed to investigate mothers’ questions related to parenting young children in the internet community. Methods: One representative in the internet community was selected and parenting questions were collected over 2 weeks in October 2019. A total of 15,016 questions were analyzed by frequency and proportion after categorizing of 10 themes; health and daily care, connecting and communicating, play and learning, development and growth, poos and wees, sleep, feeding, solid foods, safety, behavior. Results: The most frequently asked questions per age ranged from 1 to 3 months (32.2%). The most frequently asked questions by theme per age were about feeding newborn up to 6 months, solid foods from 7 to 12 months, health and daily care from 13 to 24 months, and play and learning from 25 to 71 months. Conclusion As these results reflect mother’s need for information and support, it is suggested that more specific and targeted online/offline support per age should be developed.

Over the past century, since the introduction of non steroidal anti-inflammatory drugs (NSAID), antacid, histamine H2-receptor antagonists (H2RA), proton pump inhibitors (PPI), and discovery of Helicobacter pylori infection, the paradigm of peptic ulcer disease has changed with marked decrease in morbidity and mortality. However, peptic ulcer disease still occupies a position as a major health problem with increase of aged population and NSAIDs usage. In daily general practice, the management of peptic ulcer disease is directed according to the presence of bleeding or not. For non-bleeding peptic ulcer disease, proper acid suppression and the correction of underlying causes such as Helicobacter pylori infection and NSAID use is the main stay of treatment. Though a complete understanding of pathophysiology and a perfect treatment strategy are still a challenge, this guideline aims to provide practical recommendations based on evidences or consensus of experts through in-depth literature review and expert meeting.
Antacids/toxicity ; Anti-Inflammatory Agents, Non-Steroidal/toxicity ; Anti-Ulcer Agents/therapeutic use ; Bismuth/therapeutic use ; Helicobacter Infections/diagnosis/drug therapy ; Helicobacter pylori ; Histamine Antagonists/therapeutic use ; Humans ; Peptic Ulcer/*drug therapy ; Proton Pump Inhibitors/therapeutic use

The mainly used polymeric material for the denture is PMMA because of its cost and easiness to handle. So it was widely used material among dentists for past decades. But the acrylic-based denture materials have several common weak points such as shrinkage after curing and lack of strength. In order to solve these problems, we adapted one of hybrid system using acrylic polymer and vinyloligosilsesquioxane(POSS). POSS, which is a well known expandable monomer during polymerization process, may eventually suppress volumetric shrinkage. And the hybrid system makes it possible for the polymer to be stable in various severe conditions. Eight different kinds of samples were designed and synthesized. Each samples were characterized with dynamic mechanical analyser(DMA) to confirm their thermodynamic properties, fractured to analyze the cross-sectional morphology of the samples. And elongation, flexural and impact tests were also executed to evaluate the mechanical properties of the samples. From the results, hybrid composites had well defined crosslinked network structure compared to the widely used denture materials, and the mechanical strength improved without changing any surface condition as increment with POSS ratio in hybrid system. Fractured morphology showed homogeneous surfaces in spite of mutli component system, therefore we can conclude that the adoption of the POSS brought the reinforcement of the denture resin.
Dentists ; Dentures* ; Humans ; Polymerization ; Polymers ; Polymethyl Methacrylate ; Thermodynamics

BACKGROUND: Inverted papilloma is an uncommon benign tumor which is characterized by local aggressiveness, high recurrence rate, associated malignancy and tendency to multicentricity. Most authors advocate radical surgical removal of these tumors; however, conservative endoscopic surgery has been reported to be effective in selected cases. OBJECTIVES: To compare with operative methods of the inverted papilloma. MATERIAL AND METHODS: This study comprised 14 cases of inverted papilloma, which were divided into 3 groups. The first was lateral rhinotomy and traditional medial maxillectomy treated group with 7 cases. The second group was treated with conservative endoscopic intranasal resection of 4 cases and the third group was treated by endoscopic medial maxillectomy of 3 cases. RESULTS: The follow-up periods in average were 23 months, 19 months and 11 months in first, second and third groups respectively. All cases showed no recurrence. CONCLUSION: Although follow-up periods are insufficient, the endoscopic approaches are meaningful methods to treat inverted papilloma.
Follow-Up Studies ; Papilloma, Inverted* ; Recurrence

PURPOSE: The mechanisms underlying syncope remain unknown in about 20% of patients with recurrent syncope. The implantable loop recorder (ILR) has been shown to be a useful diagnostic tool in patients with unexplained syncope even after negative initial evaluations. Nevertheless, ILR has rarely been used in clinical practice. MATERIALS AND METHODS: This study included 18 consecutive patients who had an ILR implanted at our center because of recurrent unexplained syncope after extensive diagnostic tests between February 2006 and June 2011. RESULTS: Diagnosis was confirmed in 10 (55.6%) of the 18 enrolled patients (13 males, 61+/-15 years). The confirmed diagnoses included sick sinus syndrome (n=6, 60%), advanced atrioventricular block (n=2, 20%) and ventricular tachyarrhythmia (n=2, 20%). The mean follow-up durations of the total study subjects and the diagnosed patients were 11.3+/-10.6 months and 5.6+/-9.2 months, respectively. Of the 10 diagnosed patients, 8 (80%) were diagnosed within 6 months of loop recorder implantation. CONCLUSION: ILR may be a valuable and effective diagnostic tool for patients with unexplained syncope.
Adult ; Aged ; Electrocardiography/instrumentation/methods ; Female ; Humans ; Male ; Middle Aged ; Monitoring, Physiologic/instrumentation/methods ; Syncope/*diagnosis/etiology

BACKGROUND: Transcatheter coil embolization has been described as a method of nonsurgical closure of variable pathologic vascular structures. This study was aimed to evaluate the outcome of transcatheter coil embolization in variable clinical conditions. METHODS AND RESULTS: We collected data from patients' medical record and their cardiac angiography films. From January 1995 to June 1997, coil embolization was attempted in 51 patients who were 38 patients with systemic-pulmonary collaterals (5 patients have venous collaterals, too), six patients with venous collaterals, nine patients with patent ductus arteriosus (PDA), one patient with Blalok-Taussig shunt (BT shunt), one patient with coronary-right atrial fistula and one patient with coronary-right ventricular fistula. In 38 patients with systemic-pulmonary collaterals, 123 coils were inserted to 70 collaterals, therefore mean 1.79+/-0.77 coils were inserted to one collateral. The results were complete occlusions (74%), incomplete occlusions (21%), and partial occlusions (4%). In six patients with venous collaterals, the outcomes were complete occlusions (50%) and incomplete occlusions (50%). In a patient with BT shunt, hemolytic anemia occurred in 1st attempt and in 2nd attempt, shunt was incompletely occluded and one coil was carried away and embolized the peripheral pulmonary artery. In nine patients with PDA, ten cases of transcatheter coil embolization was executed. Mean minimum ductal diameter was 2.1+/-0.85 mm. The results were initial occlusion (30%), occlusion within one month (66%), and occlusion within one year (75%). Left pulmonary artery stenosis owing to coil insertion was not found. In one case of coil malposition, retrieval and reinsertion of coil was successful. In two patients who have coronary artery fistula, coil embolization was successfully executed without any complications. CONCLUSIONS: Transcatheter coil embolization executed in variable clinical conditions without significant complications. It was effective and safe nonsurgical method.
Anemia, Hemolytic ; Angiography ; Child* ; Constriction, Pathologic ; Coronary Vessels ; Ductus Arteriosus, Patent ; Embolization, Therapeutic* ; Fistula ; Humans ; Medical Records ; Pulmonary Artery