Heat disorders are not uncommon in the military society due to supposedly hard training to overcome the environmental conditions. Twenty-two soldiers with heat disorders were admitted to Chin Hae Naval Hospital June 1969 through July 1970. Hoping that our clinical studies on them contribute to a renewed understanding, the results are reported in summary as follows: 1) Heat disorders occurred with an overall incidence of 3.1 per cent during running in early summer. 2) Of the twenty-two patients, eight (37 per cent) had heat cramps, six (27 per cent) heat exhaustion, five(23 per cent) heat stroke, and three(13 per cent) had undetermined disorder. 3) Ten patients(45 per cent) were comatous, and this occurred most frequently(80 per cent) among those with heat stroke. 4) All patients were grouped into four according to their physical status on admission. Those with heat exhaustion mostly belonged to group I (good) or group II (fair). Those with heat stroke and heat cramps eomprised most of group III (poor) and group IV (grave). 5) Group I and II patients recovered within 12 hours; group III, within 12~24 hours; and group IV, required more than 24 hours of care. 6) One patient with heat stroke, graded V, expired with sudden hypothermia 15 hours following admission. Overall mortality of heat disorders was 4.5 per cent, and that of heat stroke 20 per cent. 7) The rest recovered uneventfully within 19 hours of average.
Chin ; Emergencies* ; Heat Exhaustion ; Heat Stress Disorders ; Heat Stroke ; Hope ; Hot Temperature* ; Humans ; Hypothermia ; Incidence ; Military Personnel ; Mortality ; Running

OBJECTIVES: In oder to investigate the cognitive and cortical functions of patients with conduct disorder, the present study was carried out with the neuropsychological test battery and Event-Related Potentials(ERPs:P300). METHODS: The subjects were consisted of 18 patients with conduct disorder who fulfilled DSM-IV criteria and 18 normal controls. For all subjects the neuropsychological test battery and ERPs were administered. The neuropsychological test battery consisted of attention tests, memory tests and Card Sorting Test which is used to evaluate the problem-solving and hypothesis-testing. The P300 was measured by oddball paradigm in which 1,000Hz tone was served as standard stimulus and 2,000Hz tone as target stimulus. The task of the subject was to press response-button whenever the target stimulus was presented. K-WAIS was administered in order to control the intelligence of the subjects. RESULTS: The results were as follows: 1) Among subtests of the neuropsychological test battery, only the result of Card Sorting Test showed significant difference between conduct disorder group and control group. The conduct disorder group showed significant low hit-rate compared with control group. 2) The conduct disorder group showed decreased P300 amplitude compared with control group on Fz and Cz. Among 18 patients with conduct disorder, 12 patients showed negative potentials on Fz. 3) The conduct disorder group showed prolonged P300 latency compared with control group on Fz. CONCLUSION: These results indicate that the patients with conduct disorder seem to have retarded functions of problem-solving and hypothesis-testing, and this retardation seems to be related to the frontal dysfunction.
Conduct Disorder* ; Diagnostic and Statistical Manual of Mental Disorders ; Evoked Potentials ; Humans ; Intelligence ; Memory ; Neuropsychological Tests

PURPOSE: The purpose of the present study is to determine the relation between in vitro resistance to 9 drugs, measured with colorimetric methylthiazol tetrazolium(MTT) assay and prognostic factors. METHODS: Thirty children with leukemia were evaluated at the pediatric department of Dongsan Medical Center. All samples tested with the MTT assay contained 80% or more leukemic cells, which were isolated by Ficoll density gradient centrifugation, and were incubated with 9 drugs for 4 days. The optical density(OD) of the wells was measured with microplate spectrophotometer. Leukemic cell survival(LCS) was calculated by OD treated well/OD control wellsx100(%). LD50 was calculated from the dose-response curve and used as a measure of resistance. RESULTS: Among the 30 children with leukemia, 16 were ALL, 14 were AML. Seventeen boys and thirteen girls ranged in age from 9 months to 16 years. Comparing LD50 values according to leukemic type, AML revealed relatively high LD50 values for all drugs, except VCR. But there were no significant differences between ALL and AML(P>0.05). Male showed high LD50 values for ASP, DET, ARA-C, VP16, ADR and 6TG. Age<2 and >10 years children showed high LD50 values for all drugs, except 6TG. Patients with a leukocyte count>100,000/mm3 at diagnosis showed high LD50 values for VCR, ASP, DET, MTX, ARA-C, ADR, and 6TG. Patients with normal chromosome showed higher LD50 values. CONCLUSION: Our study showed higher LD50 values at AML, male, age<2 and 10>years old, leukocyte count>100,000/mm3, and normal karyotype. The MTT test may contribute to the selection of effective chemotherapeutic agent for children with acute leukemia.
Centrifugation, Density Gradient ; Child ; Cytarabine ; DEET ; Diagnosis ; Etoposide ; Female ; Ficoll ; Humans ; Karyotype ; Lethal Dose 50 ; Leukemia ; Leukocytes ; Male ; Viperidae

Of 14,682 samples of feces examined, 81.7% were positive for intestinal helminths. Trichocephalus trichiurus was observed most frequently, in 73.2%. Eight other species of helminths found were Ascaris lumbricoides, Hookworm, Trichostrongylus orientalis, Clonorchis sinensis, Tapeworm, Hymenolepis nana, Paragoniumus westermani and Enterobius vermicularis, listed in decreasing order. Double infections were found more frequently than single infections, and mixed infection of five or more species of helminths occurred in 0.2% Of 10,320 samples of feces examined, 22.3% were positive for intestinal protozoa, Entamoeba coli was observed most frequently, in 11.1%. Six other species, Endolimax nana, Giardia lamblia, Entamoeba histolytica, Iodamoeba butschlii, Chilomastix mesnill and lsospora hominis were found, in the order. It was noticed that E. histolytica was found more frequently in trichurial infection than with other helminths. Of 1,050 samples of sputum from the T. B. Clinic, 7.0% were positive for paragonimus eggs. Trichomonas vaginalis were found in 35.8%of 1,146 vaginal swabs examined. Seven cases of Plasmodium vivax infection were found among 140 suspected blood smears.
Incidence

BACKGROUND: Despite improvement of mortality in acute myocardial infarcrtion, high mortality rate associated with cardiogenic shock remains essentially unchanged. We have reviewed our result of coronary intervention in 15 patients and found relative survival advantage. METHODS: Between Sep. 1992 and Aug. 1995, 15 consecutive patients(M. 10, F. 5) with cardiogenic shock in acute myocardial infarction were treated with coronary intervention using ballon PTCA. IABP was inserted in all patients prior to PTCA. RESULTS: 1) Most commonly found infarct related artery was left anterior descending artery(11) followed by right coronary artery(3) and left main coronary artery(1). 2) Successful reperfusion rate was 86.7%(13/15), and in-hospital mortality rate was 26.7%(4/15). 3) In-hospital mortality was higher in elderly patients compared with less than 70yaer old patients(0%(0/11)vs. 75.0%(3/4)(P < 0.05). 4) Mortality rate was lower in single vessel disease than multivessel disease(11.1%(1/9) vs. 50%(3/6) p<0.05). CONCLUSION: Although this study is uncontrolled, the date suggest that urgent coronary intervention for improving coronary perfusion may reduce mortality of acute myocardial infarction complicated by cardiogenic shock, particularly with single vessel disease and young age group.
Aged ; Arteries ; Hospital Mortality ; Humans ; Mortality ; Myocardial Infarction* ; Perfusion ; Reperfusion ; Shock, Cardiogenic*

BACKGROUND: Although the superior reperfusion and improved clinical outcome following angioplasty for acute myocardial infarction (AMI) have been well known, 10 to 15% of reinfarction and recurrent ischemia in hospital are main limitation of primary percutaneous transluminal coronary angioplasty (PTCA). This study was undertaken to examine the safety and feasibility of stent-supported primary angioplasty in acute myocardial infarction. METHODS: Between July 1995 and Jun. 1997, 32 patients underwent direct or rescue PTCA, including patients with cardiogenic shock. After PTCA, stenting was attempted in patient with dissection or having more than 30% of residual stenosis. Result: In patient with direct PTCA, angiographic success rate was obtained in 91% (30/32). Stenting was attempted in 15 of 30 patients. These patients had suboptimal results (8 patients), non-occlusive dissection (3 patients) and acute occlusion (2 patient). Thrombolysis in myocardial infarction (TIMI) grade 3 flow was restored in 28 patients (93%). In one patient no-reflow phenomena was observed following stent insertion. Despite intra-aortic balloon pumping, there was one death during the hopitalization due to cardiogenic shock following PTCA. Subacute stent thrombosis developed in two patients. 27 patients (90%) were event-free and clinically improved through out the follow up period (11.5+/-5.2 month). Quantitative angiography showed excellent angiographic result after stenting compared with balloon PTCA (2.4+/-0.6 mm vs. 3.4+/-0.3 mm p<0.01). CONCLUSION: After failure of initial angioplasty, coronary stenting can be a supportive therapeutic strategy. Coronary stenting results in a high degree of angiographic success, a low incidence of subacute thrombosis.
Angiography ; Angioplasty* ; Angioplasty, Balloon* ; Angioplasty, Balloon, Coronary ; Constriction, Pathologic ; Follow-Up Studies ; Humans ; Incidence ; Intra-Aortic Balloon Pumping ; Ischemia ; Myocardial Infarction* ; Reperfusion ; Shock, Cardiogenic ; Stents ; Thrombosis

0.05). 2. At the total success rate, osteotome group was 92.4% and Hatch reamer group was 94.9%. There was no statistically significant difference between the two groups (P > 0.05). 3. On the discomfort during the operation by using numerical rating scale, osteotome group was 2.87 +/- 0.83 and Hatch reamer group was 1.12 +/- 0.64. There was statistically significant difference between the two groups (P < 0.05). The Hatch reamer group' clinical results was similar to osteotome group and we thought that Hatch reamer technique can overcome the faults of osteotome technique.]]>
Alveolar Bone Loss ; Dizziness ; Floors and Floorcoverings ; Humans ; Maxilla ; Transplants

It is now generalized to perform cardiac surgery in the patients with end-stage renal disease. The growing number of patients with chronic renal failure wake us up to the need to prepare for proper management. There are not only the prevalence of coronary artery disease, but also a great amount of valve dysfunction exist in this group. Peritoneal dialysis may be one of the obstacles for cardiopulmonary bypass but it is not a great hindrance in cardiac surgery with careful preparation and well organized perioperative care. The author has performed mitral valve replacement in a 33-year-old anuric female patient with chronic renal failure and severe mitral insufficiency. Preoperatively, the patient was kept in adequate fluid and electrolyte balance using peritoneal dialysis. Peritoneal dialysis continued and regulated according to the laboratory data in this patient during and after the surgery. She recovered well showing an uneventful course and was discharged on postoperative 1 th day.
Adult ; Cardiopulmonary Bypass ; Coronary Artery Disease ; Dialysis ; Female ; Humans ; Kidney Failure, Chronic* ; Mitral Valve ; Mitral Valve Insufficiency ; Perioperative Care ; Peritoneal Dialysis ; Prevalence ; Thoracic Surgery ; Water-Electrolyte Balance

PURPOSE: The chronic kidney disease (CKD) is defined as structural or functional abnormalities of the kidney diagnosed by abnormalities of pathology, composition of blood or urine, imaging tests and glomerular filtration rate (GFR) less than 60 mL/min/1.73m2. GFR less than 60 mL/min/1.73m2 is known to increase the number of complications. This guideline is universally used but there are no studies on whether the guideline is applicable to Korean people, especially to elderly population. METHODS: We randomly selected 1,000 subjects aged more than 65 years who lived in Seong-nam city during September, 2005. We used the modified MDRD equation to estimate the glomerular filtration rate (eGFR) and categorized the subjects into 5 groups (group 1: GFR >70, group 2: 60-70, group 3: 50-60, group 4: 40-50, group 5: <40 mL/min/1.73m2). RESULTS: The mean creatinine level was 1.1 (+/-0.3) mg/dL and the mean value of eGFR was 60.9 (+/-12.9) mL/min/1.73m2. The frequency of subjects with eGFR less than 60 mL/min/1.73m2 was 48%. The frequencies of old age, female, hypertension, coronary heart disease, anemia, hypoalbuminemia, proteinuria, and increased waist circumference increased as eGFR fell. When evaluating the odds ratios of complications of CKD (Group 2-5 versus Group 1), the risk of coronary heart disease was increased in Group 3, 4, 5, hypertension in Group 4, 5 and diabetes mellitus, anemia, and proteinuria in Group 5, respectively. CONCLUSION: The prevalence of CKD in the elderly population was high. The elderly Koreans with CKD showed increasing comorbidities at a lower GFR.
Aged ; Anemia ; Comorbidity ; Coronary Disease ; Creatinine ; Diabetes Mellitus ; Female ; Glomerular Filtration Rate ; Humans ; Hypertension ; Hypoalbuminemia ; Kidney ; Odds Ratio ; Prevalence ; Proteinuria ; Renal Insufficiency, Chronic ; Waist Circumference

Since the first report on infective endocarditis by Rokitansky in 1985, this subject has been extensively dealt with in the world literature. Nowadays by use of echocardiography, there has been a high discovery rate of vegetation, and thus made it a valuable tool in diagnosis, treatment, and the evaluation of the patient. However in Korea, there have been only a few case reports and even fewer studies on infective endocarditis. This study is a clinical analysis of 87 infective endocarditis cases, which were admitted and treated at the department of Pediatrics and Internal medicine, diagnosed as infective endocarditis, during the period from january 1975 through February 1984. 1) The mean age was 24.8 years and male to female ratio was 1.49:1. 2) Annual incidence showed no increment during the period and it was 1:2500. 3) Underlying heart diseases consisted of rheumatic heart disease(52.3%), congenital heart disease(39.7%), no underlying heart disease(8%), previous infective endocarditis(4.6%), and prosthetic valve endocarditis(3.4%). 4) Frequent clinical manifestations on admission were high fever, heart murmur, congestive heart failure and frequent laboratory findings were positive blood culture results, anemia, positive C-reactive protein, and hematuria. 5) Blood culture was positive in 75.9% and the most common infecting organism was alpha-streptococcus, which represented 42.4% of total positive cases. S. aureus and S. epidermidis were next common and these three organisms consisted of 71.2% Culture positivity was not significantly related to the type and incidence of complications. 6) Antibiotics sensitivity of the major isolated organisms were performed. Alpha-streptococcus was sensitive to almost all antibiotics except Tetracycline. Group D-streptococcus was sensitive to Chloramphenicol and Cephalosporin. S. aureus and S. epidermidis showed same results, which showd sensitivity to Chloramphenicol, Cephalosporin and Methicillin and resistence to penicillin. 7) Echocardiography was performed in 55 cases and showed vegetation in 58.2%. Complications related to the echocardiographic identification of the vegetations showed difference only in the mortality rate, which was greater by 3 times in the positive cases than in the negative. 8) Peripheral embolizations occurred in 29.9% of cases, and by far the mostcommon site was the brain, where 63% of the embolism was localized. 9) Sufficient duration of hospitalization(4-6 weeks) and judicious antibiotics administration was done in 43.7%. The initial response to therapy was noted in 48.5% of total febrile cases. 10) The mortality rate of the cases was 13.8% of the patients died. However, as many patients were discharged against advice because of socio-economic factors, precise therapeutic results of these cases could not be obtained.
Anemia ; Anti-Bacterial Agents ; Brain ; C-Reactive Protein ; Chloramphenicol ; Diagnosis ; Echocardiography ; Embolism ; Endocarditis* ; Female ; Fever ; Heart ; Heart Diseases ; Heart Failure ; Heart Murmurs ; Hematuria ; Humans ; Incidence ; Internal Medicine ; Korea ; Male ; Methicillin ; Mortality ; Pediatrics ; Penicillins ; Tetracycline