Since Romano(1963) described Romano-Ward syndrome which is characterized by Q-T prolongation, abnormal T wave, ventricular tachcardia and syncopal attacks, about twenty cases have been reported in various countries of the world, but this case represents the first report of this syndrome in Korea. Authous experienced a case of Romano-Ward syndrome in a 23-year-old man who had been suffering from intermittent paroxysmal palpitation, chest discomfort and dyspnea for 11 years. On admission, he had tachycardia, gallop and engorgement of jugular veins. EKG showed ventricular tachycardia which promptly recurred after repeated attempts of cardioversion. Then, procainamide and digoxin were given. One day later, sinus bradycardia with Q-T prolongation with Deep T wave inversion occured. Therefore, propranol was prescribed under the impression of Romano-Ward syndrome. About 4 months later, EKG was normal except for mild Q-T prolongation and he was able to maintain normal life activity without difficulty.
Bradycardia ; Digoxin ; Dyspnea ; Electric Countershock ; Electrocardiography ; Humans ; Jugular Veins ; Korea ; Procainamide ; Romano-Ward Syndrome* ; Tachycardia ; Tachycardia, Ventricular ; Thorax ; Young Adult

No abstract available.
Morphine*

OBJECTS: The purpose of this study was to present a model of inpatient group psychotherapy led by a doctor in charge, to evaluate this model in practice, and to give a effective inpatient treatment by application of this model. METHODS: The subject composed of 25 psychiatric inpatient. The authors performed this model of group psychotherapy for 6 months and evaluate this model by objective data. Also we analyzed this model globally to get comprehensive understandings. RESULTS: The results of the objective data were as follows: 1) This model was effective to subside patients' symptoms. And the patients estimated this model to be important and helpful to them. 2) Identification with therapist' among therapeutic factors was high rank. This meant that therapist him- or her-self is a important tool for therapy. 3) Therapeutic factors in upper level group was much different from those in lower level group. And various therapeutic factors was used complementarily between two groups. 4) To check '13 therapeutic factors' repeatedly made the patients acquire therapeutic factors spontaneously. And to check 'the most important event' repeatedly gave the opportunity of self-reflection. The results of global analysis to this model were as follows: 1) This group psychotherapy gave a field in which a therapist met patients as human being. 2) This model was easy to perform, and helpful to a comprehensive therapeutic approach. 3) This model was able to make the basis of continuous outpatient and day hospital treatment, and the basis of outpatient group psychotherapy or individual psychotherapy. 4) In this model, social workers, nurses, or students in practice played a role of the healthy ego. Therefore they were able to activate group psychotherapy. 5) This model was a practical and useful tool of the education for psychiatric residents, medical students, social works, and other students. CONCLUSION: This model of group psychotherapy was useful f3r inpatient treatment and easy to perform in general.
Education ; Ego ; Humans ; Inpatients* ; Outpatients ; Psychiatry* ; Psychotherapy ; Psychotherapy, Group* ; Social Workers ; Students, Medical

BACKGROUND: Aprotinin, which is a nonspecific serine protease inhibitor, has an antiinflammatory and thrombogenic effect. However, it has an antithrombogenic effect during the cardiopulmonary bypass. This study was performed to evaluated the effects of aprotinin on the activated clotting time(ACT) and the total amount of the heparin used during the cardiopulmonary bypass. MATERIAL AND METHOD: From December 1998 to November 1999, 82 consecutive patients electively underwent open heart surgery at Gachon medical school. The patients were older than 18 years. Eighty two patients were classified into a control group(group C, n=36) and a aprotinin-treated group(group A, n=46). Body weight, height, body surface area(BSA), pump time(PT), aortic cross clamping time(ACCT), and body temperature(BT) were determined. Total amount of heparin and protamine during the CPB were also measured. ACT was determined before heparin administration, at 20, 40 and 60 minutes after heparin administration, and after protamine administration. RESULT: No significant differences were noted in either group in body weight, height, BSA, BT, and the total amoun of heparin and protamine. Group A demonstrated a significant(p<0.05) increase in age, PT, ACCT, and ACT at 20, 40, and 60 minutes after heparin administration. CONCLUSION: In summary, the use of aprotinin prime resulted in an increase in ACT. The total amount of heparin in aproinin-treated patient was similar to that of the control group in spite of having the prolonged pump time. Therefore aprotinin may reduce the requirement of heparin.
Aprotinin* ; Body Height ; Body Weight ; Cardiopulmonary Bypass ; Constriction ; Heart* ; Heparin* ; Humans ; Schools, Medical ; Serine Proteases ; Thoracic Surgery*

The surgical technique for removal of ruptured lumbar intervertebral disc has changed very little since it was introduced by Mixter and Barr in 1934. The technique of the interlaminar operation used by most neurosurgeons was used successfully in early cases to relieve the sciatica, but many patients were unable to return to heavy work because of low back pain. Cloward described a different surgical technique for removal of a ruptured lumbar intervertebral disc. The operation utilizes a transverse skin incision and a wide bilateral stlipping and retraction of fascia and muscles. The ligamentum flavum is not removed but detached and reflected medially in a flap. Only the bone margins of the adjacent facets are removed. A complete laminectomy is never done except for spondylolisthesis when the separate neural arch is disarticulated and removed. Using a "Vertebral Spreader", and interlaminar exposure is developed two to three times larger than that obtained y the "standard" technique. The advantages are obvious: 1. Both operations were done through a single transverse incision. A wider lateral exposure for the skin wound, being made parallel to the lumbar operation was possible and the normal skin lines, heals better with less scar. 2. The entire ligament is preserved, by separating its attachments from the lamina and reflecting in a flap, a larger opening into the spinal canal is obtained and the replaced flap protects the dura and prevents scarring. 3. Cloward recommends the use of a narrow, sharp chisel and hammer, but we used the spinal rongeurs including the Kerrison punch to remove part of the laminal edge. We leave the articular facets of the lumbar disc surgery because the articular facets are considered important major elements in the articulation of the vertebral joints, and as an essential bony surface to be used in posterior spinal fusion operation. 4. The routine use of intrathecal cortisone after lumbar disc operation has not been used in our cases because of increased pressure of the cerebrospinal fluid in modified prone position of the patient.
Cerebrospinal Fluid ; Cicatrix ; Cortisone ; Fascia ; Humans ; Intervertebral Disc ; Joints ; Laminectomy ; Ligaments ; Ligamentum Flavum ; Low Back Pain ; Muscles ; Prone Position ; Sciatica ; Skin ; Spinal Canal ; Spinal Fusion ; Spondylolisthesis ; Wounds and Injuries

Regular hemodialysis has been established as a way of treatment for end stage renal failure. In adults, hemodialysis 5 hours each time, three times weekly with one square meter hemodialyzer is now widely accepted as a standard, and there are many reports on long term follow up studies. Quite a large difference are present, however, in our community mainly originated from patient's poor compliance in frequent dialysis with short interdialysis interval. The author analyzed 200 cases of chronic renal failure who have received hemodialysis treatments during the 5 year period from July 1976 to June 1981 at the hemodialysis unit of the hanyang University Hospital and the following results are obtained; 1. Actual one year survival rate was much higher in thrice(87.1%) than one(35.1%) or twice(54.1%) weekly dialysis. 2. Long term(more than 6 months) complications were also more frequent in once(85.7%) or twice(70.2%) weekly treatments than in thrice(22.2%). The predominant complications were congestive heart failure, pericarditis, and infections. 3. Those who recieved three times weekly dialysis had better rehabilitation grades than the patients groups of twice or once weekly treatment. 4. Of peridialysis distressful symptoms, nausea, vomiting dizziness were less frequent in the group three times a week dialysis. In contrast, headache, hypotension, muscle cramps, and weakness were not significantly related with frequency of hemodialysis. 5. Those who voided a large amount of urine output had better survival and less frequent requirement of blood transfusions. 6. Main causes of death were due to patient poor compliance, hyperkalemia and cerebrovascular acidents. 7. Economic problems were the major cause of dialysis interruption.
Adult ; Blood Transfusion ; Cause of Death ; Compliance ; Dialysis ; Dizziness ; Follow-Up Studies ; Headache ; Heart Failure ; Humans ; Hyperkalemia ; Hypotension ; Kidney Failure, Chronic* ; Kidneys, Artificial ; Muscle Cramp ; Nausea ; Pericarditis ; Rehabilitation ; Renal Dialysis* ; Renal Insufficiency ; Survival Rate ; Vomiting

Ascorbic acid, which is toxic to retinal pigment epithelial cells in vitro, can stimulate fibrotic tissue formation. This study investigated the influence of ascorbic acid on endotoxin-induced fibrosis. Experimental vitreal fibrosis was induced in the rabbit by injecting endotoxin with or without ascorbic acid into the vitreous, and compared the degree of fibrosis. Inflammation induced by 1 microgram of endotoxin first appeared on day 1, remained on day 3. On day 7, organized membrane was developed. The striking decrease in ascorbic acid occurred after the intravitreal injection of endotoxin. In a series of experiment in which ascorbic acid were used, endotoxin produced less inflammatory response compared to the control. Rabbits which were injected 1 microgram of endotoxin (with or without ascorbic acid) had shown significant vitreal fibrosis. Even though the high conentration of ascorbic acid can provide extacellular protection for the ocular tissues during ocular inflammation, It was not effective in preventing the formation of membrane.
Ascorbic Acid* ; Epithelial Cells ; Fibrosis* ; Inflammation ; Intravitreal Injections ; Membranes ; Rabbits ; Retinaldehyde ; Strikes, Employee

Various susceptibility tests have been used to determine minimal inhibition concentration (MIC) of dermatophytes. They have limitations to apply practically because they need long time to determine MiC. Authors examined MIC of T. rubrum to ketoconazole and itraconazole using 96- well microplate and 24-well macroplate by method of Granade and Artis and tried to check the possibility of this method on clinical application. Nine strains of T. rubrum from patients with dermatophytosis were used. Evaluations of the factors affecting MIC were also tried. The results as follows. 1. Effect of inoculation density on determination time and MIC: Determination of MIC were possible in 4th days after inoculation at higher inoculation density (aborbance 2.0, 1.0) compared to 6th days at lower inoculation density (absorbance 0.5, 0.25). 2. Effect of incubation temperature on MIC: When incubating at 37℃, MIC were below 0.006-0.04µg/ml to ketoconazole and below 0.006-0.04µg/ml to itraconazole while at 25℃ 0.08-5.68µ8/ml to ketoconazole and 0.006-0.71µg/ml to itraconazole. Significant reduction of MIC was observed at 37℃ compared to 25℃. 3. Effect of container size on determination time and MIC: When incubating in 96–well microplate and 24-well macroplate, determination of MIC was possible in 4th to 6th days after inoculation in broth-containig 96-well microplate compared to 8th to 12th days in broth-containing 24-well macroplate. But no difference in MIC was observed between different container size. 4. Effect of media on MIC: When using broth as media, MIC were below 0.006-5.68µg/ml to ketoconazole, below 0.006-0.36µg/ml to itraconazole in broth-containg 24-well macroplate. When using agar as media, MIC were below 0.006-5.68 µg/ml to ketoconazole, below 0.006-5.68 µg/ ml to itraconazole in agar-containing 24-well macroplate. 5. These findings confirm that determination of MIC of dermatophtes by method of Granade and Artis is fast and simple technique for antifungal susceptibility test.
Agar ; Arthrodermataceae ; Humans ; Itraconazole ; Ketoconazole ; Methods* ; Tinea ; Trichophyton*

PURPOSE: Porous orbital implant Medpor(R) which is made of polyethylene is being widely used currently. Compared with previously used porous orbital implants, it is somewhat preferred due to cheaper and easier usage but reports on its postoperative complications are not sufficient. We report the first case of Medpor(R) infection developed domestically. METHODS: A 20 year-old male patient was admitted with Medpor(R) infection 14 months after Medpor(R) orbital implant insertion. He was treated with antibiotics. RESULTS: Infection was controlled with antibiotics without implant removal. Implant exposure occurred after infection control so dermis graft was done.
Anti-Bacterial Agents ; Dermis ; Humans ; Infection Control ; Male ; Orbit* ; Orbital Implants* ; Polyethylene ; Postoperative Complications ; Transplants ; Young Adult

The complications of peripheral or posterioruveitis, such as vitreous opacity, epiretinal membrance, and tractional retinal detachment may need vitreous surgery. This study was undertaken to evaluate the efficacy of transpars plana vitrectomy in the case of epiretinal membrance or tractional retinal detachment secondary to chronic uveitis.We included 23 eyes of 21 patients, and among them there was 16 eyes of epiretinal membrance and 7 eyes of tractional retinal detachment respectively. Improvement of vision, 2 lines or more in Anellen Chart, was noted in 10 eyes(63%) for epiretinal membrance and 2 eyes(29%) for tractional retinal detachment within post-operative 1 month. Final visual acuity decrease, compared with preoperative vision, was noted in 4 eyes(25%) for epiretinal membrance and 6 eyes(86%) for tractional retinal detachment with a mean follow-up of 34 months. The most common cause of visual acuity decrease was recurrent or persistent inflammation and resultant fibrous tissue proliferation, which became obvious within post-operative 3 months.Therefore, we`re able to conclude that the main cause of postoperative visual acuity decrease is persistent intraocular inflammation and fibrous change. So it is necessary to remove posterior hyaloid membrance actively and combine with medical treatment like corticosteroid therapy in order to control the inflammation even after vitreous surgery.
Follow-Up Studies ; Humans ; Inflammation ; Retinal Detachment ; Traction ; Uveitis* ; Visual Acuity ; Vitrectomy*