The effect of Atenolol on the blood pressure were studied in 31 cases of essential hypertension and on the effect of plasma renin activity in 8 cases. There were 8 cases of male with age 49.5(42-70) and 23 cases of female with age 49(35-71) years. 27 cases of 31 cases were untreated hypertensive patients and 4 cases were refractory to hypotensive drugs of diuretics and vasodilators. The Atenolol 50mg once-daily was given to all patients orally for 3 weeks. The blood pressure, heart rate, ECG and symptoms were checked in one week interval. In 8 cases, the plasma renin activity was measured by Dainabot Kit before and after one week medication. The results were as follows: 1. In 27 cases of untreated hypertension, the control blood pressure was 182.9/11.4mmHg in average. The blood pressure decreased in average by 18.3/11mmHg in one week, 23.7/15.9mmHg in two week and 21.5/10.5mmHg in three week. The heart rate also decreased by 7.4/min. in one week, 14.9/min. in two week and 7.8/min. in three week. These data showed considerable reduction of blood pressure and heart rate with 50mg Atenolol once-daily. 2. The basal plasma renin activity after one week medication was reduced by 46% in 8 cases and this data showed considerable reduction regardless control level of basal plasma renin activity. 3. There were considerable blood pressure reduction by adding Atenolol 50mg once-daily to diuretics and vasodilator to which patient's blood pressures were refractory. 4. There was no orthostatic hypotension or serious side effect by Atenolol medication.
Atenolol ; Blood Pressure* ; Diuretics ; Electrocardiography ; Female ; Heart Rate ; Humans ; Hypertension* ; Hypotension, Orthostatic ; Male ; Plasma* ; Renin* ; Vasodilator Agents

Bacterial meningitis results in significant neurologic dificits despite in spite of much effort in the treatment of the disease. This study was performed to determine the incidence of caustive organisms and to correlate between the organisms and computed tomographic (CT) findings with clinical outcome of bacterial meningitis in newborns and infants. We analyzed the brain CT and clinical records of 15 infants who had been diagnosed as bactrial meningitis by CSF culture. We found that the most common organisms were Group B streptococcus in neonates withou no neurologic complications in all but one and Hemophilus influenza in infants whose clinical outomes were poor in all except one. CT findings related with poor prognosis in this study were cerebral edema, basal cistermal obliteration & enhancement, and cerebral infarction on initial CT and ventriculomegaly on follow-up CT. We concluded that CT diagnosed intracranial complications of bacterial meningitis well and could contributed to better treatment of bacterial meningitis.
Brain ; Brain Edema ; Cerebral Infarction ; Follow-Up Studies ; Haemophilus ; Humans ; Incidence ; Infant* ; Infant, Newborn* ; Influenza, Human ; Meningitis ; Meningitis, Bacterial* ; Prognosis ; Streptococcus

The aim of this stud y was to compare the epidermal thinning properties of four corticosteroid ointments applied under occlusion, using histology and histometry. The results were surnmerized as follows: 1.The stratum corneurn was dramatically thinned, appearing as a wispy layer of horny cells as apposed to the norrnal basket-weave configuration. this effect was prominent at sites treated with clobestasol propionate, fluocinonide, and fluocinolone acetonide. 2. With the histometry, visible epidermal thickness wa.s markedly reduced. This effect w is prominent in the following ascending order: fluocinolone acetonide, fluocienonide, clobestasol-17-propionate. Hydrocortisone was the least atrophogenic. 3. Clohestasol-17-propionate and fluocinonide caused significant flattening of dermo-epidermal junction, Fluocinolone acetonide and hydrocortisone caused less pronounced cbanges. 4. Marked capillary dilation af papilly dermis is caused by clobestasol-17-propionate, fluocinonide and fluocinolone acetonide.
Adrenal Cortex Hormones* ; Atrophy* ; Capillaries ; Dermis ; Diethylpropion ; Epidermis* ; Fluocinolone Acetonide ; Fluocinonide ; Humans* ; Hydrocortisone ; Ointments

No abstract available.
Joints*

PURPOSE: To describe MR imaging features of hypoxic brain damage in relation to time elapse and prog-nosis of patients. MATERIALS AND METHODS: We reviewed 19 MR studies of 18 patients with hypoxic brain damage. MR imaging studies were performed between 1 to 20 days after the hypoxic insults (mean 8.6 days). MR images were analyzed with regard to the locations of abnormal signal intensities, the presence of brain edema. And imaging findings were correlated with the time elapse after the insults and the prognosis of patients. RESULTS: On 19 cases of MR studies, abnormal high intensities on T2-weighted images were found in the basal ganglia (15, 78.9%), cerebral cortex (13, 68.4%), white matter (9, 47.4%), thalamus (6, 31.6%), cerebellum (4, 21.1%) and brainstem (1, 5.3%), respectively. Cerebral cortical involvement was typically bilateral and diffuse, but sometimes limited to the parieto-occipital area. The brainstem and cerebellar involvement was rare and in all cases, cerebral cortical lesions accompanied. Most of the white matter lesions were accompanied with cortical and deep gray matter lesions and found in subacute period(>6 days). The cortical high signal intensity lesions on T1-weighted image were found mostly in subacute stage, but in some cases involvement was also found in acute stage (< or =6 days). The cortical edema is found on 11 cases in acute and subacute stages. In cases of recovered consciousness, cortical involvement and edema on MR were rare. CONCLUSION: MR findings of hypoxic brain damage were various, but diffuse bilateral involvement of cortex and/or deep gray matter was found in most of the cases. White matter involvement was rarely found in acute stage and usually found in subacute stage. In cases of good pronosis, cortical involvement and edema were rare.
Anoxia ; Basal Ganglia ; Brain ; Brain Edema ; Brain Stem ; Cerebellum ; Cerebral Cortex ; Consciousness ; Edema ; Humans ; Hypoxia, Brain* ; Magnetic Resonance Imaging ; Prognosis* ; Thalamus

No abstract available.
Dilatation* ; Kidney* ; Pelvis*

PURPOSE: To investigate the efficacy and advantages of the lateral approach for internal fixation of the distal humeral shaft fractures. MATERIALS AND METHODS: Twelve patients with distal humeral shaft fractures who underwent open reduction and internal fixation using plate and screws by lateral approach from January, 1997 to May, 2002 were investigated. Postoperative results after a minimum 1 year follow-up were assessed using union rate, elapsed time to union, postoperative complications such as iatrogenic radial nerve palsy, range of motion of the elbow joint. Clinical outcomes were evaluated with Mayo elbow performance scoring system. RESULTS: Union was achieved in all cases. The average time to union was 9 weeks (range, 7~12 weeks). Four cases of preoperative radial nerve palsy were revealed as contusion of the intact nerve and resolved completely by three months. The mean elbow range of motion was from 5 to 138 degrees. The average Mayo elbow performance score was 91 points; 9 cases ranked as excellent and 3 as good. CONCLUSION: Distal humeral shaft fractures can be treated successfully through open reduction and internal fixation using plate and screws. Lateral approach is recommended to stabilize distal humeral shaft fractures without compromising the range of motion of the elbow, and to protect or explore the injured radial nerves easily
Contusions ; Elbow ; Elbow Joint ; Follow-Up Studies ; Humans ; Paralysis ; Postoperative Complications ; Radial Nerve ; Range of Motion, Articular

PURPOSE: To evaluate MR characteristics of acute disseminated encephalomyelitis (ADEM) in children, which was confirmed by clinical findings. MATERIALS AND METHODS: The subjects were six patients, who were diagnosed by clinical findings. One subject had recurrence one year after clinical improvement leading to one additional care with the total of seven. The modes of viral infections were as follows;four cases of non-specific upper respiratory tract infection, one of E-B virus, one of Japanese-B-encephalitis vaccination, and one of upper respiratory infection in Bruton's disease. The Gd-DTPA enhanced scan was performed in all cases. MR findings were evaluated in anatomic location of the lesions, presence or absence of contrast enhancement, and the temporal changes were also evaluated on follow-up MRI. RESULT: There were multifocal high signal intensity lesions on T2WI in all cases. The location of lesions were basal ganglia in five, thalamus and brain stem in four, and cerebral gray and white matter and cerebellar white matter in three. Bilaterality was 77%. There were contrast enhancement in two of three cerebral cortical lesions and one of three white matter lesions. The size of lesions decreased on the first follow-up MRI which were done after 1 month in 4 cases, but new lesions were developed in two cases. On the second follow-up MRI which were done 2 months after, all lesions were decreased in size and there was no newly developed lesion. However, in one case who had recurrent similar symptom after 1 year, several new lesions developed on follow-up MRI, and it was comidened as a recurrence. CONCLUSION: The characteristic MR findings of ADEM were multifocal bilateral white and gray matter lesions which were high signal intensities on T2WI. The majority of lesions improved on follow-up MRI, but occasionally showed multiphasic pattern.
Basal Ganglia ; Brain Stem ; Child* ; Encephalomyelitis, Acute Disseminated ; Follow-Up Studies ; Gadolinium DTPA ; Herpesvirus 4, Human ; Humans ; Magnetic Resonance Imaging ; Recurrence ; Respiratory Tract Infections ; Thalamus ; Vaccination

BACKGROUND/AIMS: Hepatic resection is an accepted therapeutic modality for hepatocellular carcinoma (HCC). In the present study, surgical results are analyzed with an aim toward further improving the treatment of HCC. METHODS: We reviewed 831 patients with HCC who underwent a curative hepatic resection in Seoul National University Hospital from 1990 to 2001. We analyzed age, sex, GOT/ GPT, alpha-fetoprotein (alpha FP), HBsAg, anti-HCV, Child classification, size and number of tumor, extent of resection, resection margin, and perioperative transfusion. RESULTS: 1-, 3-, and 5-year overall survival rates were 91.1%, 79.8%, and 71.7%. 1-, 3-, and 5-year disease-free survival rates were 66.9%, 39.3%, and 29.8%. Risk factors of multivariate analysis of recurrence were GOT (>40 IU/L), alpha FP (>20 ng/dl), Child classification (B and C), tumor number (> or =2), tumor size (>5 cm), and extent of resection (major hepatectomy). Prognostic factors of multivariate analysis of overall survival rate were GOT, tumor number, and extent of resection. CONCLUSION: Although the recurrence rate is still high, identifying an individual patient who is at risk of tumor recurrence (GOT>40 IU/L, alpha FP>20 ng/dl, Child B and C, tumor number> or =2, tumor size >5 cm, and major hepatectomy) is helpful to estimate disease-free survival.
alpha-Fetoproteins ; Carcinoma, Hepatocellular* ; Child ; Classification ; Disease-Free Survival ; Hepatitis B Surface Antigens ; Humans ; Multivariate Analysis ; Recurrence ; Risk Factors ; Seoul ; Survival Rate

STUDY DESIGN: This is a retrospective study analyzing early problems of open discectomy for lumbar intervertebral disc herniation. OBJECTIVES: To analyse the incidence of intraoperative and postoperative problems developed within six weeks and their relationship with reoperation and prognosis. MATERIALS AND METHODS: Hundred and ninty-four patients with intervertebral disc herniation, treated by open discectomy from April 1987 to December 1997, were assessed for intraoperative and postoperative problems. The problems were classified into three degrees : major, moderate and minor problem. when the problem was related to readmission, reoperation and prolonged admission for more than six weeks, it was classified as major problem. When the problem was related to prolongation of duration of admission for two to six weeks, it was classified as moderate problem. When the problem was not related to any prolongation of duration of admission, it was classified as minor one. RESULTS: Seven intraoperative and twenty-three postoperative problems were developed in twenty-seven patients. There were seven major problems : three recurrence of symptom and four suspicious deep infections. Nine moderate problems : six remained radiating pain, two serous discharge from operative wound and one urinary tract infection. and remained fourteen were minor problems : two recurrent symptom, two persistent pain, three serous discharge and seven intraoperative complications. CONCLUSIONS: The early major problems of open discectomy were recurrence of intervertebral disc herniation and deep infections. Problems with remainded radiating pain usually don't need reoperation and those symptoms were relieved with time goes. The prognosis was not influenced by minor problems.
Diskectomy* ; Humans ; Incidence ; Intervertebral Disc* ; Intraoperative Complications ; Prognosis ; Recurrence ; Reoperation ; Retrospective Studies ; Urinary Tract Infections ; Wounds and Injuries