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

The transorbital intracranial injury is a rare penetrating brain injury and few homicidal cases were reported. We report a case of 37 year-old man who died from a homicidal transorbital intracranial injury. The assailant was one of his friends, who pierced his left eye by a metallic chopstick. Despite the intensive care, he died one week after. Postmortem examination revealed only a small laceration with subcutaneous hematoma in left lower eyelid, fractures of medial orbital roof, body of sphenoid bone and sella turcica, diffuse cerebral edema, basal subarachnoid hematoma, focal subdural hematoma, and intraventricular hematoma in the right lateral ventricle.
Adult ; Autopsy ; Brain Edema ; Eyelids ; Friends ; Head Injuries, Penetrating ; Hematoma ; Hematoma, Subdural ; Homicide ; Humans ; Critical Care ; Lacerations ; Lateral Ventricles ; Orbit ; Sella Turcica ; Sphenoid Bone

No abstract available.
Child* ; Hematuria* ; Humans

BACKGROUND: For the diagnosis of HIV infection, enzyme immunoassay (EIA) or chemiluminescence immunoassay (CLIA) is commonly used as a screening test. Although these methods have a high sensitivity and low cost, their high false positive rate can cause confusion in the patients and clinicians until a more specific test is done. OraQuick Advance Rapid HIV-1/2 Antibody Test (OraQuick) (OraSure Technologies, USA) is a rapid test that can detect HIV-1/2 antibodies in 20 minutes. It uses oral fluid, whole blood or serum sample. In this study, we evaluated the usefulness of the OraQuick as a screening and point-of-care test for HIV infection. METHODS: From Jan 2007 to Dec 2008, 45,276 samples referred to our laboratory were tested by CLIA method using the ADVIA Centaur (Bayer Healthcare LTD., USA) for HIV-1/2 antibody detection. Among them, 74 positive and 50 negative samples were tested by the Western immunoblot assay (WIB) and OraQuick test as a case-control study. Also, oral fluids from 30 HIV patients and 48 healthy persons were tested by OraQuick test. RESULTS: The sensitivity and specificity of OraQuick test (using serum samples) were 100% and 98.8% (95% confidence interval 96.9~100%), respectively. OraQuick tests (using oral fluid samples) were all positive for HIV patients but all negative for healthy persons. CONCLUSIONS: This study suggests that OraQuick can be used successfully as a rapid test for the early detection of HIV-1/2 antibody in patients visiting emergency departments and for the prevention of HIV infection in the health care providers.
Antibodies ; Blotting, Western ; Case-Control Studies ; Delivery of Health Care ; Emergencies ; HIV ; HIV Infections ; Humans ; Immunoassay ; Immunoenzyme Techniques ; Infection Control ; Luminescence ; Mass Screening ; Sensitivity and Specificity

We presented here a rare case of intestinal Behecet's disease simulating Grohn's disease. A 20 year old female complained of recurrence of oral ulcer, genital ulcer, arthralgia, erythema nodosum, abdominal pain and diarrhea, but she had no anal ulcer or anal fistulas. The colonoscopic examanation disclosed diffuse colonie involvement with multiple longitudinal ulcers and inflammatory pseudopolyposis. In hospital, she received ileocecectomy because of distal ilea perforation. Postoperative specimen showed multiple geographic ulcer on ileocecal region, creeping mesenteric fat and thickening of cecal wall. Pathological examination showed perivasculitis, transmural inflammation, fissuring, multiple lymph follicles which are compatible with intestinal Behect's disease. There were no granuloma sugges tive of Crohn's disease. Clinically, the patient met the international criteria of Behcet's disease. Punched out ulcer in the ileocecal region and pathological findings described above confirmed the diagnosis of intestinal Behcet's disease.
Abdominal Pain ; Arthralgia ; Colon* ; Crohn Disease ; Diagnosis ; Diarrhea ; Erythema Nodosum ; Female ; Fissure in Ano ; Granuloma ; Humans ; Inflammation ; Oral Ulcer ; Rectal Fistula ; Recurrence ; Ulcer* ; Young Adult

PURPOSE: To compare preoperative and postoperative ocular biometry in patients with iris-fixated phakic intraocular lens (pIOLs): Artisan and Artiflex. MATERIALS AND METHODS: This study included 40 eyes with Artisan and 36 eyes with Artiflex pIOL implants. Anterior chamber depth (ACD) and axial length (AL) were measured by applanation ultrasonography (A-scan) and partial coherence interferometry (IOLMaster) preoperatively and 3 months after pIOL implantation. RESULTS: ACD measurements after Artisan or Artiflex pIOL implantation were smaller than preoperative measurements. Specifically, the difference after Artisan pIOL implantation was -1.07+/-0.17 mm by A-scan and -0.08+/-0.08 mm by IOLMaster. The difference after Artiflex pIOL implantation was -1.31+/-0.15 mm by A-scan and -0.05+/-0.07 mm by IOLMaster. After Artisan pIOL implantation, differences in AL measurements by A-scan were insignificant (difference: -0.03+/-0.15 mm), whereas postoperative AL measurements by IOLMaster were significantly longer than preoperative measurements (difference: 0.12+/-0.07 mm). After Artiflex pIOL implantation, AL measurements by both A-scan and IOLMaster were significantly longer than preoperative measurements (difference: 0.09+/-0.16 mm by A-scan and 0.07+/-0.10 mm by IOLMaster). In the Artiflex group, differences in AL measurements by A-scan correlated with the central thickness of the Artiflex pIOL. CONCLUSION: ACD and AL measurements were influenced by iris-fixated phakic IOL implantation.
Adult ; Biometry ; Eye/ultrasonography ; Female ; Humans ; Interferometry ; Lens Implantation, Intraocular/*adverse effects ; Male ; Middle Aged ; Postoperative Complications

A 45-year-old female with psychosis complained urological symptom of urinary incontinence and voiding difficulty with abdominal pains and expansion during her psychiatric hospitalization and suddenly collapsed at the 14th day of the admission. At autopsy, the urinary bladder showed a focal perforation and the abdominal cavity was filled with massive urinary ascites. The both lower lobes and the right upper lobe of the lung were accompanied by atelectasis. The death mechanism of this case could be explained that an increased abdominal pressure produced by massive uroperitoneum with spontaneous bladder rupture led to respiratory failure. The so-called abdominal compartment syndrome was manifested by massive uroperitoneum and caused a death. This would be the first forensic medical case that an undiagnosed spontaneous bladder rupture resulted in death of a psychiatric illness patient.
Abdominal Cavity ; Abdominal Pain ; Ascites ; Autopsy ; Female ; Hospitalization ; Humans ; Intra-Abdominal Hypertension ; Lung ; Middle Aged ; Psychotic Disorders ; Pulmonary Atelectasis ; Respiratory Insufficiency ; Rupture* ; Urinary Bladder* ; Urinary Incontinence

In recent times the modification and injury of foot are shown due to various activity. It is essential to have detailed knowledges about the anatomical structure of medial longitudinal arch of foot for doing orthodigita or making shoes to prevent variation of medial longitudinal arch of foot. This study aimed to measure the constitution and to suggest the index of medial longitudinal arch of foot. Fifty four feet (30 M/24 F) obtained from the collection of the Department of Anatomy and Cell Biology of College of Medicine, Hanyang University were studied. We measured the length of foot, the height of foot, and the first ray angle. Also, we found the index of medial longitudinal arch and compared this results with various races anthropologically. Each items was analyzed using SPSS win 13.0. The length of foot was 211.12+/-13.02 mm and the height of foot was 39.03+/-6.27 mm. There was statistically significant difference between the values of male and female and among the age groups (p>0.001). The first ray angle was 24.98+/-2.16 degrees. There was statistically significant difference between the values of male and female (p>0.001). The medial longitudinal arch index was 18.43+/-2.33. The date shows clear distinction between the value of index in this study and the American's value of index as a result of comparing races. The results of this study would be useful to clarify the characteristics of the medial longitudinal arch.
Constitution and Bylaws ; Continental Population Groups ; Female ; Foot ; Humans ; Male ; Shoes

OBJECTIVES: Medically unexplained physical symptoms comprised the predominant complaints of patients with depression in clinical settings. Previously, tricyclic antidepressants, which inhibit both presynaptic reuptake of serotonin and norepinephrine, had been used to relieve pain as well as treat depression. The objective of this study was to evaluate the efficacy of venlafaxine ER, which also has the effects on both serotonin and norepinephrine, in patients suffering from depression with somatic symptoms. METHODS: The subjects were recruited from outpatients who had been treated for depression with venlafaxine ER. They were divided into two groups, based on whether they voiced somatic symptoms as their chief complaint (somatic group) or not (non-somatic group). In addition, they were also divided into two groups according to whether they met the criteria of multisomatoform disorder (DSM-IV, Primary Care Version). The duration from the time venlafaxine ER was used to the point when treatment was changed because of the recurrence of symptoms or side effects was assessed and compared using survival analysis in the two groups. RESULTS: Sixty-four patients fulfilled the inclusion criteria of this study, and 39 patients 'were placed into the somatic group', while the other 25 patients 'were placed into the non-somatic group'. The survival rates of maintenance treatment in the somatic group was significantly higher than in the non-somatic group (logrank test p=0.033), and the mean duration of maintenance treatment in the somatic group was 41.5+/-3.38 weeks, while that in the non-somatic group was 26.0+/-4.95 weeks. When the subjects were classified by the criteria of multisomatoform disorder, no significant difference was observed between the two groups (logrank test p=0.314). CONCLUSION: In the present study, treatment venlafaxine ER was maintained longer in patients suffering from depression with somatic complaints, which suggests the efficacy of venlafaxine ER on somatic symptoms of these patients. Large-scale, controlled trials are needed to confirm our findings.
Antidepressive Agents, Tricyclic ; Depression ; Depressive Disorder, Major* ; Humans ; Norepinephrine ; Outpatients ; Primary Health Care ; Recurrence ; Serotonin ; Survival Rate ; Venlafaxine Hydrochloride

OBJECTIVE: Prescription patterns have changed rapidly due to the development of new drugs, results of new researches, and increment of clinician's experience. The goal of this study was to examine and compare the trend of prescription patterns for major depressive disorder at a university hospital between year 2001 and 2006. METHODS: We evaluated the medication usage of inpatients with major depressive disorder in 2001 and 2006, including antidepressants used as the first choice, switching, and combination, and various augmentation agents. And we evaluated the time to switching and combination of antidepressant in 2001 and 2006. RESULTS: The antidepressants used as first line drug were SSRIs (49.3%), mirtazapine (24.0%), and TCAs (4.8%) in 2001, and SSRIs (50.0%), mirtazapine (24.7%) and venlafaxine (19.0%) in 2006, in frequency order. The antidepressants used as switching drug were TCAs (33.3%), mirtazapine (25.0%), and nefazodone (16.7%) in 2001, and SSRIs (33.3%), mirtazapine (33.3%), and venlafaxine (19.0%) in 2006. As combination treatment, SSRIs and TCAs combination was used mostly by far in 2001 (87.5%), but in 2006, various combination were used including SSRIs and mirtazapine, SSRIs and TCAs, mirtazapine and venlafaxine (36.8%, 23.6%, 18.4%, respectively). The time to combination in 2001 and 2006 year were not different significantly (17.4+/-7.9 day vs 18.0+/-12.9 day, respectively; p=0.829) but the time to switching was significantly shorter in 2006 than in 2001 (13.1+/-7.5 day vs 24.1+/-11.7day; p=0.009). The use of typical antipsychotics as augmentation agent decreased and the use of atypical antipsychotics increased significantly in 2006. Most frequently used atypical antipsychotic was quetiapine in 2006. The use of thyroid hormone and trazodone were significantly decreased in 2006, but the use of mood stabilizer was not changed between 2001 and 2006. While the use of lithium decreased, the use of lamotrigine increased in 2006. CONCLUSION: The results of the present study suggested that there were lots of change in prescription patterns for major depressive disorder between 2001 and 2006. Especially, these changes could be seen in use of various antidepressants, increment in use of atypical antipsychotics and lamotrigine. It can reflect not only the current progress of psychopharmacology and clinical experience, but also the clinical complexity of treatment of depression.
Antidepressive Agents ; Antipsychotic Agents ; Depression ; Depressive Disorder, Major* ; Humans ; Inpatients* ; Lithium ; Prescriptions ; Psychopharmacology ; Thyroid Gland ; Trazodone ; Quetiapine Fumarate ; Venlafaxine Hydrochloride