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

No abstract available.
Child* ; Hematuria* ; Humans

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

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

BACKGROUND: When it comes to wasting blood components, it usually means wastage before transfusion due to several reasons such as improvement of the patient's condition, death of the patient, delay of blood returning, etc. Yet blood components can sometimes can be wasted after a transfusion is started and this is referred as residual blood wastage. In this study, we analyzed the rate and causes of discarded blood components that are not used and the residual blood wastage in order to help reduce the rate of blood component wastage. METHODS: From January 2009 to December 2010, the number of and the reasons for discarded blood components without use and residual blood wastage were analyzed by reviewing the laboratory information system and wastage statements at Soonchunhyang University Seoul Hospital. RESULTS: The number of blood components issued during the study period was 24,001 units. Among them, the number of units discarded without use was 162 units (0.7%) and the number of units of residual blood wastage was 115 units (0.5%). Among the reasons for the discarded blood component without use, improvement of the patient's conditions ranked as 1st with 80 units (49.5%) and death of the patient ranked as 2nd with 42 units (25.9%). The biggest reason for the residual blood wastage was transfusion-related side effects with as many as 52 units (45.2%). Other than side effects, the wastage of residue from pediatric transfusion were 48 units (41.7%), followed by delay of surgery with 5 units (4.3%) and patients' refusal with 4 units (3.5%). CONCLUSION: The wastage of residue from pediatric transfusion was the second most common cause of residual blood wastage in our hospital. According to this, we should evaluate the routine use of pediatric transfusion bags and their cost-effectiveness in our hospital.
Clinical Laboratory Information Systems ; Disulfiram ; Humans ; Korea

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: The aim of this study is to evaluate whether low FDG uptake would be associated with the biological low-aggressiveness of invasive ductal carcinoma. METHODS: The subjects consisted of 124 female patients with primary invasive ductal carcinoma. All the patients were examined with (18)F-FDG PET/CT before neoadjuvant chemotherapy. RESULTS: With regard to histopathologic grading, 117 were histopathologic grade 1 and 2, and 7 were grade 3. Low FDG uptake correlated with well and moderate histopathologic grade (p=0.003) and low (18)F-FDG uptake in invasive ductal carcinoma depended on the presence of axillary lymph node metastases (p=0.014) and small tumor (<2.0 cm, p=0.022). Ki-67 positivity ranged from 0% to 60% (mean 15%). Sixty seven specimens showed low immunoreactivity to Ki-67 antigen (<10% of tumor cells). This revealed a significant correlation between low FDG uptake and Ki-67 (p=0.003). Logistic regression analysis between these factors showed that lower histologic grade, no axillary lymph nodes metastases and low Ki-67 (<10%) were correlated with low FDG uptake. CONCLUSION: Our results demonstrated that an association exists between low FDG uptake and good prognostic factors such as lower histologic grade (1, 2), no axillary lymph node metastases and low Ki-67 (<10%).
Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Female ; Humans ; Ki-67 Antigen ; Logistic Models ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis

PURPOSE: The aim of this study is to evaluate whether low FDG uptake would be associated with the biological low-aggressiveness of invasive ductal carcinoma. METHODS: The subjects consisted of 124 female patients with primary invasive ductal carcinoma. All the patients were examined with (18)F-FDG PET/CT before neoadjuvant chemotherapy. RESULTS: With regard to histopathologic grading, 117 were histopathologic grade 1 and 2, and 7 were grade 3. Low FDG uptake correlated with well and moderate histopathologic grade (p=0.003) and low (18)F-FDG uptake in invasive ductal carcinoma depended on the presence of axillary lymph node metastases (p=0.014) and small tumor (<2.0 cm, p=0.022). Ki-67 positivity ranged from 0% to 60% (mean 15%). Sixty seven specimens showed low immunoreactivity to Ki-67 antigen (<10% of tumor cells). This revealed a significant correlation between low FDG uptake and Ki-67 (p=0.003). Logistic regression analysis between these factors showed that lower histologic grade, no axillary lymph nodes metastases and low Ki-67 (<10%) were correlated with low FDG uptake. CONCLUSION: Our results demonstrated that an association exists between low FDG uptake and good prognostic factors such as lower histologic grade (1, 2), no axillary lymph node metastases and low Ki-67 (<10%).
Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Female ; Humans ; Ki-67 Antigen ; Logistic Models ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis

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

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