A Clinical study was done on 90 cases of acute myocardial infarction admitted to Busan Wallace Memorial Baptist Hospital from January, 1977 to Febuary, 1983. The following results have been obtained. 1) The ratio of male to female was 2.2:1. The most age group were 5th decades(35.6%) and over 5th decades(5th decades and 6th decades) were two-thirds of all age group. And annual incidency were increasing tendencies, in 1980-1982 than 1977-1979. 2) Between the preceding diseases and the risk factors, the most common cause was the smoking (60%). And other associated diseases and factors were hypertension(54.4%), hypercholesterolemia (43.8%), hyperlipidemia(51.4%) and angina pectoris (34.4%). 3) The most common inducing factor was physical exertion(33.3%). And others were emotional stress(23.3%), alcohol drinking(10%), rest and sleeping(5.6%). 4) The major symptoms of acute myocardial infarction were precordial or epigastric pain(96.7%), dyspnea(53.3%), radiating chest pain (51.7%) and painless infarction(3.3%). 5) On laboratory data, there were leukocytosis in 50.5% increased SGOT in 68.6%, increased serum LDH in 75.9% and cardiomegaly in chest x-ray film were 82 percents. 6) The ratio between the anterior and inferior infarction on EKG was 1.9:1. 7) When admission, normal sinus rhythms on EKG were 59 percents. And the common associated electrocardiographic abnormalities were ventricular premature beat (23.6%), atrial fibrillation(15.7%), first degree A-V block (15.7%), left ventricular hypertrophy(15.7%). The most common abnormality was ventricular premature beat(23.6%). 8) The mortality rate of acute myocardial infarction was 10 percents. The causes of death were heart failure(33.3%), ventricular arrhythmia(33.3%), sudden death (22.2%) and cardiogenic shock(11.1%).
Angina Pectoris ; Aspartate Aminotransferases ; Busan ; Cardiac Complexes, Premature ; Cardiomegaly ; Cause of Death ; Chest Pain ; Death, Sudden ; Electrocardiography ; Female ; Heart ; Humans ; Hypercholesterolemia ; Infarction ; Leukocytosis ; Male ; Mortality ; Myocardial Infarction* ; Protestantism ; Risk Factors ; Smoke ; Smoking ; Thorax ; X-Ray Film

BACKGROUND: This study used MDS-HC 2.0 (Minimum Data Set-Home Care) to analyze the health and the state of function of the traveling health objects. This study was intended to make use of it with the basic materials for providing them with traveling health service suited for the requirement on the health of the traveling health objects. METHODS: The subjects of this study were 1160 people (over 65 years) living under management control of local Health Center from September 7th to October 3th, 2006. This study was analyzed with inter RAI program & SPSS/WIN 10.0, chi-square -test, t-test, and ANOVA. RESULTS: The result showed that 8.97 CAPs per an elderly person was identified and the subjects over 60% had an injury problem from a fall, health prevention service, vision, IADL, pain, and cognition. The number of CAPs in general was high in higher age and the less educated, and those without a job. But, in subjects that had a life partner and a spouse, the number of CAPs was low. In CAPs by the distinction of sex, CAPs which was much more in man than women in statistics were the improvement of health, the abuse of alcohol and drinking wine, bedsore, and the weak supply system. CAPs which women had much more were the function of the heart and the lungs, pain, the performance of the doctor's advice, health prevention service, and incontinence of urine and insertion of catheter. According to the results comparing CAPs by the level of the ADL, the number of CAPs was shown that the group of ADL 2 was higher than group ADL 1. The matter in which the traveling health service had to be applied in all both ADL1 and ADL2 was injury from a fall, health prevention service, and vision. Conculsion: MDS-HC is applicable to decide the care needs for health and social service supplies. The results can be further applicable for careplan, and referral criteria in continuum of care service over long-term care spectrums.
Activities of Daily Living ; Aged ; Catheters ; Cognition ; Continuity of Patient Care ; Drinking ; Equipment and Supplies ; Female ; Health Services ; Heart ; Humans ; Long-Term Care ; Lung ; Pressure Ulcer ; Referral and Consultation ; Social Work ; Spouses ; Vision, Ocular ; Wine

Clinical study was carried out on the 64 hemodialysis patients(HD) with chronic renal failure who had been treated from December 1992 to July 1993 in Yeungnam University Hospital. The following results were obitained. In hematologic parameters, MCH was 28.8±2.0pg, and MCV was 92.4±4.7fl. Result revealed normochromic and normocytic anemia. Mean values of serum ferritin were 657.4±292.0ng/ml in men and 511.5±370g in women. Mean values of serum iron were 145.5±63.7µg/dl. Mean values of transferrin saturation was 61.6±28.4%. Serum frerritin, serum iron and transferrin saturation were higher in HD group than normal reference. In erythropoeitin treatment group, Hb and Hct were significantly higher than non-erythropoietin treatment group. Amount of transfusion was significantly higher in non-erythropoietin treatment group than erythropoeitin treatment group(p<0.05). Values of iron, transferrin saturation were significantly higher in abnormal liver function test(LFT0 hemodialysis group than normal LFT group(p<0.05). Transfusion amounts revealed positive correlation with ferritin(r=0.4675), transferrin satruation (r=0.3823) and iron(r=0.3386) (p<0.05).
Anemia* ; Clinical Study ; Erythropoietin* ; Female ; Ferritins ; Humans ; Iron ; Kidney Failure, Chronic ; Liver ; Male ; Renal Dialysis ; Transferrin

To verify the accuracy and reproducibility of corneal thickness measurements obtained with Orbscan (Orbtek, Inc., Salt Lake City, USA), the measurements were compared with those taken with an ultrasound pachymeter (Omega Compuscan, Storz). Central corneal thickness was measured by each method in 100 eyes of 50healthy subjects. The averages by the two methods were compared. One examiner took the measurements twice by each method in 20 eyes of 10 subjects, and intraexaminer reproducibility was evaluated. Two examiners measured the thickness in 20 eyes of 10 subjects and interexaminer reproducibility was assessed. The average corneal thickness was 550.27+/-3.56 micrometer in the Orbscan measurements and 526.62+/-3.70 micrometer in the ultrasound pachymetry: There was a statistically significant difference between the two methods. Significant difference was noticed but this showed a constant corresponding correlation with the Orbscan showing a 4.4%lower average. The intraexaminer and interexaminer reproducibility showed high reliability(Guttman split-half point<0.99). The Orbscan pachymetry is a highly reliable method and may be widely used in clinical practice.
Corneal Pachymetry* ; Lakes ; Ultrasonics* ; Ultrasonography

The femoral fracture, occurred associated with the cemented hip arthroplasty, is well-known cornplication but the proximal femoral fractures of the noncemented hip arthroplasty, were occurred more than those. Among the 290 patients, who were treated by the noncemented hip arthroplasty from Dec. 1987 to April 1992, the 24 cases of the femoral fracture were experienced and the results were as follows: 1) of the 24 cases, the male was nine and the female was fifteen. The age distribution was mostly occurred between 41 and 60 years old and most fracture were developed in 1 1mm stem size. In revision cases, 225mm stem length (Wagner) was common. The locations of fracture were proximal 1/3 (type I: 19 cases), tip (type II; 1 case), distal 1/3 (type III; 1 case) and comminuted (type IV; 3 cases) by Johansson; siclassification. 2) The femoral fracture was mostly developed during the stem insertion and the fracture site in anatomical stem was only proximal femur. 3) 1n cases of revision, most of the fractures were occured on the anterior or lateral side of the femur. It was difficult to manage the fracture because of the severe osteoporosis and comminution. 4) As the problem of the operative technique, the fracture incidence can be decreased by accurate preoperative measurement and it must be cautious in the stem more than 225 mm length, which were used in revision case. 5) The circumferential wiring for proximal and plate & screws in middle and distal were done as the treatment of fracture and the results were all good, but stem tip fracture in osteoporotic patients was troublesome. We think that long plate(>8 holes) & both cortex purchase and bone graft are best methods so far.
Age Distribution ; Arthroplasty ; Female ; Femoral Fractures ; Femur ; Hip ; Humans ; Incidence ; Male ; Osteoporosis ; Transplants

To evaluate the reproducibility in measuring the velocities of perifoveal hyperfluorescent dots, we analyzed fluorescein angiographs of 24 eyes[24 patients]which had central serous retinopathy. Fluorescein angiography was performed with a scanning laser ophthalmoscope[SLO, Rodenstock, Mnchen, Germany]Distances between 5 moving hyperfluorescent dots in a perifoveal capillary were measured at each consecutive frame[interval 1/30 sec]. And then velocities of 5 fluorescent dots were measured with image analysis program by converting the distances to real retinal size using the Littmann's curve in 20 eyes. In the other 4 eyes, the velocities between 5 fluorescent dots of each 2 to 4 capillaries were measured. Perifoveal capillary mean blood flow velocity and standard deviation were 2.08 +/-0.36 mm/sec, and mean coefficient of variation of the velocities measured in a vessel of one patient was 12.58%. However, reliability of the velocities of 2 to 4 capillaries on the 4 eyes was relatively low. In conclusion, the measurement of velocities between perifoveal fluorescent dots with scanning laser ophthalmoscope may be a reproducible method for a perifoveal capillary. However, reliability of measuring velocities was not sufficient enough to use the velocity of one perifoveal capillary as macular blood flow.
Blood Flow Velocity ; Capillaries ; Central Serous Chorioretinopathy ; Fluorescein Angiography* ; Fluorescein* ; Humans ; Ophthalmoscopes* ; Retinaldehyde

On video fluorescein angiogram, it is known that arm-to-retinal circulation(ART)influences retinal macrocirculation and arterio-venous passage time(AVP)influences microcirculation.In diabetic retinopathy(DR), midperiphery involved earlier than posterior pole.However, there has been no study on the circulation of the entire retinal circulation including the peripheral retina. The authors conducted a prospective study by performing fluorescein angiography on 19 controls and 19 DR patients in order to measure the ART, AVP and venous filling time(VFT). The VFT correspond to the circulation of the peripheral retina. In the DR group, the retina circulation time was compared with the existence of proliferative diabetic retinopathy(PDR), distribution of nonperfusion area and beading vessels. There was no significant difference between diabetic group and the control group in the ART.AVP was 1.8+/-0.7sec in the control group and 2.5+/0.7sec(p=0.04)in the DR group and venous filling time was 6.4+/-2.4sec and 8.9+/-1.5sec(p=0.006)respectively. Patients with PDR showed prolongation only in VFT compared to patients with non-proliferative diabetic retinopathy(NPDR). In addition, patients presenting with nonperfusion areas and beading of vessels showed longer prolongation of VFT than of AVP. In conclusion, the VFT is delayed in DR compared to control group and in PDR compared to NPDR. The VFT can be utilized as an indicator of DR to measure the retinal circulation including the peripheral retina.
Diabetic Retinopathy* ; Fluorescein Angiography* ; Fluorescein* ; Humans ; Microcirculation* ; Prospective Studies ; Retina ; Retinaldehyde*

This study was performed to develop a new method, fluorecent leukocyte angiography(FLAG), to measure retinal circulation. Fluorescein-stained leukocytes can be seen in all the retinal vessels during fluorescein angiography using Scanning Laser Ophthalmoscope(SLO FAG) and retinal blood flow can be measured by using leukocyte velocities in the retinal vessels. Methods were followings. Firstly, blood was withdrawn from vein, mixed with fluorescein(10%) and anticoagulant and then centrifuged. The yellowbrown coat layer containing fluorescin-stained leukocytes was selected and injected into the vein while performing SLO FAG. The image of FLAG displayed circulating hyperfluorescent leukocytes clearly in all retinal vessels, and allowed the measurement of leukocyte velocities. In conclusion, FLAG is a new method to measure blood flow in all the retinal vessels simultaneously and can be a useful tool for studying animal and human retinal circulation.
Angiography* ; Animals ; Fluorescein Angiography ; Humans ; Leukocytes* ; Retinal Vessels ; Retinaldehyde* ; Veins

Acute necrotizing pancreatitis (ANP) is a disease with high morbidity and mortality despite the progress made in intensive medical care. This study was conducted to clarify the strategy and the prognostic factors in its surgical management.We reviewed retrospectively 26 patients who had operative treatment for ANP from March 1990 to February 1995 at Wallace Memorial Baptist Hospital. The results were as follows:1) The most common cause of the ANP was alcohol (38.5%) and the next most common cause was gallstone (23.1%). 2) The operative indications were an acute surgical abdomen (15 cases), sepsis (6 cases), organ failure (3 cases), and shock (2 cases). 3) The culture results for the specimens which were obtained from the necrotic lesions or from fluid collections showed bacterially positive patients in 78.9% of the cases and polymicrobial infection in 31.6% of the cases. 4) Of the operative methods, a necrosectomy with open drainage and delayed lavage was applied to 17 cases (65.4%), and the mortality of this procedure was 23.5%. 5) During the postoperative course, reoperation was required in 3 cases (11.5%) and diabetes was seen in 6 cases of 22 cases (27.3%). 6) We analyzed prognostic factors like the Ranson score, infection, inadequate necrosectomy with drainage, and preoperative organ failure with statistical methods (Student's t-test and Chi-square test). The Ranson score and infection showed little correlation with the postoperative mortality, but an inadequate necrosectomy with drainage and preoperative organ failure showed a statistically significant correlation (p=0.006, p=0.009, respectively). In conclusion, we applied a necrosectomy with open drainage and delayed lavage to most of the ANP patients. An inadequate necrosectomy with drainage and preoperative organ failure had important meanings as prognostic factors and affected the postoperative mortality. Hence we think that necrotic lesions and fluid collections require early radical debridement and wide drainage, especially in infected necrotizing pancrectitis, and that multiple, well-positioned drains are important for decreased morbidity and mortality.
Abdomen ; Atrial Natriuretic Factor ; Coinfection ; Debridement ; Drainage ; Gallstones ; Humans ; Mortality ; Pancreatitis, Acute Necrotizing* ; Protestantism ; Reoperation ; Retrospective Studies ; Sepsis ; Shock ; Therapeutic Irrigation

OBJECTIVE: The aim of this study is to evaluate the effects of intracranial-extracranial arterial bypass(EIAB) surgery on cerebrovascular reserve capacity(CRC) in patients with hemodynamic cerebral ischemia and to assess the significance of transcranial doppler(TCD) examination before and after EIAB surgery. METHODS: In 29 consecutive patients who underwent EIAB surgery due to symptomatic internal carotid artery or middle cerebral artery(MCA) occlusion, 21 patients were studied using preoperative and postoperative digital subtraction angiogram(DSA), SPECT, and TCD examination. After measuring mean radioactivity count of a region of interest, relative regional cerebral blood flow(rrCBF) was quantitated by the following formula: lesional radioactivity count/contralateral radioactivity count x 100%. CRC was calculated as the percentage change from baseline flow after a vasodilatory challenge. RESULTS: Postoperative DSA showed good collateral circulation through the bypass except 4 patients. Preoperative mean value of rCRC improved significantly after EIAB surgery from -14.8+/-2.6% to 6.9+/-2.7%(p<0.01). Intraoperatively, flow velocity of superficial temporal artery(STA) and MCA just after anastomoses increased remarkably in comparison with the values just before anastomoses(p<0.01). There was no correlation between the change of pre- and postoperative flow velocity and the change of rrCBF. In patients with the increase of flow velocity after surgery manifested good collateral circulation through the bypass. The difference was statistically significant(repeated measures ANOVA, p<0.05). Over a mean follow-up period of almost 3 years, no patient had another episode of brain ischemia. CONCLUSION: We believe that the measurement of flow velocity is expected a good method to evaluate the degree of collateral circulation through the bypass.
Brain Ischemia* ; Carotid Artery, Internal ; Collateral Circulation ; Follow-Up Studies ; Hemodynamics* ; Humans ; Radioactivity ; Tomography, Emission-Computed, Single-Photon