Small and large airways functions were studied in patients with hypertensive heart disease in slightly ro moderately compromised state functionally. In this study, the forced vital capacity and various flow paramaeters reflecting expiratory flow rate were determined from simultaneously recorded forced expiratory volume and maximal expiretory flow volume curves in 86 cases. The closing volume was measured by a single breath nitrogen mrthod in 57 cases and airway resistance with its related parameters by a body plethysmograph in 11 cases. These results were compared with those obtained from the same numbers of healthy controls matched for sex, age and height. In the patient group, the forced vital capadity and all the observed values of flow parameters, execpt for the ratio of the first second vital capacity to the forced vital capacity, were significantly reduced than those in the controls. When the remainder of flow parameters was volume-adjusted to the forced vital capacity, however, the mean of the peak expiratory flow rate and the maximal expiratory flow rate at the 75 percent of the vital capacity were not significantly different from that of controls. In contrast, the volume-adjusted values of maximal expiratory flow were remained significantly smaller than those in the controls. The closing volume and its ratio to the vital capacity were significantly larger in the patient group. Airway resistance and its related parameters revealed no significant differences between two groups. These findings suggest that the patients with hypertensive heart disease in a mild to moderate failure are associated with restrictive ventilatory impairment and a small airways obstruction, but with little or no large airway dysfunction.
Airway Resistance ; Closing Volume ; Forced Expiratory Volume ; Heart Diseases* ; Heart* ; Humans ; Maximal Expiratory Flow Rate ; Nitrogen ; Peak Expiratory Flow Rate ; Vital Capacity

Thirty three patients with mild to moderate essential hypertension were administered ramipril, a new ACe inhibitor, 2.5-5mg once daily for 6 weeks to evaluate the hypotensive efficacy and safety. The results were as follows : 1) The patients consisted of 18 males, 15 females, aged 54 on average and classified as mild in 19 and moderate in 14 patients. 2) At the end of 6 weeks trial, blood pressure dropped 13/6mmHg on average, rewarding 70% effectiveness and normalized below 150/90mmHg in 39%. 3) The most frequent side reaction was dry cough in 5 patients(15%) followed by asthenia, GI trouble, dizziness, edema, eye injection and one case of GPT elevation which normalized after completion of trial. 4) The rating of safety of safety was 79% and of overall usefulness was 73%. In conclusion, ramipril 5mg once daily regimen is well tolerated and effective in the treatment of mild to moderated essential hypertension.
Asthenia ; Blood Pressure ; Cough ; Dizziness ; Edema ; Female ; Humans ; Hypertension* ; Male ; Ramipril* ; Reward

No abstract available.
Angiotensins* ; Cough* ; Peptidyl-Dipeptidase A* ; Reflex*

T cell immunity and phagocytic activity were studied in the blood of patients with IgA nephropathy in order to clarify their roles in the pathogenesis of IgA nephropathy. The percentages of total T lymphocytes, helper T cell and suppressor T cells were significantly reduced in patients. A significantly elevated helper T cell/suppressor T cell ratio in patients showed a predominant reduction in suppressor T cells. There was a significant relationship between histologic findings and helper T cell/suppressor T cell ratio in patients. Natural Killer (NK) cell activity was significantly reduced but the lymphocyte response after phytohemagglutinin (PHA) stimulation was not in patients. ConA-induced suppressor cell activity was not depressed despite of a decrease in suppressor T cells in patients. Phagocytic activity of polymorphonuclear leucocytes (PMNs) ingesting yeasts was significantly reduced in patients. Also an inverse correlation was found between serum IgA levels and phagocytic activity of PMN. It is concluded that suppressor T cell defects, depressed phagocytic activity and impaired NK cell activity may play a role in the pathogenesis of IgA nephropathy.
B-Lymphocytes/immunology ; Glomerulonephritis, IGA/*immunology/pathology ; Humans ; Killer Cells, Natural/immunology ; Neutrophils/immunology ; *Phagocytosis ; T-Lymphocytes/*immunology ; T-Lymphocytes, Regulatory/immunology

Acute fatty liver of pregnancy are relatively rare but extremely dangerous, because they may quickly develop into a fulminant disease and become a serious life-threatening disorder for mother and fetus in the third trimester. Therefore, early diagnosis, prompt delivery and intensive supportive care the cornerstones in the management of acute fatty liver of pregnancy. Clinical findings in acute fatty liver of pregnancy vary because it may occur with varying degrees of clinical severity and in conjunction with other third trimester symptoms, making early diagnosis difficult. However, careful history and physical examination, in conjunction with compatible laboratory and imaging results, are often sufficient to make the diagnosis, and liver biopsy is rarely indicated. We have experienced a case of acute fatty liver of pregnancy presenting as early hepatic encephalopathy, renal failure which developed during the third trimester. We diagnosed acute fatty liver of pregnancy based on clinical presentation and laboratory abnormalities. Despite of prompt delivery and adequate supportive care management, this severe complication of pregnancy has had an adverse outcome for mother.
Biopsy ; Early Diagnosis ; Fatty Liver ; Female ; Fetus ; Hepatic Encephalopathy ; Humans ; Liver ; Mothers ; Physical Examination ; Pregnancy ; Pregnancy Complications ; Pregnancy Trimester, Third ; Renal Insufficiency

In patients with fully edentulous maxilla, fabrication of implant-supported overdenture can be a viable treatment option, when a minimum of six implants were strategically placed. Among several attachment systems used for implant-supported overdentures, milled-bars prevent rotational movement of denture, thus showing great stability, and have the advantage of splinting multiple implants with each other. In this case report, a milled-bar supported overdenture was fabricated for a patient suffering from condition of fully edentulous maxilla with severe ridge resorption in the anterior residual ridge. Seven implants composed of three different systems were effectively utilized by CAD/CAM customized abutment and cement-retained milled bar.
Dental Implants ; Denture, Overlay* ; Dentures ; Humans ; Maxilla* ; Rehabilitation* ; Splints

Intravenous immune globulin (IVIG) is widely used in treatment of hypogammablobulinemia and for immunomodulation. Passive transfer of anti-D activity through administration of IVIG may cause difficulty in serologic assessment of patients. Here we report on a case of passive anti-D from IVIG in a D positive patient. The patient was a 72-year-old Korean woman who was hospitalized for refractory immune thrombocytopenic purpura that is not cured after steroid therapy. IVIG 6,000 mg was administered for treatment of immune thrombocytopenic purpura. After IVIG administration for two days, we identified anti-D in the patient and a positive direct antiglobulin test was demonstrated. The patient's hemoglobin level remained unchanged. After IVIG administration for 10 days, the patient's specimen was negative for anti-D, as would be expected with passively acquired antibody. Antibodies in IVIG may confuse and complicate serologic testing of transfusion candidates. Therefore, passive transfer of anti-D should be considered when anti-D is detected, especially when the patient has received IVIG, as in this case.
Aged ; Antibodies ; Coombs Test ; Female ; Humans ; Immunoglobulins, Intravenous* ; Immunomodulation ; Purpura, Thrombocytopenic, Idiopathic* ; Serologic Tests

BACKGROUND: Among the many methods estimating the quantity of beta-hCG for pregnancy testing in urine, immunochromatography is one of most widely used semi-quantitative detection method for its convenience to use and also for its rapid result reporting system. PREG-Q(TM) is a newly introduced semi-quantitative immunochromatography method for detecting b-hCG. Clinical usefulness of PREG-Q(TM) was evaluated as a screening test for early pregnancy detection. METHODS: Accuracy, detection limit, cross-reactivity with various glycoprotein hormones, interference study, and comparison study using total 100 urine samples from pregnant (50 samples) and non-pregnant women (50 samples) was evaluated. RESULTS: All the 50 urine samples of pregnant women showed positive results, and another 50 urine samples of non-pregnant women showed negative results with PREG-Q(TM). The lower detection limit of PREG-Q(TM) was 25 mIU/mL and the result was not affected by addition of glycoprotein hormones tested. Interfering substance causing false negative or false positive results enrolled didn't affect the test results in this study. CONCLUSIONS: We conclude PREG-Q(TM) is an excellent test kit for pregnancy test, and is valuable especially for detecting early pregnancy.
Female ; Glycoproteins ; Humans ; Immunochromatography ; Limit of Detection ; Mass Screening* ; Pregnancy Tests ; Pregnancy* ; Pregnant Women

BACKGROUND: Platelet refractoriness is associated with immune and nonimmune factors. It has been shown that the incidence of platelet refractoriness caused by HLA alloimmunization is decreased by using of leukocyte-depleted blood components. The purpose of this study was to determine the incidence of platelet refractoriness in relation to the use of leukocyte removal filter and the relative importance of immune and nonimmune factors. METHODS: One hundred and eighty-five patients with thrombocytopenia, treated with multiple transfusion were classified into three groups according to use of leukocyte removal filters (group I: no filter, II: Asahi filter, III: Pall filter). Patients were considered to be refractory when the 20-hour posttransfusion corrected count increment (CCI) was less than 4.5 x 109/L on three subsequent platelet transfusions. Nonimmune factors analyzed were fever, sepsis, disseminated intravascular coagulation, splenomegaly, bone marrow transplantation, and administration of amphotericin-B. RESLUTS: The overall incidence of platelet refractoriness was 45% in group I, 44% in group II, and 47% in group III. In more than 90%, platelet refractoriness was associated with the presence of nonimmune factors. The incidence of platelet refractoriness presumably caused by alloimmunization was less than 5% and is much higher in aplastic anemia than in leukemia. Patients with pregnancy history developed platelet refractoriness with an increased incidence compared to patients without pregnancy history. CONCLUSION: This study revealed that nonimmune factors were predominant causes of platelet refractoriness regardless of transfusion of leukocyte-depleted blood components.
Anemia, Aplastic ; Blood Platelets* ; Bone Marrow Transplantation ; Disseminated Intravascular Coagulation ; Fever ; Humans ; Incidence ; Leukemia ; Leukocytes ; Platelet Transfusion ; Reproductive History ; Sepsis ; Splenomegaly ; Thrombocytopenia

The vascular actions of local anesthetics are important in determining the uptake and distribution of these agents from their site of injection as well as influencing their hemodynamic effects once absorbed. Because of the importance of the endothelium in determining of modulating the vascular response of a wide variety of agents, cumulative dose-dependent vasular effects of lidocaine, mepivacaine and bupivacaine on isolated rings of thoracic aorta in normotensive rats(NTR) and spontaneously hypertensive rats(SHR) were studied in the presence and absence of intact endothelium. The results were as follows ; The body weight of NTR and SHR averaged 274.71+/-55.80(N = 38) and 241.43+/-17.73gm(N = 18) and mean arterial pressure was 74.4l+/-3.60 and 129.34+/-2.89mmHg respectively. The mean absolute value of the contraction induced by 5Xl0(-6) M phenylephrine was 3.27+/-0.98(N = 18) and 2.3l+/-50.64gm(N = 18) with intact endothelium and 3.12+/-0.92 and 2.46+/-0.87 gm without intact endothelium in aortic rings of NTR and SHR respectively. In the response to local anesthetics in preparation with resting tension(1.0 gm), lidocaine and mepivacaine in concentration of 10(-3) to 1.25X10(-2) M not produced dose dependent contraction in aortic ring with intact endothelium from NTR. but bupivacaine produced dose-dependent contraction in aortic rings with intact endothelium from NTR. In the aortic rings from NTR and SHR previously contracted with phenylephrine, lidocaine in contraction of 10(-3) to 1.25X10(-2) M caused dose related relaxation in aortic rings with or without endothelium but in concentration of 10(-3) to 510(-3) M, aortic rings with endothelium were more relaxed than those af without endothelium in NTR. In SHR, aortic rings without endothelium in concentration of 5X10(-3) to 1.25X10 M were more significantly relaxed than those of with endothelium. In aortic rings from NTR previously contracted with phenylephrine, mepivacaine caused dose-related relaxation, which was more profound in SHR. In aortic rings with endothelium from NTR previously contracted with phenylephrine, bupivacaine in concentration of 10(-3) to 1.5X10(-3) M caused a relaxation and in concentration of 2.5X10(-3) to 7.5X10(-3) M and 1.25X10(-3) M caused a relaxation again. But in the aortic rings without intact endothelium, bupivacaine caused dose-related relaxation. In the aortic rings without intact endothelium, bupivacaine caused dose-related relaxation in NTR. In the aortic rings from SHR previously contracted with phenylephrine, bupivacaine caused dose-related relaxation, which was more profound than those of NTR. The local anesthetics appear to exert their relaxant effect on endothelium independently and more profoundly in SHR.
Anesthetics, Local* ; Aorta, Thoracic* ; Arterial Pressure ; Body Weight ; Bupivacaine ; Endothelium ; Hemodynamics ; Lidocaine ; Mepivacaine ; Muscle, Smooth, Vascular ; Phenylephrine ; Rats, Inbred SHR* ; Relaxation