Total exchangeable sodium and plasma volume were measured to evaluate role of sodium in hypertension by radioisotope 24 Na and Evans blue in 25 patients with essential hypertension, 10 with malignant hypertension, 5 with renal hypertension and 15 normal controls. The results obtained are as follows. 1. The total exchangeable sodium content was 35.8+/-3.5mEq/kg in normal controls, 35.6+/-2.7mEq/kg in essential hypertension and 36.2+/-3.5mEq/kg in renal hypertension revealing no statistical significance in difference. In malignant hypertension, it was 44.9+/-2.0mEq/kg and it was markedly elevated than in normal controls. 2. Plasma volume in normal controls was 44.0+/-4.7ml/kg. In essential hypertension there was two groups, one (group II, 35.2+/-5.6ml/kg) was slightly lower than the other (group I, 43.2+/-4.8ml/kg). In malignant hypertension, it was 56.9+/-7.5ml/kg revealing significant increase than in normal controls. 3. Changes of the total exchangeable sodium content was observed after the administration of hydrochlorothiazide 50mg in normal controls and essential hypertension. In normal controls there was no statistical significance in reduction. In essential hypertension, initially low salt group (group II) showed no significant reduction and the other group (group I) showed significant reduction with depression on blood pressure. 4. Long term therapy with hydrochlorothiazide 50mg for 2~3 months in the group of hypertension who responded well with short term therapy (group I), the contents of exchangeable sodium reduced significantly than normal controls and the antihypertensive effect was sustained. 5. The reduction of plasma volume with hydrochlorothiazide in essential hypertension are similar as changes of total exchangeable sodium. 6. In cases of low salt diet 4gm of daily salt intake, there was similar results as diuretic therapy in exchangeable sodium. 7. In patients who responded well to antihypertensive effect of hydrochlorothiazide or low salt diet (group I), salt loading of 10gm daily showed an increase of total exchangeable sodium and an elevation of blood pressure with statistical significance.
Blood Pressure ; Depression ; Diet ; Evans Blue ; Humans ; Hydrochlorothiazide ; Hypertension* ; Hypertension, Malignant ; Hypertension, Renal ; Plasma Volume* ; Plasma* ; Sodium*

Total exchangeable sodium and plasma volume were measured to evaluate role of sodium in hypertension by radioisotope 24 Na and Evans blue in 25 patients with essential hypertension, 10 with malignant hypertension, 5 with renal hypertension and 15 normal controls. The results obtained are as follows. 1. The total exchangeable sodium content was 35.8+/-3.5mEq/kg in normal controls, 35.6+/-2.7mEq/kg in essential hypertension and 36.2+/-3.5mEq/kg in renal hypertension revealing no statistical significance in difference. In malignant hypertension, it was 44.9+/-2.0mEq/kg and it was markedly elevated than in normal controls. 2. Plasma volume in normal controls was 44.0+/-4.7ml/kg. In essential hypertension there was two groups, one (group II, 35.2+/-5.6ml/kg) was slightly lower than the other (group I, 43.2+/-4.8ml/kg). In malignant hypertension, it was 56.9+/-7.5ml/kg revealing significant increase than in normal controls. 3. Changes of the total exchangeable sodium content was observed after the administration of hydrochlorothiazide 50mg in normal controls and essential hypertension. In normal controls there was no statistical significance in reduction. In essential hypertension, initially low salt group (group II) showed no significant reduction and the other group (group I) showed significant reduction with depression on blood pressure. 4. Long term therapy with hydrochlorothiazide 50mg for 2~3 months in the group of hypertension who responded well with short term therapy (group I), the contents of exchangeable sodium reduced significantly than normal controls and the antihypertensive effect was sustained. 5. The reduction of plasma volume with hydrochlorothiazide in essential hypertension are similar as changes of total exchangeable sodium. 6. In cases of low salt diet 4gm of daily salt intake, there was similar results as diuretic therapy in exchangeable sodium. 7. In patients who responded well to antihypertensive effect of hydrochlorothiazide or low salt diet (group I), salt loading of 10gm daily showed an increase of total exchangeable sodium and an elevation of blood pressure with statistical significance.
Blood Pressure ; Depression ; Diet ; Evans Blue ; Humans ; Hydrochlorothiazide ; Hypertension* ; Hypertension, Malignant ; Hypertension, Renal ; Plasma Volume* ; Plasma* ; Sodium*

A 36-year old man with neck pain developed an acute cervical prevertebral hematoma after acupuncture therapy at an oriental medicine hospital. MR imaging demonstrated a fluid collection, and this suggested a diagnosis of retropharyngeal hematoma, and the patient was managed conservatively. We report here on a case of a retropharyngeal hematoma following acupuncture therapy and we review the relevant literature.
Acupuncture ; Acupuncture Therapy ; Hematoma ; Humans ; Medicine, East Asian Traditional ; Neck Pain

No abstract available.
Follow-Up Studies* ; Intermittent Urethral Catheterization*

Case histories of isolated and complete volar dislocation of the carpal scaphoid have rarely been reported .We report here another such case. On examination, the wrist was moderately swollen and tender over its volar aspect. Radiographs showed isolated, complete volar dislocation of the scaphoid. We used open reduction with K-wire fixation as treatment. After four weeks of operative reduction the patient had undertaken neurolysis due to median nerve compression symptom (carpal tunnel syndrome). At six weeks, the K-wires were removed and the patient was allowed to do a range of motion exercise. Twenty months after injury, the wrist was asymptomatic and had a mid-range of active motion without instability. There was no roentgenographic evidences of scapholunate dissociation or avascular necrosis
Dislocations* ; Humans ; Median Nerve ; Necrosis ; Range of Motion, Articular ; Wrist

Correction of funding statement.

Correction of funding statement.

Accelerated atherosclerosis is not only a frequent complication but also the most common cause of death in patients with chronic renal failure (CRF). Although mechanisms are unclear, disorder of lipid metabolism may be a major factor. Since apolipo-protein (apo) E is known to play a major regulatory role in lipid metabolism, we evaluated apo E genotype in 72 male patients with CRF and compared with that in 194 rnale normal controls. In addition, we measured plasma lipid and apolipoprotein concentrations and evaluated them according to apo E genotype in patients and controls. Apo E genotype was determined with the INNO-LiPA Apo E kit (Innogenetics, Belgium), which is based on reverse hybridization. The results are as follows ; 1) The distribution of the three major apo E alleles in patients with CRF ( e 2: 6.2%, e 3: 80.6%, e 4: 13.2%) was not different from that in controls ( e 2: 4.1%, e 3: 87.6%, e 4: 8.3%). 2) In patients with CRF, total cholesterol, lowdensity lipoprotein (LDL) and high-density lipoprotein (HDL) levels were significantly lower and the triglyceride and lipoprotein (a) levels were significantly higher than those in controls. 3) In controls, E 4/3 group had significantly lower levels of HDL than E 3/3 and E 3/2 groups. In patients with CRF, E 4/3 group had significantly higher levels of total cholesterol and apo B lipoprotein than E3/2 group. In conclusion, although there was no significant difference in the apo E genotype frequencies between male patients with CRF and controls, apo E polymorphism may play an important role in the determination of individual differences in plasma lipids in male patients with CRF.
Alleles ; Apolipoproteins B ; Apolipoproteins E ; Apolipoproteins* ; Atherosclerosis ; Cause of Death ; Cholesterol ; Genotype ; Humans ; Individuality ; Kidney Failure, Chronic* ; Lipid Metabolism ; Lipoprotein(a) ; Lipoproteins ; Male* ; Plasma* ; Triglycerides

There are 3 basic methods for surgical treatment of axillary osmidrosis; 1) method that removes only subcutaneous cellular tissue without removing skin 2) method that removes skin and subcutaneous cellular tissue en bloc, and 3) method that partially removes skin and subcutaneous cellular en bloc as well as removing the subcutaneous cellular tissue of the adjacent region. We studied the results of partial removal of the skin and subcutaneous cellular tissue en bloc, as well as the removal of subcutaneous cellular tissue of the adjacent region to compare the results of the bipedicled flap with the graft conversion method. There was no difference between two methods in results and complication rates. There are 3 advantage to this procedure. First, about 70-80% of apocrine glands were centrally distributed among the axillary hairbearing region therefore, resection of the central portion of axillary hair distribution area is important for good result. Second, the preservation of the subdermal plexus with careful excision of adjacent underlying subcutaneous tissue under the aid of the magnifying surgical loupe, is important for good wound healing. Third, the central excision of the axillary hair distribution area provides good exploration for undermining and defatting of the undersurface of the adjacent area, therefore it tooks a shorter operation time.
Apocrine Glands ; Hair ; Skin ; Subcutaneous Tissue ; Transplants ; Wound Healing

BACKGROUND: As an antihypertensive drug, Nifedipine, a calcium channel blocker was introduced recently, which also has antianginal effect. But due to the relatively short duration of action, another antihypertensive agents having longer duration of action and stronger hypertensive effect were under investigation. Nilvadipine, a new calcium channel blocker, was introduced to have more prologned duration of action and to act more specifically on vascular smooth muscle. So the efficacy and safety of oral Nilvadipine on essestial hypertension was investigated and represented by our institute. METHODS: In order to investigate the efficacy and safety of oral Nilvadipine, daily doses of 4mg twice a day were administered in 30 hypertensive patients whose states were compatible to the criteria : 1) severity of hypertension rated in Stage I and Stage II according to the classification by WHO, 2) ages ranging from 30 to 74 years regardless of sex, 3) blood pressure with 95mmHg or higher but less than 115mmHg in diastolic pressure which was the mean in a sitting position at the last two out of not less three consultations in the 2 week observation period, 4) outpatients with informed consent for 6 weeks. Blood pressure and heart rate were measured every 2 weeks. The complete with blood count with platelet, uronalysis and the electrocardiography were performed at the beginning period and the 6th weeks of therapy. And kinds of side effects were questioned by examining physicians. RESULTS: The following results were obtained : 1) Blood pressure fell significantly in 6 weeks of treatment with Nilvadipine(Mean pressure+/-S.D., 6.00mmHg vs 108.90+/-9.68mmHg p<0.05), 2) There was no significant change in EKG in 6 weeks of treatment with Nilvadipine, 3) Pulse rate was decreased in 6 weeks of treatment with Nilvadipine(80.14+/-11.90/min vs 75.39+/-6.47/min, p<0.05). 4) No significant chsange in body weight was observed(64.50+/-8.7kg vs 63.50+/-10.25kg, p<0.05). 5) There were no significant changes in blood chemistry including blood sugar, cholesterol, electrolytes, serum creatinine and alkaline phosphatase values, 6) Hematologic findings and urinalysis findings reamained unchanged, 7) Total 10 patients(33.30%) had various side effects;facial flushing 30.00%, palpitation 23.33%, headache 20.00%, nausea 10.00%, drowsiness 3.33%, heaviness 3.33% and indigestion 3.33%. But there was no serious side effect that requires to discontinue the medication of the test drug. And there was no need to reduce the dosage due to the side effect, 8) The antihypertensive effect was judged to decrease markedly in 76.70%, decrease 20.00%, unchange 3.30% and increase 0.00%, 9) The utility which was assessed with the data from the overall safety and antihypertensive effect, the drug was judged to be very useful in 60.00%, useful 33.30%, useless 6.67% and inhibited 0.00%. CONCLUSION: From the above results, Nilvadipine in doses of 4mg twice a day was effective and useful in most cases without severe side effects in essential hypertensive patients with diastolic blood pressure of 95 to 115mmHg.
Alkaline Phosphatase ; Antihypertensive Agents ; Blood Glucose ; Blood Platelets ; Blood Pressure ; Body Weight ; Calcium Channels ; Chemistry ; Cholesterol ; Classification ; Creatinine ; Dyspepsia ; Electrocardiography ; Electrolytes ; Flushing ; Headache ; Heart Rate ; Humans ; Hypertension* ; Informed Consent ; Muscle, Smooth, Vascular ; Nausea ; Nifedipine ; Outpatients ; Referral and Consultation ; Sleep Stages ; Urinalysis