BACKGROUND: To evaluate depressure effect and safety of delapril, a new ACE inhibitor, in Korea. METHOD: Thirty three patients, aged 37-69, with mild to moderate essential hypertension were first observed for 2 weeks with placebo followed by administration of 15mg of delapril twice daily for 2 weeks, then doubled dosage to 30mg b.i.d. and combined with 25mg of dihydrochlorothiazide if optimal BP were not obtained at the end of 4th week, continued the same dose until the end of 10 week's trial period. RESULT: BP dropped 15/9mmHg inaverage at the end of 10th week rewarding 70% of cumulative effectiveness. Most frequent side reaction was dry cough, occurred in 9% of patients followed by chest tightness, headache, constipation and transient elevation of GPT. CONCLUSION: Delapril 15-30mg twice daily as monotheraphy or combined with diuretics is well tolerated and effective in the treatment of mild to moderate essential hypertension.
Constipation ; Cough ; Diuretics ; Headache ; Humans ; Hydrochlorothiazide ; Hypertension* ; Korea ; Reward ; Thorax

The present study was performed in order to test the effects of diphenylhydantoin (DPH) and two central nervous system (CNS) stimulants, intermittent light stimulation(ILS) and pentylenetetrazol (Metrazol) on body temperature (Tb) during cold exposure in the bat DHP delayed the onset of entry into hibernation in both the oriental discoloured bats and the little brown bats and formed long and prominent plateaus that were not found in the normal and the controls. The responses of body temperature to the ILS were sensitive and the body temperature fell dramatically in the big brown bats. Metrazol effects on body temperature were obvious but; seemed dose-dependent. The experimental results further support the hypothesis that hibernation is an epileptic fit as suggested by serveral researchers.
Animal ; Body Temperature/drug effects ; Body Temperature Regulation ; Chiroptera/physiology* ; Female ; Hibernation* ; Light ; Male ; Pentylenetetrazole/pharmacology ; Phenytoin/pharmacology

Arytenoid subluxation or recurrent laryngeal nerve paralysis may result from injury to the larynx following endotracheal intubation or blunt laryngeal trauma. Early diagnosis is important for appropriate treatment and better prognosis. A 62-years-old man was admitted for cholecystectomy. He was intubated without any difficulty and nasogastric tube was inserted with the help of laryngoscope and Magill forcep before surgery. He had a weak voice and hoarseness after atraumatic extubation and those symptoms did not improve even 2 days after. Indirect laryngoscopy, videolaryngotelescopy, electromyography(EMG) and computed tomographic findings revealed anterior, inferior subluxation of left cricoarytenoid cartilage associated with left thyroarytenoid muscle denervation and resultant unilateral vocal cord palsy. Conservative treatment for 40 days after the operation and follow-up examination was done. The voice quality was improved and indirect laryngoscopy examination showed that right vocal cord crossed midline in a attempt to meet its paralyzed counterpart on phonation.
Anesthesia, General* ; Cartilage ; Cholecystectomy ; Denervation ; Early Diagnosis ; Follow-Up Studies ; Hoarseness ; Intubation, Intratracheal ; Laryngeal Muscles ; Laryngoscopes ; Laryngoscopy ; Larynx ; Paralysis* ; Phonation ; Prognosis ; Recurrent Laryngeal Nerve* ; Surgical Instruments ; Vocal Cord Paralysis ; Vocal Cords ; Voice ; Voice Quality

No abstract available.
Osteogenesis Imperfecta* ; Osteogenesis*

OBJECTIVE: Transpedicular screw fixation has some disadvantages such as postoperative back pain through wide muscle dissection, long operative time, and cephalad adjacent segmental degeneration (ASD). The purposes of this study are investigation and comparison of radiological and clinical results between interspinous fusion device (IFD) and pedicle screw. METHODS: From Jan. 2008 to Aug. 2009, 40 patients underwent spinal fusion with IFD combined with posterior lumbar interbody fusion (PLIF). In same study period, 36 patients underwent spinal fusion with pedicle screw fixation as control group. Dynamic lateral radiographs, visual analogue scale (VAS), and Korean version of the Oswestry disability index (K-ODI) scores were evaluated in both groups. RESULTS: The lumbar spine diseases in the IFD group were as followings; spinal stenosis in 26, degenerative spondylolisthesis in 12, and intervertebral disc herniation in 2. The mean follow up period was 14.24 months (range; 12 to 22 months) in the IFD group and 18.3 months (range; 12 to 28 months) in pedicle screw group. The mean VAS scores was preoperatively 7.16+/-2.1 and 8.03+/-2.3 in the IFD and pedicle screw groups, respectively, and improved postoperatively to 1.3+/-2.9 and 1.2+/-3.2 in 1-year follow ups (p<0.05). The K-ODI was decreased significantly in an equal amount in both groups one year postoperatively (p<0.05). The statistics revealed a higher incidence of ASD in pedicle screw group than the IFD group (p=0.029). CONCLUSION: Posterior IFD has several advantages over the pedicle screw fixation in terms of skin incision, muscle dissection and short operative time and less intraoperative estimated blood loss. The IFD with PLIF may be a favorable technique to replace the pedicle screw fixation in selective case.
Back Pain ; Follow-Up Studies ; Humans ; Incidence ; Intervertebral Disc ; Muscles ; Operative Time ; Skin ; Spinal Fusion ; Spinal Stenosis ; Spine ; Spondylolisthesis

Creutzfeldt-Jakob disease (CJD) is presumably caused by a slow infectious pathogen or prion. The principal clinical features of Creutzfeldt-Jakob disease are dementia, pyramidal and extrapyramidal symptoms and signs, cerebellar dysfunction, and myoclonus. The patient rapidly deteriorates, declines to a vegetative state, becomes comatous, and is ultimately dead within several months. The authors present a case of Creutzfeldt-Jakob disease, proved by clinical findings, typical serial EEG, and pathologic features.
Creutzfeldt-Jakob Syndrome/*diagnosis/pathology/radiography ; Electroencephalography ; Female ; Humans ; Middle Aged ; Tomography, X-Ray Computed

A case changing blood pressure severely by manipulation of the huge tumor mass during the brain tumor surgery was observed. Decreased blood pressure (55/35 mmHg) might be caused by the stimulation of the brain increased to 150/75 mmHg after a neurosurgeon undermined and elevated the tomor mass, and blood pressure decreased again to 55/35 mmHg when he put it on the same position. Removing the mass completely, blood pressure was stabilized (about 130/70 mmHg). There are central vasomotor centers of autonomic nervous organization in the hypothalamus, midbrain, pons or medulla oblongata of the brain. By the stimulation of specific region in the above area, various features of responses were anatomically defined. The supratentorial contents may herniate through the tentorial incisura into the infratentorial spaces and posterior fossa, when intracranial pressure gradients become large enough to overcome the resistance of the brain tissue, and they can affect vital changes.
Blood Pressure* ; Brain Neoplasms* ; Brain* ; Hypothalamus ; Intracranial Pressure ; Medulla Oblongata ; Mesencephalon ; Pons

PURPOSE: The purpose of this study is to compare and analyze the results of primary and secondary patency rates and limb salvage rates in DM (Diabetes Mellitus) and Non-DM patients with atherosclerosis in the lower extremity after arterial reconstruction. METHODS: A retrospective study was done by reviewing admission notes and follow up records of 95 atherosclerotic limbs which had infrainguinal arterial reconstruction due to claudication induced severe impediment and limb threatening ischemia (reat pain, minor and major tissue loss). Kaplan-Meier survival analysis was used in the comparison of the primary, secondary patency rates and limb salvage rates, and statistical examination was handled by the Log-Rank significance test. RESULTS: 1 and 3 year primary patency rates were 76.0% and 65.6% each in the DM group and 63.9% and 56.5% each in the Non-DM group. 1 and 3 year secondary patency rates were 80.0% and 69.7% in DM patients and 81.1%, 73.9% each in Non-DM patients. The 1 and 3 year limb salvage rates of DM patients were 83.8% and 72.6% while Non-DM patients revealed a 84.9% and 77.8%. CONCLUSION: Aggressive arterial reconstruction is recommended as well, in DM patients with atherosclerosis in the lower extremity, considering the insignificant differences in the risk of surgery as well as the primary, secondary patency rates and limb salvage rates.
Atherosclerosis ; Extremities* ; Follow-Up Studies ; Humans ; Ischemia ; Limb Salvage* ; Lower Extremity ; Retrospective Studies ; Transplants*

Sarcoidosis is a systemic granulomatous disease of unknown origin that may affect multiple organs including the lung, mediastinal and peripheral lymph nodes, eyes, and skin. Although cutaneous manifestations occur in around 25% cases, to our knowledge, oral mucosal involvement is very rare as a leading symptom of sarcoidosis. A 28-year-old female presented with localized skin-colored to yellowish indurated papules and plaques on the lower lip mucosa. The lesions were presented for the past month and it progressively enlarged. Histopathologic examination revealed multiple, variable sized, well circumscribed, non-caseating granulomas in the dermis. Serum level of angiotensin converting enzyme was slightly elevated (63.0 U/L) and chest CT revealed bilateral hilar lymphadenopathies. Herein, we report an oral mucosal sarcoidosis, as an initial presentation of the systemic sarcoidosis.
Adult ; Dermis ; Eye ; Female ; Granuloma ; Humans ; Lip ; Lung ; Lymph Nodes ; Mouth Mucosa ; Mucous Membrane ; Peptidyl-Dipeptidase A ; Sarcoidosis ; Skin ; Thorax

The modulation of leukocyte cell surface adhesion molecules may influence the development of cellular events that determine the course of the inflammatory process. Direct interaction between activated T cells and monocytes resulted in a large production of IL-1beta by monocytes. In this reactions, adhesion molecules play an important part, yet the role of them in T-monocytes interaction remain unclear. This study was undertaken in an effort to elucidate, 1) the influence of 1.25(OH)2D3-induced differentiation on the monocyte responsiveness to direct contact with T lymphocytes, and 2) the role of adhesion molecules on the T-monocyte direct interaction. Initially, I observed that direct contact of monocyte cell line THP-1 with stimulated fixed T cell line HuT78 markedly induces IL-1beta production by THP-1. IL-1beta production was higher when THP-1 had been previously exposed to 1.25(OH)2D3 as compared to control, with alpha-1.25(OH)2D3 dose-dependent and exposure time-dependent manner. It was shown that 1.25(OH)2D3 also increased the expression of beta2 integrin adhesion receptor Mac-1(CD11b/CD18) dose- and time- dependently, but did not increase the expression of human leukocyte antigen-D(HLA-D) and intercellular adhesion molecule-1(ICAM-1). The IL-1beta producing activity of THP-1 cells correlated well with the ability to induce the Mac-1 expression on THP-1 surface. Monoclonal antibody raised against relevant cell surface glycoproteins on THP-1 were tested for their ability to block the response of THP-1 to T cells. Antibody to Mac-1 only partially blocked IL-1beta production by THP-1, whereas antibodies to ICAM-1 and HLA-D did not. These data indicate that regulation of Mac-1 expression on THP-1 cells can alter the responsiveness of these cells to contact by activated T cells, however other unknown structures on the THP-1 cells may be involved in this process also.
Antibodies ; Antigens, CD18* ; Cell Line ; HLA-D Antigens ; Humans ; Intercellular Adhesion Molecule-1 ; Leukocytes ; Membrane Glycoproteins ; Monocytes* ; T-Lymphocytes*