No abstract available.
Arteriovenous Fistula ; Renal Dialysis

No abstract available.

No abstract available.

The antihypertensive effect and side reactions of perdipine was studied in 22 cases of essential hypertension using 20mg 3 times daily regimen for average period of 5 weeks. 1) Average reduction of 20mmHg in systolic and 17mmhg in diastolic pressure was observed and percentile reduction was 11.90% and 14.92%, respectively. The overall effect rate was 81.82%. The blood pressure lowered significantly after 2 weeks of treatment both in systolic and diastolic pressure. 2) There was no significant change in heart rates before and after treatment. 3) No specific side reaction was observed except 1 case in which discontinued the medication because of severe headache and fatigability on the 1st day of medication.
Blood Pressure ; Headache ; Heart Rate ; Hypertension ; Nicardipine*

We report a hybrid repair approach to the treatment of abdominal aortic aneurysm in patients with complex anatomies when typical endovascular aneurysm repair is limited due to juxtarenal involvement. A 63-year-old man presented with a 3-day history of fever and abdominal pain. He was diagnosed with acute cholecystitis along with incidental findings of two separate aneurysms of the abdominal aorta: a 3.7 cm saccular aneurysm at the suprarenal level, and a 6.6 cm fusiform aneurysm above the iliac bifurcation. He was treated with a hybrid technique involving an open approach for antegrade debranching of the superior mesenteric artery, and renal arteries and endovascular stent placement for treatment of an abdominal aortic aneurysm. The procedure was successfully completed with no adverse events as of the most recent 6-month outpatient follow-up.
Abdominal Pain ; Aneurysm* ; Aorta, Abdominal ; Aortic Aneurysm, Abdominal* ; Cholecystitis, Acute ; Fever ; Follow-Up Studies ; Humans ; Incidental Findings ; Mesenteric Artery, Superior ; Middle Aged ; Outpatients ; Renal Artery ; Stents

BACKGROUND AND OBJECTIVES: Studies in patients with mitral valve prolapse syndrome (MVPS) have shown the coexistence of various forms of autonomic dysfunction, and so this is an area that requires further investigation. METHODS AND MATERIALS: The study group consisted of 65 patients (36 men and 29 women), aged 16 to 43 years (mean+/-SD, 28+/-8) with symptomatic, echocardiographically proven mitral valve prolapse (MVPS) who were free of other organic heart diseases and arrhythmias. In a prospective study, heart rate variability (HRV) indexes were calculated from 24-hour Holter recordings obtained during normal daily activity and plasma norepinephine was measured, and then these data were compared among the study group according to clinic heart rate (HR). RESULTS: The study group was divided into below 60 bpm (group 1: n=13), 60 - 80 bpm (group 2: n=36) and over 80 bpm (group 3: n=16) on the basis of clinic HR. These patient groups were matched with respect to age and gender. There were significant difference in SDNNIDX, rMSSD and pNN50 between these groups (p=0.005, 0.009 and 0.002 respectively), and these HRV measures correlated inversely with clinic HR (p<0.01). As clinic HR increased, there was a tendency for plasma norepinephrine concentration to also rise (p<0.05), but there was no statistical significant difference between these groups. CONCLUSION: Our data suggests that MVPS may have subgroups of HRV, reflecting cardiac autonomic modulation, according to clinic HR.
Arrhythmias, Cardiac ; Heart Diseases ; Heart Rate* ; Heart* ; Humans ; Male ; Mitral Valve Prolapse* ; Mitral Valve* ; Norepinephrine ; Plasma ; Prospective Studies

No abstract available.
Axilla ; Syringoma

The medical educators in Korean are acutely aware of the need for the revision of the medical education programs in Korea which have many drawbacks. In planning for a new medical curriculum, we examined the problems of the traditional curricula of medical schools in Korea, followed by a review of the "integrated" curricula of other countries. Finally, we have chosen a program that we consider best adaptable to the medical schools in Korea. We believe that the objectives of the new medical curriculum should be to prepare the student to acquire sufficient knowledge, skills, and attitudes which on graduation will allow him to further pursue various specialities of medicine, including areas of basic medicine and a career as a medical scientist. Our approach to medical education in that of (a) integrated teaching, (b) medically and patient oriented, (c) problem-oriented, (d) student-centered, (e) identifying both the core and marginal material in course content and (f) encouraging and motivating for self-learning. The major portion of the program for the new curriculum includes eight weeks of introductory course followed by 52 for the body system courses, which run on an interdisciplinary basis between basic sciences and clinical disciplines during the first two years. The student will then enter the final two years of clerkship with various clinical rotations. We also propose the establishment of a learning center where most of the audio-visual materials used in the curriculum will be shelved. Finally, We propose the administrative structure of the medical programme which will allow the interdisciplinary approach to medical education.
Curriculum* ; Education, Medical ; Humans ; Korea ; Learning ; Schools, Medical

We report a case of congenital giant pigmented nevus with malignant melanoma of brain in a 14-year-old male patient. He had giant pigmented nevus on the back and neck, and multiple satellite lesions over the whole body since birth. One year prior to visit to our hospital, the patient suffered from various neurologie symptoms including headache, nausea, vomiting, seizure and right side motor weakness. Flistologic findings of skin lesions were benign nevocytic nevi. Computed tomogram of brain demonstrated increased densities in the both fronto-parietal leptameninges and brain parenchyme. Histologic findings of brain parenchyme by stereotaxic long needle biopsy showed the infiltration of melanin containing atypical melanocytes. There was no evidence of malignant melanoma at other organs. All of these findings suggested that origin of malignant melanoma of brain parenchyme was leptomeninges rather than skin.
Adolescent ; Biopsy, Needle ; Brain* ; Headache ; Humans ; Male ; Melanins ; Melanocytes ; Melanoma* ; Nausea ; Neck ; Nevus ; Nevus, Pigmented* ; Parturition ; Seizures ; Skin ; Vomiting

BACKGROUND: Lung carcinogenesis is a multistage process involving alterations in multiple genes and diverse pathway. Mutational activation of oncogenes and inactivation of tumor suppressor genes, and subsequent increased genetic instability are the major genetic events. The p53 gene and FHIT gene as tumor suppressor genes contribute to the pathogenesis of lung cancer, evidenced by mutation, microsatellite instability(MI) and loss of heterozygosity(LOH). METHODS: We analysed genetic mutations of p53 and FHIT gene in 29 surgical specimens of nonsmall cell lung cancer using PCR-single strand conformation polymorphism, DNA sequencing and RT-PCR. MI and LOH were analyzed in loci of D3S1285, D9S171, and TP53. RESULTS: In 2 cases, point mutation of p53 gene was observed on exon 5. MI of 3 times and LOH of 14 times were observed in at least one locus. In terms of the location on microsatellite, D3S1285 as a marker of FHIT was observed in 5 cases out of 26 specimens;D9S171 as a marker of p16 in 5 out of 17;and TP53 as a marker of p53 in 7 out of 27. In view of histologic type, squamous cell carcinoma presented higher frequency of microsatellite alteration, compared to others. Mutation of FHIT gene was observed in 11 cases and 6 cases of those were point mutation as a silent substitution on exon 8. FHIT mRNA expression exhibited deletion on exon 6 to 9 in 4 cases among 15 specimens, presenting beta-actin normally. CONCLUSION: Our results show comparable frequency of genetic alteration in nonsmall cell lung cancer to previous studies of Western countries. Microsatellite analysis might have a role as a tumor marker especially in squamous cell carcinoma. Understanding molecular abnormalities involved in the pathogenesis could potentially lead to prevention, earlier diagnosis and the development of novel investigational approaches to the treatment of lung cancer.
Actins ; Carcinogenesis ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Diagnosis ; Exons ; Genes, p53 ; Genes, Tumor Suppressor* ; Loss of Heterozygosity ; Lung ; Lung Neoplasms ; Microsatellite Instability ; Microsatellite Repeats* ; Oncogenes ; Point Mutation ; RNA, Messenger ; Sequence Analysis, DNA