No abstract available.
Magnetic Resonance Imaging* ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Hemolytic-Uremic Syndrome* ; Postpartum Period*

Angiosarcomas are rare tumors that are derived from vascular endothelial cells. They may occur in various sites, including the skin, breast, visceral organs and deep soft tissues. The pleura usually a metastatic site from angiosarcomas. However, thirty one cases of primary pleural angiosarcomas have been reported worldwide. Here, we report a 61-year-old man with a primary angiosarcoma of the pleura with a brief review of the literature.
Breast ; Endothelial Cells ; Hemangiosarcoma* ; Humans ; Middle Aged ; Pleura* ; Skin

No abstract available.
Endometrial Neoplasms* ; Female ; Humans

BACKGROUND: The cause of blood pressure (BP) variation is difficult to identify because genes and environment interact to produce the BP phenotype. Different genetic background and culture in a population make different gene frequency and environment for hypertension. Therefore, we studied the determinants of BP with reference to genes, metabolic factors and environmental factors in Korean population. METHODS: A study was carried out in two hundred fifty- eight patients (mean age 49, females 74%) with newly detected hypertension. Twenty-four hour ambulatory blood pressure monitoring (Accutracter II, Suntecr) was performed as an index of the magnitude of BP. The contributory factors studied were angiotensin-converting enzyme (ACE), angiotensinogen (AGT ; T174M and M235T) gene as a genetic factor, alcohol and smoking habitus, exercise, sodium intake as an environmental factor, and body mass index (BMI), insulin, lipid, renin, and aldosterone as a intermediate phenotype. RESULTS: 1) Genetic factors : There were no significant associations between ACE and AGT polymorphisms and the magnitude of BP. 2) Environmental factors : Alcohol and weight were significantly correlated with daytime systolic BP (r=.13, p=.04 and r=.15, p=.02), diastolic BP (r=.17, p=.01 and r=.12, p=.05), and nighttime diastolic BP (r=.15, p=.02 and r=.11, p=.01). Sodium intake, as assessed by fasting spot urine Na/K ratio in the morning, was not related to the magnitude of BP. 3) Intermediate phenotype : Plasma aldosterone level was significantly correlated to daytime diastolic BP (r=.16, p=.03), nighttime systolic BP (r=.17, p=.03), and nighttime diastolic BP (r=.16, p=.04). In women, plasma aldosterone was reversely correlated to urine Na/K ratio (r=-.42, p=.001). CONCLUSIONS: The magnitude of blood pressure in essential hypertension seems to be mainly determined by weight, alcohol intake, and plasma aldosterone level.
Aldosterone ; Angiotensinogen ; Blood Pressure Monitoring, Ambulatory ; Blood Pressure* ; Body Mass Index ; Fasting ; Female ; Gene Frequency ; Humans ; Hypertension* ; Insulin ; Phenotype ; Plasma ; Renin ; Smoke ; Smoking ; Sodium

BACKGROUND: After the World-Wide-Web(www) appeared, history has abruptly fallen in the new era of the Internet. In Korea, after the first medical internet site appeared, there was a major development in the WWW. But the quality and quantity of the web-page remains in infancy. Therefore, through the analysis of the Korean medical internet sites on present status, directions for development of Korean medical internet sites can be made. METHODS: From April 1st, 1999 to June 30th, 1999 in the Korean web sites, we visited 1044 sites. They included "Medmark Korea" representing medical search engine, "Eulji medical library" in the Eulji Medical College Hospital, and the medical sites of the "Yahoo Korea", "naver.com", and "simmani.com". Through this internet search, the information about locations, first publication year, classification by characteristics of homepage, speciality, web service form was obtained. Among these sites, acquireing from insufficient source further, questions were sent to the webmasters of 143 websites by e-mail. The questions included 7 items on the characteristic of webmasters, 8 items on the general characteristics of internet sites, 8 items on the contents, and their own comments. RESULTS: The occupation of webmasters was as follows: were physicians 94.4%, were male. According to age distribution, those in their thirties was 48.2%, and forties, 33.3%. Amone the 521 websites confirmed, there were 44 sites in 199 151 in 1996, 237 in 1997, and 79 in 1999. According to the distribution of location, metropolitan areas including Seoul, Inchon, Kyonggi occupied 68.9% among total. The main portion of the intentional visitors was ordinary people comprising 39.2%, members 9.8%, and physicians 7.7%. Concerning the purposes of publication, 38.7% of websites intended for health education to citizens, 31.0% for publicity of hospital or organizations, and 15.5% for exchange of information between members. For the most significant contents, 26.6% focused on the common-sense health issues, 35.7% on exchange of special medical information, 8.4% on education data for medical students, and 13.3% on publicity of hospitals. For the update interval, 22.0% renewed their sites within 1 week, 22.7% in 1 month, 23.4% in 3 months, and 20.6% in 6 months. For the effectiveness of homepage, the rate of `good' and `very good' response was 52.8%. CONCLUSION: Our investigation, showed that medical internet sites are lead by those in their thirties and forties. Web sites was concentrated to metropolitan areas where informational infrastructure was well developed. It is emphasized that efforts to informationalization by are needed by, governmental medical database systems should be established, and that the guidelines which enables validity of medical information should be set forth.
Age Distribution ; Classification ; Education ; Electronic Mail ; Gyeonggi-do ; Health Education ; Humans ; Incheon ; Internet* ; Korea* ; Male ; Occupations ; Publications ; Search Engine ; Seoul ; Students, Medical

No abstract available.
Intervertebral Disc*

A chylous ascites, especially drug-induced, is very rare complication in CAPD. The diagnostic criteria for the drug-induced chylous peritoneal dialysate include 1) turbid dialysate developed within Chrs after the administration of causative drug, 2) no clinical symptoms being suggestive of peritoneal inflammation, 3) the fluid containing normal leukocyte counts and being negative for bacterial and fungal culture, and 4) it disappeared spontaneously after the withdrawal of the assumed causative agent and never recurred thereafter. We report a case of chylous ascites emerging after use of manidipine, dihydropyridine calcium channel blocker, in a patient undergoing CAPD. The chylous ascites in that patient was improved after discontinuation of manidipine.
Calcium Channels ; Chylous Ascites* ; Humans ; Inflammation ; Leukocyte Count ; Peritoneal Dialysis, Continuous Ambulatory*

Despite improvements in dialysis care, the mortality of patients with end-stage renal disease(ESRD) remains high. One factor that has so far received little attention, but which might contribute to morbidity and mortality, is the timing of referral to the nephrologist. We performed a retrospective analysis in 358 patients(male 275, female 151) who were initiated renal replacement therapy first at this hospital from Jan 1995 to Dec 1996. Patients were defined by the time of first nephrology as early referral(E, n=163) encountered after more than 8 weeks; late early referral(LE, n=19) encountered between 8 weeks and 4 weeks; late referral(L, n=55) encountered from 1 week to 4 weeks; urgent referral(U, n= 121) encountered less than 1 week. There were no differences in age, gender, primary renal disease, cause of dialysis, and renal replacement therapy modalities. However, there were significant differences in rnean arterial pressure and serum phosphate levels between these 4 groups. The mean arterial pressures (mmHg) were 109.15 +/- 17.16, 105.37+/-18.76, 117.24 +/- 27.24 and 116.98+/-24.26 for E, LE, L and U, respectively(p<0.05, compared E to U). In the U group, serum phosphate levels were elevated at initiation of dialysis compared to the E group(6.39+/-1.72 vs 7.29 +/- 3.54mg/dL, p<0.05). One year mortality in the U group had on increased tendency compared to the E group, especially earlier mortality(7.4% vs 14.9N, p>0.05). In the E group, there was more controlled blood pressure and serum phosphate levels compared to the U group at initiation of renal replacement therapy, but other parameters were not significantly different among the 4 groups. Delays in initiation of renal replacement therapy may result in patients entering dialysis in a compromised state, therefore adequate long-term predialysis care by a nephrologist is important. Socioeconomic - and medical factors respon-sible for late referral and late initiation of dialysis need to be evaluated and corrected to further improve the outcome of these patients.
Arterial Pressure ; Blood Pressure ; Dialysis* ; Female ; Humans ; Mortality ; Nephrology ; Referral and Consultation* ; Renal Replacement Therapy ; Retrospective Studies

A 72-year-old diabetic male patient with high grade fever, right upper quadrant abdominal pain and Klebsiella pneumoniae septicemia is reported. He suffered from high fever and abdominal pain in spite of aspiration of liver abscess and antibiotic treatment. A few days later, we found a palpable pulsating abdominal mass on physical examination. Computed tomography and angiography revealed infected abdominal aortic aneurysm associated with pyogenic liver abscess. He was treated by antibiotics and Endovascular stent without surgical resection. He improved without complications and has been followed-up after discharge with excellent condition. To our knowledge, this is the first case of infected abdominal aortic aneurysm as a septic metastatic lesion secondary to liver abscess.
Abdominal Pain ; Aged ; Aneurysm, Infected ; Angiography ; Anti-Bacterial Agents ; Aortic Aneurysm, Abdominal* ; Fever ; Humans ; Klebsiella pneumoniae ; Liver Abscess* ; Liver Abscess, Pyogenic ; Liver* ; Male ; Physical Examination ; Sepsis ; Stents*