No abstract available.
Wound Healing* ; Wounds and Injuries*

OBJECTIVE AND METHODS: To determine correlations among ambulatory renin activity, ambulatory blood pressure and microalbumin excretion rate, 66 Korean essential hypertensives were studied after 4 week wash-out period. The ambulatory blood pressure was monitored every 30 minutes and mean BP were calculated automatically. Urinary microalbumin excretion rate(UAER) and ambulatory plasma renin activity(aPRA) collected at mid-day were measured by radioimmunoassays. Subjectives were divided into 2 groups by aPRA value(2ng/ml/hr). RESULT: 14 cases were high renin group and 52 cases low renin group. The mean BP were 148.83/94.69mmHg in low renin group, and 146.57/98.07mmHg in high-renin group without difference. UAER were not different also between both groups. 23.07%(4/14) of non-dippers were included in high renin group and 25.58%(12/52) in low renin group without statistical difference. The aPRA was significantly related to UAER and systolic and diastolic mean blood pressure. Also UAER was related significantly to day mean blood pressures. CONCLUSION: Thus aPRA is thought to be a meaningful indicator to predict hypertensive renal target organ damage as well as blood pressure measured with 24-hr ABPM.
Blood Pressure* ; Hypertension* ; Plasma* ; Radioimmunoassay ; Renin*

BACKGROUND: Total intravenous anesthesia(TIVA) with various kinds of sedatives and synthetic analgesics has many advantages such as no air pollution, no hepatic or renal toxicity and good postoperative pain relief compared with inhalation anesthesia. METHODS: TIVA with fentanyl and propofol was applied to the 25 patients in ASA class I and II. The changes of hemodynamics, arterial blood gas, blood sugar level, hepatorenal function and complications were evaluated perioperatively. RESULTS: Systolic blood pressure and mean arterial pressure decreased after induction, but intraoperatively systolic blood pressure became preoperative value while mean arterial pressure increased compared with preoperative value. Heart rate increased after induction and intraoperatively. At recovery room there were no clinically significant changes in the data of arterial blood gas. The blood sugar level slightly increased during postoperative period. There were no clinically significant changes in hepatic or renal function test of postoperative 3rd day compared with preoperative one. The chief complications of TIVA during anesthesia were pain on injection site and slight movement, while nausea or vomiting, dizziness and urinary retention were the major complications at postoperative period. CONCLUSIONS: TIVA with fentanyl and propofol is considered to have good controllability and it can be applied as one of the general anesthesia methods in the case of contraindications to N2O and volatile anesthetics, but further study will be required to quantify the appropriate dosage of propofol or fentanyl to minimize perioperative hemodynamic change and respiratory depression.
Air Pollution ; Analgesics ; Anesthesia ; Anesthesia, General ; Anesthesia, Inhalation ; Anesthesia, Intravenous* ; Anesthetics ; Arterial Pressure ; Blood Glucose ; Blood Pressure ; Dizziness ; Fentanyl* ; Heart Rate ; Hemodynamics ; Humans ; Hypnotics and Sedatives ; Nausea ; Pain, Postoperative ; Postoperative Period ; Propofol* ; Recovery Room ; Respiratory Insufficiency ; Urinary Retention ; Vomiting

Fine needle aspiration of the breast is an important diagnostic tool in malignant lesions, but is also useful in differentiation of inflammatory breast diseases mimicking carcinoma clinically and radiologically. Recently, the authors have experienced eight biopsy-proven cases of chronic inflammatory diseases of the breast, which consisted of 4 cases of duct ectasia, 2 cases of fat necrosis, and a case of tuberculous mastitis and granulomatous mastitis respectively, Their cytoiogic features mainly based on the components and the relative frequency of inflammatory cells were evaluated for differential diagnosis of chronic inflammatory breast diseases. The results are as follows ; 1. In cases of duct ectasia, varying amount of neutrophils, mononuclear leukocytes, histiocytes and multinucleated giant cells were intermixed with benign epithelial cell clusters. 2, Abundant fat tissue fragments were diagnostic for fat necrosis. Histiocytes and mononuclear cells were main components but not rich, and neutrophils and giant cells were infrequently observed. 3. Characteristic granulomas composed of epithelioid cells, mononuclear leukocytes and Langhans' type giant cells and lymphocytic infiltrates were conspicuous in tuberculous mastitis, and occasionally neutrophils, necrotic materials and epithelial cell clusters were found. 4. In granulomatous mastitis, epithelioid cell granulomas were also noted but numerous neutrophils and histiocytes were intermingled within or outside the granulomas.
Biopsy, Fine-Needle ; Breast ; Breast Diseases ; Child* ; Diagnosis, Differential ; Dilatation, Pathologic ; Epithelial Cells ; Epithelioid Cells ; Fat Necrosis ; Female ; Giant Cells ; Granuloma ; Granulomatous Mastitis ; Histiocytes ; Humans ; Leukocytes, Mononuclear ; Mastitis ; Mothers* ; Neutrophils ; Salivary Glands

In a six-year period(1988. 5-1994. 4), fine needle aspiration cytology(FNAC) of 322 pulmonary lesions from 296 patients were performed at Soonchunhyang University Hospital. Of these 322, malignancy was diagnosed cytologically in 139(43.2%), suspicious malignancy in 7(2.2%), negative in 164(50.8%), and insufficient material in 12(3.8%). Malignant lesions consisted of 54 cases of adenocarcinoma, 50 cases of squamous cell carcinoma, 18 cases of small cell carcinoma. They were verified by histologic examination in 70 cases. There were 2(0.6%) false positive cases due to florid bronchoalveolar hyperplasia and atypical bronchial epithelial cells associated with granulomatous lesion. The overall accuracy rate was 90%, the sensitivity 84.3% and the specificity 94.7%.
Adenocarcinoma ; Biopsy, Fine-Needle ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Child* ; Epithelial Cells ; Humans ; Hyperplasia ; Multicystic Dysplastic Kidney* ; Sensitivity and Specificity ; Tuberculosis, Pulmonary

Background: Robot-assisted laparoscopic radical prostatectomy is an advanced and popular surgical technique. However, increased intracranial pressure which is caused by CO2 pneumoperitoneum and Trendelenburg position is the main cerebrovascular effect. Measurement of optic nerve sheath diameter using ocular ultrasound is a noninvasive and reliable method for the assessment of intracranial pressure. The primary endpoint of this study was to identify whether low blood pressure regulation has any benefit in attenuating an increase of optic nerve sheath diameter during robot-assisted laparoscopic radical prostatectomy. Methods: Optic nerve sheath diameter and cerebral oxygen saturation were measured at baseline (supine position), one and two hours after pneumoperitoneum and Trendelenburg position respectively, and after return to supine position in normal (n = 27) and low blood pressure groups (n = 24). Results: Mean optic nerve sheath diameter values measured at one and two hours after pneumoperitoneum and Trendelenburg position were significantly increased compared to the baseline value (P < 0.001 in normal blood pressure group; P = 0.003 in low blood pressure group). However, the mean optic nerve sheath diameter and cerebral oxygen saturation measured at any of the time points as well as degrees of change between the two groups did not show any significant changes. The peak values of optic nerve sheath diameter in normal and low blood pressure groups demonstrated 14.9% and 9.2% increases, respectively. Conclusions Low blood pressure group demonstrated an effect in maintaining an increase of optic nerve sheath diameter less than 10% during CO2 pneumoperitoneum and Trendelenburg position.

OBJECTIVE: The concern about auditory verbal imagery has increased due to its possible relationship with auditory hallucinations. The research on auditory hallucinations was activated in accordance with the advance of neurophysiologic and functional neuroimaging studies, and the relationship between auditory verbal imagery and auditory hallucination was also investigated with neuroscientific methods. In particular, the group of neuropsychiatrists who insisted that auditory hallucination results from the abnormality of self monitoring systems has attempted to document the relationship between auditory verbal imagery and auditory hallucination using brain activation studies. Most auditory hallucinations are derogatory in content and accompany negative emotions. If auditory verbal imagery plays an important role in the pathogenesis of auditory hallucination, then it must be influenced by negative emotions. This study was aimed to examine the hypotheses that negative emotions have influence on cortical activity provoked by auditory verbal imagery and that the area which is influenced by negative emotions is where it is regarded to be related to either auditory hallucinations or self monitoring systems. METHOD: To examine these hypotheses, quantitative electroencephalography (Q-EEG) was applied during the auditory verbal imagery tasks using a two word list. The one word list accompanied negative emotion and the other accompanied neutral emotions, and they were suggested to the subject via computer monitor system. Total 18 right handed normal subjects(11 male subjects and 7 female subjects) were enrolled. RESULTS: The difference of EEG amplitude between during the baseline task and during auditory verbal imagery task using neutral word list: there were no significant difference in all electrode and all alpha, beta, theta, and delta frequency bands. The difference of EEG amplitude between during the baseline task and during auditory verbal imagery task using negative word list: In alpha frequency band, the EEG amplitude was increased in bilateral parietal, bilateral posterior temporal and bilateral occipital area. In beta frequency band, the EEG amplitude increased in bilateral parietal, bilateral occipital and left posterior temporal area. In theta frequency band, the EEG amplitude increased in TT2, T5, T6. In delta frequency band, there were no significant differences. The difference of EEG amplitude between during the two auditory verbal imagery tasks using negative word list and neutral word list: In alpha frequency band, there was an increasing trend in TT1 and a decreasing trend in frontal area including F4 during the negative auditory verbal imagery in EEG amplitude, although statistically not significant. In beta frequency band, EEG amplitude was increased in temporal area such as TCP1. In addition, there was an increasing trend in T5 in EEG amplitude, although statistically not significant. In theta frequency band, the EEG amplitude was decreased in the right hemisphere areas such as FP2, F4, C4, CP2, P4. In delta frequency band, there were no significant differences. CONCLUSION: In summarizing the above results, left temporal area was more activated during auditory verbal imagery using negative word list than using neutral word list. Left temporal area is known to play an important role in self monitoring systems and left temporal abnormality has been observed in schizophrenic patients in many studies. According to the above results, during auditory verbal imagery with negative emotion, more activation in left temporal area is necessary, but that may not achieved in schizophrenia patients. So, the possibility that the resultant disturbance of self monitoring system may be related to auditory hallucination is suggested in this study.
Brain ; Electrodes ; Electroencephalography ; Female ; Functional Neuroimaging ; Hallucinations ; Hand ; Humans ; Male ; Rabeprazole ; Schizophrenia

OBJECTIVES: This study was purposed to examine the changes of plasma homovanillic acid(HVA), 5-hydroxyindoleacetic acid(5-HIAA), and HVA/5-HIAA ratio during an 8-week risperidone trial and to investigate the relationship between the plasma monoamine metabolites and risperidone-induced treatment resposes. METHOD: Eighteen schizophrenic patients were treated for 8 weeks with risperidone. The psychopathology was assessed at baseline just before risperidone trial and then at 1st week, 2nd week, 4th week, and 8th week using the Positive and Negative Syndrome Scale(PANSS) and the Clinical Global Impression scale(CGI). The plasma HVA and 5-HIAA levels were measured using high performance liquid chromatography with electrochemical detection method. RESULTS: 39% of the patients treated with risperidone was categorized as responders, who showed at least a 20% decrease in PANSS total score at the end point of the study. At the end point of the 1st week, there was significant difference in the percent change of plasma HVA between responders(39% increment) and nonresponders(9% increment). But no significant differences in the percent change of plasma 5-HIAA and the percent change of plasma HVA/5-HIAA ratio between responders and nonresponders were observed. CONCLUSION: These results suggest that the magnitude of the early increase of plasma HVA may be associated with risperidone-induced treatment response in schizophrenia.
Chromatography, Liquid ; Homovanillic Acid* ; Humans ; Hydroxyindoleacetic Acid ; Plasma* ; Psychopathology ; Risperidone ; Schizophrenia*

BACKGROUND: Nationwide evaluation of physicians' smoking rate may be helpful to predict future trend of smoking in a general population. Thus, we investigated physicians' smoking rate and their habits in Korea. METHODS: Ten percent of physicians among the registered members of the Korean Medical Association were chosen by stratified random sampling and a mail questionnaire survey was conducted in 2000. Of the 2,977 physicians to whom the questionnaires were delivered, 1,248 (41.9%) responded. RESULTS: Overall smoking rate among Korean doctors was 29.9%. Smoking rate of males was 34.9% and that of females was 2.3%. In the current smokers, the most frequently reported age when they had begun smoking were 15~20 years (60.3%), the majority of daily smoking amount was less than or equal to 1 pack (92.5%), and those who were planning to quit smoking within 1 month were 11.9%. In the ex-smokers, the most frequently reported age when they had begun smoking were in their 20s (67.7%) and the most frequently reported age when they had stopped smoking were in their 30s (38.0%). CONCLUSION: The smoking rate of Korean physicians was estimated to be less than that of the general Korean population, but higher than that of physicians in major developed countries. More efforts to lower smoking rate of physicians and regular follow up is needed.
Developed Countries ; Female ; Humans ; Korea* ; Male ; Postal Service* ; Prevalence* ; Smoke* ; Smoking* ; Surveys and Questionnaires

OBJECTIVE: To evaluate the feasibility and effect of ultrasound-guided ethyl alcohol injection on malleolar and olecranon synovial proliferative bursitis. METHODS: Twenty-four patients received ultrasound-guided 50% diluted ethyl alcohol injection at the site of synovial proliferative bursitis after aspiration of the free fluid. RESULTS: Swelling and symptoms significantly decreased in 13 of the 24 patients without any complications. Eleven patients had partial improvement in swelling and symptoms. CONCLUSION: Ultrasound-guided alcohol injection could be an alternative therapeutic option before surgery in patients with chronic intractable malleolar and olecranon synovial proliferative bursitis.
Bursitis* ; Ethanol* ; Humans ; Olecranon Process* ; Pilot Projects* ; Prospective Studies* ; Synovial Membrane ; Ultrasonography