Since the Plasma-Renin Activity (PRA) value varies by many factors such as amount of sodium in-take, diuretics and posture, the basal PRA with double stimulated PRA measurement is most widely used. However the method of the study is different according to investigators and especially the PRA study in out-patient is not easy. Author attempted to establish an easy and reliable method of PRA study in out-patient and their data were compaired with those of in-patient by the study of 38 normal cases in 207 hypertensive patients. Twenty four hours urine and overnight urine sodium measurement showed that the overnight urine sodium was about 45% of that of twenty four hour urine. More than 70mEq of overnight urine sodium is considered to be borderline to neglect sodium intake for study. The PRA of normal adult was measured at 30 minutes and one hour rest in supine or sitting position after arrival to hospital. There were minor increase of PRA after 30 minutes and one hour rest than basal PRA which will not confuse the evaluation of PRA. After Lasix 40mg and 20mg intravenous injection with walking respectively, the PRA changes were measured in 30 minutes, 1, 2, and 3 hours in normal adult. The results appeared that Lasix 20mg intravenous injection and 1 hour walking double stimulation is suitable method of PRA stimulation test in out-patient clinic. The Lasix 40mg I.V. and 2 hour walking stimulation test is considered to be suitable method of PRA stimulation test in ward patient. With above study, the following method of PRA study in out-patient clinic is recommended; 1) Overnight fasting and overnight urine collection for urinary sodium measurement 2) Patient should visit hospital in fasting state and take rest for 30 minutes in supine or sitting position and thereafter take blood sample about 5-10ml as out-patient basal PRA. Inject Lasix 20mg intravenously and walk for 1 hour and take blood sample again as double stimulation test. As double stimulation test of PRA for in-patient, Lasix 40mg l.V. and 2 hours walking is recommended. By using above method, the basal PRA in clinic in 16 young normal adults was 2.30+/-1.02(0.70-3.47)ng/ml/h sitting rest and 1.76+/-1.21(0.1-4.03)ng/ml/h in supine rest. In 47 non-hypertensive ward patients who will not have any abnormality in PRA, the 24 hour urinary sodium was average 221mEq and the basal PRA was and the basal PRA was 1.46+/-0.89(0.30-3.75)ng/ml/h. In outpatients with essential hypertension without complication, the average basal PRA was not different from that of normal adult. However male ward-patients with essential hypertension without complication had slightly higher average PRA than normal adult. The distribution of low(<0.56ng/ml/h) average(0.57-2.35ng/ml/h) and high(>2.36ng/ml/h) renin groups in essental hypertension showed higher incidence of high renin group in male ward-patients. But in out-patients with hypertension, the low renin group of patient was high. Relatively low normal value of PRA in this study may be due to high sodium in-take. The higher incidence of high PRA group in essential hypertension of in-patients may be due to the difference of hypertensive status between out-patient and in-patient.
Adult ; Diuretics ; Fasting ; Furosemide ; Humans ; Hypertension* ; Incidence ; Injections, Intravenous ; Inpatients* ; Male ; Outpatients* ; Plasma* ; Posture ; Reference Values ; Renin* ; Research Personnel ; Sodium ; Urine Specimen Collection ; Walking

BACKGROUND: In anemic patients, it has been usually traditional practice to correct the anemic state with preoperative blood transfusion. But now, there is an increasing tendency of refusing blood transfusion due to the transfusional complications, especially AIDS etc. The purpose of this study is to survey the effects of anesthesia in anemic patients with normal cardiopulmonary function compared to non-anemics. METHOD: 40 patients with uterine myoma were divided into two groups, an experimental group of 20 patients with hemoglobin concentration of 8~10 gm% and a control group of 20 patients with hemoglobin concentration higher than 10 gm%, and their blood pressure, pulse rate and arterial oxygen saturation were monitored and compared. RESULTS: There were no significant differences between two groups in blood pressure, pulse rate and arterial oxygen saturation. CONCLUSION: Preoperative blood transfusion, in patients with moderate anemia, does not seem to be a mandatory practice.
Anemia ; Anesthesia ; Blood Pressure ; Blood Transfusion* ; Heart Rate ; Humans ; Leiomyoma* ; Oxygen

Infrahepatic interruption of the inferior vena cava with azygos continuation is relatively infrequent cardiovascular developmental anomaly occurring both in association with congenital heart disease and as an isolated anomaly of no hemodynamic importance. During the past 5 years, we observed 38 cases of infrahepatic interruption of IVC with azygos continuation out of 2,397 cases of congenital heart disease catheterized at Yonsei Cardiovascular Center. We conducted the study with a view point of position of the heart and abdominal organs and segmental analysis of the underlying congenital heart disease. We also analysed the associated exracardiac vascular anomalies The following results wer obtained: 1) The incidence of this anomaly among congenital heart disease was 1.7% and the sex ratio 1.4:1. Twenty four cases(63.1%) was below 5 years of age and 30 cases (79.0%) had cyanosis. 2) We observed 21 cases (55.2%) with the malposition of the heart and 17 cases (44.8%) with malposition of the abdominal organs. The ventricular loops revealed D-loop in 25 cases, L-loop in 5 cases and in the remaining 7 cases, it was uncertain. Eighteen showed normally related great arteries and malposition was present in another 18 cases. 3) Associatcd cardiovascular anomalics wcre as follows: right-sidcd aortic arch: 12 cases, patentductus arteriosus: 10 cases, pulmonic stenosis: 19 cases and bilateral superior vena cava: 9 cases. In conclusion, the presence of this anomaly should alert one to seek the severeintracardiac anomalies which are usually associated with it. Also, it is essential that, if any patient with this anomaly should come to thoracotomy, the azygos vein be not sacrificed.
Aorta, Thoracic ; Arteries ; Azygos Vein ; Catheters ; Cyanosis ; Heart ; Heart Defects, Congenital* ; Hemodynamics ; Humans ; Incidence ; Pulmonary Valve Stenosis ; Sex Ratio ; Thoracotomy ; Vena Cava, Inferior ; Vena Cava, Superior

PURPOSE: It is agreed that tumor stage is the definitive prognostic indicator for patients with renal cell carcinoma. We investigated pathologic grade and cell subtype as another prognostic in each tumor stage. MATERIALS AND METHODS: We reviewed the medical records of 206 patients who underwent partial or radical nephrectomy for renal cell carcinoma between January 1991 and June 1998. Renal cell carcinoma grade, stage and cell subtype (conventional [clear cell], papillary, chromophobe, sarcomatoid type) were evaluated using the 1997 Union International Contre Ie cancer (UICC) and the American Joint Committee on Cancer (AJCC) grading, TNM staging criteria and renal cell carcinoma classification. Kaplan -Meier survival curves were used to determine 5-year survival for all patient groups. Univariate analysis using log rank test was performed to evaluate the prognostic significance of TNM stage, Fuhrman nuclear grade, cell subtype and tumor size. We investigated pathologic grade and cell subtype with log rank teat whether those were another significant prognostic factors in each tumor stage. Multivariate analysis was performed to determine which factors had an independent impact on survival of patients with renal cell carcinoma. RESULTS: Univariate analysis revealed that TNM stage (p<0.001), pathologic grad (p<0.001) were the important prognostic indicators for renal cell carcinoma. Survival was affected significantly by tumor size when cutoff diameter for localized T1 lesions was 7cm but not 2.5cm. Pathologic grade had a significant impact on patient survival (p<0.0001). In the cell subtype chromophobe type had the best survival and sarcomatoid type had the worst survival though cell subtype did not appear to affect survival significantly (p=0.0583). Multivariate analysis revealed that N classification (p=0.009) and M classification (p=0.018) were the most important prognostic indicators for cell subtype (p=0.841) were not shown to have any independent impact on patient survival. In the group of localized disease(TXN0M0 stage) at the diagnosis, cell subtype had a significant impact on survival in T1(p<0.001), T2(p=0.01) and T3(p=0.029) and grade in T1(p=0.0016) and T3(p=0.0054). CONCLUSIONS: Pathologic grade and cell subtype were significant predictors of survival in each T stage of localized disease though they didn't have independent impact on the patient survival.
Carcinoma, Renal Cell* ; Classification* ; Diagnosis ; Humans ; Joints ; Medical Records ; Multivariate Analysis ; Neoplasm Staging ; Nephrectomy

No abstract available.
Rhinoplasty*

Mullerian Mucinous papillary Cyatadenernas of Borderline tumor(MMBT) is lined by mucinous epithelium of endocervical type and is characterized by papillae architecturally similer to those of serous horderline tumors, It has been described rarely in the literature, Thia case was reported with a brief review of the concerened literatures. It has important clinical and pathological diBerences from mucinous birderline tumors with intestinal differentiation, but has many similatities to mixed epithelial borderline tumora of Mulierian type. Recently, a case of MMBT in a 22 years old woman was experienced at our department. We presented this case with a brief review of literature.
Cystadenoma, Papillary* ; Epithelium ; Female ; Humans ; Mucins* ; Young Adult

The present study investigated the prevalence rate of Cryptosporidium parvum as a cause of diarrhea. We examined 942 stools of unidentified reasons occurring in patients in whom no immunosuppression had been detected. We examined the stools for Cryptosporidium parvum via modified acid-fast staining. The clinical records of all of the positive patients were then analyzed. Nine (1%) of the stools among the 942 diarrheal patients were positive for C. parvum. The positive rate in the males was 1.1% (6/522) and the positive rate of the females was 0.7% (3/420). Age distribution revealed that the highest positive rates were in patients in their sixties, with a positive rate of 2.5% (4/158). In the clinical tests, levels of c-reactive protein, erythrocyte sedimentation rates, and neutrophil proportions were normally increased in the peripheral blood, whereas the lymphocyte proportion exhibited a tendency towards decrease. The pathological findings were compatible with an inflammatory reaction in the host.
Adult ; Aged ; Animals ; Child, Preschool ; Cryptosporidiosis/*epidemiology/immunology ; *Cryptosporidium/isolation & purification ; Cryptosporidium parvum/isolation & purification ; Diarrhea/*epidemiology/immunology/parasitology ; Feces/parasitology ; Female ; HIV Seronegativity ; Humans ; Immunocompetence ; Korea/epidemiology ; Lymphocyte Count ; Male ; Middle Aged ; Prevalence ; Research Support, Non-U.S. Gov't ; Staining and Labeling

Pityriasis rotunda is an uncommon chronic dermatosis characterized by multiple, round or oval, hyperpigmented or hypopigmented patches that have a fine scale on the trunk and extremities. Most of the cases reported predominantly occurred in Oriental and black patients in association with internal disease. However, in Caucasians it has been documented in healthy persons usually as a familial tendency. We report a case of pityriasis rotunda which showed familial occurrence and had no underlying disease.
Extremities ; Humans ; Pityriasis* ; Skin Diseases

No abstract available.
Biofeedback, Psychology* ; Electric Stimulation* ; Pelvic Floor* ; Urinary Incontinence*

No abstract available.
Carcinoma, Transitional Cell* ; Urinary Bladder*