No abstract available.
Primary Health Care*

No abstract available.

No abstract available.

No abstract available.
Rehabilitation*

No abstract available.
Humans ; Nitric Oxide* ; Tissue Donors*

We measure left ventricular mass, mitral peak flow velocity and isovolumic relaxation time(IVRT) with M-mode and Doppler echocardiography to evaluate daistolic function of the heart in hypertensive patients, who are seperated into group A(18 patients) with normal electrocardiogram and group B(24 patients) with abnormal electrocardiogram. There is no difference in fractional shortening, which reflects systolic function of the heart,between normal subjects and both groups of patients(36.5+/-6.7% in group B).The left ventricular mass index in group A is higher than in normal subjects(139.8+/-33.6g/m2, 100.2+/-28.8g/m2, respectively, p<0.005). But, that is lower than group B(200.7+/-40.6g/m2, p<0.005). The sensitivity and specificity of electrocardiograohy to detect left ventricular hypertrophy in patient whose left ventricualr mass index is above 160.8g/m2, are 80% and 91%, respectively. The peak flow velocities in early diastolic(PFVE) are 0.67+/-0.15m/sec in normal subjects and 0.60+0.14m/sec in group A (p=not siginificant). In group B, that is lower than normal subjects(0.54+/-0.15m/sec, p<0.005). In both groups, the peak flow velocities in late diastole(PFVA) are higher than normal subjects(0.48+/-0.11m/sec in normal, 0.69+/-0.18m/sec in groups A, 0.71+/-0.16m/sec in group B, p<0.005). The PFVE/PFVA ratio is lower in both groups of patients(1.40+/-0.23 in normal subjects, 0.90+/-0.25 in group A, 0.77+/-0.23 in group B, p<0.005). The IVRT is also prolonged in both groups(85+/-10m/sec in normal, 112+/-16msec in group A, 123+/-23msec in group B, p<0.005). The PFVE/PFVA ratio decreases in relation with the increament of index of IVRT(r=0.60, p<0.01). The IVRT increases in relation to the left ventricular mass index in hypertensive patients(r=0.34, p<0.05), but, the PFVE/PFVA ratio reveals no relation to those. In cocclusion, the impairment of diastolic function develops before the systolic function or electrocardiogram show abnormalities in htpertensive patients.Therefore, it is importment to detect early any abnormalities in the indices of the diastolic function, such as mitral peak flow velocity and isovolumic relaxation time, in the prevention and treatment of hypertensive geart disease.
Echocardiography, Doppler ; Electrocardiography ; Heart ; Humans ; Hypertension* ; Hypertrophy, Left Ventricular ; Relaxation ; Sensitivity and Specificity

PURPOSE: A retroperitoneoscopic adrenalectomy is theoretically the ideal procedure for an adrenalectomy. However, it is not popular due to its technical difficulty. Herein, we report our experience with retroperitoneoscopic adrenalectomies and describe the difficulties encountered during the operations. METHODS: From November 1996 to October 1999, a total of 41 retroperitoneoscopic adrenalectomies were performed. Forty (40) patients had a unilateral adrenal tumor (size: 1-6 cm): 21 aldosteronomas, 12 Cushing adenomas, 3 neurogenic tumors, 2 nonfunctioning adenomas, 1 vascular cyst, and 1 angiomyolipoma of the kidney. One (1) had bilateral hyperplasia. The operations were carried out in prone position in all cases with 3 trochars. RESULTS: Thirty five (35) operations were completed endoscopically. Five were converted to open procedures, and one was converted to a transperitoneal laparoscopic approach. The causes of conversion were 1 severe subcutaneous emphysema, 2 technical difficulties, 1 bleeding, 1 partial nephrectomy, and 1 missing tumor. The average operating time for the complete endoscopic adrenalectomies was 183 minutes in the first 14 cases and 142 minutes in the next 21 cases. There was no operative morbidity or mortality. The average hospital stay was 4.3 days in the first 14 cases and 2.8 days in the next 21cases. CONCLUSION: A retroperitoneoscopic adrenalectomy is a less invasive procedure than any other adrenalectomy procedure, and its only disadvantage is technical difficulty. However, the technical difficulty can be overcome with increasing experience.
Adenoma ; Adrenalectomy* ; Angiomyolipoma ; Hemorrhage ; Humans ; Hyperplasia ; Kidney ; Length of Stay ; Mortality ; Nephrectomy ; Prone Position ; Subcutaneous Emphysema

No abstract available.

RePUVA therapy is the combination of an oral aromatic retinoid(etretinate) with oral photochemotherapy (PUVA) for the treatment of psoriasis. This combination therapy has the advantage of faster clearance with fewer side effects. Twenty three ambulatory psoriasis patients received RePUVA treatment. Etretinate was administered in a dosage of approxirnately 0.75 mg/kg body weight for 2 weeks and discontinued. One week after discontinuance of etretinate, PUVA therapy was begun. Complete clearance occured in 96% of the patients with an average of 9.5+4 irradiations and an accumulated ultraviolet A (UVA) dose of 67.5+42 J/cm. The primary side effects were dry rnucous membranes and mild cheilitis. Laboratory findings revealed no significant abnormalities before or after etretinate treatment.
Acitretin* ; Body Weight ; Cheilitis ; Etretinate* ; Humans ; Membranes ; Photochemotherapy* ; Psoriasis* ; PUVA Therapy

The clinical, gross, light microscopic and immunohistochemical findings of three cases of blue nevus of the uterine endocervix were described. All three cases were incidentally found in hysterectomy specimens from middle-aged women, 45 to 48 years of age. The lesions were small and measured 1 to 4 mm in the greatest diameter. The presence of elongated, somewhat wavy and dendritic melanin-containing cells, in clusters or scattered deep in the subepithelial stroma and between the endocervical glands, was the distinct feature. The cytoplasmic granules appeared black with Grimelius and Fontana-Masson stains. The cells showed strong positive reaction with S-100 protein in perinuclear cytoplasm, in addition to the diffusely dispersed melanin granules. The demonstration of S-100 protein in the blue nevus, along with the histochemical findings, supports combined melanocytic and schwannian differentiation of the blue nevus cells.
Female ; Humans