The effect of Atenolol on the blood pressure were studied in 31 cases of essential hypertension and on the effect of plasma renin activity in 8 cases. There were 8 cases of male with age 49.5(42-70) and 23 cases of female with age 49(35-71) years. 27 cases of 31 cases were untreated hypertensive patients and 4 cases were refractory to hypotensive drugs of diuretics and vasodilators. The Atenolol 50mg once-daily was given to all patients orally for 3 weeks. The blood pressure, heart rate, ECG and symptoms were checked in one week interval. In 8 cases, the plasma renin activity was measured by Dainabot Kit before and after one week medication. The results were as follows: 1. In 27 cases of untreated hypertension, the control blood pressure was 182.9/11.4mmHg in average. The blood pressure decreased in average by 18.3/11mmHg in one week, 23.7/15.9mmHg in two week and 21.5/10.5mmHg in three week. The heart rate also decreased by 7.4/min. in one week, 14.9/min. in two week and 7.8/min. in three week. These data showed considerable reduction of blood pressure and heart rate with 50mg Atenolol once-daily. 2. The basal plasma renin activity after one week medication was reduced by 46% in 8 cases and this data showed considerable reduction regardless control level of basal plasma renin activity. 3. There were considerable blood pressure reduction by adding Atenolol 50mg once-daily to diuretics and vasodilator to which patient's blood pressures were refractory. 4. There was no orthostatic hypotension or serious side effect by Atenolol medication.
Atenolol ; Blood Pressure* ; Diuretics ; Electrocardiography ; Female ; Heart Rate ; Humans ; Hypertension* ; Hypotension, Orthostatic ; Male ; Plasma* ; Renin* ; Vasodilator Agents

Aggressive angiomyxoma (AAM) is a rare, benign tumor. It usually involves the connective tissue of the perineal regions in women of reproductive age. In this report, we present a case of AAM in a 66-year-old female, which presented itself as a retrovesical tumor on pelvic magnetic resonance imaging and caused lower urinary tract symptoms. The tumor was resected en bloc and the patient's voiding symptoms disappeared.
Aged ; Connective Tissue ; Female ; Humans ; Lower Urinary Tract Symptoms ; Magnetic Resonance Imaging ; Myxoma ; Pelvic Neoplasms

No abstract available.
Aneurysm* ; Hydrocephalus* ; Hypothalamus* ; Subarachnoid Hemorrhage*

Combined hepatocellular carcinoma and cholangiocarcinoma is found at a frequency of 1.0~6.3% in resected primary hepatic tumors. However, the case of double cancers of hepatocellular carcinoma and cholangiocarcinoma that are discovered synchronously in different lobes of a liver is very rare. We experienced a case of a 74-year-old man who was found to have hepatocellular carcinoma and cholangiocarcinoma in different lobes of the liver, which were accompanied by early gastric cancer. To our knowledge, this is the first case report of double primary hepatic cancers accompanied with early gastric cancer. The pathogenesis and previous related reports of these lesions are discussed.
Adenocarcinoma/diagnosis ; Aged ; Bile Duct Neoplasms/diagnosis ; Bile Ducts, Intrahepatic/pathology ; Carcinoma, Hepatocellular/diagnosis ; Cholangiocarcinoma/diagnosis ; Human ; Liver Neoplasms/*diagnosis ; Male ; Neoplasms, Multiple Primary/*diagnosis ; Stomach Neoplasms/*diagnosis

BACKGROUND: Use of one lung anesthesia for thoracic surgery may compromize PaO2. The aim of this study was to compare the shunt and oxygenation effects of the application of CPAP and CPAP/PEEP between right and left thoracic surgery under one lung anesthesia. METHODS: 10 patients for right thoracic surgery were selected as group 1, and 10 patients for left thoracic surgery were selected as group 2. Measurements in each group, were made during each of the following stage. First 30 minutes, One lung anesthesia alone with 50% oxygen (control value), next 30 minutes, CPAP 10 cmH2O to upper lung with 50% oxygen (CPAP), and then CPAP 10 cmH2O to upper lung and PEEP 10 cmH2O to down lung with 50% oxygen for 30 minutes (CPAP/PEEP). RESULTS: PaO2 in CPAP and CPAP/PEEP were significantly increased as compare to control value at both group (P<0.05). Shunt percentage in CPAP and CPAP/PEEP were significantly decreased as compare to control value at both group (P<0.05). But, no statistically significant differences were observed between right and left thoracic surgery group in the PaO2 and shunt percentage. CONCLUSIONS: We confirmed that CPAP and CPAP/PEEP during one lung ventilation is thought to be effective method in preventing hypoxemia, but no differences were observed between right and left thoracic surgery group.
Anesthesia ; Anoxia ; Humans ; Lung ; One-Lung Ventilation* ; Oxygen* ; Thoracic Surgery*

BACKGROUND: The intravenous infusion of sodium nitroprusside is widely used as a means of producing deliberate hypotension in a variety of clinical situations. However, sodium nitroprusside reported to inhibit platelet aggregation. So we studied the effects of sodium nitroprusside on platelet function in patients undergoing intracranial aneurysm surgery with isoflurane anesthesia. METHODS: Platelet rich plasma from the patients receiving sodium nitroprusside was studied for aggregation in response to adenosine diphosphate, epinephrine and collagen. Maximum aggregation rate and maximum aggregation time were evaluated from the samples collected at pre-sodium nitroprusside infusion, 30min and 90min after sodium nitroprusside infusion, respectively. At the same time, bleeding time was measured. RESULTS: The mean maximum aggregation rate of adenosine diphosphate, epinephrine and collagen at pre-sodium nitroprusside infusion decreased significantly 30min and 90min after sodium nitroprusside infusion, respectively(P<0.05). But the maximum aggregation time showed no significant change. Prolongation of bleeding time was not observed after sodium nitroprusside infusion. Correlation between the total sodium nitroprusside dose delivered and the maximum aggregation rate of adenosine diphosphate, epinephrine and collagen were significant (r=0.797(P<0.05), r=0.732 (P<0.05) and r=0.737(P<0.05)). CONCLUSIONS: In situation where sodium nitroprusside is administered for deliberate hypotensive anesthesia during intracranial aneurysm operation, the platelet aggregation was inhibited by sodium nitroprusside. However, bleeding time was not prolonged.
Adenosine Diphosphate ; Anesthesia* ; Anesthetics ; Bleeding Time ; Blood Platelets* ; Collagen ; Epinephrine ; Humans ; Hypotension ; Infusions, Intravenous ; Intracranial Aneurysm* ; Isoflurane* ; Nitroprusside* ; Platelet Aggregation* ; Platelet-Rich Plasma ; Sodium*

BACKGROUND: Since March 1, 1989, a new health care system has been introduced. But the departments of ENT, ophthalmology, dermatology and PMR (rehabilitation medicine) in tertiary health care hospitals were exempted from the new system and were allowed to see patients directly. Thereafter, the Ministry of Health revised the National Health Insurance regulation, and required the above departments to see patients only with referral. This study was done to analyze whether the revision has contributed to providing adequate specialized medical services and to know what role family physicians can assume under revision by analyzing the referred patients. METHODS: From November 1998 to June 2000 and from July 2000 to February 2002, both 20 months, we reviewed the charts of 331 patients who were referred from family medicine department of KHMC (Kyung Hee Medical Center) to the above four departments and analysis has done. RESULTS: During both periods, the number of cases increased from 94 to 237, and the patients group had no significant difference in age and sex. Reviewing the number of referred cases, before revision, cases were concentrated to the department of ENT and to PMR. After revision, cases were evenly distributed in three departments. except for PMR. Reviewing referral contents, the three departments except for dermatology showed no significant difference. CONCLUSION: The sum of cases increased by 2.5 times, but the three departments except for dermatology showed no significant difference in referral and diagnosis content. In dermatology, the majority of the patients wanted a referral with the objective of obtaining a referral paper. Therefore, we can consider that the revision didnot contribute to specialized medical services. But after revision, referral cases to ophthalmology and dermatology increased by 4 and 6 times. We recommend that family physicians know and experience more about these.
Delivery of Health Care* ; Dermatology ; Diagnosis ; Humans ; National Health Programs ; Ophthalmology ; Physicians, Family ; Referral and Consultation* ; Tertiary Care Centers*

We studied clinically 33 in patients(48 eyes) of windshield ocular injuries among 72 in patients who had ocular injuries by traffic accidents and underwent surgical treatment in Department of Ophthalmology of Han Gang Sacred Heart Hospital from 1. Jan, 1980 to 31. July, 1987. The results of analysis were as follows: 1. The incidence of windshield ocular injuries was 45.8% of all the ocular injuries caused by traffic accident. 2. The incidence was more common in male(81.9%) and in the age of 4th decades(39.4%). 3. The incidence of bilateral ocular injuries was 45.3%. 4. The ocular injuries were more common in front right seats(54.5%) than driver's seats(45.5%). 5. Eyebll injuries occured in 77.1% and among them, corneoscleral laceration was most common. 6. There was no significant statiscal value of final visual acuity between laceration involvin the cornea only and laceration involving the cornea and anterior sclera. 7. Final V.A less than 0.1 was 43.7% and the most common cause of visual impairment was corneal opacity.
Accidents, Traffic ; Cornea ; Corneal Opacity ; Heart ; Humans ; Incidence ; Lacerations ; Ophthalmology ; Sclera ; Vision Disorders ; Visual Acuity

PURPOSE: The prognostic factors influencing the survival rate of patients with localized renal cell carcinomas were evaluated. MATERIALS AND METHODS: The records of 100 patients that had undergone a radical nephrectomy for renal cell carcinomas, and who were pathologically diagnosed with T1N0M0 and T2N0M0 carcinomas, between January 1990 and January 2002, were reviewed. The survival rate according to each prognostic factor, such as T1 or T2 stage, nuclear grade, histologic type, microscopic vascular invasion, the expression of p53 protein and the expression of Human Erythrocyte Glucose Transporter (Glut-1), was analyzed by the Kaplan-Meier method. RESULTS: Among the 100 patients, metastases occurred in 11 and death in 10. The 5-year survival rates of the T1 and 2 were 84 and 89%, respectively. According to the Fuhrman grade, the 5-year survival rates for grades I, II, III and IV were 100, 87, 84 and 64%, respectively. According to the histologic type, the 5-year survival rates for the conventional type, papillary type and chromophobe type were 84, 100 and 88%, respectively. There was no significant difference in the survival rate between the groups, according to the stage, Fuhrman grade and histologic type (p>0.05). No statistical differences were noted between the two groups for microscopic vascular invasion, the expression of p53 protein and the expression of Glut-1 (p>0.05). CONCLUSIONS: Localized renal cell carcinomas treated by a radical nephrectomy had a good prognosis (5-year survival rate: 85%). Fuhrman nuclear grade IV and microscopic vascular invasion tended to have poor prognoses.
Carcinoma, Renal Cell* ; Glucose Transporter Type 1 ; Humans ; Neoplasm Metastasis ; Nephrectomy ; Prognosis ; Survival Rate*

OBJECTIVES: We carried out tests for neurobehavior by using WHO-NCTB (neurobehavioral core test battery) and Perdue pegboard score test to identify differences between lacunar infarction cases and controls. METHODS: Among the subjects who underwent MRI between February 2001 and March 2002 in a university hospital located in Seoul and who were diagnosed only as lacunar infarction without any intracranial disease, 46 patients were selected as cases (male: 21, female: 25). Controls were selected who had no cerebrovascular disease on MRI by matching age (5 years), gender, and education (2 years) in a ratio of 1: 1. Among WHO-NCTB, the following 5 tests and Perdue pegboard score test were used to categorize the study subjects: digit and symbol matching, simple reaction time, Benton visual retention, digit span, and Pursuit aiming test. RESULTS: Among the above 6 tests of neurobehavior, lacunar infarction cases showed lower score than controls except for the simple reaction time test. As the controlling variables of multivariate analysis in the stepwise regression analysis, the followings were selected due to their significant association: age, education, BMI, gender, drinking, exercise, and systolic blood pressure. From multivariate regression analysis, there was significant difference (p< 0.05) between lacunar infarction cases and controls in digit and symbol matching, Benton visual retention, digit span, pursuit aiming, and Perdue pegboard score test, but not in the score of simple reaction time test. CONCLUSIONS: We suggest that the above 5 tests for neurobehavior, with the exception of the simple reaction time test, might be used as the basis for recommendation of further treatment and other neurological tests by the earlier detection for neurological abnormality in lacunar infarction.
Blood Pressure ; Case-Control Studies* ; Cerebrovascular Disorders ; Drinking ; Education ; Female ; Humans ; Magnetic Resonance Imaging ; Multivariate Analysis ; Reaction Time ; Seoul ; Stroke, Lacunar*