No abstract available.
Emergencies* ; Emergency Service, Hospital*

No abstract available.
Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction* ; Sputum*

In order to investigate the efficacy and safety of oral fosinopril, a new phosphorus containing angiotensin converting enzyme inhibitor, a single dose of 10 to 20mg was administered in 23 hypertensive patients with diastotic blood pressure above 95mmHg and all other anti-hypertensive agents were not administered during 4 weeks of study. Blood pressure and heart rate were measured on the 2nd and 4th week of therapy. The complete blood count with platelet count, blood chemistry by SMA-12 and serum electrolytes were performed at the begining and 4th week of therapy. The urinalysis and electrocardiography were performed at the beginning and 4th week of therapy. Any kinds of side effects were actively questioned by the examining physicians. The following results were obtained : 1) At the beginning and 4th weeks of therapy, the average systolic and diastolic pressure were 170.0+/-17.6/101.6+/-6.1mmHg, 142.7+/-15.1/87.3+/-6.7mmHg respectively. The systolic and diastolic blood pressure were declined statistically significantly(p<0.05) throughout the period of treatment and diastolic blood pressure of all subjects except 3 patients(86%) was maintained below 90mmHg after 4th week of treatment. 2) There was no significant change in the pulse rate before and after therapy. 3) There were no significant changes in blood chemistry, serum electrolytes, hematologic findings, urinalysis and electrocardiographic findigns. 4) side effect were developed in 5 patients(23%) with dry cough, 3 patients(13%) with headache and 2 patients with facial edema but side effects were mostly mild in nature without potenitally serious episodes. These results suggested that antihypertensive therapy with onec-daily fosinopril was effective and well tolerated in essential hypertensive patients.
Antihypertensive Agents ; Blood Cell Count ; Blood Pressure ; Chemistry ; Cough ; Edema ; Electrocardiography ; Electrolytes ; Fosinopril* ; Headache ; Heart Rate ; Humans ; Hypertension ; Peptidyl-Dipeptidase A ; Phosphorus ; Platelet Count ; Urinalysis

No abstract available.
Holoprosencephaly*

The authors report a case of Normal Volume Hydrocephalus with recuring ventricular catheter obstraction treated by bilateral subtemporal craniectomy. Subtemporal craniectomy provide temporary relief from increased intracranial pressure while the same time encouraging dilatation of ventricle, would protect against further catheter obstruction by prevent trapping of catheter tip between the abutting ventricular wall. The patient had been followed-up for 2 years and postoperative result was excellent.
Catheter Obstruction ; Catheters ; Decompression* ; Dilatation ; Humans ; Hydrocephalus* ; Intracranial Pressure

Background: There has been controversy regarding the association between primary aldosteronism (PA) and dyslipidemia and few studies considered the effects of diabetes and renal function on lipid metabolism. We analyzed lipid profiles of PA patients and compared them to propensity-score (PS)-matched essential hypertension (EH) patients adjusting for glycemic status and renal function. Methods: Patients who were diagnosed with PA using a saline-infusion test at Seoul National University Hospital from 2000 to 2018 were retrospectively analyzed. EH patients who had aldosterone-renin ratio (ARR) results were selected as controls. Covariates, including diabetes, were PS-matched for patients with PA, lateralized PA, non-lateralized PA, and high ARR to EH patients, respectively. Results: Among a total of 80 PA and 80 EH patients, total cholesterol (TC) and triglyceride (TG) levels were significantly lower in the PA patients than in the EH patients (least-squares mean±standard error: 185.5±4.4 mg/dL vs. 196.2±4.4 mg/dL, P=0.047, for TC; and 132.3±11.5 mg/dL vs. 157.4±11.4 mg/dL, P=0.035, for TG) in fully adjusted model (adjusting for multiple covariates, including diabetes status, glycosylated hemoglobin level, and estimated glomerular filtration rate). There were no significant differences in high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol levels between the two groups. According to increments in aldosterone levels, an increasing tendency of HDL-C and decreasing tendencies of TG and non-HDL-C were observed. Conclusion PA patients had lower TC and TG levels than EH patients, independent of glycemic status and renal function.

Background: There has been controversy regarding the association between primary aldosteronism (PA) and dyslipidemia and few studies considered the effects of diabetes and renal function on lipid metabolism. We analyzed lipid profiles of PA patients and compared them to propensity-score (PS)-matched essential hypertension (EH) patients adjusting for glycemic status and renal function. Methods: Patients who were diagnosed with PA using a saline-infusion test at Seoul National University Hospital from 2000 to 2018 were retrospectively analyzed. EH patients who had aldosterone-renin ratio (ARR) results were selected as controls. Covariates, including diabetes, were PS-matched for patients with PA, lateralized PA, non-lateralized PA, and high ARR to EH patients, respectively. Results: Among a total of 80 PA and 80 EH patients, total cholesterol (TC) and triglyceride (TG) levels were significantly lower in the PA patients than in the EH patients (least-squares mean±standard error: 185.5±4.4 mg/dL vs. 196.2±4.4 mg/dL, P=0.047, for TC; and 132.3±11.5 mg/dL vs. 157.4±11.4 mg/dL, P=0.035, for TG) in fully adjusted model (adjusting for multiple covariates, including diabetes status, glycosylated hemoglobin level, and estimated glomerular filtration rate). There were no significant differences in high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol levels between the two groups. According to increments in aldosterone levels, an increasing tendency of HDL-C and decreasing tendencies of TG and non-HDL-C were observed. Conclusion PA patients had lower TC and TG levels than EH patients, independent of glycemic status and renal function.

Lymphoceles are the most frequent surgical complications following kidney transplantation. Symptomatic lymphoceles following kidney transplantation are managed best by surgical marsupialization with intraperitoneal drainage. We performed laparoscopic intraperitoneal drainage in a patient with a large lymphocele and secondary hydronephrosis following a kidney transplant.
Drainage* ; Humans ; Hydronephrosis ; Kidney Transplantation ; Kidney* ; Laparoscopy ; Lymphocele* ; Transplantation

Dermal melanocytosis is histologically characterized by the presence of ectopic melanocytes in the dermis. Mongolian spots, nevus of Ota, nevus of Ito and blue nevus are the most common types and these are usually present at birth or in early childhood. However, it has been reported that several types of dermal melanocytosis could appear in adult life. We report here on an unusual case of acquired dermal melanocytosis occurring in a 51 year-old female. She had bilaterall brownish or slate-bluish pigmented patches on the face and the posterior auricular, supraclavicular, scapular and back areas. The skin biopsy specimen taken from the upper back revealed scattered, darkly pigmented, spindle-shaped cells and dendritic cells containing abundant golden brown pigment in the dermis.
Adult ; Biopsy ; Dendritic Cells ; Dermis ; Female ; Humans ; Melanocytes ; Mongolian Spot ; Nevus ; Nevus of Ota ; Nevus, Blue ; Parturition ; Skin

BACKGROUND: Medication adherence (MA) is poor among patients with chronic illnesses, such as those involving the risk factors of stroke. However, the impacts of poor MA on the modifiable risk factors of stroke are not well known. METHODS: We evaluated the MA for the control of hypertension, diabetes, hyperlipidemia, and previous ischemic stroke among consecutive patients with ischemic stroke within 7 days of symptom onset. Nonadherence was defined as taking doctor-prescribed medications for less than 3 weeks during the previous month. Demographic data, risk factor profile, stroke mechanism, and baseline score on the National Institutes of Health Stroke Scale (NIHSS) were compared among patients with nonadherence and those without. RESULTS: Among 1133 patients with at least one medicated risk factor, the rates of nonadherence in hypertension, diabetes, hyperlipidemia, and previous ischemic stroke were 18.5%, 15.3%, 30.3%, and 28.1%, respectively. Overall, 27.4% of patients with more than one risk factor presented nonadherence, with a predilection toward being male (male, 63.9% vs. female, 56.1%, p=0.02) and younger (mean age 64.9 years vs. 66.4 years, p=0.01). Stroke severity according to MA did not differ using either crude analysis (NIHSS score: 5.5+/-5.9 vs. 5.4+/-5.5, p=0.71) or multivariable analysis after log transformation. The prevalence of nonadherence was low for large-artery disease and small-vessel occlusion, and high for cardioembolism. CONCLUSIONS: Prestroke poor MA for the major risk factors was common among patients with chronic illnesses, and was more frequent in younger male patients. Stroke severity was not affected by MA during the month preceding stroke.
Chronic Disease ; Female ; Humans ; Hyperlipidemias ; Hypertension ; Male ; Medication Adherence ; National Institutes of Health (U.S.) ; Prevalence ; Risk Factors ; Stroke