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

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

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

No abstract available.
Holoprosencephaly*

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

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.

Exogenous factors, including environmental substances and drugs, are known to induce scleroderma-like reactions. Various scleroderma-like reactions induced by anti-cancer drugs have recently been reported. This is the first report that doxifluridine (Didox), an oral prodrug of the antineoplastic agent 5-fluorouracil (5-FU), induced a localized sclerderma-like reaction. A 51-year-old woman was referred to our clinic with multiple pearly, shiny patches on both her breasts, her pelvis and her back. After surgical excision and radiation therapy due to her right breast cancer, she took Didox for 7 months. A skin biopsy specimen revealed that the dermal collagen thickening extended even to the subcutaneous tissue. The routine laboratory tests were within the normal ranges and the tests for antinuclear antibody (ANA), anti SS-A antibody, anti SS-B antibody and anti U1-RNP antibody were all negative. After discontinuation of Didox, the lesions gradually improved. Based on these finding, we diagnosed this case as a localized scleroderma-like reaction induced by doxifluridine and we should pay attention to detect this adverse effect of the long term use of doxifluridine.
Antibodies, Antinuclear ; Biopsy ; Breast ; Breast Neoplasms ; Collagen ; Female ; Floxuridine ; Fluorouracil ; Humans ; Hydroxamic Acids ; Middle Aged ; Pelvis ; Reference Values ; Skin ; Subcutaneous Tissue

In spite of high-dose, hyperventilation, hyperosmolar agents, appropriate surgical evacuation, and cerebrospinal fluid when possible, uncontrolled intracranial hypertension, which was defined as occurring when intracranial pressure(ICP) exceeded 25 mmHg for 2 hours or more, occurred in 8 patients. Persistent elevated ICP occurred in 4 patient with acute subdural hematoma and brain contusion, in 2 patients with aneurysm and brain infarction, in 1 patient with hypertensive intracerebral hematoma, and in 1 patient with meningioma. All of these patients received intravenous barbiturate to control the ICP. The initial thiopental loading dose(10mg/kg) effectively reduced the ICP in 5 patients(62.5%). In those patients responding to the initial loading dose, four have survived, and one died due to pulmonary complication. None of three nonresponders to barbiturate survived. Two of the survivors have returned to a productive life, and two ramain moderately disabled. The favorable outcome in this series suggests that early aggresive treatment of intracranial hypertension with barbiturate and careful attention to medical complications can improve the outcome in patients with uncontrolled intracranial hypertension, with barbiturate and careful attention to medical complications can improve the outcome in patients with uncontrolled intracranial hypertension, especially in postoperative state. A broader investigation of the clinical application of barbiturates in indicated.
Aneurysm ; Barbiturates ; Brain Infarction ; Brain Injuries ; Cerebrospinal Fluid ; Coma* ; Hematoma ; Hematoma, Subdural, Acute ; Humans ; Hyperventilation ; Intracranial Hypertension* ; Meningioma ; Survivors ; Thiopental

No abstract available.
Allografts* ; Humans ; Ultrasonography*