Authors want to report that PTA was an out-standing therapeutic method in treatment of renovascular hypertension by renal artery stenosis due to Takaysu's arteritis in an 18-years-old Korean female. Abdominal aortogram and bilateral renal arteriogram showed mild smooth narrowing of the mid abdominal aorta of 4cm length from origin of renal arteries, complete occlusion of left renal artery from it's origin with a few small collateral arteries and severe stenosis of proximal right renal artery. PTA of right renal artery was performed with Gruntzign Balloon dialtation catheter, and the patient's blood pressure was down to 120/80 from 220/130,stable for 8 months follow-up examination. Takayasu's arteritis is one of the msot important cause of renovascular hypertension in Orenals. Multiple treatement modalities, such as steroid administration or variable surgical intervention, were attempted and limited response was presented. But PTA is a simple, cost-effective, repeated,and relatively complicaiton-free method in treatment of renovascular hypertension due ot Takayasu's arteritis, with an outstanding result, as authors case.
Angioplasty ; Aorta, Abdominal ; Arteries ; Arteritis ; Blood Pressure ; Catheters ; Constriction, Pathologic ; Female ; Follow-Up Studies ; Humans ; Hypertension, Renovascular ; Methods ; Renal Artery Obstruction ; Renal Artery ; Takayasu Arteritis

Ethical problems in an emergency department (ED) are much more common than is usually recognized. But these difficult ethical dilemmas have not been dealt with by general medical ethicists. Most medical ethics guidelines tend to concentrate on chronic or at least relatively stable situations rather than on the acute, episodic cases that are typical in the ED. most ethical problems such as abortion, euthanasia, and professionalism can be solved after reflection and deliberation, and after a process of communication that reveals the values and interests of the patient or the patient's family. In contrast, when health care professionals in the ED recognize ethical problems, they often don't have enough time for an ethical consultation such as a Hospital Ethics Committee. Ethical principles such as autonomy, beneficence, nonmaleficence, and justice need to be applied to the unique setting of emergency medicine. Hence, it is necessary to develop ethics guidelines in emergency medicine and ethics education for health care professionals in emergency departments. At first, we collected cases involving ethical problems and reviewed the ethical and legal aspects of those cases. In this article, we summarize the ethical issues in emergency medicine, deal with actions in emergency medical services, and also consider the relationships between ethical issues and act on emergency medical services. We want to present the important factors that should be considered in ethical decision making within an emergency medicine department including patient decision making capacity, legal custody, and ethical principles.
Beneficence ; Decision Making ; Delivery of Health Care ; Emergencies ; Emergency Medical Services ; Emergency Medicine ; Ethicists ; Ethics Committees, Clinical ; Ethics, Medical ; Euthanasia ; Humans ; Jurisprudence ; Social Justice

Body fluid Lactate dehydrogenase and its isoenzyme Measurement was performed in 132 patients: 8 cases with peritonitis, 21 cases with malignant ascites, 43 cases with liver cirrhosis, 48 cases with tuberculous pleuritis, 12 cases with malignant pleural effusion respectively. Body fluid protein and glucose contents, red blood cell counts, white blood cell counts, cytologic examination were also performed as a comparative study. The results were as follows: 1. Measurement of total LD and protein amount could differentiate between transudate and exudates in the ascitic fluids. 2. In the malignant exudate of ascites and pleural fluid, the activity of LD2 isoenzyme was statistically increased compared with that of inflammatory exudates and the activity of LD4 isoenzyme was also incereased compared with that of serum (P<0.05). 3. The inflammatory exudates of pleural fluid and ascites demonstrated the increase of LD5 isoenzyme activity statistically compared with that of serum and malignant exudates (P<0.05). 4. A difference of total LD activity between malignant ascites and inflammatory ascites was significant statistically, while this was not observed in the pleural exudate. 5. Total LD and LD5 isoenzyme activity didn't correlated with the number of white blood cells in the exudate.
Ascites ; Ascitic Fluid ; Body Fluids* ; Erythrocyte Count ; Exudates and Transudates ; Glucose ; Humans ; L-Lactate Dehydrogenase ; Lactic Acid* ; Leukocyte Count ; Leukocytes ; Liver Cirrhosis ; Peritonitis ; Pleural Effusion, Malignant ; Pleurisy

BACKGROUND: The use of prednisone in the treatment of myasthenia gravis (MG) has been required circumspection because of its tendency to produce exacerbations of weakness in the early stages of treatment, often requiring critical management. However, factors influencing the exacerbation has not been defined well. The purpose of this study was to evaluate the clinical factors predicting the exacerbation by prednisone in the early stage of treatment in MG. METHODS: Fifty five patients, first-ever prescribed high dose prednsone (40-80 mg) during hospitalization in Samsung Medical Center were included. Prednisone induced exacerbation was defined as significant exacerbation of objective neurologic signs of MG within 4 weeks after prednisone addition by utilizing Myasthnia gravis Severity Scale (MSS). We investigate the differences between the exacerbated and nonexacerbated groups in the clinical, laboratory and electrophysiological features. RESULTS: Twenty three patients (42%) experienced definite exacerbation after prednisone treatment. Old age, presence of bulbar symptom, and severe neurologic finding reflected by MSS score were significant predictors of prednisone induced exacerbation in multivariate logistic regression analysis. Higher prednisone dosage per body weight (Kg) was neither a significant predictor of exacerbation nor related with the early improvement in bivariate correlation. CONCLUSIONS: Prednisone induced exacerbation in MG is a frequent challenging problem to clinician. Clinicans should keep in mind the possibility of exacerbation of MG when prescribing prednisone especially, to old, bulbar dominant, severe and disable myasthenic patients.
Body Weight ; Hospitalization ; Humans ; Logistic Models ; Myasthenia Gravis* ; Neurologic Manifestations ; Prednisone

Contusions ; Facial Bones ; Facial Nerve ; Facial Nerve Injuries ; Facial Paralysis ; Humans ; Incidence ; Lacerations ; Orbit ; Salivary Glands ; Skin ; Soft Tissue Injuries ; Wounds and Injuries

No abstract available.
Nipples*

No abstract available.
Cytosine Deaminase* ; Cytosine* ; Genetic Therapy* ; Osteocalcin* ; Prostate* ; Prostatic Neoplasms*

No abstract available.
Kidney Transplantation*

It is known that Korean pregnant women take iron supplements at a higher than the recommended level. This study was designed to provide data on current iron intake levels both from food sources and supplement to better guide iron supplement use during pregnancy. We also explored associations of iron supplement intake levels with varioussociocultural factors and pregnancy outcomes. Dietary intakes of 510 pregnant women were assessed by a validated 102- item food frequency questionnaire, and information on types and amounts of nutritional supplement intakes were also attained. While dietary intake levels of most nutrients exceeded the KDRIs (Korea Dietary Reference Intakes: EAR: Estimated Average Requirements), folate fell short of the KDRIs. A total of 428 women (83.9%) reported to take iron supplement. The pregnant women were divided into the three groups (group I: Fe supplement intake < or = EAR, group II: EAR< Fe supplement intake < or = 3 times of EAR, group III: 3 times of EAR< Fe supplement intake). The mean dietary intake of iron was 24% of the total iron intake for pregnant women. Iron intake from food was not significantly different among I, II, and III. In case of iron intake from supplements, the most frequent dose (34.1%) was 90-100 mg/day, and the mean iron supplement intake was 362% of the EAR. The study findings showed that those with higher levels of iron supplements had better meal quality measured by NAR (Nutrient Adequacy Ratio) and INQ (Index of Nutrient Quality). In addition iron supplement intake levels were significantly related to age (20s: 66.5 +/- 38.6 mg/day, 30s: 77.3 +/- 47.8 mg/ day, p< 0.0116) and experience of childbirth (1st pregnancy: 70.9 +/- 41.2 mg/day, 2nd pregnancy: 64.5 +/- 39.5 mg/day, > or = 3rd pregnancy: 94.4 +/- 63.8 mg/day, p< 0.005). However, no significant difference was found between iron supplement intake levels and various pregnancy outcomes including birth weight, birth height, gestational age, weight gain during pregnancy, and jaundice. It is worrisome that iron intake by supplement use greatly exceeded the EAR, suggesting the need of appropriate guidelines for iron supplement intake during pregnancy. Thus iron overdose from supplements in pregnancy should be considered as a serious condition.
Birth Weight ; Ear ; Female ; Folic Acid ; Gestational Age ; Humans ; Iron ; Jaundice ; Meals ; Parturition ; Pregnancy ; Pregnancy Outcome ; Pregnant Women ; Weight Gain ; Surveys and Questionnaires

PURPOSE: It has been reported that varicocele is found less frequently in obese men. Accordingly, we evaluated varicocele patients and statistically analyzed the correlation between varicocele and somatometric parameters. MATERIALS AND METHODS: A total of 211 patients underwent surgery for varicoceles. All patients underwent history taking, physical examination, and scrotal ultrasound to determine the presence and severity of varicocele. An age-matched control group consisted of 102 patients who were found not to have varicocele according to physical examinations and scrotal ultrasound. The age, weight, height, and body mass index (BMI) of the two groups were compared. The statistical analyses were performed by use of PASW Statistics ver. 18.0. A p-value of less than 0.05 was used for statistical significance. RESULTS: In the varicocele group, the mean age, height, weight, and BMI were 29.42+/-14.01 years, 168.53+/-9.97 cm, 62.14+/-13.17 kg, and 21.66+/-3.21 kg/m2, respectively. The distribution of varicocele grade was as follows: 103 (48.8%) grade III, 72 (34.1%) grade II, and 36 (17.1%) grade I. In the control group, the mean age, height, weight, and BMI were 30.83+/-17.31 years, 161.93+/-19.83 cm, 64.69+/-17.86 kg, and 24.04+/-3.64 kg/m2, respectively. Analyzing these data specifically in adolescents, they showed significant differences in age, height, and BMI (p=0.000, p=0.000, and p=0.004, respectively) between two groups. There were no significant differences in somatometric parameters between patients with different grades of varicocele. CONCLUSIONS: Our results showed that patients with varicoceles were significantly taller and had a lower BMI than did patients without varicoceles, especially among adolescents. Carefully designed future studies may be needed.
Adolescent ; Adult ; Anthropometry/methods ; Body Height/physiology ; Body Mass Index ; Body Weight/physiology ; Case-Control Studies ; Humans ; Male ; Scrotum/ultrasonography ; Varicocele/*etiology/physiopathology/ultrasonography ; Young Adult