Angioedema is a disorder characterized by well-demarcated nonpitting edema involving the tongue, floor of the mouth, larynx, lips, and face. The incidence of angiotensin converting enzyme(ACE) inhibitor related angioedema has been reported to be about 0.1% to 0.2%, and the time of onset is usually during the first week of therapy. These ACE inhibitors include captopril, enalapril, and lisinopril. A 53-year old man with an 8 month history of hypertension previously controlled with atenolol, was presented to the dermatologic department with angioedema of the face and tongue. He had begun therapy with captopril one day before this episode. Even though he was treated with epinephrine and methylprednisolone sodium succinate, the edema gradually progressed and finally dyspnea developed. He was urgently intubated and treated with steroids and pheniramine maleate in the intensive care unit. The edema resolved after 24 hours.
Angioedema* ; Angiotensin-Converting Enzyme Inhibitors ; Angiotensins ; Atenolol ; Captopril* ; Dyspnea ; Edema ; Enalapril ; Epinephrine ; Humans ; Hypertension ; Incidence ; Intensive Care Units ; Larynx ; Lip ; Lisinopril ; Methylprednisolone Hemisuccinate ; Middle Aged ; Mouth ; Pheniramine ; Steroids ; Tongue

PURPOSE: This study was designed to evaluate the usefulness of a technetium-99m mercaptoacetyltriglycine (Tc-99m MAG3) single photon emission computed tomography (SPECT) performed on transplanted kidney. MATERIALS AND METHODS: Thirty renal transplant patients were included in this study. Planar scan was performed for 30 minutes using 555 MBq Tc-99m MAG3. A post-voiding SPECT scan was acquired on the third, seventh, fourteenth and twenty eighth day after transplantation. RESULTS: SPECT scan showed interpretable image quality in 26 of 30 patients (86.7%) and 84 in 120 scans (70%). Fourteen of 26 patients with interpretable SPECT image showed decreased or increased radioactivity, but only 5 had abnormal findings on the planar scan. Focal SPECT defects were seen in allografts with normal function (n=3), acute tubular necrosis (n=3), and acute rejection (n=2). The defects are thought to reflect focally underperfused renal parenchyme or, in normal allografts, an artifact from uneven radioactivity distribution. Four of 10 patients with renal arterial variation showed focally decreased radioactivity and SPECT helped guide further studies that confirmed the exact cause. Five of 10 patients with acute tubular necrosis or acute rejection showed focally decreased radioactivity, but its relation to the patients' clinical course was not clear. Focally increased radioactivity was observed in 5 allografts with normal function and 1 with double ureter in which local clearance delay was observed. CONCLUSION: Tc-99m MAG3 SPECT renal scan can detect additional focal abnormalities compared to planar scan. Further study is necessary to elucidate the exact clinical significance of the SPECT findings.
Allografts ; Artifacts ; Humans ; Kidney* ; Necrosis ; Radioactivity ; Tomography, Emission-Computed, Single-Photon* ; Ureter

PURPOSE: The purpose of this study is to evaluate the signal intensity and size of anterior pituitary gland in postpartum women, and to compare with those of control group. MATERIALS AND METHODS: In 34 postpartum women(18-43 years, mean:27 years) and another 35 control nonpregnant women(20-29 years, mean :24 years), midsagittal Tl-weighted MR images were obtained. The signal intensity and height of the anterior pituitary gland were compared between the post-partum and normal control groups. RESULTS: In postpartum women, the signal intensity of the anterior pituitary gland relative to the pons was higher than that of the control gorup. Pituitary gland height of postpartum women was higher(5-11. 8mm, mean:8.18 +/- 1.8mm) than that of control group(2-9mm, mean :6.2 +/- 1.7mm). CONCLUSION: It is concluded that the hyperintensity of the anterior pituitary gland on Tl-weighted image is a normal finding in postpartum women, which is useful in differentiation from pituitary abnormality.
Magnetic Resonance Imaging* ; Pituitary Gland ; Pituitary Gland, Anterior* ; Pons ; Postpartum Period*

No abstract available.
Animals ; Embryonic Structures* ; Freezing* ; Mice*

In order to evaluate the value of vertebral angiography in assessment of hemifacial spasm, we reviewed retrospectively the vertebral angiography of 28 patients(30 cases) with surgically proved hemifacial spasm but normal CT scans of posterior fossa. There were 9 males and 19 females. Angiography revealed vascular focus of hemifacial spasm located at anterior inferior cerebellar artery, posterior inferior cerebellar artery, and vertebral artery in 19, 9, and 2 cases respectively. Right side was involved in 20 cases. All involved vessels were elongated, tortuous, and dilated. In conclusion, vertebral angiography was valuable in evaluating hemifacial spasm of vascular origin in the posterior fossa.
Angiography* ; Arteries ; Female ; Hemifacial Spasm* ; Humans ; Male ; Retrospective Studies ; Tomography, X-Ray Computed ; Vertebral Artery

The study was conducted to determine the lateral tibio-articular angle of ankle joint in 100 korean adults(160 cases) ranging from second to eight decades of age. The authors have defined as the lateral tibio-articular angle of ankle joint, that is the sharp angle between the lateral tibial axis which is the lateral longitudinal line through each midpoints of the upper and lower one third of the tibia, and the line to connect the anterior and posterior tips of the tibial articular surface of ankle joint. 1. It was 79.3°±3.4°in all cases. 2. It was 79.2°±3.6°in male and 79.6°±2.7°in female. It was reduced in male approximately 0.4°compared with female. 3. It was 79.1°±3.1°in the left side and 79.5°±3.6°in the right side. It was reduced approximately 0.4°in the left side compared with the right side. 4. It was reduced approximately 0.9°in the left side compared with both sides of the same person.
Adult ; Ankle Joint ; Ankle ; Female ; Humans ; Male ; Statistics as Topic ; Tibia

No abstract available.
Pressure Ulcer*

Distance teaming has been the tuning point for accomplishing adult teaming in nursing education. This study was conducted to demonstrate the effectiveness of the distance learning courseware with the RN-BSN students at Yonsei university, College of Nursing. The distance learning courseware was developed cooperatively by content experts, instructional designers. programmers and graphic designers. The course subject, 'Growth and Development' was made by a computerized instructional module using the internet. The programming developed with the virtual school developing support system of Samsung SDS based on the Web Sever and Oracle DB through the Internet. The instructional courseware was developed after taking into consideration the learners' levels of competencies and knowledge and utilized the integrate information through the multimedia, mainly via screens in the computer network. The students learned about the growth and development of infants to adolescents through the interaction with peers as well as instructors using many functional keys on the internet. The effects of learning were evaluated as their satisfaction of this distance learning courseware by 60 RN-BSN students. The student's responses have been very positive. The distance learning courseware for RN-BSN students developed at Yonsei University's Collage of Nursing is an available and interactive method used a Multimedia Instructional Design through the Internet.
Adolescent ; Adult ; Education, Distance* ; Education, Nursing ; Growth and Development ; Humans ; Infant ; Internet* ; Learning ; Multimedia ; Nursing*

An ABO discrepancy was observed in a 37-year-old patient with duodenal ulcer bleeding and B subgroup was suspected. The results of adsorption-elution test, saliva and serum inhibition test and family study suggested Bx phenotype that is not a usual phenotype and is the second case to be reported in Korea.
Adult ; Duodenal Ulcer ; Hemorrhage ; Humans ; Korea ; Phenotype ; Saliva

BACKGROUND: Pneumoperitoneum for laparoscopic cholecystectomy induces prompt hemodynamic changes. The rapid onset of these changes suggests a neurohumoral response. The present study investigated the effects of pneumoperitoneum on plasma catecholamines and vasopressin during laparoscopic cholecystectomy. METHODS: We studied 18 healthy patients under general anesthesia using a isoflurane and nitrous oxide (50%). In our study, nine patients were selected for Group LC; they underwent the laparoscopic cholecystectomy. The remaining nine patients constituting Group OS served as the control, and underwent minor orthopedic surgery. Venous blood samples were collected 10 minutes after the induction of anesthesia, as well as 10 minutes after the insufflation of pneumoperitoneum or skin incision, and 10 minutes after desufflation of pneumoperitoneum or skin closure. Plasma vasopressin was measured using a radioimmunoassay method. Plasma epinephrine and norepinephrine were measured using the method of high-performance liquid chromatography. RESULTS: In Group LC, the plasma concentration of vasopressin increased remarkably from 2.1 pg/ml to 70.7 pg/ml after insufflation of pneumoperitoneum, and declined to 18.3 pg/ml after desufflation (P < 0.05). Plasma concentrations of epinephrine and norepinephrine also increased significantly after insufflation of pneumoperitoneum (P < 0.05). In Group OS, however, plasma concentrations of vasopressin, epinephrine, and norepinephrine remained stable throughout the operation. CONCLUSIONS: The pneumoperitoneum resulted in a substantial increase of plasma concentrations of vasopressin as well as a signifiant increase in the plasma concentration of epinephrine and norepinephrine during laparoscopic cholecystectomy.
Anesthesia ; Anesthesia, General ; Catecholamines* ; Cholecystectomy, Laparoscopic ; Chromatography, Liquid ; Epinephrine ; Hemodynamics ; Humans ; Insufflation ; Isoflurane ; Nitrous Oxide ; Norepinephrine ; Orthopedics ; Plasma* ; Pneumoperitoneum* ; Radioimmunoassay ; Skin ; Vasopressins*