No abstract available.
Humans ; Shock*

No abstract available.
Disasters*

No abstract available.
Catheters* ; Ventriculoperitoneal Shunt*

Down syndrome is the most, well known autosomal trisomy and e large number of abnormal skin features have been reported to occur in patients with Down syndromir. including syringoma. Syringomas occur with increased frequency in patients with Down syringoma, usually limited to the region around the eyes. but few cases of eruptive syringoma with Down syndrome have been reported. We reported the case of familial eruptive syringoma in a 13 years old patient with Down syndrome.
Adolescent ; Down Syndrome* ; Humans ; Livedo Reticularis ; Skin ; Syringoma* ; Trisomy

Ependymomas constitute no more than 5 to 7% of all primary CNS neoplasm and their biologic behavior is difficult to predict by microscopic appearances. Recently, many studies have attempted to correlate biologic behavior with tumor proliferation index, tumor suppressor gene and oncogene using immunohistochemical stains. We evaluated 25 cases of surgically resected intracranial ependymomas for the proliferation activity using Ki-67, and expression of p53 and bcl-2 protein with regard to the prognosis. The cases were divided into 17 ependymomas (WHO Grade II), 3 papillary ependymomas (WHO Grade II), and 5 anaplastic ependymomas. Clinically, the patients were divided into two groups, recurrent (18 cases) or non-recurrent (7 cases). The Ki-67 proliferation index was significantly higher in the recurrent group (p<0.05) and in the younger ages (correlation index=0.534). Although Ki-67 proliferation index was higher in anaplastic ependymoma, it was not significant statistically (p>0.05). p53 protein expression tended to increase in the patients who had anaplastic ependymoma and in the recurrent group. bcl-2 expression was not correlated with histologic grade or recurrence of the tumor. We conclude that Ki-67 proliferation index and p53 expression are important markers for predicting biologic behavior of ependymoma.
Coloring Agents ; Ependymoma* ; Genes, Tumor Suppressor ; Humans ; Oncogenes ; Prognosis ; Recurrence

BACKGROUND: This study was performed to determine and compare the practice patterns of management of hypertension of the internists and family physicians in general hospitals and to compare them according to the JNC V guidelines. METHODS: Questionnaires were mailed to total 964 of internists and family physicians in general hospitals during May, 1996. 217 of them were returned with the response rate of 23.5%. Chi-square test and Fishers exact test were performed to examine the statistical difference between two groups. RESULTS: The mean age of the respondents was 39.1 and 77.9% of them were male. 65.4 % of hospitals for respondents were located in metropolitan cities. Concerning the number of measurements of blood pressure, 0.5% of the respondents measured just once before confirmation of the diagnosis. Items for physical examinations for initial evaluation were as follows; cardiac auscultation(94.0%), measurements of body weight and height(58.9%), abdominal examination(52.8%), auscultation for carotid bruit(41.7%), fundoscopic examination (25.6%). Regarding the laboratory tests, the frequency of evaluation of all item were higher than that of the physical examinations. For initial drug therapy, calcium channel blockers and ACE inhibitors were the most frequently chosen mediations. No difference was found between two specialties or tertiary and secondary hospitals in this trend. With educations for the life-style modification, 60-80% of the respondents educated the patients. No difference was found between two specialties except one item. CONCLUSIONS: As a whole the JNC V guidelines were not followed faithfully for the management of hypertension.
Angiotensin-Converting Enzyme Inhibitors ; Auscultation ; Blood Pressure ; Body Weight ; Calcium Channel Blockers ; Surveys and Questionnaires ; Diagnosis ; Drug Therapy ; Hospitals, General* ; Humans ; Hypertension* ; Male ; Physical Examination ; Physicians, Family* ; Postal Service ; Surveys and Questionnaires

Skin necrosis is a rare complication of heparin administration that is usually localized to injection sites. We report a case of skin necrosis that was caused by minidose intraarterial infusion of porcine heparin which had been used in a touch to prevent coagulation in percutaneous intraarterial cannula. The skin necrosis appeared 35 days after starting heparin use.
Catheters ; Heparin* ; Infusions, Intra-Arterial ; Necrosis* ; Skin

PURPOSE: The purpose of this study was to evaluate alterations of regional cerebral blood flow (CBF) and cerebrovascular reserve (CVR), and correlation between these alternations and cognitive dysfunction in patients with chronic traumatic brain injury (TRI) and normal brain MRI findings. MATERIALS AND METHODS: Thirty TBI patients and 19 healthy volunteers underwen1 rest/acerazolamide brain SPECT using Tc-99m HMPAO. Korean-Wechsler Adult Intelligence scale test was also performed in the patient group. Statistical analysis was performed with statistical parametric mapping software (SPM97), RESULTS: CBF was diminished in the left hemisphere including Wernicke's area in all patients with lower verbal scale scores. In addition, a reduction in CBF in the right frontal, temporal and parietal cortices was related with depressed scores in information, digital span, arithmetic and similarities, In patients with lower performance scale scores. CBF was mainly diminished in the right hemisphere including superior temporal and supramarginal gyri, premotor, primary somatomotor and a port of prefrontal cortices, left frontal lobe and supramarginal gyrus. CVR was diminished in sixty-four Brodmann's areas compared to control. A reduction in CVR was demonstrated bilaterally in the frontal and temporal Iobes in patients with lower scores in both verbal and performance tests, and in addition, both inferior parietal and occipital lobes in information subset. CONCLUSION: Alterations of CBF and CVR were demonstrated in the symptomatic TBI patients with normal MRI finding. These alterations were correlated with the change of intelligence, of which the complex functions are subserved by multiple interconnected cortical structures.
Adult ; Brain ; Brain Injuries* ; Frontal Lobe ; Healthy Volunteers ; Humans ; Intelligence* ; Magnetic Resonance Imaging ; Occipital Lobe ; Rabeprazole ; Technetium Tc 99m Exametazime ; Tomography, Emission-Computed, Single-Photon

Although the conclusion is controversial, there has long been an appealing notion that catecholamines may be involved in some way in the pathogenesis of primary hypertension and almost invariably most of hypotensive drugs involve at various sites of the neuron and produce their effect by depletion of norepinephrine in the sympathetic nerve ending. The authors undertook the comparative study on catecholamine depleting action of 3 most effective drugs available for the treatment of hypertension, reserpine, guanethidine and alpha-methyldopa, measuring the plasma catecholamine levels and urinary exceretion of caecholamine by the modified fluorometric method of Weil-Malherbe and Bone during the treatment of hypertension. The results are as follows: 1) Before the administration of hypotensive drugs, mean blood pressure was 180/110mmH, mean psalma epinephrine level was 0.36+/-0.23gamma%, mean plasma norepinephrine level was 0.48+/-0.35gamma%, 24 hours urinary excretion of epinephrine was 3.6+/-0.12gamma/day and 24 hours urinary excretion of norepinephrine was 68.9+/-0.34gamma/day. 2) In group 1 (reserpin administered group), the mean blood pressure was 190/110mmHg before the treatment and which was declined to 155/89mmHg on the last day of 4th week, in group 2 (guanethidine administered group), the mean blood pressure measured before the treatment was 185/110mmHg and which was declined to 150/85mmHg on the last day of 4th week, and in group 3 (alpha-methylodpa administered group), the mean blood measured pressure measured before the treatment was 182/110mmHg and which was declined to 153/88mmHg on the last day of 4th week. 3) After the treatment for 4 weeks with reserpin guanethidine and alpha-methyldopa, the mean plasma epinephrine levels were declined from 0.37+/-0.12gamma% to 0.11+/-0.08gamma% in group 1, from 0.38+/-0.16gamma% to 0.14+/-0.10gamma% in group 2 and from 0.33+/-0.23gamma% to 0.10+/-0.09gamma% in group 3. 4) The mean plasma norepinephrine levels were declined from 0.05+/-0.21gamma% to 0.22+/-0.12gamma% in group 1, from 0.51+/-0.25gamma% to 0.20+/-0.10gamma% in group 2 and from 0.51+/-0.21gamma% to 0.20+/-0.11gamma% in group 3 after the treatment of 4 weeks respectively. 5) Urinary exceretion of epinephine was declined from 32.3+/-0.16gamma/day to 10.4+/-0.10gamma/day in group 1, from 34.5+/-0.34gamma/day to 17.2+/-0.16gamma/day in group 2, and from 28.2+/-0.14gamma/day to 10.3+/-0.11gamma/day in group in group 3 after the treatment of 4weeks duration. 6) The mean value of 24 hours urinary excretion of norepinephrine was declined to from 72.2+/-0.35gamma/day to 28.5+/-0.14gamma/day in group1, from 69.2+/-0.34gamma/day to 22.6+/-0.21gamma/day in group 2 and from 68.6+/-0.34gamma/day to 18.2+/-0.10gamma/day in group 3 after the treatment of 4 weeks duration. 7) From the above result we can summarized as follows: Antihypertensive effect of each drugs was; guanethidine>alpha-methylodopa>reserpin in order but depressing action plasma norepinephrine levels was; alpha-methyldopa>guanethidine>reserpin and depressing effect of urinary norepinephrine excretion was; alpha-methyldopa>guanethidine>reserpin, in order.
Antihypertensive Agents* ; Blood Pressure ; Catecholamines ; Epinephrine ; Guanethidine ; Humans ; Hypertension ; Methyldopa ; Nerve Endings ; Neurons ; Norepinephrine ; Plasma* ; Reserpine

No abstract available.