BACKGROUND: This study was designed to evaluate the safety and the efficacy of fosinopril(Monopril(R)) in the treatment of mild to moderate essential hypertension. METHOD: Fosinopril(10mg) once a day was administrated as a starting dose in 20 patients with essential hypertension in the morning and a one step upward titration was performed(fosinopril 20mg once a day, after 4 weeks treatment). RESULT: After 2 weeks treatment with dose of 10mg, the systolic blood pressure(SBP) was decreased(183.8+/-28.5 vs, 161.5+/-25.9mmHg, p<0.05) and the diastolic blood pressure(DBP) was also decreased significantly(108.3+/-9.3 vs, 96.6+/-10.3mmHg, p<0.05). The effect of fosinopril were maintained. The SBP an DBP were decreased in 14 out of 20 patients till 8 weeks. There was no significant change in heart rate before and after fosinopril treatment(74.3+/-10 vs, 76.4+/-7.9beats/min). Fosinopril had no significant effects on laboratory findings such as serum creatinin, BUN, AST/ALT, WBC, Platelet and lipid profiles. Mild dry coughing was noticed only in 5 patients and it did not disturb continuing medication. CONCLUSION: Fosinopril is an effective antihypertensive agent, as monotherapy once a day in patients with mild to moderate hypertension.
Blood Platelets ; Cough ; Fosinopril* ; Heart Rate ; Humans ; Hypertension*

Nail-patella syndrome is a relatively rare autosomal dominant disorder characterized by dysplastic nail, hypoplastic or absent patella, and dislocation of radial head and iliac horns. In addition, renal abnormalities have been reported. The usual clinical signs of the renal involvement are asymptomatic proteinuria, microscopic hematuria, and in some cases progression to end stage renal disease. We present the case of adult with nail-patella syndrome, who developed proteinuria. Electron microscopy revealed irregular thickening of the glomerular basement membrane with areas of rarefaction, giving rise to a pathognomonic "moth-eaten" appearance.
Adult ; Animals ; Dislocations ; Glomerular Basement Membrane ; Head ; Hematuria ; Horns ; Humans ; Kidney Failure, Chronic ; Microscopy, Electron ; Nail-Patella Syndrome* ; Patella ; Proteinuria

No abstract available.
Echocardiography* ; Electrocardiography*

BACKGROUND: It has not been completely understood whether acute phase responses of unstable angina were from the disruption of coronary plaques or from the instability & hypersensitivity of the plaque itself. Meanwhile, plasma IL-6 can be affected by several systemic factors, so it is difficult to conclude that IL-6 level in peripheral blood always reflects that of the coronary sinus blood. METHODS: We measured the IL-6 level in coronary sinus blood and peripheral blood of 14 patients (11 men, 3 women, mean age 55+/-6 years, range 43 to 65 years) with unstable angina before, and 4, 8, 16, 24, 36 hours after undergoing percutaneous coronary intervention(PCI), respectively. RESULT: A statistically significant increase of all IL-6 levels in both coronary sinus blood and peripheral blood after PCI was noted. There was correlation between IL-6 levels in coronary sinus blood and peripheral blood after PTCA(correlation coefficient r=0.416, p=0.01), but the difference of the concentration of IL-6 between coronary sinus blood and peripheral blood after PCI was increased as time passed. There was no statistically significant relationship between the number of coronary lesions treated with PCI and the amount of elevation of plasma IL-6 level. CONCLUSION: It is difficult to infer that IL-6 level in peripheral blood exactly reflect that of the coronary sinus blood, and that plaque rupture induced by PCI is the main cause of elevated plasma IL-6.
Angina, Unstable* ; Coronary Sinus* ; Female ; Humans ; Hypersensitivity ; Interleukin-6* ; Male ; Plasma ; Rupture

For the treatment of coarction of aorta, surgical intervention has been known as a standard therapy.During last decade balloon angioplasty for coarctation of the aorta has been reported as a successful and safe procedure in about 300 cases. This angioplasty was done mainly in infants and children, and little cases in adults and adolescents. A 22 year-old adult with coarctation of aorta have recieved balloon angioplasty. He visited to emergency room due to severe headache and the blood presure of arm was 240/130mmHg at emergency room. The blood pressure at ward was 168/92mmHg in upper extremities, 104/82mmHg in lower extrimities. His aortogram showed coarctation of thoracic aorta below left subclavian artery. The pressure gradient beween ascending aorta and right femoral artery was decreased from 60mmHg to 0mmHg after balloon dilatation (2 times, balloon diameter 18mm). There were no significant complications. The follow-up magnetic resonance image in 4 month after balloon angioplasty showed no evidence of restenosis or saccular aneurysm. Initial hypertension turned to normal blood pressure in 4 months after balloon angioplasty. This adult case of successful balloon angioplasty for coarctation of aorta is the first case reported in Korea.
Adolescent ; Adult* ; Aneurysm ; Angioplasty ; Angioplasty, Balloon* ; Aorta ; Aorta, Thoracic ; Aortic Coarctation* ; Arm ; Blood Pressure ; Child ; Dilatation ; Emergency Service, Hospital ; Femoral Artery ; Follow-Up Studies ; Headache ; Humans ; Hypertension ; Infant ; Korea ; Subclavian Artery ; Upper Extremity ; Young Adult

Kikuchi-Fujimoto disease (KFD) is an acute febrile disease that mainly involves histiocytic necrotizing lymphadenitis in children and young adults. Diagnosis of KFD is even more difficult if image-guided percutaneous biopsy is technically challenging. We present a case of clinically diagnosed KFD in an 11-year-old boy who presented with fever, abdominal pain, and mesenteric lymphadenopathy, resulting in a diagnostic challenge. Additionally, we conducted a systematic review, and our goal was to describe the spectrum of disease, therapy, and outcomes. We identified 15 cases of KFD with symptoms that mimicked mesenteric lymphadenitis. Reports from the Americas, Europe, and Asia were also included. Most patients were male, exhibited leukopenia and elevated inflammatory markers, and recovered without significant sequelae or complications. A high index of suspicion of KFD should be maintained in children presenting with prolonged fever and unusual manifestations, such as mesenteric lymphadenitis.

Paratubal cysts come from paraovarium of the broad ligament between the fallopian tube and ovary. Overall, these cysts constitute 10% of all adnexal masses and are commonly incidental findings upon surgical exploration for other reasons. They more commonly occur in women between 30 and 40 years of age. We report two cases of rapidly growing, huge paratubal cysts in young women, which are presented with brief review of literature.
Broad Ligament ; Fallopian Tubes ; Female ; Humans ; Incidental Findings ; Ovary ; Parovarian Cyst

OBJECTIVE: The aim of this investigation was to analyze the association between ovarian tumor markers and the clinicopathologic features of ovarian mature cystic teratoma. METHODS: The medical records of 195 patients whose pathologic diagnosis were made as mature cystic teratoma after surgery from June, 2000 to July, 2006 at Ewha Womans University Mok-dong Hospital were reviewed. The proportions of elevation of each tumor marker were evaluated in all patients and CA19-9 which showed the greatest elevation rate was selected as a promising relevant tumor marker. The patients were alloted to either Group I showing elevated CA19-9 or Group II showing normal level of CA19-9. The relationship between CA19-9 level and demographic data or clinicopathologic features were investigated by usual statistical method. RESULTS: The mean age of all patients was 35.4+/-12.8, and the average size of tumor was 7.1+/-3.5cm. Bilaterality of the mature cystic teratoma was 12.8%. The proportion of the patients showing elevated levels was greatest in CA19-9 as 33.3% (65/195), compared with 12.0% in CA-125, 5.8% in CEA, 1.1% in AFP. Significant difference between Group I and Group II were found in age, parity, tumor size, and bilaterality. Bilaterality and tumor size were greater in Group I, and age and proportion of parous women were lower in Group I. On the other hand, the rate of ovarian torsion or laparotomy conversion showed no difference. Likelihood ratio for bilaterality which may be clinically used during surgical procedure were 2.2 for CA19-9 suggesting its potential role in gynecologic practice. CONCLUSION: This study shows that CA19-9 may be a useful tumor marker associated with tumor size and bilaterality in ovarian mature cystic teratoma. Further confirmative study with larger sample size is in need in order to establish its definite clinical role in ovarian mature cystic teratoma.
Diagnosis ; Female ; Hand ; Humans ; Laparotomy ; Medical Records ; Ovary* ; Parity ; Sample Size ; Teratoma* ; Biomarkers, Tumor

We report a case of synchronous double primary vulvar cancer and renal cell carcinoma. Kidney mass was incidentally detected during preoperative evaluation of vulvar cancer, and was finally confirmed as a renal cell carcinoma. Although the initial result of 18F-fluorodeoxyglucose positron emission tomography was negative for a renal malignancy, nephrectomy was performed under the radiological and urologic impression of renal cell carcinoma which was supported by computerized tomography findings. Histological analysis finally confirmed a renal cell carcinoma. This is the first case report of synchronous double primary vulvar cancer and renal cell carcinoma, which emphasizes multidisciplinary approach to unexpected lesions when the clinical experience of one specialist is limited.
Carcinoma, Renal Cell* ; Kidney ; Nephrectomy ; Positron-Emission Tomography ; Specialization ; Vulvar Neoplasms*

PURPOSE: This survey was aimed to examine the current dietary restrictions practices for neutropenic patients among hospitals with 500 and more beds. METHODS: Self-administered questionnaires were sent to 100 head or charge nurses of oncology or hemato-oncology wards by mail during October 2009, and 51 questionnaires were returned. The data were analyzed with descriptive statistics using SPSS (WIN version 12.0). RESULTS: Of the hospitals surveyed, 47.1% (n=24) had guidelines on the dietary restrictions, and 80.4% (n=41) placed patients with neutropenia on restricted diets. The major decisional criteria of the dietary restriction was absolute neutrophil count (30.5%) and cooking status (29.2%). The most commonly restricted foods were raw fish or fresh meat (98.0%), uncooked intestine (98.0%), raw eggs (98.0%), draught beer (96.1%), and fresh fruits or vegetables (86.3%). CONCLUSION: The results showed variation in pattern of dietary restrictions and lower rate of guideline among hospitals, so that the need for the standard dietary restriction guideline is high. However, the role of diet in the development of infection in neutropenic patients is still unclear, which makes it difficult to establish dietary restriction guideline. Therefore, additional research are required to identify the relationship between dietary factors and infections.
Beer ; Cooking ; Diet ; Eggs ; Fruit ; Head ; Humans ; Intestines ; Meat ; Neutropenia ; Neutrophils ; Nursing, Supervisory ; Ovum ; Postal Service ; Surveys and Questionnaires ; Vegetables