No abstract available.
Carcinoma, Transitional Cell* ; Diagnosis* ; Kidney*

BACKGROUND: The insulin resistance is common in the patients with essential hypertension, even in the absence of non-insulin-dependent diabetes mellitus(NIDDM) or hyperlipidemia. It is well known that the offspring of patients with NIDDM have shown less insulin sensitivity compared with that of normal parents. But it is not yet known whether the insulin resistance is common in the offspring of patients with essential hypertension in Korea, who have no hypertension, NIDDM and hyperlipidemia. The aims of this study were to find out whether the insulin resistance exist in the middle aged normal offspring of the patients with essential hypertension and whether the insulin resistance is dependent on the metabolic abnormalities such as the body mass index(BMI), obesity and hyperlipidemia. METHODS: The serum lipid profiles and oral glucose tolerance test were performed. The anthropometrical measurement was done. The abdominal CT scan at umbilicus level and thigh CT was performed in the 11 offspring of parents with essential hypertension(group I;male : 7, female : 4)and 24 offspring of parents without essential hypertension, NIDDM, ischemic heart disease and hyperlipidemia(group II; male : 9, female : 15). RESULTS: The average age of group I was 44.1+/-6.9 years, and that of the group II was 47.5+/-9.5 years. There were no significant differences in the blood pressure, weight, BMI, waist to hip ratio, waist to thigh ratio. And there were no significant differences in the serum cholesterol, triglyceride, HDL-cholesterol, serum Na, and plasma renin activities between both groups. Fasting plasma insulin and 2 hour insulin after 75gm glucose ingestion were significantly higher in group I than in group II(8.5+/-3.0mU/mL versus 5.0+/-1.8mU/mL, 61.6+/-31.7mU/mL versus 33.3+/-16.8mU/mL, p<0.05). The insulin sensitivity index was significantly lower in group I than in group II(355.1+/-92.6 versus 451.8+/-88.1, p<0.05). The visceral fat area was wider in group I than in group II(102.0+/-30.7cm2 versus 64.5+/-28.5cm2, p<0.05). The multiple regression analysis with the fasting plasma insulin and insulin sensitivity index as the dependent variables and family history of essential hypertension, visceral fat area and BMI as the predictor variables revealed that only the family history was associated with the fasting plasma insulin and insulin sensitivity index. CONCLUSIONS: The offspring of the parents with essential hypertension showed the insulin resistance with increased visceral fat area in comparison with the offspring of the parents without essential hypertension.
Blood Pressure ; Cholesterol ; Diabetes Mellitus, Type 2 ; Eating ; Fasting ; Female ; Glucose ; Glucose Tolerance Test ; Humans ; Hyperlipidemias ; Hypertension ; Insulin Resistance* ; Insulin* ; Intra-Abdominal Fat ; Korea* ; Male ; Middle Aged* ; Myocardial Ischemia ; Obesity ; Parents* ; Plasma ; Renin ; Thigh ; Tomography, X-Ray Computed ; Triglycerides ; Umbilicus ; Waist-Hip Ratio

A systematic review (SR) provides the best and most objective analysis of the existing evidence in a particular field. SRs and derived conclusions are essential for evidence-based strategies in medicine and evidence-based guidelines in clinical practice. The popularity of SRs has also increased markedly in the field of hepatology. However, although SRs are considered to provide a higher level of evidence with greater confidence than original articles, there have been no reports on the quality of SRs and meta-analyses (MAs) in the field of hepatology. Therefore, we performed a quality assessment of 225 SRs and MAs that were recently published in the field of hepatology (January 2011 to September 2014) using A MeaSurement Tool to Assess systematic Reviews (AMSTAR). Using AMSTAR, we revealed both a shortage of assessments of the scientific quality of individual studies and a publication bias in many SRs and MAs. This review addresses the concern that SRs and MAs need to be conducted in a stricter and more objective manner to minimize bias and random errors. Thus, SRs and MAs should be supported by a multi-disciplinary approach that includes clinical experts, methodologists, and statisticians.
*Gastroenterology ; Humans ; *Meta-Analysis as Topic ; *Publication Bias ; *Review Literature as Topic

There is the trend of increasing number of outpatients who are requiring surgical intervention because of medical insurance and general improvement of economic state. Ambulatory surgical clinics are prospering in the United States. Thus we have analyzed 1957 cases of outpatient anesthesia excluding local infiltration performed by surgeons from total of 4302 cases o fout patient surgery during the 5 year period between 1975 and 1979. The results of this analysis were as follows: 1) Ketamine IM or IV was used as a sole agent in 500 cases who were under 12 years of age and mean operation and recovery time were 19.95 and 58. 45 minutes, respectively. 2) Mean operation and recovery time for 1,125 cases of pentothal+N2O+O2, anesthesia were 15. 55 and 108. 23 minutes, respectively. 3) For 321 cases of halothane+N2O+O2, anesthesia, mean operation and recovery time were 40.67 and 145. 94 minutes, respectively. 4) During recovery period there were no serious complications or mortality. 5) The majority of 1,125 among 1,957cases were gynecological outpatients and the rest were distributed among the surgical departments and dermatology, 6) Pentothal, nitrous oxide, halothane and ketamine were used safely for the outpatient anesthesia according to our experiences.
Anesthesia* ; Clinical Study* ; Dermatology ; Halothane ; Humans ; Insurance ; Ketamine ; Mortality ; Nitrous Oxide ; Outpatients ; Surgeons ; Thiopental ; United States

No abstract available.
Atrial Fibrillation* ; Heart* ; Thoracic Surgery*

STUDY DESIGN: Authors experienced three cases of malignant schwannoma arising from multiple neurofibromatosis and invading the vertebrae. OBJECTIVE: To report treatment results and preventive idea in three cases of malignant schwannoma transformed from neurofibromatosis within the retroperifoneal area and invading the vertebrae. SUMMARY OF BACKGROUND DATA: The patients with neurofibromatosis are clearly at increased risk to develop the malignant schwannoma. A review of Korean literature revealed no such cases. RESULTS: The first case presented in the L4 body and was treated by surgical excision and chemotherapy, but she expired due to secondary metastasis in six months after diagnosis. The second case was treated by diagnostic biopsy and chemotherapy with adriamycin, ifosfamide, DTIC, mesna. He eventually lived for 14 months. After a diagnostic biopsy, the third case died due to lung metastasis before we could begin the treatment. CONCLUSION: We recommend that neurofibromatsis patients be regularly followed-up and if necessary, CT examination of spine or abdomen should be done. If a malignant schwannoma is detected, then early treatment can be started.
Abdomen ; Biopsy ; Dacarbazine ; Diagnosis ; Doxorubicin ; Drug Therapy ; Humans ; Ifosfamide ; Lung ; Mesna ; Neoplasm Metastasis ; Neurilemmoma* ; Neurofibromatoses ; Spine*

No abstract available.
Diagnosis* ; Hernia, Obturator*

Granular cell myoblastoma is an uncommon tumor occurring on the skin as a single nodule. The tumor are generally small, the usual size being 0.5 to 2cm in diameter. Its rate of growth is usually slow. It is found in nearly equal distribution in men and women and is most common in the third to fifth decade of life. This is a case report of a 37-year-old woman with solitary nodular mass on right brachial plexus. The histopathology of the lesion revealed the pale cytoplasm filling with characteristic granules. Nerve bundles are often seen among or adjacent to the tumor cells. The histogenesis of this tumor is still disputed but the most accepted theory today is the neural derivation. The treatment of choice is surgical excision.
Adult ; Brachial Plexus* ; Cytoplasm ; Female ; Granular Cell Tumor* ; Humans ; Male ; Skin

High tibial osteotomy has been widely accepted as a method of treatments for middle-aged varus osteoarthritides with uncompartmental involvements. There have been several reports regarding the managements of fibula and their complications during the valgization procedure of tibia. They are, for example, osteotomy of fibular diaphysis or neck and excision of fibular head. Each level of fibular management is often complicated by nonunison, peroneal nerve palsy and lateral instability respectively. We have reviewed 20 cases of cases of high tibial osteotomy using proximal tibiofibular arthrolysis performed between March 1987 and February 1993. This method has proved excellent exposure of upper lateral tibia for the wedge removal, internal fixation and relief of the tethering effect of fibula. There was no peroneal nerve palsy relate to this degenerative change of the proximal tibiofibular was 3.4mm(range 1-11mm) and there was neither degenerative change of the proximal tibiofibular joint nor varus instability. In conclusion the arthrolysis of proximal tibiofibular joint can be highly recommended in high tibial osteotomy.
Diaphyses ; Fibula ; Head ; Joints ; Methods ; Neck ; Osteoarthritis ; Osteotomy ; Paralysis ; Peroneal Nerve ; Tibia

No Abstract Available.
Autografts* ; Ligaments* ; Patellar Ligament* ; Posterior Cruciate Ligament* ; Transplants*