Since the Plasma-Renin Activity (PRA) value varies by many factors such as amount of sodium in-take, diuretics and posture, the basal PRA with double stimulated PRA measurement is most widely used. However the method of the study is different according to investigators and especially the PRA study in out-patient is not easy. Author attempted to establish an easy and reliable method of PRA study in out-patient and their data were compaired with those of in-patient by the study of 38 normal cases in 207 hypertensive patients. Twenty four hours urine and overnight urine sodium measurement showed that the overnight urine sodium was about 45% of that of twenty four hour urine. More than 70mEq of overnight urine sodium is considered to be borderline to neglect sodium intake for study. The PRA of normal adult was measured at 30 minutes and one hour rest in supine or sitting position after arrival to hospital. There were minor increase of PRA after 30 minutes and one hour rest than basal PRA which will not confuse the evaluation of PRA. After Lasix 40mg and 20mg intravenous injection with walking respectively, the PRA changes were measured in 30 minutes, 1, 2, and 3 hours in normal adult. The results appeared that Lasix 20mg intravenous injection and 1 hour walking double stimulation is suitable method of PRA stimulation test in out-patient clinic. The Lasix 40mg I.V. and 2 hour walking stimulation test is considered to be suitable method of PRA stimulation test in ward patient. With above study, the following method of PRA study in out-patient clinic is recommended; 1) Overnight fasting and overnight urine collection for urinary sodium measurement 2) Patient should visit hospital in fasting state and take rest for 30 minutes in supine or sitting position and thereafter take blood sample about 5-10ml as out-patient basal PRA. Inject Lasix 20mg intravenously and walk for 1 hour and take blood sample again as double stimulation test. As double stimulation test of PRA for in-patient, Lasix 40mg l.V. and 2 hours walking is recommended. By using above method, the basal PRA in clinic in 16 young normal adults was 2.30+/-1.02(0.70-3.47)ng/ml/h sitting rest and 1.76+/-1.21(0.1-4.03)ng/ml/h in supine rest. In 47 non-hypertensive ward patients who will not have any abnormality in PRA, the 24 hour urinary sodium was average 221mEq and the basal PRA was and the basal PRA was 1.46+/-0.89(0.30-3.75)ng/ml/h. In outpatients with essential hypertension without complication, the average basal PRA was not different from that of normal adult. However male ward-patients with essential hypertension without complication had slightly higher average PRA than normal adult. The distribution of low(<0.56ng/ml/h) average(0.57-2.35ng/ml/h) and high(>2.36ng/ml/h) renin groups in essental hypertension showed higher incidence of high renin group in male ward-patients. But in out-patients with hypertension, the low renin group of patient was high. Relatively low normal value of PRA in this study may be due to high sodium in-take. The higher incidence of high PRA group in essential hypertension of in-patients may be due to the difference of hypertensive status between out-patient and in-patient.
Adult ; Diuretics ; Fasting ; Furosemide ; Humans ; Hypertension* ; Incidence ; Injections, Intravenous ; Inpatients* ; Male ; Outpatients* ; Plasma* ; Posture ; Reference Values ; Renin* ; Research Personnel ; Sodium ; Urine Specimen Collection ; Walking

Onychomycosis can be diagnosed by mycological examination, but it is not easy to detect its causative organisms because the positive rate of culture is lower and its scores are variable due to the contamination inherently introduced in the current method used in sampling the ovychomycosis organisms. It was suggested that the scores depended upon the handicraft of operates and the gainning method of nail material, so we modeled the watch mending drivers into the punching instruments, and holed deeply & widly through the nail plate, from the surface to the bottom. Afterward, the KOH mount & culture were performed to compare this new punch method used with that of standard scrapping method. Through the KOH examination more numerous hypaes were found in the punch methods sample than the scrapping methods sample. Also, the punch methods positive culture rate was found to be 2. 5 times higher than that of the scrapping methods culture rate, with a 5 to 5. 5 times lower amount of contamination. In conclusion, the punch method was found to be a more precise and effective method of obtaining onychomycosis organisms. Although this method required a slight greater time to perform than the standard scrapping method, I believe it will be a valuable aid in the detection of causative organisms of onychamycosis.
Onychomycosis*

The maximal stress exercise test was studied in 49 normal korean and 231 cases of various diseases. Bicycle ergometer was used in 122 cases and treadmill was used in 109 cases by modified Bruce protocol which was designed by author. The maximal heart rate, maximal work capacity, End point of maximal exercise and ST changes especially in coronary artery disease were investigated. Total 231 cases in cluded 8 cases of myocardial infarction, 46 cases of anginal pectoris, 91 cases of atypical anginal pain, 68 cases of hypertension and 18 and of diabetes mellitus. The results are as follows; 1. The maximal heart rate was markedly reduced in myocardial infarction(115/min. comparing 162/min. in normal) and slightly less reduction in angina pectoris. Also mild reductions were observed in atypical anginal pain, hypertension and diabetes mellitus. 2. The maximal work capacity was markedly reduced in myocardial infarction(93 wt comparing 180 wt in normal). It was only slightly reduced in anginal pectoris, atypical anginal pain, hypertension and diabetes mellitus which were not significantly reduced from that of normal, especially in anginal pectoris, the reduction on maximal work capacity was unremarkale comparing that of maximal heart rate. 3. The End point of maximal exercise test were exhaution in 34%, leg pain in 30%, maximal heart rate in 22%, ST depression more than 1 mm in 21%, dyspnea in 19%, anginal pain in 15% by bicycle ergometer, while by treadmill test, the End point were exhaution in 47%, dyspnea in 35%, Maximal heart rate in 22%, ST depression more than 1 mm in 19%, leg pain in 15% and anginal pain in 10%. 4. In coronary artery disease, the positive maximal exercise test(sensitivity) was 76% in treadmill test and 68% in bicycle ergometer test. 5. The ST changes among 231 patients druing the maximal exercise test occured in 47 cases(20%). In 43 cases the ST segment depressed more than 1 mm and the degree of depression ranged 1-3.5mm. The upward sloping type and horizontal depression type were equally common. There were 4 cases(1.7%) of ST elevation during exercise which returned to normal after exercise. There were 3 cases among 54 cases of coronary artery disease(5.5%) and 2 cases among 46 cases of anginal pectoris(4.3%). In one case of anginal pectoris with elevated ST segment, myocardial infarction occured in few days later. Therefore it appears that the variant angina in this study is very few.
Angina Pectoris ; Coronary Artery Disease ; Coronary Vessels ; Depression ; Diabetes Mellitus ; Dyspnea ; Exercise Test* ; Heart Rate ; Humans ; Hypertension ; Leg ; Myocardial Infarction

No abstract available.
Memory

The Enchondroma is a benign cartilage forming harmartoma arising chiefly from short tubular bones on hands and feet. If on a long tubular bone or flat bone such as femur or ilium, it is most likely to be a true neoplasm such as chondrosarcoma, not a harmartoma. A case of enchondroma was reported. It occurred over right ischium of 19 years old male and was found incidentally by roentgenogram. The lesion was biopsied and diagnos's was confirmed by histologic examination. It was treated by curretage with filling of cavity with bone chips. Post operative-course was uneventful.
Cartilage ; Chondroma ; Chondrosarcoma ; Femur ; Foot ; Hand ; Humans ; Ilium ; Ischium ; Male

A considerable body of evidence has been accumulated suggesting that invasive squamous cell carcinoma develops from cervical intraepithelial neoplasia(CIN). Most women with invasive cancer of the cervix are from lower socioeconomic groups, have begun heterosexual activity early in life, marry early, are multiparous, and have many sexual partners. Although the epidemiology of the cervical cancer is known well, the pathogenesis of the cervical cancer from CIN is subtle yet. Apoptosis, including the programmed cell death, is important event in normal cell turnover and maintenance of adult tissues. Apoptosis exerts a homeostatic function in relation to tissues dynamics, as the steady state of continuously renewing tissues achieved by a balance between cell replication and cell death. The specific labelling of nick ends of fragmented DNA was used to see the apoptotic cells from normal epithelium of the cervix to invasive cervical cancer. The apoptotic cells were found normally in the parabasal layer of the epithelium. As the grade of CIN increase, the apoptotic cell were found in superficial of the cervix and number of the apoptotic cell were increased. In the cervical cancer, the apoptotic cell were found in the cancerous tissues more than in the normal epithelium. This results suggest that the cell proliferation is more important than the inhibition of the apoptosis in the carcinogenesis of the cervical cancer.
Adult ; Apoptosis* ; Carcinogenesis* ; Carcinoma, Squamous Cell ; Cell Death ; Cell Proliferation ; Cervix Uteri ; DNA ; Epidemiology ; Epithelium ; Female ; Heterosexuality ; Humans ; Sexual Partners ; Uterine Cervical Neoplasms*

No abstract available.

Atrophie blanche is a rare vasculitis reported by Milian in 1929, that is characterizel by small erythematous, telangiectatic purpura which developes central hemorragic curst or painful ulceration and heals with atrophic white scar several months later. It is seen more commonly in middle-aged women and become worse in summer. It manifests primarly on the lower legs, ankles and dorsa of the feet, rarely on the elbows and dorse of the hands, where are the areas of the poor blood circulation. This case was 45 year-old woman who had suffered from periodic painful ulceration on the legs, ankles, dorsa of feet k hands and. elbows for about 18 years. Histopathologic findings showed fibrinoid degeneration R partial occlusion in the capillaries and mild perivascular chronic inflammatory cells infiltration in the upper corium. The lesion was not so improved by systemic k local corticosteroid therapy for about 3 months,
Ankle ; Blood Circulation ; Capillaries ; Cicatrix ; Dermis ; Elbow ; Female ; Foot ; Hand ; Humans ; Leg ; Middle Aged ; Purpura ; Ulcer ; Vasculitis

No abstract available.
Flail Chest*

Primary pericardial tumors are rare than those originating within the myocardium or endocardium and, moreover, primary benign pericardial tumors are much rare in occurrence. Fine(1986) was able to collect only 43 cases of lipoma. Most cases are diagnosed only at autopsy. One fourth of the cardiac lipoma arise subepicardially, where they suggest the presence of pericardial effusion with compression or displacement of the heart. A case of primary intrapericardial lipoma simulating pericardial effusion is presented. This tumor originated in left anterior aspect of pericardium. The tumor was measured 30x30x5cm in size and 2,200mg in weight. Total excision of the mass was accomplished by posterior lateral thoracotomy incision, resulting in complete cure. This is the first case of primary benign lipoma of the pericardium in literatures in our knowledge.
Autopsy ; Endocardium ; Heart ; Lipoma* ; Myocardium ; Pericardial Effusion* ; Pericardium ; Thoracotomy