Left ventricular hypertrophy(LVH) is one of common cardiovascular complications in hypertensive patients and it is well known that hypertensive cardiac disease accompained by LVH is still common cause of congestive heart failure in spite of treatment of hypertension. The authors assessed the prevalence of anatomical and functional abnormalities of left ventricle by EKG, chest X-ray and echocardiography in 45 essential hypertensive patients and also in 20 normal controls. Average values of left ventricular posterior wall thickness(LVPWd), interventricular septal thickness(IVSd), left ventricular mass(LVM), and left ventricular mass index(LVM/BSA) by echocardiography in hypertensive groups with LVH by EKG or chest X-ray were significantly higher than those of hypertensive groups without LVH by EKG or chest X-ray(P<0.005). Among 27 hypertensive patients with LVH by EKG and chest X-ray increased LVPWd was found in 24 patients(18%) and increased LVH in 26 patients(19%). Increased LVPWd and LVM were found in 3 patients(23%) among 13 hypertensives without LVH by EKG and chest X-ray. Hypertensive patients with increased LVH showed LVH by EKG and chest X-ray more frequently than those with increased LVPWd. Also, hypertensive patients without increased LVM showed MVH by EKG and chest X-ray less frequently than those without increased LVPWd. Therefore, echocardiography appears to be superior to routine chest X-ray and EKG for defecting LVH in hypertensive patients, especially without LVH by these tests. In conclusion, even though estimation of LVM by echocardiography seems to be a better method than single measurement of LVPWd, it seems thant estimation of LVM together with LVPWd will be more valuable in diagnosis of LVH in hypertensive patients.
Diagnosis ; Echocardiography* ; Electrocardiography ; Heart Diseases ; Heart Failure ; Heart Ventricles ; Humans ; Hypertension* ; Hypertrophy, Left Ventricular* ; Prevalence ; Thorax

PURPOSE: To assess the role of the preoperative portal vein embolization (PVE) in patients in need of major hepatectomy. MATERIALS AND METHODS: Total of 11 cases consisted of Klatskin tumor (n:6), gallbladder cancer (n=2), and hepatocellular carcinoma (n=3). After percutaneous transhepatic puncture of portal vein (right:7, left:4), the embolization of 1st order branch of right portal vein was done with Gentamicin soaked Gelfoam cubes. Radiologically, the angle between the middle hepatic vein and the inferior vena cava was measured on pre- and post-PVE CT (F/U :10 days) to evaluate the hypertrophy of the left lobe. Clinically, amount and nature of the drained bile through the PTBD tube of both lobes were analyzed in 5 patients with Klatskin tumor. The interval between PVE & operation was 10-24 days. Operative findings & the changes of postop. total bilirubin were analyzed and the complication after procedure was checked. RESULTS: There was decrease in mean angle between the middle hepatic vein and the inferior vena cava from 35.9 degree to 23.9 degree, but it was insignificant statistically (p=0.09). The embolization of right portal vein was done and there was increase in amount of drained bile from the nonembolized left lobe by 2-3 folds 8-14 days after PVE. The color and consistency between both lobes were significantly different; right lobe was darker in color and softer in consistency. Postoperative total bilirubin increased by 2-3 folds 1 to 4 days after PVE and normalized 10 to 14 days after PVE. Most of the patients had mild abdominal pain and fever after PVE and 1 patient had localized hematoma at puncture site which was subsided spontaneously. CONCLUSION: The preoperative portal vein embolization is a useful method for minimizing postoperative liver failure in patients in need of major hepatectomy.
Abdominal Pain ; Bile ; Bilirubin ; Carcinoma, Hepatocellular ; Fever ; Gallbladder Neoplasms ; Gelatin Sponge, Absorbable ; Gentamicins ; Hematoma ; Hepatectomy* ; Hepatic Veins ; Humans ; Hypertrophy ; Klatskin's Tumor ; Liver Failure ; Portal Vein* ; Punctures ; Vena Cava, Inferior

The hypotensive effect and side reactions of Buterazine were evaluated in 21 patients with essential hypertension. The results were as follows; 1) Before medication and after 2 and 4 weeks of medication, the over all average systolic and diastolic pressure were 188+/-23/112+/-7, 168+/-13/101+/-17, and 158+/-12/95+/-8mmHg, respectively. After 2 and 4 weeks of medication, the over all average systolic pressure decreased by 20 and 30mmHg(P<0.005, P<0.001), and the over all average diastolic pressure decreased by 11 and 17mmHg(P<0.025, P<0.001), respectively. In 69% of all cases, marked or moderate degree of hypotensive effect was observed. 2) There was no significant changes in heart rates before and after treatment. 3) In 84% of all cases, improvement of symptoms were observed. 4) There was no side effects which required discontinuing the treatment, except 2 cases which discontinued the medication.
Blood Pressure ; Heart Rate ; Humans ; Hypertension

The diagnostic value of nerve conduction study of spinal stenosis is far limited due to its deeply located lesion and its very short length of diseased nerve compared to the relatively long length of total conduction distance. Recently it became possible to stimulate the deep sited spinal nerve roots non-invasively with magnetic stimulation. The authors made a new method to calculate the motor nerve conduction time of lumbar spinal root using magnetic stimulation and planned to verify the delayed conduction time in patients with spinal stenosis who didn't show any abnormalities in the conventional electrophysiologic studies(peripheral nerve conduction velocity, F-wave and needle EMG). Three steps of magnetic stimulation were applied to vertex(transcortical stimulation), T12 spinous process(thoracic stimulation) and S1 spinous process(sacral stimulation), and three channel recording were performed at rectus abdominis(RA), right and left abductor hallucis(AH) simultaneously. Central motor conduction time(CMCT) was calculated by time difference between vertex and spinal stimulation at RA and AH. Lumbar-segment motor conduction time(LMCT) was defined as conduction time by subtracting CMCT of RA from CMCT of AH. The results as follows; LMCT was delayed in the group of patients with spinal stenosis(5.36+/-2.11 msec) compared to the normal control group(4.05+/-1.23 msec), but the range of LMCT was not quite different individually. Dividing the patients group into multi-level and single-level spinal stenosis group, LMCT in the multi-level spinal stenosis group was 6.12+/-1.95 msec which was significantly different from that of single-level(4.48+/-1.96 msec). The authors conclude that LMCT, the short segmental motor nerve conduction study of lumbosacral nerve root, is useful to confirm the entrapment of spinal nerve root across the lumbosacral spinal canal and is also non- invasive, simple and applicable to any other spinal nerve roots.
Evoked Potentials, Motor ; Humans ; Needles ; Neural Conduction* ; Spinal Canal ; Spinal Nerve Roots ; Spinal Stenosis*

No abstract available.
Amebiasis* ; Diabetes Mellitus* ; Humans ; Kidney* ; Liver*

PURPOSE: Alpha adrenergic components do not seem prevalent in the female bladder neck. Nevertheless, some studies using alpha-blockers in women suffering from obstructed urine flow have been reported. We assessed the effectiveness of administering an alpha 1-adrenoceptor antagonist, tamsulosin, in patients with a maximal flow rate less than 12 ml/sec. MATERIALS AND METHODS: From January 2007 to December 2007, 150 patients with a maximal flow rate less than 12 ml/sec were selected for this study. Patients were treated with tamsulosin at a dose of 0.2 mg per day. The effectiveness of tamsulosin was assessed by analyzing the International Prostate Symptom Score (IPSS) and other parameters, including the maximal urinary flow rate (Qmax) and the amount of postvoid residual urine. The data for these parameters were acquired at baseline and after 4 and 12 weeks of treatment. RESULTS: Of the 150 patients, 113 patients (75.3%) completed the study. Except for the storage symptom score, all clinical parameters, including total IPSS, voiding symptom score, Qmax, and the amount of residual urine, showed significant improvement after 4 and 12 weeks of treatment (p<0.05). The incidence of adverse events was only 4.4%, including dizziness in 3 patients, stress incontinence in 1 patient, and lethargy in 1 patient. CONCLUSIONS: The alpha-1 adrenoceptor antagonist tamsulosin significantly improved subjective symptoms and uroflowmetric parameters in female patients with a low maximal flow rate of less than 12 ml/sec. The use of tamsulosin may be an initial treatment option in females with a low maximal urinary flow rate.
Dizziness ; Female ; Humans ; Incidence ; Lethargy ; Lower Urinary Tract Symptoms ; Neck ; Prostate ; Stress, Psychological ; Sulfonamides ; Urinary Bladder ; Urinary Bladder Neck Obstruction

PUROPOSE: To evaluate the effects of nocturia on health-related quality of life (HRQoL) and sleep. MATERIAL AND METHODS: From January 2007 to December 2007, 180 patients with lower urinary tract symptoms were prospectively selected for this study. Study was conducted among respondents with nocturia (void/night> or =1) (n=119) and age matched controls (no nocturia) (n=61), with participants completing a series of questionnaires on HRQoL (OAB-q short form) and Medical Outcomes Study (MOS) sleep scale and frequency voiding chart. RESULTS: The patients population had a mean age of 57.2 years. In the patients, the mean number of void per night was measured, 58 patients reported 2>void/night> or =1, 32 patients reported 3> voids/night> or =2 and 29 patients reported void/night> or =3. The number of nocturia episodes/night was significantly associated with the overactive bladder (OAB) symptom score (p=0.001), symptom bother (p=0.001) and the MOS sleep index (p=0.016). CONCLUSIONS: Increases in the number of voids/night have further negative effects on sleep, symptom bother and HRQoL.
Surveys and Questionnaires ; Female ; Humans ; Lower Urinary Tract Symptoms ; Nocturia* ; Prospective Studies ; Quality of Life* ; Surveys and Questionnaires ; Urinary Bladder, Overactive

Neurological manifestations of internal carotid aretry (ICA) dissection include amaurosis fugax, cerebral ischemia, oculosympathetic paresis, and various cranial nerve palsies. Isolated hypoglossal nerve palsy is a rare manifestation of ICA dissection. A 55-year-old man developed dysarthria following sudden pain in the left retroauricular area. His tongue was paralysed on the left side. Magnetic resonance image and carotid angiogram showed characteristic features of left ICA dissection, which may be the most plausible cause of hypoglossal nerve palsy in this patient. Expanding hematoma of dissecting aneurysm of ICA seems to have compressed the nutrient artery of the hypoglossal nerve, although the possibility of direct compression of the hypoglossal nerve itself is not completely ruled out.
Amaurosis Fugax ; Aneurysm, Dissecting ; Arteries ; Brain Ischemia ; Carotid Artery, Internal* ; Carotid Artery, Internal, Dissection* ; Cranial Nerve Diseases ; Dysarthria ; Hematoma ; Humans ; Hypoglossal Nerve Diseases* ; Hypoglossal Nerve* ; Middle Aged ; Neurologic Manifestations ; Paresis ; Tongue

No abstract available.
Humans ; Stress, Psychological* ; Suicide*

BACKGROUND: There are different models of skin substitutes, but no skin substitutes have the characteristics of native skin. It was reported that the incubation of skin substitutes in medium containing ascorbic acid extends cellular viability and promotes formation of an epidermal barrier in vitro. OBJECTIVE: The purpose of this study is to observe the effects of ascorbic acid on the proliferation of keratinocytes and on the reconstruction of epidermis. MATERIALS AND METHODS: Normal human keratinocytes and fibroblasts were isolated and used for culturing living skin equivalent (LSE). RESULTS: When ascorbic acid was added, the expression of p63 and a6 integrin was definitely increased compared to control models. In addition, ascorbic acid increased the proliferation of normal human keratinocytes at a dose dependent manner. Especially, ascorbic acid induced the phosphorylation of ERK and up-regulation of EGF-R CONCLUSION: Results suggest that ascorbic acid is essential in the control of keratinocyte proliferation and basement membrane formation. Ascorbic acid-related keratinocytes proliferation is seemed to be mediated by ERK phosphorylation and EGF-R up-regulation.
Ascorbic Acid* ; Basement Membrane ; Epidermis ; Fibroblasts ; Humans ; Keratinocytes* ; Phosphorylation ; Skin* ; Skin, Artificial ; Up-Regulation