No abstract available.

Antihypertensive effect and side effect of Tripamide(Normonal(R)) was studied in 22 cases of essential hypertension using 15mg once daily regimen for average period of 9 weeks. 1) Antihypertensive effect Average reduction of 25mmHg in systolic and 19mmHg in systolic and 19 mmHg in diastolic pressure was observed and reduction rate was 15.7% and 17.6% respectively. The overall effect rate was 86%. The blood pressure lowered significantly in 1 week of treatment both in systolic and diastolic pressure and the extent of fall in systolic pressure approached near the level of maximum reduction in 2 weeks of administration and that of diastolic after 5 weeks of treatment. 2) Laboratory tests and side effect There was no significant changes in individual and mean value of Na, K, Cl, BUN, creatinine, uric acid, fasting blood sugar, cholesterol, GOT, GPT studied before and after treatment except one case showing elevation of uric acid. No significant side effect was observed during trial except of 2 cases of transient diuretic effect.
Blood Glucose ; Blood Pressure ; Cholesterol ; Creatinine ; Diuretics ; Fasting ; Hypertension ; Uric Acid

Hemodialysis that to maintain life quality and may be preliminary stage of kidney transplantation is essential in end-stage renal disease(Esrd) patients. Since 1996, Brescia-cimino are used to internal radio- cephalic fistula and this fistula method was the most popular in world-wide. And then variable methods (e.g, Autogenous, PTFE, Dacron etc.) were usually tried instead of above standard fistula. We experienced 75 fistulas in 62 cases from Jan. 1993 to Dec. 1996 and among 75 fistula operations standard radio-cephalic fistula was 56, brachio-cephalic fistula 10, graft fistula 9. Early patency failure rate of A-V fistula was 9 cases, 14.5%. Significant factors to effect in patency of A-V fistula were propably diabetic mellitus, venous diameter, graft material and were not related to age/sex, blood pressure, BUN/creatinine etc. In conclusion the reduction of early patency failure rate in A-V fistula is to maintain long patency rate of A-V fistula
Blood Pressure ; Fistula ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Polyethylene Terephthalates ; Polytetrafluoroethylene ; Quality of Life ; Renal Dialysis ; Transplants

The Klippel-Trenaunay syndrome is a rare congenital pathology that includes hemangioma and varicose vein to involving lower extremity, hypertrophies of soft tissue and bone. When this syndrome has been associated with additional arteriovenous fistula,it has been termed Klippel-Trenaunay-Parkes-Weber syndrome. To avoid errors in managament, it is important to recognize the syndrome. Surgical correction should be performed only to relieve deep venous obstruction(if present) or to correct inequality in the lengths of legs. We report these cases with the review of literatures of Klippel-Trenaunay Syndrome.
Hemangioma ; Hypertrophy ; Klippel-Trenaunay-Weber Syndrome ; Leg ; Lower Extremity ; Pathology ; Socioeconomic Factors ; Varicose Veins

PURPOSE: Endoscopic thyroidectomy has recently been widely used in clinical practice. The operative method can be classified into CO2gas insufflation and the gasless technique. This study assessed the safety of low pressure CO2gas insufflation (up to 6 mmHg) by performing continuous measurement of the end-tidal CO2 (ETCO2) pressure. METHODS: From March 2003 to October 2006, 95 patients (90 hemithyroidectomies and 5 total thyroidectomies) underwent endoscopic thyroidectomy. The low pressure CO2gas insufflation technique was applied in all cases. The ETCO2 pressure of the patients was measured by capnometry at the time of a pre-gas insufflation status (0 minutes) and at the time of post-CO2gas insufflation (30 minutes) and then it was measured every 30 minutes with also performing capnograms. We analyzed the ETCO2 pressure at the time of the pre-CO2gas insufflation status (0 min) and we compared this with that of each status by using paired T-test. RESULTS: For all 95 cases, the mean patient age was 36.2+/-9.1 (range: 21~57 years), the mean tumor size was 1.7+/-1.1 (range: 0.1~4.5 cm) and the mean operative time was 135.0+/-46.1 (range: 50~340 min). The mean ETCO2 pressure (mmHg) was 33.0+/-3.9 at the time of pre-CO2gas insufflation status (0 min); the mean ETCO2 pressure was 31.1+/-3.7 at 30 min (n=95), 33.5+/-3.7 at 60 min (n=95), 35.2+/-3.6 at 90 min (n=95), 34.9+/-3.7 at 120 min (n=90), 34.6+/-3.8 at 150 min (n=70), 34.1+/-3.4 at 180 min (n=40), 34.3+/-5.2 at 210 min (n=15) and 34.0+/-4.2 at 240 min (n=9). There was a significant difference the early post-CO2gas insufflation status (P<0.05 at 30 min, 90 min, 120 min), but there was no significant difference in the late post-CO2gas insufflation status (P>0.05; at 60 min, 150 min, 180 min, 210 min, 240 min). At each time point, the ETCO2 pressures were all within the normal range. CONCLUSION: We successfully performed endoscopic thyroidectomy with using the low pressure CO2gas insufflation technique and there were no significant complications. We think that performing endoscopic thyroidectomy with using the low pressure CO2gas insufflation technique is a safe procedure.
Humans ; Insufflation* ; Operative Time ; Prospective Studies* ; Reference Values ; Thyroidectomy*

PURPOSE: The development of publicized screening methods for breast carcinoma detection has led to a marked increase in the discovery of ductal carcinoma in situ (DCIS) or DCIS with microinvasion (DCIS-MI). Axillary lymph node status has been believed to be not only an indicator of prognosis, but also a direction of adjuvant therapy. But the incidence of axillary metastasis in DCIS or DCIS-MI has diversely found in from 0% to 20%. This study was performed to analyze the incidence of axillary metastasis and the predictive factors associated with axillary lymph node metastasis in DCIS or DCIS-MI. METHODS: Patients with DCIS or DCIS-MI and axillary lymph node dissection from 1987 to 2004 were selected from Korea University Medical Center. We reviewed their medical records for age, palpability and size of the tumor, histolgic subtype, nuclear grade, hormone receptor status, and pathologic slides. RESULTS: Fifty two patients in DCIS and Thirty eight patients in DCIS-MI were included in the study. Axillary lymph node metastases were identified in 2 patients (3.8%) in DCIS and 4 patients (10.5%) in DCIS-MI. Tumor size and nuclear grade in DCIS had a borderline significance in association with microinvasion. We could not be able to find any predictive factor associated with axillary lymph node metastasis in DCIS and DCIS-MI. CONCLUSION: Axillary lymph node metastasis in DCIS or DCIS-MI appeared to be not low and there was no predictive factor associated with axillary lymph node metastasis in DCIS and DCIS-MI. But DCIS patients with large tumor size and poor nuclear grade have the high possibility associated with microinvasion, therefore, in that cases, there is a need to consider the possibility of axillary metastasis.
Academic Medical Centers ; Breast ; Breast Neoplasms ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Humans ; Incidence ; Korea ; Lymph Node Excision ; Lymph Nodes* ; Mass Screening ; Medical Records ; Neoplasm Metastasis* ; Prognosis

PURPOSE: To reduce the side effects and improve the effectiveness of standard chemoradiation therapy, many complementary or alternative medicines have been tried. However, little is known about its immunologic effects in breast cancer patients. The aim of this study was to assess the immunologic effects of mistletoe extract (Viscum album L., VAE) in patients with early breast cancer after surgery followed by standard adjuvant chemoradiation therapy. METHODS: A total 20 patients with early breast cancer treated with breast conserving surgery followed conventional chemoradiation therapy. Ten of these patients received subcutaneous injections of VAE for 7 weeks. IL-2, IL-4, IL-6, IL-10, TGF-beta, and IFN-gamma levels in serum samples were measured in all patients. RESULTS: The concentrations of IL-2, IL-4, IL-10, and TGF-beta were not significantly changed between before and after VAE treatment in both test and control group. The concentration of IL-6 in the test group was increased from 8.19+/-1.75 pg/mL to 9.86+/-1.46 pg/mL after treatment (p=0.013). The concentration of IFN-gamma in the test group was remarkably increased from 91.76+/-17.16 pg/mL to 167.42+/-66.61 pg/mL after treatment (p=0.009). CONCLUSION: Significant increases in the concentration of IL-6 and IFN-gamma were observed after VAE treatment. These results suggest that VAE treatment can stimulate immune responses, especially cell-mediated immunity in immune-compromised patients received the chemoradiation for breast cancer.
Breast ; Breast Neoplasms ; Humans ; Immunity, Cellular ; Injections, Subcutaneous ; Interleukin-10 ; Interleukin-2 ; Interleukin-4 ; Interleukin-6 ; Mastectomy, Segmental ; Mistletoe ; Transforming Growth Factor beta

PURPOSE: Neck surgery is one of the newest fields of endoscopic surgical application. We have developed a technique for performing endoscopic thyroidectomy using a breast approach and low-pressure CO2. We report this surgical procedure and its results. METHODS: One hundred patients underwent endoscopic thyroidectomy using a breast approach. Preoperative fine needle aspiration cytology revealed 74 benign nodules, 21 follicular neoplasms, 4 in which there was difficulty in distinguishing between benign and malignant tumor and 1 not checked. We used 3 incisions on both upper circumareolar areas and one at about 3 cm below the clavicle on the tumor side. Three trocars, 5 mm, 10 mm, 15 mm were used. Subplatysmal and subcutaneous operative space was created with CO2 insufflation at 6 mmHg of pressure. The thyroidal vessels and the parenchyme of the gland were dissected and divided with an ultrasonically activated scalpel and commonly used laparoscopic instruments. RESULTS: The subjects were 93 women and 7 men with ages ranging from 7 to 63 years (mean 38.9 yerars). The operation time 136+/-9.85 minutes before year 2000 and 66.8+/-8.26 at year 2000. There were 6 cases of conversion to conventional thyroidectomy, 1 case of uncontrolled intraoperative bleeding, 1 case of invasive follicular carcinoma and 4 papillary carcinoma. Postoperative complications occurred in 5 cases; 1 case of permanent recurrent laryngeal nerve palsy, 3 cases of transient voice change and 1 case of severe chest discomfort for 3 months. There was no occurrence of subcutaneous emphysema. The average of postoperative hospitalization time was 4.5+/-0.35 days. Operative scars were completley concealed by clothes and the patients were satisfied with the cosmetic result. CONCLUSION: This approach completely avoided operative scars in the neck and resulted in satisfactory cosmetic result with minimal scars in the breast. We believe that endoscopic thyroidectomy using breast approach is feasible and safe for resection of thyroid tumors.
Biopsy, Fine-Needle ; Breast* ; Carcinoma, Papillary ; Cicatrix ; Clavicle ; Female ; Hemorrhage ; Hospitalization ; Humans ; Insufflation ; Male ; Neck ; Postoperative Complications ; Subcutaneous Emphysema ; Surgical Instruments ; Thorax ; Thyroid Gland ; Thyroidectomy* ; Vocal Cord Paralysis ; Voice

PURPOSE: Granulomatous mastitis is a rare benign inflammatory breast disease of an unknown etiology. Clinically and radiologically, it can mimic a breast carcinoma. Therefore, surgeons, pathologists, radiologists need to be aware of this condition in order to avoid unnecessary mastectomies. This study examined the modalities that are important for diagnosing and treating of the granulomatous mastitis. METHODS: The data regarding 14 patients with histologically confirmed granulomatous mastitis and treated at our hospital were analyzed. Age, associated disease, parity, past history of breast feeding and oral contraceptives, radiology findings were retrospectively evaluated. RESULTS: Among the 14 patients, the mean age was 41 years with 5 being in their thirties. Breast pain was the most common presentation. Of the 14 patients, 11 patients had breast-fed and none had previously used oral contraceptives. No patient suffered from pulmonary tuberculosis. Preoperative mammography and ultrasonography was not helpful in identifying granulomatous mastitis. After ultrasonography, 7 patients were found to have mastitis with an abscess and a benign or malignant tumor was found in 3 patients. Two of the 14 patients were diagnosed using pre-operative fine-needle aspiration, which that showed an epithelial histiocyte or multinucleated giant cell. Three cases completely recovered after an excision. In 11 cases, incision and drainage were performed but there was a recurrence in 4 of these, which needed to be treated more than twice by an incision and drainage and steroid. The average treatment period was 5 months and a recurrence was encountered in 4 patients within a 30-month follow-up period. CONCLUSION: Granulomatous mastitis is rare, but it is important to make a histological diagnosis at the early stages. It is believed that a complete excision of the lesion will help prevent a recurrence, and patients with a frequent recurrence can be treated with steroid after stopping unnecessary antibiotic treatment.
Abscess ; Biopsy, Fine-Needle ; Breast Diseases ; Breast Feeding ; Breast Neoplasms ; Contraceptives, Oral ; Diagnosis ; Drainage ; Female ; Follow-Up Studies ; Giant Cells ; Granulomatous Mastitis* ; Histiocytes ; Humans ; Mammography ; Mastectomy ; Mastitis ; Mastodynia ; Parity ; Recurrence ; Retrospective Studies ; Tuberculosis, Pulmonary ; Ultrasonography

Sparganosis is not a common disease. Uncooked snake or frog, infected water and fresh water fish are the usual important source of sparganosis. Most cases of sparganosis are found in subcutaneous or adipose tissue of the abdominal and thoracic wall, and also in the inguinal inguinal regions, but the lesions are rarely found in the breast. We experienced 2 cases of sparganosis in the breast of a 69-year-old female & in the breast of a 37-year-old female. Among them, the 37-year-old female had a history of drinking impure water. The diagnosis was confirmed by surgical excision of the mass, and the plain mammography showed the characteristic finding of an irregular shaped, heterogenous mass lesion. We report here on this case and we briefly review the related literature.
Adipose Tissue ; Adult ; Aged ; Breast ; Diagnosis ; Drinking ; Female ; Fresh Water ; Humans ; Mammography ; Snakes ; Sparganosis* ; Thoracic Wall ; Water