Paroxysmal nocturnal hemoglobinuria(PNH) is a rare, acquired disease involving multiple hematopoietic lines. Characteristics of PNH are intrinsic hemolytic anemia, iron deficiency anemia and venous thrombosis. report a case of PNH with characterostoc MR and CT findings. The signal intensity of renal cortex was lower than that of medulla on both T1- and T2- weighted MR imaging. On T2 weighted MR images, the liver showed very low signal intensity but the signal intensity of the spleen was normal. On precontrast CT the attenuation of renal cortex was higher than that of renal medulla and the attenuation of liver was higher than that of the spleen. These findings of MR imaging and CT were the result from the deposition of hemosiderin in the cells of proximal convoluted tubules and transfusional hemosiderosis of liver.
Anemia, Hemolytic ; Anemia, Iron-Deficiency ; Hemoglobinuria, Paroxysmal* ; Hemosiderin ; Hemosiderosis ; Liver ; Magnetic Resonance Imaging ; Spleen ; Venous Thrombosis

No abstract available.
Ambulatory Care Facilities* ; Humans ; Outpatients*

No abstract available.
Iron*

No abstract available.

Five cases of ovarian serous borderline tumor associated with multiple peritoneal implants were analysed. The age of 5 patients ranged from 34 to 45(mean: 39) years at the time of diagnosis. Two patients presented with secondary infertility underwent hyperstimulation of the ovary under the in vitro fertilization program. One patient was presented with abdominal pain and the remaining two with lower abdominal mass accompanied by abdominal pain. Serous surface papilloma of borderline malignancy, involving one or both ovaries, was present in all 5 cases and papillary serous cystic tumor of borderline malignancy was associated simultaneously in one or both ovaries in all cases. Marked adhesions between the pelvic organs, and multiple granularities and nodularities of the omentum and peritoneum were noted. Microscopically, the peritoneal lesions were composed of noninvasive implants of tumor cells and pasmmoma bodies on the surface of entire pelvic and abdominal organs. Flow cytometric analysis of nuclear DNA content from paraffin-embedded tissue fo primary ovarian tumor classified as aneuploidy in 3 cases and as diploidy in 2 cases. The DNA index of the aneuploid tumors ranged from 1.21 to 1.37. Four patients underwent hysterectomy, bilateral salpingo-oophorectomy and partial omentectomy in which two were followed by chemotherapy and one case underwent bilateral salpingo-oophorectomy.

The effects of several anesthetios (thiopental, ketamine, Innoyar) and muscle relaxants (succinylcholine and vecuronium) on IOP, blood pressures and pulse rates were studied in 60 Patients ranging in are 12 to 56 years. IOP was measured with the Schiotz tonometer. In addition to tonometric determinations, the blood pressures and pulse rates were recorded. The patients were divided into 4 groups: Thiopental-succinylcholine-intubation(Group 1) ; Ketamine-succinrlcholine-intubation (Group 2) ; Innovar-succitrlcholine-intubation (Group 3) and Thiopental-vecuronium-intubation (Group 4) . The results were as follows : 1) In group 1 and 4, IOP changes following thiopental(5 mg/kg) administration showed highly significant decreases(p<0.01) after 1 minute compared with the control value. 2) In group 1 and 3, IOP changes after 1 minute following succinrlcholine administration showed mild increases and were not statistically significant(p>0.05) and in group 2, IOP changes after 5 minute following succinylcholine administration shewed highly significant increases (p<0.01) . 3) In group 3, IOP changes after 5 minutes following Innovar (1 ml/15 kg) administration showed highly significant decreases (p<0.01) compared with the control value. 4) IOP changes after 1 minute of endotracheal intubation showed highly significant inc- reases (p<0.01) in all groups compared with the control value. 7) In group 4, IOP changes following vecuronium administration instead of succinylcholine showed highly significant decreases, but could not prevent the increases in IOP following endotracheal intubation. 6) In all groups, blood pressures and pulse rates showed highly significant increases after endotracheal intubation. 7) After succinylcholine administration, blood pressures showed aignificant increases in group 1 and highly significant increases in group 2. 8) In group 2, blood pressures showed highly significant increases after ketamine administration.
Anesthetics* ; Blood Group Antigens ; Heart Rate ; Humans ; Intraocular Pressure* ; Intubation, Intratracheal ; Ketamine ; Succinylcholine ; Vecuronium Bromide

No abstract available.
Sepsis* ; Yersinia*

BACKGROUND: Recently in Europe, some epidemiologic studies reported that various physical symptoms and social, psychological wellbeing are related to low blood pressure. But in Korea, none has been studied on symptoms related to low blood pressure yet. In this study, we would like to see if the somatic symptoms and social, psychological wellbeing shown t,o be related to low SBP is truly associated with it. METHODS: Questionnaire interview was done to the people who have visited Department of family practice in two university hospitals and two health promotion center from April, 1996 to August, 1996. Seven somatic symptoms and Psychosocial Wellbeing Index(PWI) for the evaluation of social, psychological health status were included in the questionnaire. SAS statistics packages was used in statistical precess. We used logistic regression to see the frequency of somatic symptoms related to the systolic blood pressure(SBP) group and the confirmation of confounding variables was done by ANOVA. RESULTS: Total of 304 completed the questionnaire. Average age was 44 years old and average SBP was 115.4+/-16.4. 84 of them (27.6%) felt that they had a low BP & 69 were women compared to 21 men, being meaningfully more common. 107(35.2%) people answered that they had heard that their blood pressure was low and 66% were from doctors. Only 32(38.1%) of the group who felt of having hypotensive symptoms and 38 of the group who heard of having hypotension actually had SBP of below 100 mmHg. Vocation, income, smoking & alcohol history, present illness, marital status were not significant as a confounding variable. SBP of 100 or below group had a less presentation of fatigue & significantly higher PWI than the group of above 100mmHg (p<0.05). The group who felt that they had a low BP had more complaints of fatigue, dizziness, palpitation, cold hands and feet and had significnatly higher PWI than the group who didnt. CONCLUSIONS: SBP of 100mmHg or below group has more frequent manifestion of fatigue and low level of sociopsycholgiacl health index than the above 100mmHg group. But most of the people who complained of hypotensive symptoms didnt have low blood pressure and a lot of them misunderstand of having low blood pressure and after checking blood pressure by doctors, so great deal of caution is called for when seeing patients.
Adult ; Blood Pressure* ; Confounding Factors (Epidemiology) ; Dizziness ; Epidemiologic Studies ; Europe ; Family Practice ; Fatigue ; Female ; Foot ; Hand ; Health Promotion ; Hospitals, University ; Humans ; Hypotension ; Korea ; Logistic Models ; Male ; Marital Status ; Occupations ; Smoke ; Smoking ; Surveys and Questionnaires

Extramedullary plasmacytoma is a rare malignancy, composed of plasma cell dyscrasias localized to an extramedullary site in the soft tissue. The great majority of extramedullary plasmacytoma occurs in the head and neck region, mainly in the upper respiratory tract and oral cavity. Extramedullary plasmacytoma arising in the kidney, termed a primary renal plasmacytoma, is a very rare malignancy. Primary renal plasmacytoma is not distinguished from a renal cell or transitional cell carcinoma using conventional imaging studies. The diagnosis of a primary renal plasmacytoma is only made on histopathological examination. Herein, a case of primary renal plasmacytoma, in a 39-year-old male patient, is reported.
Adult ; Carcinoma, Transitional Cell ; Diagnosis ; Head ; Humans ; Kidney ; Kidney Neoplasms ; Male ; Mouth ; Neck ; Paraproteinemias ; Plasmacytoma* ; Respiratory System

BACKGROUND: Thoracoscopic sympathicotomy was, at first, thought to be a simple and safe method for treatment of hyperhydrosis. However, the main disadvantage of this procedure is irreversibility in additions so-called rebound sweating occurred in 30 40% of patients during the first 1 2 weeks after operation. Some patients regret the surgery, even to the extend of preferring the original sweaty hands. Recently clipping has been suggested one of the way to minimize such problem. Hypothesis of this study was that sympathetic nerve block effect by clipping may be weak compared to sympathicotomy. The aim of this study was to evaluate and compare the sympathicotomy by clipping effect on cardiovascular system. METHODS: Sixty-five patients with essential hyperhydrosis in ASA physical status class 1 undergoing thoracoscopic sympathetic block were randomly divided into two groups: The Clipping group (N = 21) and the sympathicotomy (N = 44) group. Anesthesia was induced with thiopental sodium (5 mg/kg) and pancuronium (0.05 mg/kg) and maintained with enflurane. The operation was done to the left side first and the to the right by an experienced surgeon. During the procedure, we measured blood pressure using a non invasive technique at the right forearm, heart rate and temperature after anesthetic induction as baseline values, immediately after the left side resection of the T2 sympathetic trunk or clipping, and after completely both sides resection. All the records were coded and analysed single blind by one author. RESULTS: After the T2 sympathicotomy, heart rate decreased from 87 +/- 14 to 76 +/- 17 (P < 0.05) and the mean blood pressure was reduced from 77 +/- 14 to 64 +/- 10 mmHg (P < 0.05). After T2 clipping, heart rate decrease from 88 +/- 18 to 73 +/- 14 (P < 0.05) and mean blood pressure was reduced from 74 +/- 12 to 67 +/- 13 mmHg (P < 0.05). CONCLUSION: The main result of this study was that there was no significant difference in sympathetic block effects on blood pressure and heart rate between clipping and sympathicotomy during the procedure.
Anesthesia ; Autonomic Nerve Block ; Blood Pressure* ; Cardiovascular System ; Enflurane ; Forearm ; Hand ; Heart Rate* ; Heart* ; Humans ; Pancuronium ; Sweat ; Sweating ; Thiopental