The effects and safety of using oral Nicardipine(NCP, Perdipine(R)) a calcium blocking agent of the dihydropyridine derivative, were assessed in 29 patients(14 males, 15 females, mean age 56.3 years) with essensed hypertension with complications of left ventricular hypertrophy and/or hypertensive retinopathy. The patients with a sitting blood pressure(BP) of more than 160/100mHg at 4th week while off all antihypertensive agents, were entered into the study and recieved NCP, 20mg tid for 2 weeks, BP being measured once every week. NCP significantly reduced. The systolic BP from 179.5+/-18.2mmHg to 143.4 +/-18.2mmHg, the diastolic BP from 112.9+/-16.2mmHg to 93.1+/-10.4mmHg and the mean BP from 135.2+/-11.7mmHg to 110.0+/-9.9mmHg(mean+/-S.D. of weekly BP for 4 weeks)(P<0.001). Fall in systolic, distolic and mean BP was 35.1+/-15.1mmHg, 20.0+/-8.3mmHg and 25.3+/-10.2mmHg, respectively. A fall in systolic BP of more than 20mmHg, in diastolic BP of more than 10mmHg and in mean BP of more than 13mmHg was obtained in 86.2%, 89.6% and 86.2% of the cases, respectively. The heart rate did not change with oral NCP. The side effects were headache, facial flushing, dizziness and palpitation, but they were tolerable. These finding suggest that NCP is an effective and safe drug for the treatment of sustained essential hypertension.
Antihypertensive Agents ; Calcium ; Dizziness ; Female ; Flushing ; Headache ; Heart Rate ; Humans ; Hypertension* ; Hypertensive Retinopathy ; Hypertrophy, Left Ventricular ; Male ; Nicardipine*

No abstract available.
Subarachnoid Space* ; Syringomyelia*

PURPOSE: Benign prostatic hyperplasia (BPH) is a representative urological disease in men at senescence. The etiology of BPH is multifactorial, with chronic conditions, such as non insulin dependent diabetes mellitus (NIDDM), treated hypertension, obesity, low and high density lipoprotein (HDL) cholesterol levels and high insulin levels, constitute for the development of BPH. The prevalence of metabolic syndrome in a BPH population was investigated and the relationship between BPH and metabolic syndrome evaluated. MATERIALS AND METHODS: The BPH group consisted of 162 patients (63.4+/-7.8 years old) diagnosed as BPH and the control group of 68 patients (59.7+/-6.4 years old) without voiding difficulties. In each group, the relating factors, prevalence of BPH and metabolic syndrome were investigated and analyzed for comparison. RESULTS: Comparing the voiding factors of the BPH and control groups, all of the measured values showed aggravation of the voiding difficulty in the BPH compared with the control group. The prevalence of metabolic syndrome in the BPH group was 64.2%, which was about double that in the control group (32.4%) (p<0.001). Among the components of metabolic syndrome, hypertension (70.4%) was found to have the highest prevalence. CONCLUSIONS: The probability of patients with BPH having metabolic syndrome is high compared to those without BPH. Consequently, in BPH patients, careful evaluation for metabolic syndrome is needed, with the early diagnosis and proper management of metabolic syndrome should accompany the treatment of BPH.
Aging ; Cholesterol ; Diabetes Mellitus ; Early Diagnosis ; Humans ; Hypertension ; Insulin ; Lipoproteins ; Male ; Obesity ; Prevalence ; Prostatic Hyperplasia* ; Urologic Diseases

Purpose: The occurrence of coronary artery disease is rising with the recent changes in diet and the westernization of lifestyle. In 1998, the World Health Organization (WHO) defined "metabolic syndrome" as a condition in which all the risk factors of coronary artery disease exist in an elderly individual. We investigated the relationship between metabolic syndrome and voiding difficulty of women. Materials and Methods: In 2004, we investigated 66 female out-patients who visited the endocrinology department and health care center between the months of March and October. We divided the patients into two groups: one which corresponded to the metabolic syndrome criteria (n=42, 56.0+/-5.6 years old) and one which did not (n=24, 55.7+/-05.2 years old), and we compared the voiding factors of these two groups. Results: When comparing the components of metabolic syndrome in the patient study group to that in the control study group, the metabolic syndrome patients scored poorly for all the metabolic syndrome components in comparison to the control group (p<0.05). On comparing the voiding factors of metabolic syndrome patients to that of the control group, the metabolic syndrome patient group scored substantially lower than the control group for all voiding factors (p<0.05). Conclusions: We proved that metabolic syndrome and voiding difficulty of women were related based on the results of this study. Therefore, performing more active investigation for metabolic syndrome in the patients who are admitted with voiding difficulty, earlier diagnosis of metabolic syndrome would be possible.
Aged ; Coronary Artery Disease ; Delivery of Health Care ; Diagnosis ; Diet ; Endocrinology ; Female ; Humans ; Life Style ; Metabolic Syndrome X ; Outpatients ; Risk Factors ; Urination Disorders ; World Health Organization

No abstract available.
Epidural Abscess* ; Spondylitis*

No abstract available.
Tumor Necrosis Factor-alpha*

OBJECTIVES: Postoperative bleeding and adhesion formation are the two most common complications after endoscopic sinus surgery (ESS). The former sometimes can be life threatening and the latter is the most common reason requiring revision surgery. This study was designed to evaluate the effect of newly developed chitosan gel (8% carboxymethyl chitosan, Surgi shield) on hemostasis and wound healing after ESS. METHODS: A prospective, randomized, double-blind controlled trial was conducted in 33 patients undergoing symmetric ESS. At the conclusion of the operation, Surgi shield was randomly applied on one side of the nasal cavity, with the opposite side acting as control and the bleeding quantity of the surgical field was evaluated every 2 minutes. And then, Merocel was placed in the ethmoidectomized areas of the both sides. Five milliliters of Surgi shield was applied to the Merocel of intervention side and saline was applied to the other side. Merocel in both nasal cavities was removed and 5 mL of Surgi shield was applied again to the intervention side on the second day after surgery. The nasal cavity was examined using a nasal endoscope and the degree of adhesion, crusting, mucosal edema, infection, and granulations were graded at 1, 2, and 4 weeks after surgery. RESULTS: Complete hemostasis was rapidly achieved in the Surgi shield applied side compared with the control side at 2, 4, 6, 8, and 10 minutes after application of Surgi shield (P#x0003d;0.007, P#x0003d;0.004, P<0.001, P#x0003d;0.001, and P<0.001, respectively). There were significantly less adhesions on the Surgi shield applied side at postoperative 1, 2, and 4 weeks (P#x0003d;0.001, P<0.001, and P<0.001, respectively). The degree of mucosal edema, infection, crusting, or granulation formation assessed by the endoscopic features in the Surgi shield applied side was not significantly different from that of the control side (P>0.05). No adverse effects were noted in the patient series. CONCLUSION: Surgi shield containing chitosan can be used safely to achieve rapid hemostasis immediately after ESS and to prevent adhesion formation.
Chitosan* ; Edema ; Endoscopes ; Endoscopy ; Hemorrhage ; Hemostasis* ; Humans ; Nasal Cavity ; Prospective Studies ; Wound Healing

The spontaneous rupture of splenic artery aneurysm during pregnancy is a rare but catastrophic event. Two thirds of all ruptures happen during the third trimester. Clinical presentation is often non-specific, with good hemodynamic compensation, followed by a rapid deterioration. Active management and operation are the most important procedures for diagnosis and therapy of the bleeding. Abdominal delivery will help to establish diagnosis and should be performed immediately. We report a case of a patient at 38 weeks of gestation suffering epigastric pain and fetal distress. At emergency cesarean delivery, an aneurysmal rupture of the splenic artery was found to be the reason for the hemoperitoneum. Spleen, aneurysm and the tail of the pancreas were removed. In spite of fatal hemorrhage, the patient survived but her fetus was dead. With a review of the literature on this topic, diagnostic aspects and treatment options are discussed.
Aneurysm* ; Cesarean Section ; Compensation and Redress ; Diagnosis ; Emergencies ; Female ; Fetal Distress ; Fetus ; Hemodynamics ; Hemoperitoneum ; Hemorrhage ; Humans ; Pancreas ; Pregnancy ; Pregnancy Trimester, Third* ; Rupture ; Rupture, Spontaneous* ; Spleen ; Splenic Artery*

BACKGROUND: Diffuse panbronchiolitis(DPB) is a chronic inflammatory disease affecting the respiratory bronchioles which was first described in Japan in 1966. DPB is prevalent in Japan and is known to be very rare in western countries. The first cases of DPB were reported in Korea in 1992 and the number of the patients has been increasing. The prognosis of DPR had been very poor because there had been no effective treatment for the disease. Hut it has been dramatically changed since the introduction of low-dose long-term erythromycin therapy. In Korea, there is rare experience of 1ong-term follow-up of DPH patients and we presents the results of mean 21.6 months of follow-up after erythromycin treatment. METHODS: We analyzed the long-term follow-up data of 25 DPH patients who were diagnosed in Seoul National University Hospital during the period from September 1989 to December 1994 and followed up more than 6 months with erythromycin therapy. We tried erythromycin 250mg b.i.d. on all the patients and analyzed the changes of subjective symptoms, physical signs, pulmonary function tests, and chest X-rays. RESULTS: 1) The mean follow-up period was 21.6 months. 2) Subjective symptoms improved in 96% of the patients within 3 months and 76% of the patients showed no symptom after 18 months of treatment. 3) Crackles and wheezing decreased in all patients within 3 months and completely disappeared in 76% of the patients after 18 months of treatment. 4) Diffuse small nodular lesions on chest X-ray decreased in 56% of the patients within 3 months and chest PA was normal in 32% of the patients after 12months of treatment. 5) FVC and FEV1 increased remarkably during the first 3 months and slowly increased thereafter, reaching normal level after 12 months of treatment. FEV1/FVC was 60.4% before treatment and in- creased slowly reaching 76.1% after 24 months of treatment. 6) Erythromycin therapy could be finished in 7 patients. The mean duration of medication was 26 months and no evidence of recurrence was found in 6 months of follow-up. 7) No patients had experienced the side effect of erythromycin, CONCLUSION: The prognosis of DPR is very goad when treated with erythromycin. And at least 2 years of erythromycin treatment seems to be needed for DPB patients.
Bronchioles ; Erythromycin* ; Follow-Up Studies* ; Humans ; Japan ; Korea ; Prognosis ; Recurrence ; Respiratory Function Tests ; Respiratory Sounds ; Seoul ; Thorax

Gaucher's disease is an autosomal recessive disorder resulting fror i mutation at the glucocerebrosidase locus on chromosome 1q21. As a result, glucocerebroside accumulates principally in the phagocytic cells known as Gaucher ce Is. In our case, a five-year old girl was admitted with seven days history of fever and abdominal distension. At physical examination the patient had hepatosplenomegaly. Laboratory tests revealed a hemoglobin concentration of 2.8g/L: platelet counts of 23,0001?l: normal range of white cell and differential counts, and negative Coombs' test. Liver enzymes were normal. For the evaluation of hepatosplenomegaly, fine needle aspiration was aerformed blindly against the palpable spleen. Wet-fixed hematoxylin and eosin-stained smears are made. The smears from the spleen showed predominantly macrophages with abundant cytoplasm and rather small, uniform, often eccentric nuclei with small nucleoli. The multinucleated cells were often found. The cytoplasm was pale, with more or less distinct fibrillarity. The cells had the characteristic appearance of Gaucher cells. Gaucher cells were also found it the tissue section from the liver, spleen and lymph node and the bone marrow aspirate. The diagnosis was later confirmed by determination of beta-glucosidase activity in peripheral blood leucocytes. Fine needle aspiration of the spleen is considered as a convenient procedure with a low complication rate for the diagnosis of lysosomal storage disease.
beta-Glucosidase ; Biopsy, Fine-Needle ; Bone Marrow ; Coombs Test ; Cytoplasm ; Diagnosis ; Female ; Fever ; Gaucher Disease* ; Glucosylceramidase ; Hematoxylin ; Humans ; Liver ; Lymph Nodes ; Lysosomal Storage Diseases ; Macrophages ; Phagocytes ; Physical Examination ; Platelet Count ; Reference Values ; Spleen*