Twenty-two cases of idiopathic myocardiopathy were observed during the period of 1962 to 1971 and follow up clinical study was made in 5 cases. The criteria of diagnosis was based mainly on exclusive diagnosis in etiology unknown marked cardiomegaly. 1) Male and female ratio of idiopathic myocardiopathy was 1.1:1 and age of onset were distributed from first decade to fifth decade with similar number of cases. 2) Cardinal symptoms were dyspnea, palpitation, chest pain and cough. Common physical findings were protodiastolic gallop (in 2 cases), moist rales (in 3 cases) and hepatomegaly(in 3 cases). 3) Laboratory findings were normal except elevated T.T.T. in one case. 4) Electrocardiogram were abnormal in all cases. There were 3 cases of left ventricular hypertrophy, 3 cases of non-specific ST-T changes and one case of first degree A-V block, intraventricular conduction defect, abnormal Q wave and low valtage, respectively. 5) After medical treatment, symptoms were improved in 4 cases but heart size was reduced in only one case and E.C.G. abnormalities were unchanged in all cases.
Age of Onset ; Cardiomegaly ; Cardiomyopathies* ; Chest Pain ; Cough ; Diagnosis ; Dyspnea ; Electrocardiography ; Female ; Follow-Up Studies ; Heart ; Humans ; Hypertrophy, Left Ventricular ; Male ; Respiratory Sounds

We report two cass of HIV infection associated with condyeloma acuminatum. Two patients were healthy men who showed multiple pinkish verruc ous papules on the perianal area. Anti-HIV antibodies were detected in the patients' secatory particle agglutination test and confirmed by Western blot assay.
Agglutination Tests ; Antibodies ; Blotting, Western ; HIV Infections ; HIV* ; Humans* ; Male

BACKGROUND: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder that often resolves spontaneously. It was long believed that the condition was caused by inorganic particles in the cupula of the posterior semicircular canal. Management of this condition includes medication, surgery, physical exercise and more recently particle repositioning maneuvers. Among the various therapies, exercise therapy (ET) reported by Brandt-Daroff was based on the theory of cupulolithiasis and is designed to treat BPPV through dispersion of the debris from the cupula. METHODS: Fifty four patients with BPPV were treated with ET to determine the effectiveness. Fifteen additional patients with BPPV were treated with only medication and served as a control group. RESULT: Forty eight of 54 cases (88.9%) treated with ET showed improvement after 2 weeks. With medication alone, 8 of the 15 cases (53.4%) showed improvement after 2 weeks. CONCLUSIONS: The most important benefit of this maneuver seemed to be more expedient recovery than that with medication alone.
Exercise ; Exercise Therapy* ; Humans ; Semicircular Canals ; Vertigo*

BACKGROUND: Generalized immune activation occurs early in the course of many infectious disease. Laboratory investigations have shown that immune activation can be quantified by the measurement of soluble immune activation products in serum. Soluble CD25, CD8, and CD4 are major immune activation products. Soluble CD8 and CD4 are indices of CD8+ T cell and CD4+T cell activity, respectively. OBJECTIVE: We estimated the concentrations of these molecules in patients with leprosy. METHODS: The study population consisted of 31 patients with tuberculoid leprosy and 71 patients with lepromatous leprosy(32 cases of M. leprae negative patients and 39 cases of M. leprae positive patients). Serum samples and clinical and laboratory data were collected form each patient and control. The levels of serum soluble CD25, CD8, and CD4 were measured by sandwich enzyme immunoassay. RESULTS: The levels of serum soluble CD25 were significantly raised in leprosy patients as compared to control and did not vary signficantly between tuberculoid and lepromatous leprosy. The soluble CD8 levels in the serum of patients with leprosy did not differ from the levels of the control. The levels of serum soluble CD4 were significantly decreased in the patients with lepromatous leprosy, but not in the patients with tuberculoid leprosy. However, there was no significant correlation between CD25, CD8, and cD4 and bacterial indices in patients with lepromatous leprosy. CONCLUSIONs: There data suggest that non-specific immune activation occurs the spectrum in leprosy, while CD4+ T cell activity is significantly decreased in patients with lepromatous leprosy.
Communicable Diseases ; Humans ; Immunoenzyme Techniques ; Leprosy* ; Leprosy, Lepromatous ; Leprosy, Tuberculoid

Postoperative hepaotoxicity may develope as a result of many causes. These poasble cau may include direct injury to the liver cella due to anesthetic drugs such as halothane, chronic liver disease, viral hepatitis, sepsis, severe burns, pregnancy, drug administration and transfusion. We had seven cases of acute hepatitis following surgery for the past 6 months. CASE 1: A 26-year-old male had an operation for maxillar fracture under isoflurane anesthesia. The preoperative liver enzyme (SGOT, SGPT) were elevated but other tests were within normal range. He developed high fever, marked elevation of SGOT, SGPT, upper abdominal pain and nausea on the 7th postoperative day. He died of acute respiratory and renal failure on the 23 rd postoperative day. CASE 2: A 55-year-old woman had an operation for cervical spondylosis under halothane anesthesia. She developed high fever, headache and leukocytosis on the 12th postoperative day. Liver function tests showed marked elevation of SGOT, SGPT, bilirubin and hypoalbuminemia on the 17th day. She died of acute respiratory failure on the 30th postoperative day. CASE 3: A 53-year-old woman had an operation for epidermal cyst under halothane anesthesia. On the 12th postoperative day she developed high fever, skin rash, marked elevation of SGOT, SGPT and leukopenia. She recovered gradually from hepatitis and went home in good health on the 30th postoperative day. CASE 4: A 68-year-old man had an operation for oral cancer under enflurane anesthesia. On the 16th postoperative day, liver function tests showed elevation of SGOT, SGPT and leukopenia, He gradually recovered on the 19th postoperative day. CASE 5: A 64-year-old woman had an operation for MCA aneurysm under enflurane anesthesia. He developed hypotension on the 20th postoperative day and respiratory difficult and marked elevation of SGOT, SGPT, BUN, creatinine, and generalized edema on the 22nd day. She recovered gradually and went home in good health on the 45th postoperative day. CASE 6: A 23-year-old woman had an operation for mandible fracture under enflurane anesthesia. The preoperative liver function tests showed a mild elevation of SGOT, SGPT, ALP. She recovered gradually and went home in good health on the 30th postoperative day. CASE 7: A 19-year-old woman had an operation for mandible fracture under halothane anesthesia. On the 30th postoperative day, she developed jaundice and marked elevation of SGOT, SGPT. She recovered gradually and went home in good health on the 55th postoperative day.
Abdominal Pain ; Adult ; Aged ; Alanine Transaminase ; Anesthesia ; Anesthesia, General* ; Anesthetics ; Aneurysm ; Aspartate Aminotransferases ; Bilirubin ; Burns ; Creatinine ; Edema ; Enflurane ; Epidermal Cyst ; Exanthema ; Female ; Fever ; Halothane ; Headache ; Hepatitis ; Humans ; Hypoalbuminemia ; Hypotension ; Isoflurane ; Jaundice ; Leukocytosis ; Leukopenia ; Liver ; Liver Diseases ; Liver Function Tests ; Male ; Mandible ; Middle Aged ; Mouth Neoplasms ; Nausea ; Pregnancy ; Reference Values ; Renal Insufficiency ; Respiratory Insufficiency ; Sepsis ; Spondylosis ; Young Adult

A clinical study was done on 29 cases of spontaneous pontine hemorrhage which were confirmed by brain CT scan at Keimyung university Dongsan hospital from Jan. 1981 to Feb. 1986. The results are summarized as follows. 1. The incidence of pontine hemorrhage was 7.4% of all spontaneous intracranial parenchymal hemorrhage. 2. The most prevalent age group were 40th and 50th decades and male to female ratio was 2.2:1. 3. The most common precipitating factor was hypertension and most of pontine hemorrhage occurred during daily routine or increased activities. 4. Symptoms on onset were headache, altered consciousness, vomiting, dizziness, motor weakness, dysarthria, sensory disturbance and generalized convulsion, in order of frequency. 5. Cardinal neurologic signs on admission were loss of consciousness, ocular signs e.g. Pinpoint or miotic pupil absent horizontal doll's eye movement ocular bobbing skew deviation MLF syndrome, motor weakness e.g. quadriparesis hemiparesis decerebrate rigidity, positive Babinski sign. 6. Mean size of hematoma on CT was 6.8cc and 44% was under 5cc. Hematoma of 4th ventricle was seen in 36% of pontine hemorrhage. 7. 25 cases of pontine hemorrhage were divided into 3 groups according to the location of hematoma on CT-basilar (2 cases), tegmental (15 cases), diffuse (8 cases). 8. All 29 cases of pontine hemorrhage were treated medically, 21% were improved, and 79% hopeless discharge or death. 9. Mild disturbance of consciousness on admission, small size (under 5cc) of hematoma and absence of hematoma in the 4th ventricle seem to be good prognostic indicators.
Brain ; Consciousness ; Decerebrate State ; Dizziness ; Dysarthria ; Eye Movements ; Female ; Headache ; Hematoma ; Hemorrhage* ; Humans ; Hypertension ; Incidence ; Male ; Neurologic Manifestations ; Ocular Motility Disorders ; Paresis ; Precipitating Factors ; Pupil ; Quadriplegia ; Reflex, Babinski ; Seizures ; Tomography, X-Ray Computed ; Unconsciousness ; Vomiting

BACKGROUND: Many physiologic, pharmacologic and immunologic abnormalities were reported in atopic dermatitis but the cause and pathogenesis of the disease remain obscure. OBJECTIVE: This study was done to investigate the systemic immunologic abnormalities in atopic dermatitis. METHOD: To evaluate the cell mediated immunity, me quantified pei ipheral blood T lymphocytes and their subsets, using flow cytometery, and assessed plasma neopteiin levels by means of radioimmunoassay. To evaluate the abnormal humoral immunity, we assessed the serum IgE levels by means of enzyme-immunoassay. RESULTS: Mean proportions of peripheral blood T lymphocytes and, heir subsets in atopic Dermatitis patients were within normal limits. Hut the suppvessor/cytotoxic T lyrphocytes(T8) were significantly decreased in the group of se"ere atopic dermatitis compared with the group of mild atopic dermatitis(P<0.05). Plasma neopterin lervels in the group of atopic dermatitis were found to be significantly elevated as compared vith the control group(P<0.01), but no significant cifference was found between the mild and severe group of atcpic dermatitis(P>0.05). Mean serum IgE levels in the patients with atopic dermatitis were higher than reference value. But there was no significant difference between the mild and severe atopic dermatitis group. Serum IgE levels ivere negatiiely correlated with T8(r=-0.3774, P<0.05) and positively with T4/T8 ratio(r =0.5007, P<0.05). Conclusions : These data;uggest that the atopic der matitis has abr ormalities in cell mediated immunity as well as elevated IgE level.
Dermatitis, Atopic* ; Humans ; Immunity, Cellular ; Immunity, Humoral ; Immunoglobulin E ; Neopterin* ; Plasma* ; Radioimmunoassay ; Reference Values ; T-Lymphocyte Subsets* ; T-Lymphocytes

BACKGROUND: Cyclosporin A (CsA), a potent immunosuppressant, has been reported to be effective in the treatment of severe atopic dermatitis (AD). OBJECTIVE: The aim of this study was to evaluate the efficacy and side-effects of CsA in Korean patients with severe AD. MATERIALS AND METHODS: 16 patients with recalcitrant AD took CsA for at least 6 weeks. Among them, 11 patients were followed up for more than 16 weeks. Initial dose was 5mg/kg/day (maximum 300 mg/day) and the dose was reduced according to their therapeutic responses. SCORAD (Scoring AD) was used to evaluate clinical efficacy of CsA. During the 1st month of therapy, the therapeutic efficacy and side-effects were evaluated every 2weeks and after 1 month, every month. We checked blood pressure and laboratory abnormalities including liver function test, blood urea nitrogen (BUN), creatinine (Cr) and urinalysis at each visit in addition to observing clinical adverse effects. RESULTS: Significant reduction of SCORAD was noted in 15 patients after 6 weeks of CsA therapy. Only one patient stopped CsA therapy because of the elevation of blood pressure. Three patients showed albuminuria, which disappeared after CsA dose reduction. CONCLUSION: CsA can be used effectively and safely in severe Korean AD patients. Albuminuria seems to be a peculiar side-effect in Korean patients.
Albuminuria ; Blood Pressure ; Blood Urea Nitrogen ; Creatinine ; Cyclosporine* ; Dermatitis, Atopic* ; Humans ; Liver Function Tests ; Urinalysis

Postictal sequential serum prolactin concentrations were observed in 28 patients with various type of seizures who were hospitalized at Keimyung University Hospital. Of 28 epileptic patients, 18 male and 10 female, age ranged from 18 years to 79 years (mean 42 years), 15 with generalized seizures, 13 with focal seizures (5 with simple partial seizures and 8 with partial seizures with generalization). Symptomatic epilepsy and epileptic patients with factors which may affect serum prolactin concentrations were excluded in this study. Serum prolactin concentrations were measure at 15, 30 and 60 minutes after convulsion and 24 hours after convulsion for the base line serum prolactin level. Patients with generalized seizsures and significant elevation of serum prolactin concentrations at 15, 30 and 60 minutes after ictus (Table 1). Same results were obtained in patients with simple partial seizures at 30 minutes and 60 minutes after ictus, and 15 minutes and 30 minutes after ictus in patients with partial seizures with secondary generalization (Table 2 and 3). Level of serum prolactin concentrations were higher in patients with generalized seizure than the other type of seizures. Therefore, measuring serum prolactin level could help differentiate postictal state and other causes of mental change, and also differentiative various type of seizures.
Epilepsies, Partial ; Epilepsy ; Female ; Generalization (Psychology) ; Humans ; Male ; Prolactin* ; Seizures*

BACKGROUND: Myelopathies are classified as intramedullary and extramedullary one on the basis of location of lesion. Though there are some characteristic clinical findings which can differentiate extramedullary from intramedullary lesions, it is not easy to tell extramedullary from intramedullary lesions in complicated cases. We performed this study to figure out the relationships between anatomic location (intramedullary or extramedullary), clinical parameters (motor and sensory symptoms and signs), and electrophysiologic findings in myelopathy. We also investigated the diagnostic value of motor evoked potential (MEP) compared with that of somatosensory evoked potential (SSEP) in myelopathy. The amplitude changes of compound muscle action potential (CMAP) after motor cortex stimulation have a lot of intra-individual and inter-individual variability, so were not used to determine pyramidal tract dysfunction in clinical ground. We analyzed CMAP amplitude changes in myelopathy. METHODS: Fifty-six patients with myelopathy demonstrated in MRI were studied. We defined abnormal CMAP amplitude changes as intra-individual inter-side amplitude ratio more than 50%. RESULTS: Lower MEP showed abnormal findings in 93% of tests and lower SSEP, 37% (p<0.05). The correla-tions between clinical parameters and electrophysiologic findings were higher in lower MEP (71%) than lower SSEP (42%) (p<0.05). CONCLUSIONS: The results of this study suggest that MEP is more useful than SSEP for detecting spinal cord dysfunction but as false positivity of lower MEP was considerable, MEP and SSEP are reciprocal diagnostic method for myelopathy. SSEP and MEP do not have significant diagnostic values in differentiating extramedullary from intramedullary myelopathy. The inter-side CMAP amplitude difference may indicate subclinical spinal cord dysfunction.
Action Potentials ; Evoked Potentials ; Evoked Potentials, Motor* ; Evoked Potentials, Somatosensory ; Humans ; Magnetic Resonance Imaging ; Motor Cortex ; Pyramidal Tracts ; Spinal Cord ; Spinal Cord Diseases*