The year 1943 saw the introduction, by Mahoney and his associates, of penicillin treatment for syphilis. That period was an epic turning point in many respects, not least of which was the commencement of the antibiotic era in venereology. Frorn that point on, there were no antibiotics as effective, as cheap,or as low in toxicity as penir.illin, despite the discovery of a number of ather. a.ntibiotics. Also, na signs of resistance by Treponema pallidum t,o the antibiotic have yet been noted, although this possibility ha.a not bcen evaluated adequately. Sirice then Benzathine penicillin G, a long acting l3epo-penicillin, (discovered by Seifter, et al, in 1951), has been uti.lized for treating ayphilis. Aft.er the discovery of penicillin, syphilis began to decline. However, during the r.niddle 1950s the incidence of syphilis began to increa se throughout the world. In the 1960's, this rate of increase became quite pronounced. Thus, the present trend. is to treat most syphi]is with Benzathine penicillin Ci. However, occasional adverse reacf.ions, (e.g. hypersensitivity, anaphyIactic shack, phobia of injections and other untoward effects), sometimes render treatment with Renzathine Fenicillin G irnpossible. In such cases, treatment consists of the oral administration of Vibramycin' (Doxycycline to compensate for the defects of the penicillin. Although the previous alternatives have tra,ditionally been Tetracycline and Erythromyr,in, by utiIizing Vibramycin, we are a.41e to repozt the results comparing the effectiveness of Vibramycin with the effectiveness of Renza.cillin. The results focus on clini.cal irnprcivement and serological tests. Thirty five patients were treateif, with Vibramycin, but despite our requests, only ten patients participated in the foliowup study. among these ten patients, three patients were hypersensitive to penicillin. Forty nine patients were treated with Benzacillin, among which only thirteen patients responded to our follow-up studies. All members of the Benzacillin group were skin tested for penicillin hypersensitivity before treatment was initiated. The Vibramycin treatment regirnen was the oral administration of 200mg twice on the first day, and from the second day to the fourteenth day, 100mg twice daily. Three million units of Benzacillin were given .intra;nuscularly in weekly intervals for three weeks. The therapeutic results obtained were as follows: 1) The Vibramycin group showed remarkable clinical irnprovernent en the third day of treatment, with clinical manifestations completely disappearing en the following days- Lymphangitis dorsalis penis, sixth day of treatment; headache ninth day' maculopapulo-squamous syphilids, eleventh day; condyloma lata, fourteenth day' primary chancre, tenth day after finishing treatrnent. However, regional lymphadenopathies persisted for over four and a half months. 2) In most patients, serological follow-up studies, (VDRL slide test, and Wasserrnann complement fixation test), revealed declining titers one month after concluding treatment. These titers continued to decline in the following months. One case of sero-relapse, howe ver, was shown in both the Vibramycin group and the Benzacillin group. R) No cases of side effects were observed in either treatrnent group. 4) It is concluded from this study that nine of ten patients (90%) in the Uibramycin group, and twelve of thirteen patients (92. 3 %) in the Benzacillin group showed serological improvement. Thus, in those instances where penicillin is contraindicated, (e.g. hypersensitivity, anaphylactic shock, etc.), Vibramycin (Doxycycline) appears to be one of the most valuable treatment alternatives available.
Administration, Oral ; Anaphylaxis ; Anti-Bacterial Agents ; Chancre ; Complement System Proteins ; Doxycycline* ; Follow-Up Studies ; Headache ; Humans ; Hypersensitivity ; Incidence ; Lymphangitis ; Male ; Penicillin G Benzathine ; Penicillins ; Penis ; Phobic Disorders ; Serologic Tests ; Skin Tests ; Syphilis* ; Syphilis, Cutaneous ; Tetracycline ; Treponema pallidum ; Venereology

Twenty-three bacteriologically positive leprosy patients were randomly selected from a leprosarium, randomly divided into four treatment groups, and given vaying dosages of Isoprodian, the tablet contained INAH 175mg, Prothionamide 175mg and DDS 50 mg, for five months. Group I: Initial 1/2 tablet dose per week with 1/2 tablet increment every weeks until 12 tablets were being consumed w.
Humans ; Leprosy* ; Prothionamide ; Tablets

A 59-year-old male farmer, an alcohol addict, has experienced repeated bullous skin lesions on the erythematous base over the exposed areas of tbe skin, especially on the face and hands, after sun-light exposure. The face showed hyperpigmenation, hypertrichosis and sclerodermoid changes. And also there were hypopigmented scars on the dorsum of the hands and cIaw-1ike fingers. Characteristic laboratory findings were as follows: Urine appeared portwine color and fluoresced under the Woods Iight. A 24-hour urine collection contamed 4l32ug of uroporphyrin and 3815ug of corproporphyrin. BSP retention(7% in 45 Min.) was increased, and A/G ratio(0. 8:1) was inverted. Gamma globulin(44, 9%) was markedly increased on serum electrophoresis. Roentgenograms revealed minimal tuberculosis on the chest P-A and superficial gastritis on the upper G-I series. Electrocardiogram showed left ventricular hypertrophy. Pathological findings of the specimen obtained from sclerodermoid lesion of the forehead revealed hypermelanosis in the basal cell layer and amorphous, basophilic collagen degeneration in the upper dermis, on the other hand loss of sinusoids due to swelling of hepatocytes and chomic inflammatory cell infiltrate in the interlobular septa were noticed on the specimen taken from the liver. For treatment, phlebotomy and metabolic alkalinization were trjed.
Basophils ; Cicatrix ; Collagen ; Dermis ; Electrocardiography ; Electrophoresis ; Fingers ; Forehead ; Gastritis ; Hand ; Hepatocytes ; Humans ; Hyperpigmentation ; Hypertrichosis ; Hypertrophy, Left Ventricular ; Liver ; Male ; Middle Aged ; Phlebotomy ; Skin ; Thorax ; Tuberculosis ; Urine Specimen Collection ; Wood

To Evaluate the clinical characteristics of childhood-onset systemic lupus erythemoatosus (SLE) and analyse the factors related to outcome of renal function in lupus nephritis, we reviewed medical records of 18 cases of SLF diagnosed at the Department of Pediatrics. Pusan National University Hospital from January 1981 to December 1990. The results were as follow: 1)Male to female ratio was 1:2.6. 2) Nephropathy was the most common initial impression, and 8 cases were diagnosed as SLE at first. 3) The clinical menifestation. was ANA (+), malar rash, renal disorder, hematologic disorder in frequency. 4) Diffuse proliferative lupus nephritis was the most common in renal histopathologic studies. 5) Among the follow-up cases, active lupus was 39%, remission was 28%. 6) As factors related to outcome of lupus nephrits were, hypertension and proteinuria were siginificant statistically.
Busan ; Exanthema ; Female ; Follow-Up Studies ; Humans ; Hypertension ; Lupus Erythematosus, Systemic* ; Lupus Nephritis ; Medical Records ; Pediatrics ; Proteinuria

No abstract available.
Chancre ; Lip

Congenital adrenal hyperplasia is inherited disorder of adrenal steroidogenesis. 21-hydroxylase deficiency is the most commone enzymatic defect and is divided into classic and late-onset or nonclassic forms. Both classic non-classic 21-hydrozylase deficiencies are inherited in a recessive manner as allelic variants. But it is rare that happened in twin infants. Chief complaints of affected twins in our case were ambiguous genitalia, hyperpigmentation and dehydrations. They were revealed into hyponatremia, hyperkalemia and increased amount of serum progesterone, 17-hydroxyprogesterone and urinary 17-ketosteroid excretion and were administered with DOCA, 9alpha-fluorohydrocortisone, hydrocortisone to control the electrolyte imbalance. And now, both of them are going to normal ratio of weight gain and body growth.
17-alpha-Hydroxyprogesterone ; Adrenal Hyperplasia, Congenital* ; Desoxycorticosterone Acetate ; Disorders of Sex Development ; Humans ; Hydrocortisone ; Hyperkalemia ; Hyperpigmentation ; Hyponatremia ; Infant ; Progesterone ; Steroid 21-Hydroxylase* ; Twins* ; Weight Gain

The penetrating atherosclerotic ulcer of the aorta resulting from the atherosclerosis of the aortic wall can clinically mimic type III aortic dissection, since both diseases produce the ulceration and dissection of aortic wall. However, their imaging features and pathophsiologies are distinctly different from each other. Familial hypercholesterolemia(FH) menifests overt hyperlipidemia that can results in premature atherosclerosis of the aorta as well as the coronary artery. We report a clinically and radiologically evident case of perntrating atherosclerotic ulcer of the descending thoracic aorta which was developed in a 36-year-oldd heterozygote FH male.
Aorta ; Aorta, Thoracic* ; Atherosclerosis ; Coronary Vessels ; Heterozygote* ; Humans ; Hyperlipidemias ; Hyperlipoproteinemia Type II* ; Male ; Ulcer*

We herein report a 4-year-old boy with infantile digital fibrornatosis developing on the distal & middle phalanx portion of the right index & ring fingers, and the middle phalanx portion of the right middle finger, which started at the age of 5 months after birth. Biopsy specimen taken from the right middle finger showed the proliferating collagen bundles and fibroblasts in the dermis and eosinophilic cytoplasmic inclusions within the fibroblasts. Although we attempted to treat tbe patient with intralesional injection of triamcinolone acetonide suspension and cryotherapy 5 times biweekly, there was no signifit effect.
Biopsy ; Child, Preschool ; Collagen ; Cryotherapy ; Dermis ; Eosinophils ; Fibroblasts ; Fibroma* ; Fingers ; Humans ; Inclusion Bodies ; Injections, Intralesional ; Male ; Parturition ; Triamcinolone Acetonide

OBJECTIVES: REM sleep behavior disorder (RBD) has received little attention in epidemiologic studies. This study aimed to determine the prevalence of probable REM sleep behavior disorder (pRBD) in the elderly population and its clinical features. METHODS: A random sample of 1,588 was selected from a roster of 14,050 elderly population living in Osan city. The subjects were asked to fill out the REM sleep behavior disorder screening questionnaire (RBDSQ). Subjects whose score were 5 or higher on RBDSQ underwent a diagnostic phase of person-to-person assessment by experts in RBD. RESULTS: Among 1,588 subjects, 886 elderly subjects participated in the screening phase and 123 subjects were assessed in the diagnostic phase. Eleven subjects were diagnosed as having pRBD, so prevalence was 1.5% (95% CI=0.70-2.30%). The frequency of depression and cognitive decline was significantly increased in patients with pRBD compared to subjects without pRBD, and there was no difference in sleep disturbances between two groups. CONCLUSIONS: Probable REM sleep behavior disorder is not rare in the elderly but frequently under-recognized. More attention should be paid to evaluation and treatment of RBD.
Aged ; Depression ; Epidemiologic Studies ; Humans ; Mass Screening ; Prevalence ; Surveys and Questionnaires ; REM Sleep Behavior Disorder ; Sleep, REM

Clinical EPS was performed in 16 normal adults without evidence of conduction disease on the surface standard 12 lead electrocardiogram in order to provide normal electrophysiological values of the sinus node function and AV conduction. EPS was also performed in 15 patients with sick sinus syndrome and 10 patients with AV conduction disturbance to evaluate the clinical usefulness of EPS in detecting sinus node dysfunction and AV conduction disturbance. The results were as follows. 1) The results of sinus node function test in the normal group were m-SNRT 853+/-198msec(range 800-1,560msec), c-SNRT 230+/-66msec(range 120-370msec), and %m -SNRT/SCL 127+/-11%(range 114-149%). 2) In 15 patients with SSS, the M-SNRT were ranged from 1,270 to 12,330msec and 10 patients(66%) had significantly increased m-SNRT exceeding 1,560msec. The c-SNRT were ranged from 230 to 10,730msec and 13 patients(83%) had significantly increased c-SNRT exceeding 370msec. The % m-SNRT/SCL were ranged from 136 to 770% and 12 patients(80%) had significantly increased % m-SNRT/SCL exceeding 150%. 3) The SACT in normal group were 84+/-14msec(range 70-105msec) measured by continuous atrial pacing method and 80+/-19 msec(range 60-115msec) measured by atrial extrastimulation method. 4) In SSS, the SACT measured by continuous atrial pacing method was ranged from 80 to 1,050msec and 11/12 patients(92%) had significantly increased SACT exceeding 112 msec. The SACT measured by atrial extrastimulation method was ranged from 90 to 310msec and 7/8 patients(88%) had significantly increased SACT exceeding 118 msec. 5) C-SNRT, % m-SNRT/SCL, and SACT were more useful in detecting sinus node dysfunction than m-SNRT. 6) The AV conduction intervals in normal group were PA interval 17+/-6(range 5-25msec), AH interval 96+/-18 msec(range 70-135msec), and HV interval 46+/-7msec(range 35-55msec). 7) Rapid atrial pacing induced Wenckebach type second degree AV block proximal to H at pacing rate of 90 to 190/min in 14/16 normal adults. 2 patients maintained intact AV conduction upto maximum pacing rate of 200/min. 8) His bundle electrogram showed the site of AV block in 9 of 10 patients with AV conduction disturbances. The sites of AV block were AV nodal area 1 case, intraHis bundle 4 cases, and infraHis bundle 4 cases. 9) EPS provided a good supportive information that was useful in selecting pacemaker therapy in a patient with chronic bifascicular block who revealed prolonged HV interval and infraHis bundle block at a pacing rate of 70min. 10) The refractory periods of AV conduction system in normal group were AERP 274+/-54msec (range 170-410msec), AVN-FRp 467+/-74msec(range 285-600msec), AVN-ERP 341+76msec(range 190-460), and V-ERP 280+/-25msec(range 240-320msec).
Adult ; Atrioventricular Block ; Electrocardiography ; Electrophysiologic Techniques, Cardiac ; Humans ; Sick Sinus Syndrome ; Sinoatrial Node*