PURPOSE: We evaluated the effects of amitriptyline in patients with urinary frequency or pelvic pain syndrome and compared with propiverine hydrochloride (BUP-4(R)) and diazepam (Valium(R)). MATERIALS AND METHODS: One-hundred and sixty-eight patients with urinary frequency or pain were included and 38 out of 168 patients were lost to follow up. The patients with interstitial cystitis, UTI and neurogenic bladder were excluded. Amitriptyline group were instructed to take 25mg to 75mg of amitriptyline before bed. Propiverine hy drochloride and diazepam group were instructed to take 20mg, 4-6mg before bed, respectively. The clinical effects and side effects were evaluated after 4 weeks of medication. RESULTS: In the amitriptyline group, 73.1% in 78 patients with frequency, 68.3% in 60 pain, 65.6% in 32 nocturia, 53.8% in 26 weak urinary stream, 53.8% in 13 dysuria, 72.7% in 11 urgency showed symptom improvement. Urinary frequency and pain score were significantly decreased in the amitriptyline group. In the propiverine hydrochloride group, 66.7% in 21 patients with frequency, 38.8% in 18 pain showed symptom improvement. In the diazepam group, 37.5% in 24 patients with frequency, 31.3% in 16 pain showed symptom improvement. Side effects of amitriptyline had appeared in 24 (27.6%) out of 87 patients; 17 cases of dry mouth, 10 drowsiness, 2 agitation, 2 nausea, 1 constipation and 1 skin rash. CONCLUSIONS: Amitriptyline is useful in vague voiding symptoms especially in urinary frequency and chronic pelvic pain syndrome. It is equally effective in both men and women. Side effects are minimal and tolerable. A double-blind placebo-controlled trial is necessary for general acceptance in the future.
Amitriptyline* ; Constipation ; Cystitis, Interstitial ; Diazepam ; Dihydroergotamine ; Dysuria ; Exanthema ; Female ; Humans ; Lost to Follow-Up ; Male ; Mouth ; Nausea ; Nocturia ; Pelvic Pain* ; Rivers ; Sleep Stages ; Urinary Bladder, Neurogenic

Cheilitis glandularis simplex, the clinical term first defined by Puente and Acevedo in 1935, is characterized by the development of hyperplastic mucous glands in the lips, associated with dilated ductal canals; it is manifested clinically by a usually painless swelling of the lips and a variably constant, bothersome, sticky mucoid discharge. Recently we have experienced a case of cheilitis glandularis simplex in a 13-year-old boy and an excellent cosmetic result was obtained after surgical excision and repair.
Adolescent ; Cheilitis* ; Humans ; Lip ; Male

We present herein a case of sebaceous hyperplasia in a 55-year-old male, who showed multiple asymptomatic yellowish papules on the forehead and the cheeks. Histopathologic examination of a papule revealed numerous sebaceous lobules grouped around several enlarged sebaceous ducts. Three weeks of oral administration. of isotretinoin 40 mg per day brought marked improvement.
Administration, Oral ; Cheek ; Forehead ; Humans ; Hyperplasia* ; Isotretinoin* ; Male ; Middle Aged

We experienced three cases of non-giant congenital nevus. They showed zosteriform or heart-shaped grouping of pigmented papules which were pierced by hairs. Histopathologic examination disclosed nevus cell infiltration in and around hair follicles and in the upper two thirds of reticular dermis. We would like to report these cases as follicle-centered spotted grouped pigmented nevi.
Dermis ; Hair ; Hair Follicle ; Nevus ; Nevus, Pigmented*

Two cases of malignant histiocytosis, in which skin involvement was a prominent finding at initial clinical presentation, are reported. 1nteresting histopathologic findings, including Langerhans granule in one case and numerous eosinophils in another, were observed. In one case remission was achieved with BACOP chemotherapy (Bleomycin, Adriamycin, Cyclophosphamide, Vincristine, and Prednisone). In the other case, the patient died nine months after the onset of the disease without any treatment.
Cyclophosphamide ; Doxorubicin ; Drug Therapy ; Eosinophils ; Histiocytic Sarcoma* ; Humans ; Skin ; Vincristine

BACKGROUND: Tufted angioma is an uncommon slowly progressive vascular tumor found typically in infants and young children with characteristic histologic findings, so called "cannonball" appearance. OBJECTIVE: The purpose of this study was aimed to investigate the clinical and histopathological characteristics of tufted angioma and the response to intralesional steroid. METHODS: Clinical information of 10 patients with tufted angioma diagnosed in Severance hospital and Pundang CHA hospital from 1983 to 1999 was obtained from the medical records and clinical follow-ups. We re-evaluated 10 biopsy specimens obtained from them with routine H&E staining. RESULTS: Five male and five female patients were included. In 9 patients the lesion appeared before 2 months of age. Four had a lesion at birth. The thigh was the most common site. The clinical symptoms were diverse, but characteristically tenderness was present in most cases. In all the patients the lesions had a tendency to spread progressively. Microscopically, numerous, distinct, variably sized, tightly packed capillary and endothelial cellular lobules were scattered in the dermis. There were characteristic semilunar spaces adjacent to the capillary tufts. Six patients received intralesional triamcinolone. This treatment was found to be effective in 5 patients who experienced remarkable improvement. The improved cases had similar histologic findings which were composed of cellular mass more than lumen formation. We classified our specimens into two categories, one with more cellular mass and the other with more lumen formation in relative proportion. The former was different from the latter in that it had more solid appearance and more definite margin. And we realized that it was useful to divide into these two categories since its response to treatment could be different. CONCLUSIONS: Tufted angioma is a relatively uncommon disease with characteristic histopathologic findings. It seems not to regress spontaneously. So early treatment is required to pre-vent further spreading up to the extent. We treated 6 patients with intralesional injection of triamcinolone and 5 patients experienced marked improvement which had more cellular mass more than lumen formation histopathologically.
Biopsy ; Capillaries ; Child ; Dermis ; Female ; Follow-Up Studies ; Hemangioma ; Humans ; Infant ; Injections, Intralesional ; Male ; Medical Records ; Parturition ; Thigh ; Triamcinolone

PURPOSE: New cutoffs have recently been proposed for restaging T1 diseases, as the prognostic differences were more prominent with these cutoffs. The validity of these cutoffs was evaluated by restaging patients with localized renal cell carcinomas (T1-2N0M0) using the new cutoffs (2.5, 3, 4, 5, 7 and 10cm, and capsule invasion). MATERIALS AND METHODS: 99 patients with pathologically confirmed T1 and T2 carcinomas, who had undergone radical nephrectomy between June 1990 and March 2003, were retrospectively reviewed. The study group comprised of 61 men and 38 women, with a mean age of 56.2, ranging from 21 to 78 years. The mean follow up length was 69, ranging from 8 to 162 months. The patients were divided into two groups using the new cutoff points (2.5, 3, 4, 5, 7 and 10cm, and capsule invasion). The survival curves were calculated by the Kaplan-Meier method for each cutoff point, with Log-rank tests used to compare the values of the new cutoff points. RESULTS: Statistically significant cancer specific survivals at 4, 5 and 7cm cutoffs, with a 5cm cutoff point, were used to maximize the differences in the cancer specific survivals. The 4cm cutoff point was the only statistically significant cutoff value for disease free survivals. Capsule invasion was not a statistically significant cutoff value. CONCLUSIONS: A 5cm cutoff point was proposed to divide the T1N0M0 classification into T1a and T1b subclasses. Patients with localized renal cell carcinomas larger than 4cm in size were considered for radical nephrectomy rather than a partial nephrectomy in relation to a local recurrence.
Carcinoma, Renal Cell* ; Classification ; Female ; Follow-Up Studies ; Humans ; Male ; Nephrectomy ; Prognosis ; Recurrence ; Retrospective Studies

No abstract available.
Electromyography*

Carcinoma of the breast can produce cutaneous metastases which sbow highly diversified clinical pictures. The cutaneous metastases produce four definite clinical types: inflammatory carcinoma, telangiectatic carcinoma, nodular carcinoma, and carcinoma, en cuirasse. We present a case of 78-year-old nulliparous woman who had several painful dark purplish colored zosteriform papulovesicular eruptions, suggestive of herpes zoster, on the right breast, right axilla, scapular area, and upper arm for three month. Two month later, well dermacated linearly arranged erysipeloid eruptions appeared around the previous skin lesions and the right chest wall. Histopathological findings showed metastatic ductal carcinoma with massive vascular permeation but the primary focus was undetermined.
Female ; Humans ; Neoplasm Metastasis

The Taylor's approach is a special paramedian approach to enter the L5-S1 interspace. The L5-S1 interspace is the largest in vertebral column. This approach is particularly useful when the interspace has been narrowed by pathologic bone destruction such as rheumatoid arthritis or osteoarthritis. Surgery in geriatric patients is associated with a markedly higher incidence of perioperative complication or mortality rate. Optimal anesthetic management of geriatric patients depends on understanding of the normal anatomy and physiologic changes in response to drug in aging. We studied of 3-geriatric patients with Taylor's approach. These patients had problems with respiratory dysfunction and anatomic constraints, which make other approaches unfeasible.
Aging ; Arthritis, Rheumatoid ; Humans ; Incidence ; Mortality ; Osteoarthritis ; Spine