Alopecia totalis is a varient of alopecia areata which is a depilated, round or oval patch, which developed on scalp, eye lashes, eye brows, and beared areas. There is two sisters, elder is 7 year -3month-old, younger is 5-year 7-month-old. Hair loss began to developed on scalp (especially on forehead) 2 months and and 14 months prior to visit to our OPD. We consult the psychiatric department, and concluded that the etiology of our cases are suggested to have emotional disturbances which are ambivalent mother and fear of loss
Affective Symptoms ; Alopecia Areata ; Alopecia* ; Hair ; Humans ; Infant ; Mothers ; Scalp ; Siblings*

We studied serum uric acid in 120 patients of essential hypertension visiting Department of Internal Medicine of Seoul Red Cross Hospital from October 1985 to November 1986 and analyzed its values in terms of various clinical and laboratory parameters. The results wereas follows; 1) The mean concentration of serum uric acid and incidence of hyperuricemia were 6.5+/-1.86mg%, 50.8% in hypertension group and those of normal control were 3.75+/-1.27mg%, 13.3%, respectively with significant high values in hypertension group. 2) The mean concentration of serum uric acid and the incidence of hyperuricemia were significantly correlated with the levels of diastolic blood pressure but there was only correlation between the incidence of hyperuricemia and the level of systolic pressure. 3) The mean concentration of serum uric acid and the incidence of hyperuricemia were significantly correlated with the level of BUN and serum creatinine, especially more in serum creatinine. 4) The mean concentration of serum uric acid and the incidence of hyperuricemia were not correlated with each level of serum cholesterol and triglyceride. 5) There was significant correlation between mean concentration of serum uric acid and abnormal urine finding but not in incidence of hyperuricemea.
Blood Pressure ; Cholesterol ; Creatinine ; Humans ; Hypertension* ; Hyperuricemia ; Incidence ; Internal Medicine ; Red Cross ; Seoul ; Triglycerides ; Uric Acid*

OBJECTIVES: The purpose of this study was to examine whether Symptom Management Module-Korean Brief Version(SMM-B) is effective as a psychosocial treatment of the inpatients with chronic schizophrenia. We also questioned which of demographic and clinical characteristics could be predictors of differential treatment response. METHODS: The subjects were composed of 30 inpatients with chronic schizophrenia, who were trained with weekly session of SMM-B for 5 weeks. Before and after the training, the level of psychopathology, knowledge about schizophrenia were assessed as dependent variables by using Clinical Global Impression(CGI) and Scale to Assess Unawareness of Mental Disorder(SUMD). RESULTS: Overall, patients showed improvement over the treatment period on psychopathology as well as knowledge about psychosis. Total scores of SUMD were changed from 16.9+/-4.0 before training to 12.9+/-4.2 after training(p<0.01) and scores of CGI were improved from 3.7+/-0.9 to 2.8+/-0.8 (p<0.01). However age, gender, years of education, age of onset, duration of illness, duration of admission, numbers of psychiatric admission, and clinical status evaluated by CGI were not correlated with un-awareness of psychosis. CONCLUSION: These results suggest that SMM-B could be a reliable method to improve self-awareness of psychosis in patients with chronic schizophrenia and one of important elements in rehabilitation.
Age of Onset ; Education ; Humans ; Inpatients* ; Psychopathology ; Psychotic Disorders ; Rehabilitation ; Schizophrenia*

No abstract available.
Humans ; Peritonitis*

BACKGROUND: Papillary thyroid carcinoma (PTC) is frequently accompanied by lymphocytic thyroiditis (LT). Some reports claim that Hashimoto's thyroiditis (the clinical form of LT) enhances the likelihood of PTC; however, others suggest that LT has antitumor activity. This study was aimed to find out the relationship between the patterns of helper T cell (Th) cytokines in thyroid tissue of PTC with or without LT and the clinicopathological manifestation of PTC. METHODS: Fresh surgical samples of PTC with (13 cases) or without (10 cases) LT were used. The prognostic parameters (tumor size, extra-thyroidal extension of PTC, and lymph node metastasis) were analyzed. The mRNA levels of two subtypes of Th cytokines, Th1 (tumor necrosis factor α [TNF-α], interferon γ [IFN-γ ], and interleukin [IL] 2) and Th2 (IL-4 and IL-10), were analyzed. Because most PTC cases were microcarcinomas and recent cases without clinical follow-up, negative or faint p27 immunoreactivity was used as a surrogate marker for lymph node metastasis. RESULTS: PTC with LT cases showed significantly higher expression of TNF-α (p = .043), IFN-γ (p < .010), IL-4 (p = .015) than those without LT cases. Although the data were not statistically significant, all analyzed cytokines (except for IL-4) were highly expressed in the cases with higher expression of p27 surrogate marker. CONCLUSIONS: These results indicate that mixed Th1 (TNF-α, IFN-γ , and IL-2) and Th2 (IL-10) immunity might play a role in the antitumor effect in terms of lymph node metastasis.
Biomarkers ; Cyclin-Dependent Kinase Inhibitor p27 ; Cytokines ; Follow-Up Studies ; Interferons ; Interleukin-4 ; Interleukins ; Lymph Nodes ; Necrosis ; Neoplasm Metastasis ; RNA, Messenger ; T-Lymphocytes, Helper-Inducer ; Thyroid Gland ; Thyroid Neoplasms ; Thyroiditis ; Thyroiditis, Autoimmune*

General anesthesia for the removal of a large mediastinal mass has been associated with life-threatening airway obstruction. We present a case of general anesthesia for a patient with superior posterior mediastinal mass and critical airway compression who was allowed to maintain spontaneous ventilation throughout general anesthesia for a thoracotomy. The patient was a 5-year-old boy complaining of productive cough and intermittent fever for 3 weeks. His chest radiograph and magnetic resonance imaging(MRI) film demonstrated a critically narrowed and deviated trachea at the level of the thoracic inlet to the proximal portion of the right bronchus. We can secure the airway by spontaneous ventilation without muscle relaxation and allowing the patient to breathe spontaneously and insertion of endotracheal tube distal to the narrowed portion of trachea.
Airway Obstruction ; Anesthesia, General ; Bays ; Bronchi ; Child, Preschool ; Cough ; Fever ; Humans ; Male ; Muscle Relaxation ; Radiography, Thoracic ; Thoracotomy ; Trachea ; Ventilation

Osteonecrosis of the humeral head is an uncommon and slow progressive condition. This condition is difficult to be recognized because its initial symptoms are nonspecific. Simple radiography is the standard tool to stage disease progression. However, plain radiographic findings of osteonecrosis are nearly normal in the initial stage. We report a case of 74 years old female patient who have suffered from painful limitation of the shoulder joint. She had no trauma history and no specific predisposing factors for osteonecrosis of the humeral head. To confirm, follow up radiography and shoulder magnetic resonance imaging were performed.
Causality ; Disease Progression ; Female ; Follow-Up Studies ; Humans ; Humeral Head* ; Magnetic Resonance Imaging ; Osteonecrosis* ; Radiography ; Shoulder ; Shoulder Joint

PURPOSE: The purpose of this study was to evaluate a new technique for localizing impacted mesiodens using its horizontal magnification ratio on panoramic radiographs. MATERIALS AND METHODS: Location-magnification equation of a panoramic equipment was obtained from horizontal magnification ratio of a metal ball which was located variable positions from the center of image layer at interval of 2 mm. Panoramic radiographs were obtained from a skull phantom with a metal ball which was a substitute for impacted mesiodens and was embedded 10mm(Group 1), 15mm(Group 2), and 20mm(Group 3) posterior to the central incisor. Each group obtained 7 panoramic radiographs at variable positions and one periapical radiograph. Three methods were used to estimate the actual width of the incisors and the balls which were used to calculate the magnification ratio. The methods included using the actual incisor width and the calculated ball width (Method 1), using the actual incisor width and the ball widths measured on periapical radiograph (Method 2), and using the incisor and the ball widths measured on periapical radiograph (Method 3). The location of the metal ball was calculated by using the location-magnification equation. RESULTS: The smallest difference between the calculated and the actual distance was 0.1+/-0.7 mm in Group 1/Method 3. The largest difference was -4.2+/-1.6 mm in Group 3/Method 2. In all groups, method 3 was the most accurate. CONCLUSION: Quantitative localization of impacted mesiodens is possible by using panoramic radiograph.
Incisor ; Radiography, Dental ; Radiography, Panoramic ; Skull ; Tooth, Supernumerary

BACKGROUND:Clonidine, an alpha2-adrenergic receptor agonist, has been shown to have a sedative effect and to suppress hemodynamics when used as a premedicant. We evaluated the change of AEP index and hemodynamics after clonidine premedication and induction with propofol. METHODS:The study design was a prospective, randomized, double-blind study. 90 patients who were scheduled for elective surgery were randomly assigned in 3 groups (Group 1, 2 and 3). In groups 2 and 3, the patients were administered 2 microgram/kg or 4 microgram/kg of i.v. clonidine 30 minutes before the induction of propofol anesthesia, respectively. We measured A-lineTM ARX index (AAI), systolic blood pressure, mean arterial pressure, diastolic blood pressure and heart rate at the ward; before the administration of clonidine premedication, before induction, just before intubation and 1 minute after endotracheal intubation, and compared these parameters among the 3 groups. RESULTS:Each dose of clonidine had a suppressive effect before the induction of anesthesia and suppressed hemodynamics successfully during intubation. In groups 2 and 3, the AAI was lower than in group 1 (P < 0.05), but 7 patients had bradycardia and 3 patients had been hypotensive in group 3. CONCLUSIONS: Intravenous injection of 2 microgram/kg clonidine as a premedicant reduced AAI significantly (P < 0.05) compared to the control group, with good hemodynamic stability. Therefore, we believe that AAI can be used to predict hypnotic state during propofol anesthesia.
Anesthesia* ; Arterial Pressure ; Blood Pressure ; Bradycardia ; Clonidine* ; Double-Blind Method ; Heart Rate ; Hemodynamics* ; Humans ; Hypnotics and Sedatives ; Injections, Intravenous ; Intubation ; Intubation, Intratracheal ; Premedication* ; Propofol* ; Prospective Studies

PURPOSE: Serum level of carcinoembryonic antigen (CEA) is clinically one of the prognostic factors in the follow-up evaluation of the colorectal cancer (CRC) patient. It has been recently suggested that the bile CEA level is also useful in early detection of the liver metastasis of colrectal cancer. If the bile CEA is also correlated with the cancer progression or prognosis like as serum CEA, it will be another useful clinical parameter in the evaluation and treatment of CRC patients. Therefore this study is aimed to reveal the correlation of the bile CEA with the progression of tumor and to estimate the possibility of bile CEA as a useful clinical parameter. METHODS: Preoperative serum levels of CEA were measured in 58 patients of CRC who were operated in Pundang CHA hospital. The levels of bile CEA were also checked with the aspiration of bile in gall bladder at laparotomy. The positive value of CEA was settled as more than 5ng/ml. RESULTS: The 58 patients were classified into 29 cases of Dukes'AB group, 23 cases of Dukes'C group & 6 cases of Dukes'D group. The positive rates of serum CEA were 24.1% in AB group, 30.4% in C group & 66.7% in D group, and those of bile CEA were 44.8%, 56.5% & 83.3% individually. When group C was also divided into N1(13 cases) & N2 (10 cases) groups according to the number of the metastatic lymph nodes, serum & bile CEA positive rates were 15.4% & 46.1% in N1 group, and 50% & 70% in N2 group. Both of serum & bile CEA levels were all positive and markedly elevated in 4 hepatic metastasis cases of group D. CONCLUSIONS: Positive rate of bile CEA was increased according to the progression of tumor stage. Marked elevation of bile CEA was especially noted in liver metastatic cases. Therefore bile CEA can be considered as a clinical parameter in evaluation of cancer progression & prognosis like as serum CEA, and also as a useful indicator of hepatic metastasis.
Bile* ; Carcinoembryonic Antigen* ; Colorectal Neoplasms* ; Follow-Up Studies ; Humans ; Laparotomy ; Liver ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Urinary Bladder