No abstract available.
Surveys and Questionnaires*

PURPOSE: We evaluated the distribution of hypoperfusion in patients with traumatic brain injury (TBI) and the relationship of thalamic hypoperfusion to severity of cognitive and behavioral sequelae. MATERIALS AND METHODS: Tc-99m ECD SPECT and MRI were performed in 103 patients (M/F=81/22, mean age 34.7+/-15.4 yrs) from 0.5 to 55 months (mean 10.3 months) after TBI. The patients were divided into three groups showing no abnormalities (G1), focal (G2) and diffuse injury (G3) on MRI. Psychometric tests assessed 11 cognitive or behavioral items. In all patients, we evaluated the distribution of hypoperfused areas in SPECT, and in 57/103 patients, neuropsychological (NP) abnormalities in patients with thalamic hypoperfusion were compared with those of patients without thalamic hypoperfusion. RESULTS: The perfusion deficits were most frequently located in the frontal lobe (G1, 42.3%: G2 34.5%: G3 33.3%), temporal lobe (24~26%) thalami (21~22.4%), parietal and occipital lobe (< or =10%). Numbers of NP abnormalities in the cases of cortical hypoperfusion with or without concomitant thalamic hypoperfusion were following: the former 4.7+/-1.5 and the latter 3.2+/-1.4 in G1, 5.0+/-1.1 and 4.8+/-1.2 in G2, 6.8+/-1.8 and 6.3+/-1.1 in G3, respectively. This difference according to thalamic hypoperfusion was significant in G1 (p=0.002), but was not significant in G2 or G3. CONCLUSION: SPECT in patients with TBI had demonstrated hypoperfusion mostly involving the frontal, temporal and thalami. In normal group on MRI, frontal hypoperfusion was more prominent than that of any other group, Furthermore in this group, SPECT could predict severity of NP outcome by concomitant thalamic hypoperfusion with cerebral cortical abnormalities.
Brain Injuries* ; Brain* ; Equidae* ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging ; Occipital Lobe ; Perfusion ; Psychometrics ; Rabeprazole ; Temporal Lobe ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: Complete fibrovascular ingrowth within the hydroxyapatite ocular implant is necessary for peg drilling which is performed to prevent infection and to provide motility to the ocular prosthesis. We compared planar bone scintigraphy and SPECT for the evaluation of the vascularization within hydroxyapatite ocular implants. MATERIALS AND METHODS: Seventeen patients (M:F=12:5, mean age: 50.4+/-17.5 years) who had received a coralline hydroxyapatite ocular implant after enucleation surgery were enrolled. Patients underwent Tc-99m MDP planar bone and SPECT imaging by dual head gamma camera after their implant surgery (interval: 197+/-81 days). Uptake on planar and SPECT images was graded visually as less than (grade 1), equal to (grade 2), and greater than (grade 3) nasal bridge activity. Quantitative ratio of implanted to non-implanted intraorbital activity was also measured. Vascularization within hydroxyapatite implants was confirmed by slit lamp examination and ocular movement. RESULTS: All but three patients were considered to be vascularized within hydroxyapatite implants. In visual analysis of planar image and SPECT, grade 1 was noted in 9/18 (50%) and 6/18 (33%), respectively. Grade 2 pattern was 7/18 (39%) and 4/18 (22%), and grade 3 pattern was 2/18 (11%) and 8/18 (44%) respectively. When grade 2 or 3 was considered to be positive for vascularization, the sensitivity of planar and SPECT imaging were 60% (9/15) and 80% (12/15), respectively. In 3 patients with incomplete vascularization, both planar and SPECT showed grade 1 uptake. The orbital activity ratios on planar imaging were not significantly different between complete and incomplete vascularization (1.96+/-0.87 vs 1.17+/-0.08, p>0.05), however, it was significantly higher on SPECT in patients with complete vascularization (8.44+/-5.45 vs 2.20+/-0.87, p<0.05). CONCLUSION: In the assessment of fibrovascular ingrowth within ocular implants by Tc-99m MDP bone scintigraphy, SPECT image appears to be more effective than planar scintigraphy.
Durapatite* ; Eye, Artificial ; Gamma Cameras ; Head ; Humans ; Orbit ; Radionuclide Imaging* ; Technetium Tc 99m Medronate ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Purpura, Schoenlein-Henoch* ; Scarlet Fever*

In 1932, Harris, et al., reported that vitamin A had an anti-keratinizing effect on acne vulgaris, and in 1948, Straumfjord, somewhat over-enthusiastically reported that oral use of vitamin A also had a beneficial effect on acne. In spite of studies by Lynch and Cook (1947), and Andrew and Stokoe (1963), which questioned its effectiveness, the original enthusiasm for this regimen has not been completely dampened. Kligman (1969) reported that vitamin A acid (VAA), a metabolic end-product of vitamin A metabolism, produced a peeling effect and when applied topically, was effective in tbe treatment of acne. The mechanism of action of VAA is incompletely understood, however, it is observed to cause, arnong other things, an increase in the speed of proliferation of the cells of the epidermis; dissolution of the intracellular lysosomes; increase in the rate of keratin formation and the conversion of hard keratin to soft keratin; and an increase in the secretion of the sebaceous glands. The effect of VAA in acne treatment is due to the increase in the secretion of the sebaceous glands which prevents the formation of comedones. It is believed that the increased speed of cell division, increased keratinization and softening of the keratin cause a weakening of the intercellular adhesion. These processes cause an acceleration of the flow of cells out of the sebaceoua glands which prevents the formation of comedones and forces existing comedones to the surface of the skin. For this study, thirt:y eight patients with acne vulgaris were selected from among the outpatients of Severance Hospital. They were divided into two groups. The first group was treated with application of vitamin A acid alone. The second group was treated concurrently with topical vitamin A acid and oral tetracycline.
Acceleration ; Acne Vulgaris ; Cell Division ; Epidermis ; Humans ; Lysosomes ; Metabolism ; Outpatients ; Sebaceous Glands ; Skin ; Striae Distensae* ; Tetracycline ; Tretinoin ; Vitamin A

Soft Contact Lenses(SCL) are used widely instead of glasses among young female, especially university students, for cosmetic purpose. Usually Shirmer test has been used to evaluate the tear production state however more objective method is the tear film break up time. Authors evaluated the effect of soft contact lenses on BUT. We selected 40 femalse wearing on Hyper-Thin soft contact lenses, and One Soflens(Baush and Lomb) as soft contact lens wearing group and 30 females without no evidence of systemic disease or ocular disease affecting on tear production as normal control group. And authors studied mean value of BUT at each group, difference of BUT between 2 groups and finally evaluated the BUT change accord ing to duration of wearing. The results were as follows. 1. The mean value of tear film break up time(BUT) was 8.64 +/- 3.91 seconds and 11.12 +/- 4.94 seconds in soft contact lens wearing group and normal control group respectively. 2. There was a statistically significant difference of BUT between each group(P<0.05). 3. There was statistically significant difference of BUT between more than 4 years of soft contact lens wearing group and less than 3 years of wearing gorup(P<0.05).
Contact Lenses, Hydrophilic* ; Eyeglasses ; Female ; Glass ; Humans ; Tears*

About 5% of patients with SCLC have the ectopic production of ACTH. Ectopic ACTH production of SCLC is suspected when patients of SCLC have unexplained metabolic alkalosis and hypokalemia. Most patients lack the classic feature of Cushing's syndrome. According to the recent report, they have poor prognosis, which median survival is less than 4 months and associated with a high rate of complication during chemotherapy. Also a case of paraneoplastic CRH production with SCLC can mimic the ectopic ACTH syndrome hut it can be distinguished by immunohistochemistry or direct measurement of serum CRH level. We report here a case of small cell lung cancer associated with Cushing's syndrome of ectopic ACTH production. That is immunohistochemically provened by staining with ACTH.
ACTH Syndrome, Ectopic ; Adrenocorticotropic Hormone* ; Alkalosis ; Cushing Syndrome* ; Drug Therapy ; Humans ; Hypokalemia ; Immunohistochemistry ; Lung Neoplasms* ; Lung* ; Prognosis ; Small Cell Lung Carcinoma

A sepsis or multiple organ dysfunction occurs frequently in the intensive care unit and causes a significant number of mortality and morbidity. Somtimes polyneuropathy of varying severity occurs in association with a sepsis or critical illness. Since the clinical evaluation is often difficult, electrophysiologic studies are employed to reveal a definitive evidence for polyneuropathy. The purpose of this study was to investigate the frequency of polyneuropathy and to determine the electrophysiologic features of critically ill patients. The subjects were 23 patients between ages of 42 and 72 with a sepsis or systemic inflammatory response syndrome combinded with the multiple organ failure. The results revealed reductions in the amplitude of compound motor action potential and sensory nerve action potential, as the most marked abnormality. Needle EMG revealed the signs of denervation of limb muscles. Approximately 65.3% of adult patient with sepsis or multiple organ dysfunction has an axonal polyneuropathy. We suspect that the axonal polyneuropathy is related to the severity of multiple organ dysfunction.
Action Potentials ; Adult ; Axons ; Critical Illness* ; Denervation ; Extremities ; Humans ; Intensive Care Units ; Mortality ; Multiple Organ Failure ; Muscles ; Needles ; Polyneuropathies* ; Sepsis ; Systemic Inflammatory Response Syndrome

This report is a clinical analysis and comparative study with previous report of bronchial asthma at National Medical Center on bronchial asthma in children who were admitted to the MP dept. of national Medical Center from January 1987 to December 1990. The results of the study were as follows: 1) The out-break ratio of bronchial asthma is 3.7% of hospitalized children which is no change that about 4% since 1980. 2) The children under 6 years of ge was 62.7% which among under 3 years was 33.1%. The rate of under 3 year children is increased as previous study. 3) The out-break of bronchial asthma was most common in September and October and so peak incidence was noted in fall and duration of hospitalization was most 2 week. 4) Familial allergic history was positive in 54.6% and bronchial asthma was most common. The presence of allergic past history was 52.2%) and atopic dermatitis was most common 5) Eosinophilia was found in 80.8% and elevated IgE was also in 61.6% of bronchial asthma. 6) We could get positive results of IgE RAST and skin test: D. pteronyssinus, D. farinae, Houst dust. 7) The most frequent findigs of the chest radiograph were within normal limits. 8) The clinical improvement rate of bronchial asthma is 52.5%.
Asthma* ; Child* ; Child, Hospitalized ; Dermatitis, Atopic ; Dust ; Eosinophilia ; Hospitalization ; Humans ; Immunoglobulin E ; Incidence ; Radiography, Thoracic ; Skin Tests

Cow milk allergy can be defined as an adverse immunologic reactions to cow milk protein. The term is often mistakenly applied to other causes of milk intolerence, such as lactase deficiency and galactosemia, which must be differenciated and excluded. We have experienced 10 children of cow milk allergy at neonatal onset who had suffered from G-I symtoms, such as diarrhea, irritability, weight loss, vomiting and abdominal distension. One half of this patients had family history of allergic diseas. All patients have positive specific IgE RAST to cow's milk protein, milk elimination test and milk challenge test. Brest milk feeding and soy bean formula feeding and soy bean formula feeding have started after diagnosis and then gastrointestinal symtoms and signs of all patients are improved but other allergic diseases are combined in 5 children.
Child ; Diagnosis ; Diarrhea ; Galactosemias ; Humans ; Hypersensitivity* ; Immunoglobulin E ; Infant* ; Lactase ; Milk ; Milk Hypersensitivity ; Milk Proteins ; Soybeans ; Vomiting ; Weight Loss