We have presented three cases of Ritter's disease appearing on 11, 14, and 14 days old boys respectively. Staphyloccccus albus was cultured from bullar contents of case 1 and 2, and coaguIase positive staphylococcus from case 3. These patients were successfully treated with systemic and topical antimicrobials.
Humans ; Staphylococcal Scalded Skin Syndrome* ; Staphylococcus

No abstract available.
Gemfibrozil* ; Humans ; Peritoneal Dialysis, Continuous Ambulatory*

Dieulafoys lesion consists of abnormally large gastric submucosal artery which ruptures into the stomach causing massive or recurrent intragikstric bleeding. The lesion is very small and easily overlooked even at laparatomy and aan only be correctly diagnosed by endoscopy or arteriography if the patient is actively bleeding. Three patients who were admitted with bleeding of upper gastrointestinal tract and eventually diagnosed as having Dieulafoys lesions were analysed. All were men with age range of 44 to 55 years. All patient were asymptomatic before presenting with hematemesis. Two of the three patients had had history of upper Gl bleeding. One patient used analgesics daily for ureteral colic and two patient drank alcohol excessively. Gastroscopy was performed during the bleeding episode in all three patients. Dieulafoy's lesion was seen in all three cases and in the second case, there was concomittent diffuse petechia in the whole stomach. The lesion was situated on the posterior wall of upper body in one, on anterior wall of upper body in another, lesser curvature side of gastric fundus in the other case. All three patient underwent laparotomy for persistent bleeding and the lesion was suture ligated only in two patients while in one patient vagotomy and pyloroplasty was added. Resection biopsy was performed in two cases and both revealed only normal gastric mucosa. All patients discharged after complete recover.
Analgesics ; Angiography ; Arteries ; Biopsy ; Endoscopy ; Gastric Fundus ; Gastric Mucosa ; Gastroscopy ; Hematemesis ; Hemorrhage ; Humans ; Laparotomy ; Male ; Renal Colic ; Rupture ; Stomach ; Sutures ; Upper Gastrointestinal Tract ; Vagotomy

The purpose of this study was to evaluate the usefulness of retinal nerve fiber layer [RNFL] photography and Heidelberg Retina Tomograph [HRT, Heidelberg, Germany] in early detection of glaucoma. Among 2802 people who underwent routine health checkup at. Seoul National University Hospital from July I to Decernber 31, 1996, forty-nine persons were included whose IOP was above 21mmHg or cup/disc ratio was 0.5 or greater. RNFL photography, HRT and automated perimetry [Humphrey Field Analyzer, program C30-2] were performed. Twelve eyes were diagnosed as glaucoma and one sye as glaucoma suspect. Four eyes with glaucoma had RNFL defect with normal visual field and 7 eyes with glaucoma had both RNFL defect and glaucomatous visual field defect. Of 26 eyes suggested as glaucoma by FSM classification of HRT, only 8 eyes met the diagnostic cri-teria of glaucoma of this study. Among 21 eyes with decreased hump height in HRT only 7 eyes were diagnosed as glaucoma. RNFL photography increased the detection rate for glaucoma by 50% over that with visual field test. only. RNFL photography will be a valuable method for early detection of glaucorna while HRT may play a suppleinentary role.
Classification ; Glaucoma* ; Humans ; Nerve Fibers* ; Photography ; Retina ; Retinaldehyde* ; Seoul ; Visual Field Tests ; Visual Fields

No abstract available.
Catheters* ; Drainage* ; Lung Abscess* ; Lung*

An endoscopic retrograde cholangiographic study of 25 consecutive cases of hepatic clonorchiasis was performed during the period from Aug. 1986 to Sep. 1991 Hepatic clonorchiasis was confirmed by stool of examination for Clonorchis sinensis. The findings consist of characteristic filling defects and changes in the intrahepatic and extrahepatic bile ducts. The filling defects due to adult worms are significant diagnostic criteria of clonorchiasis. Its appearance is elliptical and/or round. The change in the intrahepatic bile ducts consisits of dilatation, irregularity(tortousity and elongation) and blunting of termieal branches of bile tree, irregular stenosis, fuzziness and raggedness. The characteristic changes in the extrahepatic bile ducts in clonorchiasis are duct wall irregularities and mild dilatation of bile duct. ERCP is an excellent method to evaluate biliary tree in patient with clonorchiasis because it reveals not only its characteristic findings of clonorchiasis but also its severity and associated lesions.
Adult ; Bile ; Bile Ducts ; Bile Ducts, Extrahepatic ; Bile Ducts, Intrahepatic ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde* ; Clonorchiasis* ; Clonorchis sinensis ; Constriction, Pathologic ; Dilatation ; Humans

An endoscopic retrograde cholangiographic study of 25 consecutive cases of hepatic clonorchiasis was performed during the period from Aug. 1986 to Sep. 1991 Hepatic clonorchiasis was confirmed by stool of examination for Clonorchis sinensis. The findings consist of characteristic filling defects and changes in the intrahepatic and extrahepatic bile ducts. The filling defects due to adult worms are significant diagnostic criteria of clonorchiasis. Its appearance is elliptical and/or round. The change in the intrahepatic bile ducts consisits of dilatation, irregularity(tortousity and elongation) and blunting of termieal branches of bile tree, irregular stenosis, fuzziness and raggedness. The characteristic changes in the extrahepatic bile ducts in clonorchiasis are duct wall irregularities and mild dilatation of bile duct. ERCP is an excellent method to evaluate biliary tree in patient with clonorchiasis because it reveals not only its characteristic findings of clonorchiasis but also its severity and associated lesions.
Adult ; Bile ; Bile Ducts ; Bile Ducts, Extrahepatic ; Bile Ducts, Intrahepatic ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde* ; Clonorchiasis* ; Clonorchis sinensis ; Constriction, Pathologic ; Dilatation ; Humans

OBJECTIVE: To evaluate the efficacy of new protocol (Modified luteal long; MLL protocol) to improve the clinical outcomes in IVF-ET. METHODS: New protocol was applied to repeated ART failure group for 7 months (GroupI, n=106) after informed consent. Outcomes of new protocol group were evaluated and compared to conventional long protocol group (Group II, n=315) prospectively and compared to same indication group with GroupI (Group III, n=144) historical prospectively. RESULTS: There were no differences in the clinical characteristics except patient's age between GroupI and II (35.16+/-4.35 vs. 33.22+/-4.14, p<0.05). Outcomes of IVF-ET, such as numbers of retrieved oocytes, numbers of transferred embryos, numbers of 2 PN, rates of ICSI, rates of blastocyst ET, rates of fertilization, ampules of gonadotropin between GroupI & II, and GroupI & III, respectively. But the embryo quality score of GroupII was significantly higher than GroupI. There was significant increase of implantation rate (25.2 vs. 17.1%, p=0.02) in GroupII compared to GroupI, especially in 31-35 years old group. Implantation rate of less than 35 years old group and clinical pregnancy rate of 31-35 years old group in GroupII tubal factor patients were significantly higher than GroupI tubal factor patients. Clinical pregnancy rate (47.2 vs. 12.8%, p=0.001) and implantation rate (15.2 vs. 5.5%, p=0.009) of GroupI was significantly higher than GroupIII, especially in 36-40 years old group. Implantation rates of ES factor patients (especially in 36-40 years old) and unknown factor patients (especially less than 35 years old), and clinical pregnancy rate of ES factor patients (especially in 36-40 years old) were significantly higher in GroupI than III. CONCLUSION: These results suggest that new protocol may play some role in the increase of endometrial receptivity. Further investigation, including molecular research work will be needed to clarify the factors concerned in the increase of implantation rate.
Adult ; Blastocyst ; Embryo Transfer* ; Embryonic Structures* ; Fertilization ; Fertilization in Vitro* ; Gonadotropins ; Humans ; Informed Consent ; Oocytes ; Pregnancy Rate ; Prospective Studies ; Sperm Injections, Intracytoplasmic

OBJECTIVES: Protein-calorie malnutrition is a common problem in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Serum albumin(SA) concentration has been used as a marker for assessing nutritional status. Hypoalbuminemia has been linked to an increased risk of morbidity and mortality and more numerous, prolonged hospitalization for peritoneal dialysis patients. The aim of this study was to determine factors affecting SA value in CAPD patients. METHODS: We performed a cross-sectional study which included patients' demographics, anthropometric data, biochemical parameters, urea kinetic data and comorbidity in 106 stable CAPD patients. RESULTS: 1) There were 50 men and 56 women with a mean CAPD duration of 43 months and mean age of 49 years. The mean concentration of SA was 3.9+/-0.5 (range 2.5-5.3) g/dl and weekly Kt/Vurea 2.0+/-0.4 (range 1.32-3.79) 2) Twenty-one patients(20%) were classified as group I(SA<3.5g/dl)and the remaining patients(80%) as group II(SA 3.5g/dl) 3) Group I patients were significantly older(55+/-11 vs 47+/-11 years, p<0.05) and had significantly higher comorbidity score(1.5+/-0.8 vs 0.7+/-0.9, p<0.05), C-reactive protein (4.5+/-0.9 vs 0.5+/-0.1 mg/dl, p<0.05), 24-hr dialysate-toplasma creatinine(D/PCr) ratio(0.84+/-0.1 vs 0.76+/-0.1, p<0.05), 24-hr dialysate protein (7167+/-2031 vs 5471+/-1515 mg, p<0.05) and had significantly lower residual renal function(RRF)(0.2+/-0.3 vs 0.7+/-1.2 ml/min, p<0.05), BUN(48+/-14.8 vs 55.6+/-14.9 mg/dl, p<0.05), serum creatinine(10.4+/-2.8 vs 12.6+/-3.5 mg/dl, p<0.05), IGF-1(186+/-99 vs 260+/-131 ng/ml, p<0.05), serum phosphorus(4.1+/-1.2 vs 5.0+/-1.3 mg /dl, p<0.05) than group II.4) SA showed positive correlation with anion gap (r=0.43, p value=0.001), transferrin(r=0.41, p value= 0.001) phosphorus(r=0.31, p value=0.001) and negative correlation with 24-hr dialysate protein loss(r=-0.51, p value=0.001), 24-hr D/PCr ratio(r=-0.49, p value=0.001), comorbidity score(r=-0.36, p vluue=0.001). NPCR(r=0.22, p value=0.023), IGF-1(r=0.30, p value=0.002), BUN(r=0.23, p value=0.016) weakly correlated with SA.5) By stepwise multiple logistic regression analysis, age, CRP, 24-hr D/PCr ratio and RRF independently influenced SA level. CONCLUSION: SA level seems to be affected by non-nutritional factors such as age, peritoneal membrane transport characteristics, residual renal function and presence of acute phase protein response manifested by CRP elevation, in addition to nutritional factors.
Acid-Base Equilibrium ; Acute-Phase Proteins ; C-Reactive Protein ; Comorbidity ; Cross-Sectional Studies ; Demography ; Female ; Hospitalization ; Humans ; Hypoalbuminemia ; Logistic Models ; Male ; Membranes ; Mortality ; Nutritional Status ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Protein-Energy Malnutrition ; Serum Albumin* ; Urea

Takotsubo cardiomyopathy, also called stress-induced cardiomyopathy, usually occurs in patients with severe emotional or physiologic stress. The prognosis is favorable, and the wall motion abnormlities normalize within weeks. However, stress-induced cardiomyopathy is rarely assosicated with left ventricular thrombus and thromboembolic complications. Here, we report a case of stress-induced cardiomyopathy with left ventricular thrombus that embolized to cause cerebral infarction.
Cardiomyopathies ; Cerebral Infarction ; Humans ; Prognosis ; Takotsubo Cardiomyopathy ; Thrombosis