No abstract available.
Peptic Ulcer Perforation* ; Peptic Ulcer*

No abstract available.
Herpes Zoster* ; Psoriasis*

Most of the malignant tumors of the pancreas are adenocarcinomas arising from the ductal epithelium. Primary leiomyosarcoma of the pancreas, even though it is the most common sarcoma of the pancreas, is very rare. We present a case of leiomyosarcoma of the pancreas, probably primary, with metastases to the stomach, lymph nodes, and abdominal wall. A 52-year-old woman visited the hospital with vague right upper abdominal pain and weigh loss of 6 kg for 2 months. The radiological and endoscopic examination revealed that she had a large heterogeneous mass, 11 cm in size, in the pancreatic body and tail, a 4 cm-sized mass in the paraaortic area, and a 3 cm-sized polypoid mass in the stomach. Histologically, they were all similar to one another and composed of markedly pleomorphic cells. Immunohistochemical and electron microscopic studies showed definite smooth muscle differentiation of the tumor cells. Two months later, the patient underwent an excision of a new 3 cm mass in the right lower abdominal wall, showing features of well differentiated leiomyosarcoma.
Abdominal Pain ; Abdominal Wall ; Adenocarcinoma ; Epithelium ; Female ; Humans ; Leiomyosarcoma* ; Lymph Nodes ; Middle Aged ; Muscle, Smooth ; Neoplasm Metastasis ; Pancreas* ; Sarcoma ; Stomach

Although febrile convulsion (FC) is a common clinical entity with a high recurrence rate, no specific factors have been identified to be highly predictive of its recurrence. A total of 114 cases of FC identified during a 28 month period (January, 1989-May, 1991) was analysed. A slight predominance of boys over girls (1.3 to 1.0) was observed. the majority of cases (89.4%) were under 3 years of age and the most common age range for the onset of FC was 1~2 years. The most common form of FC was tonic type (54.0%), followed by tonic-clonic (32.5%), clonic (5.3%), and complex partial type (5.3%). Most FC episodes lasted less than 5 minutes (81.6%), and common clinical diagnosis underlying FC were as follows: pharyngotonsillitis (64.0%), bronchitis and/or pneumonia(16.7%), and gastroenteritis (9.7%). The family history for seizure disorder was present in 27.2% of the cases: FC in 21.1%, epiepsy in 4.4%, and both in 1.8%. Among 78 cases of the first FC, 43 cases were followed for 5 to 29 months without prophylactic anticonvulsant therapy. The overall recurrence rate of FC in this group was 67.4% and the highest incidence was observed in patients less than one year old (86.7%). A higher recurrence rate (80%) was observed in patients whose body temperature was lower than 39degrees C, as opposed to higher than 39degrees C (50%). It is concluded that the recurrence of FC is positively correlated with factors such as younger age (less than one year old), and lower body temperature at the time of onset of FC.
Body Temperature ; Bronchitis ; Diagnosis ; Epilepsy ; Female ; Gastroenteritis ; Humans ; Incidence ; Recurrence ; Seizures, Febrile*

The word "Delayed" in the legend of Figure 2 should have been written as "Controls."

Intramedullary myelitis due to bacterial meningitis associated with cervical epidural abscess is very rare. Its cause and clinical features are non-specific, therefore exact diagnosis is often missed or mistaken for other disease and immediate treatment may be delayed. We report a case of intramedullary myelitis due to epidural abscess presented with prominent symptoms of meningitis and manifestations of acute cerebrovacular accident. A 69 -year-old man was admitted due to right hemicranial headache with pain on right posterior neck and febrile sensation. At first, the patient's headache was improved by conservative therapy. Three weeks later, the patient showed abrupt right hemiparesis (MRC grade 2/5) with drowsy mentality. The CSF findings of the patient were compatible with acute bacterial meningitis. Cervical spine MRI showed cervical epidural abscess and extensive intramedullary myelitis from cervical to lumbar spinal cord. After antibiotic therapy, mentality of the patient became to be alert and right hemiparesis was improved to MRC grade 4/5. Follow up cervical spine MRI after several weeks represented that the lesions of cervical epidural abscess and intramedullary myelitis were significantly diminished.
Diagnosis ; Epidural Abscess* ; Follow-Up Studies ; Headache ; Humans ; Magnetic Resonance Imaging ; Meningitis ; Meningitis, Bacterial* ; Myelitis* ; Neck ; Paresis ; Sensation ; Spinal Cord ; Spine

No abstract available.
Colorectal Neoplasms, Hereditary Nonpolyposis*

Disodium cromoglycate(DSCG) has been widely used in the treatment of bronchial asthma and has become the prophylactic drug of choice in patients with mild-to-moderate asthma, because it has anti-allergic, anti-inflammatory and mast cell stabilizing properties. DSCG has been considered one of the safest medications among drugs for asthma treatment. The most common side effects are irritation of throat and dry mouth. Bronchospasm and chest tightness have been reported, but they were usually experienced by patients using spinhaler powdered capsules rather than metered dose inhalers (MDI). In this report, we presented a case of recurrent DSCG-induced bronchoconstriction with brief review of the literature. He had had an aspirin-induced asthma and had been well controlled with steroid inhalers and DSCG-MDI. After aspirin-bronchopro vocation test, he complained of chest discomfort and tightness immediately after inhaling DSCG-MDI. On serial monitoring of peak expiratory flow rate (PEER), there was a significant decline of PEER after two puffs inhalation of DSCG-MDI. Thus we performed DSCG-inhalation broncho provocation test with the nebulizer solution, which was pure DSCG without any addition of ingradients or propellants. This produced an early asthmatic reaction with more than 40% decline of FEV,. He was diagnosed as DSCG-induced bronchoconstriction and his clinical conditions were improved after avoidance of DSCG-MDI.
Asthma* ; Asthma, Aspirin-Induced ; Bronchial Spasm ; Bronchoconstriction* ; Capsules ; Humans ; Inhalation ; Mast Cells ; Metered Dose Inhalers ; Mouth ; Nebulizers and Vaporizers ; Occupations ; Peak Expiratory Flow Rate ; Pharynx ; Thorax

Congenital hypoprothrombinemia is a rare congenital coagulation defect. The clinical signs are manifestation of generalized tendency such as; mucosal bleeding, hypermenorrhea and post tooth extraction hemorrage. It is associated with prolongation of PT and PTT with normal thrombin time and decreased serum prothrombin level. A case with congenital hypoprothrombinemia was experienced by the authors. A 36 days old male baby was admitted with palor skin and vomiting started one day before admission. Right side brain parenchymal hemorrhage and left shift of lateral ventricle were on brain CT scan. Prologation of prothrombin time and partial prothrombin time with decreased serum prothrombin level were resulted. Serum factor I, V, VII, VIII, IX and X were within normal level. We report a case congenital hypoprothrombinemia with a brief review of relaed literatures.
Brain ; Female ; Fibrinogen ; Hemorrhage ; Humans ; Hypoprothrombinemias* ; Lateral Ventricles ; Male ; Menorrhagia ; Prothrombin ; Prothrombin Time ; Skin ; Thrombin Time ; Tomography, X-Ray Computed ; Tooth Extraction ; Vomiting

This study is a methodical research to develop a health behavior assessment scale for patients with rheumatoid arthritis, and to test the validity and reliability of the instrument. The research procedure was as follows; 1) The first step was to develop conceptual framework based on a comprehensive review of the literature, in-depth interviews patients with rheumatoid arthritis. This conceptual framework was organized in eight dimensions; pain management, exercise, rest, diet control, active committment, self-management, positive thinking, interpersonal maintenance. Initially 56 items were selected from 164 statement. 2) These items were reviewed by panel of eight specialists and the Index of Content validity (CVI) was calculated, and forty six items were selected which met more than 70% on the CVI. 3) 174 rheumatoid arthritis pateints were interviewed, and data was gathered from Jan. 25 to Feb. 18, 1999 for test reliabilities and validities of the scale. The item analysis was carried out and 40 items were selected. Factor analysis by varimax rotation was carried out to test construct validity. The internal consistency by chronbach's alpha was calculated. The findings were as follows; 1) Item analysis and factor analysis were carried out to test the validity of the health behavior assessment scale. The item analysis was based on the corrected item`s to total correlation coefficient (.30 or more), and information about the alpha estimate. However, this was only if this item was deleted from the scale. As a result of the item analysis, forty items were selected. Thirty items were selected by a initial factor analysis by varimax rotation, and ten items were deleted because of factor complexity. In the secondary factor analysis, eight factors were labled as 'positive thinking', 'exercise', 'rest', 'pain management', 'active committment', 'self-management', 'diet control', and 'interpersonal maintenance', each similar with the conceptual framework. 2) Chronbach's alpha coefficient to test reliability of the scale was. 903 for total the thirty items. The Scale for assessing health behavior developed in this study was identified to be a tool with a high degree of reliability and validity. Therefore this scale can be effectively utilized for assessment in the health behaviors of the patients with rheumatoid arthritis.
Arthritis, Rheumatoid* ; Diet ; Health Behavior* ; Humans ; Pain Management ; Reproducibility of Results ; Self Care ; Specialization ; Thinking