A lg year-old female patient with pityriasis lichenoides et varioliforrnis acuta (PLEVA) was been treated with PUVA, At first, she was treated with tetracycline for 8 weeks with improvement somewhat. But 2 months later, her skin lesions aggravated slowly. So, we tried to treated her with PUVA and then she was cleared completely. The initial dose of UVA was 5 J/cm The UVA dosage increased by 10g of the previous exposure and increased to the maximum dose, 15 J/cm The patient exposed to UVA R times per week. 12 times after the PUVA therapy, the skin lesions begin to improve and completely improved at 21 times of Pl.JVA therapy. She was followed up every week and there was no side effect except hyperpigrnentation till 24 months. The total dose during treatment is 210 J/cm.
Female ; Humans ; Photochemotherapy* ; Pityriasis Lichenoides* ; Pityriasis* ; PUVA Therapy ; Skin ; Tetracycline

The author analyzed detailed pattern of pelvic bone fracture in 52 cases of posterior urethral injuryassociated with pelvic bone fracture in male. The relationship between fracture and urethral injury was reviewed n38 cases who received retrograde urethrography at the time of injury. The pattern of urethral injury due to pelvicbone fracture was newly classified. The results were as follows; 1. In age distribution, the most common was 5thdecade(26.9%). 2. The most freqent type of pelvic rami fracture was two rami fracture(52%). 3. There was no casewith only the superior ramus fracture, and all cases were associated with inferior ramus fracture with or withoutsuperior ramus fracture. 4. In inferior ramus fracture, the ratio of ischial ramus fracture to pubic ramusfracture was 46.1:17.4. 5. In cases with only the ischial ramus or pubic ramus fracture, unilateral fractureexceeded bilateral fracture(44.2:19.3). 6. The bladder rupture was found in 10 among the total 52 cases, 9 ofwhich were associated with superior ramus fracture, and 8 were extraperitoneal type. 7. The most common type ofurethral injury was Type III(73.7%), and followed by Type II(10.5%), Type I(7.9%), and Type IV(7.9%). 8. Theseresults strongly suggested that the superior ramus frature was related to bladder rupture, and inferior ramusfracture to urethral injury.
Age Distribution ; Humans ; Male ; Pelvic Bones ; Rupture ; Urinary Bladder

No abstract available.
Blood Platelets*

There is increasing need for network connecting personal computers(PC) together. Thus Local Area Network(LAN) emerged, which was designed to allow multiple computers to access and share multiple files and programs and expensive peripheral devices and to communicate with each user. We built PC-LAN in our department that consisted of 1) hardware-9 sets of personal computers(IBM compatible 80386 DX, 1 set:80286 AT, 8sets) and cables and network interface cards (Ethernet compatible, 16bits) that connected PC and peripheral devices 2) software - network operating system and database management system. We managed this network for 6 months. The benefits of PC-LAN were 1) multiuser (share multiple files and programs, peripheral devices) 2) real time data processing 3) excellent expandibility and flexibility, compatibility, easy connectivity 4) single cable for networking ) rapid data transmission 6) simple and easy installation and management 7) using conventional PC's software running under DOS(Disk Operating System) without transformation 8) low networking cost. In conclusion, PC-LAN provides an easier and more effective way to manage multiuser database system needed at hospital departments instead of more expensive and complex network of minicomputer or mainframe.
Database Management Systems ; Hospital Departments ; Humans ; Microcomputers* ; Minicomputers ; Pliability ; Running

No abstract available.
Vesicovaginal Fistula*

BACKGROUND: The testes are one of the most common extramedullary sites of relapse in boys with acute lymphoblastic leukemia(ALL). The reported incidence of isolated testicular relapse varies from 3 to 40%. If these patients are treated exclusively with testicular irradialion, a systemic relapse occurs within a few months. Recently, the use of intensive chemotherapy and testicular irradiation improved the survival rate for boys with testicular leukemia. So, we performed this study to identify clinical manifestations, disease free survival and prognostic factors of testicular leukemia in children. METHODS: We reviewed 33 patients of testicular leukemia among total 410 boys with ALL diagnosed at the Department of Pediatrics, Seoul National University Children's Hospital from Jan. 1970 to Aug. 1996. Testicular leukemia was confirmed by testicular biopsy in all 33 patients. These patients were treated with combined local testicular irradiation(2,400~2,500 cGy/8~12fractions) and systemic chemotherapy. Two patients, in whom testicular relapse was diagnosed before 1979, unilateral orchiectomy of the involved site and testicular irradiation of the opposite site were performed. Probability estimates of disease free survival (DFS) were calculated by the method of Kaplan and Meier, and the relationship of prognostic factors to DFS was compared using the chi-square test in survival analysis. RESULTS: In 410 boys with ALL, testicular leukemia occurred in 33 patients(8%). Of 33 patients, 6 patients presented with testicular involvement at initial diagnosis, 16 patients had testicular relapse while still receiving chemotherapy and 11 patients had testicular relapse 3 to 57 months(median : 15 months) after cessation of chemotherapy. The median age of 33 patients was 7.4 yrs(9 months~18 yrs) and median WBC count 7,600/ L(2,700~270,000/L). All patients presented with painless testicular enlargement and testicular leukemia was confirmed by testicular biopsy. Among 33 patients, 2 had prior CNS relapse and 11 had concomitant bone marrow and/or CNS relapse. Twenty nine patients were treated with combined local testicular irradiation and systemic chemotherapy. Eleven had second relapse(6 bone marrow, 3 CNS, 2 opposite testis). Seventeen have been followed until now: 6 patients on chemotherapy and 11 patients(37.9%) in complete remission for 48.5+/-22.3 months(19~86 months). The 3 year DFS for 29 patients was 55.3%+/-10.1%. The following prognostic factors showed no significant association with DFS in testicular relapse : age and WBC count at initial diagnosis, age at testicular relapse, and concomitant relapse. Whether testicular relapse occurred on initial therapy or off initial therapy has prognostic value in predicting DFS. The 3 year DFS for boys with testicular relapse on and off initial therapy were 40.0%+/-12.9% and 78.8%+/-13.4%, respectively(P: 0.046). CONCLUSION: With the use of chemotherapy and testicular irradiation, prolonged second re mission can be achieved in many patients with testicular leukemia. The patients with testicular relapse off initial therapy fared significantly better than patients on therapy. So, to improve the DFS for boys with testicular leukemia, a better understanding of its biology and prognostic factors is needed.
Biology ; Biopsy ; Bone Marrow ; Child ; Diagnosis ; Disease-Free Survival ; Drug Therapy ; Humans ; Incidence ; Leukemia ; Missions and Missionaries ; Orchiectomy ; Pediatrics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Recurrence ; Seoul ; Survival Rate ; Testis

We retrospecively analyzed MRI findings of 14 patients with intracranial tuberculosis according to the disease process before anti-tuberculous medication. We also analyzed the correlativity between these findings and the clinical outcome after anti-tuberculous medication in 8 patients who had taken follow-up MR imaging. MR imaging was performed with either a 0.5T(1 patients) or 1.0T(13 patients) superconducting system with spinecho pulse sequences. Abnormalities on MRI were seen in 87%(12/14) of the patients. MRI findings consisted of meningeal enhancement(n=10), parenchymal tuberculoma(n=6), hydrocephalus(n=5), and infarction(n=5). Most of them were found within 3 months from symptom-onset. Parenchymal tuberculomas were found after 1 month of symptom-onset. All cases of hydrocephalus and infarction were associated with meningeal enhancement. On follow-up MRI after anti-tuberculous medication, changes of MR imaging did not correlate with clinical outocome in 4(50%) of 8 patients. Improvement of MRI findings were observed in patient treated for more than 3 weeks. In conclusion, MRI is a good modality in the diagnosis of intracranial tuberculosis, however, the MRI findings are not always correlated with clinical outcome after, anti-tuberculous medication.
Diagnosis ; Follow-Up Studies ; Humans ; Hydrocephalus ; Infarction ; Magnetic Resonance Imaging* ; Tuberculoma ; Tuberculosis*

No abstract available.
Gallium* ; Neoplasm, Residual* ; Wounds and Injuries*

BACKGROUND: Hereditary spherocytosis(HS) is a clinically and biochemically very heterogeneous disorder The purpose of this study is to detect erythrocyte membrane protein abnormalities by SDS-PAGE and to investigate the frequency of erythrocyte membrane protein defects in hereditary spherocytosis and correlation between some of the hereditary spherocytosis biochemical subsets and the selected clinical phenotype. METHODS: We evaluated the clinical and laboratory characteristics of 14 normal healthy persons and 23 hereditary spherocytosis patients and 8 their family members. The patients were divided into three groups based on clinical and hematological severity(mild, typical, severe). In addition to routine hematologic determlnatlons, osmotic fragility and autohemolysis, RBC membrane protein analysis were performed in all patients by densitometric tracing of SDS-PAGE(sodium dodecyl sulphate polyacrylamide gel electrophoresis) stained by Coomassle blue utilizing both the discontinuous buffer system of Laemmli with acrylamide linear gradient from 4% to 12% and the continuous buffer system of Fairbank with exponential gradient of acrylamide from 3.5% to 17%. RESULTS: 1) The patients could be seperated into three classes of different clinical severity as mild(3 cases), moderate(16 cases) and severe(4 cases) on the clinical feature. 2) Eighteen patients(82.6%) among 23 hereditary spherocytosis revealed abnormal erythrocyte membrane protein and we detected six patients(26.1%) with spectrin deficiency combined with ankyrin reduction, 4 patients(17.4%) with ankyrin deficiency, 4 patients(17.4%) with isolated spectrin deficiency and 3 patients(13.0%) with band 3 deficiency. Five HS patients(21.7%) showed normal RBC membrane protein. 3) Eight HS and their family members showed same RBC membrane protein deficiency. 4) The type and degree of RBC membrane protein reduction were variale with spectrin at 66~94%, with ankyrin at 48~82% of normal levels. These showed that each patient had different clinical severities according to different RBC membrane protein levels and type. CONCLUSION: RBC membrane protein abnormalities were observed in 82.6% of HS patients. The combined spectrin and ankyrin deficiency is the most common molecular defect in HS. The clinical severity and biochemical expression is heterogeneous. SDS-PAGE analysis of RBC membrane protein was provided the diagnosis of RBC membrane defects and basic molecular studies. We believed that the early identification of the biochemical defect responsible for HS is important because it is helpful starling point for the identification of the primary molecular defect, and it could help to anticipate the clinical outcome of the disease. For these reasons, we consider the SDS-PAGE of the red cell membrane to be of crucial importance for a complete evaluation of children with HS. Further studies with more cases would be to clarify the correlation between clinical and biochemical phenotypes.
Acrylamide ; Ankyrins ; Cell Membrane ; Child ; Diagnosis ; Electrophoresis, Polyacrylamide Gel* ; Erythrocyte Membrane* ; Erythrocytes* ; Erythrocytes, Abnormal ; Humans ; Membrane Proteins ; Membranes ; Osmotic Fragility ; Phenotype ; Population Characteristics* ; Spectrin ; Starlings

No abstract available.
Catheters* ; Peritoneal Dialysis, Continuous Ambulatory*