Primary biliary cirrhosis, a chronic, progressive, and often fatal cholestatic liver disease, is characterized by destruction of intrahepatic bile ducts, portal inflammation and scarring, and the eventual development of cirrhosis and liver failure. We reviewed four cases of primary biliary cirrhosis primarily suspected with peritoneoscopic liver biopsy specimens. All patients were female and their age ranged from 29 to 50 years(median age: 43.8 years). Presenting symptoms were typically pruritus and/or upper abdominal discomfort. On physical examination, interus was presented in 3; hepatomegaly in 3; chronic liver disease stigmata in one. Co-existing autoimmune diseases such as Hashimoto' thyroiditis and Sjoegren' syndrome were found in 2 cases. Biochemical tests of liver function revealed a cholestatic pattern. An antimitochondrial-antibody test was positive in 2 out of 3 patients(75%). Increase levels of serum immunoglobulins, especially of IgM, were evident in 3 cases. Histologic staging(Ludwig et al.) disclosed stage I lesion in one, stage III in two, and stage IV in the remaining one.
Female ; Humans ; Biopsy

The Duodenal diverticulum is the rare cause of the common bile duct obstruction. We experienced a case of the diverticulum of the second portion of duodenum in a 59-year-old male, who complained recurrent attacks of right upper abdominal pain and fever since 16 months prior to admission. Duodenoscopic finding and UGI study revealed a typical duodenal diverticulum just side to the papilla of Vater. Diverticulectomy and cholecystectomy was performed and after than, he has been free front above mentioned symptoms. We reported a case of duodenal diverticulum which caused recurrent common bile duct obstruction.
Abdominal Pain ; Cholecystectomy ; Common Bile Duct* ; Diverticulum* ; Duodenum ; Fever ; Humans ; Male ; Middle Aged

A new hypolipidemic agent, lovastatin, hydroxy-methyl-gultaryl coenzyme A reductase inhibitor was administred to 25 patients with primary hyperlipidemia 20 to 40 mg daily for 12 weeks and sequential changes of serum lipid profile were analysed as follow. 1) Mean average at baseline period of serum total cholesterol, triglyceride, HDL and low desity lipoprotein cholesterol were 271, 179, 51 and 185 mg/dl respectively. 2) Total cholesterol showed 20% decrease at 4th week and 23% decrease at the end of 12th week while low density lipoprotein cholesterol decreased 31% and 33% respectively. 3) Triglyceride dropped 7% at 8th week and 3% at 12th week. High density lipoprotein cholesterol increased 4% at 4th week and showed 2% decrease at the end of study. 4) Only one patient complained of moderate abdominal pain, which subsided after 2 weeks drug withdrawal. In conclusion, lovastatin was well tolerated and effective, in the treatment of primary hyperlipidemia.
Abdominal Pain ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Coenzyme A ; Humans ; Hyperlipidemias* ; Lipoproteins ; Lovastatin ; Oxidoreductases ; Triglycerides

The authors have had contact with 508 cases of perineal surgery receiving various kinds of anesthetic methods and these cases who were analazed at the Department of Anesthesiology, Ewha Womans University Hospital during the 5 year period from January 1976 to December 1980. The results are as follows: 1) There is the trend towards increasing numbers of perineal operations annually. 2) Ratio of males to females was 1.1:1.0. 3) Spinal anesthesia was the most commonly used technique(56.9%). 4) For geriatric patients, selection of anesthesia was regional aensthesia rather than general anesthesia. 5) The most common diagnosis and performed operation was hemorryhoidectomy and other perianal procedures(61.2%). 6) For premedication, demerol and atropine were commonly used(50.2%). 7) Most cases ended within 30minutes(62.8%). 8) Saddle block was satisfactory for perineal operation. And for this level, 6~8 mg of tetracaine was sufficient in spinal anesthesia.
Anesthesia* ; Anesthesia, General ; Anesthesia, Spinal ; Anesthesiology ; Atropine ; Diagnosis ; Female ; Humans ; Male ; Meperidine ; Premedication ; Tetracaine

BACKGROUND/AIMS: This study was conducted to assess the disease burden of pneumonia according to age and presence of underlying diseases in patients admitted with community-acquired pneumonia (CAP). METHODS: We performed a retrospective, observational study and collected data targeting patients with CAP (> or = 50 years) from 11 hospitals. Disease burden was defined as total per-capita medical fee, severity (CURB-65), hospital length of stay (LOS), and mortality. RESULTS: Of the 693 enrolled subjects, elderly subjects (age, > or = 65 years) had a higher mean CURB-65 score (1.56 vs. 0.25; p < 0.01) and higher mortality than nonelderly subjects (4.4% [n = 21] vs. 0.5% [n = 1]; p = 0.00). In addition, the total cost of pneumonia treatment was higher in elderly patients compared to in nonelderly patients (KRW 2,088,190 vs. US $1,701,386; p < 0.01). Those with an underlying disease had a higher CURB-65 score (1.26 vs. 0.68; p < 0.01), were much older (mean age, 71.24 years vs. 64.24 years; p < 0.01), and had a higher mortality rate than those without an underlying disease (3.5% [n = 20] vs. 1.7% [n = 2]; p = 0.56). Total per-capita medical fees were higher (KRW 2,074,520 vs. US $1,440,471; p < 0.01) and hospital LOS was longer (mean, 8.38 days vs. 6.42 days; p < 0.01) in patients with underlying diseases compared to those without. CONCLUSIONS: Due to the relatively high disease burden in Korea, particularly in the elderly and in those with an underlying disease, closer and more careful observation is needed to improve the outcomes of patients with CAP.
Age Distribution ; Age Factors ; Aged ; Aged, 80 and over ; Community-Acquired Infections/diagnosis/economics/*epidemiology/mortality/therapy ; Comorbidity ; Costs and Cost Analysis ; Female ; Health Care Costs ; Hospitalization ; Humans ; Length of Stay ; Male ; Middle Aged ; Pneumonia/diagnosis/economics/*epidemiology/mortality/therapy ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Severity of Illness Index ; Time Factors

Granulocyte colony-stimulating factor (G-CSF) is a hematopoietic growth factor (HGF) with many applications in cancer therapy. Many cutaneous adverse reactions associated with G-CSF have been reported in recent years, including injection site reactions, pyoderma gangrenosum, Sweet's syndrome, cutaneous leukocytoclastic vasculitis, and widespread folliculitis. We report a case of vasculitis with atypical myeloid cell induced by G-CSF on the lower extremities
Folliculitis ; Granulocyte Colony-Stimulating Factor* ; Granulocytes* ; Lower Extremity ; Myeloid Cells* ; Pyoderma Gangrenosum ; Sweet Syndrome ; Vasculitis ; Vasculitis, Leukocytoclastic, Cutaneous

The authora have had contact with 951 cases of surgery of the lower extremities receiving various kinds of anesthtic methods and these cases were analyzed at the department of Anesthesiology, Ewha Womans University Hospital during the 7 year period from January 1970 to December 1982. The result are as follows: 1) There is a trend towards increasing numbers of operations annually. 2) The most common age group was 3rd decade(24%) 3) Ratio of males to females was 2:1. 4) Class I of physical status(ASA) was most common(61.2%) 5) For premedication, meperidine and atropine sulfate were commonly used(32.9%). 6) In the section of surgery, Orthopedic surgery is most common(90.4%) 7) General anesthesia was the most commonly used technique(69.8%) 8) Most cases ended within 2 hours(60.1%)
Anesthesia* ; Anesthesia, General ; Anesthesiology ; Atropine ; Female ; Humans ; Lower Extremity* ; Male ; Meperidine ; Orthopedics ; Premedication

Morphea is a rare, sclerotic connective tissue disorder and is thought to be caused by a decreased collagenase activity. Numerous treatment modalities have been tried, such as infiltration with glucocorticosteroid, D-penicillamine, antimalarial agents and cyclosporine. However, all have shown only limited success. We report a case of a 21 year- old female with localized scleroderma, who showed a marked improvement after localized therapy with high dose UVA-1.
Antimalarials ; Collagenases ; Connective Tissue ; Cyclosporine ; Female ; Humans ; Penicillamine ; Phototherapy* ; Scleroderma, Localized*

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Mucormycosis is a rare, fulminating, opportunistic fungal infection that occurs almost exclusively in immunocompromised hosts such as patients with diabetes, leukemia, lymphoma. These fungi are ubiquitous in nature, and can be found on decaying vegetation and in the soil. So they are relatively frequent contaminants in the clinical microbiology laboratory. Recently the incidence of mucormycosis is rising associated with the increasing use of immunosuppressive agents, antibiotics. Though mucormycosis is frequently fatal, there has been a significant improvement in the outcome by early diagnosis and aggressive treatment. Mucormycosis can be categorized as rhinocerebral, pulmonary, gastrointestinal, cutaneous, widely disseminated and miscellaneous; gastro-intestinal involvement is extremely rare. We report a patient with gastric mucormycosis who had diabetes mellitus and alcoholic hepatitis. His chief complaint was an epigastric pain, and the gastroscopy showed huge multiple ulcers, coated with exudates. The histologic examination revealed multiple broad, nonseptate hyphae with right angle branchings, diagnosed as mucormycosis.
Alcoholics* ; Anti-Bacterial Agents ; Diabetes Mellitus* ; Early Diagnosis ; Exudates and Transudates ; Fungi ; Gastroscopy ; Hepatitis, Alcoholic* ; Humans ; Hyphae ; Immunocompromised Host ; Immunosuppressive Agents ; Incidence ; Leukemia ; Lymphoma ; Mucormycosis* ; Soil ; Ulcer