No abstract available.
Family Practice* ; Humans ; Smoke* ; Smoking*

Familial lichen planus is an uncommon disease, and there are 104 cases reported in the English literature. Several theories regarding the etiopathogenesis of lichen planus have been proposed. However, immunological mechanisms and genetic susceptibility have been emphasized the most. Several reports showed HLA analysis in lichen planus patients, and recently 2 cases have revealed an increased frequency of DR1 antigen in patients with lichen planus compared to a control group. We observed two brothers with typical skin lesions of lichen planus of almost simultaneous onset. We confirmed lichen planus by skin biopsies in both brothers and analyzed HLA typing. We also observed the occurrence of DR1 antigen in both of them.
Biopsy ; Genetic Predisposition to Disease ; Histocompatibility Testing ; Humans ; Lichen Planus* ; Lichens* ; Siblings ; Skin

Congenital Abnormalities ; Female ; Humans ; Jaw ; Jeollabuk-do ; Male ; Orthognathic Surgery ; Osteotomy ; Osteotomy, Sagittal Split Ramus ; Rehabilitation ; Surgery, Oral

No abstract available.
Myofibromatosis* ; Skull*

Anti-E and anti-c is one of the clinical significant irregular antibodies developing a delayed hemolytic transfusion reaction and hemolytic disease of the newborn. Since anti-c occurs frequently with anti-E in immunized people whosoe cells are E-and c-, it has been recommended to select blood of the patient's own R1 phenotype for transfusion, even when the presence of anti-c cannot be demonstrated in his/her serum. To determine the utility of this approach, we reviewed the blood bank laboratory records of patients identified anti-E and anti-c in his/her serum in Severance hospital over a 12 year period (1985-1996). During the 12-year period of study, 53 patients were identified with anti-E and/or anti-c; 30(56.6%) patients had anti-E alone, 6(11.3%) had anti-c, and 17(32.1%) had both. Thirty eight of forty two patients whose Rh-hr phenotypes were tested were R1R1. Of these 38 R1R1 patients, 16 patients (42.1%) presented with anti-c concomitant with anti-E. Ouru study showed that the incidence of antni-c in R1R1 patients with anti-E is similar to that of studies reported in Caucasian groups. We highly suggest the transfusion protocol of prophylactic use of c negative blood for R1R1 patients with anti-E. Furthermore, because anti-c may be present in concentrations too low to be detected, the enzyme technique is recommended in parallel with standard serologic methods for the identification of irregular antibodies.
Antibodies ; Blood Banks ; Blood Group Incompatibility ; Humans ; Incidence ; Infant, Newborn ; Phenotype

Background: Patients with the chronic physical illness are more likely to experience depression, and the accompany of chronic physical illness and depression is particularly high in middle-aged and elderly women. Considering that depression is associated with somatization and the decline of therapeutic compliance when accompanied by chronic physical illness, middle-aged and elderly women who experience depression among chronic physical illness may increase their use of medical services. This study is to identify the effect of depression on the use of medical services, especially among middle-aged and elderly women with chronic physical illness. Methods: This study used the 2016 Korean Health Panel. For analysis, it used T-test, negative binomial regression, and multivariate regression combining propensity score matching. Results: First, depressive groups had a higher number of medical service utilization and total medical expenditure than the non-depressive group. Second, depression significantly increased medical service utilization (β=0.17, p=0.04) at the 5% significance level. Also, depression significantly increased total medical expenditure (β=0.37, p=0.08) at the 10% significance level. Conclusion For those who have chronic physical illness among middle-aged and elderly women, the experience of depression was confirmed to be a factor affecting the use of medical services. In the end, it is important to come up with policy countermeasures for middle-aged and elderly women accompanied by depression and chronic physical illness.

Background: Patients with the chronic physical illness are more likely to experience depression, and the accompany of chronic physical illness and depression is particularly high in middle-aged and elderly women. Considering that depression is associated with somatization and the decline of therapeutic compliance when accompanied by chronic physical illness, middle-aged and elderly women who experience depression among chronic physical illness may increase their use of medical services. This study is to identify the effect of depression on the use of medical services, especially among middle-aged and elderly women with chronic physical illness. Methods: This study used the 2016 Korean Health Panel. For analysis, it used T-test, negative binomial regression, and multivariate regression combining propensity score matching. Results: First, depressive groups had a higher number of medical service utilization and total medical expenditure than the non-depressive group. Second, depression significantly increased medical service utilization (β=0.17, p=0.04) at the 5% significance level. Also, depression significantly increased total medical expenditure (β=0.37, p=0.08) at the 10% significance level. Conclusion For those who have chronic physical illness among middle-aged and elderly women, the experience of depression was confirmed to be a factor affecting the use of medical services. In the end, it is important to come up with policy countermeasures for middle-aged and elderly women accompanied by depression and chronic physical illness.

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

The patient was a 51 year-old woman suffering fraen dysphagia due to upper esoyhageal lye stricutue whieh had developed as a result of a suicide attempt 21 years ago. Shortly after that, she underwent feeding gastrostomy and has lived in the gastrostomy state for 2l years. After admission, she underwent a barium esophagoram which revealed a near total obstruction at the cricoid cartilage level. Bougie dilatation with American Dilation System was tried on day 3. But the spring tip marked guide wire which was to be used with the American Dilation System could not be passed through the stricuture. Therefore, we performed a bougie dilatation using angiographic guide wire M(H-AG-35in-150 cm) with success. On day 14, she underwent a barium esophagogram which revealed her improved condition, and she was discharged on day 16.
Barium ; Constriction, Pathologic* ; Cricoid Cartilage ; Deglutition Disorders ; Dilatation* ; Female ; Gastrostomy* ; Humans ; Lye* ; Middle Aged ; Suicide

PURPOSE: The aim of this study was to define the characteristics of female voiding difficulty, and evaluate the effects of the alpha-blocker, tamsulosin, on the symptoms in those patients. MATERIAL AND METHODS: 148 patients, who complained of voiding difficulty between March 2002 and September 2004, were retrospectively evaluated. 32 patients with anatomical and neuropathic causes were excluded, with the remaining 116 assigned to 4 groups from their urodynamic evaluations: group I, bladder outlet obstruction (BOO) only; group II, BOO plus an overactive bladder (OAB); group III, detrusor underactivity (DU) only; and group IV, DU plus an OAB. After 2 weeks of observation, tamsulosin, 0.2mg/d, was prescribed in all groups, with the patients re-evaluated after 3 months. RESULTS: 58 (50%), 23 (19.8%), 20 (17.3%) and 15 (12.9%) of the 116 study subjects were placed into groups I, II, III and IV, respectively. In group I, 45 (77.5%) had symptomatic improvement after taking tamsulosin for 3 months, and in group II improvement was observed in 73.9% (17/23) of patients. In groups III and IV; however, improvements were seen in only 25 (5/20) and 13.3% (2/15) of cases, respectively. Dizziness, postural hypotension and urinary incontinence occurred in some patients, but these disappeared after the medication was discontinued. CONCLUSIONS: 81 patients (69.8%) had a bladder outlet obstruction, without detrusor underactivity, and 62 (76.5%) of these exhibited a voiding improvement after taking tamsulosin for three months. However, in patients with detrusor underactivity, the response rate was very low (20%).
Adrenergic alpha-Antagonists ; Dizziness ; Female ; Humans ; Hypotension, Orthostatic ; Retrospective Studies ; Urinary Bladder Neck Obstruction ; Urinary Bladder, Overactive ; Urinary Incontinence ; Urination Disorders ; Urodynamics