Paget's disease of bone (osteitis deformans), a chronic osseous disease of unknown etiology, is extremely rarein Asia although well known in western countries. This disease is characterized by the simultaneous absorption ofbone and the new bone formation of abnormal character affecting middle and later age groups. The authorsexperienced a case of monostotic Paget's disease involving left pelvic bone in 56-years old female. To ourknowledge, this is the first cas report of monostotic Paget's in Korea.
Absorption ; Asia ; Female ; Humans ; Korea ; Osteitis Deformans ; Osteogenesis ; Pelvic Bones

A 59-year-old man was rushed to the emergency room. The patient complained of headache with impaired memory function. Brain MRI showed a necrotic tumor in Lt cerebral hemisphere, with severe peritumoral edema (Fig. 1). Pathologic examination of the brain lesion confirmed that the tumor was a small cell lung cancer (SCLC). Chest computed tomography revealed a large soft tissue mass with central necrosis at subcarinal area in spite of an initial normal chest X-ray (Fig. 2). Bronchoscopic biopsy of the polypoid mass at subcarina revealed that the mass was a SCLC (Fig. 3). This is the case of SCLC only with an extrapulmonary symptoms despite of a normal chest X-ray. When metastatic brain tumor was found, appropriate chest evaluation should be performed even though chest X-ray was normal because brain is a common site of invasion of lung cancer.
Biopsy ; Brain ; Brain Neoplasms ; Cerebrum ; Edema ; Emergencies ; Headache ; Humans ; Lung Neoplasms ; Memory ; Middle Aged ; Necrosis ; Small Cell Lung Carcinoma ; Thorax

PURPOSE: Relapses are a major problem in children with steroid responsive nephrotic syndrome(SRNS). This study has been performed to determine the predictive factors for relapse in children with SRNS. METHODS: The study group consisted of 73 children with SRNS who had been admitted to the Department of Pediatrics, Kyungpook National University Hospital, over 6 years from 1996 to 2001. The medical records were reviewed retrospectively and analyzed to determine significant relationships between selected variables[age at onset, sex, laboratory data, the rapidity of response(days to remission), interval to first relapse] and the frequency of relapse. RESULTS: The age(mean+/-SD) of patients was 4.53+/-2.53 years old. The male to female ratio was 52:21. In 95%, 39 out of the 41 children had a renal biopsy, and the final diagnosis was minimal change nephrotic syndrome. There was no significant correlation between the frequency of relapse and the following variables:age at onset, sex, and presence of hematuria. However, the rapidity of response correlated well with the frequency of relapse, especially during the first year after the onset of the disease(P=0.006). CONCLUSION: The rapidity of response is expected to be one of the predictive factors for relapse in children with SRNS.
Biopsy ; Child* ; Diagnosis ; Female ; Gyeongsangbuk-do ; Hematuria ; Humans ; Male ; Medical Records ; Nephrosis, Lipoid ; Nephrotic Syndrome* ; Pediatrics ; Recurrence* ; Retrospective Studies

Slipped capital femoral epiphysis is a rare hip disorder that mainly occurs in pubertal children. Although the exact cause of this disorder is unknown, it is known to be associated with obesity, trauma, delayed sexual development, delayed bone maturation, chronic renal failure, genetic diseases, endocrine disorders (growth hormone deficiency, hypothyroidism, hypogonadism), growth hormone therapy, and gonadotropin releasing hormone agonist (GnRH agonist) therapy. We report 2 cases of slipped capital femoral epiphysis in adolescent females who were receiving growth hormone therapy. The first case is of a 16 year-old-girl with chronic renal failure and renal osteodystrophy. The second case is of an 11 year-old-girl with idiopathic precocious puberty who had received GnRH agonist and growth hormone therapy. Unilateral or bilateral slipped capital femoral epiphysis developed at 1 year 3 months after treatment in both the cases. The chief complaints were pain in the hip joint and lower extremities. Growth hormone and/or GnRH agonist therapy was stopped, and in situ screw fixations of the involved hip epiphyses were performed.
Adolescent ; Child ; Endocrine System Diseases ; Epiphyses ; Female ; Gonadotropin-Releasing Hormone ; Growth Hormone ; Hip ; Hip Joint ; Humans ; Hypothyroidism ; Kidney Failure, Chronic ; Lower Extremity ; Obesity ; Puberty, Precocious ; Renal Osteodystrophy ; Sexual Development ; Slipped Capital Femoral Epiphyses

BACKGROUND: Matrix metalloproteinase (MMP)-2 and MMP-9 degrade type IV collagen and are antagonized by the tissue inhibitors of metalloproteinase (TIMP)-2 and TIMP-1, respectively. METHODS: We studied by immunohistochemistry the expressions of MMP-2, MMP-9, TIMP-1 and TIMP-2 in 72 cases of adenocarcinoma of the gallbladder. RESULTS: The MMP-2, MMP-9 and TIMP-1 expressions were significantly higher in well/moderately differentiated adenocarcinomas than in poorly differentiated adenocarcinomas, in adenocarcinomas that had invaded the lamina propria/proper muscle than in those that had invaded the perimuscular connective tissue or beyond the serosa, and in adenocarcinomas with fungating growth than in those with infiltrative growth. The TIMP-2 expression showed a similar pattern without statistical significance. Regarding the status of lymph node metastasis, the MMP-2 expression was significantly higher in cases without lymph node metastasis. The MMP-2 and MMP-9 expressions were significantly related to those of TIMP-2 and TIMP-1, respectively, with regard to depth of invasion, differentiation, and growth patterns of the adenocarcinomas. CONCLUSIONS: MMP-2, MMP-9, TIMP-1 and TIMP-2 are suggested to play important roles in the progression to early invasion of adenocarcinomas, in which the function of MMP-2 is inhibited by TIMP-2.
Adenocarcinoma* ; Collagen Type IV ; Connective Tissue ; Gallbladder Neoplasms ; Gallbladder* ; Immunohistochemistry ; Lymph Nodes ; Matrix Metalloproteinases ; Neoplasm Metastasis ; Serous Membrane ; Tissue Inhibitor of Metalloproteinase-1 ; Tissue Inhibitor of Metalloproteinase-2* ; Tissue Inhibitor of Metalloproteinases

Rifampin is sometimes associated with hematologic complications such as hemolytic anemia or thrombocytopenia. Patients with drug-induced thrombocytopenia develop a drug- dependent antibody that binds to platelets in the presence of the drug causing platelet clearance. It has been previously proposed that the antibody binds the drug, resulting in an immune complex that is then adsorbed onto platelets. However, it has been recently known that drug-dependent antibodies bind to one or more of the platelet membrane glycoprotein Ib, IIb, IIIa, and IX. We, hereby, report a case of rifampin-induced thrombocytopenia in which drug-dependent antibody specific for platelet glycoprotein Ib/IX and IIb/IIIa was demonstrated by modified antigen capture ELISA method. The case was a 37 year-old female who had had pulmonary tuberculosis and taken antituberculous regimen including rifampin. Intermittent epistaxis appeared 10 days after treatment with rifampin. She was admitted to hospital due to gingival bleeding for 3 days and menorrhagia for 2 days. On admission, her platelet count was dropped to 7,000/microliter.
Adult ; Anemia, Hemolytic ; Antibodies* ; Antigen-Antibody Complex ; Blood Platelets* ; Enzyme-Linked Immunosorbent Assay ; Epistaxis ; Female ; Glycoproteins* ; Hemorrhage ; Humans ; Menorrhagia ; Platelet Count ; Platelet Glycoprotein GPIb-IX Complex ; Rifampin ; Thrombocytopenia* ; Tuberculosis, Pulmonary

PURPOSE: The penile hypersensitivity is one of the complicated causes of premature ejaculation so that it has been applied to the local anesthesia or the penile dorsal neurectomy in the cases of treatment. The authors had compared the clinical efficacy of various kinds of OTC topical agents which were designed for premature ejaculation and were approved of selling in Korean market. MATERIALS AND METHODS: 10 normal adult male with ages from 29 to 24 years (ave. 33.4) were enrolled in this study. 8 topical agents of cream-type such as SS-cream(R), gel-type such as Power gel(R), B.M. gel(R), BIGTO gel(R) and Control gel(R), solution-type such as E.L.T soln(R), and spray type such as Sanova(R), Tstone(R) were applicated. With exception of SS-cream(R) which was natural medicine, the rest of them were made from lidocane 9.6%. We evaluated characteristics, efficacy, satisfaction and adverse reactions in treatment of premature ejaculation with 8 topical agents. RESULTS: In concerning of their odor, SS-sream(R) was the strongest (p<0.05). The viscosity was the highest in cream-type agent as SS-cream(R). However washing after sexual intercourse is relatively easy in every cases with the lowest necessity of washing in solution-type E.L.T soln(R) (p<0.05). The main causes of feeling the usage of drugs by partners were delay of ejaculation time, feeling of foreign bodies in genital organ, and the odor of drugs itself. Except SS-cream(R) with 60 minutes, the interval time of drug effect was about 15 to 20 minutes in every cases without any significant difference as well as adequate duration of drug efficacy. The times of usage per one pack was more in both E.L.T(R). soln which was make-up compact-type, and Sanova(R), Tstone(R) which was spray-type than the rest of drugs which were contained in disposal pack or tube. Also E.L.T soln(R), Sanova(R) and Tstone(R) had showed the convenience of usage (p<0.05). With overall satisfaction, there was excellent convenience of usage in E.L.T. soln which was packed in make-up compact (p<0.05). CONCLUSIONS: Topical anesthetic agents designed for premature ejaculation are safe and effective medical treatment with no significant difference in their characteristics, efficacy, and occurrence of adverse reaction among the various topical agents. Therefore, we suggest that the most important factors which influence the satisfaction and selectivity to topical anesthetic agents for premature ejaculations are the preserving container and method of application.
Adult ; Anesthesia, Local ; Anesthetics ; Coitus ; Ejaculation ; Foreign Bodies ; Genitalia ; Humans ; Hypersensitivity ; Male ; Odors ; Penis ; Premature Ejaculation* ; Viscosity

PURPOSE: In this study we evaluated the long-term outcomes and prognostic factors of trabeculectomy with mitomycin C (MMC) in eyes with uveitic glaucoma (UG) compared with primary open-angle glaucoma (POAG). METHODS: We performed a retrospective chart review of 60 eyes with UG and 402 eyes with POAG that were followed up for at least 1 year after trabeculectomy with MMC between June 2000 and December 2012. The review included intraocular pressure (IOP), number of anti-glaucoma medications, and postoperative complications. Surgical success was analyzed using the Kaplan-Meier life-table method based on 2 definitions of successful IOP control with topical anti-glaucoma medications: Definition A (IOP < or = 15 mm Hg) and Definition B (IOP < or = 18 mm Hg). Risk factors for surgical failure of trabeculectomy were analyzed using the Cox proportional hazards model. RESULTS: Success rate at 5 years after trabeculectomy was lower in UG than in POAG (65.8% vs. 76.4%, Definition B), but without significant difference. However, UG had a significantly lower cumulative probability of success than POAG based on Kaplan-Meier survival curves (p = 0.049 and 0.044, respectively). Postoperative hypotony and hypotony maculopathy was more frequent in UG (p = 0.044 and 0.044, respectively). In UG, the Cox proportional hazards model showed postoperative shallow anterior chamber was associated with surgical failure in both Definition A and B. CONCLUSIONS: Long-term results of trabeculectomy with MMC in eyes with UG showed successful IOP control similar to POAG. Trabeculectomy with MMC is a reasonable surgical option for the management of UG.
Anterior Chamber ; Glaucoma* ; Glaucoma, Open-Angle* ; Intraocular Pressure ; Kaplan-Meier Estimate ; Mitomycin* ; Postoperative Complications ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Trabeculectomy*

BACKGROUND: Infarct size determines left ventricular (LV) systolic and diastolic dysfunctions after acute myocardial infarction, and also may affect the recovery from functional impairment. We studied the differences of LV remodeling and changes of systolic and diastolic functions of LV during two weeks after acute myocardial infarction, according to Killip class at admission. METHODS: Echocardiographic examinations were performed within two days (23.9+/-2.3 hours), and two weeks after the attack in 27 patients with acute myocardial infarction, and the results were compared with those of 19 controls. Patients were divided into two groups according to Killip class at admission; 18 patients in Killip class I (group I) and 9 patients in Killip class II to IV (group II). Group II had larger infarct, reflected by higher levels of peak serum cardiac enzymes. RESULTS: LV systolic function was more depressed in group II. Regional wall motion score index decreased in group I after two weeks, but not in group II. LV systolic and diastolic volume indexes increased after two weeks in group II but not group I. E/A ratio of mitral inflow was less than 1, and isovolumic relaxation time was prolonged in group I immediately after the attack. Group II had E/A>1 and shorter deceleration time (DT) of mitral inflow, and higher peak reverse flow velocity associated with atrial contraction (AR) of pulmonary venous flow than those of controls immediately after the attack. In group II, E/A ratio was greater, DT was shorter, peak systolic/diastolic flow velocity ratio of pulmonary venous flow was less, and AR was higher than those of controls after two weeks. CONCLUSION: Infarct size affected remodeling and changes of systolic and diastolic functions of LV after acute myocardial infarction. In patients with large infarct, LV was dilated and regional wall motion was not improved during two weeks. Restrictive pattern of LV filling, which was more aggravated during two weeks, was noted immediately after the attack. In patients with small infarct, LV was not dilated and regional wall motion was improved during two weeks. LV filling pattern showed relaxation abnormality.
Deceleration ; Echocardiography ; Heart Ventricles* ; Humans ; Myocardial Infarction* ; Relaxation

OBJECTIVES: The aim of this study was to evaluate the subjective well-being of schizophrenic patients who switched their antipsychotics to risperidone as the maintenance treatment over 24 weeks. METHODS: Thirty-one patients were evaluated using Positive and Negative Syndrome Scale (PANSS) for psychopathology and UKU side effects rating scale for drug-induced adverse events. Also the subjects were asked to score the 10 items self-rating scale (KmSWN-10), which derived from the 19-items of Korean modified version of Subjective Well-being under the neuroleptic treatment (KmSWN) scale. The assessments were administered at baseline, 2 weeks, 12 weeks and 24 weeks after switching to risperidone. Analysis were done using repeated measures of ANOVA. Pearson correlation analysis were also done to assess the correlation between KmSWN-10 and psychopathology and drug induced side effects. RESULTS: There were significant improvements on the scores of KmSWN-10 and reductions on the PANSS and UKU side effect rating scores during the treatment of risperidone. KmSWN-10 was negatively correlated with the total, negative and general psychopathology scales of PANSS at baseline, and also negatively corrleated with total, positive, negative, general psychopathology scales and depressive factor of PANSS scores and total UKU side effects rating scores at 24 weeks of treatment. CONCLUSION: The results suggest that the maintenance treatment with risperidone positively affected on the subjective well-being of schizophrenic patients due to improvement of psychotic symptoms and decrement of side effects. KmSWN-10 may be more related with negative and general psychopathlogy scales of PANSS in this study.
Antipsychotic Agents* ; Humans ; Psychopathology ; Quality of Life ; Risperidone* ; Schizophrenia ; Weights and Measures