Regular hemodialysis has been established as a way of treatment for end stage renal failure. In adults, hemodialysis 5 hours each time, three times weekly with one square meter hemodialyzer is now widely accepted as a standard, and there are many reports on long term follow up studies. Quite a large difference are present, however, in our community mainly originated from patient's poor compliance in frequent dialysis with short interdialysis interval. The author analyzed 200 cases of chronic renal failure who have received hemodialysis treatments during the 5 year period from July 1976 to June 1981 at the hemodialysis unit of the hanyang University Hospital and the following results are obtained; 1. Actual one year survival rate was much higher in thrice(87.1%) than one(35.1%) or twice(54.1%) weekly dialysis. 2. Long term(more than 6 months) complications were also more frequent in once(85.7%) or twice(70.2%) weekly treatments than in thrice(22.2%). The predominant complications were congestive heart failure, pericarditis, and infections. 3. Those who recieved three times weekly dialysis had better rehabilitation grades than the patients groups of twice or once weekly treatment. 4. Of peridialysis distressful symptoms, nausea, vomiting dizziness were less frequent in the group three times a week dialysis. In contrast, headache, hypotension, muscle cramps, and weakness were not significantly related with frequency of hemodialysis. 5. Those who voided a large amount of urine output had better survival and less frequent requirement of blood transfusions. 6. Main causes of death were due to patient poor compliance, hyperkalemia and cerebrovascular acidents. 7. Economic problems were the major cause of dialysis interruption.
Adult ; Blood Transfusion ; Cause of Death ; Compliance ; Dialysis ; Dizziness ; Follow-Up Studies ; Headache ; Heart Failure ; Humans ; Hyperkalemia ; Hypotension ; Kidney Failure, Chronic* ; Kidneys, Artificial ; Muscle Cramp ; Nausea ; Pericarditis ; Rehabilitation ; Renal Dialysis* ; Renal Insufficiency ; Survival Rate ; Vomiting

Clinical history and dermatological examinations were performed in 51 patients with contact dermatitis due to metal working fluid who were working at the metal industry. Patch tests were also performed with standard series and oil cooling fluid series. Chronic lichenified eczema such as lichenified and fissured was the most common clinical type(45.1%). 19 patients had positive reaction to either one or more of the standard series and oil & cooling fluid series. We found ammoniated mercury chloride was the most common sensitizer in standard series, followed by potassium dichromate, 4-phenylendiamine dihydrochloride, cobalt chloride, nickel sulfate, quinoline mix and cabra mix. Microbiocide was the most common allergen(4 of 6 positive result in oil & cooling fluid series.
Cobalt ; Dermatitis, Contact* ; Eczema ; Humans ; Nickel ; Patch Tests ; Potassium Dichromate

Black staining of the teeth in children and adolescents does not cause pain or serious illness, but it can be socially debilitating for esthetic reasons. Black staining is easily removed through periodic professional mechanical tooth cleaning and ultrasonic scaling, but it can easily recur within few months. Using essential oil-containing mouth rinses diluted at 50% twice per day could prevent the black staining from returning after it is removed, reducing the need for mechanical treatments and improving esthetics.

Angiostatin is a potent angiogenesis inhibitor that is composed of the first four kringles of plasminogen fragment. Angiostatin with one less kringle molecule (kringle 1 to 3) was recently demonstrated to be an effective angiogenic inhibitor. To determine whether recombinant plasminogen kringle 1-3 (rPK1-3) can inhibit the corneal neovascularization induced by potent angiogenic factors; angiogenin, bFGF, or VEGF, hydron polymer discs each containing 2.0 microg of angiogenin, 500 ng of bFGF, or 500 ng of VEGF respectively were implanted into the corneal stroma of 138 rabbit eyes, and then discs each containing 10 microg, 12.5 microg, 20 microg or 30 microg of rPK1-3 were implanted randomly. Discs containing phosphate buffered saline were also implanted as a control. The angiogenesis score on number and length of newly formed vessels on the each of the rabbit's cornea were recorded daily by two observers (blinded). The treated corneas were also examined histologically. Recombinant PK1-3 treated corneas showed less neovascularization induced by all angiogenic factors (p < 0.05). and the extent of inhibition of neovascularization was proportional to the concentration of rPK1-3 (p < 0.05). Histologic examination showed leukocyte infiltration into the corneal stroma on the PBS treated eyes whereas rPK1-3 treated eyes showed only traces of leukocytes. These results of the effective rPK1-3 inhibition of corneal neovascularization induced by angiogenin, bFGF, or VEGF suggest that this angiostatin related fragment, rPK1-3, may be useful in the treatment of various neovascular diseases. Copyright 2000 Academic Press.
Angiogenesis Inhibitors/pharmacology* ; Angiogenesis Inhibitors/genetics ; Animal ; Chick Embryo ; Chorion/drug effects ; Chorion/blood supply ; Cornea/pathology ; Cornea/drug effects ; Cornea/blood supply* ; Endothelial Growth Factors/pharmacology ; Fibroblast Growth Factor, Basic/pharmacology ; Kringles/genetics ; Lymphokines/pharmacology ; Microscopy/methods ; Neovascularization, Pathologic/drug therapy* ; Plasminogen/pharmacology* ; Plasminogen/genetics* ; Rabbits ; Recombinant Proteins/pharmacology ; Recombinant Proteins/genetics ; Ribonuclease, Pancreatic/pharmacology

The simultaneous occurrence of a renal cell carcinoma and a urothelial carcinoma in the same kidney is uncommon. Here we report the case of a 79-year-old woman with ipsilateral synchronous renal cell carcinoma and urothelial carcinoma. She was referred to our hospital for gross hematuria and right flank pain. A computed tomography scan showed a 15x20 mm enhanced lesion on the upper calyx and a 12x15 mm mass on the lateral aspect of the right kidney. We thus suspected a renal pelvis tumor and performed right hand assisted laparoscopic nephroureterectomy with bladder cuff excision (HALSNU). Gross findings were multiple, pale yellowish papillary masses on the upper and lower major calices, of which the largest one measured 16x20 mm. A separated solid mass measuring 12x16 mm was also noted on the anterior midportion of the kidney. The former was a urothelial carcinoma and the latter was a chromophobe renal cell carcinoma. We present a rare case of a chromophobe renal cell carcinoma and a urothelial carcinoma in the same kidney.
Aged ; Carcinoma, Renal Cell ; Female ; Flank Pain ; Hand ; Hematuria ; Humans ; Kidney ; Kidney Pelvis ; Urinary Bladder

Sturge-Weber syndrome is a rare congenital anomaly which includes facial port-wine stains with ipsilateral intracranial, hemangioma, ipsilateral choroidal hemangioma, and congenital glaucoma. The syndrome is thought to result from dysmorphogenesis of cephalic neuroectoderm. We report a case of Sturge-Weber syndrome combined with congenital ocular anomaly such as phthisis bulbi, corneal opacity, and iris anomaly.
Choroid ; Corneal Opacity ; Glaucoma ; Hemangioma ; Iris ; Neural Plate ; Port-Wine Stain ; Sturge-Weber Syndrome*

Several high molecular weight polymers were tested as a barrier against adhesion between extraocular muscle and its surrounding tissue in a rabbit. We used 48 rabbits to investigate the efficacy of hyaluronic acid, methylcellulose, and gel form as compared to balanced salt solution as a control group in reducing the postoperative adhesion. Under general anesthesia, superior rectus muscle was detached and reattached to original insertion site after coating with barrier materials. Rabbits were killed and histologic examinations were done for degree of adhesion formation at 1. 2, 3, and 6 weeks after surgery. The results were as follows; 1. In control group, the portion that showed the most severe fibrosis was within muscle itself and the portion of the least fibrosis was between muscle and sclera. But in experimental group, there was no differences in degree of fibrosis according to operation site. 2. In control group, the fibrosis progressively increased during the postoperative 6 weeks. In hyaluronic acid group and methylcellulose group, the fibrosis decreased from postoperative 1 week and the degree of decreased fibrosis was more evident in methylcellulose group. In gelform group, fibrosis decreased until postoperative 3 weeks and then increased at postoperative 6 weeks. And one case of foreign body reaction was noted in gel form group. The above results suggest that high molecular weight polymers such as hyaluronic acid and methylcellulose are effective in prevention of adhesion syndrome after extraocular muscle surgery and that methylcellulose is more effective compared to hyaluronic acid.
Anesthesia, General ; Fibrosis ; Foreign-Body Reaction ; Hyaluronic Acid ; Methylcellulose ; Molecular Weight ; Polymers ; Rabbits ; Sclera

Nodular cystic fat necrosis, first described by Przyjemski and Schuster, is a peculiar form of encapsulated necrosis of subcutaneous fat characterized by totally or near-totally encapsulated necrosis of fatty tissue in which clusters of nonviable adipocytes are surrounded by condensed fibrous tissue. We report two cases of nodular cystic fat necrosis associated with history of trauma about the site of the lesion. Each lesion was a subcutaneous movable nodule on buttock (case 1) and shin (case 2) which has evolved over months. Both cases showed possible relation to multiple intramuscular injection or direct trauma injury. Pathologically, encapsulated nodule showed a characteristic feature of nodular cystic fat necrosis which composed of the ghosts of anucleated adipocytes showing fairly well-preserved outline.
Adipocytes ; Adipose Tissue ; Buttocks ; Fat Necrosis* ; Injections, Intramuscular ; Necrosis ; Subcutaneous Fat

BACKGROUND: Spinal anesthesia has several advantages in cesarean section. Those are rapid induction, complete analgesia, profound muscle relaxation, low failure rate and systemic toxicity. But the determination of anesthetic level is more difficult in spinal anesthesia than in epidural anesthesia. So we would like to determine the appropriate dosage of 0.5% hyperbaric bupivacaine and the effects of addition of intrathecal fentanyl. METHODS: Sixty full term parturiants scheduled for cesarean section were randomly received 0.5% hyperbaric bupivacaine 8, 10, 12 mg intrathecally. Analgesia, sensory and motor blockade, muscle relaxation, hypotension and side effects were assessed. We compared these results with the previous study that was done with the same dosages mixed with 10 microgram fentanyl. RESULTS: The maximum level of block was higher in 12 mg group (T2) then 8 and 10 mg group (T3). 5 parturients showed more than T1 sensory block in 12 mg group (n=20). 4 parturients did not reach T4 in 8 mg group (n=20). 7, 4 and 0 parturients complained pain during operation in each 8, 10, 12 mg group (p=0.012 between 8 and 12 mg group, p=0.062 between 10 and 12 mg group). Addition of 10 microgram fentanyl showed better analgesia and less shivering. CONCLUSION: Intrathecal 0.5% hyperbaric bupivacaine 12 mg showed complete analgesia for all parturients but the tendency of high spinal anesthesia. Analgesia was inadequate in 8 mg group. Addition of 10 microgram fentanyl showed better analgesia and less shivering.
Analgesia ; Anesthesia, Epidural ; Anesthesia, Spinal* ; Bupivacaine* ; Cesarean Section* ; Female ; Fentanyl* ; Hypotension ; Muscle Relaxation ; Pregnancy ; Shivering

BACKGROUND: The purpose of this stady is to define the clinical characteristics of Tsutsugamushi disease. METHODS: We analyzed 12 cases of tsutsugamushi disease admitted to BAG AE general hospital from 1999. Oct. 1st to Dec. 10. Tsutsugamushi disease was diagnosed by indirect immunofluorescent antibody test. RESULTS: 1) Among them, 8 cases were female and 4 cases were male. The prevalence was predominantly high in female. 2) The age distribution ranged from 40 to 80 years old. The high incidence of age was 70's and 80's. 3) The peak incidene was showed between October and November.(91.6%). 4) The most frequent symptoms were fever and chills(91.6%). 5) Rash and eschar were observed in 83.3%(10 of 12) both. 6) Hepatosplenomegaly and lymphadenopathy were also observed in 25%(3 of 12), 16.6%(2 of 12) respectively. 7) The Laboratory finding showed the elevation of AST 66.6% (8 of 12), ALT 58.3%(7 of 12), alkaline phosphatase 25%(3 of 12) and LDH 25%(3 of 12). Albuminuria and hypoalbuminuria were also observed in 25%(3 of 12), 58.3%(7 of 12) respectively. 8) The therapeutic efficacy of doxycycline was excellent. CONCLUSION: Tsutsugamushi disease which appeared in Pyoungtack area showed typical clinical pattern and was effective to doxycycline treatment.
Age Distribution ; Aged, 80 and over ; Albuminuria ; Alkaline Phosphatase ; Doxycycline ; Exanthema ; Female ; Fever ; Gyeonggi-do* ; Hospitals, General ; Humans ; Incidence ; Lymphatic Diseases ; Male ; Prevalence ; Scrub Typhus*