BACKGROUND: Sulfonylurea is recommended to be taken before meal. But since premeal administration is against Koreans usual medication habit, it can be the cause of poor compliance. Such recommendation is based on the results of a few clinical trials about appropriate medication time. But most of the clinical studies had a limitation : observe only acute effects of medication, subjects were only healthy volunteer. So the chronic effect of sulfonylurea of each kind must be validated. METHODS: From 1996 May to 1996 July, data were collected from diabetic patients who visited an university hospitals for managing diabetes and used a intermediate-acting sulfonylurea. The subjects were randomized to two groups of premeal group and postmeal group, by chart number and were asked to take the previous medicine according to assignment. After 1 month medication, mixed meal tolerance test was done with 300Kcal carbohydrate, 400+/-50Kcal diet. The subjects were switched to the other group and 2nd mixed meal tolerance test was done 1 month later. The Area under curves was calculated in preand post-prandial glucose curve and was compared by paired t-test. RESULTS: During the study period, total 16 diabetic patients were enrolled. There was no significant statistical difference between pre-prandial group and post prandial group in AUC. CONCLUSIONS: Intermediate-acting sulfonylurea can be administered at any time in relation to meaL.
Area Under Curve ; Compliance ; Diet ; Eating* ; Glucose ; Healthy Volunteers ; Hospitals, University ; Humans ; Meals

No abstract available.
Korea*

The pathogenesis of vitiligo has not been fully elucidated, but three different hypothese have been advanced to explain the cause of vitiligo. One is related to autoimmunity, another concerns neurohumoral factors and the third involves self-destruction of melanocytes. The autoimmune theory of vitiligo is further strengthened by the increased association of vitiligo with a nurnber of autoimmune disorders and by the increased prevalence of organ-specific autoantibodies in vitiligo. Also decreased T lymphocytes in vitiligo patients were reported. The present study was undertaken to evaluate the cell mediated immune status of patients with vitiligo using several in vitro and in vivo immune parameters. Thirty patients between the ages of 12 and 65 were observed at the Department of Dermatology of Ewha Womans University Hospital from Apri11981 through October 1981. Age matched 30 healthy persons comprised the control group. The results were summarized as follow: 1) The mean percentage of T lymphocytes in 30 vitiligo subjects and 30 control subjects were 55.3% and 67.4% respectively. There was a significant decrease of T lymphocytes in patients with vitiligo(p<0.05). 2) The percentage of subjects showing positive delayed hypersensitivity reactions to candidin, trichophytin and PPD were 33.3%, 43%, 50% respectively in 30 vitiligo patients and 60%, 75%, 80% respectively in 20 controls. A slight depression in delayed cutaneous hypersensitivity in gatients with vitiligo. (p<0.1). 3) The percentage of subjects showing positive sensitization with DNCB was 53% in 30 vitiligo patienta and 85% in 20 controls. A slight depression in DNCB sensitization was evident in vitiligo patients(p<0.1).
Autoantibodies ; Autoimmunity ; Depression ; Dermatology ; Dinitrochlorobenzene ; Female ; Humans ; Hypersensitivity ; Hypersensitivity, Delayed ; Immunity, Cellular* ; Melanocytes ; Prevalence ; T-Lymphocytes ; Trichophytin ; Vitiligo*

Housewife's eczema is not a specific disease but an inflammatory pattern of response to variety of stimuli: it is characterized by erythema, papules, vesicles, exudation, and scaling. Nickel is one of the most common causes of allergic contact dermatitis, particularly in women. The authors reported a case of housewife's eczema due to nickel sulfate occuring in a 30 year-old housewife for 3 years which was confirmed by patch test with 5% nickel sulfate and dimethyl glyoxime spot test on patients wedding ring and stainless bowels. Literature were reviewed briefly.
Adult ; Dermatitis, Allergic Contact ; Eczema* ; Erythema ; Female ; Humans ; Nickel* ; Patch Tests

Although the clavicle is probably the most commonly fractured bone, nonunions are rare. We experienced 19 cases of clavicle nonunions, trested at the Depatment of Orthopedic Surgery of Wonju Christian Hospital, between January 1980 and June 1988(seven years and six months). This study focused on predisposing factors in relation to nonunion of clavicle and treatment. The factors predisposing to nonunion were middle and lateral 1/3 of clavicle, primary open reduction, severe trauma with associated injury and persistent gross displscement of fregment. Among the 19 patients, 16 patients were treated with semitubular plating and iliac bone grafting, 2 patients with the resection of the distal fregment and one patient was treated with treated with K-wire fixation and bone graft. All patients achived good union by the postoperative 10.7 week on average and symptomes disappeared. It was concluded that symptomatic nonunion of the clavicle could be trested by operation, and the procedure of choice seemed to be rigid internal fixation with plate applied in compression and bone graft.
Bone Transplantation ; Causality ; Clavicle ; Gangwon-do ; Humans ; Orthopedics ; Transplants

PURPOSE: The study of the causative factors, surgical approachs and the clinical course of symptoms related to sciatic nerve injury after THR. MATERIAL AND METHODS: A retrospective review of 6 patients with sciatic nerve injury in 669 hips total hip arthroplasty during the period from Jan., 1986 to Dec., 1994. Each patient's record was reviewed with respect to age, sex, possible etiology, clinical course, surgical approach, treatment, and clinical condition at follow-up examination. RESULTS: ➀ The increased prevalence of nerve palsy was seen in revision surgeries(4 cases, 3.2%) compared to primary arthroplasty(2 cases, 0.4%) ➁ There was 2 cases(0.8%) of sciatic nerve injury in direct lateral approach and posterior approach, 4 cases(1%) ➂ Possible mechanisms of nerve injury included excessive soft tissue traction(3 cases), electrical thermal injury(1 case), Trochanteric fracture during femoral stem removal(1 case), and overlengthening of femur(1 case). ➃ The isolated peroneal division of the sciatic nerve was injured in 5 cases, and the both peroneal and tibial divisions were injured in one case. ➄ At a following period of 5 month, recovery of neurologic function was complete in con case, and two years follow up, 4 cases had a enough recovery of neurologic function(modified Sunderland scale 1,2). However, remained one case had a persistent severe weakness & dysesthesia at even 3 years follow-up. The prognosis for neurological recovery was related the degrees to which the nerve was damaged.
Arthroplasty, Replacement, Hip ; Femur ; Follow-Up Studies ; Hip ; Humans ; Paralysis ; Paresthesia ; Prevalence ; Prognosis ; Retrospective Studies ; Sciatic Nerve

Although the purpose of orthodontic treatment is to increase the function and esthetics of the jaws along with increasing stability, there are many side effects during the treatment itself, such as root resorption and alveolar bone resorption. Such resorption of the apical root is unpredictable, and may even proceed into the dentin layer. Once the process has begun, it is irreversible. By evaluating the effect of many oral habits, especially that of nail biting, in correlation with the root and the periodontal tissues, the appropriate biomechanics for orthodontic treatment can be taken into consideration, along with the possibility of root resorption and alveolar bone loss during orthodontic treatment, and any legal problems that might occur. Among the male and female patients of the ages 10~15 without skeletal deformity, 63 were chosen as the experiment group with known nail biting habits at time of examination, and within the same age group without nail biting habits as the control. After the orthodontic treatment, number of the experiment group was 31 and the control group was 22. The periapical radiographies of anterior teeth were taken and the assesment of the root length and alveolar bone level were taken before(T1) and after(T2) the orthodontic treatment. The results from this study were as follows : 1. Before the orthodontic treatment, average crown-to-root ratio of the experimental group showed noticeably high values in 4 maxillary incisors and mandibular right central incisor. 2. Before the orthodontic treatment, comparing the root length, maxillary and mandibular right central incisors and both mandibular incisors had a smaller value in the experimental group. 3. Before the orthodontic treatment, comparing and evaluating the alveolar bone loss measured from the cemento-enamel junction to the alveolar bone crest, some crestal bone of the experiment group showed greater loss than the control. 4. After the orthodontic treatment, there was shortening of the root length and loss of the crestal bone in both groups. 5. After the orthodontic treatment, the changes of C/R ratio and the shortening of root length were significantly high in the experimental group. 6. After the orthodontic treatment, the level of alveolar crestal bone showed greater loss in the experimental group.
Alveolar Bone Loss ; Bone Resorption ; Congenital Abnormalities ; Dentin ; Equidae ; Esthetics ; Female ; Humans ; Incisor ; Jaw ; Male ; Nail Biting* ; Root Resorption ; Tooth

Thirty-six cases of paroxysmal supraventricular tachycardia which were observed at the Department of Pediatrics, Seoul National University Hospital from 1976 till October 1982, were analyzed. 1. The sex ratio was 1.8:1, male predominance. Sixteen cases (44.4%) were under 1 year of age and 11 cases (30.6%) were under 4 months of age. 2. Cases without known heart disease were 22(61.6%). Among Known etiology, most frequent one was 7 cases(19.4%) of W-P-W syndrome. 3. The sex ratio of group without known heart disease was 2.1:1, and that of group with known heart disease was 1.3:1. Under 4 months of age, there were more cases without known heart disease(72.7%) and after 4 months of age number of cases with and without known heart disease were similar. 4. Most frequent clinical manifestation was tachydyspnea. hepatomegly, irritability, palipitation, cyanosis and pallor, vomiting, chest pain, edema, abdominal pain, and fever were followed in order of frequency. 5. Congestive heart failure occurred in 22 cases(61%). The incidence was related to the duration of attack of tachycardia, age of patients, and heart rate. The longer the duration of attack and the younger the age of patients and the faster the heart rate, the higher incidence of heart failure was observed. 6. As treatment, vagal reflex stimulation was almost ineffective, and digitalization was effective in most of the cases. Verapamil and electrical cardioversion were tried in small number of cases and proved to be effective. 7. One case (2.8%) expired becase of the supraventricular tachycardia. 8. Eight cases (30.8%) had recurrence. In younger age group, recurrence rate was lower. 9. Digoxin was given in 15 cases for prevention of recurrence and was effective in 12 cases.
Abdominal Pain ; Chest Pain ; Child* ; Cyanosis ; Digoxin ; Edema ; Electric Countershock ; Fever ; Heart ; Heart Diseases ; Heart Failure ; Heart Rate ; Humans ; Incidence ; Infant* ; Male ; Pallor ; Pediatrics ; Recurrence ; Reflex ; Seoul ; Sex Ratio ; Tachycardia ; Tachycardia, Supraventricular* ; Verapamil ; Vomiting

PURPOSE:Chronic autoimmune thyroiditis is the most common thyroid disease in children and adolescents, and also is the most common cause of hypothyroidism in children and adolescents. We studied the clinical manifestations and natural courses of chronic autoimmune thyroiditis in children and adolescents. METHODS:We analyzed retrospectively twenty one children and adolescents who were diagnosed as chronic autoimmune thyroiditis before 15 years of age. The diagnoses were made from July 1997 to February 2004 at Ajou Univesity Hospital. We reviewed the clinical manifestations and thyroid functions of these patients. RESULTS:Nineteen patients were female and two were male. The mean age at diagnosis was 9.95+/-3.1 years, the mean duration of follow up was 23.52+/-22.98 months. At diagnosis, the most common chief complaint was goiter (15 patients/21 patients) and the others were short stature, easy fatigue, cardiac murmur and weight loss. Eighteen patients had goiters at diagnosis. Four had familial history of thyroid disease, Three of them had maternal history of thyroid disease and one had paternal history of thyroid disease. At diagnosis, Seven patients were euthyroid and four patients were hyperthyroid, eighteen patients had antithyroglobulin antibody, seventeen patients had antimicrosomal antibody, fourteen patients had both of them. At last follow-up, eight patients were euthyroid and ten patients were hypothyroid, three patients were hyperthyroid. CONCLUSION: Chronic autoimmune thyroiditis in children and adolescents can have the various important influences on the metabolism including the growth. The clinical manifestations and thyroid functions should be monitored in children and adolescents with chronic autoimmune thyroiditis.
Adolescent* ; Child* ; Diagnosis ; Fatigue ; Female ; Follow-Up Studies ; Goiter ; Heart Murmurs ; Humans ; Hypothyroidism ; Male ; Metabolism ; Retrospective Studies ; Thyroid Diseases ; Thyroid Gland ; Thyroiditis, Autoimmune* ; Weight Loss

Genus of aspergilli are ubiquitous saprophytic molds in nature, which are recognized about 700 species, at least eight are pathologic for human. Pulmonary aspergillosis is rare disease, most frequent presenting as secondary invasion, and aspergillosis of the nasal cavity is the most common sites of the extrapulmonary aspergillosis. Predisposing factors for pulmonary aspergillosis are chronic lung disease, tuberculosis, antibiotics, cytotoxins and neoplasia, hematologic disorders, and histoplasmosis etc. Authors have experienced 10 cases of pulmonary aspergillosis and a case of aspergillosis of nasal cavity in Dept. of Pathol. Chosun univ. hospital and christian hospital from Feb. 1981 to July 1984. Patient of pulmonary aspergillosis are received surgical resection and survived well without complications.
Humans ; Cytotoxins