OBJECTIVES: Our aims of this study is to analyze the clinical characteristics and the prognos is of the disease which develops in patient swith chronic liver disease as acutely exacerbated hepat it is accompanied by myosit is. Finally we try to identify and is olate the causative agent. METHODS: The patient swith chronic liver diseases, who developed muscle weakness and paralysis, were classified to group A or group B, according to the level of creatinine kinase ( CK) activity. The group A consists of patients with less than 3-fold increase of normal CK activity and the group B includes patients with over 3-fold increase of it. We evaluated clinical characteristics, blood chemistry, clinical course, and causes of deathin patients of study groups, compared with those of patients with chronic liver disease with normal CK activity as controls. The causative agent was suggested by conventional culture and RT-PCR analysis in two cases of group B. RESULTS: 1. There was no significant differences in age, sex, underlying disease, or liver function test bet ween control and study group ( control and group A or B) before entry. 2. The clinical symptoms and signs , such as drowsy mental state, generalized weakness/myalgia caused by hepatic encephalopathy and myositis , occurred frequently in the study group. 3. Significant elevation of aspartic acid transaminase (AST ) and alaninetr ans aminase ( ALT ) was noted in Group B. AST / ALT ratio is over 2 in group A or B. Synthetic function of the liver such as prothrombin time ( PT ) or serum albumin level is significantly decreased. Blood urea nitrogen ( BUN) and creatinine were increased as a result of impaired renal function. 4. Culture of coxs ackievirus was positive by immunofluor escence as say IFA) as a caus ative agent and also was positive in reverse transcription-polymerase chain reaction (RT-PCR) analys is using universal primer of enterovirus in two recent cases of group B. 5. Death rate increased significantly in study group, compared with that of control group ( 20.7% versus 5.6%). Major cause of death, 12 patients died of which, is hepatic failure. CONCLUSION: The patients with chronic liver disease abruptly developed a exacerbated hepaticdys function and muscle paralysis and/or weakness. This exacerbated hepatitis accompanied by myositis was suggested to be caused by coxsackie B viral infection. Furthermore, this infection increase deathrate and resulted in poor prognosis. Thus, further study should be continue to confirm the causative agent and classify the subtype.
Aspartic Acid ; Blood Urea Nitrogen ; Cause of Death ; Chemistry, Clinical ; Creatinine ; Enterovirus ; Hepatic Encephalopathy ; Hepatitis* ; Humans ; Liver Diseases* ; Liver Failure ; Liver Function Tests ; Liver* ; Mortality ; Muscle Weakness ; Myositis* ; Paralysis ; Phosphotransferases ; Prognosis ; Prothrombin Time ; Serum Albumin

No abstract available.
Carcinoma, Renal Cell* ; Cell Line* ; Humans*

One hundred fifty-seven patients wha underwent radical hysterectomy and pelvic lymphadenectomy for FIGO stage IB and IIA carcinoma of the cervix between February l975 and May 1987 were retros-pectively analysed to identify specific risk factors associsted with treatment failures. Prognostic factors inciuded clinical stage, histologic cell type, degree of differentiation, size of primary tumor, depth of stromal invasian, lymph-vaseular space invasion, and lymph node metastasis. Treatment results were evaluated according to the recurrence rate and 2-year absolute recurrence-free survival(NED) rate by the prognostie faetors and treatment modalities. Patients with lymph node me tases had a significantly higher incidence of bulky primary(-> 4cm), depth of stromal invasion(> 60% thickness), and lymph-vascular invasion(P<0.005). There was significant difference in the recurrence rate and 2-year, NED rate between cervical carcinoma stage IB and I1A(P <0.005). The pat,ients who had bulky primary tum~or(>4cm) and/or depth of stromal invasion (>60% thickness) had a higher recurrence and lower 2-year NKD rate(P<0.025, P<0.005), Unfortunately, it was not possible to demonstrate that these detrimentel effects could be overeorne by postoperetive radiation. When adjoined for these risk group, traditionally reported poor prognostic factors such as nodal metatasis, cell type and differentiation, lyrnphi-vascular mvasion assume less importance in our studies. In this study, prognosis is most inf1ueneed by clinical stage, depth of stromal invasion, and size of primary tumor,
Cervix Uteri* ; Female ; Humans ; Hysterectomy ; Incidence ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Risk Factors ; Treatment Failure*

A forty-seven-year-old male miner complained of paresthesia over right hypothenar area and ring and little fiugers for 3 months. On physical examination and electromyography, ulnar nerve dysfunction below elbow was noted. Intraoperatively, an anomalous muscle, the epitrochleoanconeus muscle, was found between the triceps muscle and flexor carpi ulnaris muscle, but it was clearly distinguished from them. Resection of the muscle and medial epicondylectomy were performed. The epitrochleoanconeus muscle is an anomalous muscle which arises from the medial epicondyle of the humerus and inserts into the medial border of the olecranon. The reports on ulnar nerve entrapment syndrome by this muscle were rare. On 14 months follow up, the symptoms and signs were improved.
Elbow ; Electromyography ; Follow-Up Studies ; Humans ; Humerus ; Male ; Miners ; Olecranon Process ; Paresthesia ; Physical Examination ; Ulnar Nerve Compression Syndromes ; Ulnar Nerve

This clinical and histopatholgical study was performed with 149 cases of acquired melanocyticnevi, which were obtained as surgical specimens from 1975 to 1985 at Depa.rtment of Clinical Pathology, Seoul Red Cross Hopital. The results were as follows: 1) Histologic subdivision of melanocytic nevus into junctional(,J), IJC, compound (C,"), ICI, and intradermal(I) is used. IJC is a lesion in an intermediate state between ,junctional and compound nevus, and ICI, between compound and intradermal nevus. 2) The age distribution of the excisional melanocytic nevus peaks during the third decade of life, with 47% of patients between 21 40 year old of age. 3) Of l49 specimens with excisional melanocytic nevus, the number of junctional, IJC, compound, ICI and intradermal nevus were 17, 4, 21, 32 and 75 in each group And so, it is likely that evolution of the melanocytic nevus have an increased opportunity for surgical excision. 4) Among the 17 cases of junctional nevus, one case is found in 5th and the other one in 7th decade. 5) In distvibution of melanocytic nevus, head including face is the most common site among the body area and then trunk, neck, lower and upper extremity in decreasing orders.
Adult ; Age Distribution ; Head ; Humans ; Neck ; Nevus ; Nevus, Intradermal ; Nevus, Pigmented* ; Pathology, Clinical ; Red Cross ; Seoul ; Upper Extremity

No abstract available.

STUDY OBJECTIVE: We evaluate the clinical characteristics and natural history of patients presenting with spontaneous pneumomediastinum (SPNM) . DESIGN: A retrospective case series was conducted to identify patients diagnosed with SPNM. ICD-7(J98.2) discharge codes were used for Jan. 1993 to Aug. 1996 at four institutions , and emergency department(ED) records and admission charts were reviewed. Clinical features, interventions, complications, setting, etiology, symptoms, and length of hospital stay were recorded. PARTICIPANTS: All ED patients more than 12 years old with a diagnosis of SPNM. RESULTS: Thirteen cases were identified. Age range was 14 to 58 years(mean 24 years). Presenting symptoms were chest pain in eight(62%), dyspnea in six(46%), both symptoms in three(23%), no complaints in three(23%). Seven(54%) patients complained only of throat discomfort. Seven(54%) had subcutaneous emphysema, and two(15.3%) had a small pneumothorax. Two(15.3%) were smokers. Three(23%) had normal esophagograms and another three had normal chest CT findings. Two cases(15.3%) were associated with inhalational drug use and three cases were due to exercise. Nine cases(69%) had a history of "Valsalva-type" maneuver. Two patients(15%) had a history of antituberculous treatment and one(7.7.%) had suffered from bronchial asthma. Mean hospital days were 7.3 days(range 3 to 14), none of all needed any intervention. Specifically, no patient developed a subsequent pneumothorax or airway compromise. Seven cases(54%) were received prophylactic antibiotics. CONCLUSION: Most simple SPNM cases are benign disease and most of them(78%) had shown typical chest pain, dyspnea and subcutaneous emphysema. Inhalational drug use is not a main cause of SPNM yet, but increase in use of bronchoinhalers is a suspicous cause of SPNM.
Anti-Bacterial Agents ; Asthma ; Chest Pain ; Child ; Diagnosis ; Dyspnea ; Emergencies ; Humans ; Length of Stay ; Mediastinal Emphysema* ; Natural History* ; Pharynx ; Pneumothorax ; Retrospective Studies ; Subcutaneous Emphysema ; Tomography, X-Ray Computed

Based on the theory that benign prostatic hypertrophy may be induced by androgenic effect of testosterone derivatives, especially 5-alpha - dihydrotestosterone, on prostatic tissue, Chlormadinone acetate(CMA), potent oral synthetic antiandrogen was investigated in the treatment of benign prostatic hypertrophy. Twenty-two patients of prostatic hypertrophy were studied over six months period with a special reference to uroflowmetry and following results were obtained : 1) Chlormadinone acetate induced improvement of obstructive urinary symptoms in terms of uroflowmetric measurement. 2) It is very worthwhile to initiate medical treatment before undergoing any surgical intervention or when surgery is contraindicated.
Chlormadinone Acetate* ; Dihydrotestosterone ; Humans ; Prostatic Hyperplasia* ; Testosterone

BACKGROUND: In vitro epidermal keratinocytes(EKs) culture systems are widely used in studying skin biology and differentiation. Recently a monolayer culture method of nail matrix cells(NMCs) has been developed. OBJECTIVE: This study was designed to establish a method of culture of NMCs and compared its characteristics with those of EKs. METHODS: Human NMCs were isolated and cultured in a defined medium. Phase contrast microscopic examination, growth rate and ketatin expression were evaluated. RESULTS: In in vitro monolayer culture, NMCs had a similar growth pattern and morphological features as EKs. The synthesis of hard keratins was detected. CONCLUSION: These observations suggest that the NMCs culture model may be useful for the study of nail properties and the effects of drugs.
Biology ; Humans ; In Vitro Techniques ; Methods ; Skin

It is well estabilshed that the xerosis is closely related to diabeic pruritus. Although the causes of xerosis are thought to bie the abnormalities of sweating and autonomic nervous system, the exact mechanism of the xerosis in diabetic skin is still unknown. This study was designed to investigate the possible derangement of glucose metabolism in the skin of diabetes mellitus patients with xerosis. The epidemal glucose content and hexokonase activities were masured in the skin samples obtained from normal individuals and diabetes mellitus patients with xerosis The epidermal glucose content was measured by the enzymatic cycling method. The enzymatic activities of hexokinase were assayed by fluorometric method. The epidermal glucose content of diabetic patients increaed approximately twice [27.46+9.52 (mmole/kg /dry weight) that of normal individuals [13.90+4.79(mmole/kg /dry weight)] (p<0. 0001). The epidermal hexokinase activities of diabetes patients were significantly decreased [0.56+0.15(mole/hr/kg/dry weight)] compared to that of normal indivduals [0.96+0.24(mole/hr/kg dry weight)] (p<0.0001). There were no significant differences in the epidermal glucose content and enzyme activities of hexokinase between the diabetic patients with: erosis and diabetic patients without xerosis. These data indicated that decreased activities of hexokinase could reduce the glucose phopkiorylation and uptake into keratinocytes, and which could lead to accumulat. glucose in the interstitial space of diabetic epidermis. And the decreased hexokinase activities may exert on lipid metabolism and glycolysis of diabetic epiidermis, because hexokinase is a key enzyme of hexose monophosphate pathway and glycolysis.
Autonomic Nervous System ; Diabetes Mellitus ; Epidermis ; Glucose ; Glycolysis ; Hexokinase* ; Humans ; Keratinocytes ; Lipid Metabolism ; Metabolism ; Pruritus ; Skin ; Sweat ; Sweating