Ipratropium bromide (IP) is a new anticholinergic bronchodilator. To evaluate its effect on bronchial asthma which is still unknown in Korea, a double blind and randomized study was done on all patients of bronchial asthma who visit out-patients clinic of out department from June to September 197 and showed 75 to 100% of FEV1/FVC ratio on prebronchodilator spirometry (pre BD). The selected patients were given 2 puffs of Fenoterol (FE) or Ipratropium inhalator blindly and Spirometry. The repeated results are: 1. In both FE and IP groups, there was a significant bronchodilatory effect on 5 and 60 minutes after administration. 2. One 5 minutes, effect of FE was significantly greater than IP (FVC p<0.05, FEV1 p<0.01). 3. One 60 minutes, effect of IP was slightly less than FE but statistically non-significant. On the basis of above results, we concluded that onset of effect of IP is slower than FE, but its effect is significant and nearly comparable to FE.
Asthma* ; Fenoterol ; Humans ; Ipratropium* ; Korea ; Nebulizers and Vaporizers ; Outpatients ; Spirometry

No abstract available.
Pancreaticoduodenectomy*

No abstract available.
Arthrography* ; Wrist*

PURPOSE: Congenital hereditary endothelial dystrophy is a rare disease and is usually characterized by diffuse, bilaterally symmetric corneal opacity and edema inherited by autosomal dominant or recessive pattern. We experienced this rare disease and performed PKP. We report the result with a review of the literature. METHODS: We performed PKP on 7 eyes with congenital corneal opacity inherited by autosomal dominant type, and histopathologically confirmed. We checked preoperative visual acuity, potential visual acuity, intraocular pressure and corneal thickness. Then postoperatively visual acuity, intraocular pressure, corneal thickness and endothelial cell count was checked. RESULTS: After the 1 year follow up, all transplanted cornea survived and there were no rejection. Postoperative visual acuities all increased to potential acuity and the postoperative corneal thickness and endothelial cell count all maintained their normal levels. There was no recurrence of the disease at the 1 year follow up, however secondary glaucoma developed in 2 patients(27.5%), and they were treated by glaucoma surgery. CONCLUSION: The PKP performed on patients of congenital hereditary endothelial dystrophy occurred in one family tree, which has not yet been reported in korea, showed good postoperative results.
Cornea ; Corneal Opacity ; Edema ; Endothelial Cells ; Follow-Up Studies ; Glaucoma ; Humans ; Intraocular Pressure ; Korea ; Pedigree ; Rare Diseases ; Recurrence ; Visual Acuity

PURPOSE: Primary localized orbital amyloidosis is a very rare disease and it may deposit in the local area without any other previous disease. It may also form nodules in the cornea, conjunctiva, and eyelid. It may involve levator aponeurosis and extraocular muscles, and develops the various symptoms such as ptosis, opthalmoplegia and proptosis. We experienced this rare disease and report the case with a review of the literature. METHODS: A 54-year old woman who presented with ptosis, exophthalmos and conjunctival mass was diagnosed to have localized orbital amyloidosis by orbital CT and pathological review of conjunctival mass and orbital lesion. No systemic involvement was noted by systemic work up and we confirmed as primary localized orbital amyloidosis. RESULTS: It is a first case of primary localized orbital amyloidosis in Korea and should be differentiated with other diseases with similar symptoms as above.
Amyloidosis* ; Conjunctiva ; Cornea ; Exophthalmos ; Eyelids ; Female ; Humans ; Korea ; Middle Aged ; Muscles ; Orbit* ; Rare Diseases

ERCP was performed in 38 cases of clonorchiasis of the liver, which was confirmed by stool egg test withStoll's dilution method from Apr. 1979 to Oct. 1982. The resuls were as follows 1. The sex distribution ofclonorchiasis showed marked male predominance by 97.4% and age distrigution were higher in 5th and 6th decades. 2.Multiple small filling defects in the intrahepatic bile duct was the most characteristic finding in ERCP and widespread irregular stenosis, dilatation of terminal portion, disturbance of peripheral filling, fuziness andraggedness of intrahepatic duct were also noted. 3. The severity of clonorchiasis by ERCP were classifed asfollows; Grade I-7 cases (18.4%), GradeII-9 cases(23.7%) Grade III-12 cases (31.6%) and Grade IV-10 cases(26.3%)4. Chronic cholecystitis 10 cases(26.3%), Billary tree stone 7 cases (18.4%), malignancy of distal CBD 1 case(2.6%) were found with clonorchiasis by ERCP. 5. Three cases, treated with Niclofolan, showed marked improvementof pathology on follow-up ERCP.
Bile Ducts, Intrahepatic ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystitis ; Clonorchiasis ; Constriction, Pathologic ; Dilatation ; Follow-Up Studies ; Humans ; Liver ; Male ; Methods ; Niclofolan ; Ovum ; Pathology ; Sex Distribution ; Trees

It is widely believed that, compared with younger patients, elderly having surgery have a significantly high incidence of complications or death. So, we reviewed clinical records of 2094 patients aged over 65 out of 41,129 surgical cases performed at Catholic University Kang-Nam St. Mary Hospital from May 1980 to December 1989. The case were analysed statistically according to age, sex, department, preoperative physical status, operation site, anesthetic techniques and agents, duration of anesthesia, intraoperative transfusion, intraoperative complication, asaociated disease, postoperative complication and mor- tality. The results were as follows: 1) Of the total 41, 129 cases, 2,094 cases (5.1%) were over 65 years of age consisting of 1,039 male (49.6%) and 1,055 female (50.4%). 2) The most common age group for geriatric anesthesia (1, 164 cases) was 65~70 years of age (55.6%). 3) The rate of elective and emergency surgery was 90.2% (1,889 cases) and 9.8% (205 caaes). 4) Among the 2,094 cases, 1.029 cases were general surgry (49.1%), 373 cases were orthopedic surgery (20.7%) 5) The number of upper abdominal surgery cases were 643 cases (30.7%) and the number of lower abdominal surgery cases 433 cases (20. 7%). 6) The duration of anesthesia was within 1 hour in 286 case (13.1%), 1~2 hours in 755 cases (36.1%), 2~3 hours in 516 cases (24.6%). 7) The technique of anesthesia was done under the general anesthesia for 1,445 cases (69.0%) and epidural anesthesia for 433 cases (20.7%). 8) The anesthetics were halothane for 631 cases (30.1%), enflurane for 435 cases (20.8%) and fentanyl for 364 eases (17.8%), lidocaine and bupivacaine mixture for 254 cases (12.1%). 9) Among the 2.094 cases, 1,471 cases had preoperative disease (70.3%), which of the most common disease (24.1%) was the chronic obstructive pulmonary disease (545 cases). 10) The numbers of postoperative death were 40 cases (1.9%).
Aged ; Anesthesia* ; Anesthesia, Epidural ; Anesthesia, General ; Anesthetics ; Bupivacaine ; Emergencies ; Enflurane ; Female ; Fentanyl ; Halothane ; Humans ; Incidence ; Intraoperative Complications ; Lidocaine ; Male ; Orthopedics ; Postoperative Complications ; Pulmonary Disease, Chronic Obstructive

PURPOSE: This study was performed to determine the natural history of histologically confirmed IgA nephropathy in pediatric patients who presented with hematuria and proteinuria. PATIENTS AND METHODS: We reviewed the clinical course of 57 patients diagnosed with IgA nephropathy at the age of 15 years or younger from 1981 to 2000. All patients presented with hematuria or minimal proteinuria(<40 mg/m2/day) and had normal renal function and blood pressure at the time of renal biopsy. Based on the clinical and pathological findings at the time of diagnosis, we sought for complications of IgA nephropathy such as heavy proteinuria(> or =40 mg/m2/day), hypertension, and chronic renal failure. RESULTS: The mean age at presentation was 9.5+/-2.8 years(4 to 15 years) and 42(74%) were male. Isolated gross hematuria was observed in 20 patients(35%), microscopic hematuria in 3(5%), minimal proteinuria in 4(7%), both gross hematuria and minimal proteinuria in 15(26 %), and both microscopic hematuria and minimal proteinuria in 15(26%). During a median follow-up of 7.0+/-3.5 years, 38(67%) had complete resolution of hematuria and proteinuria, 12(21%) had persistently abnormal urinalysis without development of adverse events. Only 7(12%) developed adverse events:4(7%) developed severe proteinuria, 1(2%) became hypertensive, and 2(3%) developed impaired renal function. By univariate analysis using the chi-square test, the age at presentation(>10 years)(P<0.01) and poor histological classes of the Lee or Haas classification at onset(P<0.05) were significantly correlated with adverse events, whereas sex and clinical signs at onset were less concordant. CONCLUSION: We can conclude that the prognosis of IgA nephropathy diagnosed in early childhood is better and a good correlation exists between the clinical manifestations of this disease and the histological classes.
Biopsy ; Blood Pressure ; Child* ; Classification ; Diagnosis ; Follow-Up Studies ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Hypertension ; Immunoglobulin A* ; Kidney Failure, Chronic ; Male ; Natural History ; Prognosis* ; Proteinuria ; Urinalysis

To assess neurobehavioral effects of 48 low level lead-exposed workers in CRT manufacturing factory, simple and choice reaction time test with NTOS (Neurobehavioral Tests for Occupational Screening), digit symbol and digit span with K-WAIS (Korean Wechsler Adult Intelligence Scale), and SCL-90-R (Symptom Check List 90 revised) was examined. These screening test battery reflect 3 psychological domain; psychomotor, short term memory, and symptom. Average blood lead level was 17.7 microgram/dl and mean exposure duration was 5.6 years. Nobody exceeded blood lead level over 40 microgram/dl, the guideline. We divided workers to two group, shorts-term exposed group(< or = 5 years) and long-term exposed groups 5 years) for analysis. ANCOVA model of simple reaction time, hostility, phobic anxiety, somatization were statistically significant and coefficient of independent variable of exposure duration was also significant. MANCOVA model of SCL-90-R was significant, too. The results of this study were consistent with previous study; symptoms were early neurobehavioral effects of low level lead exposure. And this study showed that current blood lead level as independent variable was able to mask the early neurobehavioral effects.
Adult ; Anxiety ; Hostility ; Humans ; Intelligence ; Masks ; Mass Screening ; Memory ; Reaction Time

The familial environment may also play an important role in the epidemiology of HCV infection through vertical and horizontal transmission by infected household members. However, it is still controversial whether familial clustering of HCV occurs. We experienced a case of familial clustering of hepatitis C virus. A 10-year old girl presented with nausea, vomiting and anorexia for a month was diagnosed as hepatitis C. Her mother, grandmother, a maternal aunt and her daughter had contracted with HCV. Her laboratory findings showed AST/ALT 63/122 IU/L, positive anti-HCV Ab and HCV RNA (3.54 x 10(5) copies/mL). Pathologic findings of the liver biopsy revealed chronic hepatitis with minimal lobular activity, mild porto-periportal activity and mild portal fibrosis. After treatment with interferon-alpha 2b for 6 months, the clinical symptoms and laboratory findings were normalized.
Anorexia ; Biopsy ; Child ; Cluster Analysis* ; Epidemiology ; Family Characteristics ; Female ; Fibrosis ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Interferon-alpha ; Liver ; Mothers ; Nausea ; Nuclear Family ; RNA ; Vomiting