In dermatologic practice, acute urticaria showing leukocytosis and fever suggesting syatemic bacterial infection is often observed. The clinician in dealing with such patients is tempted to use antibiotics in addition to corticosteroids and antihistamines before the patient can be sure that there is no bacterial infection. Authors observed the degree of the leukocytosis with its differential counts in 106 cases of acute urticaria to evaluate what percentages of acute urticaria patients are showing similar data with the changes seen in leukocyte counts of patients of erysipelas, and evaluated the effect of aqtibiotics-administered group with non-administered group of acute urticaria patients. The results were as follows: 1. In 106 acute urticaria patients, 42% showed higher total leukocyte count ( >12, 500/cu mm) than the mean total leukocytes of 20 erysipelas patients(12, 412/cu mm) and 29% showed greater neutrophilia(>70%) than the mean neutrophil differential count of the erysipelas (69.1%). In the cases showing both leukocytosis (>12,500/cu mm) and fever (>37. 5C) there was no difference in the course of treatment between the antibiotics-administered group and non-administered group. 3. The corticosteroid hormone reduced the total WBC count toward normal level generally within a week.
Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Bacterial Infections ; Erysipelas ; Fever ; Histamine Antagonists ; Humans ; Leukocyte Count ; Leukocytes* ; Leukocytosis ; Neutrophils ; Urticaria*

No abstract available.
Polyps*

An epidemiological study on brugian filariasis was carried out in endemic areas including Cheju Island in Korea, with a brief review of literatures.The results showed that the incidence among residents has remarkably decreased in Cheju Island, which was the main endemic area. Reviewing available informations on the prevalence of filariasis reported in recent years and also judging from the present socio-economic conditions which enable people to practice personal protection against mosquitos, it can be said with confidence that filariasis has almost disappeared from Cheju Island and inland areas. The disease is considered to remain at a low level of endemicity in Hugsan Islands. Certainly mass diethylcarbamazine (DEC) treatment carried out in Cheju Island in the 1960s and 1970s and remarkable economic growth followed by improved living standard and altered life-style of inhabitants could all have combined effects on the disappearance of this mosquito-borne diseae in this island. If the present trends go on, the possibility of resurgence of filariasis in Cheju Island is hardly postulated.
parasitology-helminth-nematoda ; Brugia malayi ; filariasis ; epidemiology

BACKGROUND: The use of caudal morphine for postoperative analgesia has been increased in popularity since 1981. The purpose of this study was to compare the effect of analgesia and incidence of side effects of a mepivacaine-morphine mixture with mepivacaine alone. METHODS: Forty patients were randomly divided into two groups. In group 1, caudal block was performed with 1% mepivacaine 1 ml/kg alone. In group 2, caudal block was performed with 1% mepivacaine 1ml/kg-morphine 0.03 mg/kg mixture. Postoperative five-point pain scores and side effects were measured. RESULTS: There were no significant differences in sedation dose, incidence of side effects and supplemental analgesics. Pain scores were significantly lower at postoperative 2 and 3 hours in mepivacaine-morphine mixture group. CONCLUSIONS: Caudal epidural mepivacaine-morphine (0.03 mg/kg) mixture is effective in children for control of postoperative pain without significant side effects.
Analgesia* ; Analgesics ; Child* ; Humans ; Incidence ; Mepivacaine ; Morphine* ; Pain, Postoperative

The double pylorus-is a fistulous communication between the gastric antrum and duodenal bulb, usually extending from the lesser curvature of the stomach to the superior aspect of the duodenal bulb, and seperated by septum or bridge of normal mucosa. Although its incidence is rare, reports concerning double pylorus are increasing with the recent development of upper gastrointestinal endoscopy and more awareness of this abnormality. We recently experienced two cases of double pylorus; an aquired one in 72-year old male who had an another opening with healing ulcer at the superior aspect of the original pyloric channel, central erosion with clubbing and fusion of mucosal folds at the greater curvature of the lower body and a 3 x 4 cm sized ulcer at the lesser curvature of the lower body, and the other congenital one in 53-year old male who had an another opening at the superior aspect of the original pyloric channel with histologically intact muscularis mucosa in the pyloric septum with no evidence of chronic peptic ulcer scarring. We report here two cases of double pylorus, one-acquired, and the other-congenital, with a review of the literature.
Aged ; Cicatrix ; Endoscopy, Gastrointestinal ; Humans ; Incidence ; Male ; Middle Aged ; Mucous Membrane ; Peptic Ulcer ; Pyloric Antrum ; Pylorus ; Stomach ; Stomach Ulcer ; Ulcer

A case of right-sided infective endocarditis in a 22-year-old male with ventricular septal defect of perimembranous type, right ventricular(RV) infundibular and pulmonic valve stenosis was reported. The vegetations were found on the mural endocardium of RV infundibulum and pulmonic valve. Streptococcus viridans was identified in 5 consecutive blood cultures, Pulmonary embolism and septic infarction in the lung was associated with systemic embolization, which was manifested by left renal infarction. The RV infundibular stenosis was due to anomalous muscle bundle at the proximal portion. Therefore, we thought that the mechanism of RV infundibular vegetation was probably due to 'Venturi effect and turbulence'. Several clinical features which were found in this case were also reviewed.
Constriction, Pathologic ; Endocarditis* ; Endocardium ; Heart Septal Defects, Ventricular ; Humans ; Infarction ; Lung ; Male ; Pulmonary Embolism ; Viridans Streptococci ; Young Adult

Little has been reported concerning post-operative hypoglycemia in previously asymptomatic individuals. Post-operative hypoglycemic coma is one of the most perplexing problems and must be differentiated from other conditions accompaning coma. We experienced a case of hypoglycemia following emergency cesarean section in primigravida with cephalopelvic disproportion on the fourth post operative day. The comatous state appeared abruptly and developed repeatedly. The causes of post-hypoglycemic coma are discussed and the prolonged starvation before and after operation was suspected to be the cause of coma.
Cephalopelvic Disproportion ; Cesarean Section* ; Coma ; Emergencies ; Female ; Hypoglycemia* ; Pregnancy ; Starvation

PURPOSE: The pharmacologic effect of atropine on HPS can be considered to control pyloric muscle spasm. Therefore, we studied the effects of intravenous atropine sulfate on the clinical course of HPS, and periodically observed the ultrasonographic appearance of the pyloric muscles after atropine treatment. METHODS:From April 1998 to May 1999, 14 infants who were diagnosed with HPS were treated with intravenous atropine sulfate. Intravenous atropine sulfate was administered at an initial dose of 0.04mg/kg/day, which was divided into 8 equal doses. The daily dose was increased by 0.01 mg/kg/day until vomiting was controlled for an entire day while infants received unrestricted oral feeding. Ultrasonographic examinations were performed during hospitalization and repeated at least every 2 months until normalization of pyloric muscles was confirmed. RESULTS: Intravenous atropine was effective in 12 of 14 infants with HPS and the conditions of 9 of them improved. Two infants who were not free from vomiting despite a week of intravenous atropine sulfate treatment underwent pyloromyotomy. A series of ultrasonographic examinations were done after vomiting had improved with intravenous atropine sulfate. The ultrasonographic findings showed good passage of gastric contents through pyloric canals despite thickening of the pyloric muscles. CONCLUSION: Intravenous administration of atropine sulfate is an effective therapy for HPS and can be an alternative to pyloromyotomy. (J Korean Pediatr Soc 2000;43:763-768)
Administration, Intravenous ; Atropine* ; Hospitalization ; Humans ; Infant ; Muscles ; Pyloric Stenosis, Hypertrophic* ; Spasm ; Vomiting

Local or distant flap surgery has been applied in the soft tissue defect area where bone and tendon are exposed, but there are many pitfalls in these surgeries including limitation of donor site selection, as well as functional and aesthetic dissatisfaction of the donor and recipient site. So these problems have facilitated the development and study of skin substitute (artificial dermis). The history of artificial skin began in the 1980s with the invention of Stage I membrane by Yannas and Burke. Since then it has been developed and applied to chinical cases of extensive burn injury and soft tissue defect. In 1989, and artificial dermis (Terudermis) composed of fibrillar collagen and heat denaturated atelocollagen was developed by Konish. It has the advantage of allowing early-incorporation of cellular and vascular components into its collagen sponge, as well as dehydrothermal cross-linking, which is very weak. This study included 18 consecutive cases which underwent application of artificial dermis on bone and tendon from January 1997 to November 1998. The exposed areas were the result of trauma in 10 cases, postoperative complications in 2 cases, and other causes in 6 cases. The follow-up period ranged from 3 months to 18 months, averaging 11 months. A week after wound debridement and Terudermis application, neovascularization had begun and granulation tissue appeared aften 2-3 weeks. Then the split or full -thickness skin graft was secondarily applied resulting in the production of sufficient skin. In conclusion, Terudermis application to an area of exposed bone and tendon is a very useful method, especially when primary local or distant flap surgery cannot be used. This method is very simple, convenient and reliable.
Burns ; Collagen ; Debridement ; Dermis ; Fibrillar Collagens ; Follow-Up Studies ; Granulation Tissue ; Hot Temperature ; Humans ; Inventions ; Membranes ; Porifera ; Postoperative Complications ; Skin ; Skin, Artificial ; Tendons* ; Tissue Donors ; Transplants ; Wounds and Injuries

We have analysed 72 cases of geriatric patients over 70 year of age who underwent anesthesia in our Aospital from Jan. 1970 to May 1979 and the results were as follows; 1) Male patients were more than female(1.05: 1). (Male, 37 cases(51.4%) and female, 35cases (48. 6%). 2) By ASA classification, physical status was class II in 32 cases, E II in 24 cases, III in 12 cases, E III in 2 cases and IV in 2 eases. 3) The number of the patients of general surgery department(46.63%) was highest. 4) Preoperative problems were cardiovascular diseases including hypertension (11cases) and LVH(25 cases), arrhythmia(6cases), tachycardia(4cases), RBBB(2cases) and bradycardia (2 cases) in EKG. 5) Preoperative pulmonary disease including pulmonary tbc(14 cases), chronic bronchitis (6 cases), and emphysema(4 cases) was revealed in the chest PA. 6) There was no mortality during the operative or postoperative period.
Anesthesia ; Bradycardia ; Bronchitis, Chronic ; Cardiovascular Diseases ; Classification ; Electrocardiography ; Female ; Humans ; Hypertension ; Lung Diseases ; Male ; Mortality ; Postoperative Period ; Thorax