Dizziness is one of the most frequent symptoms encountered by a physician. Moreover, the term denotes different sensations for different people. It is essential to clarify what the patient means by asking for examples. There are several common subgroups of dizziness ; vertigo, multisensory dizziness, presyncopal lightheadedness, psychophysiological dizziness, etc. There are many causes of dizziness ; labyrinthine disorders including benign paroxysmal positional vertigo, eight cranial nerve disorders including vestibuloneuronitis, brainstem stroke, cerebellar and temporal lesions. The new diagnostic tools-rotating chair test, videooculography, computerized dynamic posturography have been introduced in assessing the dizziness. Systemic approach is essential for diagnosis of dizziness.
Benign Paroxysmal Positional Vertigo ; Brain Stem Infarctions ; Cranial Nerve Diseases ; Diagnosis ; Dizziness* ; Humans ; Sensation ; Vertigo

BACKGROUND: The 5α-reductase inhibitor finasteride blocks the conversion of testosterone to dihydrotestosterone(DHT), the androgen responsible for androgen- etic alopecia in genetically predisposed men. OBJECTIVE: The purpose of this study was to determine the efficacy of finaster- ide treatment according to the type of androgenetic alopecia in Korea. METHODS: 196 patients with finasteride(1.25mg/day) were registered in this study and 68 patients were followed over 8 months. Efficacy was evaluated by globa1 photographs, investigator assessment of clinical change,and patients' self assessment via self administered hair growth questionnaire. RESULTS: Patients' self-assessment demonstrated that finasteride treatment slowed hair loss, increased hair growth, and improved appearance of hair. These improvements were corroborated by objective assessments after 4 months of treatment. Adverse effects such as sexual dysfunction were minimal. CONCLUSION: Oral finasteride 1.25mg/day slowed the progression of hair loss and increased hair growth in clinical tria1s of men with androgenetic alopecia over 8 months. With its generally good tolerability profile, finasteride is a new approach to the management of this condition, for which treatment options are few.
Alopecia* ; Finasteride* ; Hair ; Humans ; Korea ; Male ; Research Personnel ; Self-Assessment ; Testosterone

No abstract available.
Continuous Positive Airway Pressure* ; Ventilation*

No abstract available.
Rheumatic Diseases* ; Spondylarthropathies

No abstract available.

A 59-year-old male farmer, an alcohol addict, has experienced repeated bullous skin lesions on the erythematous base over the exposed areas of tbe skin, especially on the face and hands, after sun-light exposure. The face showed hyperpigmenation, hypertrichosis and sclerodermoid changes. And also there were hypopigmented scars on the dorsum of the hands and cIaw-1ike fingers. Characteristic laboratory findings were as follows: Urine appeared portwine color and fluoresced under the Woods Iight. A 24-hour urine collection contamed 4l32ug of uroporphyrin and 3815ug of corproporphyrin. BSP retention(7% in 45 Min.) was increased, and A/G ratio(0. 8:1) was inverted. Gamma globulin(44, 9%) was markedly increased on serum electrophoresis. Roentgenograms revealed minimal tuberculosis on the chest P-A and superficial gastritis on the upper G-I series. Electrocardiogram showed left ventricular hypertrophy. Pathological findings of the specimen obtained from sclerodermoid lesion of the forehead revealed hypermelanosis in the basal cell layer and amorphous, basophilic collagen degeneration in the upper dermis, on the other hand loss of sinusoids due to swelling of hepatocytes and chomic inflammatory cell infiltrate in the interlobular septa were noticed on the specimen taken from the liver. For treatment, phlebotomy and metabolic alkalinization were trjed.
Basophils ; Cicatrix ; Collagen ; Dermis ; Electrocardiography ; Electrophoresis ; Fingers ; Forehead ; Gastritis ; Hand ; Hepatocytes ; Humans ; Hyperpigmentation ; Hypertrichosis ; Hypertrophy, Left Ventricular ; Liver ; Male ; Middle Aged ; Phlebotomy ; Skin ; Thorax ; Tuberculosis ; Urine Specimen Collection ; Wood

PURPOSE: Caliceal diverticular calculi are mostly asymptomatic. In certain cases they may be associated with chronic or recurrent pain, recurrent urinary tract infections, progressive renal damage and hematur ia. The treatment of symptomatic caliceal diverticular calculi has evolved from open surgery to less invasive procedures, such as extracorporeal shock wave lithotripsy (SWL), percutaneous techniques, retrograde ureteroscopy and laparoscopy, but it remains controversial. Percutaneous techniques are frequently used to address the diverticular stone burden, to fulgurate the diverticular wall, to dilated the diverticular neck and improve drainage. For this reason, we reviewed 33 patients with caliceal diverticular calculi to determine whether they could be treated successfully by percutaneous nephrolithotomy (PCNL) as the initial treatment. MATERIALS AND METHODS: A total of 33 patients with caliceal diverticular calculi underwent PCNL between February 1990 and February 2000. The majority of diverticula were located at the upper pole. Access was gained via a direct target puncture. After sequential dilatation of the tract, stones were removed and the diverticular wall was fulgurated. The diverticular neck was dilated with the Amplatz dilator upto 24-30 Fr. and a 20 Fr. nephrostomy catheter was placed. RESULTS: PCNL was performed successfully in 30 patients (90.9%), but puncture was failed in 3. Mean operative time was 105 minutes and mean hospital stay was 4.5 days. All patients who were treated successfully with PCNL became stone-free without any complication. Mean follow-up was 20 months (ranged from 1 to 108 months). Of the 26 patients with symptoms preoperatively, 25 patients were rendered symptom-free (96.2%). Twenty-four patients were assessed with an intravenous urogram at 1 or 3 months and 6, 12 months and there was no stone recurrence. The diverticula were obliterated or had improved drainage in 95.8% (23/24) of assessable cases. CONCLUSIONS: We confirmed that PCNL is a safe, less invasive and effective procedure and should be considered an acceptable form of primary management of patients with caliceal diverticular stone.
Calculi ; Catheters ; Dilatation ; Diverticulum ; Drainage ; Follow-Up Studies ; Humans ; Laparoscopy ; Length of Stay ; Lithotripsy ; Neck ; Nephrostomy, Percutaneous ; Operative Time ; Punctures ; Recurrence ; Shock ; Ureteroscopy ; Urinary Tract Infections

BACKGROUND: Bohmer and Straumann have proposed that downbeat nystagmus is due to an asymmetry of the geometry of the vertical semicircular canals of the vestibular labyrinth. This hypothesis does not predict any sustained change in vertical nystagmus when subjects are placed in a head-upside-down position. METHODS: Using the magnetic search coil technique, I measured vertical eye movements in darkness in three normal human subjects while they maintained head-erect or head-upside-down positions. RESULTS: Two subjects had upbeat nystagmus and one downbeat nystagmus with their heads erect (slow-phase velocity < 1 deg/sec). All developed sustained nystagmus with quick phases directed towards their chins while in the head-upside-down position. CONCLUSIONS: These findings suggest that factors other than canal imbalance - otolithic or ocular - may also cause downbeat nystagmus.
Cerebellum ; Chin ; Darkness* ; Eye Movements ; Head ; Humans ; Nystagmus, Pathologic ; Otolithic Membrane ; Semicircular Canals ; Vestibule, Labyrinth

No abstract available.
Chorea* ; Humans

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*