BACKGROUND: Pemphigus is a rare, chronic blistering disease of the skin and mucous membranes with severe morbidity and occasional mortality. The clinical data of Korean pemphigus patients are quite limited, and an appropriate treatrnent regimen is not yet established. OBJECTIVE: Our purpose was to analyze the clinical characteristics of, and establish an appropriate treatment regimen for Korean pemphigus patients. METHODS: A retrospective analysis was conducted for 24 pemphigus patients seen between 1992 and 1996. RESULTS: Pemphigus vulgaris(PV) was the most common type with 17 cases, followed by seven cases of pemphigus foliaceus(PF). There were no sexual preferences, and the average age at onset for PV and PF was 46 and 50 years old, respectively. Mucosal involvement was noted in 14 cases(82%) of PV and only in one case(14/o) of PF. There was no correlation between the extent of involvement and the titer of anti ICS(intercellular substance) antibody. Most patients received prednisolone of lmg/kg, and 12 PV patients also received immunosuppressive agents. Systemic side effects were noted in 10 cases of PV, and seven PF cases did not manifest any systemic side effects. CONCLUSIONS: The clinical manifestations and results of imrnunofluorescent studies of 24 Korean pemphigus patients were similar to those of the previous studies. For treatment of pemphigus, the lowest possible doses(less than 1mg/kg) of corticosteroid in combination with immunosuppressive agents appears to be more effective and less toxic than high doses of corticosteroid. We propose a regimen for treatment of Korean pemphigus patients based on these experiences. Further rnulti-center clinical trials are advocated to confirm an effective management protocol for Korean pemphigus patients.
Blister ; Humans ; Immunosuppressive Agents ; Middle Aged ; Mortality ; Mucous Membrane ; Pemphigus* ; Prednisolone ; Retrospective Studies ; Skin

The common bile duct and the duct of Wirsung cojoin at the level of the duodenum, forming the major. papilla of Vater. Existence of a double major papilla, i.e., two neighboring independent papillary structure:, is infrequent. In our endoscopy unit we have experienced one case of double papilla of Vater wherein canulation of the common bile duct and pancreatic duct could be accom plished through either orifice independently.
Common Bile Duct ; Duodenum ; Endoscopy ; Pancreatic Ducts

BACKGROUND AND OBJECTIVES: Percutaneous transluminal septal myocardial ablation (PTSMA) and surgical septal myotomy-myectomy are two treatment options for patients with drug-resistant hypertrophic cardiomyopathy & a left ventricular outflow tract (LVOT) obstruction. The clinical courses, after nonsurgical and surgical septal myotomy-myectomy, are described in 3 patients with hypertrophic cardiomyopathy that continued to be symptomatic following medical management. SUBJECTS AND MEHTODS: 3 patients (2 women, 1 man), with symptomatic drug-refractory obstructive hypertrophic cardiomyopathy, were the subjects of this study. One patient underwent a PTSMA by injection of ethanol into the septal perforator branches of the left anterior descending coronary artery, and 2 a surgical myotomy-myectomy. Examinations of the early and late follow-up echocardiographic results were performed. RESULTS: Both treatment modalities significantly reduced the peak gradient across the LVOT (ablation : 85 to 7.7 mmHg, myectomy : 104 to 10 mmHg), and led to similar improvements in the New York Heart Association class (ablation : NYHA IV to II, myectomy : NYHA III or IV to NYHA I or II). One patient, who underwent a successful PTSMA, showed a temporary right bundle branch block on the ECG for several days following the PTSMA. At the 1-year follow-up, 2 patients were observed to have persistent symptomatic improvements, with no cardiac complications. CONCLUSION: Both a percutaneous septal myocardial ablation and a surgical myotomy-myectomy resulted in similar degrees of significant improvements of the left ventricular outflow tract obstructions, with improvements of the symptoms. Prospective studies are necessary to compare the long-term efficacy of these two treatment modalities.
Bundle-Branch Block ; Cardiac Surgical Procedures ; Cardiomyopathy, Hypertrophic* ; Catheter Ablation ; Coronary Vessels ; Echocardiography ; Electrocardiography ; Ethanol ; Female ; Follow-Up Studies ; Heart ; Humans ; Ventricular Outflow Obstruction*

No abstract available.
Rectal Neoplasms*

No abstract available.
Rectal Neoplasms*

Urachal carcinoma is an uncommon neoplasm associated with a poor prognosis. We have encountered two another cases of urachal adenocarcinoma recently 5 years after our first report. The common sign of urachal cancer was painless hematuria. We diagnosed the specific site of origin preoperatively by means of computerized tomography. One patient was performed partial cystectomy and another was total cystectomy with double barrel ureterocutaneostomy. A brief review of the literature of urachal adenocarcinoma was also made.
Adenocarcinoma* ; Cystectomy ; Hematuria ; Humans ; Prognosis

No abstract available.
Esophageal and Gastric Varices*

No abstract available.
Liver Abscess* ; Liver*

No abstract available.
Hemorrhage*

he Magnetic. resonance imaging has been used widely to evaluate the disk position without any interruption of the TMJ structures, and the dynamic MRI presenting computed serial imaging or the video-recorded simulation images is thought to be very effective to evaluate the disk position under function. This is to study the correlation between the clinical diagnosis and the findings of dynamic MRI for diagnosis of internal derangement of the 7 patients were examined clinically, and the movement of TMJ meniscus was reviewed in the dynamic MRI. MRI was very reliable to diagnose the amount of anterior displacement of articular disc, the structural abnormality of temporomandibular joint, the cause of functional limitation, and to differentiate the muscle related pain & dysfunction.
Diagnosis ; Humans ; Magnetic Resonance Imaging* ; Temporomandibular Joint Disorders* ; Temporomandibular Joint*