No abstract available.
Peutz-Jeghers Syndrome*

Hypertensive encephalopathy is an acute clinical syndrome that shows central nerve dysfunction with sudden and marked elevation in blood pressure. But its pathophysiologic mechanisms, clinical courses and prognosis are still not clear. In order to study clinical manifestations and response to treatment in patients with hypertensive encephalopathy, we reviewed 45 patients with hypertensive encephalopathy who were admitted in Dept. of Internal Medicine, National Medical Center, from January 1975 to December 1984. The following results were obtained: 1) The ratio of male to female was 1.1:1. The peak age of incidence was in the 6th and 7th decade with mean age of 57.5 years. 2) Among 45 patients, only 29 had known history of hypertension and the average duration of hypertension was 8.1+/-3.6 years. 3) The most common sympotm was severe headache (68.9%). And altered consciousness, nausea and/or vomiting, focal neurologic signs and visual disturbance were also common symptoms in decreasing order of frequency. 4) Funduscopic examination showed hypertensive retinopathy in 20 of 24 (91.7%) patients and lumbar puncture revealed increased CSF pressure in 12 of 20 (60%) patients. 5) In most patients, the mean interval to symptomatic improvement was 2.1 days after administration of anti hypertensive agents, but in 6 patients with initial mean arterial blood pressure above 170mmHg, 4 patients showed delayed response and 2 patients were expired.
Antihypertensive Agents ; Arterial Pressure ; Blood Pressure ; Consciousness ; Female ; Headache ; Humans ; Hypertension ; Hypertensive Encephalopathy* ; Hypertensive Retinopathy ; Incidence ; Internal Medicine ; Male ; Nausea ; Neurologic Manifestations ; Prognosis ; Spinal Puncture ; Vomiting

To evaluate the results and clinical impact of defecography in patients with anorectal diseases, 304 defecographic examinations from 304 patients were reviewed. The defecographic results were screened for the anorectal angle and perineal descent at rest, squeezing and during straining. Changes of rectal configuration and canal width during straining were reviewed. 304 patients had defecation problems such as terminal constipation, defecation defficulty, blood or mucus discharge, tenesmus, obstruction sensation etc. They were performed anorectal physical examination and anal manometry etc., and were later treated by operation and conservative management. Normal anorectal angle were measured to be 101°, 91°, 131°at rest, during squeezing and straining respectively. In the spastic pelvic floor syndrome, increase of anorectal angle less than 10 ° from rest to straining was observed. Incontinent patients had a larger anorectal angle (mean: 128°) at rest. 7.8cm of perineal descent was found in descending perineal syndrome in comparison to 4.0cm in normal. Normal anal canal width was measured 1.4cm only during straining but identified in incontinent patients at rest (mean:1.2cm). Abnormal rectal configuration was found in 254 defecographic examinations: rectoceles were observed in 235 cases and were associated with rectal prolapse in 115 cases, and rectal prolapses were found in 134 cases. In conclusion, the anorectal angle was valuable in evaluation of spastic pelvic floor syndrome and fecal incontinence. Degree of perineal descent was abnormally increased in descending perineal syndrome. In the cases of the rectoceles and rectal prolapses, defecography is helpful in preoperative evaluation of rectal wall change and postoperative follow up.
Anal Canal ; Constipation ; Defecation ; Defecography* ; Fecal Incontinence ; Follow-Up Studies ; Humans ; Manometry ; Mucus ; Muscle Spasticity ; Pelvic Floor ; Physical Examination ; Rectal Prolapse ; Rectocele ; Sensation

No abstract available.
Child* ; Humans

Tumoral calcinosis was coined by Inclan in 1943 and thereafter about 40 cases have been reported in the literature, but there has not been reported on a case which involved knee joints. The majority of cases hitherto reported were found in Negro. There was no report in yellow race. Authors presented a case of tumoral calcinosis that involved boih knee joints of a 55 years old Korean housewife. On physical examination chronic draining sinuses with spontaneous extrusion of calcific material was noted on the left infrapatellar region. A radiograph of the both knees showed dense, multinodular deposits of calcium. The masses were confined to the soft tissues; the contiguous joint showed no pathological change. En-block excisianal biopsy was done. The histological section of the excised mass disclosed the foreign-body giant cell with inflamed connective tissue surrounding calcific deposits.
African Continental Ancestry Group ; Biopsy ; Calcinosis ; Calcium ; Connective Tissue ; Continental Population Groups ; Giant Cells, Foreign-Body ; Humans ; Joints ; Knee ; Knee Joint ; Numismatics ; Physical Examination

No abstract available.
Aged* ; Humans

Self expandable metal stent (stent) implantation of upper gastrointestinal (UGI) tract is now widely accepted for the palliation of obstructive symptoms caused by inoperable malignant UGI obstruction. With the technical progress and accumulation of clinical experiences, it became possible to perform the procedure easily, safely and effectively. However, clinicians should pay attention to the post-procedural care, because early or late complications such as ulceration, pain, bleeding, food impaction, perforation, migration or in-stent tumor growth could occur. In this review, several topics about stent placement in the UGI tract are discussed, such as major indications for stenting, kinds of stents, and post-procedural management.
Hemorrhage ; Stents ; Ulcer

Myasthenia gravis is an autoimmune disorder, caused by the presence of anti-ac- etylcholine receptor antibody or acetylcholine-receptor deficiency and involved neuro- muscular endplate. The clinical course and outcome of myasthenia gravis are variable during pregnancy. The special caution and adequate management for myasthenic mother and myasthenia gravis occurred newborn of myasthenic mother are essential for good perinatal outcomes. We experienced a case of myasthenia gravis associated with pregnancy who underwent cesarean section. We present this case with a brief review of literatures.
Cesarean Section ; Female ; Humans ; Infant, Newborn ; Mothers ; Myasthenia Gravis* ; Myasthenia Gravis, Neonatal ; Pregnancy*

Glucocorticoid hormones have been identified as one of the B cell activating signals necessary in IgE synthesis in the presence interleukin 4(IL-4). One question to be addressed in IgE synthesis is whether there is difference between atopics and non-atopics. In the present study, we aimed at looking the different effects of interleukin 4(IL-4) and hydrocortisone(HC) in IgE synthesis by peripheral blood monounclear cells (PBMCs) from 12 atopic patients and 6 non-atopic controls. PBMCs were cultured with IL-4 and/or HC for 14 days, and net IgE production was measured in the supernatant. Significant spontaneous IgE production by PBMCs was oberserved only in atopics. IL-4 increased net IgE synthesis by PBMCs from both atopics and non-atopics by similar amounts, whereas HC had that effect only in some atopics who showed high spontaneous IgE production. HC acted synergically with IL-4 in a narrow range of concentration which is individually different. This effect was more remarkable in subjects with low total serum IgE levels. These data suggest that atopic patients may have larger numbers of B cells committed to produce IgE, and that the effect of HC on IgE synthesis in vitro may be due to the priming effect of IL-4 in vivo.
Antibodies* ; B-Lymphocytes ; Humans ; Hydrocortisone* ; Immunoglobulin E* ; Interleukin-4* ; Interleukins*

BACKGROUND: Although the basic cellular and molecular requirements for the induction and synthesis of whole human IgE antibody have extensively been investigated, the mechanisms involved in the regulation of allergen-specific IgE synthesis are not yet fully understood. OBJECTIVES: The aims of this study were to elucidate the differences in the total and specific IgE regulation by hydrocortisone(HC) with interleukin 4 (IL-4) between atopics and non-atopics and to determine the relationship between in vitro IgE synthesis and serum IgE levels. METHODS: Peripheral blood mononuclear cells(PBMCs) from sixteen atopic asthma patients sensitive to Dermatophagoides farinae(D.f) and seven non-atopics were cultured with IL-4 and/or HC. Total and D.f-specific IgE in culture supernatant were measured using ELISA and FAST methods respectively. RESULTS: PBMCs from 8 of 16 atopics produced D.f-specific IgE in vitro either spontaneously or by IL-4 and/or HC. HC had more profound effects than IL-4 in these patients. They also showed higher total IgE synthesis by HC, and higher specific serum IgE levels than the others. IL-4 and/or HC did not induce any D.f-specific IgE synthesis by PBMCs from non-atopics. CONCLUSION: These data suggest that atopic patients have allergen-specific B cells that have already been switched to IgE production, probably due to in vivo priming effect of IL-4.
Asthma ; B-Lymphocytes ; Dermatophagoides farinae ; Enzyme-Linked Immunosorbent Assay ; Humans ; Hydrocortisone* ; Immunoglobulin E* ; Interleukin-4* ; Interleukins* ; Pyroglyphidae