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

No abstract available.
Child* ; Humans

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

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

BACKGROUND AND OBJECTIVES: Allergic rhinitis (AR) and rhinitis medicamentosa (RM) have different mucosal color and pathophysiology. To investigate whether the mucosal color and nasal blood flow are different between the diseases in spite of same symptoms, we designed this study. Materials and Methods: 20 patients with allergic rhinitis and 21 patients with rhinitis medicamentosa were compared with 20 normal volunteers using mucosal color grading and Laser Doppler flowmetry. The Laser Doppler flowmetry was performed with a Periflux 4001 (Perimed, Jrtlla, Sweden) and perfusion unit (PU), velocity unit (VU), and concentration Unit (CU) were measured. The Laser Doppler flowmetry data in AR and RM were compared with those of the normal subjects, and between AR and RM. RESULTS: The perfusion score of AR and RM were lower than the control (p<0.05) and it was statistically significant that the mucosal color of AR were pale and of RM were reddish, comparing to the control group (p<0.05). CONCLUSION: The nasal blood flow was decreased with AR and RM compared to control but the mucosal color of AR and RM were different because of the difference of pathophysiology of diseases. When diagnosing RM, observation of mucosal color and measurement of nasal blood flow will be helpful besides the history of long-term use of nasal decongestant.
Healthy Volunteers ; Humans ; Laser-Doppler Flowmetry* ; Perfusion ; Rhinitis*

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*

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

We experienced a complication of brachial plexus palsy secondary to operative position during thoracoscopic thoracic sympathectomies. His general health was excellent and no previous histories vulnerable to peripheral nerve systems were observed. The thoracic sympathectomies were done under general anesthesia. The patient was placed left lateral position with his right arm abduced 150o on padded arm board. An operation was lasted 2 hours and 30 minutes at this position because of severe right apical lung adhesion. The controlateral side was performed same procedure and lasted 20 minutes. After the patient recovered from the anesthesia, the patient had a complete paralysis of right arm. There was also slightly diminished sensation to pinprick on the arm and hand. Neurologic examination and EMG study revealed brachial plexus palsy. Nerve blocks and physiotherapy were performed to treat brachial plexus injuries. His motor functions were improved day by day and he was discharged with a complete range of motion against gravity on 14th. postoperation day. However, there were loss of muscle powers against some resistances and tingling sensations of fingertips. Two months later, he was recovered completely and there was no residual disabilities.
Anesthesia ; Anesthesia, General ; Arm ; Brachial Plexus* ; Gravitation ; Hand ; Humans ; Lung ; Nerve Block ; Neurologic Examination ; Paralysis* ; Peripheral Nerves ; Range of Motion, Articular ; Sensation ; Sympathectomy*

PURPOSE: This one group experimentation was designed to develop a program for relieving 'Hwa-Byung'(HB) symptoms and examine its effects on HB symptoms, pain threshold emotions like anger, anxiety and depression. METHOD: The program consisted of three components the change of the cognitive thoughts, the formation of a supportive network, and induction of mind-body relaxation. Sixteen middle-aged women with HB were divided into three groups for group dynamics according to the time of the recruitment. Data was collected for nine months at three time points, before, immediately after, and one month later of its application. RESULT: There were statistically significant differences in the severity level of state anger, state anxiety, depression, and HB symptoms according to the time interval. The means of state anger and state anxiety were reduced after the intervention, but it was slightly increased one month later. The means of depression and HB symptoms were continuously reduced after the intervention and one month later. CONCLUSION: This was the first management program for HB women in Korea. A future study must be done with the research design formethodological strength revision of the program.
Adult ; Anger ; Anxiety ; Cognitive Therapy ; Depression/therapy ; Female ; Humans ; Mental Disorders/complications/*therapy ; Middle Aged ; Relaxation Therapy ; Social Support ; Somatoform Disorders/psychology/*therapy