No abstract available.
Encephalomyelitis, Acute Disseminated* ; Magnetic Resonance Imaging

Herein we report a 51-year-old male with angioimmunoblastic lymphadenopathy who had developed rnaculopapular eruptions after the administration of crystalline penicillin, acetylsalicylic acid and sulpyrine. Skin biopsy showed mild lyrnphohistiocytic infiltration and extravasated RBCs around the blood vessels in the upper dermis. He had run a progressively downhill course in spite of vigorous chemotherapy and ultimately died.
Aspirin ; Biopsy ; Blood Vessels ; Crystallins ; Dermis ; Dipyrone ; Drug Therapy ; Humans ; Immunoblastic Lymphadenopathy ; Lymphatic Diseases* ; Male ; Middle Aged ; Penicillins ; Skin

Recently cryogenic therapy is widely used for the treatment of herpes simplex keratitis. We had experimental studies on the effect of iodine cautery and cryocautery upon the regeneration of corneal ulceration. On 10 adult albino rabbits, one eye was treated by iodine, and the other by cryocautery in area of 0.6cm X 0.6cm. The epithelium in this area was completly removed by cotton applicator. There after, the rate of epithelial regeneration was observed every 12 hours. The results were as follows: (1) The average period of complete epithelial regeneration was 48 hours in animal treated with cryocautery and 78 hours in animals treated with iodine cautery. This difference is statistically highly significant. (2) Corneal opacity was not demonstrated in eyes treated with cryocautery. Six eyes treated with iodine, however, showed various degree of corneal opacities. These results support the view that the healing time in human herpes simplex keratitis is shortened in patients with cryocautery as compared with iodine.
Adult ; Animals ; Cautery* ; Corneal Opacity ; Corneal Ulcer* ; Epithelium ; Humans ; Iodine* ; Keratitis, Herpetic ; Rabbits ; Regeneration*

No abstract available.
Cellulitis* ; Staphylococcus aureus* ; Staphylococcus*

Pulmonary artery sling is an uncommon and potentially lethal vascular anomaly that can produce airway obstruction. Despite the availibility of a corrective operation, the mortality rate remains very high due to the high incidence of associated obstructive anomalies of the tracheobronchial tree. We experienced a 70-day-old male infant who was admitted to our unit because of sudden dyspnea, cyanosis, coarse expiratory wheezing and inspiratory stridor. At first, he was treated with bronchodilator and steroid under the impression of infantile asthma, but the symptoms went on without interval change. We performed magnetic resonance imaging study followed esophagography and two dimensional echocardiography. Finally he was diagnosed as a vascular sling. We report this with a brief review and related literatures.
Airway Obstruction ; Asthma ; Cyanosis ; Dyspnea ; Echocardiography ; Humans ; Incidence ; Infant ; Magnetic Resonance Imaging ; Male ; Mortality ; Pulmonary Artery ; Respiratory Sounds

The abnormalities in Hypothalamic-pituitary-adrenal(HPA) axis are associated with many psychiatric symptoms including depression. We present a report of a 71 year old man who was admitted to the psychiatric department presenting symptoms of headache, avolition, loss of energy, psychomotor retardation, poor appetite, insomnia, anxiety resulting from adrenal insufficiency and hypopituitarism. Hypothyroidism and electrolyte disturbance were managed and headache, insomnia, anxiety, GI symptoms were improved. But he remained in anergic state. After discharge, he was readmitted to infection department with high fever and drowsy mentality. Adrenal insufficiency was recognized and he was treated with corticosteroid replacement therapy. Finally his diagnosis was made as panhypopituitarism and overall symptoms were resolved. In this case, we showed how the atypical symptoms resulting from hypopituitarism develop and progress. Hypothyroidism, adrenal insufficiency, and growth hormone deficiency resulting secondarily from panhypopituitarism were associated with various nonspecific symptoms such as loss of energy, fatigue, insomnia, weight loss, decreased appetite etc. In clinical situation, differential diagnosis with depression is needed when clinicians were met a patient with these nonspecific symptoms. It is important that laboratory tests and differential diagnosis with endocrine diseases should be conducted, especially in geriatric patients with nonspecific symptoms like anergia, fatigue, poor appetite and so on.
Adrenal Insufficiency ; Anxiety ; Appetite ; Axis ; Depression ; Diagnosis, Differential ; Endocrine System Diseases ; Fatigue ; Fever ; Growth Hormone ; Headache ; Humans ; Hypopituitarism ; Hypothyroidism ; Sleep Initiation and Maintenance Disorders ; Weight Loss

OBJECTIVE: To evaluate the basophil histamine releasability in response to IgE- and non- IgE-mediated stimuli in children with atopic asthma. Met: Basophil histamine releasability was measured in Dermatophagoides farinae (D. farinae)-sensitive atopic asthmatics, D.farinae-sensitive healthy atopics, non-atopic asthmatics, and healthy non-atopics. Basophils were stimulated with D.farinae, goat antihuman IgE antibody, formyl-Met-Leu-Phe(fMLP), and Calcium ionophore A23187. Histamine was measured by automated fluorometric technique. RESULTS: Sponianeous histamine release was higher in atopic asthmatics compared to healthy non-atopics. Histamine release by D.farinae and by anti-IgE antibody was higher in atopic asthmatics compared to the other groups. There was no difference in histamine release by fMLP among all groups. Histamine release by Calcium ionophore was higher in healthy atopics and non-atopic asthmatics compared to healthy non-atopics. The atopics showed correlation between histamine release by D.farinae, by anti-IgE antibody and total serum IgE levels. CONCLUSIONS: Spontaneous and IgE-mediated histamine release were related to the presence of both atopy and asthma, whereas non-IgE mediated histamine release was different depending on the stimuli.
Asthma* ; Basophils* ; Calcimycin ; Calcium ; Child* ; Dermatophagoides farinae ; Goats ; Histamine Release ; Histamine* ; Humans ; Immunoglobulin E

BACKGROUND: Efficacy of percutaneous transluminal angioplasty(PTA) in the treatment of Peripheral arterial disease has been established. Complications such ans PTA-induced dissections or residual stenosis with occasional mural thrombi have been reported, which compromise the results. New procedures can be used in combination with PTA to improve the immediate and long term results, such ans prolonged balloon inflation, atherectomy, or implantation of endovascular prosthesis. In addition, the occurrence of other lesions, such as spontaneous or post-catheterization dissection or post-PTA restenosis, has prompted the insertion of a vascular stent. But there was few reports on stenting for peripheral arterial disease in Korea. METHODS: To evaluate the safety, efficacy and stability of stent in peripheral arterial disease, twenty-six consecutive symptomatic patients with 37 peripheral lesions were treated with 39 balloon expandable(33 Strecker and 6 Palmaz)stents with or without prior balloon angioplasty in the period of March 1991 and February 1994. RESULTS: The major cause of disease was arteriosclerosis(22 out of 26). The implantation sites for our study include 22 in common iliac artery, 11 in external iliac artery 2 in aorta, subclavian artery, superficial femoral artery each other. Indication for stent deployment were primarily suboptimal results(19 lesions), insufficient PTA such as dissections(4), restenosis after previous PTA(2), and primary stenting was performed without preceding therapeutic PTA(10). Stent deployment was technically successful in 24 of the 26 patients(92%) and clinical success rate was in 25 of the 26 patients treated(96%). Hemodynamic change revealed markedly improvement before and after stenting(peak pressure difference from 66.329.0mmHg to 9.1+/-7.1mmHg; Mean pressure difference from 33.0+/-22.5mmHg to 4.7+/-4.3mmHg). There were two procedural complications which included one stent migration and one artery perforation. During the 7 months of follow-up(1-18 momths), two restenosis occurred. One patient died due to cerebral hemorrhage during thrombolysis with urokinase. CONCLUSION: The stent deployment is relatively safe and very effective primary therapeutic modality and may abolish the limitation of PTA such as suboptimal result, dissection with sudden occlusion and restenosis in peripheral vascular disease and highly recommended in selected cases.
Angioplasty, Balloon ; Aorta ; Arteries ; Atherectomy ; Cerebral Hemorrhage ; Constriction, Pathologic ; Femoral Artery ; Hemodynamics ; Humans ; Iliac Artery ; Inflation, Economic ; Korea ; Peripheral Arterial Disease* ; Peripheral Vascular Diseases ; Prostheses and Implants ; Stents* ; Subclavian Artery ; Urokinase-Type Plasminogen Activator

Myotonic dystrophy is an autosomal-dominantly inherited neuromuscular disorder characterized by slowly progressive muscular dystrophy, muscle weakness and myotonia. The clinical features may vary from just cataracts to involvement of multiple organ systems such as various muscles, heart, lung and intestine. During pregnancy and delivery, serious maternal and obstetrical complications may occur. The myotonia is often aggravated during pregnancy and it leads to obstetrical complications such as fetal loss, preterm premature delivery, hydrops, in-utero fetal death, difficulties in fetal expulsion, postpartum hemorrhage and/or anesthetic accidents. The affected neonate may display severe hypotonia, facial displegia and respiratory distress. This report presents a woman with myotonic dystrophy complicated with congestive heart failure and preterm delivery during pregnancy.
Cataract ; Edema ; Estrogens, Conjugated (USP)* ; Female ; Fetal Death ; Heart Failure* ; Humans ; Infant, Newborn ; Intestines ; Lung ; Muscle Hypotonia ; Muscle Weakness ; Muscular Dystrophies ; Myocardium ; Myotonia ; Myotonic Dystrophy* ; Obstetric Labor, Premature* ; Postpartum Hemorrhage ; Pregnancy*

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