No abstract available.
Angiomyoma ; Ear

No abstract available.
Prurigo

BACKGROUND: The HMG-CoA reductase inhibitor is the most powerful cholesterol lowering drug and lovastatin, simvastatin and pravastatin are used clinically. We studied the efficacy and side effects of pravastatin monotherapy in patients with hypercholesterolemia(type IIa or IIb). METHODS: Patients who showed 12-hours fasting serum total cholesterol level more than 240mg% were enrolled to diet therapy. After 4weeks of diet therapy, serum lipid profiles were checked and the drug therapy was considered according to NCEP guidelines. The pravastatin 5mg po bid was administrated and the patients had regular follow-up every 2weeks for 8week. RESULTS: The total study population was 20 patients and the mean age of them was 55 years old (55+/-18, M : F=6 : 14). There were a few side effects in 5% of study patients and no patient discontinued pravastatin due to side effects.The side effect was G-I trouble and there were not other side effects. Serum CK was elevated in only one patient but the elevation was mild(less than 3 times) and transient. The LFT, serum uric acid, BUN and creatinine level did not show any significant changes during therapy. Among lipid profiles, total cholesterol, LDL-cholesterol and apolipoprotein B level showed significant reduction after therapy and the maximum reduction was achieved after 2week of therapy. The mean reduction was 20%, 33% and 23% respectively. HDL-cholesterol and apolipoprotein A1 11% and 17% respectively. The triglyceride level did not show any changes during therapy but in one type IIb patient, the triglyceride level decreased significantly. CONCLUSIONS: The pravastatin is effective and safe in patients with hypercholesterolemia.
Apolipoprotein A-I ; Apolipoproteins ; Cholesterol ; Creatinine ; Diet Therapy ; Drug Therapy ; Fasting ; Follow-Up Studies ; Humans ; Hypercholesterolemia* ; Lovastatin ; Middle Aged ; Oxidoreductases ; Pravastatin* ; Simvastatin ; Triglycerides ; Uric Acid

No abstract available.
Anemia, Pernicious* ; Osteoporosis*

No abstract available.
Biopsy*

No abstract available.
Hypopigmentation ; Lichens

Stress urinary incontinence is mainly treated by major surgical procedures. Bolstering the urethra with injectable compound is an attractive, although not new, procedure for stress urinary incontinence. Recently it has been popularized to use the autologous fat for injection. A total of 6 women with stress urinary incontinence underwent periurethral injection of autologous fat. Patients' age ranged from 41 to 69 years( mean 55.8). The fat was harvested from the low abdominal wall by liposuction unit. Follow up was 2 to 10 months( mean 6.8). of the patients, 5(83%) are cured, 1 is improved significantly( from Grade III to I). We conclude that the periurethral autologous fat injection is a reliable, safe, low-cost, and high benefit procedure.
Abdominal Wall ; Female ; Follow-Up Studies ; Humans ; Lipectomy ; Urethra ; Urinary Incontinence*

Background: Multiple endocrine neoplasia type I(MEN I) is a rare, eomplex, and potentially lethal disease. In Korean, only five anecdotal cases were reported as yet. The authors rescently experienced four cases of MEN I, and analysed the clinieal characteristics of MEN I in Koreans. Methods: The authors evaluated nine cases of MEN I, retrospectively. Four cases were analysed by clinical records in patients admitted to Asan Medical Center and five cases were reviewed by previously reported Korean literature from 1986 to 1995. Results: The average age was 39 years(ranged from 33 to 59 years). Eight of the nine patients had hyperparathyroidism documented by elevated serum calcium and PTH level with or without evidence of parathyroid mass. Initial presenting manifestations were symptomatic urinary stone, hypoglycernia due to insulinoma, hypogonadism, acromegaly, or peptic ulcer. Eight of nine patients had pancreatic islet cell tumors, and three of them were be malignant by radiologic and/or pathologic findings. The pancreatic tumors produced various hormones, such as gastrin, insulin, glucagon, or combination of them. Six of the nine cases had pituitary lesion. The most cornmon pituitary tumor was prolactinoma and the remaining was GH or GH and TSH producing tumor. In addition to the major components of MEN I, four had adrenocortical hyperplasia or adenoma and two had carcinoid tumor. There was only one familial case. Conclusion: The clinical charateristics of MEN I in Korean are mostly not different from the previous reports except older age at diagnosis, more comrnon adrenal involvement(44%) and gastrointestinal carcinoid tumor(22%). Although only one case was familial, more cases could be found if careful screening were done for the family members of the MBN I patients. In addition, screening and close follow up for endocrine pancreatic tumors are required for MEN I patients without detectable pancreatic lesion becau~se the malignant potential of pancreatic tumors has beeome an increasing concem for the prognosis of MEN I.
Acromegaly ; Adenoma ; Asian Continental Ancestry Group ; Calcium ; Carcinoid Tumor ; Chungcheongnam-do ; Diagnosis ; Follow-Up Studies ; Gastrins ; Glucagon ; Humans ; Hyperparathyroidism ; Hyperplasia ; Hypogonadism ; Insulin ; Insulinoma ; Islets of Langerhans ; Mass Screening ; Multiple Endocrine Neoplasia Type 1 ; Multiple Endocrine Neoplasia ; Peptic Ulcer ; Pituitary Neoplasms ; Prognosis ; Prolactinoma ; Retrospective Studies ; Urinary Calculi

Establishment of a noninvasive diagnostic method to document coronary vasospasm would be useful in the management of the patients with variant angina, especially in the screening of the patients, evaluation of the therapeutic efficacy of the prescribed drugs and determination of the activity of the disease. The present study was performed to clarify the clinical feasibility and diagnostic validity of bedside intravenous ergonovine test and to determine the variables affecting the diagnostic sensitivity of the test. The study group consisted of 59 patients with chest pain in whom diagnostic coronary angiography with intracoronary acetylcholine challenge test for the induction of coronary vasospasm was performed ; 30 patients were proven to have variant angina and 29 patients to have atypical chest pain. Bedside ergonovine test was done one day after the diagnostic coronary angiography and reversible ST segment displacement(elevation or depression) and/or T wave changes in ECG with ergonovine injection was used as the only positive criteria of the test. A bolus of ergonovine maleate(0.025 or 0.050mg) was injected intravenously at 5 minute intervals up to total cumulative dosage of 0.25 mg, and blood pressure and a 12-lead ECG were recorded every 3 minutes after each injection. Intravenous nitroglycerin of 0.25mg was administered for the termination of the test when hypertension(systolic BP>200mmHg), hypotension(systolic BP<90mmHg) or significant arrhythmia was observed. Twenty seven out of 30 patients with variant angina developed chest pain or discomport during the test and among them 22 showed simultaneous reversible ECG changes. In 29 patients with atypical chest pain 11 patients(38%) complained of chest pain or discomport without reversible ECG change during the test, and the overall sensitivity and specificity of the beside ergonovine test were 73% and 100% respectively. The mean cumulative dose of ergonovine which evoked the positive reponse was 117microgram. The patterns of reversible ECG changes of the positive response were variable : 50%(11/22) showed significant ST segment elevation, while ST segment depression(18%) and T wave changes without ST segment displacement(32%) were observed with ergonovine injection. Degree of disease activity of the variant angina, number of spasm-induced vessels and presence of concomitant fixed lesion are important variables affecting the sensitivity of the test. The changes of blood pressure and heart rate were minimal during the test and there was neither significant arrhythmia nor test-related mortality. Thus we concluded that bedside intravenous ergonovine test is a safe, sensitive and highly specific test for coronary vasospasm in selected group of patients with chest pain syndrome. Further study with other methods besides ECG to document myocardial ischemia seems to be necessary for improvement of the sensitivity of bedside ergonovine test.
Acetylcholine ; Arrhythmias, Cardiac ; Blood Pressure ; Chest Pain ; Coronary Angiography ; Coronary Vasospasm ; Diagnosis* ; Electrocardiography ; Ergonovine* ; Heart Rate ; Humans ; Mass Screening ; Mortality ; Myocardial Ischemia ; Nitroglycerin ; Sensitivity and Specificity

With highly active antiretroviral therapy, human immunodeficiency virus (HIV) infection is considered to be a manageable chronic disease. The improved prognosis increases the desire of individuals with HIV to have biological offspring. With the establishment of washing protocol, no HIV transmission has been reported among more than 11,000 assisted reproduction technology (ART) cycles. Although the Acquired Immunodeficiency Syndrome Prevention Act in Korea prevents the use of HIV-infected blood, organs, tissues and semen, we recently obtained the authentic approval from the Korea Centers for Disease Control and Prevention for the practice of ART in HIV-serodiscordant couples. We report a 32-year-old HIV-seronegative female with her husband who was HIV-1 seropositive. After semen washing was performed by means of a density gradient and the swim-up technique, HIV-1 ribonucleic acid was not detected in the semen. An aliquot of processed semen was cryopreserved before ART. None of 3 cycles of intrauterine insemination was successful. After the third frozen-thawed embryo transfer following two cycles of intracytoplasmic sperm injection, an intrauterine singleton pregnancy was identified. She gave birth to a normal healthy male baby at full term by Cesarean section. She and her baby were tested for HIV during pregnancy and after delivery and the results were negative. Semen washing may be a safe ART method for HIV-serodiscordant couples who desire to have a baby in Korea.