Lumbar hernias are rare posterolateral abdominal wall defects that may be congenital or acquired. There are two types of lumbar hernia, the superior lumbar hernia through Grynfeltt triangle, and the inferior lumbar hernia through Petit triangle. Many techniques have been described for the surgical repair of lumbar hernias including primary repair, local tissue flaps, and conventional mesh repair. But these open techniques require a large skin incision. We report a case of superior lumbar hernia, which was successfully repaired using a laparoscopic approach.
Abdominal Wall ; Hernia ; Skin

BACKGROUND: Statistical errors have been noted in a large percentage of articles appearing in medical journals. Their incidence in the Annals of Dermatology and the Korean Journal of Dermatology, however, has not been studied. OBJECTIVE: The purpose of this study was to evaluate the accuracy of statistical methods in the Annals of Dermatology and the Korean Journal of Dermatology. METHOD: Original papers using the t test in the Annals of Dermatology(AD) and in the Korean Journal of Dermatology(KJD) from January 1990 to July 1994 were analyzed for correctness of statistical methods. RESULTS: Of the 376 original papers in the period considered, 78(20.7%) presented t tests and 43(55.1%) of these also contained some errors. Of the 9 papers from the Annals of Dermatology, 4(44.4%) included at least one error. Of the 69 papers from the Korean Journal of Dermatology, 39(56.5%) included at least one error. CONCLUSION: Misuse of statistical methodology may not be uncommon in the two Korean Dermatology journals, and it would be prudent to give more attention to statistical methodology.
Dermatology* ; Incidence ; Methods

BACKGROUND: As co-factors of metalloenzymes, zinc(Zn) and copper(Cu) have a considerable effect on nearly all the metabolism that takes place in organs of the body, including the skin. OBJECTIVE: The purpose of this study was to evaluate zinc and copper status in alopecia areata patients. METHODS: We measured serum levels of zinc and copper in 30 cases of alopecia areata patients and 10 normal individuals by atomic absorption spectrometry. Furthermore, we studied the significance of the ratio between serum levels of the two metals. RESULTS: The serum levels of zinc were significantly lower in alopecia areata patients than in healthy controls. The serum levels of copper were slightly lower in alopecia areata patients than in healthy controls. Ratios of Cu/Zn were slightly higher in alopecia areata patients than in healthy controls. But their differences were not statistically significant. CONCLUSION: We suggest that a serum Zn assay should be included in the chemical assessment of patients with alopecia areata.
Absorption ; Alopecia Areata* ; Alopecia* ; Copper* ; Humans ; Metabolism ; Metals ; Skin ; Spectrum Analysis ; Zinc*

PURPOSE: This study was done to investigate the degree of self-care, family support and depression, and relationship among these variables for elder with diabetes mellitus. METHOD: Participants were 202 diabetic patients, 65 years or over, living in Seoul, Korea. Data were collected using the self-care tool for diabetic patients by Kim (1996), the family support tool for diabetic patients by Park (1984), and Korea\' s BDI scale by Lee (1995). RESULTS: Of the patients, 43.1% showed HbA1c levels than higher 7%. The highest mean score was for self-care for medication compliance, and the lowest for blood glucose testing compliance. Factors affecting self-care were employment, education, HbA1c level, diabetic self-care education and complications. Factors affecting family support were living with family, diabetic self-care education, hospitalization and complications. Factors affecting depression were gender, living with family and complications. All of these factors were significant. Patients experiencing depression were 16.8% of patients. There was a significant positive correlation between self-care and family support, and significant negative correlations between self-care and depression, and family support and depression. CONCLUSION: For more effective management of diabetes mellitus in elders, improvement in self-care compliance, and family support are needed
Aged ; Blood Glucose ; Compliance ; Depression ; Diabetes Mellitus ; Employment ; Hospitalization ; Humans ; Korea ; Medication Adherence ; Self Care

No abstract available.

CT and portographic findings of 63 patients with hepatoma, undergone hepatic angiography and superiormesenteric portography for evaluation of tumor and thrombosis of portal vein and determination of indication oftranscatheter arterial embolization for palliative treatment of hepatoma from April,85 to June, 86 in Hanyanguniversity hospital, were reviewed. The results were as follows: 1. In 36 cases, portal vein thrombosis wasdetected during portography. Nineteen of 37 cases which revealed localized hepatoma in the right lobe of the livershowed portal vein thrombosis; 9 of 11 cases of the left lobe; 8 of 14 cases which were involved in entire liverrevealed thrombosis. One case localized in the caudate lobe showed no evidence of invasion to portal vein. 2.Twenty-four of 34 cases with diffuse infiltrative hepatoma revealed portal vein thrombosis and the incidence ofportal vein thrombosis in this type were higher than in the cases of the nodular type. 3. The portal veinthrombosis appeared as filling defects of low density in the lumen of the portal veins in CT and they did notreveal contrast enhancement. 4. CT revealed well the evidences of obstructions in the cases of portal veinthrombosis and the findings were well-corresponded to the findings of the superior mesenteric portography. 5. Fiveof the cases of the portal vein thrombosis were missed in the CT and the casuses were considered as due to partialvolume effect of enhanced portal vein with partial occlusion or arterioportal shunts. 6. Six of 13 cases withocclusion of main portal vein showed cavernous transformation and they were noted as multiple small enhancedvascularities around the porta hepatis in the CT. According to the results, we conclude that CT is a usefulmodality to detect the changes of the portal veins in the patients of the hepatoma.
Angiography ; Carcinoma, Hepatocellular ; Humans ; Incidence ; Palliative Care ; Portal Vein ; Portography ; Thrombosis ; Veins ; Venous Thrombosis

BACKGROUND: Postoperative pain control in children is a difficult problem for management. Fentanyl is one of the most commonly used narcotics in infants and children due to its rapid onset and brief duration. Infants older than 3 months had a lower incidence of apnea than adults given fentanyl; however, the dosage of fentanyl varies a great deal depending on the purpose and plan for the postoperative management. This study is designed to evaluate the effective dose of intraoperative intravenous fentanyl for pain control following inguinal herniorrhaphy in pediatric patients. METHODS: Sixty children for inguinal herniorrhaphy under general anesthesia were divided into four groups. Group I received no analgesics as a control. Group II, III and IV received intravenous fentanyl 0.5 microgram/kg, 1 microgram/kg and 1.5 microgram/kg respectively. Fentanyl was injected intravenously at the beginning of fascia closure. Extubation time and the degree of pain was evaluated. RESULTS: Our result showed that group III and IV had a lower pain score than that of the control group during the first 30 min in the recovery room (p<0.05), but no significant differences were found between the group III and group IV. The time interval from fascia closure to extubation was prolonged in the group II, III and IV compared to the control group (p<0.05). But no significant differences were found between the three groups. CONCLUSION: We suggest that intravenous administration of fentanyl 1 microgram/kg at the closure of fascia would be an easy, simple and effective means for relieving postinguinal herniorrhaphy pain in recovery room.
Administration, Intravenous ; Adult ; Analgesics ; Anesthesia, General ; Apnea ; Child* ; Fascia ; Fentanyl* ; Herniorrhaphy* ; Humans ; Incidence ; Infant ; Narcotics ; Pain, Postoperative ; Recovery Room

The columnar cell variant of papillary thyroid carcinoma is an aggressive tumor associated with wide spread dissemination and a fatal outcome. We report two cases of columnar cell carcinoma occurring in two women aged 27, 66 years, respectively. The histologic feature of both cases showed focal papillary growth with columnar cell and nuclear stratification. Recognizing the columnar cell variant of the thyroid is important in light of the aggressive nature of the lesion and its apparent resistance to standard therapeutic interventions. These tumors occur over a wide age range, can metastasize widely, and are not usually responsive to radioactive iodine or chemotherapy. The presence or absence of extrathyroidal invasion represents the single most important parameter in predicting the behavior of these tumors. A large series of these tumors is needed to more fully appreciate the clinicopathologic spectrum of this aggressive thyroid neoplasm.
Drug Therapy ; Fatal Outcome ; Female ; Humans ; Iodine ; Thyroid Gland* ; Thyroid Neoplasms*

Gastritis cystica profunda is a rare condition in which mature glandular epithelium extends ino the tissues beneath the muscularis mucosae. It is analogous to similar conditions affecting the small and large intestines that are called, enteritis and colitis cystica profunda. Macroscopically, gastritis cystica profunda may present not only as a submucosal tumor or as solitary or diffuse polyps, but also as a giant gastric mucosal fold rarely These lesion have been found not only at the site of a gaatroenterostony but also in the stomach of patients without previous surgery. We present herein a patient having gastritis cystica profunda without any previous surgery, in which it present as a giant gastric mucosal fold.
Colitis ; Enteritis ; Epithelium ; Gastritis* ; Humans ; Intestines ; Mucous Membrane ; Polyps ; Stomach

Multiple myeloma is a disease originated from plasma cell line. A single protein is generally produced by myeloma cells, but a few cases of biclonal gammopathy are reported. We experienced a case of multiple myeloma, a 53-year-old woman, with IgG and IgA biclonal gammopathy. She has maintained in complete remission after 6 cycles of combination chemotherapy with cyclophosph- amide, vincristine, adriamycin, and prednisolone.
Doxorubicin ; Drug Therapy, Combination ; Female ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Middle Aged ; Multiple Myeloma* ; Plasma Cells ; Prednisolone ; Vincristine