No abstract available.
Multiple Endocrine Neoplasia Type 2a* ; Multiple Endocrine Neoplasia*

No abstract available.
Multiple Endocrine Neoplasia Type 2a* ; Multiple Endocrine Neoplasia*

PURPOSE: Chronic lymphocytic leukemia (CLL) is the most common form of leukemia in western countries but it has been reported rarely in Korea. The purpose of this study was to evaluate the clinical characteristics, treatment responses and prognosis of the patients with CLL. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 17 patients with CLL diagnosed at the Catholic University of Taegu-Hyosung & Kyungpook National University Hospital from Jan. 1986 to Mar. 1996. RESULTS: There were 9 males and 8 females and the mean age was 55 years. The majority of patients had systemic symptoms (77%) and advanced clinical stage (Binet stage C, 70%) at the time of diagnosis. The bone marrow histology was reviewed in 13 cases and patients were subdivided into those with a diffuse (9cases) and nondiffuse (4cases) pattern of bone marrow histology. In patients with advanced clinical stage, diffuse pattern was predominated and showed poor survival. 14 patients were treated with chlorambucil/steroid or combination chemotherapy. Among the 13 evaluable patients, 1 (8%) achieved a complete response and 7 (54%) achieved partial responses, and median survival duration was 18months. 11 patients died after 2~18 months of follow-up and infection was the main cause of death. CONCLUSION: Poor prognostic factors, such as high blood lymphocyte counts, diffuse bone marrow involvement pattern & advanced clinical stage, are common in our patients at presentation & showed poor survival.
Bone Marrow ; Cause of Death ; Diagnosis ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Gyeongsangbuk-do ; Humans ; Korea ; Leukemia ; Leukemia, Lymphocytic, Chronic, B-Cell* ; Lymphocyte Count ; Male ; Medical Records ; Prognosis ; Retrospective Studies

The authors carried out the funduscopic examination in 53 cases of leukemia (acute myeloblastic leukemia 17, acute lymphoblastic leukemia 2.0, acute monocytic leukemia 9, chronic myelogenous leukemia 5, acute progranulocytic leukemia 2) and 51 cases of various anemias (aplastic anemia 37, iron deficiency anemia, secondary anemia due to bleeding 4, miscellaneous 4) which were confirmed by hematological studies at Kyung-Pook National University Hospital from October 1969 to October 1975. The following results were obtained. 1) Of 53 cases of leukemia, 62% revealed retinopathy with retinal homorrhage. In 65% of 17 cases of acute myeloblastic leukemia, 55% of 2.0 cases of acute lymphoblastic leukemia, 77 % of 9 cases of acute monocytic leukemia, and 4.0% of 5 cases of chronic myelogenous leukemia, retinopathies were noted. 2) Of 51 cases of anemia, 45% revealed retinopathy with retinal hemorrhage. In 49% of 37 cases of aplastic anemia, and 33% of 6 cases of iron deficiency anemia, retinopathies were noted, but none of secondary anemia due to blood loss had retinal hemorrhage. 3) Acute leukemia had more retinal hemorrhage frequency than chronic leukemia. 4) The extent of the retinal hemorrhages seemed to parallel the severity of the anemia in aplastic anemia. 5) Generally the thrombocytopenia was noted in the aplastic anemia but the extent of the retinal hemorrhages not seemed to parallel the severity of the thrombocytopenia. 6) The extent of the retinal hemorrhages seemed to parallel the severity of the anemia in iron deficiency anemia. 7) Specific retinal pictures could not be noted in the various blood dyscrasias. 8) With the retinal pictures, no differentiation on type of the leukemia and the anemia could be noted.
Anemia* ; Anemia, Aplastic ; Anemia, Iron-Deficiency ; Granulocyte Precursor Cells ; Hemorrhage ; Leukemia* ; Leukemia, Monocytic, Acute ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid, Acute ; Leukemia, Promyelocytic, Acute ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Retinal Hemorrhage ; Retinaldehyde ; Thrombocytopenia

PURPOSE: As a baseline study for clinical application, we investigated MRI findings of normal cruciate ligaments in the knee being flexed as compared to those in the knee being extended. MATERIALS AND METHODS: Seven asymptomatic volunteers were studied. Knee MRI was performed with a 1.5 Tesla unit using a dual 3 inch coil. Inthe decubitus position, sagittal scanning was performed with the knee in extension, and subsequently, in flexion. We observed the shape and signal intensity of both cruciate ligaments, and measured the angles between the longaxis of the femur and ligaments, and the ligament dimensions in extension and flexion images. RESULTS: As flexionand extension images were compared, cruciate ligaments differed both in their appearance and dimensions. With flexion, joint space was widened, PCL became straightened and the signal intensity of ACL became homogeneously low; both cruciate ligaments became longer and thinner. These MRI findings were statistically significant except forthinning of PCL. CONCLUSION: MRI appearance and the dimensions of cruciate ligaments were different in the flexed knee as compared to those in the extended knee.
Femur ; Joints ; Knee* ; Ligaments* ; Magnetic Resonance Imaging* ; Volunteers

No abstract available.
Lymphoma*

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is highly prevalent in hospitals in Korea. The overall rate of MRSA in hospitals in Korea was estimated over 60%. Recently hospital infections caused by MRSA are getting increased and problematic in Korea, Our hospital Seoul Paik Hospital, has been trying to solve this problem. We had not applied exact methods for hospital infection control. Therefore, we adapted strict methods under the control of hospital infection control committee (HICC) and assessed the effectiveness of these methods. METHODS: Every month, the number of MRSA isolates was collected and analyzed; the results of the analysis were reported to every ward. All wards were supplied with Microshild(R) (Johnson & Johnson, Australia), Clean N' Fresh(R) (Carroll, USA), and standard paper towels. Health care workers were regularly educated for hospital infection control. The use of antibiotics was controlled by the HICC. We compared MRSA isolation rate between before and after applying the strict infection control methods under the regulation of HICC. Mann-Whitney U test, one-way ANOVA, and Chi-square test were used for statistical analysis of the results. RESULTS: After restricting the uses of antibiotics, glycopeptides and carbapenems were prescribed 15% less (20.3 vs 17.3 DDD /1000 patient-days) and 35% less (9.3 vs 6.0 DDD /1000 patient-days) respectively, compared to before restricting antibiotics. Methicillin resistance rate was decreased from 78% to 69% compared to before the methods(p=0.02). The isolation rate of MRSA was reduced by 31-42% from 2.33 to 1.35-1.60/1000 patient-days compared to before adapting strict infection control methods (p=0.04-0.07). CONCLUSION: This study showed that applying the strict infection control methods in the hospital can be effective to reduce the isolation rate of MRSA.
Anti-Bacterial Agents ; Carbapenems ; Cross Infection* ; Delivery of Health Care ; Dichlorodiphenyldichloroethane ; Glycopeptides ; Infection Control ; Korea ; Methicillin Resistance ; Methicillin* ; Methicillin-Resistant Staphylococcus aureus ; Seoul ; Staphylococcus aureus* ; Staphylococcus*

BACKGROUND: Acquired idiopathic sideroblastic anemia (AISA) is a heterogeneous condition. Most instances, involving only the erythroid line, are benign disease with a longer survival and a low propensity for evolution into acute leukemia. A subset of patients have severe clinical course and evidence of other cell line involvement at presentation, may develop the emergence of blast cells and evolution into acute leukemia. In an attempt to identify the natural history and the risk factors for the development of acute leukemia, the clinical, hematological and outcome data were studied in the patients with AISA. METHODS: We reviewed retrospectively the medical records of 15 patients of AISA treated at the Catholic University of Taegu-Hyosung and Kyungpook National University Hospital from March 1989 to December 1995. RESULTS: The median age at diagnosis was 41 years and the male to female ratio was 8 : 7. On bone marrow examination, erythroid abnormalities were prominent in all cases, 5 patients also showed involvement of the granulocytic and/or megakaryocytic cell lines (AISA with myelodysplastic features, AISA-M). The median follow-up duration was 32 months. Transfusion dependence occurred in 11 of 16 cases. Progression towards refractory anemia with excess of blasts or acute leukemia (M2) was observed in two patients with AISA-M after follow-up period of 16 months and 24 months, respectively. Infections and hemorrhages were causes of death in 3 patients with AISA-M but not in patients with dyserythropoiesis only (AISA-erythroid, AISA-E). CONCLUSIONS: Most patients with AISA have a relatively benign course with prolonged survival after the onset of anemia. Patients with features of dysgranulopoiesis and/or dysmegakaryopoiesis in addition to dyserythropoiesis at presentation were increased risk of transformation to refractory anemia with excess of blasts or acute leukemia and shorter surtival. But further study of larger numbers of patients and longer follow-up may be warranted.
Anemia ; Anemia, Refractory, with Excess of Blasts ; Anemia, Sideroblastic* ; Bone Marrow Examination ; Cause of Death ; Cell Line ; Diagnosis ; Female ; Follow-Up Studies ; Gyeongsangbuk-do ; Hemorrhage ; Humans ; Leukemia ; Male ; Medical Records ; Natural History ; Retrospective Studies ; Risk Factors

BACKGROUND: Onychomycosis, especially toenail onychomycosis has become one of the common fungal infection and has historically been regarded as a cosmetic rather than medical problem by many patients, even by physicians. Recently, however, there are several reports that this is a refractory disease which may cause a deleterious effect on patients' quality of life (QOL). OBJECTIVE: The purpose of this study was to investigate the impact of toenail onychomycosis on QOL in Korea and to assess the changes of QOL after treatment. METHODS: Total 1004 patients with toenail onychomycosis which was confirmed by clinical findings and KOH preparation were enrolled at 47 dermatologic centers in Korea, and interviewed with standardized QOL questionnaire before and after systemic antifungal treatment. Responses to the questionnaire were scored by f-point scale (0~4) and averaged, and were analyzed for 5 dimensions of emotional impact, social impact, symptom and functional impact, patients' views concerning treatment, and relationship with doctor. RESULTS: 1. Before and after treatment, the most serious impact was emotional dimension showing 1.90 and 1.30 in average score (AS), and social (AS: 1.14 and 0.83) and symptom and functional impact (AS: 1.05 and 0.92) was also affected. 2. In female rather than male, statistically more significant impact on patients' QOL was observed in all dimensions. 3. After treatment, 3 of 5 dimensions were improved significantly - emotional dimension (AS: from 1.90 to 1.30), social dimension (AS: from 1.14 to 0.83), patients' view concerning treatment(AS: from 1.34 to 1.02) 4. The degree of patients' satisfaction at the therapeutic effect was very high - 62.4% (immediately after. treatment) and 65.8% (9 months after initiation of treatment) of patients answered excellent or good. CONCLUSION: This study confirms that toenail onychomycosis has significant Impact on the overall QOL of patients. Also the effect of antifungal therapy on patients' QOL were satisfactory. Therefore, both doctor and patient should pay more attention to the treatment of onychomycosis.
Female ; Humans ; Korea* ; Male ; Nails* ; Onychomycosis* ; Quality of Life* ; Social Change ; Surveys and Questionnaires