No abstract available.
Kidney Transplantation*

Prurigo pigmentosa is a chronic pruritic inflammatory dermaoss characterized by erythematous papules in a reticulated pattern that resolve leaving a reticulated, mottled hyperpigmentation. Most cases have been reported from Japan. Two cases of prurigo pigmentosa have been reported in Korean women. We experienced a casc of prurigo pigmentosa in a Korean man of 20 years of age. Histopathological findings of reddish papule showed exocytosis, sponsiosis, intraepidermal vesicles, hydropic degeneration of basal cells in the epidermis, and hyphohistiocytic infiltration in the upper dermis. Direct irnmunofluorescence was negetive. Therapy with dapsone, 50 mg given daily, resulted in a rerinable regression of the reddish papules. The daily dose of clapsone was reduced to 25mg; however, no new reddish, pruritic papules have appeared.
Dapsone ; Dermis ; Epidermis ; Exocytosis ; Female ; Humans ; Hyperpigmentation ; Japan ; Prurigo*

PURPOSE: To determine the CT findings of immediately postoperative complications including anastomoticleakage, and to evaluate the usefulness of CT scan in the assessment of early postoperative complications ofpylorus preserving Whipple pancreaticoduodenectomy (PPPD) MATERIALS AND METHODS: During the early postoperativeperiod, fluid accomulated in the abdominal cavity of ten of 23 patients who had undergone PPPD. In all cases, thetime interval between the first follow up CT scan and surgery was no more than two weeks. At each leakage site, wecompared CT findings with those of conventional fluoroscopic studies: upper gastrointestinal studies with oralwater-soluble contrast materials, a contrast injection study via drainage catheters in place in the stomach, thesite of choledochojejunostomy during surgery and pancreaticojejunostomy, and nine cases of sinogram viapercutaneous drainage catheters. We also evaluated CT findings of the locations, amounts, and margin of the fluidcollections. If conventional fluoroscopic studies showed no evidence of anastomotic leakage, as was the case withsix patients, the leakage site was determined on the basis of clinical and laboratory data. In four of the six,this was found to be the site of pancreaticojejunostomy, and in the other two, an abscess without anastomoticleakage. RESULTS: Eight patients showed intra-abdominal fluid collections due to leakage at anastomotic sites: infive, this was the site of pancreaticojejunostomy, and in three, that of choledochojejunostomy. One patient showeda right subphrenic abscess, and another, a loculated fluid collection between the jejunal loops, without leakageat the anastomotic site. CT scans in all three cases with leakage at the site of choledochojejunostomy showed thesmall collection of fluid to be relatively well demarcated and confined to the areas of lesser sac or gallbladderbed. In four of five cases of leakage at the site of pancreaticojejunostomy, the large collection of fluid waswidespread; it occupied areas which included the perihepatic and peripancreatic space, as well as the paracolicgutters and pelvic cavity. CONCLUSION: In some cases of suspected complications arising after PPPD, and includinganastomotic leakage and abdominal abscess, leakage is not revealed by conventional fluoroscopic studies; in suchcases, CT scanning may help detect the complications and determine the site of anastomotic leakage.
Abdominal Abscess ; Abdominal Cavity ; Abscess ; Anastomotic Leak ; Catheters ; Choledochostomy ; Contrast Media ; Drainage ; Follow-Up Studies ; Humans ; Pancreaticoduodenectomy* ; Pancreaticojejunostomy ; Peritoneal Cavity ; Postoperative Complications* ; Stomach ; Subphrenic Abscess ; Tomography, X-Ray Computed

Leukemia, the most common malignant disease in the pediatric field, is one of the most interesting targets ofmodern medical research. So we reviewed the bone changes in 51 patients of leukemia admitted to the Dept. ofPediatrics Jeonbug National University Hospital for 5 years from Jan. 1st 1977 to Dec. 31st 1981. The results wereas follow. The male patient was more prevalent with sex ratio male to female 2.7:1, and the highest incidence wasnoticed between 2 years and 4 years of age (23.5%) and followed by between 6 years and 8 years of age (21.6%).Acute lymphocytic leukemia occurred in 62.7%(32 cases) and acute myelocytic leukemia in 33.3%(17 cases), chronicmyelocytic leukemia in 2%(1 case), acute monolcytic leukemia in 2%(1 case). The most common symptoms and signs onadmission was fever (56.9%), and followed by lymphadenopathy(52.9%), hepatosplenomegaly (49.0%) in order ofincidence. The most common chief complaint on admission was fever (39.2%), and followed by pallor (37.3%), andgeneralized malaise (25.5%). The patients with hemoglobin value under 4.0m% occupied 21.6% and about two thirdsshowed hemoglobin less than 8.0m%. The leukocyte counts on admission between 5,000 and 1,10,000/mm3 was noticed in6 cases(11.85) and lower than 5,000/mm3 in 8 cases (15.7%). In the chest X-ray the most common osseous change wasmetaphseal band of humerus in 24 cases (47.1%) , and followed by metaphseal cortical scalloping of upper humerusin 39.2%, osteolytic change in 31.4% periosteal reaction in 7.8%, osteosclerosis in 2%. The most common extraosseous change in chest P-A was mediastinal widening with hilar lymphadenopathy in 1.4% and followed by pulmonary infiltration in 29.4%, pleural reaction in 5.9%. The twelve cases in which hematologic changes weremild, showed radiologic abnormalities in 10 cases (83%), and the 39 cases in which hematologic changes were severe, showed radiologic abnormalities in 31 cases(79%). Especially, In hematologic mild group, showed metaphyseal cortical scalloping of proximalhumerus in 5 cases (41 %), and in hematologic severe group, showed metaphyseal cortical scalloping of proximal humerus in 15 cases (40%). 50 metaphyseal contical scalloping of proximal humerus may be the key finding on detection of early childhood leukemia. The osseous changes were noticed in 75% of ALL, and 47% of AM L, and the extraosseous changes were noticed in 60% of ALL, and 47% of AML.
Female ; Fever ; Humans ; Humerus ; Incidence ; Jeollabuk-do ; Leukemia ; Leukemia, Lymphoid ; Leukemia, Myeloid, Acute ; Leukocyte Count ; Lymphatic Diseases ; Male ; Osteosclerosis ; Pallor ; Pectinidae ; Sex Ratio ; Thorax

Argon laser iridotomy is at present the procedure of choice in Korea for the treatment of pupillarx block and angle closure glaucoma. However, despite modified argon laser techniques, difficulties in penetration of irides and closure of hole have been widely reported. Recently reported Q-switched Nd-YAG laser iridotomy have a many complications such as bleeding, lenticular opacity and small hole. And so argon laser and Nd-YAG laser combined iridotomy was performed on 80 eyes, 57 patients with angle closure glaucoma. The follow up period ranged from 1 to 14 months. 71(88.7%) of 80 eyes treated required a single lasing session for patency, and six eyes required two sessions and three eyes required three sessions. Closure of the iridotomy site occurred in 6.2% of eyes, an incidence remarkably lower than that of argon laser iridotomy alone. Localized lenticular opacity and bleeding were not observed, but immediate postoperative iritis and elevation of intraocular pressure were observed.
Argon* ; Follow-Up Studies ; Glaucoma, Angle-Closure ; Hemorrhage ; Humans ; Incidence ; Intraocular Pressure ; Iritis ; Korea ; Lasers, Solid-State*

Argon laser iridotomy is at present the procedure of choice in Korea for the treatment of pupillarx block and angle closure glaucoma. However, despite modified argon laser techniques, difficulties in penetration of irides and closure of hole have been widely reported. Recently reported Q-switched Nd-YAG laser iridotomy have a many complications such as bleeding, lenticular opacity and small hole. And so argon laser and Nd-YAG laser combined iridotomy was performed on 80 eyes, 57 patients with angle closure glaucoma. The follow up period ranged from 1 to 14 months. 71(88.7%) of 80 eyes treated required a single lasing session for patency, and six eyes required two sessions and three eyes required three sessions. Closure of the iridotomy site occurred in 6.2% of eyes, an incidence remarkably lower than that of argon laser iridotomy alone. Localized lenticular opacity and bleeding were not observed, but immediate postoperative iritis and elevation of intraocular pressure were observed.
Argon* ; Follow-Up Studies ; Glaucoma, Angle-Closure ; Hemorrhage ; Humans ; Incidence ; Intraocular Pressure ; Iritis ; Korea ; Lasers, Solid-State*

No abstract available.
Granuloma, Lethal Midline*

To investigate the effect of endothelin on intracellular free calcium ([Ca(2+)]i) mobilization and the existence of the endothelin receptor in cultured bovine corneal endothelial cells(BCEC), endothelin-1(ET-1) -induced [Ca(2+)]i increase was measuredby using calcium sensitive indicator, fura-2/AM, and the studies on its desensitizaton and receptor antagonists were also performed. ET-1 increased [Ca(2+)]i in a concentration-dependent manner(10(-9)M-10(-5)M) and ET-1 -unduced [Ca(2+)]i transient increase was significantly ingibited (~50%) by the pretreatment with EGTA for 1 min. Similarly, neomycin also attenuated ET-1 -unduced [Ca(2+)]i transient increase in a concentration-dependent mannet. Desensitizatin study with successive treatment of ET-1 and ET-3, and the experiments of antagonists(BQ-610 for the ET(A) receptor and BQ-788 for the ET(B) receptor) showed the presence of ET(B) receptor in BCEC. In addition, ET-1(10(-6)M) accumulated inositol trisphosphate about two folds (310+/-6.8 cpm) comparing to control(154+/-11.6 cpm) and this accumulation was significantly inhibited by the treatment with neomycin (187+/-28 cpm). These results suggest that endothelin-induced calcium mobilization is receptor-mediated response and TE(B) receptor exists in BCEC.
Calcium* ; Egtazic Acid ; Endothelins ; Endothelium, Corneal* ; Inositol ; Neomycin ; Receptors, Endothelin

A 62-year-old male with a smoking history of 30 pack-years presented with a 1-year history of a periumbilical pulsating mass. He had been treated for hypertension for 2 years. Physical examination revealed a huge pulsating mass in the periumbilical abdomen. Femoral and popliteal arterial pulses were palpable. Computed tomography showed arterial dissection in the proximal segment of the superior mesenteric artery, a huge aneurysm (52×50 mm) with mural thrombus and two smaller aneurysms (20×20 mm) in the right ileocolic and ileal branches, along with atherosclerotic changes. Interposition using the great saphenous vein was performed after aneurysmal isolation and ligation of jejunal branches in the sac. Distal flow was reestablished by end-to-end and end-to-side anastomoses of the right ileocolic and ileal branches, respectively. No complications were observed at 1-year follow-up.
Abdomen ; Aneurysm* ; Aortic Aneurysm, Abdominal* ; Follow-Up Studies ; Humans ; Hypertension ; Ligation ; Male ; Mesenteric Artery, Superior* ; Middle Aged ; Physical Examination ; Saphenous Vein ; Smoke ; Smoking ; Thrombosis

Stroke is a leading cause of disability in the elderly. Among complications of stroke, musculoskeletal problems are common, thereby causing improper gait biomechanics, development of pain, and limitation in performing activities of daily living. Post-stroke hip fractures and greater trochanteric pain syndrome are common complication near hip joint. Knee osteoarthritis can be accelerated by altered biomechanics of post-stroke period, that is associated with ambulation levels. Stiff knee gait and genu recurvatum can be developed after stroke and usually contribute to abnormal gait patterns, due to weakness or spasticity of various muscles, and they need to control or compensate affected muscle activities. In case of ankle and foot problems, foot varus deformity is caused by imbalance between muscles that control ankle movement, while claw toes and the persistent extension of the great toe are mainly due to overactivity of muscles that moves toes, and mainstay of treatment is to control inappropriate activities of affected muscles. It is important to make the exact therapeutic decision and establish the rehabilitation plan through the early evaluation of lower extremity musculoskeletal problems that affect the mobility and ambulation.
Activities of Daily Living ; Aged ; Ankle ; Congenital Abnormalities ; Femur ; Foot ; Gait ; Hammer Toe Syndrome ; Hip Fractures ; Hip Joint ; Humans ; Knee ; Lower Extremity* ; Muscle Spasticity ; Muscles ; Osteoarthritis, Knee ; Rehabilitation ; Stroke* ; Toes ; Walking