Etretinate is a synthetic retinoic acid which has been reported effective in hyperkeratotic disorders. Recently, it has also been tried, on a limited number, for the treatment of viral wart. A 33-year-old male patient presented with multiple, tender, confluent, verrucous lesions on the scalp, both hands and feet of 4 years duration. Before coming to us, he had been treated with intralesional injection of bleomycin and electrodesiccation with little effect. We started etretinate therapy in a daily dose of 70mg(1mg /kg). After 3 weeks treatment, most of his skin lesions were flattened and softened: but an abrupt elevation of serum aminotransferases was noticed, which was normalized soon after cessation of medication. Unfortunately, the drug stop page aggravated most of skin lesions. After two weeks of withdrawal we started again the drug in a daily dose of 30mg and observed a good response without hepatic dysfunction.
Acitretin* ; Adult ; Bleomycin ; Etretinate* ; Foot ; Hand ; Humans ; Injections, Intralesional ; Male ; Scalp ; Skin ; Transaminases ; Tretinoin ; Warts*

A clinical review of 31 cases of multiple myeloma which were diagnosed by criteria of the SWOG between May 1983 and February 1990 at Yeungnam University Hospital was done. The results were as followings: 1. The peak incidence was in 7th decade and male to female ratio was 1.8:1. 2. The most common presenting symptom at first diagnosis was bone pain (58%), but fever, dyspnea, dizziness and palpable mass were also noted. 3. The distribution of laboratory findings as following diagnostic criteria of Southwest oncology group (SWOG): Plasmacytoma on tissue biopsy was noted 6 cases, bone marrow plasmacytosis with more than 10% plasma cells was 22 cases, monoclonal globulin spike on serum electrophoresis was 24 cases, lytic bone lesions was observed 22 cases. 4. Initial clinical stages were classified as 2 cases in stage I, 3 cases in stage II, 26 cases in stage III (84%). 5. Immunoelectrophoresis revealed the distribution of IgG 64%, light chain 22%, IgA 10%, Kappa to Lambda ratio of 1.1:1. 6. Hematologic & biochemical findings revealed anemia with <8.5% of hemoglobin in 42%, hypercalcemia with <10.6 mg% of serum calcium in 22%, azotemia >2.0 mg% of serum creatinine in 19%. 7. The multiple punched out lesion of bone x-ray examination were noticed skull (65%), rib (42%), L-spine (35%), pelvis (23%), T-spine (19%). The initial skeletal roentgenographic findings showed osteoporosis, osteolytic lesion and fracture in 55%, only osteolytic lesion in 23%, only osteoporosis in 10%. 8. Complications of multiple myeloma, such as 10 cases of renal impairment, 8 cases of infection, 16 cases of compression fracture of spine were observed.
Anemia ; Azotemia ; Biopsy ; Bone Marrow ; Calcium ; Clinical Study* ; Creatinine ; Diagnosis ; Dizziness ; Dyspnea ; Electrophoresis ; Female ; Fever ; Fractures, Compression ; Humans ; Hypercalcemia ; Immunoelectrophoresis ; Immunoglobulin A ; Immunoglobulin G ; Incidence ; Male ; Multiple Myeloma* ; Osteoporosis ; Pelvis ; Plasma Cells ; Plasmacytoma ; Ribs ; Skull ; Spine

Actinomycosis is a chronic suppurative and granulomatous bacterial infection characterized by contiguous spread, abscess formation and sinus tract formation. There are four clinical forms according to the lesional site, as 1) cervicofacial, 2) thoracic, 3) abdominal, and 4) disseminated form. Recently, we experienced a case of 54 year-old patient with left mandibular actinomycosis. The pathognomonic findings of actinomycosis is sulfur granule with multiple filaments in Gram-stain and the treatment of actinomycosis is surgical excision of mass or sinus tract with massive antibiotics (esp. Penicillin) therapy for 6 to 12 months.
Abscess ; Actinomycosis* ; Anti-Bacterial Agents ; Bacterial Infections ; Humans ; Penicillins ; Sulfur

No abstract available.
Multiple Myeloma* ; Pleural Effusion*

The purpose of this study was to confirm the anti-tumor activity of an ethanol extract of Saussurea laniceps against pancreatic tumor and to isolate the active compound from S.laniceps extract. Treatment with S.laniceps extract and hispidulin inhibited proliferation of pancreatic cell lines, such as Capan-1, Capan-2, Panc-1 and S2-013 in a dose-dependent manner using the hollow fiber assay. Hispidulin showed typical hallmarks of apoptotic cell death a significant anti-tumor activity on Capan-2 cells at a dose of 100 mg/kg and 200 mg/kg. S.laniceps has potential cytotoxic and apoptotic effects on human pancreatic carcinoma cells. Its mechanism of action might be associated with the apoptotic cell death through DNA fragmentation.
Adenocarcinoma* ; Cell Death ; Cell Line ; DNA Fragmentation ; Ethanol ; Humans ; Pancreas* ; Saussurea*

No abstract available.
Dermatitis, Atopic ; Pyroglyphidae

The methodological and statistical validity of 382 original articles published in the Journal of the Korean Medical Association, from January 1980 to December 1989 was reviewed by the author-devised c heck list consisting of 21 items (14 items for methodological validity and 7 items for methodology, and of 297 articles using statistical analyses a total of 290 articles (97.6%) were found to contain at least one error in statistical methods used. The mean and standard deviation of 'validity score of one article', defined as the total number of valid items devided by the total number of applicable items and then multiplied by 100, were 43.8 and 15.2, respectively. The distribution of validity score was as follows ; over 60 (57 articles, 14.9%), 30 to 59 (266 articles, 69.6%), and under 30 (59 articles, 15.5%). The proportion of articles, of which validity score was over 60, was significantly higher in descriptive study (19.4%) than in analytic study (8.4%, p = 0.003). Also the articles of over 60 in validity score were more frequent in survey (15.9%) than in experiment (8.2%), and in cross-sectional study (16.8%) than in longitudinal study (10.6%), but this finding was not statistically significant. The averaged validity score of two year period was highest in 1984-1955 (50.24), and lowest in 1986-1987 (38.85). There was no significant time trend of the averaged validity score over 10 years(p>0.1). These results suggest that medical articles published in Korea, 1980-1989, were short of their expected quality, and there have been no evidence of improvement with time. It is concluded that a basic training in biostatistical methods in the medical postgraduates and residencies, more consultation of medical investigators with statistician or other experts, and careful review by someone knowledgeable in biostatistics or research design before accepting a manuscript are needed. In addition, refutation should be allowed for the controversial point through the journal.
Biostatistics ; Cross-Sectional Studies ; Humans ; Internship and Residency ; Korea* ; Longitudinal Studies ; Research Design ; Research Personnel

It is necessary for medical readers or reviewers to assess critically the methodological and statistical validity of medical articles before accepting their results or conclusion. The authors develope d a validity-assessing checklist of 21 items. Among them 14 items for methodological validity included the followings : clear statement of research hypothesis or specific aims, suitable focus, definition of study population (or subjects), eligibility criteria, exclusion criteria, appropriateness of samples, description of methods in detail, desconclusion of accuracy, description of reliability, presence of control, susceptability bias, performance bias, detection bias, transfer bias. The last 5 items are applicable only to analytic study. And 7 errors to statistical validity : incomplete description of basic data, statistical test performed yet not defined, incomplete description of power or confidence interval, inadequate description of measures of central tendency or dispersion, incorrect analysis, multiplicity on hypothesis testing, unwarranted conclusion. The first 3 items are 'errors of omission', and the other are 'errors of commission'. The authors suggest the checklist be very helpful, but not perfect. Critical mind is needed, which enables someone to distinguish minor errors from major fallacies.
Bias (Epidemiology) ; Checklist*

Beta-fluoroethylacetate has been extensively used as the rodenticide in Korea. In some patients with acute poisoning, beta-fluoroethylacetate caused cerebellar dysfunction as a single and persistent neurologic sequela after a period of an acute neurological disorder which is characterized by mental deterioration, seizures, and respiratory failure. But there has been no report of pathological findings to explain neurological deficit. We tried to verify the histologic changes of the central nervous systems in beta-fluoroethylacetate poisoned rats. Silver staining(Gallyas) was used to evaluate the histology. In acute intoxication experiment with LD50(7mg/Kg), beta-fluoroethylacetate elicited acute onset of consciousness deterioration, generalized tonic-clonic seizures and large amplitude tremulous activity involving whole body with full recovery after 24 hours. There was no discernible pathologic change in CNS in acutely poisoned rats. However, when poisoned with sublethal dose(5mg/Kg) daily for five days, a moderate degree of nerve cell degeneration was found selectively in dentate nucleus, Purkinie cell layer, vestibulo-cochlear nucleus and striatum. This change was not seen in hippocampus, cerebral cortex or cerebellar cortex. These findings were well correlated with the previous reports of selective pathology in human 5-FU intoxication cases. Our preliminary results suggest that beta-fluoroethylacetate, a kind of cellular metabolism inhibitor may induce selective neuropathology mainly involving cerebellar output pathway in rats.
Humans ; Rats ; Animals ; Poisons

No abstract available.
Arm* ; Dyskinesias* ; Hand* ; Multiple Sclerosis*