Subsepsis allergica's main characteristics are high intermittent fever, irregular recurring exanthemata of different types, neutrophil leukocytosis, increased sedimentation rate, negative culture, no demonstrable cause and good prognosis. This disease usually oecurs in children under age of fifteen. We had opportunity to observe a case in 30 year-old fernale presenting most of the above mentioned charactristics and presumably belonging to this disease entity. Other fever producing diseases were excluded by clinical featuree, serologic tests and skin biopsy. It was treated by antibiotics and salicylate without effect, but it responded to corticosteroid.
Adult ; Anti-Bacterial Agents ; Biopsy ; Child ; Fever ; Humans ; Leukocytosis ; Neutrophils ; Prognosis ; Serologic Tests ; Skin

The effectiveness of Sulfobenzylpenicillin in the treatment of urinary tract infection was evaluated in the Department of Urology, Seoul National University Hospital during the period from May to November, 1973. Our clinical study was performed on the 28 patients who visited the outpatients clinic and admitted to the ward. These patients were studied by bacterioscopy with Gram's method of staining. and culture in blood agar plate and chocolate agar plate In this studies. the causative organisms were divided into 8 groups; E. coli (5), coagulase positive staphylococcus (5), pseudomonas (2), Corynebacterium spp. (1), a-hemolytic etreptococcus (2), N. Gonorrheae (10), Proteus (2) and KIebsiella (1). The dosage schedule was 1 gm. of Sulfobenzylpenicillin at intervals of 12 hours for consecutive 5 days in gonococcal urethritis and nongonococcal urethritis. But in upper urinary tract infections and post-operative infections, it lasted for 7 to 10 days or more. And following results were obtained. Effectiveness on Urological diseases 1) Gonococcal urethritis; Satisfactory clinical results were obtained with Sulfobenzylpenicillin for five days. Results were excellent in 5 cases, good in 4 cases and negative effect in 1 case. 2) Non-gonococcal urethritis; In this group, the therapeutic results were favorable in 90% of all cases. (excellent-4, good-5, fail-l) 3) Urethral stricture and fistula (2 cases); AII cases were responded to the Sulbenicillin. 4) Cystitis including Prostatism; Two of three cases were caused by E. coli and they had a good response to sulbenicillin. 5) Two cases of pyelonephritis and two cases of postoperative infections were studied with sulbenicillin and more than 60% of cases were effective with sulbenicillin. Side effects were not remarkable but in a few cases who received intramuscular injection, pain on the injection site was noticed.In summary, this new semi-synthetic penicillin is considered to be a useful chemotherapeutic weapon against a variety of infection in the urological field including those due to Gram negative bacilli such as pseudomonas and proteus sp.
Agar ; Appointments and Schedules ; Cacao ; Coagulase ; Corynebacterium ; Cystitis ; Fistula ; Gonorrhea ; Humans ; Injections, Intramuscular ; Outpatients ; Penicillins ; Prostatism ; Proteus ; Pseudomonas ; Pyelonephritis ; Seoul ; Staphylococcus ; Sulbenicillin ; Urethral Stricture ; Urethritis ; Urinary Tract Infections* ; Urinary Tract* ; Urologic Diseases ; Urology

BACKGROUND: Despite concern about prevention of dermatophytosis, little is known about the survival period of dermatophytes. OBJECTIVE: The purpose of the study was to investigate the survival period of dermatophytes according to various environmental conditions. METHODS: Scales for testing were collected from skin lesions of 25 patients with dermatophytosis. They were categorised into different treatment groups: kept scales themselves(S), scales in a humid condition(S+H), scales mixed with sterilized dusts(S+D), and scales mixed with sterilized dusts in a humid condition(S+D+H). They were then cultured on Sabouraud dextrose agar once a week until there was no colony growth. Data was evaluated with the Mann-Whitney U-test. RESULTS: 1) The mean survival period of Microsporum canis isolated from 5 patients with tinea(T.) capitis was 17.6(S+D+H), 16.6(S+D), 8.4(S+H) and 7 weeks(S). 2) The mean survival period of Trichophyton rubrum isolated from 20 patients of T. corporis, T. cruris, T. pedis & T. unguium was 11.8, 7.4, 9.4 and 12.2 weeks(S+D+H); 7.4, 6.8, 9.2 and 7.4 weeks(S+D); 6.6, 3.4, 8.0 and 10.4 weeks(S+H); 5.0, 2.8, 5.4, 8.2 weeks(S), respectively. CONCLUSION: We found that the survival period of dermatophytes was longest in scales mixed with sterilized dusts in a humid condition.
Agar ; Arthrodermataceae* ; Dust ; Glucose ; Humans ; Microsporum ; Skin ; Tinea ; Trichophyton ; Weights and Measures

The authors have reviewed 63 resistant clubfeet of 40 patients who were treated by modified Turco's operstion at the Department of Orthopaedic Surgery, Seoul National University Hospital during the eight years period from July, 1979 to June, 1987. The procedure performed by the senior author(D.Y.L.) is essentially similar to Turco's original technique, but with the following modifications :(a) A curvilinear skin incision instead of Turco's straight oblique incision. (b) Aponeurotic tenotomy of the abductor hallucis. (c) Medial capsulotomies of the first metatarso-medial cuneiform joint, medial cuneiformnavicular joint and release of the medial extension of the tibialis anterior insertion. (d) Z-plastic lengtening of the tibialis posterior tendon instead of tenotomy (e) Plantar fasciotomy The average age at the time of operation was 23.4 months, the youngest being 4 months and the oldest being 6 year and 7 months. The follow-up period was minimum 12 months and maximum 6 years, the average being 27.4 months. The cases were analysed radiologically and clinically, and following observations were made. l. AP and lateral talocalcaneal angles were corrected satiafactorily in 60 feet(95%) and 59 feet(94%), respectively. The Talocalcaneal indices were corrected satisfactorily to over 40 in 60 feet(95%). 2. The talo-first metatarsal angles, which reflect adduction of the fore-foot, were corrected satisfactorily to within +10°in 55 feet(87%). 3. Good and fair results were obtained in 54 feet(86%) in the radiological evaluation. 4. Adduction deformity of the forefoot was responsible in most cases of radiologically unsatisfactory results. 5. Among 40 feet of 26 pstients who were evaluated clinically by the Wynne-Davis method, 33 feet were rated good and 7 feet were rated fair. No poor results were found clinically. 6. Senior author's modification of additional forefoot medial release is an important addition to Turco's original technique and effectively reduced unsatisfacotory results.
Clubfoot ; Congenital Abnormalities ; Follow-Up Studies ; Foot ; Humans ; Joints ; Metatarsal Bones ; Methods ; Seoul ; Skin ; Tendons ; Tenotomy

Hypernephroma comprises about 85-90% of renal malignancy in adults. The natural course of hypernephroma isvery diverse and unpredictable from abrupt explosive growth with wide spread metastasis to asymptomatic slowgrowth for several years. Reports from aliens indicated that hypernephroma with histopathological papillary growthpattern has better prognosis and more frequently hypovascular on renal angiography and less echogenic onultrasonography than non-papillary hypernephroma. Reviewed here retrospectively all the patients who were admittedand diagnosed as hypernephroma histopathologically at the Severance Hospital from March, 1973 through September,1984, in respective of angiographic vascularity, ultrasonographic echogenicity, histopathologic cell type andgrowth pattern, and following results were obtained. 1. The incidence of calcification in hypernephroma was 7cases out of 53 cases(13%). The incidence of hypernephroma according to cell type was clear cell type 20 cases(56%), mixed cell type 11 cases (31%), granular cell type 4 cases (11%), sarcomatous cell type 1 case(2%). Theincidence of hypernephroma according to growth pattern was papillary growth pattern 14 cases(45%) andnon-papillary growth pattern 17 cases(55%). 2. Renal angiographically, hypervascular hypernephroma was 19cases(73%), hypovascular hypernephromas was 6 cases(23%), all of which showed abnormal marginal vessels. 3.Angiographically hypervascular hypernephroma had high incidence of predominantly high echogenicity andangiographically hypervascular hypernephroma had high incidence of predominantly low echogenicity. 4. Clear celltype hypernephroma had high incidence of predominantly low echogenicity on ultrasonography. 5. Predominantly lowechogneic hypernephroma had high incidence of papillary growth pattern and predominantly high echogenichypernephroma had high incidence of non-papillary growth pattern. In summary, clear cell type hypernephroma hadhigh incidence of hypovascularity angiographically and hypovascularity on angiography was correlated withpredominantly low echogenicity on ultrasonography, and predominantly low echognicity had high incidence ofpapillary hypernephroma which was reported to have more good prognosis than non-papillary hypernephroma. So, itcan be suggested that if a hypernephroma show hypovascularity on angiography or predominantly low echogenicity onultrasonography, it has a good prognosis than hypervascular or predominantly high echogenic hypernephroma.
Adult ; Angiography ; Carcinoma, Renal Cell ; Emigrants and Immigrants ; Humans ; Incidence ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Ultrasonography

The bone mineral density (BMD) has been measured for evaluation of the osteoporosis. Of the various methods of measuring the BMD, dual energy X-ray absorptiometry (DEXA) has been known to be an accurate, objective, and easily reproducible method. The authors measured BMD in patients with intertrochanteric fracture of the femur for comparison with results in the normal control. The BMD was measured in thirty-two patients with intertrochanteric fracture by dual energy X-ray absorptiometry from March 1993 to March 1995. And the relationship between the severity of osteoporosis and intertrochanteric fracture of the femur was studied. The comparison of BMD between fracture patients and normal control was done in the population below 79 years old of age (23 fracture patients and 90 normal controls). The average BMD in the intertrochanteric fracture group was 0.558g/cm2 in the neck, 0.425g/cm2 in Ward's triangle and 0.568g/cm2 in the trochanter, while in the normal control group it was 0.870g/cm2 in the neck, 0.681g/cm2 in Ward s triangle and 0.772g/cm2 in the trochanter. In comparison with the normal control group, the BMD in fracture group was about 79% of the normal control group. The BMD in the proximal femur was decreased by about 14% with the age increasing decennially after 50 years. The BMD at Ward s triangle and trochanter was much lower in type III and IV of Tronzo classification than in type I and II .The BMD did not show significant correlation with the height and weight of the patients.
Absorptiometry, Photon ; Aged ; Bone Density* ; Classification ; Femur* ; Humans ; Neck ; Osteoporosis

No abstract available.
Mass Screening* ; Tomography, X-Ray Computed*

Polycystic ovary disease is a heterogenous endocrinopathy with many interacting causal factors. One potential such factor is chronic hyperinsulinemia. multiple, independent lines of evidence suppart the contention that chronic hyperinsulinemia causes ovarian hyperandragenism. This evidence includes: (1) mutations in the insulin receptor gene that cause severe hyperinsulinemia appear to be associated with ovarian hyperandrogenism, (2) insulin stimulates ovarian thecal and sttomal androgen seaetion in vitro, and (3) in some experimental models, manipulation of circulating insulin concentrations results in changes in circulating androgens. Although the association between hyperinsulinemia and hyperandrogenism remains to be fully explained at the molecular level, chronic hyperinsulinemia appears to be an important cause of hyperandrogenism. We have experienced a case of HAIR AN syndrome showing hyperandrogenism, insulin resistance and acanthosis nigricans in infertile patient. So we report this case with a brief review of literatures.
Acanthosis Nigricans ; Androgens ; Female ; Fibrinogen ; Hair* ; Humans ; Hyperandrogenism ; Hyperinsulinism ; Insulin ; Insulin Resistance ; Models, Theoretical ; Ovary ; Receptor, Insulin

OBJECTIVES: Anticardiolipin antibody (ACA) and lupus anticoagulant (LA) are acquired antiphospholipid antibodies (APAs), which are regarded as important risk factors far vascular thrombosis and recurrent fetal loss. Although the clinical relevance of APAs in dialysis patients is uncertain, recent studies have suggested that APAs are involved in bioincompatibility and thrombogenic complications in hemadialysis (HD) patients. METHOD: We performed a cross sectional study of ACA and LA in 50 stable HD patients and their 68 vascular accesses (52 native arteriovenous fistulae and 16 synthetic arterovenous grafts), with the analysis of factors associated with the presence of APAs and the retrospective evaluation of vascular access occlusion (VAO). LA was assessed by platelet neutralization method whereas IgG-ACA was measured by a solid phase ELISA. Values higher than 23GPLU/ml (IgG phospholipid units) were considered to be positive for IgG-ACA and positive values for LA was more than 8 seconds in prolongation of the clotting time with human platelet lysate. Vascular access survival was assessed by Kaplan- Meier method, RESULTS: The mean age of the subject (M:F 21:29) was 46 years and the mean duration of hemodialysis was 49 months. The frequency of VAO in entire subjects was 0.45+/-0.98 episodes/patient year. The median value of IgG-ACA was 16.0 GPLU/ml with a distribution from 2.7 to 46.1GPLU/ ml. The median titer of I.A was 4.5 (3.1-45.6) seconds. Fourteen patients (28%) were found to have at least one episode of VAO. In spite of comparable clinical and biochemical data according to the presence of VAO, the titers of IgG-ACA (13.6+/-7.7 vs, 20.3+/-8.7GPLIJ/ml, P<0.05) and LA (4.5+/-2.9 vs. 11.7 +/-12.6sec, P<0.05) were significantly higher in VAO group. Six out of 50 patients(12%) had an increased titer of IgG-ACA and LA was found in 11 patients(22%). No patients were positive for ACA and LA simultaneously. There was no significant difference in sex, etiology of ESRD, diabetic status, the dosage of heparin during HD or the amount of erythropoietin administered according to the presence of APAs. We could not find any significant correlation between the titer of APAs and age, duration of dialysis, blood pressure, platelet count and biochemical parameters. In the patients with positive ACA, the frequency of VAO was 1.05+/-0.12 episodes/patient year, which was significantly higher than patients without ACA (0.33+/-0.17 episodes/ patient year, P<0.05). In the patients with the presence of LA(1.06+/-0.43 vs. 0.12+/-0.06 episodes/ patients year, P<0.01). The median vascular access survival time in IgG-ACA positive patients (32.7 months) was significantly decreased compared to 66.8 months in IgG-ACA negative group. CONCLUSION: Our data suggest that the presence of APAs (ACA and/or LA) affects the event-free vascular access survival in HD patients. Therefore the evaluation of APAs status have to be included in the diagnostic strategies for the patients with recurrent VAO. Further studies are necessary to explore the pharmacologic intervention method to decrease APAs and prevent VAO in HD patients.
Antibodies, Anticardiolipin* ; Antibodies, Antiphospholipid ; Arteriovenous Fistula ; Blood Platelets ; Blood Pressure ; Dialysis ; Enzyme-Linked Immunosorbent Assay ; Erythropoietin ; Heparin ; Humans ; Kidney Failure, Chronic ; Lupus Coagulation Inhibitor* ; Platelet Count ; Renal Dialysis* ; Retrospective Studies ; Risk Factors ; Thrombosis

OBJECTIVE: To analyze the clinical characteristics of obese infertile women. MATERIAL AND METHOD: Height, weight, body mass index, menstrual pattern, glucose, insulin, glucose / insulin ratio, dehydroepiandrosterone sulfate (DHEA-S), testosterone, free testosterone and plasminogen activator inhibitor (PAI-1) of 15 obese infertile women were tested. RESULTS: Of 15 obese infertile women, the number of diabetes mellitus, hyperinsulinemia, and insulin resistance was 2 (13%), 2 (13%), 2 (13%), respectively. The incidence of increased DHEA-S, testosterone, and free testosterone was 7 (47%), 1 (7%), 6 (40%), respectively. Notably, all patients showed increased PAI-1. CONCLUSIONS: Obesity is associated with infertility as well as many kinds of health problems. Obesity is closely related to insulin resistance and it also causes hyperandrogenism. Increased PAI-1 is one of the important causes of thrombophilia. Consequently, in the workup of obese infertile patient, many aspects of health problems should be considered.
Body Weight ; Dehydroepiandrosterone Sulfate ; Diabetes Mellitus ; Female ; Glucose ; Humans ; Hyperandrogenism ; Hyperinsulinism ; Incidence ; Infertility ; Insulin ; Insulin Resistance ; Obesity ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Testosterone ; Thrombophilia