The authors reported here a 23 years-old female patient with acute renal failure and anaphylaxis induced by rifampicin, who was suffered from exudative pericarditis. The diagnosis was made by its reproducibility with rifampicin. The pathogenesis of acute renal failure and anaphylaxis in this case was thought to be immunologic mechanism, because of elevated IgE and depressed complements. Relevant literature was also reviewed.
Acute Kidney Injury* ; Anaphylaxis* ; Complement System Proteins ; Diagnosis ; Female ; Humans ; Immunoglobulin E ; Pericarditis ; Rifampin ; Young Adult

Heart failure is a recognized, although uncommon, cause of massive liver cell necrosis, the clinical consequence of which are intermingled with those of cardiac insufficiency in most case. But, hepatic coma is rerely caused by hepatic congestion only. We report the three cases with heart failure resulted in massive liver cell necrosis and fulminant hepatic failure. The manifestations of fulminant hepatic failure were hepatic encephalopathy, jaundice, marked increase of prothrombin time and serum transaminase and there were no evidences of viral hepatitis and toxic hepatitis as a cause of liver failure.
Drug-Induced Liver Injury ; Estrogens, Conjugated (USP)* ; Heart Failure* ; Hepatic Encephalopathy ; Hepatitis ; Jaundice ; Liver ; Liver Failure ; Liver Failure, Acute* ; Necrosis ; Prothrombin Time

No abstract available.
Amlodipine* ; Humans ; Hypertension*

No abstract available.
Doxazosin* ; Hypertension*

No abstract available.
Humans ; Hypercholesterolemia* ; Lovastatin*

OBJECTIVES: There have been growing interests about alopecia occured during childhood and adolescence in clinical practice. The purpose of this paper is to explore the clinical characteristics of early onset alopecia in order to establish effective psychiatric intervention strategy. METHODS: The subjects were 31 early onset alopecia patients(14 males, 17 females) and 62 late onset control patients(26 males, 36 females). These patients had visited psychiatric outpatient clinic consulted from the department of dermatology, Yongsan hopital, Chung Ang University, Seoul, Korea, from January 1998 to june 1999. The sociodemographic data, clinical pattern of alopecia, psychiatic characteristics, comorbid physical illnesses and treatment variables were assesed. The data was statistically analyzed using chi-squre test and t-test through SPSSWIN 9.0V. RESULTS: 1) Early onset alopecia patients were more likely born in autum, had fewer siblings, and showed higher economical level of both patient and their parents than late onset patients. 2) Early onset alopecia patients were more likely to show diffuse hair loss, had more experienced past history of alopecia, more frequently had recurrence more than 3 times, were more severely damaged, had longer duration of hair loss had more loss of hairs on the vertex area at onset of alopecia, had more loss of hairs more than 2 areas, and had poorer prognosis such as no change or exacerbation in spite of treatment, spontaneous withdrawal of tratment and lack of efficacy to treatment than late onset patients. 3) Early onset alopecia patients were poorer in their adjustment in family life, or interpersonal relations, and more suffered from school stress such as changes of school life or test stress related with school entrance examination than late onset patients. 4) Early onset alopecia patients were more likely to show serious psychopathology such as increased rate of the anxiety disorders, of anxiety symptoms or depressive symptoms, and of personality disorders including the histrionic or the passive traits than late onset patients. 5) Early onset alopecia patients were more likely showed dermatitis including seborrheic dermatitis, and more significantly responding to the treatment with anti-anxiety drug, such as alprazolam, and dermatological therapies including polytar or tretinin than late onset patients. CONCLULSION: These findings suggest that dermatologists, as primary care physicians, are in unique position to recognize psychiatric comorbidity and to execute earlier intervention, in collaboration with psychiatrists, of early onset alopecia patients.
Adolescent* ; Alopecia* ; Alprazolam ; Ambulatory Care Facilities ; Anxiety ; Anxiety Disorders ; Comorbidity ; Cooperative Behavior ; Depression ; Dermatitis ; Dermatitis, Seborrheic ; Dermatology ; Equidae ; Hair ; Humans ; Interpersonal Relations ; Korea ; Male ; Parents ; Personality Disorders ; Physicians, Primary Care ; Prognosis ; Psychiatry ; Psychopathology ; Recurrence ; Seoul ; Siblings

OBJECTIVES: The present study was performed to reveal correlations between the severity of the alopecia and their alopecia related variables such as patterns of hair loss, psychiatric characteristics, associate illnesses, and methods of treatment and to use them as basic materials for proper manaement and early prevention of the alopecia prone cases. METHODS: In order to analyze correlation between the severity of psychopathogy and the severity of hair losses, the subjects were divided into two subgroups as the 60 case of alopecia areata and the 33 cases of alopecia totalis with more severely affected loss of hairs, who had visited to the department of psychiatry after they were consulted from the department of dermatology, Yongsan hopital, ChungAng University, Seoul, Korea, from January 1998 to December 1998. In data analysis, the subjects were statistically assesed by chi-squre test and T-test through SPSS-PC+ 8.0V. RESULTS: 1) Those with the more severely affected alopecia were more likely to visit to the department of dermatology in winter, and to show lower socioeconomical level in comparison to the alopecia areata. 2) Those with the more severely affected alopecia were more likely to show past history of alopecia, to recur frequently more than 3 times, to be damaged more severely, to have an younger mean age at onset of alopecia, to have longer total duration of hair loss than 2 years, to have longer recent duration of hair loss than 9 months, to have more loss of hairs on the vertex area at onset of alopecia, to have more loss of hairs in eyebrows, to have more loss of hairs more than 2 areas, to have more family history of alopecia in their parent, and to have poorer prognosis in comparison to those of the alopecia areata. 3) Psychosocial stress were positively correlated with the severity of loss of hairs. In the more severely affected alopecia group, their degree of stress were perceived higher. The more severely affected patients with alopecia , were poorer in their adjustment in family life,interpersonal relations or heterosexual relations, and suffered more from intrafamilial life changes in comparison to those of the alopecia areata group. 4) Those with the more severly affected alopecia were more likely to show serious psychopathology such as an increased rate of the depression, to complain more frequently with anxiety symptoms or depressive symptoms, to have personality disorders including the histrionic or the passive aggressive traits in comparison to the alopecia areata. 5) Those with the more severly affected alopecia were more likely to show neurotic MMPI code profiles such as histrionic or hypochondriacal trends. 6) Antianxiety drug such as alprazolam and drug therapies including tretinin,polytar or oral sorarens plus ultra-violet light A photochemotherapy were significantly more effective in the treatment of those with the more severly affected alopecia group. CONCLUSION: The most important factors in developing a psychopathologic reaction to the hair loss due to alopecia seems to be the presence of mental disorders including depression, the presence of stressful life events such as intrafamilial life changes, the presence of a significantly higher percentages of personality disorders such as the hysterical or the passive aggressive, and the presence of the psychosocial sequele and maladjustment in various life situations. From the above facts, the authors suggested that dermatologists acting as the primary care physician are in a unique position to recognize psychiatric comorbidity and execute meaningful intervention for patients with alopecia with psychiatrists.
Alopecia Areata* ; Alopecia* ; Alprazolam ; Anxiety ; Climacteric ; Comorbidity ; Depression ; Dermatology ; Drug Therapy ; Equidae ; Eyebrows ; Hair ; Heterosexuality ; Humans ; Korea ; Mental Disorders ; MMPI ; Parents ; Personality Disorders ; Photochemotherapy ; Physicians, Primary Care ; Prognosis ; Psychiatry ; Psychopathology ; Seoul ; Statistics as Topic

The effect of ketanserin, serotonin antagonist, among 19 korean patients over 55 years with essential hypertension was assessed in an open clinical trial for three months. patients were given Ketanserin 20mg bid with monthly follow-up visits. Mean values of systolic/diastolic blood pressures fell from 169+/-17/104+/-10mmHg to 155+/-14/94+/-9mmHg at 2 weeks(p<0.01) and to 147+/-10/87+/-6mmHg at end of treatment 12 weeks after(p<0.001). There was no significant change in heart rate. Transient mild side effects were observed in 5 patients. We conclude that Ketanserin is an effective and safe drug for the treatment of elderly hypertensives.
Aged ; Follow-Up Studies ; Heart Rate ; Humans ; Hypertension* ; Ketanserin* ; Middle Aged* ; Serotonin

The authors accessed the effects of heart rate and age to echocardiographic right ventricular systolic time intervals in 27 cases with normal pulmonary artery pressure and correlation of pulmonary hemodynamic parameters with echocardiographic right ventricular systolic time intervals in 76 cases with congenital and acquired valvular heart diseases. The results were as follows; 1) As heart rate increased there was a diminution of the length of right ventricular ejection time(RVET)(r=0.642), but no significant changes in the length of right ventricular pre-ejection period(RVPEP) and the ratio of RVPEP/RVET were found. 2) As age increased there was an increase in the ratio of RVPEP/RVET(r=0.46), but no significant changes in the length of RVPEP and RVEF were found. 3) In patients with the RVPEP/RVET of 0.3 or more this ratio can predict that pulmonary artery systolic pressure is >30mmHg(sensitivity : 83%, specificity : 96%, accuracy 88%), pulmonary artery mean pressure >20mmHg(sensitivity : 87%, specificity : 96%, accuracy 90%), and pulmonary artery diastolic pressure >15mmHg(sensitivity : 86%, specificity : 90%, accuracy : 88%). 4) In patients with the RVPEP/RVET of 0.4 or more this ratio can predict that pulmonary artery systolic pressure is >50 mmHg(sensitivity : 75%, specificity : 98%, accuracy : 92%), pulmonary artery mean pressure >40mmhg(sensitivity : 93%, specificity : 96%, accuracy : 96%), pulmonary artery diastolic pressure >25mmHg(sensitivity : 75%, specificity : 98%, accuracy : 92%), pulmonary vascular resistance >6 units(sensitivity : 70%, specificity : 96%, accuracy : 89%), and Rp/Rs >0.25(sensitivity : 86%, specificity : 95%, accuracy : 93%). In conclusion, pulmonary hypertension, increased pulmonary vascular resistance and pulmonary arteriolar obstructive disease can be predicted by echocardiographic measurement of RVPEP/RVET.
Blood Pressure ; Echocardiography* ; Heart Rate ; Heart Valve Diseases ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; Pulmonary Artery* ; Sensitivity and Specificity ; Systole ; Vascular Resistance*

Doxorubicin(Adriamycin(R)) is effective in the treatment of various solid tumors and hematologic malignancies. Because of dose-related cardiotoxicity, however, early inappropriate discontinuation of doxorubicin therapy may minimize its therapeutic efficacy in many patients. Consequently, clinically sensitive tests are needed to select patients in whom treatment must be stopped early. Various techniques have been used for early detection of subclinical doxorubicin-induced cardiotoxicity, including electrocardiography, systolic time intervals, echocardiography, radionuclide angiography and endomyocardial biopsies. Most studies of doxorubicin cardiotoxicity have dealt with systolic function of the left ventricle and effects on diastolic function have not been reported. In order to determine whether impaired diastolic function may be an early sign of doxorubicin cardiotoxicity, a retrospective study was performed in 12 patients who had undergone serial radioangiography and were found to have left ventricular ejection fractions(LVEF)> or =55% prior to doxorubicin treatment and during follow-up. Average rapid filling velocity(RFV) and slow filling velocity(SFV) were both significantly reduced after doxorubicin treatment. RFV fell from 5.17+/-1.52 units/second to 4.18+/-0.96(P<0.01) and SFV fell from 2.20+/-1.32 units/second to 1.42+/-0.62(P<0.05). There were no significant changes in filling volume ratio, total diastolic time and diastolic time ratio. Since a change in left ventricular diastolic function can occur before ejection fraction falls to subnormal levels, diastolic function as well as systolic function should be examined in the early detection of doxorubicin cardiotoxicity.
Biopsy ; Doxorubicin* ; Echocardiography ; Electrocardiography ; Follow-Up Studies ; Heart Ventricles ; Hematologic Neoplasms ; Humans ; Radionuclide Angiography ; Retrospective Studies ; Systole