No abstract available.
Breast Neoplasms* ; Breast* ; Drug Therapy ; Neoadjuvant Therapy

Generalized granuloma annulare is a rare skin disease presenting generalized eruption with a distinctive histologic picture. The age of onset of generalized granuloma annulare differs from that of localized granuloma annulare. Most of the patients with generalized granuloma annulare were in the fifth to seventh decades and cases of generalized granuloma annulare in infancy or in early childhood have been rarely reported. We herein report two cases of generalized granuloma annulare in 45- and 18-month-old boys, who is the youngest patient yet reported in the Korean literature. The histopathologic findings were compatible with granuloma annulare and all lesions completely involuted in two months after administration of topical or systemic corticosteroids.
Adrenal Cortex Hormones ; Age of Onset ; Granuloma Annulare* ; Granuloma* ; Humans ; Infant ; Skin Diseases

BACKGROUND: We postulated that loss of epidural negative pressure might affect on the sensory blockade level of spinal anesthesia. METHODS: Thirty nine patients were involved in our study; group 1, spinal anesthsia with 23G spinal needle (n=20): group 2, spinal anesthesia with 27G spinal needle through the 18G Weiss epidural needle (n=19). Sensory blockade level was checked by pinprick test at 5, 10, 15, 20, 25, 30, 40, 60 and 90 minutes after spinal anesthesia. RESULTS: There was no difference of sensory blockade level between group 1 and 2. CONCLUSION: From above result, there was no evidence of loss of epidural negative pressure affecting on the spinal sensory blockade level.
Anesthesia, Spinal* ; Humans ; Needles

Various kinds of spinal instruments have been developed for the treatment of lumbar spinal disordors. Recently, the Graf instrument as soft stabilizer has been introduced in treating lumbar spinal disordors associated with instability. To determine the reliability of Graf instrument providung spinal stability we have analysed 19 cases of unstable lumbar degenerative disease treated with adequate decompression and Graf instrumentation between May 1991 and March 1992. There were 15 females and 4 males. Average age at operation was 50.8 years (Range, 35 to 70). Minimum follow up was 14 months. The main surgical indication was serious limitation of daily activity caused by intractable symptoms and signs with spinal instability. Clinical assesment based on authors modified criteria revealed satisfactory (Exellent/Good) in 16 cases (84.2%). The Graf instrument has many advantages over rigid implant such as enough stability without arthrodesis after extensive surgical decompression, rapid rehabilitation, less operative risk and preservation of spinal motion. These results suggests Graf instrument instead of rigid implant is highly recommendable in managing unstable lumbar disordors.
Arthrodesis ; Decompression ; Decompression, Surgical ; Equidae ; Female ; Follow-Up Studies ; Humans ; Male ; Rehabilitation

As a process to study the mechanism of steroid hormones at the molecular level,the activities of lactic dehydrogenase (L.D.) and malic dehydrogenase (M.D.),NAD-linked transhydrogenases, were measured in the testis and the prostate. Ahundred male rabbits were divided into ten group as follows: Group 1: Control Group 2: Estrogen (6,000 units) injected Group 3: Androgen (1,200 unite)injected Group 4: Progesterone (1,200 units) injected Group 5: Hydrocortisone(30 mg) injected Group 6: DOCA (6 mg) injected Group 7: Castration control Group8: Castration and estrogen (6, OOO units) injected Group 9: Castration and androgen (1,200 units) injected Group 10: Castration and progesterone (1,200units) injected Changes in the activities of lactic dehydrogenase and malic dehydrogenase in theorganic tissues by exogenous steroid hormones were carefullyobserved. The lactic dehydrogenase activities were measured by the method of Wroblewski and La Due, and malic dehydrogenase activities by the Bodansky's modification of Porter's method. The results are as follows: 1) The control valueof L.D. activities in the testicular tissue of normal rabbits proved to be 89,400units per ram. The L.D. activities showed an increase up to 110.4 per cent in theestrogen injected group, 179.3 per cent in the androgen injected group and 147.0 per cent in the progesterone injected group, while the administration of hydrocortisone and DOCA decreased the value down to 85.2 per cent and 81.5 per cent, respectively. 2) The control value of M.D. activities in the testicular tissue of the normal rabbits was 23,600 units per gram. The M.D. activities showed an increase upto 111.4 per cent in the estrogen injected group. 191.1 per cent in the androgen injected group, and 156.8 per cent in the progesterone injected group, while the administration of hydrocortisone and DOCA decreased the value down to 85.2 per cent and 81.5 per cent, respectively. 3) In the prostate tissues of non-castrated rabbits, the L.D. activities were estimated normally to be 48,100 units per gram. The administration of sex hormone resulted in raising the activities upto 101.8 per cent in the estrogen injected group, 196.9 per cent in the androgen injected group and 153.9 per cent in the progesterone injected group. But the administration of hydrocortisone and DOCA decreased the value down to 92.5 per cent and 97.1 per cent, respectively. 4) In the prostate tissue of non-castrated rabbits, the control value of M.D. activities proved to be 14,600 unite per gram. The M.D. activities showed an increase upto 117.8 per cent in the estrogen injected group, 206.8 per cent in the androgen injected group and, 176.7 per cent in the progesterone injected group, while the administration of hydrocortisone and DOCA decreased the value down to 81.9 per cent and 95.2 per cent, respectively. 5) The prostatic L.D. activities were decreased to half the normal two weeks after castration. The administration of sex hormones (i.e., estrogen, androgen and progesterone) acted inclusively upon elevating the level f activities. Androgen, in general, was the most effective to restore the activity to the level of pre-castrated state. 6) The prostatic M.D. activities were also decreased to half the normal two weeks after castration. The administration of sex hormones acted inclusively upon elevating the level ofthe activities. Androgen had a remarkable effect in elevating the M.D. activities, which showed twice the precastration level. In this study, it is concluded that L.D. and M.D. activities are present in the testis and the prostate. They are induced and activated by the administration of sex hormones, of which androgen has the most remarkable effect, and estrogen and progesteronehave less effect, while hydrocortisone and DOCA are ineffective in some cases orinhibitory in others.
Castration* ; Desoxycorticosterone Acetate ; Estrogens ; Gonadal Steroid Hormones ; Humans ; Hydrocortisone ; Malate Dehydrogenase* ; Male* ; Oxidoreductases ; Progesterone ; Prostate* ; Rabbits* ; Testis*

To assess the role of anorectal physiologic study for the diagnosis of chronic idiopathic constipation. METHODS: A retrospective study of 81 constipated patients (23 male, 58 female) of mean age 48 16.6 (16~83) years who had no abnormalities in colonoscopy, barium enema, and rectal exam was done. 81 patients underwent defecography and cine-defecography, of which 66 patients underwent anal manometry, 52 patients underwent colonic transit time study (CTT), and 27 patients underwent anal plug electromyography (EMG). RESULTS: Nonrelaxing puborectalis syndrome (NRPR), rectocele, rectal intussusception, anal dyschezia, and sigmoidocele were observed in 27 (33.3%), 26 (32.1%), 14 (17.3%), 3 (3.7%), and 2 (2.5%) of the patients, respectively. Normal cinedefecography finding was observed in 21 (25.9%) patients. More than one abnormal finding was found in 11 (13.6%) patients. Abnormal findings included colonic inertia in 6 (11.5%) patients and pelvic outlet obstruction in 2 (3.8%) patients. Normal colon transit time was observed in 44 (84.6%) patients. Anal hypertonia was observed in 23 (34.8%) patients by anal monometry, of which 3 patients were diagnosed with anal dyschezia in cinedefecography. 13 (48.1%) patients were diagnosed with NRPR in anal plug EMG. The correlation rate between cinedefecography/EMG, defecography/CTT, and CTT/EMG were 81.5%, 61.5%, and 51.9% respectively in the diagnosis of NRPR. Sensitivities of the three tests were 72.7% for cinedefecography, 66.7% for EMG, and 7.7% for CTT in diagnosing NRPR (p<0.05). Positive predictive values of the three tests were 80% for anal plug EMG, 72.7% for cinedefecography, and 50% for CTT in the diagnosis of NRPR. CONCLUSIONS: Defecography and EMG were complements each of the other in diagnosis of pelvic outlet obstruction especially NRPR, but CTT has no role.
Barium ; Colon ; Colonoscopy ; Complement System Proteins ; Constipation* ; Defecography ; Diagnosis* ; Electromyography ; Enema ; Humans ; Intussusception ; Male ; Manometry ; Rectocele ; Retrospective Studies ; Time and Motion Studies

Clinical and statistical observation was made on outpatient inpatients and operations in Urology Department of the Capital Army Hospital during the period from Jan., 1962 to Dec. 1963 and the results (1) Clinical statistics on outpatients. 1) Total outpatient were 2213 cases, 2179 males and U females, and the male to female ratio was 64.1:1. 2) The number of outpatient increased in winter and decreased in summer. 3) According to age distribution, the majority of the patients (96.2%) where between 21 and 40 years of age. 4) The most common diseases were urethritis (35.7%) showing annual increase, while redundant prepuce, urolithiasis, injury of genito-urinary tract, nonspecific epididymitis and hydrocele, showing annual decrease. 5) Renal tuberculosis showed annual decrease and tuberculous epididymitis, annual increase. (II) Clinical statistics on inpatients. 1) The inpatients during 2 years were 241 cases which comprised10.9% of total outpatients. The male inpatients stood for 11% of total outpatient and the female inpatients, 5.9%. 2) The most common disease were renal tuberculosis, hydrocele, non-specific epididymitis, stones of kidney and ureter, tuberculous epididymitis, urethral rupture and scrotal hematoma. (III) Clinical statistics on operations. The number of total operations were 640 during 2 years. Circumcision comprised 34.0% of total operations, vasectomy, 30.6% Nephrectomy, 6.1% ; epididymectomy, 6.1%, hydrocelectomy, 4.1% and plastic surgery of urethra, 2.3%. One case of Bricker's operation was performed.
Age Distribution ; Circumcision, Male ; Epididymitis ; Female ; Hematoma ; Hospitals, Military* ; Humans ; Inpatients* ; Kidney ; Korea* ; Male ; Nephrectomy ; Outpatients* ; Rupture ; Seoul* ; Surgery, Plastic ; Tuberculosis, Renal ; Ureter ; Urethra ; Urethritis ; Urolithiasis ; Urology* ; Vasectomy

The paramount importance of breast feeding for the health of the infants has been recognized by untritionists and physicians. Although many advantages of the breast feedng, exclusive breast feeding without weaning diet or supplement food during prolonged perind in infants may produce iron deficiencyh anemia. This study was conducted to find out the hematologic state in exclusively prolonged breast-fed infants among these anemic patients and the way of thinking about their baby's feeding method in their mothers. Mothers of the anemic patients has been surveyed with questionare. The results and problems obtained from this study are summerized as follows. 1) Among 40 patients of this study, 27 were male (67.5%) and 13 were female (32.5%). Mean age was 12.6+/-2.7 month and 9 & 11 month of age were the most common, respectively (15.0%). 2) Mean age of mothers was 29.5 year. The 25 34 year-old group was most common. 3) Education levels of mothers were primary 10%, middle 10%, high 60%, and college graduate 20%. 4) In motivatins of breast feeding. Persuasion of husband or the parent of husband' 19(47.5%). 'Convenience for use' 12 (30.0%), and 'Through mass media or public information' 9 (22.5%). 5) In the causes of prolonged breast feeding, 'Think that satisfactory nutrition for baby is possible with breast milk alone' 4(10.0%), 'Due to persuasion of husband or the parents of husband' 11 (27.5%), 'Baby did no suck milk bottle or eat other diet except breast milk' 25 (62.5%). 6) In whether or not acknowledgment of the necessity of weaning diet, 'Know it but not consider so important 22 (55.0)%, 'Do not know at all) 15 (37.5%), and 'Breast milk, that will do' 3(7.5%). 7) Hb level in patient group, from 6 to 6.9g/dl was 2 (50.0%), from 7 to 7.9g/dl was 3 (7.5%), from 8 to 8.9%g/dl was 15 (37.5%), and from 9 to 10 g/dl was 20 (50.0%). From 9 to 10g/dl was the most common. Hematologic findings were Hb 8.8+/-0.9g/dl, Hct 28.8+/-3.0%, MCV 64.7+/-6.7 fl, MCH 20.0+/-2.5pg, MCHC 30.8+/-1.5g/dl. Platelet 452.5+/-142.9x103/mm3, Reticulocyte count 1.4+/-0.6%, Fe 28.6+/-14.1 g/dl, TIBC 446.7+/-66.2 g/dl, Ferritin 10.5+/-7.0ng/ml. Transferrin saturation 6.6+/-3.5%. 8) In association with duration of breast milk feeding and hematologic findings, as duration was prolonged, Hb, Hct, MCV & MCH were significantly decreased (p<0.01).
Adult ; Anemia* ; Blood Platelets ; Breast Feeding* ; Breast* ; Diet* ; Education ; Feeding Methods ; Female ; Ferritins ; Humans ; Infant ; Iron ; Male ; Mass Media ; Milk ; Milk, Human ; Mothers ; Parents ; Persuasive Communication ; Reticulocyte Count ; Spouses ; Thinking ; Transferrin ; Weaning*

Among many causes of calcium containing urinary stones, the hypercalciuria associated with normocalcemia is the most common one. Absorptive hypercalciuria and renal hypercalciuria constitute two major forms of idiopathic hypercalciuria. According to Coe et al., a renal leak of calcium and secondary hyperparathyroidism are present in renal hypercalciuria but not in absorptive hypercalciuria. It has been suggested that fasting urinary cAMP may provide a measure of parathyroid function. So determination of fasting urinary calcium and cAMP may be useful in the differentiation of the two major forms of idiopathic hypercalciuria. We performed the study to evaluate the significance of urinary calcium and cAMP in the determinating the types of hypercalciuria. Calcium metabolism studies and urinary cAMP determination were done in 28 in-patients with urinary stones under usual diet and fasting state. The results were as followings: 1. Among 28 patients, 15 patients had renal hypercalciuria, 6 had absorptive hypercalciuria and 7 had normocalciuria. 2. On usual diet, 24-hour urine cAMP level was 3.815+/-0.560 nmol/mg creatinine in renal hypercalciuria, 3.508+/-1.253 nmol/mg creatinine in absorptive hypercalciuria and 3.202+/-0.980 nmol/mg creatinine in normocalciuric patients. 3. On fasting state, 2-hour urine cAMP level was 4.611+/-2.591 nmol/mg creatinine in renal hypercalciuria, 4.304+/-3.173 nmol/mg creatinine in absorptive hypercalciuria and 2.400+/-1.080 nmol/mg creatinine in normocalciuric patients. 4. urinary cAMP on usual diet and fasting condition did not differ significantly among 15 renal and 6 absorptive hypercalciuric patients. (t-value; 0.82 and 0.22, respectively, p>0.1)
Calcium ; Creatinine ; Diet ; Fasting ; Humans ; Hypercalciuria ; Hyperparathyroidism, Secondary ; Metabolism ; Urinary Calculi*

BACKGROUND : Till now, several studies advocated the vascular etiology as a cause of acute isolated vertigo without relevant lesions on magnetic resonance imaging (MRI). However, most of them were case series and ,even in a few case-control studies, inclusion criteria were obscure and vascular risk factors were not considered. OBJECTIVES: To investigate the clinical significance of vertebrobasilar artery (VBA) pathology in acute isolated vertigo without relevant lesions on MRI. Methods : 84 patients (26 male, 59 female; 62.5+/-0.2 years) with acute isolated vertigo who had no lesions on MRI were gathered. Seventy nine controls (30 male, 49 female; 58.4+/-0.1 years) consisted of subjects with clinically definite BPPV, epilepsy, tension headache, or lacunar infarction. All the subjects underwent MRI and magnetic resonance angiography (MRA). The vascular pathology of VBA and anterior circulation were examined and graded by the findings of MRA. Focal stenosis more than 50%, non- or faint-visualization, or dolichoectasia of VBA were regarded as significant. Risk factors of atherosclerosis were investigated and the severity of small vessel disease on MRI were ranked. RESULTS : Significant vascular pathology of VBA was found more frequently in patients with acute isolated vertigo (32.1%) than in controls (16.5%) (p<0.05). Among the risk factors of atherosclerosis, hypertension was more common in patients (44.0%) than in controls (29.1%) (p<0.05) and the others were not different between two groups. Significant vascular pathology of anterior circulation and SVD were not different, too (fP>0.05). Multivariate analysis including all the possible variables investigated confirmed the significant correlation between VBA pathology and acute isolated vertigo in our subjects (p<0.05). CONCLUSION : This study demonstrates that there is a signficant correlation between VBA pathology and acute isolated vertigo without lesions on MRI. It can support the importance of VBA pathology as a a cause of acute isolated vertigo.
Arteries ; Atherosclerosis ; Case-Control Studies* ; Constriction, Pathologic ; Epilepsy ; Female ; Humans ; Hypertension ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Male ; Multivariate Analysis ; Pathology* ; Risk Factors ; Stroke, Lacunar ; Tension-Type Headache ; Vertigo*