BACKGROUND: Chronic actinic dermatitis comprises a spectrum of chronic photosensitivity disorders. Treatment includes avoidance of UV light, application of broad-spectrum topical sunscreens, PUVA therapy, corticosteroid, azathioprine and cyclosporine. OBJECTIVE: Our purpose was to determine the efficacy of cyclosporine in the treatment of chronic actinic dermatitis. METHODS: Six patients with chronic actinic dermatitis refractory to conventional treatment were treated with cyclosporine 100-200mg a day for four to eighteen weeks. RESULTS: In all six patients improvement of the skin lesions and itching were dramatic, but in three of them hyperterision developed during the cyclosporine treatment. After stopping the cyclosporine therapy, their blood pressures normalized within two to five weeks. Other side effects of cyclosporine were not found. Although the skin lesions of all of the six patients were aggravated more or less after stopping the cyclosporine therapy, we could maintain their improved states with topical corticosteroids and oral antihistamines. CONCLUSION: 1. Cyclosporine is a good alternative in treating chronic actinic dermatitis patients who are suffering from severe symptoms refractory to conventional therapy. 2. Hypertension is the frequent side effect of cyclosporine.
Adrenal Cortex Hormones ; Azathioprine ; Cyclosporine* ; Histamine Antagonists ; Humans ; Hypertension ; Photosensitivity Disorders* ; Pruritus ; PUVA Therapy ; Skin ; Sunscreening Agents ; Ultraviolet Rays

No abstract available.
Cervix Uteri* ; Female ; Pregnancy*

Eighteen patients with primary hyperparathyroidism were treated by one of the authors (SKO) from 1981 through 1988 at the Department of Surgery, Seoul National University Hospital and the data were analyzed retrospectively. Eighteen patients comprised 6 males and 12 females, with the male to female ratio of 1 to 2. The age distribution was between 18 and 64 years. The chief complaints were associated with skeletal symptoms in 9 urinary symptoms in 5, and neurologic manifestation in 1 patient. There were 3 patients with asymptomatic hypercalcemia. All patients showed hypercalcemia and hypophosphatemia was found in 11 patients. Serum PTH level was elevated in 13 cases. performing preoperative localization with computed tomorgam, ultrasonogram and thallium-technetium subtraction scan, positive localization was made in 62.5% (10/16), 53.8% (7/13) and 85.7% (12/14), respectively. one patient, angiography and selective venous sampling were peformed and positive localization was made. All patients were treated by surgery. There were 17 patients with solitary adenoma and one with double tumors. Pathologic findings revealed adenoma of the parathyroid in all patients except one which was proved later to be carcinoma. There were no recurrent cases except one with carcinoma. There were no postoperative complications. primary hyperparathyroidism is a very rare disease in Korea. Causes of primary hyperparathyroidism in our study was confined to tumors of the parathyroid, such as adenoma and carcinoma.There was no hyperplasia causing primary hyperparathyroidism. Thallium-technetium subtraction scan was proved to be the best method for localization of the parathyroid tumors Excision of the tumor with involved parathyroid followed by frozen-section biopsy of the univolved parathyroid was the best way to treat primary hyperparathyroidism in our study.
Adenoma ; Age Distribution ; Angiography ; Biopsy ; Female ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Hyperparathyroidism, Primary* ; Hyperplasia ; Hypophosphatemia ; Korea ; Male ; Methods ; Neurologic Manifestations ; Postoperative Complications ; Rare Diseases ; Retrospective Studies ; Seoul ; Ultrasonography

Cutaneous ulcers due to candida infection are very rare condition, occurring almost in immunocompromised host or occurring as cutaneous manifestation of systemic candidal infection. A 52-year-old woman presented with cutaneous ulcer on dorsum of left hand which had lasted for about 15 days. Bacterial culture showed nonpathogenic organism, Enterobacter cloacae. Mycologic studies including KOH mount and fungus culture were positive for pseudohyphae and colonies of Candida species. A biopsy specimen from the center of ulcer revealed numerous spores and fungal hyphae in the upper dermis and necrotic epidermis. Bacterial culture and fungus culture of patient's serum and urine were negative. Initial treatment with antibiotics had no effectiveness for 2 weeks. After then we treated with antifungal drug, itraconazole 100mg/day. After 6 weeks of antifungal therapy, the skin lesion was much improved. We report this case, because it showed cutaneous ulcer due to candida infection but had neither systemic candidal infection nor clinical sign of immunosuppression.
Anti-Bacterial Agents ; Biopsy ; Candida* ; Dermis ; Enterobacter cloacae ; Epidermis ; Female ; Fungi ; Hand ; Humans ; Hyphae ; Immunocompromised Host ; Immunosuppression ; Itraconazole ; Middle Aged ; Skin ; Spores ; Ulcer*

The distance fmm skin to the lumber epidural space was measured in 60 male patients receiving epidural analgesia. The mean distance was found to be 4.45cm. The epidural depths were identified most frequently at 4.0 to 4.5cm deep and over 90% of total cases were less than 5.5cm deep. The epidural depths had correlations with weight and PI(P < 0.001), but not correlated with height.
Adult* ; Analgesia, Epidural ; Epidural Space* ; Humans ; Male* ; Skin*

BACKGROUND: In the Republic of Korea, there had been no reports about indigenous malaria cases since 1984 until a vivax malaria case was detected in 1993. Thereafter vivax malaria has been a reemerging disease in Korea, the number of cases of malaria increasing recently and the prevalent area being more wider. We suggested that we should take malaria into consideration as the differential diagnosis whenever we meet the febrile patients. We analyzed the cases of malaria who were treated in Myoungji hospital located in Goyang-Si during 4years. METHODS: We retrospectively analyzed data of 79 confirmed cases of malaria treated in the Myoungji hospital from January 1, 1998 to December 31, 2001. All of the patients had no histories of traveling abroad, drug abuse or blood transfusion. The clinical manifestation, hematologic abnormalities and prognosis of patients were reviewed. RESULTS: Seventy-nine cases of malaria were diagnosed as vivax malaria by blood smears. Vivax malaria was developed in Goyang-Si from May through November. Common symptoms were fever (100%), chilling (84.8%), headache (64.6%) and myalgia (55.7%). Splenomegaly was detected in 77.2% of cases by sonography. In 1998, Tertian fever pattern was most frequent. Since 1999, irregular and atypical fever patterns, such as almost-daily high fever or the every fourth or fifth-day fever, were increased in numbers. Laboratory findings included thrombocytopenia (92.4%), anemia (29.1%), leukopenia (25.3%) and leukocytosys (5.1%). CONCLUSION: ICases of indigenous malaria have been progressively increasing in the Republic of Korea. Therefore early diagnosis, treatment and prevention of malaria are very important. Fortunately, patients were well responsed to treatment.
Anemia ; Blood Transfusion ; Diagnosis, Differential ; Early Diagnosis ; Fever ; Headache ; Humans ; Korea ; Leukopenia ; Malaria* ; Malaria, Vivax ; Myalgia ; Plasmodium vivax ; Prognosis ; Republic of Korea ; Retrospective Studies ; Splenomegaly ; Substance-Related Disorders ; Thrombocytopenia

The incidence of cardiac arrhythmias has been studied in 50 unselected surgical patients with preexisting ECG abnormailties preoperatively, by means of continuous monitoring, utilixingan eIectrocardioscope, Burdick CS-515 Monitor, and was recorded by EK-4S ECG, at the Kyung Hee University Hospital, Seoul, Korea. The results are as follows: 1) Among 50 patients, 32 cases (64%) developed a variety of arrhythmias during general anesthesia and operation. It also showed arrhythmias excluding sinus tachycardia in 14 cases. The 28 per cent incidence of arrhythmias was rather high compared with the patient groups without preexisting heart disease or arrhythmias, such as in our previous report in 1972 of 20%, Dodds 19, 9% and Vaniks 16. 3%. 2) The most common arrhythmia seen was sinus tachycardia (26 cases, 65% of the total arrhythmias) and the next one was premature ventrieular contraction. 3) Nine cases (22. 5%) were considered serious in nature, such as premature ventricular contractions. 4) There was an increased incidence of new arrhythmias in the patients in poor general condition. 5) The vast majority of arrhythmias seen during anesthesia, except for 3 cases did not require drug treatment. It is usual to eliminate the cause of the arrhythmia by lowering anesthetic depth, eliminating excess carbon dioxide by hyperventilation and proper oxygenation of the lungs. 6) Constant electrocardiographic monitoring of patients under anesthesia has proven to be valuable adjunct to the administration of clinical anesthesia.
Anesthesia ; Anesthesia, General* ; Arrhythmias, Cardiac* ; Carbon Dioxide ; Clinical Study* ; Electrocardiography* ; Heart Diseases ; Humans ; Hyperventilation ; Incidence ; Korea ; Lung ; Oxygen ; Seoul ; Tachycardia, Sinus ; Ventricular Premature Complexes

We have experienced 20 cases of anesthesia for Total Hip Replacement(Charnleys Lov Frictinn Arthroplasty), which had been done under the Filtered Air Flow System for the prevention of wound contamination due to long term exposure. Preoperative diagnosis was, 7 cases of Hip Joint Tuberculosis, 6 cases of Femur Neck Fracture, 5 cases, of Osteoarthritis of Hip Joint, and 2 cases, of Avascular Necrosis. Average blood loss has 1500 ml for one side operation, and 2400 ml for bilateral one. In 12 cases, hypotensive response was occurred during the application of Acrylic bone cement to the medullary canal of femur, however in 4 cases, hypotensive responses was more prominentafter the application of Acrylic bone cement to the Acetabulum fossa and the rest of cases were no changes in blood pressure and pulse rate whatsoever. In two cases, hypotensive range was over 30%(in compare with preoperative one), but recovery was soon after administration of Effortil corticosteroids, volume expanders etc. There was no mortality.
Acetabulum ; Adrenal Cortex Hormones ; Anesthesia* ; Blood Pressure ; Clinical Study* ; Diagnosis ; Etilefrine ; Femoral Neck Fractures ; Femur ; Heart Rate ; Hip ; Hip Joint ; Joints ; Mortality ; Necrosis ; Osteoarthritis, Hip ; Polymethyl Methacrylate ; Tuberculosis ; Wounds and Injuries

This study was primarily undertaken to assess the value of continuous spinal anesthesia for total hip replacements (Charnley's low friction arthroplasty), which had been done under the Filtered Air Flow System for the prevention of wound contamination due to long term exposure. The results were as follows: 1. Preoperative diagnosis was in 4 cases hip joint tuberculosis,in 2 cases avascular necreosis, in 2 cases femur fracture, and in 2 cases osteoarthritis of the hip joint. 2. Average blood loss was 2, 800 ml for a one side operation and 5, 000 ml for a bilateral one. Overall average blood loss with continuous spinal anesthesia was 2, 600 ml and with general anesthesia was 1, 725 ml, and with amount of difference being 1. 175 ml more in the spinal anesthesia group (p<0. 025). 3. In 4 eases (40%) the hypotensive range was over 30% of the preoperative level, but recovery occurred soon after administration of Effortil. 4. Practically management of a patient with continuous spinal anesthesia is easier' thai with general anesthesia for total hip replacement, with fieeing of the anesthesio1ogist'a hands for better care of the patient during anesthesia.
Anesthesia ; Anesthesia, General ; Anesthesia, Spinal* ; Arthroplasty, Replacement, Hip* ; Asian Continental Ancestry Group ; Diagnosis ; Etilefrine ; Femur ; Friction ; Hand ; Hip Joint ; Humans ; Osteoarthritis ; Wounds and Injuries

Nocardiosis is a rare infection seen most commonly in immunocompromized patients. Most patients have pulmonary involvement, but some develop disseminated infection. A 52-year-old man, treated with immunosuppressive drugs for 3 months after kidney transplantation, developed pulmonary nocardiosis and disseminated infection involving brain, skin, and both uvea. The diagnosis was made by open lung biopsy specimens showing characteristic weak acid fastness with modified Ziel-Neelsen stainig and histologic examination. Immunosuppressive therapy was continued and combination of surgical drainage of brain abscess and chemotherapy with Minocycline were successful. With the increasing number of allograft recipients and concomitant immunosuppression, the possibility of an increase in Nocardia opportunistic infections exists.
Allografts ; Biopsy ; Brain ; Brain Abscess ; Diagnosis ; Drainage ; Drug Therapy ; Humans ; Immunosuppression ; Kidney Transplantation ; Kidney* ; Lung ; Middle Aged ; Minocycline ; Nocardia ; Nocardia Infections* ; Opportunistic Infections ; Skin ; Transplantation* ; Uvea