Xeroderma pigmentosum, a rare, genetically determined dermatosis, is often cornplicated by malignant chagnes of various types-most commonly, basal-cell epithelioma, squamous cell epithelioma, less frequently malignant meIanoma, keratoacanthoma, fibrosarcoma, and endothelioma have been reported. In Korea, no case has ever been reported in literature except four cases at a symposium for dermatology, two of them complicated by basal-cell epithelioma, and the others by squamous cell epithelioma. This case reported was complicated by squamous cell epithelioma. As one of the anticancer treatments, especially for skin cancer, Bleomycin is, now, drawing the attention for its high therapeutic index with only few side effects. For this case, we injected Rleomycin 15mg at once, twice a week, for 8 weeks, So total injection was 16 times and 240mg of Bleomycin was given in total. While this amount given for this case was not enough for the complete treatment of squamous cell epithelioma, we got the following results: 1. Clinically, the ulcerated lesion of the cancer on the right ala nasi had shrunken in size with reepithelialization at the margin showing clear surface, and 2. microscopically, the atypical cancer cell masses and individual cell keratinizations had been decreased in size and in number, and less remarkable comparing to those in untreated stage at his first visit to the hospital.
Bleomycin* ; Carcinoma* ; Dermatology ; Fibrosarcoma ; Keratoacanthoma ; Korea ; Skin Diseases ; Skin Neoplasms ; Ulcer ; Xeroderma Pigmentosum

No abstract available.
Dilatation* ; Urethra*

Acute epidural hematoma is the one which neurosurgeons encounter commonly in severe head injuries and needs emergency operation. But the fact that the mortality of it is still very high(20-50%), is disheartening to all neurosurgeons. In my country, the acute epidural hematoma has been recognized and treated since the 1950th by neurosurgeons. Nevertheless, the report of the collected acute epidural hematoma is rarely seen. The reason is felt that the illness is quite common around us but the mortality is so high to make the report be delayed. The authors have treated 60 cases of surgically confirmed acute epidural hematoma during 24 months from April 1969 to March 1971 and have observed clinically. Following are the results: 1) Sex incidence showed male(50), female(10), and age incidence ranged 2 years of age to 60 yrs. But it was most common in 2nd decade to 4th decade. 2) Most common mode of injury was traffic accident(33 cases) and there were 15 cases of falling down accident and 12 cases of direct batting over the head by blunt materials. 3) There were lucid interval in 13 cases. Most common papillary change was ipsilateral mydriasis(23 cases). Bilateral mydriasis were in 4 cases & other showed miotic or normal pupils. Bilateral positive Babinski's sign were noted in 22 cases and there were 14 cases of unilateral Babinski's sign. 4) Site of hematoma;Most common site of the hematoma was temporoparietal region but there were 8 cases of confined frontal pole and 3 cases of posterior fossa region. In 42 cases of 60, the site of hematoma was confirmed by carotid angiography & on the rest, direct surgery was performed without carotid angiography. 5) Mortality; 47 cases of 60, have survived. The age, level of consciousness, other intracranial associated injuries, time of operation, bilateral positive Babinski's sign, volume of hematoma were felt to be the influencing factors to mortality. In 5 cases of 13 which expired, have died 4 weeks after surgery and the causes of death were pulmonary edema, pneumonia, septicemia, tracheal bleeding & renal shut down. In survivals, hemiplegia, hydrocephalus, oculomotor nerve palsy and mental confusion were observed which improved gradually except 4 cases, & 43 cases of 60 which have survived could remain to return to his usual daily activity.
Angiography ; Cause of Death ; Consciousness ; Craniocerebral Trauma ; Emergencies ; Head ; Hematoma* ; Hemiplegia ; Hemorrhage ; Hydrocephalus ; Incidence ; Mortality ; Mydriasis ; Oculomotor Nerve Diseases ; Pneumonia ; Pulmonary Edema ; Pupil ; Reflex, Babinski ; Sepsis

PURPOSE: We investigated whether myocardial SPECT had additional usefulness to clinical, functional or surgical indices for the preoperative evaluation of cardiac risks in noncardiac surgery. MATERIALS AND METHODS: 118 patients (M: F=66:52, 62.7+/-10.5 years) were studied retrospectively. Eighteen underwent vascular surgeries and 100 nonvascular surgeries. Rest T1-201/stress Tc-99m-MIBI SPECT was performed before operation and cardiac events (hard event: cardiac death and myocardial infarction; soft event: ischemic ECG change, congestive heart failure and unstable angina) were surveyed through perioperative periods (14.6+/-5.6 days). Clinical risk indices, functional capacity, surgery procedures and SPECT findings were tested for their predictive values of perioperative cardiac events. RESULTS: Peri-operative cardiac events occurred in 25 patients (3 hard events and 22 soft events). Clinical risk indices, surgical procedure risks and SPECT findings but functional capacity were predictive of cardiac events. Reversible perfusion decrease was a better predictor than persistent decrease. Multivariate analysis sorted` out surgical procedure risk (p=0.0018) and SPECT findings (p=0.0001) as significant risk factors. SPECT could re-stratify perioperative cardiac risks in patients ranked with surgical procedures. CONCLUSION:: We conclude that myocardial SPECT provides additional predictive value to surgical type risks as well as clinical indexes or functional capacity for the prediction of preoperative cardiac events in noncardiac surgery.
Death ; Electrocardiography ; Heart Failure ; Humans ; Multivariate Analysis ; Myocardial Infarction ; Myocardial Ischemia ; Perfusion ; Perioperative Period ; Retrospective Studies ; Risk Factors ; Tomography, Emission-Computed, Single-Photon*

Eleven patients with advanced prostatic cancer who had received single agent chemotherapy with cyclophosphamide were evaluated. All patients had pathologically confirmed prostatic adenocarcinoma and were unresponsive to or in relapse after hormonal therapy. They were treated intravenously with 200mg/m2 cyclophosphamide daily for four days every four weeks. The National prostatic Cancer Project(NPCP) response criteria were used. so objective response included patients with complete or partial response as well as objectively stable disease as defined by NPCP response criteria. The response rate was 54.6 %. with three partial response(27.3 8 ) and three objectively stable disease(27.3) of the eleven patients. All the six patients with partial response and objectively stable disease lived longer than 4 year, whereas for the five patients with objective progression. only two patient lived longer than 1 year. Toxicity was mild and tolerable. Mild and asymptomatic cyclophosphamide-induced hyponatremia was observed in two patients and hemorrhagic cystitis of mild degree was observed in one patient Severe hematologic and gastrointestinal toxicities were not observed.
Adenocarcinoma ; Cyclophosphamide* ; Cystitis ; Drug Therapy* ; Humans ; Hyponatremia ; Prostatic Neoplasms* ; Recurrence

Tic disorder is a childhood neuropsychological disorder which has the characteristics of abrupt, involuntary, and repetitive stereotyped muscle movement or voice. Tourette's disorder shows a chronic prognosis, and can last for life if no medical treatment is applied. Though the tic disorder has been known for a long time, the underlying cause is still not well known. Psychotropic drugs have long been used for the tic disorder or Tourette's disorder, but few clinical studies were carried out. However, the European Society for the Study of Tourette's syndrome recently reported the clinical guideline of Tourette's syndrome and other tic disorders based on the research findings obtained so far. Also, the guideline for the evidence-based treatment was reported in Canada, and North America. By synthesizing the newly reported foreign guidelines for treatment and review articles, this study aims to investigate the psychotropic drug therapy used for the tic disorder or Tourette's disorder.
Canada ; Drug Therapy* ; Muscles ; North America ; Prognosis ; Psychotropic Drugs ; Tic Disorders ; Tourette Syndrome* ; Voice

No abstract available.
Spinal Stenosis*

No abstract available.

PURPOSE: The C-14 urea breath test (C-14 UBT) is the most specific noninvasive method to detect Helicobacter (H) pylori infection. We investigated if the C-14 UBT can reflect the presence and degree of H. pylori detected by gastroduodenoscopic biopsies (GBx). MATERIALS AND METHODS: One hundred fifty patients (M:F=83:67, age 48.6+/-11.2 yrs) underwent C-14 UBT, rapid urease test (CLO test) and GBx on the same day. For the C-14 UBT, a single breath sample was collected at 10 minutes after ingestion of C-14 urea (137 KBq) capsule and counting was done in a liquid scintillation counter for 1 minute, and the results were classified as positive ( 200 dpm), intermediate (50~199 dpm) or negative (<50 dpm). The results of CLO tests were classified as positive or negative according to color change. The results of GBx on giemsa stain were graded 0 (normal) to 4 (diffuse) according to the distribution of H. pylori by the Wyatt method. We compared C-14 UBT results with GBx grade as a gold standard. RESULTS: In the assessment of the presence of H. pylori infection, the C-14 UBT global performance yielded sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 92.5%, 88.4%, 97.1%, 88.4% and 91.3%, respectively. However, the CLO test had sensitivity, specificity, PPV, NPV and accuracy of 83.2%, 81.4%, 91.8%, 81.4% and 82.7%, respectively. The quantitative values of the C-14 UBT were 45+/-27 dpm in grade 0, 707+/-584 dpm in grade 1, 1558+/-584 dpm in grade 2, 1851+/-604 dpm in grade 3, and 2719+/-892 dpm in grade 4. A significant correlation (r=0.848, p<0.01) was found between C-14 UBT and the grade of distribution of H. pylori infection on GBx with giemsa stain. CONCLUSION: We conclude that the C-14 UBT is a highly accurate, simple and noninvasive method for the diagnosis of ongoing H. pylori infection and reflects the degree of bacterial distribution.
Azure Stains ; Biopsy ; Breath Tests* ; Diagnosis ; Eating ; Helicobacter pylori* ; Helicobacter* ; Humans ; Scintillation Counting ; Sensitivity and Specificity ; Urea* ; Urease

We have experienced an unusual case of mesenteric lymphangiomatosis in a 6-month-old male infant. Computedtomography (CT) disclosed fatty abdominal masses with attenuation coefficient being
Chyle ; Humans ; Infant ; Laparotomy ; Lymphangioma ; Male ; Mesentery