There have been no standard treatments for recurrent aphthous stomatitis, and clinical management is usually directed toward symptomatic relief. Recent immunological investigations have focused on possible imrnunopathogenesis of the disease. Several reparters suggested that levamisole, nonspecific immune-stimulator, had a beneficiaI effect in controlling attacks of recurrent a,phthous stomatitis and in reducing subsequent episodes. The present study was undertaken to evaluate the therapeutic effectiveness of levamisole in patients with recurrent aphthous stomatitis. A total of 8 patients who had had recurrent aphthous stomatitis for 2 to 20 years and who had experienced at least one episode per month were selected for this study from the department of dermatology, National Medical Center, through March 1979 to September 1979, Levamisole (Decaris') was given 150mg, p.o., once daily on 3 consecutive days every week for 2 months. Tbe results were as follows. 1) One patient had to have levamisole discontinued due to a high fever and exacerbations of tbe oral ulcerations. 2) 5 patients showed beneficial effects in reducing tbe number, frequency, pain and severity of recurrent aphthous stomatitis. 3') One patient showed no therapeutic response. 4) One patient, who has experienced new oral ulcerations continuously before starting levamisole, showed no recurrences of the lesions during the follow-up period of 3 months. 5) Side effects during levamisole administration were transient and generally mild, They included nausea, headache, dizziness and high fever.
Dermatology ; Dizziness ; Fever ; Follow-Up Studies ; Headache ; Humans ; Levamisole* ; Nausea ; Oral Ulcer ; Recurrence ; Stomatitis ; Stomatitis, Aphthous*

No abstract available.
Enzyme-Linked Immunosorbent Assay* ; Herpes Simplex* ; Immunoglobulin G* ; Immunoglobulin M*

Acute febrile neutrophilic dermatosis, which was introduced to the dermatologic literature by Sweet in 1964, is characterized by persistent high fever and preceding upper respiratory infection like symptoms, polymorphonuclear leukocytosis in the peripheral blood, raised painful plaques on the limbs, face and neck, histologically a dense dermal infiltration with polymorphonuclear leukocyte, dramatic response to corticosteroids, and the absence of scarring. Case 1 was a 35 year-old female who had suffered from malaise, sore throat, and fever 3 to 7 days before the each episode of the cutaneous manifestation. Painful, red, raised, well-demarcated plaques appeared on the face with tendency of recurrences, and was accompanied by a few, small, shallow ulcerations on the lower Iip and tongue, and conjunctivitis. Polymorphonuclear leukocytosis (10400 with 65%, 11600 with 75%) and elevated ESR(23mm/hr, 19mm/hr) were found on two occasions. Histologically a dense inflammatory cell infiltration composed predominantly of polymorphonuclear neutrophils, small round cells, and a few eosinophils were seen in the dermis and subcutis, especially around the dermal capillaries. Alao there were many nuclear debris and marked endothelial cell proliferations. (countinued...)
Adrenal Cortex Hormones ; Adult ; Capillaries ; Cicatrix ; Conjunctivitis ; Dermis ; Endothelial Cells ; Eosinophils ; Extremities ; Female ; Fever ; Humans ; Leukocytosis ; Neck ; Neutrophils ; Pharyngitis ; Recurrence ; Sweet Syndrome* ; Tongue ; Ulcer

Ultrasonography is a predominantly accurate, relatively simple unique diagnsotic method of obstructive jaundice. The ultrasonographic findings of obstructive jaundice are dilated intra- and extrahepatic duct with intraluminal hyperreflective echo or mass in and/or around the bile duct. The superiority of high resolution real time ultrasonography for the diagnosis of obstructive jaundice is based on the easy detectability of extra-and intrahepatic bile ducts by its multiple sectional images in a short time, the flexibility of probe and the small crystal size. Author evaluated real time sonographic findings 46 obstructive jaundice patients confirmed by surgery or radiographical examinations. The results were: 1. Diameter of extrahepatic duct in obstructive jaundice were varied from normal to 4.0 cm, mostly 8 to 10 mm in diameter (26%). Degree of dilatation of biliary duct appeared more prominent in cancer patients than any other causes of obstruction. 2. The site of obstruction was detected in85% (39/46) and its common site was common bile duct in 63% (29/46). 3. The diagnostic accuracy of choledocholithiasis and cancer was 82% (22/27) and 44% (4/9), respectively. Diagnostic accuracy of the real time ultrasonography in obstructive jaundice was over all 75% (34/46).
Bile Ducts ; Bile Ducts, Intrahepatic ; Choledocholithiasis ; Common Bile Duct ; Diagnosis ; Dilatation ; Humans ; Jaundice, Obstructive ; Methods ; Pliability ; Ultrasonography

Epidermal growth factor receptor (EGFR) is overexpressed in various malignancies including carcinoma of the breast, lung, esophagus, cervix, and stomach. In patients with cervical carcinoma, its overexpression may be associated with advanced stage and poor prognosis. So, we evaluated the levels of serum EGFR in patients with cervical carcinoma. The level of EGFR extracellular domain was determined in serum from 57 cervical carcinoma patients(adenocarcinoma: 2, squamous cell carcinoma: 39, carcinoma in situ(CIS): 16) and 28 cases of healthy control using enzyme-linked immunosorbent assay(Calbiochem). In invasive carcinoma, serum EGFR level was measured in 11 cases of Stage Ia, 9 cases of Stage Ib, 4 cases of Stage IIa, 15 cases of Stage IIb, 2 cases of stage III patients. The mean ages of the healthy controls, of the wome with carcinoma in situ(CIS), and with invasive cervical carcinoma were not different(49.3, 44,4, 49.5, respectively, p 0.241). The mean serum level of EGFR in healthy control(n 28), carcinoma in situ(CIS)(n 16), and invasive carcinoma patients(n=41) were not significantly different(71.4+/-12.8fmol/ml, 79.2+/-26.8fmol/ml, 61.8+/- 18.4 fmol/ml, respectively, p=0.071). In conclusion, the expression of EGFR was not increased in patients with cervical cancer compared with normal women. And no significant differences were found depending on the clinical stage.
Breast ; Carcinoma, Squamous Cell ; Cervix Uteri ; Enzyme-Linked Immunosorbent Assay ; Esophagus ; Female ; Humans ; Lung ; Prognosis ; Receptor, Epidermal Growth Factor ; Stomach ; Uterine Cervical Neoplasms*

Generally, absolute alcohol embolization has been commonly used for treatment of arteriovenous malformation (AVM) because complete surgical extirpation of AVM can be an extremely hazardous and difficult. Even if absolute alcohol is safe embolic agent, it can result in pain, pulmonary hypertension, pulmonary embolism and post-embolization syndrome such as nausea, vomiting, hemolysis and myoglobinuria. So, general anesthesia is needed for alcohol embolization. In this case, anesthesia was induced with intravenous (IV) propofol 110 mg and succinylcholine 60 mg and maintained with propofol and vecuronium. The pulmonary artery pressure was monitored with a Swan-Ganz catheter. After alcohol injectons, systolic pulmonary artery pressure was increased, ranging 35-40 mmHg. And cola-colored urine was noticed. For treatment of pulmonary hypertension, nitroglycerine was given IV. The IV fluid rate was increased and furocemide was given IV to increase the urine output. After general anesthesia, the patient was awake but appeared to be alcohol-intoxicated. Blood alcohol level was 42 mg/dl. Urinalysis showed large amounts of myoglobin, hemoglobin and albumin. So, anesthesiologists have to keep in mind of such complications when absolute alcohol embolization is done.
Anesthesia ; Anesthesia, General ; Arteriovenous Malformations* ; Catheters ; Ethanol* ; Hemolysis ; Humans ; Hypertension, Pulmonary ; Myoglobin ; Myoglobinuria ; Nausea ; Nitroglycerin ; Propofol ; Pulmonary Artery ; Pulmonary Embolism ; Succinylcholine ; Urinalysis ; Vecuronium Bromide ; Vomiting

STUDY DESIGN: Retrospective study OBJECTIVES: To evaluate the surgical outcome of congenital scoliosis with a hemivertebra treated by posterior hemivertebra excision and pedicle screw instrumentation. SUMMARY OF LITERATURE REVIEW: Posterior hemivertebra excision can be accomplished through a single posterior approach, and excellent correction and outcome may be achieved. MATERIALS AND METHODS: Forty patients with one fully segmented hemivertebra treated by posterior hemivertebra excision with pedicle screw instrumentation were retrospectively analyzed after a minimum follow-up of 2 years (range 2~7.7 years). The mean age at surgery was 15.9 years (range 2.6~37.9 years). Preoperative and postoperative standing radiographs were used to assess radiographic parameters. RESULTS: The average number of vertebrae in the major curve was 4.2 (range 3~8), and the average flexibility was 29% (range 8~59%). The average length of fusion was 3.5 segments (range 1~6). The number of fused vertebrae had a positive correlation with age at the index surgery (r=0.345, p<0.05). Mean preoperative scoliosis of 48+/-12degrees was corrected to a mean of 17+/-10degrees (65% correction), and mean preoperative kyphosis of 46+/-18degrees was corrected to a mean of 12+/-12degrees at the most recent follow-up. The compensatory curve had a mean of 25+/-10degrees preoperatively and spontaneously corrected to a mean of 8+/-8degrees (70% correction) at the most recent follow-up. The mean operating time was 233+/-81 min, with an average blood loss of 2904 ml. There was neither crankshaft phenomenon nor iatrogenic spinal stenosis in 6 patients under the age of 5 years after an average follow-up of 6 years. CONCLUSIONS: Posterior hemivertebra excision using pedicle screw instrumentation in congenital scoliosis due to a hemivertebra is a safe and effective procedure. Posterior hemivertebra excision at an early age may reduce the fusion length while avoiding the induction of iatrogenic spinal stenosis during follow-up.
Follow-Up Studies ; Humans ; Kyphosis ; Pliability ; Retrospective Studies ; Scoliosis ; Spinal Stenosis ; Spine

Genital HPV infection is the most common sexually transmitted infection, but the majority of infections are self-limited. However, persistent infection with high-risk types can cause cervical cancer in women, which is the most common female genital cancer in Korea. In addition, HPV infection is the cause of genital warts and is associated with other anogenital cancers. The HPV vaccine is composed of the HPV L1 protein, the major capsid protein of HPV. Expression of the L1 protein in yeast using recombinant DNA technology produces noninfectious virus-like particles (VLP) that resemble HPV virions. The quadrivalent HPV vaccine is a mixture of four HPV type-specific VLPs prepared from the L1 proteins of HPV 6, 11, 16, and 18 combined with an aluminum adjuvant. Clinical trials indicate that the vaccine has high efficacy in preventing persistent HPV infection, cervical cancer precursor lesions, vaginal and vulvar cancer precursor lesions, and genital warts caused by HPV types 6, 11, 16, or 18 among females who have not already been infected with the respective HPV type. The recommended age for primary vaccination of Korean females is 15-17 years, considering sexual debut and duration of protection of the vaccine. Vaccine can be administered as young as age 9 years. Catch-up vaccination is recommended for females aged 18-26 years who have not been previously vaccinated. Vaccination is not a substitute for routine cervical cancer screening, and vaccinated females should have cervical cancer screening as recommended.
Aluminum ; Capsid Proteins ; Colposcopy* ; Condylomata Acuminata ; DNA, Recombinant ; Female ; Human papillomavirus 6 ; Humans* ; Korea ; Mass Screening ; Uterine Cervical Neoplasms ; Vaccination ; Virion ; Vulvar Neoplasms ; Yeasts

OBJECTIVE: The decision of optimal age for administration of recently approved prophylactic human papillomavirus (HPV) vaccines in the world depend on the basis of the sexual behavior of each countries. The aim of the study was to survey the age-specific sexual behavior including the sexual debut time and sexual experience in the Korean young women to design the tailored HPV vaccination. METHODS: This study was conducted by the Synovate Healthcare in the 6 city of Korea e.g. Seoul, Pusan, Daegu, Incheon, Kwangju and Daejon. By a stratified sampling methods 2,400 women aged 12-29 years old were included. The measures of sexual behavior presented in this report were collected by a Computer-Assisted Self-Interviewing (ACASI), in which the respondent enters her own answers into a computer without telling them to an interviewer. RESULTS: Among women 12-29 years of age, 39 percent of women (934 persons in 2,400 women) and 33 percent of single women (724 persons in 2,190 women) have had vaginal intercourse; 8 percent of women under 19 years old single women (79 persons in 1,045) and 56 percent of single women with 20-29 years old (645 persons in 1,145). Number of sexual partner was 2.8 person and 54 percent of women had more than 2 partners. Age of the first sexual activity (sexual debut) was 21 years old. The age of partner at the sexual debut was 23.2 years old. Sexual experience before 15 years old was only 2%. About the condom, 41% did not use or rarely use. CONCLUSION: Our data demonstrate that the sexual debut time of young Korean women differ from other countries in which the prophylactic HPV vaccine had already used. We conclude that the optimal age for HPV vaccination in Korea would be determined at 15-17 years old by this situation.
Adolescent ; Busan ; Condoms ; Daegu ; Daejeon ; Surveys and Questionnaires ; Delivery of Health Care ; Female ; Gwangju ; Humans ; Incheon ; Korea ; Seoul ; Sexual Behavior* ; Sexual Partners ; Vaccination ; Vaccines ; Young Adult

BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is one of the most important armamentarium against various hematologic malignancies or some solid tumors. We investigated the number of patients who might need transplants and compared with that of actual transplants to conceptualize current status and circumstances of HSCTs in Korean children. METHODS: Questionnaires were sent to Korean Society of Hematopoietic Stem Cell Transplantation (KSHSCT) members who were taking care of children with malignancies or hematologic diseases. Almost all of the newly diagnosed patients between Jan, 1st and Dec, 31st, 2003 were enrolled in the study. RESULTS: Seven hundred forty eight children (male to female ratio = 1.4:1) were enrolled. The median age was 6.1 years old (8 days~28.8 years old). Malignant diseases consisted of 695 cases (92.9%), and among them almost half were hematologic malignancies. The participating members speculated that HSCTs should be indicated in 285 children (38.1%) which included 209 allogeneic, and 76 autologous transplants. In reality, however, allogeneic HSCTs were performed only in 140 children (67.0%) with the median interval of 5.9 month, and autologous transplants in 44 children (57.9%) with 8.3 month. In autologous setting, all the patients received peripheral blood stem cells (PBSCs), whereas bone marrow (61%), cord blood (34%), and PBSC (5%) were used in allogeneic HSCTs. Donor types were as follows: unrelated donor (37%), cord blood (34%), sibling donor (25%), and family (4%). The reasons for not performing HSCTs were unfavorable disease status or death, no availability of suitable donor, economical situation, and refusal by parental preferences. Under the strict insurance regulations, many transplants were not covered by insurance. More autologous transplants were performed without insurance coverage than allogeneic HSCTs (P=0.013). Those cases were advanced cases and HLA mismatch transplants for allogeneic setting, and relatively rare diseases still awaiting favorable results of transplants for autologous setting. CONCLUSION: HSCTs are essential part of treatment strategies for children with various diseases. Unfortunately, however, a third of patients who were in need of transplants did not receive HSCTs due to various reasons. It is necessary to expand unrelated donor pool or cord blood banks for the cases lacking HLA-identical sibling donors. Also medical insurances should cover HSCTs for rare diseases as well as for less favorable but novel situations where there are no suitable alternatives.
Autografts ; Bone Marrow ; Child* ; Disulfiram ; Female ; Fetal Blood ; Hematologic Diseases ; Hematologic Neoplasms ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Insurance ; Insurance Coverage ; Parents ; Rare Diseases ; Siblings ; Social Control, Formal ; Stem Cells ; Tissue Donors ; Unrelated Donors ; Surveys and Questionnaires