BACKGROUND: There are two kinds of mechanism for laser therapy according to selectie photothermolysis. Selective photothermolysis means that a chromophore can be selectively dei, stroyed with a laser of n appropriate wavelength and of a short pulse duration that is shortor than the thermal relaxation time of the chromophore. It is supposed that the side effects of the continuous wave laser, in which selective photothermolysis does not exist occur more often than when a pulsed wave laser is used. OBJECTIVE: We compar.d the side effects of flashlamp-pumped pulsed tunable dye laser(SPTL), whose treatment is baseal on selective photothermolysis, with those of copper vapor laser(CVL , which is a quasi-continuous thermal laser. METHODS: The laser cl arts of 498 patients with SPTL treatment and 485 patients with CVL, treatment in Asan Medical Center from 1989 to 1994 were examined, retrospectively. RESULTS: 1) Among 498 patients, with SPTL treatment, we observed various side effects in 47(9.4%). The incidences of individial side effects are as follows, hyperpigmentation in 6.2%(31), vesicl formation in 1.6% (8), surface texture change in 0.8% (4), Hypopigmentation in 0.6% (3), scar format,ion in 0.2% (1). 2) After CVL treatment, side effects occurred in 30(6.2%) among 485 patient.. Hyperpigmentation in 3.1%(15), vesicle formation in 2.5%(12), surface texture change in 0.2%(1), hypopigmentation in 0.2%(1), and scar formation in 0.1%(1) were observed. CONCLUSION: The total incidence of side effect.s after CVL treatment is not statistically different, from that after SPTL treatment, which contradicts the previous theory.
Chungcheongnam-do ; Cicatrix ; Copper* ; Humans ; Hyperpigmentation ; Hypopigmentation ; Incidence ; Laser Therapy ; Lasers, Dye* ; Lasers, Gas* ; Relaxation ; Retrospective Studies

No abstract available.
Carcinoma, Transitional Cell*

PURPOSE: A lateral thoracodorsal fasciocutaneous flap (LTFF) is a local fasciocutaneous flap that has been used in breast reconstructions since the 1980s. Although the LTFF is a wellstudied reconstruction procedure after radical surgery in Western countries, there is no report in Korea. By introducing the LTFF procedure, we suggest an easy reconstruction technique that can be performed by the breast surgeon directly. METHODS: Patients with lateral breast cancer and redundant lateral thoracic region might be candidates for this procedure. The flap consists of the lateral and dorsal extensions of the inframammarian fold as well as an extended line from the anterior axillary line. A quadrantectomy is performed through a planned skin incision, and an axillary lymph node dissection can be performed simultaneously if the sentinel lymph node is positive. The skin and subcutaneous fat with the fascia of the serratus anterior and latissimus dorsi muscle should be dissected carefully. A wedge-shaped flap can be acquired successfully. The lateral breast defect is then reconstructed by a rotation of the flap. The axis of the flap is drawn following the inframammarian fold so that the final scar would be under the brassiere line. RESULTS: Nineteen patients were treated with the LTFF after breast conserving surgery. All tumors were located in lateral breast regions. Seroma occurred in three and partial fat necrosis and partial flap necrosis were observed in each one. The cosmetic result based on four-point scoring system of breast cosmesis showed excellent in seventeen and good in two. CONCLUSION: Despite its long scar line, with appropriate patient selection, a LTFF might be a useful method for breast reconstructions.
Axis, Cervical Vertebra ; Breast Neoplasms ; Breast* ; Cicatrix ; Fascia ; Fat Necrosis ; Female ; Humans ; Korea ; Lymph Node Excision ; Lymph Nodes ; Mammaplasty* ; Mastectomy, Segmental ; Necrosis ; Patient Selection ; Seroma ; Skin ; Subcutaneous Fat ; Superficial Back Muscles

Human is infected by third stage filariform larvae of Strongyloides stercoralis which is a soil-transmitted nematode. Rhabditiform larvae passed in feces can transform into infectious filariform larvae either directly or after a free living phase of development. Most infected patients may be asymptomatic or have mild cutaneous symptoms or induces non-specific complaints such as moderate abdominal pain, nausea and diarrhea. However, in immunocompromised hosts, the parasite is augmented by autoinfection, resulting in hyperinfection and can disseminate widely and can be fatal. We report a case of strongyloidiasis associated with intestinal obstruction in a patient with alcoholic liver disease.
Abdominal Pain ; Alcoholics* ; Diarrhea ; Feces ; Humans ; Immunocompromised Host ; Intestinal Obstruction* ; Larva ; Liver Diseases, Alcoholic* ; Nausea ; Parasites ; Strongyloides stercoralis ; Strongyloidiasis*

Human is infected by third stage filariform larvae of Strongyloides stercoralis which is a soil-transmitted nematode. Rhabditiform larvae passed in feces can transform into infectious filariform larvae either directly or after a free living phase of development. Most infected patients may be asymptomatic or have mild cutaneous symptoms or induces non-specific complaints such as moderate abdominal pain, nausea and diarrhea. However, in immunocompromised hosts, the parasite is augmented by autoinfection, resulting in hyperinfection and can disseminate widely and can be fatal. We report a case of strongyloidiasis associated with intestinal obstruction in a patient with alcoholic liver disease.
Abdominal Pain ; Alcoholics* ; Diarrhea ; Feces ; Humans ; Immunocompromised Host ; Intestinal Obstruction* ; Larva ; Liver Diseases, Alcoholic* ; Nausea ; Parasites ; Strongyloides stercoralis ; Strongyloidiasis*

No abstract available.
Gastrointestinal Tract* ; Leiomyosarcoma*

BACKGROUND: Management of primary aldosteronism has undergone dramatic changes in the past 40 years. This retrospective study was carried out to review our surgical experience and postoperative outcome and to identify the clinical charateristics of primary aldosteronism. METHODS: Twenty-five patients who underwent an adrenalectomy for primary aldosteronism from 1983 to 1997 were included in the study. All patients were operated on at the Department of Surgery, School of Medicine, Kyung-Hee University. We reviewed the records of 18 women and 7 men, ranging in age from 22 to 59 years. Data examined included clinical presentation, biochemical results, hormonal evaluation, localization studies, operative results, pathologic details, and postoperative outcome. The diagnosis of primary aldosteronism was based on a demonstration of hypertension, hypokalemia, elevated plasma aldosterone concentration, and suppressed plasma renin activity. Localization studies, including computed tomography (CT) and ultrasonography (US) were performed in all patients. A follow-up study was conducted by either reviewing clinical records, telephone contact, or examination of patients during return visits. RESULTS: Hypertension and hypokalemia were present in all patients. Serum potassium ranged from 1.4 to 3.2 mEq/L (2.3+/-0.5; mean+/-standard deviation {SD}mEq/L), and hypokalemia was considered an important diagnostic clue. We found the accuracy rate for CT results in our patients to be 96.0% (24 patients). An adrenal venous sampling was performed in one patient whose CT results were not confirmatory. A unilateral adrenalectomy was performed through posterior (22 patients), an anterior transabdominal (1 patient), or a lateral transabdominal laparoscopic (2 patients) approach. A laparoscopic adrenalectomy will minimize postoperative pain and hospital stay. The histological findings were 23 aldosterone-producing adenomas and 1 nodular hyperplasia. During a mean follow-up of 31.6 months, 22 (91.7%) of the 24 patients required no further antihypertensive treatment. CONCLUSION: Primary aldosteronism due to an aldosterone-producing adenoma can be diagnosed and localized expeditiously, and surgical treatment can be performed safely.
Adenoma ; Adrenalectomy ; Aldosterone ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Hyperaldosteronism* ; Hyperplasia ; Hypertension ; Hypokalemia ; Length of Stay ; Male ; Pain, Postoperative ; Plasma ; Potassium ; Renin ; Retrospective Studies ; Telephone ; Ultrasonography

The incidence of tuberculosis (TB) had gradually been declining all over the world, but in recent years, TB has been increasing due to the spread of the human immunodeficiency virus (HIV). When immune-suppression status deteriorates further, extrapulmonary TB generally appears more often. Abdominal TB is one type of extra-pulmonary TB, which may involve the gastrointestinal tract, peritoneum, lymph nodes or solid viscera. We encountered a case who had initially been diagnosed as having abdominal TB, had progressed to acute respiratory distress syndrome and was eventually confirmed as having developed acquired immune deficiency syndrome. In cases of coinfection of TB and HIV, it is reported that immunological responses become poor and complications with higher morbidity frequently occur. Therefore, the Korean guidelines for TB should be revised to ensure whether HIV infection exists in TB patients.
Acquired Immunodeficiency Syndrome* ; Coinfection ; Gastrointestinal Tract ; HIV ; HIV Infections ; Humans ; Incidence ; Lymph Nodes ; Peritoneum ; Respiratory Distress Syndrome, Adult ; Tuberculosis* ; Viscera

BACKGROUND: Many young children suffer from wheezing illness during viral respiratory infection, and some of them experience wheezing many years later and ultimately develop bronchial asthma. It is not clear whether atopy or bronchial hyperresponsiveness in the family is a significant risk factor for asthma in this clinical setting. Objective : To examine the genetic basis for the development of asthma after early childhood wheezing. Materials and METHODS: A measurement of serum total IgE concentration, skin prick test to common inhalant allergens, and methacholine bronchial provocation test were performed in 29 asthmatic children and their parents, and 22 non-asthmatic children with the past history of wheezing illness during the first three years of age and their parents. A questionnaire was performed to assess the presence of asthma and allergic rhinitis in the parents. RESULTS: Positive skin test response to common inhalant allergens was more prevalent in asthmatics than in non-asthmatics(67.8% vs. 27.2%). Serum total IgE concentration was significantly higher in asthmatics than in non-asthmatics(geometric mean: 173 vs. 83 IU/ ml). Positive skin test response to comman inhalant allergens was more prevalent in parents of asthmatics than in thoae of non-asthmatics(51.7% vs. 25.0%), but serum total IgE level was not different between the two groups(geometric mean: 132 vs. 120 IU/ml). Positive rate of methacholine bronchial provocation test, geometric mean of PC20-methacholine, and BR index were not different between the parents of asthmatics and non-asthmatics (18.1% vs. 13.9%; 164 vs. 180 mg/ml; 1.154+-0.077 vs. 1.055+-0.068, respectively). CONCLUSION: It is suggested that personal atopy is important in the development of asthma after early childhood wheezing, and parental atopy rather than bronchial hyperresponsiveness is a risk factor for the development of childhood asthma in this clinical setting.
Allergens ; Asthma* ; Bronchial Provocation Tests ; Child ; Genetics ; Humans ; Immunoglobulin E ; Methacholine Chloride ; Parents* ; Respiratory Sounds* ; Rhinitis ; Risk Factors ; Skin ; Skin Tests ; Surveys and Questionnaires

BACKGROUND: Bronchial asthma is a complex genetic disorder. Although serum IgE level and bronchial hyperresponsiveness are well known to be under genetic control, the influence of genetic factors on basophil releasability has been seldom studied. OBJECTIVE: The present study was carried out to investigate whether genetic factors may influence the basophil histamine releasability. MATERIALS AND METHODS: We studied 50 children, 32 with atopic asthma (AA) and 18 normal control (NC), and their parents. Suspensions of leukocytes were isolated and stimulated with Ca ionophore and anti-IgE antibody. Then, histamine in the supernatant was as-sayed by an automated fluorometric analyzer. RESULTS: Among the probands, AA children had a significantly higher anti-IgE induced histamine release than NC children. In contrast, Ca ionophore-induced histamine release was similar between the two groups. Ca ionophore-induced or anti-IgE-induced histamine release was not significantly different between parents of AA children and those of NC children. However, the maximal histamine release by Ca ionophore in parents had a significant correlation with that of probands, whereas the values by anti-IgE were not correlated between probands and their parents. CONCLUSION: We confirmed that basophils from patients with atopic asthma are characterized by a specific increase in IgE-mediated histamine release. The significant correlation of Ca ionophore-induced maximal histamine release between children and their parents suggests that genetic factors may play an important role in the control of non-IgE-mediated relessability from basophils.
Asthma ; Basophils* ; Child ; Genetics ; Histamine Release ; Histamine* ; Humans ; Immunoglobulin E ; Leukocytes ; Parents ; Suspensions