We have performed the prick test on 70 patients with atopic lermatitis and at the same time measured the levels of serum IgE and peripheral eosinophil counts. The following results were obtained: 1. Patients with atopic dermatitis showed higher rates of positivty in the prick tests, espe cially to inhalant, allergens. 2. The levels of IgE were increased in these patients and those who were positive to at least one allergen in the prick tests showed higher levels of IgE ha those who were negative in the prick tests. 3. The patients with atopic dermatitis with a past history of allergic rhinitis demonstrated higher rates of skin test positivity. 4. There was no correlation between the levels of serum IgE and the peripheral eosinophil counts in these patients with atopic dermatitis,
Allergens ; Dermatitis, Atopic* ; Eosinophils ; Humans ; Immunoglobulin E* ; Rhinitis ; Skin Tests

No abstract available.
Humans ; Radiography* ; Spine*

Scalp extension involves the continuous nonvolumetric expansion of the hair-bearing scalp, via biologic creep, using implanted surgical device consists of cutting a 5 cm wide strip of plain silastic (0.02 inch thick) from a larger 16x8 inch sheet, then gluing dacron-reinforced silastic strip (5x1 cm, 0.015 inch thich) to the distal ends. A stainless steel plate from hooks is then secured to each end of the extender. During the period from March 1996 to September 1997, 21 patients including 16 patients of male pattern baldness were treated for alopecia of the scalp using internal scalp extender in the department of plastic surgery Korea university hospital. All cases were successfully reconstructed without major complications. It not only reduces the number of scalp reductions and time necessary to totally excise bald vertex scalp, but also appears to decrease the amounts of stretch back and atrophic scarring that may accompany some reductions. Scalp extension appears to be a useful adjunctive technique in hair replacement and reconstructive surgery, and has distinct advantages over standard scalp reduction and tissue expansion techniques.
Alopecia* ; Cicatrix ; Hair* ; Humans ; Korea ; Male* ; Scalp* ; Stainless Steel ; Surgery, Plastic ; Tissue Expansion

We report a case of acute transient encephalopathy with mental alteration, myoclonic jerks, and periodic triphasic wave electroencephalographic patterns caused by a therapeutic dose of baclofen. The clinical and electroencephalo-graphic abnormalities improved to a normal range shortly after baclofen was discontinued. We discuss the pathogenesis and review the literature about baclofen-induced encephalopathies.
Baclofen ; Myoclonus ; Reference Values

Hypercalcemia is a relatively common complication of cancer that is clinically important because, left unattended, it is associated with symptomatic deterioration and even death. So hypercalcemia can afflict the quality of life and complicate management of the cancer patients with anorexia, lethargic, stuporous mentality, and severely dehydrated. Nonetheless, most cancers are at an advanced stage by the time hyperclacemia develops, many clinicians share doubts about the role of antihypercalcemic therapy in this situation. Furthermore, because the symptoms of hypercalcemia may mimic that of progressive malignant disease or the toxic effects of chemotherapy and radiation therapy, this may not always be recognized. So concerns are needed for active management of patients with malignant hypercalcemia. The authors reviewed the morbidity and mortality in 20 patients with malignant hypercalcemia out of 219 patients with bone metastasis, who were treated at the department of orthopaedic surgery, Catholic University Medical College from January 1989 through December 1992. The results were as follows. 1. The overall incidence of malignant hypercalcemia was 8.6% of bone metastases (20 out of 219 cases).: lung cancer 11.2% (10 out of 89 cases), breast cancer 22.5% (7 out of 31 cases), stomach cancer 6.3% (3 out of 47 cases). 2. The underlying diseases associated with hyprecalcemia were 10 cases of lung cancer(50%), 7 cases of breast cancer(35%) and 3 cases of stomach cancer(15%). Out of lung cancers, 8 cases were squamous cell cancers, the other 2 cases were oat cell cancers. 3. Only 7 out of 20 patients were treated with hydration, diuretics, steroid, calcitonin and mithramycin. And the mean survival duration after recognition of hypercalcemia was 11.3 weeks independent of treatment. In conclusion, the authors emphasize that inspite of grave prognosis, when treated actively, calcium lowering therapy may allow patients to be discharged during terminal period of their illness.
Anorexia ; Avena ; Breast ; Breast Neoplasms ; Calcitonin ; Calcium ; Diuretics ; Drug Therapy ; Humans ; Hypercalcemia ; Incidence ; Lung ; Lung Neoplasms ; Mortality ; Neoplasm Metastasis ; Neoplasms, Squamous Cell ; Plicamycin ; Prognosis ; Quality of Life ; Stomach ; Stomach Neoplasms ; Stupor

The goal in facial paralysis treatment is to achieve the normal appearance of the face as well as to reconstruct the natural symmetrical smile. In cases of facial paralysis, a widely accepted procedure is the two stage method, which combines neurovascular free muscle transfer with cross face nerve grafting. Although the results are promising, the two operations of this method, which are about 1 year apart, impose an economic burden on the patients and require a lengthy period before results are obtained. In order to overcome these drawbacks, one stage method, using latissimus dorsi neurovascuular free muscle flap was introduced. Between January 2000 and January 2004, fifteen patients with long standing facial paralysis were treated in the Korea University Anam Hospital. The segmental latissimus dorsi with long nerve and pedicle was transferred to the paralyzed side of the face. The first postoperative movement of the transferred muscle was reported at 8.9 months, faster than that of the two stage method. During the next 24 months, a constant increase in the power of muscle contraction was observed. The fifteen cases were evaluated within an average of 31.7 months following the surgery and satisfactory results including muscle contraction were obtained in eleven of the cases but muscle contraction was not found in three cases.
Facial Paralysis* ; Free Tissue Flaps* ; Humans ; Korea ; Muscle Contraction ; Superficial Back Muscles* ; Transplants

Human orthotopic liver transplantation was first attempted in 1963. Living related liver transplantation has been introduced by Raia in 1988. In children, biliary atresia is the leading indication of living related liver transplantation. We performed 2 cases living related liver transplantation on May, 1996. The donors were 32 and 30 year old father, recipients were his 3 year old son and 4 year old daughter. The causes of liver failure were drug induced fulminant hepatitis and recurrent cholangitis due to biliary atresia. The first case was incompatible of ABO blood typing, donor AB(Rh+) and recipient B(Rh+). The ABO incompatible donor was performed preoperatively plasmapheresis. After left lateral segmentectomy of donor and total hepatectomy of recipient, donor liver was orthotopically transplanted. The average operation time of donor and recipient were 8 hours and 12.5 hours. The amount of transfusion in donor and recipient were average 2 pints and 2.5 pints. The perioperative immunosuppression was maintained with prednisone, azathioprine and cyclosporin, but 1st case was changed from cyclosporin to OKT3 on postoperative 9th day. The postoperative complications of recipient were pulmonary edema, bacterial and fungal infection. The donors were discharged on postoperative 8th and 9th day. The first case patient was discharged postoperative 42th day due to respiratory complication. The 2nd recipient was discharged postoperative 22th day. We suggested that living related liver transplantation is good modality for resolving the graft shrtage in pediatric liver transplantation.
Adult ; Azathioprine ; Biliary Atresia ; Blood Grouping and Crossmatching ; Child ; Child, Preschool ; Cholangitis ; Cyclosporine ; Fathers ; Hepatectomy ; Hepatitis ; Humans ; Immunosuppression ; Liver Failure ; Liver Transplantation* ; Liver* ; Mastectomy, Segmental ; Muromonab-CD3 ; Nuclear Family ; Plasmapheresis ; Postoperative Complications ; Prednisone ; Pulmonary Edema ; Tissue Donors ; Transplants

Because additive effects of inhaled corticosteroids and long-acting anticholinergics are unclear, we undertook this study to compare the efficacy of tiotropium alone and tiotropium plus budesonide in patients with chronic obstructive pulmonary disease. The study subjects were randomized to receive either tiotropium 18 microgram once daily with or without budesonide 200 microgram twice daily for 6 weeks. The efficacy variables were changes in trough forced expiratory volume in one second (FEV1), St. George's Respiratory Questionnaire (SGRQ), 6-minute walk distance (6MWD), and use of rescue medication. One hundred patients were randomized and 81 completed the study. The mean age was 64.0 yr, and the mean FEV1 was 39.7% predicted. Compared with tiotropium alone (N=40), the tiotropium/budesonide combination (N=41) was related to an improvement in the SGRQ total score (tiotropium -2.8 units and tiotropium/budesonide -5.6 units, p=0.003). 6MWD was improved by 13.5 m in the tiotropium group and by 22.5 m in the tiotropium/budesonide group (p=0.031). Changes in trough FEV1 and the use of rescue medication were similar between two groups. In conclusion, compared with tiotropium alone, the tiotropium/ budesonide combination was related to an improved health-related quality of life. These data support that low-dose budesonide may enhance the efficacy of tiotropium.
Aged ; Bronchodilator Agents/*administration & dosage ; Budesonide/*administration & dosage ; Exercise ; Female ; Humans ; Male ; Middle Aged ; Models, Statistical ; Pulmonary Disease, Chronic Obstructive/*drug therapy ; Quality of Life ; Questionnaires ; Scopolamine Derivatives/*administration & dosage ; Spirometry/methods ; Treatment Outcome

Horizontal canal benign paroxysmal positional vertigo (HC-BPPV) is characterized by direction-changing nystagmus of the horizontal component induced by lateral head turning in supine position. Yet, some patients with HC-BPPV show nystagmus inversion during head turning to one side. And, mostly, the nystagmus started in a geotropic direction and the inversion was observed only when the head is turned to the lesion side. Reversal of the clot movement in the canal and sensory adaptation were suggested as the hypothesis for such finding. However, bilateral inversion of geotropic nystagmus into apogeotropic nystagmus in HC-BPPV has seldom been described before. In this paper, the authors presented the characteristic features and progression during reposition of a patient with bilateral nystagmus inversion and speculated its mechanisms.
Diagnosis ; Head ; Humans ; Semicircular Canals ; Supine Position ; Vertigo*

BACKGROUND: Food restriction has been reported to ameliorate diabetes and obesity. In this study, we examined the effects of the food restriction on phenotypes of TALLYHO/JngJ (TH) mouse, a recently developed diabetic model animal. METHODS: 3 week-old TH mice were divided into 2 groups (n = 20 each for food-restricted (THR) and free-fed (THF)) and THR mice were fed the same amount of food as normal control mice (C57BL/6, n = 20). Body weight was weekly monitored till 14 weeks of age. The half of animals were sacrificed at 8 weeks of age, and liver, kidney, and fat weight were measured. The histopathology of liver and brown fat tissues and mRNA expression of leptin in adipose tissue were analyzed. The oral glucose tolerance test and insulin resistance test was done at 14 weeks of age. The plasma concentrations of glucose, free fatty acid, triglyceride, cholesterol and leptin were analyzed. RESULTS: The THR mice had lower body weights than the THF mice, similar to C57BL/6 mice, with reduced fat deposition in liver and brown fat tissue. The plasma levels of glucose, triglyceride and free fatty acid were decreased in the THR group. The THR mice, however, carried more fat than normal mice, with increased plasma leptin concentration and leptin mRNA expression in fats and no alteration in plasma cholesterol levels. Furthermore, the THR mice revealed glucose intolerance with impaired after-meal insulin secretion and slight insulin resistance CONCLUSION: The food restriction apparently ameliorated the obesity and diabetic phenotypes of TH mice. However, plasma concentration of cholesterol were not improved in THR mice with increased adiposity index and glucose intolerance, suggesting the genetically prone tendency of obesity and diabetes development in TH mice possibly with an impairment in cholesterol metabolism.
Adipose Tissue ; Adipose Tissue, Brown ; Adiposity ; Animals ; Body Weight ; Cholesterol ; Diabetes Mellitus ; Fats ; Glucose ; Glucose Intolerance ; Glucose Tolerance Test ; Insulin ; Insulin Resistance ; Kidney ; Leptin ; Liver ; Mice ; Obesity ; Phenotype ; Plasma ; RNA, Messenger