We treated the 90 wrists (83 patients) with de Quervain's disease, and studied retrospectively the factors affecting the result of treatment, and the results of several treatment modalities, compared with published series of this disease. There was significant association between outcome and duration of symptoms before treatment, but age, sex, associated disease, and hand dominance were not associated(chi-square test, p < 0.05). And 75 wrists received single injections of steroid and local anesthetic into the tendon sheaths with complete pain relief in 59 wrists (69%). Furthermore, an additional injection gave pain abatement in 6 wrists. And regardless of treatment method, 95% of the whole patients had satisfactory outcome at a mean of 54 months (minimum follow-up, 45 months). We concluded that injection of steroid is the preferred initial treatment in de Quervain's disease, giving complete and lasting relief in 87% of cases.
De Quervain Disease ; Follow-Up Studies ; Hand ; Humans ; Methods ; Retrospective Studies ; Tendons ; Wrist

PURPOSE: We conducted a phase II study in previously untreated patients with unresectable stage IIIB or IV non-small cell lung cancer to evaluate the response rate and toxicity of the combination chemotherapy regimen of etoposide, ifosfamide and cisplatin. MATERIALS AND METHODS: From September 1993 to December 1996, twenty patients with advanced non-small cell lung cancer (stage IIIB 5 and IV 15) (squamous cell 8, adeno- carcinoma 12), were enrolled in this study. There were 13 (65%) males and 7 (35%) females, and median age of patients were 56 years (range: 34~66). Eighteen patients had performance status (ECOG) 0~1, two patients had performance status 2. Treatment was consisted of cisplatin (20 mg/m2 i.v., day 1~4), VP-16 (etoposide) (75 mg/m2 i.v., day 1~4), ifosfamide (1000 mg/m2 i.v., day 1~4) with mesna. This treatment was repeated every four weeks. RESULTS: The overall response rate was 25%. Complete response rate was 5% (1/20) and partial response rate was 20% (4/20). The median cycle of response was 4 (2~6) cycles. The median overall survival time was 28 weeks (9~98 weeks). The median time to progression was 10 weeks (3~50 weeks). Toxicities were evaluated by WHO criteria. Toxicity > GradeIII included: leukopenia 1.6%, thrombocytopenia 3.2%, nausea and vomiting 15%, alopecia 30%, stomatitis 10%. These toxicities were tolerable and reversible. CONCLUSION: VIP regimen was not superior to previous regimens for advanced non-small all lung cancer, and the toxicities were tolerable.
Alopecia ; Carcinoma, Non-Small-Cell Lung ; Cisplatin* ; Drug Therapy, Combination* ; Etoposide ; Female ; Humans ; Ifosfamide* ; Leukopenia ; Lung Neoplasms ; Male ; Mesna ; Nausea ; Small Cell Lung Carcinoma* ; Stomatitis ; Thrombocytopenia ; Vomiting

Epstein's syndrome is a rare disease whish is characterized by the association of thrombocytopenia, macrothrombocytopathia, nephritis and deafness. We experienced a case of Epstein's syndrome in a 12 years old male patient who was presented with a life long history of bleeding, usually as epistaxis, bilateral sensorineural deafness and hematuria with proteinuria starting in late childhood. Hematologic studies showed thrombocytopenia with giant platelets and anemia. A bone marrow aspirate revealed the megakaryocytes to be adequate in number and many giant size platelets. Platelet do not respond to addition of A and epinephrine; collagen and ristocetin induced agglutination response is decreased. It is difficult to be certain the association of thrombocytopenia with giant platelets, nephritis and deafness constitutes a new hereditary disease with a distinct pathogenesis or if it is an expansion of the well recognized Alport's syndrome of hereditary nephritis deafness. We report a case of Epstein's syndrome syndrome with brief review of related literatures.
Agglutination ; Anemia ; Blood Platelets ; Bone Marrow ; Child ; Collagen ; Deafness ; Epinephrine ; Epistaxis ; Genetic Diseases, Inborn ; Hematuria ; Hemorrhage ; Humans ; Male ; Megakaryocytes ; Nephritis ; Nephritis, Hereditary ; Proteinuria ; Rare Diseases ; Ristocetin ; Thrombocytopenia

Anaphylaxis is a life - threatening syndrome elicited in a hypersensitive individual on subsequent exposure to a sensitizing antigen with, reactions ranging widely in severity from mild pruritus and criteria to shock and death. Anaphylaxis occurs in the United States at rates estimated to be as high as one in every 3000 inpatients and may account for more than 500 deaths annually. Preparations of kelp Laminaria digitata are used as tents in gynecologic procedures to dilate the cervix, and the kelp consists principally of a glucagon carbohydrate called laminarin. Laminarin is thought to function as the active ingredient in dilatation by changing osmotic pressure or uterine prostaglandin metabolism. The tent is inserted into the cervix several hours before the procedure. As the cervix desiccates and dilates, the tent develops an hourglass shape. Recently, we experienced one patient with anaphylaxis to laminaria diagnosed by skin test and showing good response to treatment.
Anaphylaxis* ; Cervix Uteri ; Dilatation ; Female ; Glucagon ; Humans ; Inpatients ; Kelp ; Laminaria* ; Metabolism ; Osmotic Pressure ; Pruritus ; Shock ; Skin Tests ; United States

BACKGROUND: It has been reported that hypercholesterolemia is associated with coronary heart disease and that alcohol intake has influence on the lipid metabolism. This study was conducted to evaluate the relations between alcohol intake and serum lipid level. METHODS: We reviewed 906 subjects who had visited for routine checkup at family practice of Hanil hospital and then excluded 130 subjects with DM, renal disease, thyroid disease, hepatic disease or drug administration which might have influence on serum lipids. From the remaining 776 subjects, we obtained the amount and the frequency of alcohol drinking during the previous 2 weeks and the duration of alcohol intake, using a formed questionnaire. The alcohol dependence score was recorded by the National Alcoholism Screening Test. The serum lipids such as total cholesterol, triglyceride, and HDL-cholesterol were tested by enzyme method and the obesity index was obtained by Broca's method. These data were analyzed by SAS/PC program RESULTS: The total number of subjects was 776. Of those, 67.7%(n=525) were male and 32.3%(n= 251) females. The mean age of subjects was 50.5 years(range 15 to 77 years). The distribution according to the obesity index was as follows ; underweight group 7.1%, normal-weight group 38.1%, overweight group 31.6%, obesity group 23.2%. The number of the drinkers was 382(49.2%) in males and 7 (0.9%) in females. The mean serum lipid level were compared and analyzed among the groups. The results were as follows ; the total cholesterol and triglyceride levels were higher in males and the HDL-cholesterol levels was higher in female. The total cholesterol and triglyceride levels increased with age and obesity index, the HDL-cholesterol level decreased with obesity index. In the relationship between alcohol intake and serum lipid levels in males, the geometric mean of triglyceride level was higher among all the variables of alcohol intake, and that of HDL-cholesterol level increased with the amount and the frequency of alcohol intake. The results of multiple regression analysis associated with age, obesity index, the amount and the frequency of alcohol intake in males were as follows ; the triglyceride level was positively associated with the amount of alcohol intake, and the HDL-cholesterol level was positively associated with the frequency of akohol intake. CONCLUSIONS: The effects of age, sex and the obesity index on the serum lipid level are remarkable, and in males, alcohol intake increases triglycaride and HDL-cholesterol levels. Further study is needed to find out about whether alcohol intake have influences on coronary heart disease according to serum lipid levels.
Alcohol Drinking ; Alcoholism ; Cholesterol ; Coronary Disease ; Family Practice ; Female ; Humans ; Hypercholesterolemia ; Lipid Metabolism ; Male ; Mass Screening ; Obesity ; Overweight ; Thinness ; Thyroid Diseases ; Triglycerides ; Surveys and Questionnaires

BACKGROUND: Non ulcer dyspepsia(NUD) is a commonly encountered disease at the primary practice. The relations of functional gastrointestinal disorder and Irritable bowel syndrome with depression or stress were suggested by previous studies. But the contributions of the anxiety, depression and stress as a whole to the NUD were not assessed. In this study, we wanted to show the associations of the anxiety, depression and stress levels with NUD. METHODS: This study was performed by case and control method from Aug. 1 to Sep. 7 at the outpatient department of Family Medicine and at the Health Management and Service department in Pusan Paik Hospital. The both groups were matched by sex and age. The case was defined who has three or more symptoms among nine upper gastrointestinal symtoms like dyspepsia, epigastric pain and anorexia etc. frequently or alwalys and who has no ulcer at the gastrofibroscope. The anxiety, depression, stress levels were measured by questionnaire which was validated by previous studies. The questionnaire was composed of Trait-STAI, Jung's Self Depression Scale(SDS), Modified BEPSI, and Grobal Assessment of Recent Stress(GARS) Scale. RESULTS: The total subjects were 136 persons(NUD group : 86 persons/control group : 86 persons). There were. significant differances in regularity of diet(P<0.001), levels of education(P=0.009), and history of medications(P<0.001) between two groups. The two group had higher scores than the control group in the depression score, anxiety score and modified BEPSI score(P<0.001). All items in GARS showed higher scores in NUD group than in control group(P<0.001). CONCLUSIONS: NUD group had higher degree of anxiety and depression than the control group. It seems that the NUD may have streeful status. When we encounter the NUD in outpatiet department, we had better consider the underlying psychogenic or stressful conditions.
Anorexia ; Anxiety* ; Busan ; Depression* ; Dyspepsia* ; Gastrointestinal Diseases ; Humans ; Irritable Bowel Syndrome ; Outpatients ; Ulcer* ; Surveys and Questionnaires

Chronic sclerosing sialadenitis, Mikulicz disease or Kuttner tumor has been recently recognized as a spectrum of IgG4-related sclerosing disease. IgG4-related disease is characterized by a high serum IgG4 level and tissue infiltration of IgG4-positive plasmacytes. We report three cases of chronic sclerosing sialadenitis with variably associated systemic involvement. All patients presented with a submandibular mass or swelling, and all the resected submandibular glands showed diffuse lymphocytic infiltration, lymphoid follicles, and septal fibrosis. Two of the specimens revealed numerous IgG-positive plasma cells, most of which were IgG4-positive on immunohistochemical staining. One of them was associated with dacryoadenitis and hypophysitis. The other patient had ureterorenal lesions. Immunohistochemical study was unavailable in remaining one case, but the histologic features along with elevated IgG level and associated pancreatitis supported the diagnosis. All patients received steroid therapy postoperatively and are doing well. Salivary gland involvement in IgG4-related fibrosclerosis should be recognized in systemic medical pathology.
Dacryocystitis ; Fibrosis ; Humans ; Immunoglobulin G ; Mikulicz' Disease ; Pancreatitis ; Plasma Cells ; Salivary Glands ; Sialadenitis ; Submandibular Gland

PURPOSE: To classify the cavernous sinus lesions, to describe their radiological findings, and to assess the usefulness of MR compared to CT. METHODS AND MATERIALS: Fourty-five patients with lesions involving the cavernous sinus proved by histological and/or clinical and imaging methods were studied retrospectively and classified into neoplastic, vascular, and inflammatory lesions. CT and MR findings were compared in 21 patients evaluated by both modalities simultaneously according to these 4 categories. RESULTS: Pitiutary macroadenoma was the most common cavernous sinus lesion(42%). Diffuse convex bulging of the lateral wall of cavernous sinus was the most frequent radiological finding(84%), and the others were encasement of the cavernous carotid artery(49%), remodelling of the surrounding bones(44%), and complete obliteration of Meckel's cave(38%), in descending order of frequency. Bulging of the lateral wall of cavernous sinus was equally well demonstrated on both modalities, but encasement or displacement of the cavernous carotid artery and complete or partial obliteration of Meckel's cave were much better delineated on MR than on CT with the ratio of 3.8:1 and 4.6: 1, respectively. Only bone changes were much better demonstrated on CTthan on MR with the ratio of 3.8: 1. CONCLUSION: MR issuperior to CTin demonstrating thecavernouscarotid artery encasement and obliteration of Meckel's cave, but CT is much better than MR in demonstrating bone changes.
Arteries ; Carotid Arteries ; Cavernous Sinus* ; Humans ; Retrospective Studies

No abstract available.

No abstract available.
Pelvic Exenteration*