Nocturnal enuresis is by any standard the most benign voiding dysfunction in children, with a spontaneous cure rate of up to 15% per year. On the other hand it is one of the most sociopsychologically disturbing diseases in children because of its association with taboos and rites, and for families with bedwetters it is also a significant economic burden. Many investigators have reported upon the effectiveness of drugs in alleviating nocturnal enuresis in children and adults. We evaluated the results of drug therapy in 60 children with nocturnal enuresis: 42 boys and 18 girls. mean age 8.7 years(range 5-15). All children were evaluated after treatment with imipramine, and the response rate of imipramine was 76.7%. For the remaining 14 non-responders, desmopressin was given intranasally at bedtime. And the response rate of desmopressin was 64.3%. So, the overall response rate of imipramine and desmopressin was 9l.7%. No serious side effects were observed. These data show that the combined therapy with imipramine and desmopressin is very effective in treating enuresis.
Adult ; Child ; Deamino Arginine Vasopressin* ; Drug Therapy ; Enuresis* ; Female ; Hand ; Humans ; Imipramine* ; Nocturnal Enuresis ; Research Personnel ; Taboo

BACKGROUND: In recent years the treatment of primary nocturnal enuresis (PNE) with desmopressin (DDAVP) has been promising. The route of administration until now had been intranasal, but because the tablets were introduced for the treatment of diabetes insipidus they have also become available for the treatment of PNE. PURPOSES: To find the efficacy and safety of the treatment with desmopressin tablets in a group of children with monosymptomatic nocturnal enuresis. Materials and METHODS: The efficacy and safety of at least 3 months of treatment with oral desmopressin (1-deamino-8-D-arginine-vasopressin) (DDAVP tablets, Minirin) at doses of 200 to 600 ug. at bedtime were investigated in 50 children (ages 5 to 15 years) with monosymptomatic nocturnal enuresis. The efficacy of the drug was measured in reductions of the number of wet nights per week. RESULTS: The number of wet nights per week decreased from a mean of 6.1 to 2.0 (p<0.01). During the treatment period, 22 (44%) patients could be classified as good responders (0 to 1 wet night per week) and 15 (30%) as responders (over 50% reduction of wet night) and 13 (26%) as nonresponders (less than 50% reduction of wet night). No side effects we.e observed. CONCLUSION: Oral desmopressin has a clinically significant effect on patients with monosymptomatic nocturnal enuresis, and therapy is safe when administered as long-term treatment.
Child ; Deamino Arginine Vasopressin* ; Diabetes Insipidus ; Enuresis ; Humans ; Nocturnal Enuresis* ; Tablets*

The Ankle joint is a modified complex hinge joint which plays an importnat role in weight bearing, walking and standing. Injuries about the ankle joint cause destruction of not only bony architecture but also the ligament and soft tissue components. We performed arthrography in 52 cases of ankle fracture. The Result obtained from this study was as follow; The ligament & interosseous membrane injuries were more severe, when fracture of lateral malleolus was occured higher level than ankle joint.
Ankle Fractures ; Ankle Joint ; Ankle ; Arthrography ; Clinical Study ; Joints ; Ligaments ; Membranes ; Walking ; Weight-Bearing

Total cholesterol and triglyceride were measured in sera of 40 cases of hypertension, 22 cases of myocardial infarction, 14 cases of cerebral thrombosis, 18 cases of subarachnoidal hemorrhage and 30 cases of normal control in Chungnam national University Hospital from October 1980 to September 1981, and the results are as follows; 1) The mean serum total cholesterol and triglyceride levels in normal control group are 153.57+/-40.60mg% and 150.82+/-51.76mg%. 2) The age incidence of these diseases were highest in 6th decade. 3) Serum cholesterol levels of myocardial infarction, hypertension, cerebral thrombosis and subarachinoidal hemorrhage group were higher than that of normal control group. 4) Serum triglyceride levels of acute myocardial infarction and hypertension were significantly higher than that of normal control group, but there is only slightly increases in cerebral thrombosis and subarachinoidal hemorrhage. 5) In general, serum lipid levels are higher in cardiovascular diseases(hypertension and myocardial infarction) than cerebrovascular diseases(cerebral thrombosis and subarachnoidal hemorrhage). 6) Serum Cholesterol and triglyceride levels decreased by administration of pancreatic mucopolysacharide for 1 or 2 months. In conclusion, it seems that high serum cholesterol and triglyceride level may play and important risk factor in development of hypertension and myocardial infarction.
Cholesterol ; Chungcheongnam-do ; Hemorrhage ; Hypertension ; Incidence ; Intracranial Thrombosis ; Myocardial Infarction ; Risk Factors ; Thrombosis ; Triglycerides

It has been reported that keratocytes endocytose foreign particles both in vitro and in vivo, suggesting the active participation of keratocytes in corneal wound healing and host defense mechanism. This study was conducted to investigate the phagocytosis of keratocytes against Candida albicans[C.albicans]and the intracellular response after phagocytosis. C.albicans were fixed with glutaraldehyde and then coated with fibronectin. After exposing these C.albicans to the cultured rabbit keratocytes, the phagocytosis of keratocytes against C.albicans was evaluated by light microscope[LM]and transmission electron microscope[TEM], while the intracellular response was evaluated by changes of acid phosphatase activity. Also the study about latex beads was performed at the same time to know even if keratocytes can phagocytose foreign particles, regardless of wheather or not the particles are biodegradable. After Wright staining, phagocytosed latex beads and C.albicans were observed on LM and these were recognized to be surrounded by limiting membranes inside the cytoplasm of keratocytes on TEM. The phagocytic rates of fibronectin-coated were increased to 1.5 times , as compared with that of non-coated group. Acid phosphatase activities were higher in C.albicans-exposed groups than in control[keratocytes cultured without C.albicans or latex beads]during the culture period of 24 hours and they also increased according to culture duration and reached to the plateau after 12 hours. In comparison with non-coated group, fibronectin-coated groups showed a increasing tendency of acid phosphatase activity. These results suggest that keratocytes can phagocytose not only foreign particles but also C.albicans and that fibronectin may act as effective opsonin on phagocytosis, and that keratocytes phagocytosing C.albicans increase acid phosphatase activity to digest engulfed C.albicans when corneal stroma was wounded or inflammed.
Acid Phosphatase* ; Candida albicans* ; Candida* ; Corneal Stroma ; Cytoplasm ; Fibronectins ; Glutaral ; Latex ; Membranes ; Microspheres ; Phagocytosis* ; Wound Healing ; Wounds and Injuries

The effects of dehydration on vasopressin and oxytocin immunoreactive neurons in the hypothalamus was investigated by using a immunohistochemistry. Adult Mongolian gerbil[Meriones unguiculates] were deprived of drinking water. Dehydrated animals were sacrificed on the 7th, 14th and 21st day of water retriction. The results are as follows : 1. The body weights were decreased about 1.8% daily. On the 21st day of dehydration, they were shown up to 45% compare to the control. 2. In the hypothalamus of the control group, majority of vasopressin and oxytocin immunoreactive neurons were located in the supraoptic and paraventricular nuclei. 3. Changes due to dehydrated stimulation were mainly observed in vasopressin immunoreactive neurons. And these changes in supraoptic nuclei were more severe than those in paraventricular nucleus. Size of vasopressin immunoreactived cells and of areas were increased as to proceed the dehydration. The numbers of those were increased on the 7th day of dehydration, and then they were continously decreased. 4. Although oxytocin immunoreactive neurons were slightly changed in numbers during dehydration, they were not shown conspicuous changes compare to vasopressin immunoreactive neurons. Thus it is appeared that vasopressin secretory neurons in the hypothalamus of Mongolian gerbil are affected by osmotic stress induced dehydration while oxytocin neurons may be affected by other factors.
Adult ; Animals ; Body Weight ; Dehydration* ; Drinking Water ; Gerbillinae* ; Humans ; Hypothalamus* ; Immunohistochemistry ; Neurons* ; Osmotic Pressure ; Oxytocin* ; Paraventricular Hypothalamic Nucleus ; Supraoptic Nucleus ; Vasopressins* ; Water

Hallux valgus has been defined as a static subluxation of the first metatarsophalangeal joint with lateral deviation of the proximal phalanx on the first metatarsal head from the longitudinal axis of the first metatarsal with medial deviation of the first metatarsal. And first-second metatarsal angle is increased as well as bursal hypertrophy over the medial eminence of the first metatarsal head. Many procedures have been reported for the treatment of the hallux valgus ranging from resection arthroplasty to distal first metatarsal or basal first metatarsal osteotomy. Of these, Johnson and Corless have required sufficiently good results in the modifying Mitchell osteotomy into Chevron osteotomy. The Chevron procedure is an osteotomy involving the distal portion of the first metatarsal, lateral displacement of the metatarsal head with exostosectomy, and tightening of the medial capsular structures. Authors studied 17 cases in 10 patients with the hallux valgus deformity treated by Chevron osteotomy at the Department of Orthopedic Surgery, Capital Armed Forced General Hospital from September 1987 to September 1989. The results were as follows; 1. Seven patients (12 cases) were male and three patients (5 cases) were female. All patients had bilateral hallux valgus deformity. 2. The average first-second intermetatarsal angle was 11 degrees and average valgus angle was 32 degrees, preoperatively. They were corrected to 9 degrees and 14 degrees respectively. 3. The metatarsalgia of the great toe was subsided in all cases and they were satisfied with the result of their operations in respect to cosmetically and functionally. Avascular necrosis of capital fragment, nonunion, and dorsal angulation were not developed in any case. But, one case had marginal skin necrosis, presumably due to excessive compressive dressing. 4. Chevron osteotomy is a technically easy procedure and it can be obtained early bone healing with less complication.
Arm ; Arthroplasty ; Bandages ; Congenital Abnormalities ; Female ; Hallux Valgus ; Hallux ; Head ; Hospitals, General ; Humans ; Hypertrophy ; Male ; Median Eminence ; Metatarsal Bones ; Metatarsalgia ; Metatarsophalangeal Joint ; Necrosis ; Orthopedics ; Osteotomy ; Skin ; Toes

BACKGROUND: The authors have developed a Digital image chart(DIC) and digital Radiotherapy Record System (DRRS). We have evaluated the DIC and DRRS for reliability, usefulness, ease of use, and efficiency. METHOD AND MATERIALS: The basic design o f the DIC and DRRS was to build an digital image database of radiation therapy patient records for a more efficient and timely flow of critical image in formation throughout the department. This system is a subunit of comprehensive radiation oncology managemert system (C-ROMS) and composed of a picture archiving and communication system (PACS), radiotherapy information database, and a radiotherapy imaging database. The DIC and DRRS were programmed using Delphi under a Windows 95 environment and is capable of displaying the digital images of patients identification photos, simulation films, radiotherapy setup, diagnostic radiology image... Gross lesion photos, and radiotherapy planning isodose charts with beam arrangements. Twenty-three clients in the department are connected by Ethernet (10 Mbps) to the central image server (Sun Ultra-sparc 1 workstation). RESULTS: From the introduction of this system in February 1998 through December 1999, we have accumulated a total of 15,732 individual images for 2,556 patients. We can organize radiation therapy in; paperless environment in 120 patients with breast cancer. Using this system, we have succeeded in the prompt, accurate, and simultaneous access to patient care information from multiple locations throughout the department. This coordination has resulted in improved operational efficiency within the department. CONCLUSION: The authors believe that the DIC and DRRS has contributed to the improvement of radiation oncology department efficacy as well as to time and resource savings by providing necessary visual information throughout the department conveniently and simultaneously. As a result, we can also achieve the paperless and filmless practice of radiation oncology with this system.
Breast Neoplasms ; Dacarbazine ; Hospital Information Systems ; Humans ; Income ; Patient Care ; Radiation Oncology* ; Radiotherapy*

No abstract available.
Leukemia, Plasma Cell* ; Plasma Cells* ; Plasma*

PURPOSE: There is no concensus on the type of therapy useful for elderly cancer patients. Since 2000, Korea has become an elderly society. This study aims to assess clinical characteristics of elderly breast cancer women, and to evaluate determinants and effects of treatment choice for breast cancer prognosis among elderly patients. METHODS: We reviewed the clinical reports of 123 breast cancer patients aged > or =70 yr recorded at the Asan Medical Center Breast Cancer Registry between 1992 and 2002. Patient and tumor chariteristics, comorbidity, surgical method, adjuvant therapy and cause of death were taken into consideration. Survival analysis was determined according to the treatment method. RESULTS: The median time to diagnosis was 33.6 months. Only 9 patients (5.1%) were diagnosed in the screening program. A modified radical mastectomy was performed for 74 patients (60.1%), Breast conserving surgery was performed for 26 patients (24.7%), and there was no further curative therapy for 12 patients (9.7%). 32 patients (38.1%) had axillary lymph node metastasis. The median follow-up duration was 43.1 months; the overall survival rate was 71.8%, and the disease free survival rate was 65.4%. Breast cancer related mortality was 62.8%. CONCLUSION: Delayed diagnosis and infrequent screening were frequent among elderly patients. Cancer related morbidity was less than general breast cancer patients. Treatment needs to be adapted to the general health status of the patient and comorbid conditions, but has to offer the best chance of cure, regardless of age.
Aged ; Breast Neoplasms* ; Breast* ; Cause of Death ; Chungcheongnam-do ; Comorbidity ; Delayed Diagnosis ; Diagnosis ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Korea ; Lymph Nodes ; Mass Screening ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Mortality ; Neoplasm Metastasis ; Prognosis ; Survival Rate