No abstract available.
Cushing Syndrome* ; Hyperplasia*

Although there are many methods for the treatment of actinic cheilitis including cryotherapy, vermilionectomy, and topical fluorouracil, the choice of treatment should be determined after assessment of the lesion and its location. A 67-year old woman developed actinic chelitis, where a thick keratotic plaque occupied a half of her lower lip. Surgical removal of the lesion was difficult because of its size, and repeated cryotherapy treatment also failed. The lesion was then successfully treated by a the topical application of combined fluorouracil and salicylic acid solution.
Actins* ; Aged ; Cheilitis* ; Cryotherapy ; Female ; Fluorouracil ; Humans ; Lip ; Salicylic Acid

BACKGROUND: Urinary levels of cytokines may function as indices of renal disease activity. METHODS: This study was designed to investigate the urinary excretion of IL-6 and TGF-beta in the patients with IgA nephropathy(IgAN) and the effects of AII receptor blockers(ARB : losartan) on it. RESULTS: The patients with IgAN(n=10) showed higher urinary excretion of IL-6 and TGF-beta than normal controls(n=7). There is a positive correlation between IL-6 and TGF-beta. Urinary excretion of IL- 6 was positively correlated with proteinuria in IgAN (IL-6 : gamma2=0.560; p < 0.05) but not with serum creatinine. After 2 months of ARB therapy in IgAN patients, urinary excretion of IL-6 was decreased(IL-6 : 11.3+/-7.7 vs 5.3+/-3.3 pg/mg Cr, p < 0.05). Positive correlations were noticed in ARB group between urinary cytokines and proteinuria. CONCLUSION: Our data suggest that the patients with IgAN showed higher urinary excretion of IL-6 and TGF-beta. and the IL-6 excretion can be effectively reduced by ARB therapy.
Creatinine ; Cytokines ; Glomerulonephritis, IGA* ; Humans ; Immunoglobulin A* ; Interleukin-6* ; Proteinuria ; Transforming Growth Factor beta*

Background and Objectives: To evaluate the cost-effectiveness of routine hypertension (HTN) screening as a part of the national health-screening program. Methods: Two aspects of cost-effectiveness were examined using the national general healthscreening program. First, the cost of case-finding was computed for 5-year interval age groups. Second, the cost per quality adjusted life years (QALYs) gained were estimated for 12 different scenarios varying examination starting age, pattern and interval compared with no screening. Results: The cost of finding one new HTN case was low as 26,284 Korean won (KRW) (approximately [approx.] United States Dollar 21) for 70–79 years old to as high as 70,552 KRW for 40–44 years old. Compared with no screening, the costs per QALYs of the following screening strategies were below the incremental cost-effectiveness ratio threshold (approx.KRW 30.5 million): first screening examination with the second confirmatory examination in adults aged ≥40 years every 3 years (KRW 10.2 million), every 2 years (KRW 13.2 million), or annually (KRW 19.9 million). One-way sensitivity analyses suggest that the results were mostly influenced by the sensitivity of the first screening examination, followed by the examination rate of the second confirmatory examination. Conclusions HTN screening as a part of routine national health screening program was cost-effective for adults aged 40 years or older. The most cost-effective HTN screening strategy was the first screening examination with the second confirmatory examination in aged 40 years or older every 3 years.

The association between non-islet cell tumors and fasting hypoglycemia has been recognized since 1929. The humoral mediator of this non-islet cell tumor hypoglycemia(NICTH) is now known as IGF-II. Hypoglycemia develops commonly in the course of hepatocellular carcinoma(HCC), mostly late in the course and usually mild to moderate in severity. Rarely, severe hypoglycemia occurs early in the course of HCC, suggesting NICTH. We report a case of HCC in which hypoglycemic coma due to NICTH was the presenting symptom.A 52-year-old man developed mental confusion and seizures in the early morning. At emergency room, he was found to have severe hypoglycemia. Circulating levels of insulin, C-peptide, insulinlike growth factor-I(IGF-I) and growth hormone were reduced during hypoglycemia. Diagnostic work-up revealed that he had unresectable HCC. During admission, infusion of more than 400g of dextrose per day in addition to meals was required to prevent hypoglycemia. Because the chemotherapy was refused, he was transferred to a local hospital to receive infusions of dextrose.
Adenoma, Islet Cell ; C-Peptide ; Coma ; Drug Therapy ; Emergency Service, Hospital ; Glucose ; Growth Hormone ; Humans ; Hypoglycemia ; Insulin ; Insulin-Like Growth Factor II ; Islets of Langerhans ; Meals ; Middle Aged ; Seizures

Background and Objectives: To evaluate the cost-effectiveness of routine hypertension (HTN) screening as a part of the national health-screening program. Methods: Two aspects of cost-effectiveness were examined using the national general healthscreening program. First, the cost of case-finding was computed for 5-year interval age groups. Second, the cost per quality adjusted life years (QALYs) gained were estimated for 12 different scenarios varying examination starting age, pattern and interval compared with no screening. Results: The cost of finding one new HTN case was low as 26,284 Korean won (KRW) (approximately [approx.] United States Dollar 21) for 70–79 years old to as high as 70,552 KRW for 40–44 years old. Compared with no screening, the costs per QALYs of the following screening strategies were below the incremental cost-effectiveness ratio threshold (approx.KRW 30.5 million): first screening examination with the second confirmatory examination in adults aged ≥40 years every 3 years (KRW 10.2 million), every 2 years (KRW 13.2 million), or annually (KRW 19.9 million). One-way sensitivity analyses suggest that the results were mostly influenced by the sensitivity of the first screening examination, followed by the examination rate of the second confirmatory examination. Conclusions HTN screening as a part of routine national health screening program was cost-effective for adults aged 40 years or older. The most cost-effective HTN screening strategy was the first screening examination with the second confirmatory examination in aged 40 years or older every 3 years.

The Y-TEC(R) system is an equipment for the peritoneoscopic placement of peritoneal dialysis catheter. The advantage of this method is the direct visualization of peritoneal cavity by using a small diameter minitrocar and dilatable guide. But this method has some limitations because of the expensive equipment and the difficulty in being expert at peritoneoscopy. We placed the CAPD catheter by using a minitrocar without peritoneoscopy(so called Modified Y- tec(R) system) in 44 patients who had no history of major abdominal surgery(MY-group), the classic Y- tec(R) system in 8 patients(Y-group), and surgical method in 13 patients with history of major abdominal surgery(S-group) and compared the effecacy and safety of three methods. In conclusion, the short and long term results of blind minitrocar placements were comparable to, or better than the surgical and other percutaneous methods of catheter implantation when they were used in the patients without history of major abdominal surgery.
Catheters* ; Humans ; Laparoscopy ; Peritoneal Cavity ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory

Frontal fibrosing alopecia (FFA) is one of the primary cicatricial alopecia and is considered a variant of lichen planopilaris. This condition is characterized by a progressive recession of the frontal and temporal hairline, primarily in postmenopausal women. Only two cases have been reported in premenopausal woman worldwide. We report a case of FFA in a 45-year-old female in her premenopausal age, who presented with multiple, small, bald spots on the bilateral frontotemporal area. Microscopically the lesion consisted of the inflammatory stage of lichen planopilaris and its cicatricial stage showing replacement of hair follicles by fibrous tissue. This was an additional case of frontal fibrosing alopecia in a premenopausal woman.
Alopecia* ; Female ; Hair Follicle ; Humans ; Lichens ; Middle Aged

Recently, a new classification of eosinophilic folliculitis (EF) was made as follows: classic eosinophilic pustular folliculitis (EPF; Ofuji's disease), HIV associated EF, pediatric EF, fungal EF and miscellaneous group. A 10-year-old boy presented with a 2-week history of pruritic, erythematous papules with a plaque on his left cheek. A biopsy specimen revealed folliculitis with predominant eosinophilic infiltrates. Clinicohistopathologically, the most compatible diagnosis was eosinophilic pustular folliculitis and subsequently, dapsone was administered for 2 weeks but the lesion showed insufficient improvement, and the original confluent papules changed to a KOH-positive, arciform scaly lesion. A serial section from the paraffin block of the first biopsy, which had been histopathologically negative for fungal hyphae in the first, revealed hyphae in a single follicular canal in only one section out of 100 sections examined. This is believed to be the first reported case of fungal eosinophilic folliculitis in Korea.
Biopsy ; Cheek ; Child ; Classification ; Dapsone ; Diagnosis ; Eosinophils* ; Folliculitis* ; HIV ; Humans ; Hyphae ; Korea ; Male ; Paraffin

OBJECTIVES: The purpose of the present study was to compare the general condition of peritonitis through a study of three connector systems : The Straight transfer set with Spike-and-Pork system(SPS), The Straight transfer set with Luer-Lock system(SLS), and The Y-set with Two Bag system(YS). METHODS: We reviewed our experience with 134 patients from 1988.1 to 1995.12. According to various kinds of connector system, we divided cases into 3 groups : The SPS(1988. 1-1991. 3) was used on 55 patients(mean age 47+/-2, M:F=30:25); The SLS(1991.4-1993.8) on 45 patients(mean age 55+/-1, M:F=30:15); and The YS(1993.9-1995.12) on 34 patients(mean age 49+/-5, M:F=15:19). RESULTS: 1) Total CAPD duration was 1.22 patient year in SPS, 1.08 in SLS, and 0.96 in YS. The incidence of peritonitis is 1.71 episodes per patient year in SPS, 1.03 in SLS, and 0.61 in YS. 2) Among the causative organisms of peritonitis, coagulase negative Staphylococcus was most common in the three groups(SPS:10.4%, SLS:10%, YS:20%). In SPS and SLS, S. aureus(7.7%, 8%), Pseudomonas(6.5%, 8%), E. coli(5.2%, 6%) were present in decreasing order. In YS, Pseudomonas (15%), S. aureus(15%), E. coli(10%) were present in decreasing order. There were no growth of organisms in 55.9% of SPS, 38% of SLS, and 30% of YS. 3) The probability of experiencing the first peritonitis at 1, 3, 6, and 12 months was 21.4%, 21.4%, 21.4%, and 23.9% respectively in SPS, 3.4%, 34.5%, 34.5%, and 10.3% respectively in SLS, and 0%, 28.5%, 35.7%, and 28.5% respectively in YS. 4) In the response to the treatment of peritonitis, 59.7% of the peritonitis episodes in SPS, 72% in SLS, and 85% in YS were cured with antibiotics. In 37.7% of the peritonitis episodes in SPS, 24% in SLS, and 10% in YS, the catheter was removed due to fungal, tubercolous, recurrent, or peritonitis not responding to antibiotics. 2 patients in SPS, 2 patients in SLS, and 1 patient in YS died due to peritonitis. 5) The catheter survival rate at 3, 6, 12 months was 72%, 63.6%, and 40% respectively in SPS, 89%, 78.3%, and 46.7% respectively in SLS, and 94%, 85.3%, and 76.6% respectively in YS. CONCLUSION: Our study suggests that there is a relationship between the development of connector system and a decrease of peritonitis in CAPD.
Anti-Bacterial Agents ; Catheters ; Coagulase ; Humans ; Incidence ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis* ; Pseudomonas ; Staphylococcus ; Survival Rate