At first, we review a sample size estimation method for log-rank test in survival analysis. Although it is widely used these days, it has a weakness for practical use. We propose a modification method to avoid the weakness.
Sample Size*

Hypodipsic hypernatremia is characterized by chronic or recurrent episodes of severe hypernatermia associated with dehydration and a lack of thirst. This constellation of deficits suggests that the syndrome is due to hypodipsia of destruction of the hypothalamic osmoreceptors that regulate thirst and ADH secretion. We report a child with abnormalities of the central nervous system who had hypernatremia and a lack of thirst without detectable abnormalities in the osmoregulation of ADH secretion. The patient was a 11 month old female and her chief complaints were poor oral intake and weight gain. There were recurrent hypernatremia with hyperosmosis and normal level of plasma ADH. With intravenous rehydratin, oral intake was improved and plasma sodium level decreased.
Central Nervous System ; Child ; Dehydration ; Female ; Humans ; Hypernatremia* ; Infant ; Osmoregulation ; Plasma ; Sodium ; Thirst ; Weight Gain

BACKGROUND: This study was performed to evaluate our experience on laparoscopic appendectomy. METHODS: Retrospective analysis was performed on 2,856 patients who had been operated by laparoscopic appendectomy under diagnosis of acute appendicitis at the Sung-Ae Hospital and Kwang-Myoung Sung-Ae Hospital from October 1991 to July 1998. RESULTS: Among 2,856 patients who had undergone laparoscopic appendectomy,2,379 patients (83.3%) were operated due to simple acute appendicitis, 275 patients (9.6%) due to perforated appendicitis. Operation time was 44.6 minutes for simple acute appendicitis and 60.3 minutes for perforated appendicitis. In perforated appendicitis, intra-peritoneal irrigation and drain insertion was performed. The length of hospital stay in patient with simple acute appendicitis was 3.7 days (5.82 days in conventional appendectomy) and patients with perfotrated appendicitis was 6.1 days (9.91 days in conventional appen-dectomy). Complications such as wound infection, intra-abdomen abscess, trocar site bleeding, subcutaneous emphysema developed in 43 (1.5%) patients (79/1,947, 4.5% in conventional appendectomy). In 202 (7.1%) patients, appendix was normal, but another diseases were detected, including acute pelvic inflammation, ovarian cyst, mesenteric lymphadenitis, enteritis, diverticulitis in order. CONCLUSION: Overall complication rate was lower in laparoscopic appendectomy compared with conventional appendectomy and the length of hospitalization of laparoscopic appendectomy was shorter. When the acute appendicitis is suspected, especially in the reproductive women, the laparoscopic approach would be better diagnostic and therapeutic value than conventional method. Therefore laparoscopic appendectomy would be replaced with conventional appendectomy.
Abscess ; Appendectomy* ; Appendicitis ; Appendix ; Diagnosis ; Diverticulitis ; Enteritis ; Female ; Hemorrhage ; Hospitalization ; Humans ; Inflammation ; Length of Stay ; Mesenteric Lymphadenitis ; Ovarian Cysts ; Retrospective Studies ; Subcutaneous Emphysema ; Surgical Instruments ; Wound Infection

Background and OBJECTIVE: There has been a few case reports of anaphylaxis due to honeybee in Korea. In order to observe the clinical feature of bee sting anaphylaxis. Moderials and methods: Six patients living in Kyunggi province area were referred under history of anaphylaxis after the bee sting. Atopy was defined by skin prick test result to common inhalant allergen. Serum specific IgE antibody to each bee antigen was detected by radioimmunoassay to identify the causative bee. RESULTS: All six cases were female. Three had atopy and four had combined allergic diseases such as allergic rhinitis, asthma, and urticaria. The etiologic bees consisted of yellow jacket (6 cases), paper wasp (4 cases), yellow hornet (3 cases), white faced hornet (1 case) and honey bee (1 case). Four cases had experienced anaphylaxis after ant bite and they showed positive result on specific IgE to imported fire ant. Specific immunotherapy against causative bee venom was begun using bee venom extracts from Bayer (USA) based upon results of specific IgE anti-body to bee venom. CONCLUSION: The yellow jacket is the most common cause of bee venom anaphylaxis in this area. Further studies will be needed to evaluate possible cross-reactivity between bee and ant venom.
Anaphylaxis* ; Ant Venoms ; Ants ; Asthma ; Bee Venoms* ; Bees* ; Bites and Stings ; Female ; Fires ; Gyeonggi-do ; Honey ; Humans ; Immunoglobulin E ; Immunotherapy ; Korea ; Radioimmunoassay ; Rhinitis ; Skin ; Urticaria ; Wasps

PURPOSE: It has been reported that neovascularization of the optic disc (NVD) occurs in ocular ischemic syndrome, sickle cell hemoglobinopathy, ocular sarcoidosis, Eales' disease, and central retinal artery occlusion. However, NVD in acute ophthalmic artery occlusion had not been reported. Therefore, we report one unusual case of NVD in acute ophthalmic artery obstruction. METHODS: A 56 year-old man with complaint of abrupt decrease of visual acuity and periorbital discomfort underwent medical history taking, periorbital examination, fundus examination, and fluorescein angiography. He was followed up for 5 months RESULTS: Fundus examination showed segmentation of blood flow and diffuse retinal whitish opacity on the posterior pole around the center of the macula, without any cherry red spots in the perifoveal area. Fluorescein angiography showed a marked filling delay in the nasal retinal and choroidal circulations with a definite watershed zone involving the peripapillary choroid and macula. The retinal arteries filling and arteriovenous transit time were delayed. There was no light-perception vision and low intraocular pressure. Diabetes was found on systemic examination. Five weeks later, NVD and choroidal atrophy around the optic disc were detected. Panretinal photocoagulation was performed for the regression of NVD. NVD was regressed, but recurred.
Atrophy ; Choroid ; Fluorescein Angiography ; Hemoglobinopathies ; Humans ; Intraocular Pressure ; Light Coagulation ; Medical History Taking ; Middle Aged ; Ophthalmic Artery* ; Prunus ; Retinal Artery ; Retinal Artery Occlusion ; Retinaldehyde ; Sarcoidosis ; Visual Acuity

BACKGROUND: There have been few reports suggesting involvement of mast cell and neutrophil to induce bronchoconstriction in aspirin-sensitive asthrna. OBJECTIVE: To evaluate mast cell and neutrophil activation in pathogenesis of aspirin-sensitive asthma. MATERIAL AND METHOD: We observed changes of serum NCA and MPO levels during L-ASA bronchoprovocation test in 14 subjects with aspirin-sensitive asthma. RESULTS: Serum NCA was significantly increased at 30 min(p=0.01) after the inhalation of L-ASA and then, no significant changes were noted at 240 min (p=0.14). NCA was significantly higher in subjects with late asthmatic responses than in those without it (p=0.04). Serum MPO level tended to increase at 30 min with no statistical significance (p=0.08), and then it significantly decreased at 240 min (p=0.05). There was no significant correlation between serum NCA and MPO level (r=0.22, p=0.58). CONCLUSION: These results support the view that NCA derived from mast cell may contribute to neutrophil recruitment into the airway in aspirin-sensitive asthmatic patients.
Asthma ; Bronchoconstriction ; Humans ; Inhalation ; Mast Cells ; Neutrophil Activation ; Neutrophil Infiltration ; Neutrophils*

Graves’ disease and Hashimoto’s thyroiditis are the most common types of autoimmune thyroid disease. However, these two diseases were previously considered as separate and distinct. Recent studies have shown that many authors view the two diseases as a continuum. The immune mechanism by regulatory T cells is thought to play an important role in linking these two diseases. The development of Grave’s disease into Hashimoto’s thyroiditis is observed relatively often; however, the reverse is rare, especially in children. To the best of our knowledge, this is the first report of this phenomenon, in which children with a history of Hashimoto’s thyroiditis are diagnosed with Grave’s disease, indicated by symptoms of thyrotoxicosis and elevation of antibody titer, in Korea.

Klinefelter' syndrome is a disorder of sexual differentiation in males, characterized by the presence of two or more X-chromosomes, hypogonadism, and lack of secondary sexual characteristics. The association between Klinefelter' syndrome and glomerulonephritis has been reported, while cases of glomerulonephritis associated with Klinefelter' syndrome are rare. We report the Korean case: a 31-year-old man with Klinefelter' syndrome who developed glomerulonephritis. The patient's urine analysis shows microscopic hematuria and the result of kidney biopsy was minimal change disease. The onset and course of his disease might have been influenced by the sex hormone imbalance.
Biopsy ; Glomerulonephritis ; Hematuria ; Humans ; Hypogonadism ; Kidney ; Male ; Nephrosis, Lipoid ; Sex Differentiation

No abstract available.
Humans ; Hypophosphatemia*

A simple, rapid and selective liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) is developed and validated for quantification of venlafaxine in human plasma with simple liquid-liquid extraction step consisted of extraction with ether and dichloromethane for 10 min and mixing with 1 M sodium acetate in human plasma using fluoxetine as an internal standard (IS). The analyte are separated using an isocratic mobile phase consisted of acetonitrile and 5 mM ammonium formate (4/3, v/v) on a isocratic YMC hydrosphere C18 (2.0x50.0 mm, 3.0 microm) column and analyzed by MS/MS in the multiple reaction monitoring (MRM) mode using the transitions of respective [M+H](+) ions, m/z 278.2-->260.3 and m/z 310.1-->148.1 for quantification of venlafaxine and IS, respectively. The standard calibration curves showed good linearity within the range of 1.0-200.0 ng/mL (r2=0.9986, 1/chi2 weighting). The lower limit of quantification (LLOQ) was 1.0 ng/mL. The retention times of venlafaxine and IS were 0.6 min and 0.7 min that means the potential for the high-throughput potential of the proposed method. In addition, no significant metabolic compounds were found to interfere with the analysis. Acceptable precision and accuracy were obtained for the concentrations over the standard curve range. The validated method was successfully applied to bioequivalence study after 75-mg of venlafaxine sustained-release (SR) capsule in 24 healthy Korean subjects.
Ammonium Compounds ; Calibration ; Chromatography, Liquid ; Ether ; Fluoxetine ; Humans ; Ions ; Liquid-Liquid Extraction ; Methylene Chloride ; Pharmacokinetics ; Plasma* ; Sodium Acetate ; Tandem Mass Spectrometry ; Therapeutic Equivalency* ; Venlafaxine Hydrochloride