BACKGROUND: Sulfonylurea is recommended to be taken before meal. But since premeal administration is against Koreans usual medication habit, it can be the cause of poor compliance. Such recommendation is based on the results of a few clinical trials about appropriate medication time. But most of the clinical studies had a limitation : observe only acute effects of medication, subjects were only healthy volunteer. So the chronic effect of sulfonylurea of each kind must be validated. METHODS: From 1996 May to 1996 July, data were collected from diabetic patients who visited an university hospitals for managing diabetes and used a intermediate-acting sulfonylurea. The subjects were randomized to two groups of premeal group and postmeal group, by chart number and were asked to take the previous medicine according to assignment. After 1 month medication, mixed meal tolerance test was done with 300Kcal carbohydrate, 400+/-50Kcal diet. The subjects were switched to the other group and 2nd mixed meal tolerance test was done 1 month later. The Area under curves was calculated in preand post-prandial glucose curve and was compared by paired t-test. RESULTS: During the study period, total 16 diabetic patients were enrolled. There was no significant statistical difference between pre-prandial group and post prandial group in AUC. CONCLUSIONS: Intermediate-acting sulfonylurea can be administered at any time in relation to meaL.
Area Under Curve ; Compliance ; Diet ; Eating* ; Glucose ; Healthy Volunteers ; Hospitals, University ; Humans ; Meals

The indication of hip arthrodesis has tendency to decrease since the total hip replacement proved to be very effective, but the arthrodesis is inevitable for the infectious arthritis especially in young individuals to obtain painless stable joint. Authors reviewed 11 cases of Brittain ischiofemoral arthrodesis performed for the advanced hip tuberculosis during the years between 1972 to 1978 at Fatima hospital. These cases were 6 males and 5 females having ages from 5 to 31 with an average of 16 years old. The immobilization after surgery was rest having hip spica cast for the periods from 12 weeks to 17 weekes averaging 14 weeks and the crutch walking with gradual weight bearing as tolerated was recommended after discarding the cast for the cases who have united osteotomy, well maintained graft, and no evidence of the disease progession, even though the joint is not fused. Eventuaily good bony ankylosis as well as union of the osteotomy was found in 7 cases including a case who had fracture of the osteotomy after a minor trauma during the early days of walking without crutches which became united after having an another hip spica cast for 3 months. Three cases revealed the fibrous ankylosis with good union of the osteotomy but they had painless stable joints. In one of these fibrous ankylosis the tibial graft failed to be fixed in ischium and in the rest two cases bony ankylosis was expected later on because the last examinations were at 6 months and 7 months after surgery. The most unsatisfactory result was the case who discarded the cast at home and a non-union of the osteotomy was found at the first visit on five and a half years after surgery, when she refused further treatment of the non-union because there had been surprisingly little pain with usual daily activities. Brittain arthrodesis considered to be an effective procedure for the advanced unilateral hip tuberculosis to obtain the painless stable joint permitting early ambuiation.
Ankylosis ; Arthritis, Infectious ; Arthrodesis ; Arthroplasty, Replacement, Hip ; Crutches ; Female ; Hip ; Hip Joint ; Humans ; Immobilization ; Ischium ; Joints ; Male ; Osteotomy ; Transplants ; Tuberculosis ; Walking ; Weight-Bearing

There is debatable opinions as to the nature and clinical significance of the changes that may occur in the spine after posterior spine fusion performed in growing children. Clinical survey is known to be difficult because X-ray films in children are not easy to interpret and measure in the presence of disease and accuracy is uncertain due to magnification on X-ray films. Authors selected 8 cases of tuberculous spondylitis which were managed with posterior spine fusion under the criterias that cases had surgery under 10 years old, no evidence of pseudoarthrosis clinically and roentgenologically on serial examinations at least once 1 year, follow-up more than 2 years since 3 months after surgery, enough spines are included on lateral X-ray films, and accurate measurement and correction of magnification are possible. The cases were surveyed for changes occured in fused spines after posterior spine fusion and the results were as follows: 1. There was actual lengthening of grafted bone mass after solid fusion in all cases although the amounts were minimal. 2. The fused spines grew 46% on an average less than adjacent normal unfused spines. 3. The vertebral bodies of fused spines grew nearly same as the adjacent normal vertebral bodies. 4, The intervertebral disc spaces of the fused spines were narrowed in all cases. 5. The intervertebral angles had tendency to increase and kyphosis angles to decrease.
Child ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Kyphosis ; Pseudarthrosis ; Spine ; Spondylitis ; Transplants ; X-Ray Film

No abstract available.
Incisor*

Supersoft roentgen rays called grenz rays, generated in a tube at low voltages and having wave lengths of 1 to 3 angstroms(H.V.L. 0. 01 to 0. 035mm. Al. ), are employed in the treatment of superficial derrnatoses patients (112 cases) in the Department of Dermatology, Cho Sun University hospital from March 1, 1972 to April 30, 1974. Results of these Series are as Follows: 1) Among the ll2 patients, including 28 patients of neurodermatitis, 14 patients of nummular eczema and. 10 patients of atopic dermatitis showed therapeutic success. 2) Grenz ray irradiations were remarkably effective for 6 cases of capillary hemangioma, 2 cases of basal celI epithelioma and 3 cases of verruca plana juvenilis, and less effective for psoriasis vulgaris, tinea pedis, acne vulgaris, nevus verrucosus and alopecia areata. 3) Complications included 21 cases of hyperpigmentation and burning sensations in neurodermatitis and nummular eczema.
Acne Vulgaris ; Alopecia Areata ; Burns ; Carcinoma ; Dermatitis, Atopic ; Dermatology ; Eczema ; Hemangioma, Capillary ; Humans ; Hyperpigmentation ; Neurodermatitis ; Nevus ; Psoriasis ; Sensation ; Solar System ; Tinea Pedis ; Warts

The multifactorial etiology of BCC(basal cell carcinoma) are incompletely understood, including factors leading to multiple lesions in some patients. Cases of multiple BCCs reported in the literature have been associated with UV irradiation, inorganic arsenic poisoning, X-ray therapy, hematologic malignancy and several genodermatoses such as nevoid BCC syndrome, albinism, xeroderma pigmentosum. Multiple BCCs presented on the sun-protected areas, lacking predisposing risk factors which have been known, is rare skin condition. However, it suggests that there may be an unknown genetic susceptibility to the development of multiple BCCs. We report a rare case of multiple BCCs, which had developed only on the sun-protected areas in 64-year-old man, without any known predisposing causes.
Albinism ; Arsenic Poisoning ; Carcinoma, Basal Cell* ; Genetic Predisposition to Disease ; Hematologic Neoplasms ; Humans ; Middle Aged ; Risk Factors ; Skin ; X-Ray Therapy ; Xeroderma Pigmentosum

We present a case of acquired, bilateral nevus of Ota-like macules in 50-year-old women, She had deeply brownish, confluent or solitary macules and patches distributed symmetrically on the both side of the forehead and temple, since years ago. But there was no involvement (of ocular and oral mucosa. Histopathologic findings showed flattening of the rete ridges and elongated or irregular shaped melanocytes containing many melaiiin granules, in upper-and mid-dermis. And most of melanocytes showed positive reactions on Dopa stain.
Dihydroxyphenylalanine ; Female ; Forehead ; Humans ; Melanocytes ; Middle Aged ; Mouth Mucosa ; Nevus*

We experienced a case of scrotal calcinosis which was considered to be developed from the trichilemmal cysts of the scrotum. This 22 year-old male patient has been suffered from pea-sized hard muliple yellowish nodules of the scrotum since. about 5 years ago. Histopathologic findings revealed multiple cysts or calcium lumps surrounded by variable a.mounts of granulomatous inflammatory infiltrations in the dermis. The cysts were lined by stratified squamous epithelium without intercellular bridge and surrounded by scanty inflammatory cells. Several cysts contained homogenous keratinous material but most cysts contained calcium deposits within the homogenous keratinous materials or only the calcium lumps in the intact epithelial linings. Most of calcium lumps which had partially or completely disintegrated epithelial linings were surrounded by active granulomatous inflammatory infiltrations and a few calrium lumps with completely disintegrated epithelial linings had no surrounding inflammatory cells. Observing the above histopathologic features, we could consider that this case of scrotal calcinosis was developed from the scrotal trichilemmal cyst and some cases of idiopathic scrotal calcinosis, previousely reported, were the end stage of the above process.
Calcinosis* ; Calcium ; Dermis ; Epithelium ; Humans ; Male ; Scrotum ; Young Adult

We describe here a case of Norwegian scabies in a patient with Cushing syndrorne, the first case in Korea. He had complained of intermittent mild itching for 5 month. Physical examinations revealed the characteristic features of Cushing syndrome and hyperkeratotic brownish papules or/and patches were distributed on the dorsa of hands, axillae, groins, interdigital webs, upper part of the chest and around the neck. We could find numerous burrows and many mites, eggs, lavas and scybala in the affected sites on direct microscopic examination with 25% KOH. Significant laboratory findings were as follows: 1. Total eosinophil count: 0 2. 17-hydroxycorticoids in 24 hr. urine: 10. 1 mg/900 cc 3. Bone X ray series: generalized osteoporosis 4. Mantoux test: negative About 10 days after topical application of 25% benzyl-benzoate lotion combined with 5% sulfur ointment, the skin lesions were cleared. We suspect that the lack of delayed hypersensitivity might attribute to the development of Norwegian scabies in this patient.
Axilla ; Cushing Syndrome* ; Eggs ; Eosinophils ; Groin ; Hand ; Humans ; Hypersensitivity, Delayed ; Korea ; Mites ; Neck ; Osteoporosis ; Ovum ; Physical Examination ; Pruritus ; Scabies* ; Skin ; Sulfur ; Thorax

No abstract available.
Allografts* ; Cadaver* ; Fascia*