A clinical analysis of infective endocarditis was done in 34 patients who were admitted to National Medical Center from march. 1972 to June. 1984, and the results were as follows. 1) There was no difference in ratio between sexes. The prevalence was highest in the 3rd decade. 2) The important preexisting heart diseases were rheumatic heart disease(32.4%), congenital heart disease(17.6%) and undefined cardiac condition(20.6%) in order of frequency. 3) The common symptoms and signs on admission were fever(88.3%), cardiac murmur(79.4%), malaise(70.6%), dyspnea (64.7%), palpitation(55.9%) and hepatosplenomegaly(55.9%). 4) The positive blood culture was obtained in 15(47%) of the cases. Those who had not received antibiotics before admission showed higher rate of positive culture(72.7%) than in those who had received(33.3%). 5) The laboratary findings revealed anemia(73.5%), leukocytosis(35.3%), increased ESR(73.5%), microscopic hematuria(61.8%) and positive CRP(100.0%). 6) The EKG findings showed normal(11.8%), sinus tachycardia(32.4%), LV hypertrophy(29.4%), non-specific ST-T change(20.6%) and AV block(14.7%). 7) Vegetation was detected by echocardiography in 43% of cases and the most frequently involved valve was aortic(66.7%). 8) The combination of penicillin and aminoglycoside was effective in 86.4% of patients so treated.
Anti-Bacterial Agents ; Dyspnea ; Echocardiography ; Electrocardiography ; Endocarditis* ; Heart ; Heart Diseases ; Humans ; Penicillins ; Prevalence

In 1962, Durand suggested the term primary lactose intolerance for the disorder withch resulted from a defect of the lactase activity in the intestinal mucosa. However primary lactose intolerance is rare and it is not commonly encountered in routine pediatric practice. Apart from such a primary lactose intolerance, diarrhea, meteorism, and abdominal discomfort after taking lacose containing food are more frequently encoumtered in case of gastroenteritis in which damage of the intestinal mucosa and coating of the mucosa by inflammatory secretions lead to decreased lactase it form the primary lactose intolerance. It is now considered that secondary lactose intolerance may play an important role in case of infantile diarrhea commonly encoutered in pediatric practice. The auther tried the lactase preparation Galantase?to evaluated it's clinical effect on infantile diarrhea of various kind (50 cases). Evaluation of the effect of Galantase was made on the bases of the following criteria. l Marked effective ; nature of stools and number per day returned to normal within 3 days after Galantase administration. l Effective ; nature of stools and number per day decreased within 3 days after Galantase administration. l Ineffective ; all stools remained unchainged and diarrheic. The results obtsined by this study are as followes l Marked effective ; 78 % l Effective ; 12 % l Slight effective ; 4% l Ineffective ; 6% There was no undesirable side effect observed in all 50 cases. Based upon the above effective rate, we concluded that the Galantase is a quite effective medicament for infantile diarrhea, especially for primary and secondary lactose intolerance.
Diarrhea ; Diarrhea, Infantile* ; Gastroenteritis ; Infant ; Intestinal Mucosa ; Lactase ; Lactose Intolerance ; Meteoroids ; Mucous Membrane

No abstract available.
Angiofibroma ; Carbon ; Carbon Dioxide ; Lasers, Gas

Early postoperative anastomotic obstruction after colorectal surgery rarely develops. Herein, we present a case of a 50-year-old healthy woman who had an early postoperative anastomotic obstruction which was revealed caused by a blood clot and successfully managed by endoscopic approach. The patient was discharged after laparoscopic anterior resection and visited the emergency department one day after because of abdominal pain. Computed tomography showed that the anastomosis site was obstructed with low-density material. Intraoperative endoscopy was performed under general anesthesia and blood clot filling the lumen were identified. As the scope was advanced to the blood clot with air inflation, the blood clot was evacuated. The anastomosis site could be obstructed by blot clot with mucous debris albeit it is a rare condition. An endoscopic approach seems to be the first option in the diagnosis and treatment of postoperative obstruction at the anastomosis site and it could prevent unnecessary laparotomy.

PURPOSE: It is known that secondary hyperparathyroidism in end stage renal disease (ESRD) patients is associated with vitamin D receptor (VDR) gene polymorphism, but there is no consensus on its genotype. There is lack of data in Ca, P, calcitriol and VDR polymorphism. METHODS: We measured serum Ca, P, alkaline phosphatase, parathyroid hormone (PTH), and 1,25 (OH)2D3 of the 53 hemodialysis patients. The genotypes of VDR were classified BB, Bb, bb according to restriction patterns in PCR of the patients' DNA using Bsm I restriction enzyme. RESULTS: The patients with BB, Bb, bb type were 0 (0%), 15 (28.3%), 38 (71.7%) respectively. Serum PTH levels were 70.0+/-63.3 pg/mL and 146.9+/-184.9 pg/mL in Bb, bb type respectively, and showed significant statistical difference (p<0.05). Serum 1,25 (OH)2D3 levels were 7.68+/-3.41 pg/mL and 6.59+/-2.67 pg/mL in Bb and bb genotype respectively without statistical significance. And there was no significant statistical differences among the serum levels of calcium, phosphorus, alkaline phosphatase. CONCLUSION: Vitamin D receptor gene polymorphism is associated with secondary hyperparathyroidism in hemodialysis patients, and the b allelle is suggestive of poorer bone mineral metabolism.
Alkaline Phosphatase ; Calcitriol ; Calcium ; Consensus ; DNA ; Genotype ; Humans ; Hyperparathyroidism ; Hyperparathyroidism, Secondary* ; Kidney Failure, Chronic ; Metabolism ; Parathyroid Hormone ; Phosphorus ; Polymerase Chain Reaction ; Receptors, Calcitriol* ; Renal Dialysis* ; Vitamin D* ; Vitamins*

An aneurysm arising from the intracranial portion of the internal carotid artery(ICA) is usually found at the junction of the ophthalmic, superior hypophyseal, posterior communicating or anterior choroidal artery, or at the bifurcation of the internal carotid, but very rarely at the junction of the persistent trigeminal artery. We present a case of a 49-year-old man who presented with a massive subarachnoid hemorrhage, with large intracerebral hematoma due to rupture of the aneurysm originating from the distal portion of the internal carotid artery. During surgery, we found that the aneurysm was originated at the junction of the internal carotid artery and the artery arising from the distal to anterior choroidal artery. We considered this artery to be an anatomical variant of the uncal artery(UA) arising from the internal carotid artery.
Aneurysm* ; Arteries* ; Carotid Artery, Internal* ; Choroid ; Hematoma ; Humans ; Middle Aged ; Rupture ; Subarachnoid Hemorrhage

Methotrexate (MTX) is an antimetabolite which interferes with DNA synthesis, and it is used for the treatment of moderate to severe psoriasis, atopic dermatitis and a wide variety of cutaneous diseases. Although many adverse effects of MTX, including cutaneous ulcerations, have been documented, multifocal mucosal ulceration mimicking Behcet's disease has not been reported. In our case, a 63-year-old female presented with oral, vaginal ulcer and multiple purpuric patches on both legs. Considering patient's clinical course and histopathologic findings, we presumed that these reactions may be the side effect of MTX administered for treatment of necrotizing scleritis. Herein we report the cutaneous side effect of MTX that manifested clinically like Behcet's disease.
Dermatitis, Atopic ; DNA ; Female ; Humans ; Leg ; Methotrexate ; Middle Aged ; Psoriasis ; Scleritis ; Ulcer

No abstract available.
Angiomyolipoma* ; Tuberous Sclerosis*

BACKGROUND: To assess and report the outcomes of resuscitation, we apply the 1997 published In-Hospital Utstein Style to an actual emergency department. This study was designed to develope the data base for comparing and studing the outcomes of resuscitation. METHODS: This study was carried out in a tertiary hospital from July 1998 to June 1999. The subjects were adult patients over the age of 20 years who received resuscitation at the emergency department. After making out the protocol for the In-Hospital Utstein Style, we gathered data prospectively. RESULTS: Among 51,347 patients, 36 patients received 42 resuscitations. Forty-two(42) cases(100%) had witnessed arrest. Advance life support(ALS) intervention at the time of cardiac arrest included intravenous catheterization, 41cases(97.6 %); intravenous drug injection, 20 cases(47.6%); endotracheal intubation, 20 cases(47.6%); and artificial ventilation, 12 cases(28.6%). Immediate causes of cardiac arrest were respiratory depression, 11 cases(26.2%); hypotension, 11 cases(26.2 %); metabolic, 9 cases(21.4%); and myocardial ischemia/infarction, 5 cases(11.9%). Initial EKG ryhthms were pulseless electrical activity, 31 cases(73.8 %); ventricular tachycardia/fibrillation, 6 cases(14.3%); and asystole, 5 cases(11.9%). the average interval from cardiac arrest to initial defibrillation was 1.8+/-2.2 minutes, and the average interval from cardiac arrest to epinephrine injection was 2.6+/-3.1 minutes. The average duration of resuscitation was 22.6+/-18.4 minutes. Return of spontaneous circulation occured in 26 cases/42 case(61.9%). Of the 2 survivng patients who were discharged, 1 patient is still alive after 6 months, and the other is still alive after 1 year. CONCLUSION: Although the In-Hospital Utstein Style has many complementary factors, its results were very objective thus use of the In-Hospital Utstein Style is recommended for determining the outcomes of resuscitation.
Adult ; Catheterization ; Catheters ; Electrocardiography ; Emergencies* ; Emergency Service, Hospital* ; Epinephrine ; Heart Arrest ; Humans ; Hypotension ; Intubation, Intratracheal ; Prospective Studies ; Respiratory Insufficiency ; Resuscitation* ; Tertiary Care Centers ; Ventilation

Piloleiomyoma is a benign neoplasm arising from the erector pili muscle in the skin. It occurs as linear or dermatomal arrangements of firm, red to brown intradermal nodules, which are fixed to the skin but not to the deeper tissues. Although various treatments have been attempted, they have shown limited success and several complications remain. A 21-year-old male presented with 3-year history of multiple, erythematous, firm 4 mm to 3 cm sized nodules on the chest. The histopathological examination was compatible with piloleiomyoma. The lesions were removed using the dermal shaving method with a suction-assisted cartilage shaver. Each lesion were markedly flattened. This treatment was quicker and caused less subjective pain to the patient compared with those of classic surgical excision. No signs of adverse events or recurrence have been observed.
Cartilage ; Humans ; Male ; Muscles ; Recurrence ; Skin ; Thorax ; Young Adult