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

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

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

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

BACKGROUND: Precancerous diseases of the skin such as actinic keratosis (AK), Bowen disease (BD) and skin cancer, i.e. basal cell carcinoma (BCC), are treated successfully with photodynamic therapy (PDT). In BCC, the therapeutic effect of PDT was different according to the subtypes. However, there has been no study on the response to PDT in the thickness of atypical cell layer and the histopathologic subtype of AK. OBJECTIVE: We evaluated the responses to PDT using a topical 20% aminolevulinic acid (ALA) solution and a blue light, according to the thickness of atypical cell layer in AK. Further, we assessed the therapeutic response in the histopathologic subtypes of AK. METHODS: There were a total of 29 AK lesions from 20 patients enrolled in the study. The lesions were incubated with a topical 20% ALA solution for 2 hours and were exposed to blue light (417+/-5 nm) with 10 J/cm2. They were treated 2 times at the 4 weeks intervals. The evaluation of the response to ALA-PDT was done by the skin biopsy at the post 8 weeks period from the last treatment. The therapeutic response was assessed into 3 grades (complete remission, partial remission, no response). The relationship between the therapeutic response and the thickness of atypical cell layer was evaluated. The thickness of atypical cell layer was measured from the most superficial aspect of the Malpighian layer to the tip of rete ridge. In addition, we evaluated the therapeutic effects according to the histopathologic subtypes. RESULTS: The thickness of atypical cell layer were 0.0327+/-0.0087 mm in complete remission (CR) group, 0.1253+/-0.1128 mm in partial remission (PR) group and 0.1485+/-0.1973 mm in no response (NR) group (p=.0206). CR were achieved in 100% (4/4) of atrophic type, 43.75% (7/16) of hypertrophic type and 0% (0/9) of bowenoid type in AK. The response of ALA-PDT was the best in atrophic type (p=.032) and the lowest in bowenoid type (p=.0051) as compared with other subtypes. CONCLUSION: The responses to ALA-PDT were different in the thickness of atypical cell layer and it was statistically significant. The therapeutic effect was the best in the atrophic type of AK.
Actins ; Aminolevulinic Acid ; Biopsy ; Bowen's Disease ; Carcinoma, Basal Cell ; Humans ; Keratosis, Actinic ; Light ; Photochemotherapy ; Skin ; Skin Neoplasms ; Triazenes

Erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), and white blood cell(WBC) counts are screening parameter for detection of postoperative infectious complications. We compared each values of ESR, CRP, and WBC after lumbar discectomy. These parameters were examined in all patients preoperatively, and postoperative days 1, 3, 5, 7, 9 and 11, and clinical and laboratory findings were compared. A total of 87 patients suffering lumbar disc herniation, treated surgically without any evidence of infectious problems, were included in this prospective study. The CRP and WBC counts elevated postoperative day 1, and returned to preoperative state at postoperative day 5. The ESR reacted to more steady pattern in postoperative courses. These normal spectrum of infectious parameter after lumbar discectomy will attribute more accurate diagnosis of infectious complications, such as spondylodiscitis.
Blood Sedimentation* ; Diagnosis ; Discitis ; Diskectomy* ; Erythrocytes* ; Humans ; Leukocyte Count* ; Leukocytes* ; Mass Screening ; Prospective Studies

PURPOSE: We conducted a comparative study to evaluate the diagnostic values of Tl-201, Tc-99m MIBI and I-131 scans in the follow-up assessment after ablative I-131 therapy in differentiated thyroid cancer. MATERIALS AND METHODS: The study population consisted of 20 patients who underwent surgical removal of thyroid cancer and ablative radioactive iodine therapy, and followed by one or more times of I-131 retreatments (33 cases). In all patients, Tl-201, Tc-99m MIBI, diagnostic and therapeutic I-131 scans were performed and the RESULTS were analyzed retrospectively. Also serum thyroglobulin levels were measured in all patients. The final diagnosis of recurrent or metastatic thyroid cancer was determined by clinical, biochemical, radiologic and/or biopsy findings. RESULTS: Positive rates (PR) of Tc-99m MIBI, Tl-201, diagnostic and therapeutic I-131 scans in detecting malignant thyroid tissue lesions were 70% (19/27), 54% (15/28), 35% (17/48) and 63% (30/48), respectively. The PR in the group of 20 cases (28 lesions) who underwent concomitant Tl-201 and I-131 scans were in the order of therapeutic 131 scan 71%, Tl-201 scan 54% and diagnostic I-131 scan 36%. There was no statistically significant difference between Tl-201 and diagnostic I-131 scans (p>0.05). In the group of 20 cases (27 lesions) who underwent concomitant Tc-99m MIBI and I-131 scans, the PR were in the order of Tc-99m MIBI scan 70%, I-131 therapeutic scan 52% and I-131 diagnostic scan 33%. The PR of Tc-99m MIBI was significantly higher than that of diagnostic I-131 scan (p<0.05). CONCLUSION: Tc-99m MIBI scan is superior to diagnostic I-131 scan in detecting recurrent or metastatic thyroid cancer following ablation therapy in patients with differentiated thyroid cancer. Tl-201 scan did not showed significantly higher positive rate than diagnostic I-131 scan. Instead of diagnostic I-131 scan before the I-131 retreatment, Tc-99m MIBI scan without discontinuing thyroid hormone replacement would be a prudent and effective approach in the management of these patients.
Biopsy ; Diagnosis ; Follow-Up Studies* ; Humans ; Iodine ; Retreatment ; Retrospective Studies ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms*

Complications from hysteroscopy are relatively rare events. They occur more frequently with operative hysteroscopy than with diagnostic hysteroscopy. Air embolism is a rare but devastating complication of hysteroscopy that rightly receives attention as a frightening, sudden, and potentially fatal hazard in otherwise healthy women. We experienced one case of air embolism during diagnostic hysteroscopy for abnormal uterine bleeding under general anesthesia. Early diagnosis and prompt treatment seem to be the keys to prevention of catastrophic outcomes and the hysteroscopists must understand the pathophysiology of air embolism to prevent, diagnose, and manage this potentially disastrous problem effectively.
Anesthesia, General ; Early Diagnosis ; Embolism, Air* ; Female ; Humans ; Hysteroscopy* ; Uterine Hemorrhage