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

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

Teratoma is one of germ cell tumor, common neoplasm in women of reproductive age, but it can arise at any age. Its malignant transformation is rare, less than 2%, frequently at older age. Nearly all the cases are squamous, sarcomatous and adenomatous transformation. Here we present a case of mixed transformation, adeno-squamous cell carcinoma with brief review of the concerned literature.
Carcinoma, Squamous Cell* ; Female ; Humans ; Neoplasms, Germ Cell and Embryonal ; Teratoma*

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

PURPOSE: This study sought to evaluate the clinical outcomes of various therapeutic modalities, including newly-developed anti-epileptic drugs (AEDs), prednisolone, ketogenic diet (KD) epilepsy surgery, and vagus nerve stimulation (VNS), in treating intractable childhood epilepsy. METHODS: Data of refractory epilepsy patients (n=297) treated from July 1995 through April 2003 at the epilepsy center of Sanggye Paik Hospital were retrospectively analyzed. RESULTS: Newly-developed AEDs were primarily prescribed to 290 patients, although only 20 patients (6.9%) maintained a seizure- free state. Of 138 patients for whom prednisolone was prescribed, 58 patients (42.0%) showed complete seizure controls while 41 patients experienced relapse. KD was attempted and evaluated at 12 months in 162 patients, at which time 74 (45.7%) remained on the diet and 68 (42.0%) showed seizure reduction of greater than 50%, including 37 (22.8%) who were completely seizure free. Epilepsy surgery was undergone in 38 patients, and Engel class I was identified in 25 (65.8%) patients. VNS was administered to five patients, only two of whom obtained a seizure reduction of more than 50%. RESULTS: Taken together, these findings suggest that considerable controls over intractable childhood epilepsy can be gained through KD and epilepsy surgery, whereas prednisolone treatment leads to somewhat more frequent relapses, and newly-developed AEDs are comparatively limited in their controls of refractory epilepsy.
Diet ; Epilepsy* ; Humans ; Ketogenic Diet ; Prednisolone ; Recurrence ; Retrospective Studies ; Seizures ; Vagus Nerve Stimulation

Steatocystoma multiplex is a rare autosomal-dominant disorder characterized by asymptomatic multiple, skin-colored to yellowish nodules on the trunk, proximal extremities, and axillae. Although surgical excision is the most effective method, treatment is difficult when lesions occur in multiple numbers. Therefore, various treatments such as CO2 laser therapy, needle aspiration, and oral isotretinoin have been attempted, but results are variable. A 37-year-old man presented with multiple skin-colored subcutaneous nodules on the abdomen and both axillae. A histopathological examination was consistent with steatocystoma multiplex. The lesions were removed by dermal shaving with a suction-assisted cartilage shaver. It was an effective therapeutic method for multiple lesions with no significant adverse events. Herein, we report a case of steatocystoma multiplex treated with a suction-assisted cartilage shaver.
Abdomen ; Adult ; Axilla ; Cartilage ; Extremities ; Humans ; Isotretinoin ; Lasers, Gas ; Needles ; Steatocystoma Multiplex