The kidneys play a vital role in the maintenance of normal body fluid volumes and in the composition of the extracellular fluid compartments. There are normally more than 2 million functioning glomeruli that regulate total body water and solute concentrations. As renal failure progresses, there is a decrease in the number of functioning nephrons. Chronic renal failure(CRF) is the consequence of a multitude of diseases that cause permanent destruction of the nephron. Azotemia is an elevation in blood urea nitrogen(BUN) and serum creatinine levels subsequent to a decreased glomerular filtration rate(GFR), which results in uremia. This loss of renal function can cause functional and metabolic abnomalities of body. For this problem, oral & maxillofacial surgeons have demanded to routinely treat patients with CRF. However, there has not been a reported case of orthognathic surgery by bilateral sagittal split ramus osteotomy(BSSRO) in patients with CRF, which can cause multiple complications in healthy patients. We report developmental mechanism of complication associated with CRF and preop. and postop. care of orthognathic surgery by BSSRO in ClIII patient with severe chronic renal failure.
Azotemia ; Body Fluids ; Body Water ; Creatinine ; Extracellular Fluid ; Filtration ; Humans ; Kidney ; Kidney Failure, Chronic* ; Nephrons ; Orthognathic Surgery ; Renal Insufficiency ; Urea ; Uremia

We experienced 2-cases of epileptic seizures aggravated by CBZ, of one which was 15-year old frontal lobe epileptic and the other was 8-year old occipital lobe epileptic. Their seizures were disappeared by withdrawal of CBZ. In conclusion, if a child or adult is noted to have more seizures or to have a new type of seizure when CBZ is added. One should consider the possibility that the seizures are drug-induced rather than part of the natural course of a progressive epilepsy and promptly withdraw CBZ.
Adolescent ; Adult ; Carbamazepine* ; Child ; Epilepsy ; Frontal Lobe ; Humans ; Occipital Lobe ; Seizures*

Brain infarction restricted to the unilateral hypothalamus is known to be very rare because of the abundant blood supply from the circle of Willis. We report a case of right hypothalamic infarction. A 63-year-old woman developed hyperphagia, hypersomnolence and hemihyperhidrosis limited to the left half of the face. Brain MRI revealed a high signal intensity at the right anteromedial hypothalamus.
Brain ; Brain Infarction ; Circle of Willis ; Disorders of Excessive Somnolence* ; Female ; Humans ; Hyperphagia ; Hypothalamus ; Infarction* ; Magnetic Resonance Imaging ; Middle Aged

BACKGROUND: The TRUE test is a commercially available ready-to-apply patch test widely used in many countries, but no large-scale study is available on the TRUE test in Korea. OBJECTIVE: The purpose of this study was to analyze the type, frequency, and changes in the common contact allergens in Korea using the TRUE test. METHODS: From January 2009 to March 2010, TRUE tests were performed on patients with contact dermatitis at the Departments of Dermatology of 15 hospitals. The epidemiological findings of patients, and the results of the patch tests were analyzed. RESULTS: In total, 795 patch tested cases (246 males, 549 females) were compiled and analyzed. The oldest age distribution was the third decade in both males and females, and housewives and office-workers were the most common jobs, comprising 29.7% and 19.8% of the occupations, respectively. Overall, 65.1% of patients had at least one positive reaction, and the most common allergens were nickel sulfate (34.1%), thimerosal (12.6%), cobalt chloride (11.1%), and p-phenylenediamine (8.4%), in order of frequency. A univariate analysis of multiple variables including age, gender, occupation, and affected sites was conducted and a comparison with a previous multicenter study was also analyzed. CONCLUSION: These results provide the basis for use of the TRUE test in patients with contact dermatitis in Korea.
Age Distribution ; Allergens ; Cobalt ; Dermatitis, Contact ; Dermatology ; Female ; Humans ; Korea ; Male ; Nickel ; Occupations ; Patch Tests ; Phenylenediamines ; Thimerosal

PURPOSE: We evaluated the treatment efficacy including survival and recurrence, and factors associated with recurrence in osteosarcoma patients treated with preoperative chemotherapy, surgery, and adjuvant chemotherapy. MATERIALS AND METHODS: Forty nine patients with osteosarcoma were treated with preoperative chemotherapy with intra-arterial cisplatin and adriamycin infusion for 3 cycles, followed by surgery. According to the pathologic response, if tumor was necrotized more than 90%, the same adjuvant chemotherapy was reintroduced for 3 cycles, and if the response was not enough, then the salvage regimen was introduced. Plain chest film and chest CT scan were taken monthly and every 3 months, respectively. When tumor recurred, the metastasectomy was performed whenever possible. RESULTS: Forty three patients were evaluable with amedian follow up of 53 months. Five-year disease-free and overallsurvival rate was 47.0% and 66.9%, respectively. The recurrence was observed in 22 patients (51.2%) with median time of 12.5 months. Baseline alkaline phosphatase (ALP) was the only significant factor for recurrence (p=0.03) and the patients with the possibility of metastasectomy recurrence showed higher post-relapse survival compared to other treatment modalities (26 momths vs 5~12 months). CONCLUSION: These results indicates that pre- and postoperative chemotherapy with intra-arterial cisplatin and adriamycin infusion showed comparable treatment efficacy and acceptable toxicities.
Alkaline Phosphatase ; Chemotherapy, Adjuvant ; Cisplatin ; Doxorubicin ; Drug Therapy* ; Extremities* ; Follow-Up Studies ; Humans ; Metastasectomy ; Osteosarcoma* ; Recurrence ; Thorax ; Tomography, X-Ray Computed ; Treatment Outcome

BACKGROUND: Data on the clinicopathologic features of hair follicle tumors in Korea are limited. OBJECTIVE: The purpose was to investigate the clinical and histopathologic characteristics of hair follicle tumors in Korea. METHODS: Two hundred sixty four cases of hair follicle tumors seen from 1999 to 2001 in Korea were analyzed clinically and histopathologically. RESULTS AND CONCLUSION: The most common hair follicle tumor in Korea was pilomatricoma(81.0%), followed by trichoepithelioma(6.4%), dilated pore of Winer(3.8%), and proliferating trichilemmal tumor(2.2%). Hair follicle tumors usually occurred as a solitary skin-colored nodule. The most commonly involved site was the face, and the peak age of presentation was 10 to 19. Pilomatricoma usually occurred as a solitary skin-colored nodule. The most commonly involved site was the arm, and more than 50% of tumors occurred before the age of 20. Histopathologically, the tumor was often surrounded by fibrous capsule and was composed of basophilic and shadow cells. It was usually located in the dermis and extended into the subcutis. Retraction spaces between tumor nests and stroma were frequently observed. Trichoepithelioma usually occurred as multiple skin-colored papules on the face. Histopathologically, the tumor was usually located in the dermis with sometimes connected to the epidermis. It frequently showed peripheral palisading. Dilated pore of Winer usually occurred as a solitary brownish to pigmented papule on the face in middle-aged persons. Proliferating trichilemmal tumor occurred as a solitary or multiple tumors. Histopathologically, the tumor was usually surrounded by incomplete fibrous capsule. Tumor cells frequently showed clear cell formation, nuclear atypia, mitosis, peripheral palisading, trichilemmal keratinization, and individual keratinization.
Arm ; Basophils ; Dermis ; Epidermis ; Hair Follicle* ; Hair* ; Humans ; Korea ; Mitosis ; Pilomatrixoma

BACKGROUND: Hand eczema is one of the most common skin disorders and negatively affects quality of life. However, a large-scale multicenter study investigating the clinical features of patients with hand eczema has not yet been conducted in Korea. OBJECTIVE: To identify the prevalence of various hand diseases, which is defined as all cutaneous disease occurring in hands, and to investigate the clinical features of patients with hand eczema and the awareness about hand eczema in the general population and to compare the prevalence of hand eczema between health care providers and non-health care providers. METHODS: To estimate the prevalence of hand diseases, we analyzed the medical records of patients from 24 medical centers. Patients were assessed by online and offline questionnaires. A 1,000 from general population and 913 hand eczema patients answered the questionnaire, for a total of 1,913 subjects. RESULTS: The most common hand disease was irritant contact dermatitis. In an online survey, the lifetime prevalence of hand eczema was 31.2%. Hand eczema was more likely to occur in females (66.0%) and younger (20~39 years, 53.9%). Health care providers and housewives were the occupations most frequently associated with hand eczema. Winter (33.6%) was the most common season which people experienced aggravation. The 63.0% and 67.0% answered that hand eczema hinders their personal relationship and negatively affects daily living activities, respectively. CONCLUSION: Hand eczema is a very common disease and hinders the quality of life. The appropriate identification of hand eczema is necessary to implement effective and efficient treatment.
Activities of Daily Living ; Dermatitis, Contact ; Eczema* ; Female ; Hand* ; Health Personnel ; Humans ; Korea* ; Medical Records ; Occupations ; Prevalence ; Quality of Life ; Seasons ; Skin ; Surveys and Questionnaires