No abstract available.

Uremic pruritus is the most common skin manifestat,ion of chronic renal failure nnd cloes not respond to conventional treatment for pr uritus such as antihistamine. Although the pathophysiology of pruritus in uremia is uncliar, UVE3 phototherapy is consi(dered as the most effective and safest, therpy. We report two rases of uremic pruritus treated with LJVB. Initial doses were 70mJ, cm and 60mJ/cm. Pruritus was some relieved after two treatments and nearly completely disappeared after eight, treatments. Total doses were 840mJ/cm and 94G)mJ/
Kidney Failure, Chronic ; Phototherapy ; Pruritus ; Skin ; Uremia

The present study was performed to evaluate the characteristics and incidence of the nail changes in chronic renal failure patients. Sixty-six patients who were admitted to the Department of Internal Medicine between March and December, 19R3 and thirtyn'ine patients who were receiving hemodialysis therapy at the hemodialysis unit during June, 1983 in Seoul National University Hospital, were examined. The results were as follows; 1. The brown band just proximal to the free margin of the nail is a frequent nail change in chronic renal failure patients. The term half-and-half nail can be used when the band is wide enough to call it half and the term brown distal arc may be apposite for the whole. 2 .Among the 66 admitted patients, 21 cases(31.8%,) had half-and-half nails,26 cases(39.5%) had brown arcs and 3 cases(4.5%) had white nails. Overall the brown distal arc was present in 47 cases(71.2%,). 3, Among the 39 patients receiving hemodialysis, 3 casesp. 7p,) had half-and-half nails, 9 cases(23. 1%) had brown arcs and 5 cases(23,l%) had white nails. The brown distal arc was present in 12 cases(30.8%) over all. 4. There was no correlation between the level of impaired renal function and the presence or the width of a brown distal arc.
Humans ; Incidence ; Internal Medicine ; Kidney Failure, Chronic* ; Renal Dialysis ; Seoul

OBJECTIVES: Of 339 patients with systemic lupus erythematosus(SLE) observed at Seoul National University Hospital in Seoul, 221 fulfilled criteria for lupus nephritis. We evaluated the clinicopathologic findings, outcomes and prognostic factors of patients' survival. METHODS: We searched computer system of our center using disease code for SLE from January 1973 to January 1995 and found 339 SLE patients among whom there were 221 definite lupus nephritis patients. We retrospectively reviewed medical records and investigated the influence of multiple prognostic factors on patients' survival using Cox hazard function analysis. RESULTS: Of 221 patients, 89.6% were female. The mean age of onset of SLE was 27.7+/-10.4 years and the mean follow-up duration was 42.5+/- 40.2 months. The most frequent symptoms at diagnosis were skin manifestations. Hypertension was diagnosed in 21.7% of patients and 21.6% had serum creatinine greater than 1.4mg/dL. Overall, 37.7% were nephrotic. Renal biopsy performed on 159 patients showed the following World Health Organization Class distribution : Class I 1.3%, class II 8.8%, class III 6.3%, class IV 65.4%, class V 13.2%, class IV+V 5.0%. Remission of nephritis was observed in 31.3% of patients. At the last follow-up period, there were 23 patients with deteriorated renal function among 168 patients and renal failure developed in 3.2%. Twenty eight patients died, primarily from infection, with 86.2% and 78.3% 5-year and 10-year survival rates, respectively. Initial presence of renal insufficiency(serum creatinine>or=1.4mg/dL) and treatment with prednisolone only were most important in predicting patients' survival. Combination treatment of high dose prednisolone and cytotoxic drug(azathioprine, oral cyclophosphamide, or iv cyclophosphamide) appeared to be beneficial for nephritis. Treatment modality was only independent risk factor associated with lower survival probability. CONCLUSION: The characteristics of our patients were not so different from those of others. Treatment modality and renal function were important predictors of fatality. Treatment with high dose prednisolone and cytotoxic drug improved the clinical outcome of lupus nephritis, as compared with prednisolone alone.
Age of Onset ; Biopsy ; Computer Systems ; Creatinine ; Cyclophosphamide ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Hypertension ; Lupus Nephritis* ; Medical Records ; Nephritis ; Prednisolone ; Renal Insufficiency ; Retrospective Studies ; Risk Factors ; Seoul ; Skin Manifestations ; Survival Rate ; World Health Organization

It has been reported in autopsy that most of the patients with Korean hemorrhagic fever had necrotic areas inthe anterior lobe of the pituitary gland. The high resolution CT of sella was performed to demonstrate thepossible pituitary necrosis in consecutive 13 patients with Korean hemorrhagic fever. Only 3 patients demonstrate normal sellar findings. Ten (77%) out of 13 cases reveal abnormal findings; 2 patients show typical empty sellar and the rest (8 patients) reveal localized low denstiy area in the anterior portion of the sella turcica, which may be from partial empty sella, pituitary infarction or other unknown pathology. The low denisties within the sella will be discussed.
Autopsy ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Infarction ; Necrosis ; Pathology ; Pituitary Gland ; Sella Turcica

No abstract available.
Acid-Base Equilibrium* ; Acidosis*

No abstract available.
Infarction* ; Retrospective Studies*

Authors analysed and present chest X-ray findings of serologically proven leptospirosis from Seoul NationalUniversity Hospital, either admitted or referred for serological verification, during recent 2 years. Radiologicalfindings were correlated with the lung specimen finding of experimentally induced leptospirosis in guinea pig. Theresults are as follows: 1. 24 cases(56%) showed positive X-ray findings. 2. Predominent radiological patterns ofinvolved lung were tiny dot, small nodule, rosette density in 11 cases, massive confluent consolidation in 4cases, and diffuse ill-defined veilly increased density in 9 cases. 3. Distribution of pulmonary lesions werebilateral (100%), non-lobar, non-segmental(95%), and there were conspicuous tendency of peripheral lungpredominence. 4. Extrapulmonary manifestation, such as pleural effusion or cardiomegaly was rare. 5. Pulmonarylesions resolved completely usually 5 to 10 days after their appearance. 6. From the gross and microscopicfindings of serially sacrified guinea pig's lung and a case of autopsy, authors conlcuded that fine dot-likedensity in chest X-ray was due to petechial hemorrhage in intraalveolar space at initial stage, growing up toressette density or confluent consolidation as the petechia extends to surrounding lung forming purpura andcoalescent hemorrhage.
Animals ; Autopsy ; Cardiomegaly ; Guinea ; Guinea Pigs ; Hemorrhage ; Leptospirosis ; Lung ; Pleural Effusion ; Purpura ; Seoul ; Thorax

OBJECTIVES: It is suggested that frequency of low turnover bone disease is much higher in diabetic renal osteodystrophy. We tried to find out whether bone scan images show less 99mTc-MDP uptake in diabetic renal ostwdystrophy. METHODS: We compared bone scan images of renal failure patients with and without diabetes. The number of patients studied was 134 (43 patients had diabetes and 91 patients did not). Two experienced nuclear physicians read Tc-99m-MDP bone scan twice separately and gave the score either 1 or 0 on 6 areas; axial skeleton, long bone, skull and mandible, periarticular areas, costochondral junction and sternum. The means of summed scores were compared using Students t-test. To exclude the effects of sex, age and serum creatinine concentration, we analysed these factors together with the effect of diabetes using analysis of covariance. We also interpreted on bone scan images, as classical renal osteodystrophy, renal failure and normal. RESULTS: The intra- and interobserver variations were very low. Patients of diabetes group showed significantly lower mean of summed score(2.0+/-0.95) compared to patients of non-DM group(3.3+/-1.2). Analysis of covariance revealed that lower score of diabetes group was independent of sex, age and serum creatinine level. of diabetes group, 2 nuclear physicians interpreted bone scans as classical renal osteodystrophy in 60% and 56%, However, they interpreted bone scans of non-DM group in 80%, 88%(between-observer k: 0.74). Chi-square test showed that this difference was statistically significant (p<0.05). CONCLUSION: Bone scan image of diabetic renal osteodystrophy showed less 99mTc-MDP uptake, which meant low osteoblastic activity. This influence of diabetes upon bone uptake was significant after considering other confounding factors.
Bone Diseases ; Creatinine ; Diabetes Mellitus ; Humans ; Kidney Failure, Chronic* ; Mandible ; Observer Variation ; Osteoblasts ; Renal Insufficiency ; Renal Osteodystrophy* ; Skeleton ; Skull ; Sternum ; Technetium Tc 99m Medronate

Recently, it becomes conspicuous that the network should have enough communication bandwidth and be organized with steadiness to operate and support hospital information system successfully. Seoul National University Hospital completed to reconstruct legacy network which had been used since 1995. We had a consultation to diagnose the current problems and reconstructed the network according to the consultation. The design of network architecture was mainly focused on the circuit route in case of error condition and the suitable bandwidth for the easy communication. We also regulated the use of unsuitable protocols which might broadcast inappropriate data packets over the whole network. After 6 months of operation we evaluated the performance of newly constructed network. The average traffic rate from the input port of main servers was 0.5% and that from the output port was 6% separately. The average traffic rate on the overall ATM backbone showed around 1 %.From the result, we concluded that the newly constructed network had such an enough capability supporting hospital information system without any interruption. Furthermore, we expect that it will be sufficient to support the additional traffic increment by PACS and group ware applications.
Hospital Information Systems ; Hospitals, General* ; Information Services* ; Information Systems* ; Seoul*