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

Hemorrhagic fever with renal syndrome(HFRS) is an infectious disease showing diverse clinical manifestations according to different serotypes of hantavirus. Korean hemorrhagic fever(KHF), HFRS caused by Hantaan or Seoul virus in Korea, shows diverse clinical manifestations even in the same serotype of hantavirus. On the assumption that the antigenicity, nucleotide and amino acid sequence diversity of hantaviruses, as well as immune response diversity of individual KHF patient may be present, this study was performed to analyse the genetic diversity of hantaviruses isolated from patients with KHF. In the 13 samples(9 strains of hantavirus isolated from bloods, urines or autopsy tissue of KHF patients and 4 serums of KHF patients), hantaviral RNAs were extracted, cDNAs of partial M segment were amplified by RT-PCR using genus-reactive primer, amplified cDNAs were analysed by direct sequencing method, and then the nucleotide and deduced amino acid sequences were compared with previously known sequences of four serotypes of hantavirus isolated from rodent hosts and each other by the computer assistance. The results were as follows. The nucleotide and amino acid sequences of 11 samples among the 13 human isolates showed 90.3-95.5%, 86.7-97.9%, the other 1 sample 82.7%, 71.9% homology respectively to those of Hantaan virus 76-118 strain, and another 1 sample showed 83.7%, 75.3% homology respectively to those of Seoul virus B1 strain isolated from rodent host. The nucleotide and amino acid sequences of 7 among 12 Hantaan samples showed differences within 5%, 10% respectively each other and high genetic similarities, but those of the other 5 among 12 Hantaan samples showed low genetic similarities each other. In conclusion, hantaviruses isolated from KHF patients showed genetic diversity compared with previously known hantaviruses isolated from rodent hosts.
Amino Acid Sequence ; Autopsy ; Communicable Diseases ; DNA, Complementary ; Fever ; Genetic Variation ; Hantaan virus ; Hantavirus ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Korea ; RNA ; Rodentia ; Seoul virus

BACKGROUND: Determination of antibody specificity using antigram spread sheet requires experience and knowledge on in vitro characteristics of red cell antibodies, time-consuming, and still subjective to human error. A computer-based antibody identification system was developed to overcome these disadvantages. METHODS: Decision support system program for antibody identification was designed using Visual Basic 5.0 for Dade Data-cyte Plus. This system integrates the reaction patterns of saline, 37degrees C albumin, antiglobulin, 4degrees C saline enzyme treated and user-defined phases and lists the antibodies according to the probability. 115 irregular antibodies previously confirmed by standard manual method reanalyzed with this program. RESULTS: In 111 of 115 cases (96.5%), this system produced the same results with the manual identification. In two cases, of not matched 4 cases the computer program suggested additional antibodies and in one case, the computer program detected previous human error. In the other case, antibody identification was possible only after further tests including selective adsorption of multiple antibodies. CONCLUSION: The decision support system was rapid and easy and showed good concordance rate when compared with manual antibody identificaion results. In addition, human error could be reduced. Decision support system for antibody identification could be used in small blood banks by less experienced staffs.
Adsorption ; Antibodies ; Antibody Specificity ; Blood Banks ; Expert Systems ; Humans