Authors have quantitated the T cell and T subsets(T and T cell) in the per- ipheral blood of 16 patients with alopecia areata and 16 normal healthy controls. The results are as follows: 1. The mean values of the T cell in total patient group(54,6+7.9g) and AAP group(5,3. 1+8. 1%) showed staticstially significant decrease when it compared with the mean value of the control group(64.6+3.6%) respectively(p<0.005). In ATU group the mean value of the T cell(53. 1+8. 1%) also showed decreasing tendency in comparison with that of control. The mean values of the T cell in total patient group(30.9+8. 9%) RIld AAP group(3'l. 5+8. %) showed statistically significant decrease when it compared with the mean value of the control group(42,6+8.9%) respectively(p<0. 005). In ATU group the mean value of the T< cell(28. 7+10. 9%) also showed decreasing tende- ncy in comparison with that of control. 3. The mean values of the Tr, cell in total patient group(6. 1+2. 2%) and AAP group(5.9+2.4%) showed staticstially significant decrease when it compared with the mean value of the control group(7.9+1.3%) respectively(p(p pl, pgp p25) In ATU group the mean value of the T cell(6. 7+0. 9%) also showed decreasing tendency in comparison with that of control. 4. The mean values of the T/T ratio showed no significant difference between the patient groups(total, AAP, ATU) and control group, respectively. Above data showed that defect of T cell and T subsets may be associated with the pathogenesis of alopecia areata.
Alopecia Areata ; Humans

The role of the immune system in pathogenesis of skin cancer has been attracted increasing attention in recent years. Some limited studies and observations suggest that altered immune status may be a factor in the initiation and growth of cutaneous malignancies. Authors experienced a typical case of xeroderma pigmentosum in a 6 year-old girl, who has been suffered from hyper and hypopigmented macules on sun-exposed area, photophobia and also noted eroded lesion on the lower lip. The biopsy finding of the hyperpigmented macule showed that of freckle and the finding of actinic cheilitis was observed from the specimen of eroded 1esion on the lower lip. We performed immunologic test and obtained some evidences of immunologic defect; such as decreased numbers of total T cells, T-suppressor cell and B cell in our patient.
Actins ; Biopsy ; Cheilitis ; Child ; Cytochrome P-450 CYP1A1 ; Female ; Humans ; Ichthyosis* ; Immune System ; Immunologic Tests ; Lip ; Melanosis ; Photophobia ; Skin Neoplasms ; T-Lymphocytes ; Xeroderma Pigmentosum*

Epidermolysis bullosa dystrophica(EBD) is a rare, hereditary and chronic mechanobullous disease characterized by blistering and erosions of the skin in response to even minor trauma. A 5-year old girl visited with a complaint of continuous vesicobullous skin eruptions since birth. On examination, bullae, vesicles, atrophic scars, crusts and ero:ions were scattered on whole body. Loss of finger and toe nails, partial syndactyly of all toe webs and milia on dorsa of feet were noticed. We present a case of EBD that seems to be a recessive type considering the absence of family history with histopathologic and electron microscopic findings.
Blister ; Child, Preschool ; Cicatrix ; Epidermolysis Bullosa Dystrophica* ; Epidermolysis Bullosa* ; Female ; Fingers ; Foot ; Humans ; Parturition ; Skin ; Syndactyly ; Toes

BACKGROUND: A retrospective study was performed to evaluate postoperative mortality within 30 days following surgery. METHODS: The records of 31,806 patients who received operation under general anesthesia were reviewed. RESULTS: 1) Postoperative deaths were 184 cases, the ratio of which was comprising 0.57% of all surgical operative cases. 2) The highest ratio of the mortality in age group was 51~60 years group which was 24.5%, and in physical status it was ASA class III which was 36.4%. The highest ratio to the mortality rate in postoperative days was 8~30 days which was 45.1%. 3) The most common causes of death was low cardiac output due to heart failure on operating theater, and hypovolemic shock within postoperative 2 days, and intracranial problem within postoperative 7 days, and pulmonary complication within postoperative 30 days. CONCLUSION: We conclude that fatality rate could be decreased by intensive and multidisciplinary care for postoperaive complications as respiratory and renal failure.
Anesthesia, General ; Cardiac Output, Low ; Cause of Death ; Heart Failure ; Humans ; Mortality ; Renal Insufficiency ; Retrospective Studies ; Shock

No abstract available.
Carcinoma, Non-Small-Cell Lung*

This study was performed to evaluate the effects of acute withdrawal of antiepileptic drugs in epileptic patients during continuous BEG monitoring. One hundred sixty-five withdrawals in 134 patients who were candidates for epileptic surgery were included for this study. Clinical features and frequency of seizure were observed after drug withdrawal with daily monitoring of serum drug level. The phases after withdrawal of antiepileptics were divided into phase of therapeutic drug level, phase of falling drug level, and phase of subtherapeutic or undetectable(zero) drug level. There were significant increase in frequency of seizure and seizure of secondary generalization after acute withdrawal of antiepileptic drugs. Number of seizure during the period of drugs withdrawals was not correlated with onset age of epilepsy, duration of epilepsy, duration of medication, and number of administrated antiepiteptic drugs. The number of frequency of seizure before drug withdrawal was correlated with the number of frequency of withdrawal seizure. The number of seizure frequency after carbamazepine withdrawal was significantly higher during the phase of subtherapeutic or zero drug level, and not during phase of rapid falling antiepileptic drug level.
Age of Onset ; Anticonvulsants* ; Carbamazepine ; Epilepsy ; Generalization (Psychology) ; Humans ; Seizures*

This study was performed to evaluate the usefulness of dermatomal somatosensory evoked potentials(D-SSEP) and segrnental somatosensory evoked potentials(S-SSEP) for the diagnosis of lurnbosacral radiculopathy. D-SSEP and S-SSEP were recorded from 30 healthy controls and 16 patients with lumbosacral radiculopathy(LA radiculopathy: 10 cases, L5: 13 cases, SI: 4 cases) who was diagnosed by clinical findings CT and/or MRI. D-SSEP were abnormal in 40%, 30.7% and 25% of the patients with IA, L5 and Sl radiculopathy respectively and S-SSEP were abnormal in 20%, 38% and 50% of the patients with IA, L5 and Sl radiculopathy respectively. The proportion of abnormal findings in the' patients with L4, L5 and Sl radiculopathy was increased to 50%, 46. 1% and 50% respectively by administering both of D-SSEP and S-SSEP. In conclusion, D-SSEP and S-SSEP are simple and noninvasive test but insensitive studies for diagnosis of lumbosacral radiculopathy. The diagnostic sensitivity could be increased by usmg both of these two studies.
Diagnosis ; Evoked Potentials, Somatosensory* ; Humans ; Magnetic Resonance Imaging ; Radiculopathy*

A 66 year old male with a suprarenal pheochromocytoma on the left side was treated preoperatively with oral phenoxybenzamine 20 mg, b. i. d. for 2 weeks. The night before surgery, phenobarbital 100 mg & diazepam 5 mg were given orally. One hour before induction, diazepam 10 mg i. m. was given. Preinduction BP was 210/140 and HR was 130/min. After diazepam 20 mg i. v, BP lowered to 200/130 and HR lowered to 126/min. With commencement of sodium nitroprusside i. v. dripping, a BP of 160/100 and HR of 118 were maintained. Following Thiopental sodium 250 mg i. v., mask induction was started with N2O-O2-Enflurane and pancuronium 4 mg i. v., after 5 minutes, a #8.5 tube was intubated and pindolol 0.16 mg was injected to prevent tachycardia. We maintained a tolerable BP and pulse by repeatedly adding a bolus i. v. injection of phenoxybenzamine 1 to 2 mg during tumor manipulation and removal. No arrhythmia was noted throughout the procedure, except tachycardia. After removal of the tumor, with rapid blood transfusion and fluid infusion plus dopamine i. v. dripping, a tolerable BP and pulse was maintained.
Aged ; Anesthesia* ; Arrhythmias, Cardiac ; Blood Transfusion ; Diazepam ; Dopamine ; Enflurane* ; Humans ; Male ; Masks ; Nitroprusside ; Pancuronium ; Phenobarbital ; Phenoxybenzamine ; Pheochromocytoma* ; Pindolol ; Tachycardia ; Thiopental

Median nerve somatosensory evoked potentials(SEP) and electroencephalography(E EG) were recorded in 85 patients with stroke(33 with thalamic hemorrhage, 20 with putaminal hemorrhage and 32 with cerebral infarction) to observe the origin of Nl9 and P23 wave responses in median SEP and the origin of slow waves in EEG as well as to evaluate the prognostic correlation between stroke patients and SEP and EEG findings. Nl9 and P23 were absent in 42 4% of patients with thalamic hemorrhage and 70% with putarninal hemorrhage. There was no case in which only P23 was absent in these two groups. In cerebral infarction, the most frequent finding was that both N19 and P23 were absent. P23 was absent with intact Nl9 in 2 cases with localized cortical infarction. Therefore we suggest that N19 develops in thalamus or thalamocatical pathway and P23 in the parietal cortex. There was no significant difference of EEG findings between thalamic hemorrhage and cerebral infarction. It was unlikely that slow waves on EEG is a specific finding in a localized brain lesion. The prognosis was poor in thalamic hemorrhage and cerebral infarction with loss of both Nl9 and P23 in SEP findings and in cerebral infarction with moderate to severe degree of background abnorrnalities in EEG findings. So that, SEP and EEG findings may be useful for prognostic aspect.
Brain ; Cerebral Infarction ; Electroencephalography* ; Evoked Potentials, Somatosensory* ; Hemorrhage ; Humans ; Infarction ; Median Nerve ; Prognosis ; Putaminal Hemorrhage ; Pyridinolcarbamate ; Rabeprazole ; Stroke* ; Thalamus

BACKGROUND: Because of the common etiologic factor, such as smoking, lung cancer and chronic obstructive Pulmonary disease are often present in the same patient. The preoperative prediction of remaining pulmonary function after the resectional surgery is very important to prevent serious complication and postoperative respiratory failure. 99mTc-MAA perfusion scan has been used for the prediction of postoperative pulmonary function, but it may be inaccurate in case of large V/Q mismatching. We compared 99mTc-DTPA radioaerosol inhalation scan with 99mTc-MAA perfusion scan in predicting postoperative lung function. METHOD: Preoperative inhalation scan and/or perfusion scan were performed and pulmonary function test were performed preoperatively and 2 month after operation. We predicted the postoperative pulmonary functions using the following equations. Postpneumonectomy FEV1=Preop FEV1x% of total function of lung to remain RESULTS: 1) The inhalation scan showed good correlations between measured and predicted FEV1, FVC and FEF25-75%. (correlation coefficiency; 0.94, 0.91, 0.87 respectively). 2) The perfusion scan also showed good correlations between measured and predicted FEV1, FVC and FEF25-75%. (correlation coefficiency; 0.86, 0.72, 0.97 respectively). 3) Among three parameters, FEV1 showed the best correlations in the prediction by lung scans. 4) Comparison between inhalation scan and perfusion scan in predicting pulmonary function did not show any significant differneces except FVC. CONCLUSION: The inhalation scan and perfusion scan are very useful in the prediction of postoperative lung function and don't make a difference in the prediction of pulmonary function although the former showed a better correlation in FVC.
Humans ; Inhalation* ; Lung ; Lung Neoplasms ; Perfusion* ; Pulmonary Disease, Chronic Obstructive ; Respiratory Function Tests ; Respiratory Insufficiency ; Smoke ; Smoking