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*

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

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

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*

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*

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

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

We studied on 263 patients (20 with multiple sclerosis (MS); 243 with other neurological diseases (OND), I.e., 87 with myelopathy of unknown origin (MUO), 27 with central nervous system (CNS) infection, 31 with peripheral neuropathy (PN), 23 with cerebrovascular accident (CVA), and 75 with miscellaneous diseases (MD)), who were admitted to the Keimyung University Dongsan Hospital between January 1985 and April 1991 to analyze the clinical values of the cerebrospinal fluid (CSF) Ig G in MS and OND with quantitative CSF Ig G, Ig G-albumin ratio and Ig index by immunodiffusion method, and to detect oligoclonal bands in CSF of 21 patients (2 with MS, 15 with MUO, 1 with PN, 1 with CVA and 2 with MD) by agarose-gel electrophoresis. The results were summarized as follows: 1) In the frequency of elevated quantitative CSF Ig G measurements in patients with MS, the Ig G index was 64% (9 of 14 patients), higher than those of the Ig G and Ig G-albumin ratio, but in OND, the Ig G-albumin ratio was 30% (73 of 240 patients), higher than those of the Ig G and Ig G index. 2) In the frequencies of elevated quantitative CSF Ig G measurements, the Ig G levels in CNS infection, CVA and PN were 67%, 35% and 29%, respectivelyl higher than 25% in MS, and the Ig G-albumin ratio in CNS infection and CVA were 63% and 35%, respectively, higher than 32% in MS, but the Ig G index was the highest in MS (64%) followed by CNS infection (54%). 3) In validity of the various CSF Ig G measurements for diagnosis of MS, the Ig G index was the most sensitive test at 064, the Ig G was the most specific test at 0.76, and the Ig G index had the most positive and negative predictive values at 0.16 and 0.96, respectively. 4) Oligoclonal bands in CSF are not detected in all of 21 patients.
Central Nervous System ; Cerebrospinal Fluid* ; Diagnosis ; Electrophoresis ; Humans ; Immunodiffusion ; Immunoglobulins* ; Multiple Sclerosis ; Oligoclonal Bands ; Peripheral Nervous System Diseases ; Spinal Cord Diseases ; Stroke

BACKGROUND: We have hypothesized that, if a low resistant gravity-flow membrane oxygenator is used, then the twin blood sacs of TPLS can be located at downstream of the membrane oxyenator, which may double the pulse rate at a given pump rate and increase the pump output. The purpose of this study was to determine the optimal configuration for the ECLS circuits by using the concept of pulse energy and pump output. MATERIAL AND METHOD: Animals were randomly assigned to 2 groups in a total cardiopulmonary bypass model. In the serial group, a conventional membrane oxygenator was located between the twin blood sacs. In the parallel group, the twin blood sacs were placed downstream of the gravity-flow membrane oxygenator. Energy equivalent pressure (EEP) and pump output were collected at pump-setting rates of 30, 40, and 50 BPM. RESULT: At the given pump-setting rate, the pulse rate was doubled in the parallel group. Percent changes of mean arterial pressure to EEP were 13.0+/-1.7, 12.0+/-1.9 and 7.6+/-0.9% in the parallel group, and 22.5+/-2.4, 23.2+/-1.9, and 21.8+/-1.4% in the serial group at 30, 40, and 50 BPM of pump-setting rates. Pump output was higher in the parallel circuit at 40 and 50 BPM of pump-setting rates (3.1+/-0.2, 3.7+/-0.2 L/min vs. 2.2+/-0.1 and 2.5+/-0.1 L/min, respectively, p=0.01). CONCLUSION: Either parallel or serial circuit configuration of the ECLS generates effective pulsatility. As for the pump out, the parallel circuit configuration provides higher flow than the serial circuit configuration.
Animals ; Arterial Pressure ; Cardiopulmonary Bypass ; Heart Rate ; Humans ; Life Support Systems* ; Membranes ; Oxygenators, Membrane