BACKGROUND: One of the most, probable pathogenesis of vitiliga is autoimmune. Systemic cor tico st,eroids suppress immunity and may arrest the progression of vitiligo and lead to repigmentation. OBJECTIVE: We have assessed the clinical effect of a oral small oral dose of corticosteroid to minimize side effects in vitiligo patients. METHODS: Thirty four patients(9;male, 25;female) with vitiligo were evaluated in this study. The patients took 7.5mg-20mg prednisolone initially for 2 months and then the dosage was tapered to half of the initial dosiat the 3rd month and half of dose of 3rd month for the last 4th month. We compared the effcct of treatment of vitiligo before and aft.er the study by photographs. and side efferts were issessed at. 1, 2, 3 and 4 month. RESULTS: The arrest of the progression of vitiligo was noticed in 79% of patients and repigmentation was noticed in 59% of patients which is statistically significant. The effect, of treatment according to extent, duiation, type, and site of vitiligo were not statistically significant. The side effects of treatment were minimal and did not affect the course of treatment. CONCLUSION: Small doses of iral corticosteroids are effective without any significant side effects in preventing progression and loiiduce repigmentation of active spreading vitiligo and generalized type of vitiligo that is difficult to treat with topical corticosteroids.
Adrenal Cortex Hormones* ; Humans ; Prednisolone ; Vitiligo*

No abstract available.
Carcinoma, Basal Cell* ; Eyelids*

PURPOSE: The treatment was done on benign prostatic hyperplasia (BPH) patients and BPH wth diabetes mellitus patients. Comparisons have been made before and after the treatment international prostatic symptom score (IPSS), quality of life index (QOL index), maximal flow rate (Qmax) and patient's satisfaction to find what kind of treatment results in the most effect and contentment. MATERIALS AND METHODS: 361 cases were chosen as subjects who were able to follow up for more than 3 months following the treatment. This retrospective study comprised of two groups; one is a BPH patients group (A group: n=246) and the other is BPH with DM patients group (B group: n=115). Each group was treated with medical or surgical therapy. The IPSS, QOL index, Qmax and patient's satisfaction were analyzed and compared between the groups. RESULTS: After medical therapy in the A group, the IPSS reduced from 18.8+/-4.3 to 10.8+/-2.8, QOL index from 3.9+/-1.0 to 2.1+/-1.7 and Qmax improved from 9.7+/-1.6ml/sec to 12.8+/-1.9ml/sec. In B group, from 19.4+/-4.7 to 15.2+/-3.6, 4.8+/-1.0 to 3.1+/-0.9 and 8.6+/-0.9ml/sec to 10.9+/-0.5ml/sec respectively (p<0.05). After surgical therapy in the A group, the IPSS reduced from 21.9+/-6.1 to 8.2+/-5.4, QOL index from 4.1+/-1.2 to 1.8+/-0.8 and Qmax improved from 8.6+/-1.7ml/sec to 16.6+/-2.9ml/sec. In B group, from 24.7+/-7.2 to 10.3+/-5.7, 4.3+/-1.5 to 2.2+/-0.7 and 7.7+/-1.8ml/sec to 14.0+/-1.8ml/sec respectively (p<0.05). In B group much more improvement was made than medical therapy group. CONCLUSIONS: In BPH with DM patients, the initial surgical therapy was found to have better effect than through medical therapy in the degree of the patients satisfaction, IPSS, QOL index and Qmax. We suggest that surgical therapy is good therapeutic option even in BPH with DM patients at short term postoperative period.
Diabetes Mellitus* ; Follow-Up Studies ; Humans ; Postoperative Period ; Prostatic Hyperplasia* ; Quality of Life ; Retrospective Studies

No abstract available.
Burns* ; Hand* ; Humans ; Infant*

No abstract available.
Ear, Middle*

Plasma carotenoid levels were compared among 64 healthy male subjects (control) and 38 patients of ischemic heart disease(IHD) and 20 ones of cerebral infarction(CI) all of whom were over 50years of age. Another 98 healthy male subjects aged 23 to 58 were selected to compare their plasma carotenoid levels by age groups, Levels of lutein, zeaxanthin and crpytoxanthin were lower in IHD(34+/-2, 13+/-1 and 62+/-7 microgram/dl)and CI(36+/-3, 12+/-2 and 41+/-6 microgram/dl)patient groups than in control group (84+/-5, 16+/-2 and 69+/-3 microgram/dl) while those of lycopene, alpha-and beta-carotene varied little among the three groups. The sum of the six carotenoid levels were levels were, therefore,highest(205+/-14 microgram/dl) in the control group followed by IHD(155+/-15 microgram/dl) and CI(128+/-17 microgram/dl) patient groups, Among the 98 healthy male subject for the age group study, levels of the three major carotenoids increased with age from the twenties to the fifities ; lutein, from 64+/-6 to 89+/-8 microgram/dl, cryptoxanthin, 57+/-8 to 73+/-4 microgram/dl and beta-carotene were more significantly correlated(r=0.30 to 0.61, p<0.01), whereas levels of lycopene and alpha-caroteme were significantly(r=0.21 - 0.23, p<0.05) correlated.
beta Carotene ; Cardiovascular Diseases* ; Carotenoids ; Cerebral Infarction ; Daegu* ; Heart ; Humans ; Lutein ; Male ; Myocardial Ischemia ; Plasma*

BACKGROUND: Lidocaine or verapamil are used as an antiarrhythmic agent or agent blunting the cardiovascular changes induced by intubation or extubation during anesthesia. After recovery from general anesthesia with muscle relaxants, most patients remained in a residual paralytic state, hence it might develop easily recurarization by factors that affect neuromuscular transmission. Lidocaine and verapamil are well known as agents to potentiate the neuromuscular block. We investigated the effects of lidocaine or verapamil on neuromuscular transmission in vitro. METHODS: Square wave, 0.2 ms duration at a frequency of 0.1 Hz supramaximal or train of four stimuli was applied and the twitch height response was recorded mechanomyographically on rat phrenic nerve hemidiaphragm preparations. Dose responses of rocuronium, lidocaine, verapamil, rocuronium pretreated with lidocaine or verapamil, lidocaine pretreated with rocuronium, and verapamil pretreated with rocuronium were observed by cumulative method, and effective doses (Lag dose, ED50 and ED95) between a pretreated and nonpretreated agent were compared statistically. TOF ratios were observed at 80, 70, 40 and 30% of the control twitch height value during the observation of dose responses. RESULTS: Lag dose, ED50 and ED95 of rocuronium were reduced significantly after pretreatment of lidocaine, verapamil or their mixture, and the dose response of lidocaine, verapamil or their mixture were also reduced significantly by rocuronium pretreatment. TOF ratios at the point of each twitch height decreased significantly after pretreatment. CONCLUSIONS: Lidocaine or verapamil itself did not affect the neuromuscular transmission but might have potentiated the neuromuscular blocking effect induced by rocuronium. However, in excessive doses, these agents produced neuromuscular blockade. Consequently, in the residual neuromuscular block induced by rocuronium, lidocaine or verapamil may enhance recurarization.
Anesthesia ; Anesthesia, General ; Animals ; Humans ; Intubation ; Lidocaine* ; Neuromuscular Blockade* ; Phrenic Nerve ; Rats ; Verapamil*

Background: The central line has been frequently used for drug and nutrition supply and regular blood sampling of patients with chronic diseases. However, this procedure is performed in a highly sensitive area and has several potential complications. Therefore, peripherally inserted central catheters (PICC), which have various advantages, are being extensively used. Although the number of PICC procedures is increasing, the anatomy for safe procedures has not yet been properly established. Therefore, we studied basic anatomical information for safe procedures. Methods: We used 20 fixed cadavers (40 arms) donated to the Korea University College of Medicine. The mean age was 76.75 years (range, 48–94 years). After dissection of each arm, the distribution pattern of the basilic vein and close structures was recorded, and some important parameters based on bony landmarks were measured. In addition, the number of vein branches (axillary region) and basilic vein diameter were also checked. Results: The mean length from the insertion site to the right atrium was 38.39 ± 2.63 cm (left) and 34.66 ± 3.60 cm (right), and the basilic vein diameter was 4.93 ± 1.18 mm (left) and 4.08 ± 1.49 mm (right). The data showed significant differences between the left and right arms (P < 0.05). The mean distance from the basilic vein to brachial artery was 8.29 ± 2.78 mm in men and 7.81 ± 2.78 mm in women, while the distance to the ulnar nerve was 5.41 ± 1.67 mm in men and 5.52 ± 2.06 mm in women. Conclusion According to these results, the right arm has a shorter distance from the insertion site to the right atrium, and the left arm has a wider vein diameter, which is advantageous for the procedure. In addition, the ulnar nerve and brachial artery were located close to or behind the insertion site. Therefore, special attention is required during the procedure to avoid damaging these important structures.

Hereditary hemolytic anemia comprises a group of disorders in which red blood cells are destroyed faster than they are produced in the bone marrow; various hereditary factors can cause this condition, including production of defective Hb and erythrocyte membrane. Recently, we identified Hb Koriyama, a rare Hb variant that was undetectable in Hb electrophoresis and stability tests, in a patient with severe hemolytic anemia. This is the first study to show the nucleotide-level sequence variations in Hb Koriyama. On the basis of our results, we conclude that unstable Hb may not be detectable by conventional Hb electrophoresis or stability tests. Thus, we suggest further genetic workup in cases of unexplained hereditary hemolytic anemia.
Amino Acid Sequence ; Anemia, Hemolytic/blood/*diagnosis ; Child ; Female ; Gene Duplication ; Hemoglobins, Abnormal/*genetics ; Heterozygote ; Humans ; Molecular Sequence Data ; Mutation ; Sequence Analysis, DNA

Succinylcholine is commonly administered intravenously, however sometimes it can be administered intramuscularly or sublingually when an intravenous line is not available. We investigated the neuromuscular blocking effect of subcutaneous injection of succinylcholine. The 60 adult patients (ASA 1 or 2) were randomly divided into two groups. After intravenous administration of propofol 3 mg/kg, succinylcholine 1 mg/kg was administered intravenously in one group (IV group, n=10) and subcutaneously in another (SQ group, n=50). Neuromuscular transmission was monitered continuously by the train-of-four (TOF) from response stimulated the ulnar nerve with 2Hz at wrist and the evoked compound action potential of hypothenar muscles was measured with Relaxograph (Datex Co.). We determined the maximum depressed the twitch height (T(TXD)), onset time from injection of succinylcholine to T(MXD), recovery time from T(MXD) to the recovery of 75%, and duration of action from injection of succinylcholine to the recovery of 75%. In the results, T(MXD) of SQ group varied from O% to over 75% compared with 0% in IV group. The onset time of SQ group were more delayed between 7.78+/-2.80 to 13.08+/-3.51 minutes compared with 1.08+/-0.16 minutes in IV group. The recovery time of SQ group were faster between 15.67+/-10.40 to 2.59+/-1.75 minutes compared with 18.68+/-3.68 minutes in IV group. The duration of action of SQ group were not significantly different compared with IV group. And in the SQ group, the lesser depression of twitch height the slower onset time and the faster recovery time was revealed. Conclusively, the subcutaneous administration of succinylcholine 1 mg/kg resulted that the magnitudes of neuromuscular blockade was variable and incomplete, and onset time were slower but recovery were faster than intravenous injection.
Action Potentials ; Administration, Intravenous ; Adult ; Depression ; Humans ; Injections, Intravenous ; Injections, Subcutaneous ; Muscles ; Neuromuscular Blockade* ; Propofol ; Succinylcholine* ; Ulnar Nerve ; Wrist