No abstract available.

No abstract available.
Electric Stimulation* ; Tendons*

The treatment of choice for Cushing's disease is surgical removal of tumor, the source of ACTH overproduction. In occasional patients in whom a surgical approach including total adrenalectomy is not feasible or surgical removal of tumor is not complete, medical treatment may be necessary because pituitary irradiation requires a long 1ag time to remission. Although ketoconazole, an imidazole derivative with inhibitory activity on adrenal steroidogenesis has been reported to be effective in the treatment of Cushing's disease, the limited effectiveness in lowering very high level of cortisol and occasional hepatotoxicity restrains its wide use. In this report, we describe a woman with Cushing's disease due to pituitary microadenoma. Transsphenoidal pituitary adenomeetomy followed by ketoconzole treatment had been unsuccessful in achieving remission of the disease, but combined treatment with ketoconazole and octreotide accomplished successful reduction in cortisol production.
Adrenalectomy ; Adrenocorticotropic Hormone ; Female ; Humans ; Hydrocortisone ; Ketoconazole* ; Octreotide* ; Pituitary Irradiation

PURPOSE: Childhood headache is different from adulthood headache and according to their age in clinical aspects. This study investigated the clinical differences of primary headache according to ages of children and adolescents. METHODS: A 300 children who did not show abnormalities on neurologic examination or brain CT or MRI were classified into two groups according to their ages. RESULTS: The percentage of those in the migraine group (24.2% vs. 35.9% in Groups 1 and 2 respectively) was higher in Group 2, but it was not statistically significant. In relation to the duration of headache, pain lasting for less than one hour accounted for 59.8% and 40% in Groups 1 and 2, respectively (P=0.001). In relation to the location headaches developed, the frontal region (40.2%) and temporal region (48.1%) were the most common in Groups 1 and 2, respectively (P<0.001). In relation to the nature of the headaches, tightening sensation accounted for the highest percentage in both groups; however, pulsating sensation were more common in Group 2 than in Group 1 (16.2% vs. 8.3%, P=0.038). In relation to the severity of headaches, severe to profound headaches accounted for 35.5% and 61.1% in Groups 1 and 2, respectively (P<0.001). In relation to laterality, unilateral headaches accounted for 12.4% and 26.7% in Groups 1 and 2, respectively (P=0.002). In relation to accompanying symptoms, the incidence of photophobia was higher in Group 2 than in Group 1 (P=0.047). CONCLUSION: Age factors should be considered in the diagnosis of childhood headaches. Also, we consider that there may be a need to establish diagnostic criteria specifically for childhood headaches separately from those for adulthood headaches.
Adolescent ; Age Factors ; Brain ; Child ; Headache ; Headache Disorders, Primary ; Humans ; Hydroxamic Acids ; Incidence ; Migraine Disorders ; Neurologic Examination ; Photophobia ; Sensation

To evaluate the predictive value of serum fibronectin and roll-over test for pregnancy induced hypertension (PIH), we studies 79 patients between the twenty-eighth and thirty-second week of gestation from October 1995 to May 1996. The results were as follows . 1) There was no significant difference of mean diastolic pressure difference in roll-over test and serum fibronectin levels between 13 PIH patients and 66 controls. Between two groups of patients, mean diastolic blood pressure differences were 14.3+/-3.9mmHg, 12.0+/-4.4mmHg and mean serum fibronectin levels were 231.2+/-90.8 pg/ml, 196.5+/-61.2 pg/ml respectively(p> 0.1). 2) For prediction of PIH, the sensitivity, the positive predictive value and the negative predictive value of roll-over test were 8%, 14% and 83%.
Blood Pressure ; Female ; Fibronectins* ; Humans ; Hypertension, Pregnancy-Induced* ; Pregnancy ; Pregnancy*

Background : Recurrent wheezing in infants is manifested in a number of disease spectrums and gastroesophageal reflux ( GER ) has been known to be associated with apnea, recurrent pneumonia, asthma, chronic cough, and wheezing. The prevalence of GER in infants with recurrent wheezing and the relationship between atopy and GER in infantile asthmatics have not yet been established, but it was hypothesized that microaspiration of food allergen could induce food-induced wheezing. Objective : To evaluate the prevalence of GER in infants with recurrent wheezing episodes, and to determine whether the presence of atopy affects the prevalence of GER in infantile asthmatics. Method : Seventy infants with recurrent wheezing episodes were evaluated for GER using 24 hour continuous esophageal pH monitoring. Patients were classified into five groups, : 12 atopic asthmatics : 20 nonatopic asthmatics : 15 infants with recurrent bronchiolitis : 8 infants with recurrent pneumonia : and 15 infants with chronic lung disease ( CLD ) of prematurity. GER was considered to be prevalent when reflux index was higher than 95 percentile of normal values by Vandenplas, 1991. Result : The prevalence of GER in infants with recurrent wheezing was 21.4%. The prevalence of GER in each group was 25% in atopic asthmatics, 20% in nonatopic asthmatics, 6.7% in infants with recurrent bronchiolitis, 12.5% in infants with recurrent pneumonia, and 40% in infants with CLD of prematurity. There were no significant differences in prevalence of GER between atopic asthmatics and nonatopic asthmatics, between asthmatics with atopic dermatitis and those without, and between asthmatics with family history of allergy and those without. CONCLUSION: The prevalence of GER in infants with recurrent wheezing was high, especially in infantile asthmatics and infants with chronic lung disease of prematurity. The presence of atopy may not affect the prevalence of GER in infantile asthmatics.
Apnea ; Asthma ; Bronchiolitis ; Cough ; Dermatitis, Atopic ; Esophageal pH Monitoring ; Gastroesophageal Reflux* ; Humans ; Hypersensitivity ; Infant* ; Lung Diseases ; Pneumonia ; Prevalence* ; Reference Values ; Respiratory Sounds*

The purpose of this study presents the model of Entity-Relationship Diagram on CPR. The specific purpose of this study as follows; The first goal is to identify the content and logical structure of the CPR. The second goal is to define the relationship of data coming from diverse systems(for example, clinical laboratory information systems, order entry systems) and the data stored in the CPR. The 22 kinds forms on Medical Record were collected from 10 hospitals. The Clinical heart of the CPR is the core of entities: patient, provider, problem, encounter order, service, history, etc.
Cardiopulmonary Resuscitation ; Clinical Laboratory Information Systems ; Heart ; Humans ; Logic ; Medical Records

Alzheimer's disease (AD) is the most common etiology of dementia, that has not been previously reported in Korea. We have experienced two cases of Alzheimer's disease, one occurred in a 53-year-old man with dementia and the other occurred in a 36-year-old woman with a family history of early onset dementia. A neocortical biopsy was done to rule out the cause of dementia and showed diffusely scattered numerous senile plaques and neurofibrillary tangles in cortex of both cases. Interestingly, GFAP, an immunohistochemical stain showed strong positivity in neuritic plaques and the surrounding fibrillary gathering.
Adult ; Alzheimer Disease* ; Biopsy ; Dementia ; Female ; Humans ; Korea ; Middle Aged ; Neurofibrillary Tangles ; Plaque, Amyloid

Alzheimer's disease (AD) is the most common etiology of dementia, that has not been previously reported in Korea. We have experienced two cases of Alzheimer's disease, one occurred in a 53-year-old man with dementia and the other occurred in a 36-year-old woman with a family history of early onset dementia. A neocortical biopsy was done to rule out the cause of dementia and showed diffusely scattered numerous senile plaques and neurofibrillary tangles in cortex of both cases. Interestingly, GFAP, an immunohistochemical stain showed strong positivity in neuritic plaques and the surrounding fibrillary gathering.
Adult ; Alzheimer Disease* ; Biopsy ; Dementia ; Female ; Humans ; Korea ; Middle Aged ; Neurofibrillary Tangles ; Plaque, Amyloid

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*