PURPOSE: To describe chronic rectal mucosal damage after pelvic radiotherapy (RT) for cervical cancer and correlate these findings with clinical symptoms and radiation dose. MATERIALS AND METHODS: Thirty-two patients who underwent pelvic RT were diagnosed with radiation-induced proctitis based on endoscopy findings. The median follow-up period was 35 months after external beam radiotherapy (EBRT) and intracavitary radiotherapy (ICR). The Vienna Rectoscopy Score (VRS) was used to describe the endoscopic findings and compared to the European Organization for Research and Treatment of Cancer (EORTC)/Radiation Therapy Oncology Group (RTOG) morbidity score and the dosimetric parameters of RT (the ratio of rectal dose calculated at the rectal point [RP] to the prescribed dose, biologically effective dose [BED] at the RP in the ICR and EBRT plans, alpha/beta = 3). RESULTS: Rectal symptoms were noted in 28 patients (rectal bleeding in 21 patients, bowel habit changes in 6, mucosal stools in 1), and 4 patients had no symptoms. Endoscopic findings included telangiectasia in 18 patients, congested mucosa in 20, ulceration in 5, and stricture in 1. The RP ratio, BEDICR, BEDICR+EBRT was significantly associated with the VRS (RP ratio, median 76.5%; BEDICR, median 37.1 Gy3; BEDICR+EBRT, median 102.5 Gy3; p < 0.001). The VRS was significantly associated with the EORTC/RTOG score (p = 0.038). CONCLUSION: The most prevalent endoscopic findings of RT-induced proctitis were telangiectasia and congested mucosa. The VRS was significantly associated with the EORTC/RTOG score and RP radiation dose.
Constriction, Pathologic ; Endoscopy ; Estrogens, Conjugated (USP) ; Follow-Up Studies ; Hemorrhage ; Humans ; Mucous Membrane ; Proctitis ; Radiation Injuries ; Rectum ; Telangiectasis ; Ulcer ; Uterine Cervical Neoplasms

No abstract available.
Arteries* ; Female ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Umbilical Arteries*

BACKGROUND: The measurement of nonspecific bronchial hyperreactivity is valuable for diagnosis and management of bronchial asthma. Methacholine or histamine is used for the pharmacologic provocation test. Usually a methacholine bronchial provocation test is performed by a dosing technique with counted number of breaths. A dosimeter is indispensable in the dosing technique. Recently a timed tidal breathing technique which dose not need an expensive dosimeter was introduced. We measured the degree of nonspecific bronchial hyperreactivity to histamine using a simple timed tidal breathing technique. METHOD: Forty two healthy volunteers, 12 patients with bronchial asthma(BA), 10 patients with rhinitis(RH) and 10 patients with upper respiratory infection(URI) participated in the study. The subject's nose was clipped and inhalation continued during tidal breathing for 2 minutes via a face mask. FEV1 was measured at 30 seconds, 90 seconds after inhalation and inhalation of next solution was continued until there was a fall in FEV1 of 20%. Histamine PC20 was defined as the concentration at 20% fall of FEV1 and it was obtained from the log dose-response curve by linear interpolation. RESULTS: Inhalation of serial dilution of histamine could be performed in all patients without significant side of effects. The geometric mean±standard deviation of histamine PC20 in healthy volunteers is 8.27±2.22mg/ml, BA group 0.33±3.02mg/ml, RH group 0.85 ±3.24mg/ml, and URI group 1.47±1.98mg/ml. CONCLUSION: Histamine bronchial provocation test using timed tidal breath method is a simple and suitable tool for management of patients with bronchial hyperreactivity.
Asthma ; Bronchial Hyperreactivity ; Bronchial Provocation Tests* ; Diagnosis ; Healthy Volunteers ; Histamine* ; Humans ; Inhalation ; Masks ; Methacholine Chloride ; Nose ; Respiration*

A 31-year-old woman had a livedo reticularis of reticulated, bluish discoloration on both arms and legs for 18 months with a burning pain in the right hand and numbness in both lower legs. The findings of the electromyography were consistent with mononeuropathy multiplex and bilateral ulnar-median nerve anastomosis. A biopsy specimen from the right sural nerve showed perivascular lymphocytic infiltration and occasional myelin digestion chambers, which were consistent with vasculitic neuropathy. We present a patient with livedo reticularis idiopathica associated with mononeuropathy multiplex syndrome who also has bilateral ulnar-median nerve anastomosis.
Adult ; Arm ; Biopsy ; Burns ; Digestion ; Electromyography ; Female ; Hand ; Humans ; Hypesthesia ; Leg ; Livedo Reticularis* ; Mononeuropathies* ; Myelin Sheath ; Sural Nerve

We report a case of multiple Bowen's disease associated with leprosy. A 68-year-old man was seen because of slightly pruritic multiple erythematous scaly patches and plaques on the trunk and the both extremities for 5 years. He has been treated for leprosy with many kinds of drugs consisting of the herb medications for over 40 years. He also showed decreased cell-mediated immunity in skin tests. It is considered that depressed cellular immunity may be an important predisposing factor in the development of mutiple Bowen's disease in this case, .although arsenics can not be completetly excluded.
Aged ; Bowen's Disease ; Causality ; Extremities ; Humans ; Immunity, Cellular ; Leprosy* ; Skin Tests

PURPOSE: To determine the efficacy of CarnitilR (acetylcarnitine, Hanmi, Korea) therapy in idiopathic oligoasthenospermic men. MATERIALS AND METHODS: Forty-four subfertile men with abnormal semen parameters were treated between March, 2003 and March, 2004 with 3 g of CarnitilR daily for 3 months. Changes in semen parameters were evaluated 3 months after this therapy. RESULTS: The mean age was 34.2 years and the mean follow-up duration was 3.7 months. In asthenospemic patients (n=28), semen analysis before and after CarnitilR treatment showed an increase in volume (2.64+/-1.65 ml vs. 3.10+/-1.60 ml), motility (35.1+/-17.7% vs. 45.9+/-20.4%) and viability (51.4+/-20.3% vs. 59.3+/-13.6%) respectively. In oligoasthenospermic patients (n=16), semen analysis before and after CarnitilR treatment showed an increase in sperm count (10.7+/-54.4 million/ml vs. 38.4+/-32.5 million/ml) respectively. CONCLUSIONS: These results suggested that in idiopathic oligoasthenospermic men the empirical medical therapy with acetylcarnitine may be considered as primary treatment.
Acetylcarnitine* ; Carnitine ; Follow-Up Studies ; Humans ; Infertility, Male ; Male ; Semen ; Semen Analysis ; Sperm Count

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy*

Transmycardial laser revascularization has made its position as a sole therapy for patients with chronic angina nonamenable to maximal medical therapy, percutaneous transluminal coronary angioplasty, and coronary artery bypass grafting. We report three cases of transmyocardial laser revascularization as a sole therapy for patients with recurrent angina after CABG.
Angioplasty, Balloon, Coronary ; Coronary Artery Bypass ; Humans ; Transmyocardial Laser Revascularization

Background : Atopic dermatitis(AD) is a common disease, and population-based studies indicate that the frequency of AD has increased substantially during recent decades. However, there have been few studies on the hospital based relative frequency, and clinical and laborat,ory findings of AD in Korea. OBJECTIVE: The presenl study was aimed to elucidate the relative frequency of AD on the outpatient base, and to investigate the clinical manifestations and immunological laboratory findings. METHODS: Our study was designed by analysing outpatients with AD via physical examination, questionnaires and immunological investigations such as skin prick tests, Multi test CMI, and measurernent of eosinophil counts, total IgE, Derrnatophagoides pteronyssinus-specific IgE and eosinophil cationic protein(ECP). RESULTS: The results were as follows : 1. The relat,ive frequen:y of AD on the hospital base in 1995-1996 was 8.6%. 2. The mean age of onset was 3.36 years. 57.3% of the patients had their onset of eczema by the age of 1 year, 65.5% by 2 years and 83% by 5 years. The most common site at the onset was the face followed by antecubital area, popliteal area, neck, and trunk. 3. The predilection site on physical examination were the face, neck, antecubit,al area, popliteal area and trunk in decreesing order. 4. Concomitant allergic rhinitis, keratoconjunctivitis and asthma were present in 2~3.4%, 14.1%, and 9.5% of patients with AD, respect.ively, whereas pure AD was present in 34.1%. 5. Family history of atopy was observed in 60.5% of AD patient.s. 6. The most frequent ninor fea~ture of AD was xerosis followed by perifollicular accentuation, allergic shiner, cheilitis, imitation allergy, palrnar hyperlinearity and molluscum cantagiosum. 7. Seasonal aggravation was found in 86.8% of patients with AD, especially in summer and winter, The rnost significant aggravating factors were wools followed by sweating, heating, dryness, excessive bat.hing and emotional stress. 8. Abnormal levels of .osinophils, total IgE and ECP were seen in 44.8%, 78.9% and 31.7% Of patients with AD, respec.ively. 9. Cell mediated immunty was decreased in 68.2% of patients with AD. 10. Positive reactivity( at least rnore than one allergen) in the skin prick t,est was noted in 76% of pat,ients with AD and the most popular 8 allergens were D. pteronyssinus, D. farinae, cat fur, M4 mixed threshing dust., dog hair, mugwort pollen, H3 tree pollen and birch pollen. 11. The specific IgE aritibodies to D. pteronyssinus(>+1) were found in 72.3% of AD patients and correlated with the r esults of the skin prick test in 76%. CONCLUSION: The hospi al-based relative frequency of AD investigated in our study tends to be increased. As the clinica features and laboratory findings of AD might be influenced by genetic, environrnental and psychological factors, the systernic evaluation of patients with AD will be needed.
Age of Onset ; Allergens ; Animals ; Artemisia ; Asthma ; Betula ; Cats ; Cheilitis ; Cyprinidae ; Dermatitis, Atopic* ; Dogs ; Dust ; Eczema ; Eosinophils ; Hair ; Heating ; Hot Temperature ; Humans ; Hypersensitivity ; Immunoglobulin E ; Keratoconjunctivitis ; Korea ; Neck ; Outpatients ; Physical Examination ; Pollen ; Psychology ; Rhinitis ; Seasons ; Skin ; Stress, Psychological ; Sweat ; Sweating ; Wool ; Surveys and Questionnaires

Motor disorders in childhood include tic disorder, developmental coordination disorder, and stereotypic movement disorder. A tic is a sudden, rapid, repetitive and nonrhythmic movement (motor tics) or phonic production (phonic or vocal tics) that can occur at any part of the body. Developmental coordination disorder (DCD) is characterized by marked impairment in the acquisition and performance of motor skills. Stereotypic movement disorder is a common childhood disorder which repetitive, hard to control, aimless motor activity interrupts everyday life or causes self-infliction of a child. Despite increased attention and the growing scientific knowledge about motor disorders, there are limitations in our understanding and knowledge about the pathogenesis and the management of the disorders. Motor disorders can itself be the primary diagnosis, or can be secondarily diagnosed caused by other disorders, and accompany many neuropsychiatric disorders such as autism and attention deficit hyperactivity disorder (ADHD), which in turn impairs proper learning and socializing of the children with motor disorders. Therefore comprehensive medical history taking, continuous observation of the changes in symptoms, and systematic assessment considering the child's developmental stage and current adaptive capacity are needed. Behavioral therapy and pharmacological therapy are the two most often mentioned treatments of motor disorders.
Adolescent ; Attention Deficit Disorder with Hyperactivity ; Autistic Disorder ; Child ; Diagnosis ; Humans ; Learning ; Medical History Taking ; Motor Activity ; Motor Skills ; Motor Skills Disorders ; Stereotypic Movement Disorder ; Tic Disorders ; Tics* ; Tourette Syndrome*