55 consecutive anatrophic nephrolithotomies on 53 patients performed between July, 1983 and June, 1990 were reviewed. The patients (36 male and 19 female) ranged in age from 3 to 72 years. The operation time averaged 219.8 minutes with a range of 120-330 minutes, and the ischemic time ranged between 20 and 90 minutes, with a mean of 43.5 minutes. Postoperative complications developed in 18 patients, which were such as persistent urinary tract infection in 5cases (9.4%), atelectasis in 4 (7.5%), transient urine leak in 2 (3.8%), delayed bleeding in 2 (3.8%) and urinary retention in 2 (3.8%). Postoperative residual stones were identified in 15 (27.3%), but in 8 of these 15patients stones were delivered spontaneously and thus 48 of 55 cases (87.3%) became stone free. The recurrence of stone was noted in 2 out of 48 patients during the short follow up period. Anatrophic nephrolithotomy seems to be an effective method compared to other procedure because of decreasing recurrence of stone by complete stone removal and reconstruction of abnormal collecting system.
Follow-Up Studies ; Hemorrhage ; Humans ; Male ; Methods ; Postoperative Complications ; Pulmonary Atelectasis ; Recurrence ; Urinary Retention ; Urinary Tract Infections

BACKGROUND: This study was performed to assess the effect of hormone replacement therapy (HRT) on the menopausal symptoms of Korean women by comparing the postmenopausal symptoms before and after HRT in women who continued therapy and those who stopped. METHODS: The subjects were 40 menopausal women(24 women on continuous medication, 16 women who discontinued medication) who received HRT and were alde follow of at least 2 months later in the Department of Family Practice. The menopausal symptoms were evaluated by two doctors according to the modified Kupperman Index. RESULTS: The basic values of Kupperman Index were not significantly different between women who had received the HRT continuously and those who discontinued HRT. In women with continued HRT improved symptoms after HRT were hot flushes, sweating, fatigue, headache, tachycardia and total score of Kupperman Index. However, only vertigo and headache were improved in women who discontinued HRT. Treatment period was the single most predictor of total score of Kupperman Index after therapy. And it could explain the 44.1% of variance of total score in the direction of improvement proportional to the treatment period. CONCLUSIONS: The HRT is helpful to relieve the menopausal symptoms. And the treatment period is more important than the severity of basic symptoms to improve menopausal symptoms after therapy.
Family Practice ; Fatigue ; Female ; Headache ; Hormone Replacement Therapy* ; Humans ; Sweat ; Sweating ; Tachycardia ; Vertigo

BACKGROUND: It is known that obesity is related to hypertension, hyperlipidemia and diabetes mellitus. The results of study done in Korea are widely spread. In this study, we evaluated the prevalence of obesity by four obesity measure methods and the risk of obesity for obesity related diseases. METHODS: This study was done for the period from May 1 to August 31, 1995 in three health care centers run by middle sized hospitals in Pusan. The total number of sampled population was 654(men 227, women 427) RESULTS: We compared obesity by sex and age according to four obesity measure methods. The results were as following . Obesity was more prevailed in women than in men for all measure methods. In women, there was significant difference according to age by Brocas Index(P =0.006), Kassura's modified formula(P=0.018) and Suh's formula(P=0.009) but in men there was no significant difference. We cornpared the laboratory test results of men and women. The test results elevated significantly in men were diastolic blood pressure(P=0.001), hemoglobin(P<0.001), aspartate aminotransferase(AST)(P=0.034), alanine aminotransferase(ALT)(P=0.011), gamma-glutamyltranspeptidase(rGT)(P<0.001). Total cholesterol was elevated significantly in women. We evaluated the correlation of age and obesity with the tests. For the age, systolic blood pressure(P<0.001), diastolic blood pressure(P=0.001), total cholesterol(P<0.001), glucose(P=0.038), AST(P<0.001) were correlated positively. For the obesity, systolic blood pressure(P<0.001), diastolic blood pressure(P<0.001), total cholesterol(P<0.001), glucose(P= 0.045), ALT(P=0.003) were correlated positively. The odds ratio of obesity for elevated blood pressure was 1.03(P=0.005), for hypercholesterolemia 1.03(P=0.001), for elevated ALT 1.03(P =0.005) for hyperglycemia 1.01(P=0.083). CONCLUSIONS: In this study, we found that the prevalence of obesity is higher in women than in men at 40 years old and beyond. We found that obesity is independent risk factor of elevated blood pressure, hypercholesterolemia and elevated ALT. We suggest that the clinicians be concerned in dealing with obesity.
Adult* ; Alanine ; Aspartic Acid ; Blood Pressure ; Busan ; Cholesterol ; Delivery of Health Care ; Diabetes Mellitus ; Female ; Humans ; Hypercholesterolemia ; Hyperglycemia ; Hyperlipidemias ; Hypertension ; Korea ; Male ; Obesity* ; Odds Ratio ; Prevalence ; Risk Factors

No abstract available.
Child* ; Diverticulum* ; Humans

No abstract available.
Meningitis*

We report a case of calcinosis cutis following administration of 10% calcium gluconate, used for the treatment of a hypocalcemic seizure in a 5-week-old neonate. After administration of 10% calcium gluconate, subcutaneous induration developed at the infusion site. The histopathological findings taken from the dorsum of the left foot showed multiple foci of calcium deposits with infiltration of epitheloid histiocytes between collagen bundles and foreign body giant cells phagocyting calcific granules throughout the reticular dermis and subcutis.
Administration, Intravenous* ; Calcinosis* ; Calcium Gluconate* ; Calcium* ; Collagen ; Dermis ; Foot ; Giant Cells, Foreign-Body ; Histiocytes ; Humans ; Infant, Newborn ; Seizures

BACKGROUND: This study was performed to compare the effectiveness of cholesterol-lowering diet therapy instructed by physicians with that instructed by dieticians using techniques that remove regression to the mean. METHODS: 118 patients who visited the office of Family Medicine department in Pusan Paik Hospital from February to November, 1996 and had serum total cholesterol(TC) concentrations greater or equal to 200mg/dL from two measurements were enrolled. The patients were divided into two groups randomly according to the cholesterol-lowering dietary education methods : the one was educated by physicians(Group I), and the other by dieticians(Group II). We evaluated the differences of lipid levels after education in consideration of regression to the mean. RESULTS: The mean reduction in TC concentrations achieved by dietary therapy was 10.7 % and 7.3%(without and with adjustment for regression to the mean) in Group I, and 9.8 and 6.5%(without and with adjustment, for regression to the mean) in Group II. The baseline TC concentrations and TC concentrations after dietary therapy were significantly different in individual group regardless of adjustment for regression to the mean. However, the reduction degrees of TC concentrations were not significantly different between two groups. CONCLUSIONS: The results indicate that even after adjustment for regression to the mean, dietary therapy will achieve the expected reduction. And it seems that the diet education by physicians will be effective as much as that by dieticians.
Busan ; Diet Therapy ; Diet* ; Education ; Humans ; Nutritionists*

We report two cases of Darier's disease improved with Etretmate in the 44-year-old father and his 18-year-old son. Clinically, multiple dirty brownish, verrucous, discrete or confluent papules and plaques were noted on their back, abdomen, and face. Histopathologically, both of them demonstrated hyperkeratosis, suprabasal acantholysis, acantholytic cells in the lacunae, corpsronds, grains, and dyskeratotic cells. Oral Etretinate 30mg daily was given in both cases with remakable improvement 3 weeks after treatment. Six months later, they showed almost total clearin, of their skin lesions. No specific adverse effect was noted. There has been no evidence of recurrence for 6 months follow up period.
Abdomen ; Acantholysis ; Acitretin* ; Adolescent ; Adult ; Edible Grain ; Darier Disease* ; Etretinate* ; Fathers ; Follow-Up Studies ; Humans ; Recurrence ; Skin

A 29-year-old woman had multiple, umbilicated papules on her fingers for 2 months. Skin biopsy specimen showed transepidermal perforation filled with plug of cellular debris, degenerated collagen and mucinous material. In the dermis, there were necrobiosis and peripheral palisading of mononuclear cells. Special stainings including masson's trichrome, alcian blue, acid orcein, and PAS showed necrobiotic collagen fibers and acid mucopolysaccharides on the necrobiotic zone and trasepidermal elimination canal. Topical application of 0.05% Clobetasol-17-propionate ointment improved her lesion.
Adult ; Alcian Blue ; Biopsy ; Collagen ; Dermis ; Female ; Fingers ; Glycosaminoglycans ; Granuloma Annulare* ; Granuloma* ; Humans ; Mucins ; Necrobiotic Disorders ; Skin

A 49-year-old male had erythematous to rusky red papules, indurated plaques and lichenified patches with hyperpigmentation on sun-exposed areas for 6 years. Phototest revealed the decreased rninimal erythemal dose to UVA(10J/cm. Photopatch test with 5% Trandate ointment, 5% hydrochlorthiazide ointment and vaselin. as a control were all negative. Two weeks after cessation of Trandate, an oral challenge of hydrochlorthiazide followed by phototest was perfrirmed resulting in exacerbation of skin lesions and photosensitivity with a decreased MED to UVA(10J/cm) again. After the cesation of Trandate containing hydrochlorthiazide, the skin lesions were improved with complete loss of photosensitivity. But, improvement of the infiltrated or licheified plaques were delayed. Presenile cataract previously noted in the patient seemed to be related to his longstanding intake of hydrochlorthiazide.
Cataract ; Humans ; Hyperpigmentation ; Labetalol ; Male ; Middle Aged ; Skin