No abstract available.
Lupus Erythematosus, Systemic*

STUDY DESIGN: We report two cases of symptomatic spinal epidural lipomatosis (SEL) associated with long-term use of steroid medication OBJECTIVES: The purpose of this study was to assess the clinical characteristics, diagnosis and treatment of symptomatic spinal epidural lipomatosis. SUMMARY OF LITERATURE REVIEW: Spinal epidural lipomatosis is a condition in which excess adipose tissue is deposited circumferentially about the spinal cord in the epidural space. It can present neurologic symptoms including back pain, radiculopathy or cauda equina. Magnetic resonance imaging is the most helpful dignostic means and should be used initially if suspected. Treatment is decompressive laminectomy and debulking of fat. MATERIALS AND METHODS: Two cases of lumbar epidural lipomatosis with neurologic symptoms were discussed and evaluated by physical examination, postmyelography CT and MRI. RESULTS: Two cases were treated with decompressive laminectomy and debulking of fat. Increased accumulation of the fatty tissue was seen predominently in posterior and posterolateral epidural space of the spinal canal, displacing and compressing the lumbar spinal cord anteriorly. Both gross and histologic evaluation revealed overgrowth of unencapsulated normal appearing fat consistent with spinal epidural lipomatosis. One case was demonstrated gradual improvement in symtoms after operation but the other was died due to medical problems. CONCLUSION: The authors reviewed the literature and reported the results of operative treatment of patients with lumbago, radicular pain and intermitent claudication caused by epidural lipomatosis of lumbar spine and degenerative spinal stenosis.
Adipose Tissue ; Back Pain ; Cauda Equina ; Diagnosis ; Epidural Space ; Humans ; Laminectomy ; Lipomatosis* ; Low Back Pain ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Physical Examination ; Radiculopathy ; Spinal Canal ; Spinal Cord ; Spinal Stenosis ; Spine

BACKGROUND: Some of the deficiencies in anterior pituitary function identified in subjects with macroadenomas appear to represent irrevemible necrosis of normal pituitary cells, and in addition reversible damage to viable glandular tissue and/or incomplete interruption of local circulation by compression of pituitary stalk may also contribute significantly to hypopituitarism. So anterior pituitary function may actually improve in some patients undergoing successful tumor resection or reduction in tumor size. Although direct comparisons of pituitary function among the various pituitary tumors are not presently available it was reported that there is some difference in the degree of pituitary impairment between patients with nonfunctioning macroadenoma(NFMA) and those with GH-secreting macroadenoma(GHMA).In this study, to investigate the difference in the degree of hypopituitarism we compared anterior pituitary function in subjects with NFMA to that in patients with GHMA. METHODS: In this retrospective study, preoperative and postoperative anterior pituitary function was assessed by clinical findings, basal hormone levels and/or combined pituitary stimulation test in 29 subjects with NFMA and in 24 subjects with GHMA. RESULTS: 1. There was no difference in age, sex, tumor size distribution between the two groups. 2. Preoperatively, NFMA patients had a higher prevalence of secondary hypothyroidism(34% vs. 5%; p(0.02) compared to subjects with GHMA. Patients with NFMA also had a higher prevalence of more severe pituitary failure compared with acromegalic patients; 48% of the patients in this group had more than one pituitary hormone axis impaired compared to 17% in the acromegalic group(p0.03). 3. Postoperatively, NFMA patients also had a higher prevalence of secondary hypoadrenalism (52% vs. 11%; p 0.01) compared with acromegalic patients. Additionally, the prevalence who had more than one pituitary hormone axis impaired was still greater in NFMA patients than in the acromegalic group(57% vs. 22%; p=0.054). 4. No correlation was found between the severity of pituitary failure and tumor size or extension in both groups before and after surgery. CONCLUSION: These findings suggest that anterior pituitary function is relatively better preserved in patients with GHMA than those with NFMA and that this difference is independent of tumor size and extension. The mechanism underlying the lower rate of hypopituitarism in acromegalics with macroadenoma remains to be elucidated.
Adrenal Insufficiency ; Axis, Cervical Vertebra ; Humans ; Hypopituitarism ; Necrosis ; Pituitary Gland ; Pituitary Neoplasms ; Prevalence ; Retrospective Studies

BACKGROUND: Leptin, produced in the adipose tissue, is involved in the regulation of body weight. The release of the leptin is increased in obese adults even in children. This study investigated whether the serum leptin in cord blood was related to babys birth weight and metabolic parameters. METHODS: 71 pairs of singleton pregnancy babies and their mother were studied. Babies are classified in LGA (large for gestational age), AGA (appropriate for gestational age), SGA (small for gestational age) three groups. After delivery, cord blood and maternal venous blood samples were drawn. We measured the plasma leptin, insulin-like growth factor (IGF)-1, insulin and proinsulin in cord and maternal serum. RESULTS: The concentration of leptin from cord blood was increased in LGA babies and decreased in SGA babies compued with the level in AGA babies. There was positive correlatian (r=0.55, p<0.01) between the plasma leptin level in cord and birth weight. There were positive correlatian between both the plasma proinsulin (r=0.37, p<0.01) and IGF-1 (r=0.32, p<0.01) and birth weight, too. But there was no difference between female and male baby's cord blood leptin level. In multiple regression analysis, cord blood leptin level was found independent factor related to birth weight ( p=0.001) CONCLUDION : The plasma leptin, proinsulin and IGF-1 is correlates to the birth weight. These data provide evidence that leptin and proinsulin are highly related to the nutritional status already during the fetal periods, and effect on the intrauterine fetal growth.
Adipose Tissue ; Adult ; Birth Weight* ; Body Weight ; Child ; Female ; Fetal Blood* ; Fetal Development ; Humans ; Insulin ; Insulin-Like Growth Factor I ; Leptin* ; Male ; Mothers ; Nutritional Status ; Parturition* ; Plasma ; Pregnancy ; Proinsulin

Tufted hair follliculitis is a localized, inflammatory and exudative disease of the scalp characterized by a tufted appearance of the scalp hairs emerging from single follicular openings, and may result in permanent and irreversible scarring alopecia. We report two cases of tufted hair folliculitis in a 53-year-old woman and a 47-year-old man. They had several areas of scarring alopecia with multiple bundles of hairs emerging from single follicular orifices. Histopathologic findings were typical for tufted hair folliculitis. The patients were treated successively with oral antibiotics and with topical application of clindamycin.
Alopecia ; Anti-Bacterial Agents ; Cicatrix ; Clindamycin ; Female ; Folliculitis* ; Hair* ; Humans ; Middle Aged ; Scalp

BACKGROUND: This study aimed to assess the status of infection control during influenza A pandemic (H1N1) 2009. METHODS: A questionnaire survey was conducted in November 2009 at the 100 hospitals designated by the Korea Centers for Disease Control and Prevention (KCDC) as influenza A pandemic (H1N1) 2009-treatment institutions. RESULTS: In 32.3% of the hospitals, the ventilation system of the influenza A pandemic (H1N1) 2009 isolation ward was separated from the hospital's ventilation system. With regard to wearing personal protective equipment while caring for patients with H1N1 infection, during usual patient contact, masks were always worn by all medical staff at all the hospitals; however, medical staff at 38.7% and 51.6% of the hospitals did not wear gloves and gowns, respectively. During aerosol-generating procedures, some medical staff wore surgical masks, whereas medical staff at 10% and 23.3% of the hospitals did not wear gowns and protective goggles, respectively. In all, 64.5% of the hospitals responded that the contents of the guidelines established by the KCDC were insufficient for reference purposes in actual practice. CONCLUSION: Some of influenza A pandemic (H1N1) 2009-treatment institutions are believed to be inadequate in facilities, infection control during patient treatment, and administrative measures among their efforts to prevent transmission in hospital. In preparation against the outbreak of similar diseases in the future, the government needs to establish guidelines highly applicable by medical staff, to secure exclusive spaces and personnel for treating infectious disease patients, and to develop personal protective gear support and management systems.
Centers for Disease Control and Prevention (U.S.) ; Communicable Diseases ; Delivery of Health Care ; Eye Protective Devices ; Humans ; Infection Control ; Influenza, Human ; Korea ; Masks ; Medical Staff ; Pandemics ; Ventilation ; Surveys and Questionnaires

PURPOSE: To evaluate the correlation between the Visual Prostate Symptom Score (VPSS) and International Prostate Symptom Score (IPSS). METHODS: We enrolled 240 new male patients who had visited National Police Hospital more than twice during a 6-month period starting from July 2013. At initial visit, the Korean version of the IPSS and VPSS, uroflowmetry, and transrectal ultrasonography were used to evaluate urinary symptoms. After medication, IPSS and VPSS questionnaires were issued again. The Spearman correlation test and the Mantel-Haenszel test were used to evaluate the relationship between the IPSS and VPSS. RESULTS: The median age, total prostate volume, total IPSS, and total VPSS were 59.0 years, 28.0 mL, 12, and 9, respectively. Total VPSS, VPSS obstructive symptoms, VPSS irritative symptoms, and VPSS quality of life (QoL) significantly correlated with the total IPSS, IPSS obstructive symptoms, IPSS irritative symptoms, and IPSS QoL, respectively (correlation coefficient, P-value: 0.632, <0.001; 0.431, <0.001; 0.696, <0.001; and 0.799, <0.001; respectively). The change in the total IPSS after treatment also significantly correlated with the change in total VPSS after treatment (correlation coefficient, P-value: 0.364, <0.001). There were significant correlations between maximal flow rate and IPSS/VPSS obstructive symptoms (correlation coefficient, P-value: -0.190, 0.004; -0.269, <0.001, respectively). Additionally, there was a significant increase in the ratio of the maximal flow rate <15 mL/sec to VPSS obstructive symptoms as the severity of the VPSS obstructive symptoms increased (P trend <0.001). CONCLUSIONS: VPSS might be useful in evaluating lower urinary tract symptoms at the initial visit and assessing these symptoms at longitudinal follow-up examinations.
Follow-Up Studies ; Humans ; Lower Urinary Tract Symptoms* ; Male ; Police ; Prostate* ; Prostatic Hyperplasia ; Quality of Life ; Ultrasonography

PURPOSE: We performed the present study to evaluate the prognostic factors for the surgical outcome of varicocelectomy in the treatment of a painful varicocele. MATERIALS AND METHODS: A total of 77 patients undergoing varicocelectomy were enrolled. All the patients were examined for body mass index (BMI), varicocele grade, testosterone, follicle stimulating hormone (FSH), luteinizing hormone (LH), semen analysis, maximal vein diameter, and discrepancy of testicular volume. At a follow-up visit 3~6 months after the surgery, the patient response was graded as a complete response, partial response, or no response. The resolution of pain was defined as a complete or partial response. We used logistic regression analyses to determine the preoperative factors for predicting a complete response and the resolution of pain. RESULTS: Ten subjects were lost to follow-up. The remaining 67 patients were included in this study. The pain was completely resolved in 47.8% of patients, partial resolution was observed in 25.4% of patients, and failure was reported in 26.9% of patients. Among the parameters, only a longer duration of pain (> or =3 months) was an independent factor related to the complete response of pain (odds ratio, 7.371; p=0.010) and the resolution of pain (odds ratio, 7.209; p=0.042). The parameters of semen analysis results, testosterone, LH, FSH, BMI, grade, ultrasonography results, and the type of surgical approach did not significantly predict the resolution of pain. CONCLUSIONS: The duration of pain (> or =3 months) was an independent prognostic factor for the complete response of pain and the resolution of pain.
Body Mass Index ; Follicle Stimulating Hormone ; Follow-Up Studies ; Humans ; Laparoscopy ; Logistic Models ; Lost to Follow-Up ; Luteinizing Hormone ; Microsurgery ; Semen Analysis ; Testosterone ; Varicocele ; Veins

BACKGROUND: To investigate how many rookie pitchers suffered from injuries while playing in the amateur league without guidelines for prevention of excessive pitching, we analyzed their amateur pitching patterns based on the pitch count, use of breaking balls, and pitches during winter camp. METHODS: Forty-one rookie pitchers who graduated from high school or university in 2013 and joined professional baseball teams. Participants were interviewed by a trainer using our questionnaire. Injury inclusion criteria were 1) history of shoulder surgery, 2) history of elbow surgery, 3) shoulder pain requiring treatment, and 4) elbow pain requiring treatment. RESULTS: Mean number of pitches per game and warm-up pitches for practice was 84.5 pitches (range, 15 to 130 pitches) and 16.4 pitches (range, 2 to 210 pitches), respectively. Mean number of pitches during the last year was 906.9 (range, 80 to 2,000). Mean number of maximal pitches was 127 pitches (range, 50 to 210 pitches). Fourteen pitchers had pitched over 150 pitches. Twenty-seven pitchers (65.9%) had pitched in spite of enduring pain. During winter training (mean 1.8 months), mean number of pitches per day was 162.5 pitches, and 20 pitchers (48.8%) had practiced pitching excessively despite the cold weather. Twenty-six rookies (63.4%) had shoulder pain or history of shoulder surgery, and 31 pitchers (75.6%) had elbow pain or history of elbow surgery. Only four participants (9.8%) did not have pain and history of surgery. CONCLUSIONS: For young baseball pitchers, guidelines for prevention of excessive pitching and for regulating the winter training program may be needed.
Baseball* ; Education ; Elbow* ; Humans ; Shoulder Pain ; Shoulder* ; Weather

A clinical analysis was done on 134 cases with bronchial asthma who were admitted to the Department of Pediatrics Yeungnam University from May 1987 to October 1991. The results were as follows: 1) The peak age of bronchial asthma was under 2 years. The sex ratio of male to female was 2.9:1. 2) The outbreak of bronchial asthma was most common in fall, especially in September. 3) The past history of other allergic diseases were present in 22.4% of patients (30/134 cases), and the previous bronchiolitis in infancy were experienced in 12.7% of patients (17/134 cases). 4) According to the skin test for allergens done by RAST, the most common allergens were Mites and House dust. 5) Eosinophilia (T.E.C>250/min) was found in 29.1%t of patients, and elevated lgE level (>200 IU/ml) was found in 63.2% of patients. 6) No significant differences in the serum lgE level were found between male and female patients. No significant differences in the serum lgE level were found between asthma patients with and without other allergic diseases. 7) The serum lgE level of school aged patients was significant higher than that of preschool aged (p<0.01).
Allergens ; Asthma* ; Bronchiolitis ; Dust ; Eosinophilia ; Female ; Humans ; Male ; Mites ; Pediatrics ; Sex Ratio ; Skin Tests