Recurrent epistaxis is not one of rare symptoms in children, the well-known causes of which are anatomical abnormalities of nasal cavity and systemic bleeding tendency. but, in the majority of cases of recurrent epistaxis, it is usually very difficult to find out their underlying causes, so that the treatment is only symptomatic control of nasal bleeding whenever epistaxis occurs, but it usually is impossible to manage against their underlying causes as a specific therapy. The authors considered the breakdown or weakness of vascular integrity of nasal capillary vessel wall as an important factor of recurrent epistaxis, and vitamin C, which has an important role for the synthesis of collagen fiber, could influence to the vascular integrity of nasal capillary vessels. To elucidate the relation between recurrent epistaxis and the status of vitamin C in the tissue of the patients, the authors performed urinary vitamin C loading test measuring urinary excretion of vitamin C with high-performance liquid chromatography by Sirota et al in 19 cases of control group and 32 cases of patients with recurrent epistaxis, whose underlying diseases were not identified. And also the authors administered 1.0 gm/day of vitamin C orally for the treatment of recurrent epistaxis and follow-up was done over 1 year from the beginning of treatment to evaluate the treatment response. The results were as follows: 1) The hemoglobin level was significantly decreased in patient group compared with that of control group (12.4+/-0.8 vs 9.0+/-3.2 gm/dl). 2) The results of urine loading test of vitamin C, expressed as the percent excreted ratio, revealed significantly decreased in the patient group compared to that of the control group (9.1+/-6.1% vs 13.6+/-7.9%). 3) After treatment with 1.0 gm/day of vitamin C orally, follow-up was possible in 23 cases of total 32 patients. Of the 23 patients, "excellent" therapeutic response were in 16 cases (69.6%), "good" response in 5 cases (21.7%), and "no response" only in 2 cases (8.7%). The overall treatment response were in 21 cases (91.3%). In conclusion, it seems that majority of the patients with idiopathic recurrent epistaxis in the deficient state tissue vitamin C so that administration of vitamin C will be one of the effective therapy.
Ascorbic Acid* ; Capillaries ; Child* ; Chromatography, Liquid ; Collagen ; Epistaxis* ; Follow-Up Studies ; Hemorrhage ; Humans ; Nasal Cavity ; Vitamins*

No abstract available.
Brain* ; Child* ; Humans ; Magnetic Resonance Imaging* ; Seizures*

Secondary ischemic necrosis of femoral head due to loss of blood supply following to femoral neck fracture is well known. The regional distribution of bone.seeking radiopharmaceuricals in the skeleton can depend on a number of facto rs, but bone blood flow is a major physiological determinant of regional skeletal uptake of Tc-99m polyphosphate and bone imaging may thus be used for the evaluation of vascularity of the femoral head. The authors made a comparative study of scintigraphic findings and operative findings of 28 cases of femoral neck fracture treated at Kyung Hee University Hospital from April ′80 to May ′84. The results were as follows: 1. In 16 cases of proven avscular necrosis of femoral head, scintigraphy showed absent or decreased activity in 14 cases (87.5%), while radiography showed increased density in 10 cases (62.5%). 2. In 12 cases of proven vital femoral head, scintigraphy showed increased activity in 9 cases (75%) and radiography showed decreased density in 9 cases (75%). 3. 99mTc-MDP scintigraphy was an excellent and useful method for assessing bone vitality of femoral head.
Femoral Neck Fractures ; Femur Head Necrosis ; Femur Neck ; Head ; Methods ; Necrosis ; Radiography ; Radionuclide Imaging ; Skeleton ; Technetium Tc 99m Medronate

beta-receptor antagonist as antihypertensive agent has adverse effect such as vasoconstriction, bronchoconstriction and aggravation of atherosclerosis. So beta-receptor antagonist with alpha-receptor blocking property has been studied for avoidance of adverse effects of beta-receptor antagonist. Nipradilol, a new beta-receptor antagonist with alpha-receptor blocking property was administrated in 30 essential hypertensive patients for 10 week in order to evaluate the antihypertensive effects and adverse effects. The results were as follows: 1) Nipradilol was effective in 20 patients(67%) on systolic blood pressure 22 patients (73%) on diastolic blood pressure at the end of 10 weeks treatment. 2)Before medication, mean systolic and diastolic blood pressure in sitting position were 160+/-14mmHg and 102+/-18mmHg,and after 10 weeks of medication, mean systolic and diastolic blood pressure were significantly declined to 143+/-22mmHg and 89+/-12mmHg(p<0.001). 3) There was no significant change in pulse rate, from 78+/-12 beats per minute the beginning of the treatment to 75+/-11 beats per minute after 10 week of treatment. 4) There was no significant changes in sodium, potassium, GOT, GPT, bilirubin, alkalin ephosphatase, BUN, creatinine, LDH, CPK and lipid. 5) The adverse effects of nipradilol were bradycardia(7%), dyspnea(3%), chest discomfort(3%) and headache(3%). In summary, nipradilol seemed to be effective antihyertensive drug in treating mild to moderate hypertension.
Atherosclerosis ; Bilirubin ; Blood Pressure ; Bronchoconstriction ; Creatinine ; Heart Rate ; Humans ; Hypertension ; Potassium ; Sodium ; Thorax ; Vasoconstriction

No abstract available.
Hepatitis* ; Measles*

No abstract available.
Esophageal Atresia*

No abstract available.
Flail Chest*

BACKGROUND: Childhood myelodysplastic syndrome(MDS) is a heterogenous disease complex which has characteristics of cytopenia in one or more hemopoietic cell lines in peripheral blood and of dysmorphisms of hemopoietic precursors in bone marrow, but quite different from adult one. We experienced 22 patients with childhood myelodysplastic syndrome during 9 years from 1987 to 1995 in the Department of Pediatrics, Inje University College of Medicine, Pusan Paik Hospital, Pusan, Korea and performed a clinical study about them to analyze the clinical and hematological features and treatment outcome retrospectively. METHOD: We analyzed their clinical features including age and sex distribution, chief complaints and physical findings on first admission, distribution of subtypes, hematologic features including initial hemoglobin, total WBC and platelet count, and treatment outcome including leukmic transformation and prognostic scores. RESULTS: 1) Of the total 22 patients, 10 were in 0-4 years of age on first admission, 8 in 5-9, and 4 above 10 years of age. The male : female sex ratio was 2.1 : 1. 2) Of the 22 patients, chief complaints on first admission were bleeding tendency in 9 patients(40.9%), pallor in 8(36.4%) and fever in 3(13.6%), in order, and physical findings on first admission were purpura or ecchymoses in 17(77.3%), anemia in 15(68.2%) and hepatosplenomegaly in 8(36.4%), in order. 3) Hematologic findings on first admission were as follows : hemoglobin levels were below 3 g/dl in 1 patient(4.5%), 3-6 g/dl in 10(45.5%), and 6-9 g/dl in 11(50.0%). Initial WBC counts were below 5,000/mm3 in 13 patients(59.1%), 5,000-10,000/mm3 in 5(22.7%) and above 10,000/mm3 in 4(18.2%). Initial platelet counts were below 20,000/mm3 in 10(45.5%), 20,000-50,000/mm3 in 5(22.7%), 50,000-100,000/mm3 in 5(22.7%) and above 100,000/mm3 in 2(9.1%). 4) Of the 22 patients, 12 patients(54.6%) were RA type, 1(4.6%) RAS, and 3(13.6%) RAEB, RAEB-T and JCML types, respectively. 5) According to prognostic scores by Mufti et al(1986), none were in 'good' group, 17 patients(89.5%) in 'intermediate' group with 39.5 months of mean duration of survival(range 4-95 months) and 2(10.5%) in 'poor' group with 18 months of mean duration of surviral(range 17-19) until the last follow-up. However, the subtypes and clinical status seemed not to be related to the prognostic scores. 6) Sixteen patients were treated with low dose cytosine arabinoside(10 mg/m2/12hrs), of whom 7 patients gained long-standing event-free survival, whose treatment regimen was changed to oral 6-TG about 2 years later. All 3 of JCML were treated with A-Triple-V regimen, one of whom was died of sepsis, one was transformed into AML and died of sepsis, while the remained one gained long-standig event-free survival (62 months). 7) Leukemic transformation into AML occured in 7 patients(RA 1, RAEB 2, RAEB-T 3, JCML 1), 6 of whom were dead, while one gained long-standing event-free survival of 34 months. CONCLUSION: We concluded that RA was the most dominant type among our patients, and the frequency to transform into AML was 31,8%, and 31.9% of the patients had long-term survival, and that reliability of prognostic scoring system by Mufti et al(1986) was not high.
Adult ; Anemia ; Anemia, Refractory, with Excess of Blasts ; Bone Marrow ; Busan ; Cell Line ; Cytosine ; Disease-Free Survival ; Ecchymosis ; Female ; Fever ; Follow-Up Studies ; Hemorrhage ; Humans ; Korea ; Male ; Myelodysplastic Syndromes* ; Pallor ; Pediatrics ; Platelet Count ; Purpura ; Retrospective Studies ; Sepsis ; Sex Distribution ; Sex Ratio ; Treatment Outcome

No abstract available.
Growth Hormone* ; Humans

OBJECTIVEs: Cytogenetic investigations were carried out on 770 women with primary (n=560) and secondary amenorrhea (n=210) to determine the frequency of chromosomal or genetic causes of amenorrhea. MATERIALS AND METHODS: In 770 women with primary amenorrhea (n=560) and secondary amenorrhea (n=210), chromosomal analysis were performed. RESULTS: 1) The most prevalent age group is 16-20 years of age group with primary amenorrhea and 26-30 years of age group with secondary amenorrhea. 2) Out of 560 cases of primary amenorrhea, 343 cases (61.3%) had the normal chromosome constitution and 217 cases (38.7%) had the abnormal chromosome constitution including 46,XY. 3) In 217 cases of abnormal chromosome of primary amenorrhea, 57 cases (26.3%) had 45,X and 34 cases (15.8%) had the 46,XY, 24 cases (11.0%) had 45,X/46,X,i (Xq), 23 cases (10.6%) had 45,X/46,X,+mar and 14 cases (6.6%) had 45,X/46,XY. 4) Out of 210 cases of secondary amenorrhea, 181 cases (86.2%) had the normal chromosome constitution and 29 cases (13.8%) had 45,X/46,XX. CONCLUSION: High percentage of chromosomal abnormalities was diagnosed in primary amenorrhea and most of them were sex chromosome anomalies. In secondary amenorrhea, the prevalence was lower than primary amenorrhea, so a preselection of patients with secondary amenorrhea for cytogenetic investigations seems to be necessary.
Amenorrhea* ; Chromosome Aberrations ; Constitution and Bylaws ; Cytogenetics* ; Female ; Humans ; Prevalence ; Sex Chromosomes