BACKGROUND: Psoriasis is a disease of unknown etiology. Disturbances in lipid metabolism have been suggested as a possible pathogenetic mechanism. OBJECTIVE: The study was performed to investigate the blood lipid, lipoprotein and apolipo-protein levels and their difference according to family history in Korean psoriasis patients. METHODS: Blood samples from seventy three psoriasis patients and twenty three normal persons were measured for total ciolesterol(TC), VLDL-cholesterol(VLDL-C), LDL-cholesterol(LDL-C), HDL-cholesterol(HDL-C), lipoprotein(a) (LPA), triglyceride(TG), apolipoprotein A-I(APO-AI), and apolipoprotein B(AFO-B). Psoriasis patients were divided according to their family history of psoriasis. RESULTS: Compared to ccntrols, TC, LDL-C, LPA, TG, APO-B were significantly elevated in psoriasis patients. Mean varues of LPA and APO-B in psoriasis group were above normal range. VLDL-C were significasitly elevated only in female patients. There was a tendency for psoriasis patients with family history to have higher values than those without family history. CONCLUSION: TC, LDL-C, L,PA, TG, APO-B was increased in psoriasis, especially in the patients with family history, cornpared to control. It is recommended that we must pay attention to the possible risk for the development of cardiac or cerebral vascular disease in psoriasis patients, especially in the presence of family history of psoriasis.
Apolipoproteins ; Apolipoproteins B ; Female ; Humans ; Lipid Metabolism ; Lipoprotein(a) ; Lipoproteins* ; Psoriasis* ; Reference Values ; Vascular Diseases

BACKGROUND: Oral etretinate treatment is associated with the changes in serum lipid concentration and the elevation of serum liver enzymes. In Korea, chronic degenerative diseases like diabetes and hypertension are increasing and the prevalences of HBsAg and chronic liver diseases are much higher than those in western countries. Therefore these changes in serum lipids and liver enzymes during etretinate treatrment are important in Korea as risk factors for atherosclerosis and aggravation of preexisting liver diseases. OBJECTIVE: We tried to observe the sequential pattern, frequency, severity, and relationship between pretreatment value and posttreatment values in the changes of serum lipids and liver enzymes in patients with psoriasis luring etretinate treatment. METHODS: Fourty-one patients with psoriasis were studied during etretinate treatment with the starting dose of 0.5-1.0mg/kg/day. The levels of serum triglyceride, serum cholesterol, HDL-cholesterol, and sGOT, sGPT was repeatedly determined until the 16th week of etretinate treatment. RESULTS: l. In serum triglyceride and cholesterol, the average of concentrations in each treatment period was usually higher than pretreatment value during the 16 weeks of treatment, but no sequential pattern of changes was observed 2. The number of patients with the maximum of posttreatment values higher than the normal limit were 12(29.3%) in triglyce side, 6(14.6%) in cholesterol, 0 in sGOT, and 5(12.5%) in sGPT. The number of patients with the minimum of posttreatment values lower than the normal limit were 15(36.6%) in HDL-cholesterol. 3. In serum cholesterol, patients with an abnormal pretreatment value are more prone to elevation above the normal limit duriing etretinate treatment than patients with a normal pretreatment value. CONCLUSION: In patients with psoriasis the increases in serum triglyceride, serum cholesterol, sGOT, sGPT and the decrease in HDL-cholesterol were occurred frequently during etretinate treatment. Therefore monitoring of serum lipid concentration and serum liver enzyme levels on a regular basis during etretinate treatment is essential for its safe use in patients with psoriasis, es- pecially in cases of long term etretinate treatment.
Acitretin* ; Alanine Transaminase ; Aspartate Aminotransferases ; Atherosclerosis ; Cholesterol ; Etretinate* ; Hepatitis B Surface Antigens ; Humans ; Hypertension ; Korea ; Liver Diseases ; Liver* ; Prevalence ; Psoriasis* ; Risk Factors ; Triglycerides

BACKGROUND: Pruritus, which is a frequent accompanying symptom of dermatological diseases, is also common during pregnancy, either localized or generalized. It may be related to specific dermatoses of pregnancy. OBJECTIVE: A clinical study was performed to know the exact nature of pruritus in pregnancy. METHODS: Subjects with systemic diseases, or laboratory abnormalities were excluded. People who have had pruritic dermatologic diseases before pregnancy were also excluded. One hundred and fifty five pregnant women were interviewed with physical examinations and followed up to the date of delivery. Pruritus was graded. RESULTS: Pruritus was present in 31.6%. Most affected subjects had mild or moderate severity. The abdomen was the most common site. There was a tendency for the duration of itching to increase with the duration of pregnancy. CONCLUSION: Conclusion: These findings may provide basic and useful data on pruritus during pregnancy.
Abdomen ; Clinical Study* ; Female ; Humans ; Physical Examination ; Pregnancy* ; Pregnant Women ; Pruritus* ; Skin Diseases

No abstract available.
Humans ; Lupus Erythematosus, Systemic* ; Renal Veins* ; Thrombosis*

BACKGROUND: The hemodynamic and metabolic effects of tourniquet application undergoing knee surgery with general anesthesia in elderly patients with hypertension have been rarely reported. We evaluated the hemodynamic and metabolic effects in elderly patients compared with young adults. METHODS: Thirty elderly patients (elderly hypertension group, 71.8 +/- 3.9 years) with chronic hypertension undergoing total knee replacement and 30 young adults (normal group, 33.1 +/- 5.1 years) undergoing knee surgery were studied. Mean arterial pressure (MAP), heart rate, cardiac index (CI) by esophageal doppler method, and systemic vascular resistance index (SVRI) were measured before, during, and after tourniquet application. pH, PaO2, PaCO2, Hb and lactate blood concentrations were also measured. RESULTS: MAP increased 25% and 16% in elderly hypertension and normal groups during inflation, respectively (P < 0.05) and returned to basal values after deflation. CI increased to 30% higher than basal values in both groups after deflation (P < 0.05). SVRI decreased 31% and 19% in elderly hypertension and normal groups after deflation, respectively (P < 0.05). After deflation, PaCO2 and lactate increased (P < 0.05). CONCLUSIONS: Elderly patients with hypertension have the significant hemodynamic changes during and after tourniquet application than before, however, there are no differences compared to normal group. These elderly patients should be needed the active hemodynamic monitoring due to the lower compensatory ability.
Aged* ; Anesthesia, General ; Arterial Pressure ; Arthroplasty, Replacement, Knee ; Heart Rate ; Hemodynamics* ; Humans ; Hydrogen-Ion Concentration ; Hypertension* ; Inflation, Economic ; Knee* ; Lactic Acid ; Tourniquets* ; Vascular Resistance ; Young Adult

Uterine scar dehiscence following laparoscopic myomectomy rarely occurs but can compromise both maternal and fetal well-being in subsequent pregnancy. We here present two cases of pregnancy complicated by preterm birth that resulted from uterine scar dehiscence following laparoscopic myomectomy. First case was a nulligravida who had scar dehiscence at 26 weeks of gestation after having a laparoscopic myomectomy 3 months prior to conception. Two weeks later, we observed her fetal leg protruding through the defect. The other case was a primigravida with a history of prior cesarean delivery, whose sonography revealed myomectomy scar dehiscence at 31 weeks of gestation. Within a few hours after observing, the patient complained of abdominal pain that was aggravating as fetal leg protruded through the defect. In both cases, babies were born by emergency cesarean section. Conservative management can be one of treatment options for myomectomy scar dehiscence in preterm pregnancy. However, clinicians should always be aware of the possibility of obstetric emergencies.
Abdominal Pain ; Cesarean Section ; Cicatrix* ; Emergencies ; Female ; Fertilization ; Humans ; Leg ; Pregnancy* ; Premature Birth ; Uterine Myomectomy ; Uterine Rupture

Hemorrhage due to capillary telangiectasia is rare. We report a case of capillary telangiectasia presenting with repeated cerebellar hemorrhage in a 38-year-old male. To our knowledge this is the first case of repeated cerebellar hemorrhage from the capillary telangiectasia. At the first operation, we removed hematoma only, but rebleeding occurred repeatedly in the same area. Finally, we evacuated the recurrent hematoma and vascular mass of capillary telangiectasia at the second operation under surgical microscope. Based on the findings of this case and a review of the literature, we conclude that capillary telangiectasia can be the cause of the massive repeated hemorrhage.
Adult ; Capillaries* ; Hematoma ; Hemorrhage* ; Humans ; Male ; Telangiectasis*

This study is a retrospective clinical analysis of 134 cases of anterior communicating artery aneurysms surgically treated in the Department of Neurosurgery, Chungnam National University Hospital from January 1990 to December 1996. The results of analysis were summarized as follows; 1) Peak age incidence was in the sixth decade and male to female ratio was 1: 1.2, showing female predominancy. 2) There was no statistically significant relationship between direction of aneurysm and Fisher's grade, and occurrence of hydrocephalus, and also between the direction, size and shape of aneurysm and preoperative Hunt-Hess grade. 3) There was statistically significant relationship between the shape of aneurysm and angiographic vasospasm; there was high incidence of vasospasm in lobulated and oval shape of aneurysm. But there was no statistically significant relationship between the direction, size of aneurysm and angiographic vasospasm. 4) The correlations between outcome and preoperative Hunt-Hess grade, and occurrence of angiographic vasospasm, and temporary clipping were statistically significant; the outcome was good in cases of no vasospasm, temporay clipping and better preoperative Hunt-Hess grade. 5) The direction, shape and size of aneurysm, existence or not of abnormality in circle of willis, timing of surgery and operative procedure had no statistically significant relationship with outcome. 6) Postoperative complications were vasospasm and infarction(18.7%), brain edema, hydrocephalus, in order of frequency, and the mortality rate was 3%.
Aneurysm ; Brain Edema ; Chungcheongnam-do ; Circle of Willis ; Female ; Humans ; Hydrocephalus ; Incidence ; Intracranial Aneurysm* ; Male ; Mortality ; Neurosurgery ; Postoperative Complications ; Retrospective Studies ; Surgical Procedures, Operative

OBJECTIVE: The goal of this study is to assess the safety and efficacy of the Codman Hakim programmable valve versus differential pressure valve in the treatment of patients with hydrocephalus. METHODS: The authors conducted a retrospective study of 83 patients who were implanted the Codmam Hakim programmable valve and differential pressure valve between January 1996 and April 2001. We analyzed complications, the number of shunt revision, and prognosis between the two groups. We analyzed initial pressure setting, the cause of reprogramming, and the number of reprogramming in Codman Hakim programmable valve. RESULTS: No statistically significant difference was apparent between the Codmam Hakim programmable valve group and a differential pressure valve group in complications, primary disease entities in shunt revision cases and prognosis(p>0.05). And statistically difference was not apparent in the number of shunt revision(p=0.07). The average pressure and range of initial pressure setting in the Codmam Hakim programmable valve was 97.1mmH2O and 50~150mmH2O, respectively. The number of cases of reprogragmming in the Codmam Hakim programmable valve was 12 in total, 1 time in 9 cases , 2 times in 2 cases, and 3 times in 1case. CONCLUSION: The Codmam Hakim programmable valve can decrease shunt revision caused by underdrainage and overdrainage complications. The optimal pressure settting is the key point to decreasing reprogramming and complications in the Codmam Hakim programmable valve and a differential pressure valve.
Humans ; Hydrocephalus* ; Prognosis ; Retrospective Studies

OBJECTIVE: We retrospectively analyzed survival, local control rate, and incidence of radiation toxicities after radiosurgery for recurrent metastatic brain lesions whose initial metastases were treated with whole-brain radiotherapy. Various radiotherapeutical indices were examined to suggest predictors of radiation-related neurological dysfunction. METHODS: In 46 patients, total 100 of recurrent metastases (mean 2.2, ranged 1-10) were treated by CyberKnife radiosurgery at average dose of 23.1 Gy in 1 to 3 fractions. The median prior radiation dose was 32.7 Gy, the median time since radiation was 5.0 months, and the mean tumor volume was 12.4 cm3. Side effects were expressed in terms of radiation therapy oncology group (RTOG) neurotoxicity criteria. RESULTS: Mass reduction was observed in 30 patients (65%) on MRI. After the salvage treatment, one-year progression-free survival rate was 57% and median survival was 10 months. Age (<60 years) and tumor volume affected survival rate (p=0.03, each). Acute (< or =1 month) toxicity was observed in 22% of patients, subacute and chronic (>6 months) toxicity occurred in 21%, respectively. Less acute toxicity was observed with small tumors (<10 cm3, p=0.03), and less chronic toxicity occurred at lower cumulative doses (<100 Gy, p=0.004). "Radiation toxicity factor" (cumulative dose times tumor volume of <1,000 Gyxcm3) was a significant predictor of both acute and chronic CNS toxicities. CONCLUSION: Salvage CyberKnife radiosurgery is effective for recurrent brain metastases in previously irradiated patients, but careful evaluation is advised in patients with large tumors and high cumulative radiation doses to avoid toxicity.
Brain ; Disease-Free Survival ; Humans ; Incidence ; Neoplasm Metastasis ; Radiosurgery ; Recurrence ; Retrospective Studies ; Survival Rate ; Tumor Burden