No abstract available.
Lipectomy*

Graves disease occur in association with myasthenia gravis is rare. We report a case of Graves disease and myasthenia gravis treated by bilateral subtotal thyroidectomy and total thymectomy simultaneously. A 37 year old woman was admitted with anterior neck mass and ptosis. Various examinations were compatible with combined Graves disease and myasthenia gravis. The bilateral subtotal thyroidectomy and total thymectomy were done simultaneously. The pathologic diagnosis was Graves disease and thymic hyperplasia. The patients postoperative course was uneventful. The thyroid function of patient became euthyroid and the clinical symptoms related with myastenia gravis resolved during follow up period.
Adult ; Diagnosis ; Female ; Follow-Up Studies ; Graves Disease* ; Humans ; Myasthenia Gravis* ; Neck ; Thymectomy* ; Thymus Hyperplasia ; Thyroid Gland ; Thyroidectomy*

Cortex mori (Morus alba L.: Sangbaikpi), the root bark of mulberry tree, has been used as an antiphlogistic, diuretic, and expectorant in herbal medicine. Previous studies have demonstrated that the phenolic extract of Cortex mori have hypotensive, hypoglycemic, antifungal, antiviral, antiinflammatory, and anticancer effects, and the hot water extract from Cortex mori has inhibitory effects on compound 48/80- induced mast cell degranulation and histamine release from rat peritoneal mast cells (RPMCs). This study was perforrned to investigate the effects of polysaccharide fraction from Cortex mori (PFCM) on compound 48/80-induced degranulation, histamine release, calcium influx, changes of intracellular cAMP and cGMP level, and morphological changes of RPMCs. The results were summarized as follows. 1) Compound 48/80-induced cytomorphological changes such as swelling, degranulation, intracellular vacuoles, and interrupted cell boundary were significantly inhibited by pretreatment with either hot water or polysaccaride fractions frorn Cortex mori (PFCM), 2) the compound 48/80-induced histamine release from RPMCs pretreated with PFCM was significantly inhibited, compared to that of control without PFCM pretreatment, 3) the PFCM inhibited remarkably the compound 48/80-induced calcium influx into the RPMCs, 4) the PFCM increased significantly the intracellular cAMP levels and decreased the intracellular cGMP levels of RPMCs, compared to those of normal control, and 5) the compound 48/80-induced cAMP levels of RPMCs pretreated with PFCM were significantly increased, compared to those of positive control without PFCM, and the compound 48/80-induced cGMP levels of RPMCs pretreated with PFCM were remarkably decreased, compared to those of positive control without PFCM. From the above results, it is suggested that PFCM have an activity to inhibit the compound 48/80-induced mast cell activation.
Animals ; Calcium ; Herbal Medicine ; Histamine Release ; Mast Cells* ; Morus ; Phenol ; Rats ; Trees ; Vacuoles ; Water

Darier disease is a rare genodermatosis clinically characterized by multiple hyperkeratotic papules and plaques predominantly on seborrheic areas. It has characteristic histopathological features; corps-ronds, grains, suprabasal clefts or lacunae, villi projections etc. We present a case of Darier disease in a 36-year-old woman. She had suffered from skin lesions which bore a great resemblance to those of verruca plana or eruptive syringoma. We could confirm the diagnosis as Darier disease because she had the characteristic nail changes.
Adult ; Edible Grain ; Darier Disease* ; Diagnosis ; Female ; Humans ; Skin ; Syringoma ; Warts

Callus is a nonpenetrating circumscribed hyperkeratosis produced by repeated friction or pressure. It occurs on parts subjected to intermittent pressure, particularly on the palms and soles, and particularly over the bony prominences of the joints. In painful callosities of the feet, ill-fitting shoes and orthopedic problems of the foot (bunions, exostoses) are some of the etiological factors to be considered. Gout is a condition of inborn metabolic and/or acquired form of the disease characterized by hyperuricemia, tophaceous deposits of sodium urate and recurrent attacks of arthritis. We present a case of callus caused by tophi. The patient was a 45-year-old man who had complained of a painful, well-demarcated, hyperkeratotic plaque on the heel of the left foot for 18 months. After the tophi beneath overlying whitish thickened skin had been removed, the skin lesion disappeared and to date has not recurred.
Arthritis ; Bony Callus* ; Callosities ; Foot ; Friction ; Gout ; Heel ; Humans ; Hyperuricemia ; Joints ; Middle Aged ; Orthopedics ; Shoes ; Skin ; Uric Acid

The author was to study the types and distrbution of malocclusion in the 1217 patients with diagnostic charts, cephalograms and study models, who have been treated from March, 1973 to August, 1982 in the Department of orthodontics, Infirmary of Dental College, Yon Sei University. The results were as follows; 1. In the Angle's classification of malocclusion, it was presented that class I malocclusion was 671 persons (55.1%), class II division 1 malocclusion was 241 persons (19.8%), class II division 2 malocclusion was 30 persons (2.5%) and class III malocclusion was 275 persons (22.6%). 2. In the Angle's class I malocclusion, the crowding was most remarkable (39%). 3. In the Angle's class II malocclusion, 88 persions(32.5%) were due to the undergrowth of the mandible, and deep bith was most frequent. 4. In the Angle's class II malocclusion, 94 persons (34.2%) were in the pseudo type, 84 persons (29.8%) were due the the overgrowth of the mandible, and openbite and edge to edge bite were most frequent. 5. In the sexual distribution of the patients, female patients were 791 persons (65%), male patients were 426 persons (35%), and the number of females was 1.8 time then that of male. 6. In the age distrbution of the patientsm 572 persons(47%) were in the 9-13 years old. 7. In the regional distribution of the patients, most of them lived near the hospital.
Crowding ; Female ; Humans ; Male ; Malocclusion ; Mandible ; Open Bite ; Orthodontics*

Earlier work suggested that Ginseng saponin had an effect on osteoblast and other cells, but there has been no report on saponin effects on chondrocyte. The purpose of this study was to investigate the effect of saponin on cultured human chondrocyte. The chondrocyte was isolated from human articular cartilage of knee joint during notchplasty of ACL reconstructive procedure using collagenase, and cultured in standard medium and serum free deficient medium, with addition of saponin(0(control), 10, 20, 50 microgram/ml concentration). DNA, RNA synthesis of chondrocyte was estimated on 36 hours and 5 days of culture by measuring of thymidine and uridine uptake. Human collagen type I and II synthesis was estimated by reverse transcriptation-polymerase chain reaction on 36 hours of culture. Low dose saponin was found to enhance DNA, RNA, and collagen synthesis of chondrocytes which were cultured with a deficient medium in comparison to the controls. It promoted cell proliferation of the osteoblasts cultured with a deficient medium in comparison to the controls. But, high dose saponin was found to diminish the synthesis of DNA, RNA and collagen. In summary, the results showed that the saponin increased proliferation and differentiation of the chondrocyte cultured in deficient medium. Therefore saponin seemed to act as a physiologic stimulant on human chondrocyte. But further study should be done.
Cartilage, Articular ; Cell Proliferation ; Chondrocytes* ; Collagen ; Collagen Type I ; Collagenases ; DNA ; Humans* ; Knee Joint ; Osteoblasts ; Panax* ; RNA ; Saponins* ; Thymidine ; Uridine

Coronary artery fistula is an unusual anomaly in elderly patients that consists of a communication bet- ween one of the coronary arteries and other cardiac chambers or veins. It causes many cardiac compli- cations due to hemodynamic changes, and thus has recognized its clinical significance. It occurs usually in congenital origin, but also occurs secondarily in traumatic or neoplastic or artherosclerotic coronary diseases. Congenital coronary artery fistula is a very rare congenital anomaly that results in multiple hemodynamic complications. It has reported rarely in elderly patients, that induces myocardial ischemia due to coronary steal syndrome and heart failure that caused by diastolic volume overload via a left to left shunt. We observed a 68-year-old male patient with exertional chest pain and dyspnea, in whom selective coronary angiography revealed abnormal reticular communication between left anterior descending artery and left circumflex artery and drained to left ventricle through multiple microfistulous channels. We report this patient case who complicated by myocardial ischemia and left ventricular failure those caused by hemodynamic complication due to multiple coronary artery-left ventricular fistulae.
Aged ; Arteries ; Cations ; Chest Pain ; Coronary Angiography ; Coronary Disease ; Coronary Vessels ; Dyspnea ; Fistula ; Heart Failure* ; Heart Ventricles ; Heart* ; Hemodynamics ; Humans ; Male ; Myocardial Ischemia ; Veins

Coronary artery fistula is an unusual anomaly in elderly patients that consists of a communication bet- ween one of the coronary arteries and other cardiac chambers or veins. It causes many cardiac compli- cations due to hemodynamic changes, and thus has recognized its clinical significance. It occurs usually in congenital origin, but also occurs secondarily in traumatic or neoplastic or artherosclerotic coronary diseases. Congenital coronary artery fistula is a very rare congenital anomaly that results in multiple hemodynamic complications. It has reported rarely in elderly patients, that induces myocardial ischemia due to coronary steal syndrome and heart failure that caused by diastolic volume overload via a left to left shunt. We observed a 68-year-old male patient with exertional chest pain and dyspnea, in whom selective coronary angiography revealed abnormal reticular communication between left anterior descending artery and left circumflex artery and drained to left ventricle through multiple microfistulous channels. We report this patient case who complicated by myocardial ischemia and left ventricular failure those caused by hemodynamic complication due to multiple coronary artery-left ventricular fistulae.
Aged ; Arteries ; Cations ; Chest Pain ; Coronary Angiography ; Coronary Disease ; Coronary Vessels ; Dyspnea ; Fistula ; Heart Failure* ; Heart Ventricles ; Heart* ; Hemodynamics ; Humans ; Male ; Myocardial Ischemia ; Veins

BACKGROUND: The aim of this study is to evaluate the influence of immunosuppressants on in-hospital mortality from sepsis. METHODS: Using data of the Health Insurance Review & Assessment Service, we collected data from patients who were admitted to the hospital due to sepsis from 2009 to 2013. Based on drugs commonly used for immunosuppression caused by various diseases, patients were divided into three groups; immunosuppressant group, steroid-only group, and control group. Patients with no history of immunosuppressants or steroids were assigned to the control group. To identify risk factors of in-hospital mortality in sepsis, we compared differences in patient characteristics, comorbidities, intensive care unit (ICU) care requirements, and immunodeficiency profiles. Subgroup analysis according to age was also performed. RESULTS: Of the 185,671 included patients, 13,935 (7.5%) were in the steroid-only group and 2,771 patients (1.5%) were in the immunosuppressant group. The overall in-hospital mortality was 38.9% and showed an increasing trend with age. The steroid-only group showed the lowest in-hospital mortality among the three groups except the patients younger than 30 years. The steroid-only group and immunosuppressant group received ICU treatment more frequently (p < 0.001), stayed longer in the hospital (p < 0.001), and showed higher medical expenditure (p < 0.001) compared to the normal group. Univariate and multivariate analyses revealed that age, male gender, comorbidities (especially malignancy), and ICU treatment had a significant effect on in-hospital mortality. CONCLUSIONS: Despite longer hospital length of stay and more frequent need for ICU care, the in-hospital mortality was lower in patients taking immunosuppressive drugs than in patients not taking immunosuppressive drugs.
Comorbidity ; Health Expenditures ; Hospital Mortality ; Humans ; Immunosuppression ; Immunosuppressive Agents ; Insurance* ; Insurance, Health ; Intensive Care Units ; Korea* ; Length of Stay ; Male ; Mortality ; Multivariate Analysis ; Risk Factors ; Sepsis* ; Steroids