No abstract available.

We reached the following conclusions from analyzing survival rates and causes of death of 71 patients who received hemodialysis at our hemodialysis center from January 1983 to December of 1990 using life-table method.

1) The 5-year survival rate of the whole patients was 52%.

2) The survival rate decreased significantly with increasing age after 3 years from commencement of dialysis. The 5-year survival rate of patients under the age of 30 was 89%, the rate of patients between the age of 31 and 50 was 70% . and the rate of patients above the age of 51 years was 30%.

3) Diabetes Mellitus had no slgnificant influence on survival rate in patients over the age 51.

4) The survival rates according to sex revealed no significant difference.

5) The leading cause of death was cardiovascular disease including cerebrovascular accident amounting 47.6% and next was infectious disease 23.8%.

Additional study on survival rate in age group over 51 with or without Diabetes Mellitus is required in the future.

Patient with noninsulin dependent diabetes mellitus(NIDDM) have a major risk factor of the coronary herat disease which is important cause of death in NIDDM patients. In addition, they have relatively high levels of plasma cholesterol.

In order to assess the hypolipidemic effect and adverse effect of lovastatin, we studied in 30 NIDDM with mild to moderate elevations of serum cholesterol.

Lovastatin, HMG-CoA reductase inhibitor(20mg once daily in the evening) was given for 12 wks, during which blood glucose concentration remained controlled.

The following results were obtained:

1) Lovastatin reduced totol cholesterol by 26.4%, low-density lipoprotein(LDL) by 26.9%, and triglyceride(TG) by 26.7%.

2) During the study period, one patient complained nausea and vomiting, the other patient complained itching. No abnormalities in serum values were noted.

In conclusion, lovastatin was effective agent in NIDDM with hypercholeste rolemia without siginificant side effect.

General concepts of hepatic drug-metabolizing enzymes in liver microsomes and the characteristics of induction of the enzyme are well known in adult rats. However there are few detailed reports on the properties of the enzymes and characteristics of the induction in the rat fetus. The present investigation examined the effect of maternal consumption of alcohol during pregnancy and lactation on the activities of mixed function oxygenase of liver microsomes of the neonatal rats.

The levels of the electron transfer system, such as cytochrome P-450, NADPH cytochrome C reductase were increased from 2nd week to 3rd week of postnatal age and then decrease on the alcohol treated group.

The activities of 7-ethoxycoumarin-o-deethylase were increased until 3rd week of postnatal age and then decreased on the alcohol treated group compared to control group.

These results suggested that induction of MFO were stimulated by alcohol were disturbed the liver microsomal drug metabolism.

This study analysed the differnees of MMPI responses between male(n=78) and female(n=88) depressive patients who were admitted to Ewha Womans University Hospital and were confirmed with clinical final diagnosis as depressive disorder by DSM-III diagnostic criteria from 1981-1987.

The results were as follows;

1) Generally, male depression group presented higher T score on F. Hs. Mf. Pt. Se and Si scales than female depression group.

2) On special scales A. R. Es and H. there were no significant differnees of raw scores between male and female depression groups.

3) Regarding age factor, male 20yrs group manifested higher T score on Hs. D. Hy Pd scales than another male age groups. It was suggested that 30yrs female group was higher T score on Hs scale than another female age groups.

4) T scores of Mf was moderately high in male depression group and low in female depression group As age increases, male depression group showed the tendency of decreasing and female depression group the tendency of increasing on T scores of Mf.

5) As a result of multivariate cluster analysis of T score of each MMPI scales except major depression group with psychotic feature. it was found that male and female depression group were composed of two subgroups independently. The first male subgroup(n=4l) showed a typical depression profile while the second male subgroup(n=15) presented an atypical profile with moderate psychotic features. T scores of D. Hy and Pt scales were high in the first female subgroup(n=36) and T score of Hy was followed by D scale in the second female subgroup(n=3l).

To evaluate correlation between the amounts of lipid peroxide in skin surface lipid and clinical aspect of lipid-relating cutaneous disorders, such as melasma and acne, skin surface lipid samples were collected by using cup method from the faces of 20 acne women and 20 melasma women, before and 3 months after topical treatment with 2% hydroquinone and 2.5% benzoyl peroxide, respectively. The amounts of total lipids and lipid peroxide in skin surface lipid were measured by spectrophotometer and statistically analyzed by student's t-test.

The results were as follows;

1) Before treatmentin comparison with control group, melasma group showed increase of the amounts of lipid peroxide and the ratio of lipid peroxide to total lipids. But acne group showed significant increase of the ratio of lipid peroxide to total lipids as well as the amounts of total lipids and lipid peroxide.

2) After treatment, in comparison with pretreatment, melasma group showed significant decrease of the amounts of lipid peroxide and the ratio of lipid peroxide to total lipids. And in acne group, the amounts of total lipids and lipid peroxide were also decreased significantly.

The amounts of lipid peroxide in skin surface lipid decreased at the time of improvements of clinical aspects in melasma and acne. This data suggest that clinical aspect of melasma and acne is related to the amounts of lipid peroxide in skin surface lipid.

The author has analyzed 54 cases of chronic subdural hematoma which were diagnosed by brain computerized tomography from March 1985 to February 1991.

There were 49 men and 5 women. The common incidence of age was between fifth and sixth decades. Most of the cases(76%) had a history of head injury and nearly all cases complained headache(87%).

All cases performed brain CT scan, which showed hypodense(37.1%), isodense(29.6%), hyperdense(14.8%) and mixed dense(18.5%) lesion.

Of 54 cases, 34 cases were treated with craniotomy and membranectomy. 20 cases with burr-hole and drainage. There was no difference in results in both methods and most of the cases showed good postoperative course except 2 cases.

It is clinically important to confirm early normal and abnormal pregnancy, of which diagnostic accuracy has been raised recently by the technical advance in the field of sonography and radioimmunoassay of human chorionic gonadotropin.

The author reviewed 123 cases with 5-13 gestational weeks of abdominal and vaginal sonograms which were confirmed as 87 cases of early intrauterine pregnancy. 20 cases of non viable pregnancy and 16 cases of ectopic pregnancy

The results were as follows :

1) Vaginal sonograms showed intrauterine gestational sac in 100% of cases at the 5 gestational weeks, fetal echo in 100% of cases at the 6 gestational weeks, and fetal heart activity in 79% of cases at the 7 gestational weeks, compared with abdominal sonograms showing intrauterine gestational sac in 100% of the case at the 6 gestational weeks, fetal echo in 79% of cases at 7 gestational weeks and fetal heart activity in the 73% of cases at the 8 gestational weeks, so vaginal sonogram confirmed the intrauteine gestational structures 1 weeks earlier than abdominal sonogram.

2) Intrauterine gestational sac was shown in the 100% of cases at the serum level more than 6.000 mlU/ml on the vaginal sonograms compared in the 100% of cases at the serum level more than 8.000 mlU/ml on the abdominal sonograms. Fetal echo was shown in the 100% of cases on the vaginal sonograms. compared in the 50% of cases on the abdominal sonograms at the serum hCG levels of 10,000 mlU/ml. Fetal heart activity as identified in the 80% of cases on the vaginal sonograms. compared in the 28% of cases on the abdominal sonograms at the serum hCG levels between 10,000-60,000 mlU/ml.

3) There was no difference in finding of blighted ovum or missed abortion between abdominal and vaginal sonogrms. but vaginal sonograms showed more detailed abnormal gestational structures than abdominal sonograms.

4) In ectopic pregnancy, vaginal and abdominal sonograms showed absence of intrauterine gestational sac in 100% of cases, fluid collection in cul de sac in 80% of cases and adnexal mass in 81 % of cases respectively. Extrauterine gestational sac were identified in 38% of cases on the vaginal sonograms. compared in 26% of cases on the abdominal sonograms.

With the above findings, intrauterine pregnancy can be confirmed 1 week earlier by vaginal sonogram than abdominal sonograms and we suggest that diagnostic accuracy can be raised by the combined use of abddominal and vaginal sonography compared with single use of abdominal or vaginal sonography in the cases of non-viable or ectopic pregnancy.

Ureteral obstruction is a common and important urologic disorder and may cause a hydronephrosis and result in the deterioration of renal function.

We made a clinical analysis on the cause and management of the 69 cases of the ureteral obstruction of the patients in the Department of Urology. Ewha Womans University Hospital during the period from January 1981 to December 1990.

The following results were obtained;

1) There were 36 cases(52.2%) of male and 33 cases(47.8%) of female and the major range of age distribution was between 30 decade to 50 decade, 45 cases(65.2%).

2) The level of obstruction was the upper ureter in 37 cases(51.4%), the mid in 2 cases(4.2%) and the lower in 32 cases(44.4%). The affected site was the right in 29 cases(40.3%), the left in 43 cases(59.7%) and the bilateral in 3 cases.

3) In etiology, 59 cases were caused by intrinsic factors, among which chronic inflammation of the ureter was the most common in 36 cases, and the extrinsic causative factors were found in 13 cases.

4) The degree of hydronephrosis was severe in 33 cases(45.8%), moderate in 22 cases(30.6%). mild in 6 cases(8.3%). and non-visualization of kidney in 11 cases (15.3%).

5) As the management of ureteral strictures. nephrectomy was done in 14 cases (19.4%). pyeloplasty in 11 cases(15.3%). ureteroneocystostomy in 5 cases (6.9%), segmental resection and end to end anastomosis in 8 cases(11.1%), ureteral dilation and stenting in 19 cases (26.4%) and percutaneous nephrostomy in 6 cases (8.3%).

6) The improvement of hydroncphrosis was observed in-85.7% on excretory urography, 6 months after treament.

The imaging results and medical records of 48 patients with CT appearance suggestive of fatty liver were reviewed, fatty liver often has a distinctive appearance with CT, usually with a nonspherical shape. absence of mass effect, and a density close to water or fat. Significant correlation was found between changes in CT value of the liver and fat accumulation in the liver cells.

The fat infiltrated area of hepatic parenchyma had CT value ranging from -25(HU) to 42(HU) on unenhanced scan. The CT diagnosis of fatty metamorphosis is usually suggested when the CT density of the liver is less than the spleen, because the normal hepatic parenchyma has an attenuation value approximately 9(HU) greater than the spleen.

The sensitivity of CT in demonstrating fat may prove valuable in the detection and monitoring of fatty infiltration on the liver.

Although cholelithiasis is a common biliary disease, it is little known about its prevalence in asymptomatic population samples.

Real-time ultrasonography was done with 2639 subjects for healthy screening at Ewha Womans University Hospital.

The results were as follows:

1) Among 2639 subjects, the asymptomatic cholelithiasis were found in 88 cases(3.3%).

2) The age ranged from 25 to 87 years. The highest incidence was found in 7th(36.3%) and 6th(29.5%) decades. The prevalence of the male was 3.8%, and female 2.8%. The sex ratio was 1:0.76.

3) Among the 88 cases with gallstones, most of them are single in number(51.1%), and small in size(less than 1.0cm. 55.7%).

Ninety five patients with carcinoma of the uterine cervix was treated with definitive radiation therapy at Ewha Womans University Hospital from March 1982 through December 1985. Minimum 3-year follow-up was done.

According to FIGO stage. there were 15 (15.8%), 20 (21.0%), 32 (33.7%), 11 (11.6%), and 17 cases (17.9%) of stages IB, IIA, IIB, IIIA, and IIIB, respectively. A combination of teletherapy by Linear accelerator 6MV and intracavitary radiotherapy with Cs-137 using Fletcher-suit applicator was done in all patients. Radiation doses to point A (paracervical area) and B (obturator node) were 80-90 Gy and 50-60 Gy, respectively in stages I-IIA and somewhat higher in stages IIB-IIIB.

The local control rates were 100, 85.0, 78.1, 63.6, and 58.8% in stages IB, IIA, IIIB, IIIA and IIIB, respectively. The most common failure site was pelvis (65.2%): six patients had locoregional failure with distant metastasis and two had only distant metastasis. Seven patients developed complications four had hematuria, two had rectal bleeding. and one had vesicovaginal fistula. Most of complications were developed between 2 and 3 years after completion of radiotherapy. Three-year survival rates were 100, 82.4, 78.1, 63.6, and 52.9% in stages IB. IIA. IIB. IIIA and IIIB. respectively.

Three new developed enzyme immunoassays(EIA) for urinary pregnancy tests were compared with the three older latex agglutination assays(LATEX) in the urine samples of 138 patients.

The examined kits included EIA (Testpack hCG-Urine. Tandem ICON II hCG Urine, Target hCG) and direct LATEX (Betatex direct, Pregnancy Quick test, Synchron hCG).

The results were as follows:

1) The coincidence rate between EIA and direct LATEX is 91%. The coincidence rate between EIA and radioimmunoassay(RIA) is 100%.

2) The range of the discrepancy between EIA and LATEX is 79mlU/ml to 855mlU/ml.

3) When the EIA is considered to be the standard method. the sensitivity and specificity of Latex are 78% and 100%.

4) The hCG of the urine specimen which were found to be negative by EIA and LATEX is below 50mlU/ml.

5) There is no false positive result in proteinuria(2+) and bloody urine(1+) in the EIA and Latex.

5) There is no false positive result in proteinuria(2+) and bloody urine(1+) in the EIA and Latex.

We conclude EIA is the nost sensitive procedure(lowest detection limits)for qualitatively detecting hCG in urine samples secreted by early pregnancy.

Priapism is the pathologic prolongation of a penile erection most often associated with pain but not with sexual excitement or desire. Recently we experienced one case of priapism accompained by chromic myelocytic leukemia.

For treatment of priapism, cavernososponsiosal shunt, radiotherapy and chemotherapy with hydroxyurea were done.

Graular cell tumor is a rare benign lesion of unknown histogenensis.

A 51-year-old female had a 1.0cm sized, asymptomatic, firm nodule with erythematous, shiny, and smooth surface on her right side of posterior neck for 1 year. Excisional biopsy was done under the impression of epidermal cyst. The histologic specimen showed irregularly arranged dermal nests of large polyhedral cells containing small nuclei and coarsely granular eosinophilic granules within the pale cytoplasm. The granules were PAS-positive and diastase-resistant.

Recurrence was not found until 1 year after excisional treatment.

Chronic tuberculous empyema thoracis was intially treated by anti-tuberculous medication. thoracentesis and closed tube thoracostomy. But when the empyema cavity was not completely closed. another more aggressive and extensive thoracic operations were needed.

Recently the author experienced the 4 kinds of the operations. which included 1) Decortication. 2) Thoracoplasty. 3) Open drainage and 4) Pleuropneumonectomy.

Postoperative courses uneventful in all 4 cases.