An 80-year-old woman was admitted because of ag avation of preexisting dyspnea and was refened to the dermatology deparbnent for evaluation of three tender nodules on her extremitiom. A chest X-ray and CT scan suggested pulrnonaxy tuberculosis wikh an endobromchial sprtad, Her past medical histary showed congeative heart failure, treated pulmonery tuberculosis and corticstertoid medication for arthralgia. Acid-fast bacilli were observed in tissue smears and a biopsy specimen. Mycobacterium tubereulosis was recovered from cultures. We suggest that this case was a tuberculous gumma following pulmonary tuberculosis and that a tissue or pus smear for acid-fast bacilli is a very useful diagnostic toal in tuberculous gumma because tubercle bacilli are copious in numbcr.
Aged, 80 and over ; Arthralgia ; Biopsy ; Dermatology ; Dyspnea ; Female ; Heart Failure ; Humans ; Mycobacterium ; Suppuration ; Thorax ; Tomography, X-Ray Computed ; Tuberculosis ; Tuberculosis, Pulmonary

BACKGROUND: The Wada test is an essential part of the preoperative evaluations in candidates for epilepsy surgery. Impaired reactions (IR) to intracarotid sodium amytal infusions include: confusion, disorientation, and decreased respon-siveness, thereby confounding test results. We retrospectively analyzed the factors affecting the impaired reactions (IR) regarding both individual and methodologic factors. METHODS: Subjects included 202 patients (age;28.5+/-9.48, range:8 to 64 years, M:F=113:89) with intractable epilepsy. Patients with IR (IR group) and those without IR (Non-IR group) were compared with respect to individual factors such as: age, sex, epilepsy syndromes, injected hemispheres, dominan-cy as well as methodologic factors including amobarbital doses. With regards to the dose of amobarbital, the total accu-mulated dose as well as the initial injected dose, were used. RESULTS: IR was observed in 50 patients (24.7%). Compared to the non-IR group, the IR group had more prolonged, contralateral weakness and total test times, but the same duration of EEG changes. IR occurred more frequently with injections into the left hemisphere (p<0.001), the dominant hemi-sphere (p<0.0001), and contralateral hemisphere of epileptic focus (p<0.07). The IR group received significantly higher amounts of amobarbital than the non-IR group (p<0.05). Considering the oversedation as well as the undersedation of amobarbital together, 100mg of amobarbital was the most appropriate dose in the Wada test. CONCLUSIONS: These results suggest that dominant hemisphere injections and usage of higher doses of amobarbital can frequently produce IR in the Wada test. The ideal dose of amobarbital in the Wada test for Korean patients should be 100mg.
Amobarbital ; Electroencephalography ; Epilepsy ; Humans ; Retrospective Studies

No abstract available.
Constriction, Pathologic* ; Dilatation* ; Mitomycin*

BACKGROUND: The purpose of this study was to investigate the correlation between yoga and autonomic nervous system in women with metabolic syndrome. METHODS: A randomized controlled study was performed in participants recruited from a public center for managing chronic diseases located in Gyeong-gi Province. The 39 women participants diagnosed with metabolic syndrome were randomly assigned to the 12-week yoga exercise group (n=22) or the wait-listed control group (n=17). Biochemical laboratory tests and heart rate variability were measured before and after the 12-week program. RESULTS: In post-menopausal women, the low frequency power of frequency domain significantly decreased in the yoga exercise group compared to the control group (P=0.07). On the time domain of heart rate variability and metabolic syndrome components, there were no significant differences between the groups. CONCLUSIONS: Sympathetic activity was decreased in post-menopausal women with metabolic syndrome who practiced yoga. Our results suggest that yoga might be beneficial in improving the autonomic nervous system in post-menopausal women with metabolic syndrome.
Autonomic Nervous System ; Chronic Disease ; Female ; Heart Rate* ; Humans ; Yoga*

In this report we will highlight an interesting 3 year case of a halo nevus on the back of a 13-year-old Korean girl. This was a single halo nevus with a central pinkish mole and a depigmented patch, 20 mm in diameter. The patient underwent an autologous suction blister graft on the lesion. The halo nevus was completely repigmented except for the marginal rim. At a 4 month follow-up, a new whitish halo was observed around the central pinkish mole. At this point the central nevus was excised and examined with a H & E stain and an immunohistochemical stain with an anti-Ig G antibody. After the excision of the central mole, repigmentation was completed and this condition persisted at a 3-year-follow-up.
Adolescent ; Blister* ; Female ; Follow-Up Studies ; Humans ; Nevus ; Nevus, Halo* ; Recurrence* ; Suction* ; Transplants*

No abstract available.
Peptides*

BACKGROUND: Fever is a very common complication that has been related to poor outcomes after aneurysmal subarachnoid hemorrhage (aSAH). The incidence of acalculous cholecystitis is reportedly 0.5%–5% in critically ill patients, and cerebrovascular disease is a risk factor for acute cholecystitis (AC). However, abdominal evaluations are not typically performed for febrile patients who have recently undergone aSAH surgeries. In this study, we discuss our experiences with febrile aSAH patients who were eventually diagnosed with AC. METHODS: We retrospectively reviewed 192 consecutive patients who underwent aSAH from January 2009 to December 2012. We evaluated their characteristics, vital signs, laboratory findings, radiologic images, and pathological data from hospitalization. We defined fever as a body temperature of >38.3℃, according to the Society of Critical Care Medicine guidelines. We categorized the causes of fever and compared them between patients with and without AC. RESULTS: Of the 192 enrolled patients, two had a history of cholecystectomy, and eight (4.2%) were eventually diagnosed with AC. Among them, six patients had undergone laparoscopic cholecystectomy. In their pathological findings, two patients showed findings consistent with coexistent chronic cholecystitis, and two showed necrotic changes to the gall bladder. Patients with AC tended to have higher white blood cell counts, aspartame aminotransferase levels, and C-reactive protein levels than patients with fevers from other causes. Predictors of AC in the aSAH group were diabetes mellitus (odds ratio [OR], 8.758; P = 0.033) and the initial consecutive fasting time (OR, 1.325; P = 0.024). CONCLUSIONS: AC may cause fever in patients with aSAH. When patients with aSAH have a fever, diabetes mellitus and a long fasting time, AC should be suspected. A high degree of suspicion and a thorough abdominal examination of febrile aSAH patients allow for prompt diagnosis and treatment of this condition. Additionally, physicians should attempt to decrease the fasting time in aSAH patients.
Acalculous Cholecystitis ; Aneurysm* ; Aspartame ; Body Temperature ; C-Reactive Protein ; Cerebrovascular Disorders ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Cholecystitis, Acute* ; Critical Care ; Critical Illness ; Diabetes Mellitus ; Diagnosis ; Fasting ; Fever* ; Hospitalization ; Humans ; Incidence ; Intensive Care Units ; Leukocyte Count ; Prognosis ; Retrospective Studies ; Risk Factors ; Subarachnoid Hemorrhage* ; Urinary Bladder ; Vital Signs

BACKGROUND: Hormones influence various normal biological processes in the skin and hairs. OBJECTIVE: This study was undertaken to investigate the presence of estrogen receptors(ER) and progesterone receptors (PR) in the skin and to assess differences in sex and age. METHODS: We examined seven normal volunteers' skin. The mouse monoclonal antibodies against human ER and PR were used to identify the localization of ER and PR in the frozen tissue sections by using a standard two stage indirect immunoperoxidase technique. RESULTS: The granular layer of epidermis and infundibulum of hair follicle in all the samples showed strong positivity of PR. Although each skin section did not contain all skin appendages, most of the samples showed that eccrine gland duct, inner root sheath of hair follicle stained weakly positive of PR. ER was not demonstrate in all samples epidermis. CONCLUSION: PR was presented in the granular layer of epidermis, infundibulum of hair follicle, eccrine gland duct, and inner root sheath of hair follicle. Therefore, we might suspect that the progesterone probably contributes to the keratinization of the skin because these positively staining sites are prior to complete keratinization layers.
Animals ; Antibodies, Monoclonal ; Biological Processes ; Eccrine Glands ; Epidermis* ; Estrogens* ; Hair ; Hair Follicle ; Humans ; Immunoenzyme Techniques ; Mice ; Pituitary Gland ; Progesterone* ; Receptors, Progesterone* ; Skin

OBJECTIVES: Dysfunctional uterine bleeding(DUB) is defined as abnormal bleeding from the uterine endometrium unrelated to anatomic lesions of the uterus, and its incidence is 10-15% among gynecologic diseases. We conducted this study for understanding correlation between clinical aspecets and pathological findings of DUB. Methods: We conducted a retrospective review of 599 women with DUB who underwent endometrial biopsy with special regard to the relation between pathologic findings and presenting symtoms or complaints from Jan. 1988 to Dec. 1997. RESULTS: Age distribution of DUB was mainly 5th decade, mean age was 44.1years, among various bleeding patterns, intermenstrual bleeding was the most common pattern(31.6%) and the next was menorrhagia(25.0%). Histologic findings of endometrium were proliferative phase, 327 cases(54.6%), hyperplasia, 139 cases(23.2%), secretory phase, 74 cases(12.4%) in order of frequency, and there was no difference in distribution of histologic findings among various bleeding patterns. CONCLUSION: Compared to other previoius studies, our study showed more incidence of endometrial hyperplasia, especially at age group of 40 or more. So patients aged more than this age with abnormal uterine bleeding must undergo emdometrial biopsy for pathologic diagnosis. Patients who are diagnosed endometrial hyperplasia must be carefully followed up because there are possibilities of progression to endometrial carcinoma.
Age Distribution ; Biopsy ; Diagnosis ; Endometrial Hyperplasia ; Endometrial Neoplasms ; Endometrium ; Female ; Genital Diseases, Female ; Hemorrhage ; Humans ; Hyperplasia ; Incidence ; Metrorrhagia* ; Retrospective Studies ; Uterine Hemorrhage ; Uterus

No abstract available.
Leukemia, Basophilic, Acute*