Papular mucinosis, or lichen myxedematosus, is a rare cutaneous disease characterized by papular-lichenoid eruptions, mucin deposition, paraproteinemia, no abnormalities of thyroid function and IgG or IgM deposition in the reticular dermis or just below the epidermis in about 35% cases on direct immunofluorescence study. We report a case of papular mucinosis in a 48-year-old male, who noticed the skin colored or yellowish waxy papules on his upper arm 1 year ago. Since then, similar lesions developed on his upper extremities, upper trunk, and neck during last year. Histopathological findings of the lichenoid papules showed that the collagen fibers in the upper dermis are loosly arranged and separated by amorphous materials. These amorphous materials were positve with colloidal iron stain. Serum protein electrophoresis showed no abnormal bands and an abnormal paraprotein was not detected. Direct immunofluorescenc study of a skin biopsy specimen showed a granular IgM deposit in the papillary dermis. This is the sixth case of papular mucinosis reported in Korea, but is the first case showing IgM deposit in the skin by immunofluorescence study.
Arm ; Biopsy ; Collagen ; Colloids ; Dermis ; Electrophoresis ; Epidermis ; Fluorescent Antibody Technique ; Fluorescent Antibody Technique, Direct ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Iron ; Korea ; Male ; Middle Aged ; Mucins ; Neck ; Paraproteinemias ; Scleromyxedema* ; Skin ; Thyroid Gland ; Upper Extremity

BACKGROUND: The effectiveness of some therapeutic modalities for cutaneous sporotrichosis may be changed depending on the individual and geographic characteristics, and the clinical type. Itraconazole has been known to be effective for it, however, there have been no standard and ideal guideline on the oral dosage and duration yet. OBJECTIVE & METHODS: In this study, we evaluated the effectiveness of oral itraconazole in patients with cutaneous sporotrichosis in relation to dosage and clinical status. The observation of 17 patients with sporotrichosis were made retrospectively Oral itraconazole was administered at the dose of 200 mg daily in 15 adults over 18 years old and 100 mg in the other 2 children. RESULTS: The duration for healing was within 30 days in 4 cases, within 60 days in 4 cases, within 90 days in 2 cases, within 120 days in 3 cases, and within 150 days of therapy in 2 cases. The average duration in all cases was 12.1+/-8.6 weeks. Comparison our results to the previous reported one revealed that more shorter treatment time was needed in cases treated with 200 mg daily than that with 100 mg. There was no treatment failure by drug intolerance or resistance. The duration for healing was significantly shorter in the patient groups with prevalence duration more than 5 months, however there was not any significant difference in sex of patients, and the clinical types. The cases with the lesion on the face and cases with fixed type tended to be healed more rapidly than the others. CONCLUSION: Oral itraconazole may be a safe and e(fictive antifungal agent for the treatment of cutaneous sporotrichosis in a daily dose of 200 mg for 3 months on the average. However, duration for healing could be influenced by the clinical status.
Adolescent ; Adult ; Child ; Humans ; Itraconazole* ; Prevalence ; Retrospective Studies ; Sporotrichosis* ; Treatment Failure

PURPOSE: To evaluate the usefulness of whole body bone mineral densitometry in the diagnosis of frequent osteopenia of preterm infants by comparison with the wrist radiographs and biochemical parameters. MATERIALS AND METHODS: From January 1995 to January 1996, we obtained whole body bone mineral density(BMD) studies using dual energy X-ray absorptiometry(DXA) and wrist radiographs of 39 preterm infants. They were divided into three groups according to birth weight, under 1500g, 1501g to 2000g and above 2000g, and four grades of skeletal change, as seen on wrist radiography, according to the scoring method of Koo et al. Groups of birth weight and grades of skeletal change were then correlated with whole body BMD and biochemical parameters. For comparison, normal data were obtained from 13 infants born at full term. Data were analyzed by one way analysis of variation(ANOVA) and correlation and regression analysis. A p-value of less than 0.05 was considered significant. RESUTLS: Whole body BMDs were significantly lower in the more premature and smaller birth weight infants(r=0.77, p=0.0000), and in the higher grade of skeletal change (r=-0.5276, p=0.0000). Aggravated skeletal changes were found in infants with lower birth weight(r=-0.3822, p=0.01). Interobserver variation in grading skeletal change was 42.9%, and intraobserver variation was 18.4%. Biochemical parameters such as serum calcium, phosphate, alkaline phosphatase, parathromone, calcitonin and 25-hydroxy-vitamine D did not vary significantly according to either birth weight or skeletal change (p>0.05). CONCLUSION: Premature osteopenia is more effectively diagnosed by measuring whole body BMD using DXA than by grading radiographical skeletal change or by biochemical parameters.
Alkaline Phosphatase ; Birth Weight ; Bone Diseases, Metabolic* ; Calcitonin ; Calcium ; Densitometry* ; Diagnosis ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Observer Variation ; Parturition ; Radiography* ; Research Design ; Rickets ; Wrist*

PURPOSE: To evaluate the blood flow patterns and the velocities of the carotid arteries in healthy Korean adults. MATERIALS AND METHODS: We evaluated the blood flow patterns and measured the peak systolic and end-diastolic velocities of the common, internal and external carotid arteries in 48 healthy adults who did not have cardiovascular disorders and neck lesions. The velocity difference was analyzed according to different age groups. In addition, peak systolic and end-diastolic velocity ratio of the internal to common carotid artery was estimated, and our data were compared with values reported by other authors. RESULTS: Generally, the velocity in the younger age group tends be to higher than in older group. The peak systolic and end diastolic velocities of the internal carotid artery were 84.5cm/sec and 30.5cm/sec. The peak systolic and end diastolic velocity ratio of the internal to common carotid artery were 0.715 and 0.966. The internal carotid artery was less resistant in blood flow than the external carotid artery. Our data were lower than the values which were reported by Bluth et al. CONCLUSION: The blood flow velocities of the internal carotid artery in healthy adults were lower than those of previously reported foreign values, but the patterns were similar.
Adult* ; Blood Flow Velocity ; Carotid Arteries* ; Carotid Artery, Common ; Carotid Artery, External ; Carotid Artery, Internal ; Humans ; Neck

IgA nephropathy is the most common form of glomerulonephritis characterized by deposit of IgA on mesangium. We experienced an elderly patient who was admitted for generalized edema, and diagnosed IgA nephropathy and early gastric cancer concomittantly. It has been reported that the incidence of nephrotic syndrome combined with malignancy increases with aging. Moreover, close relationship between IgA nephropathy and malignancy has been reported especially in the elderly patient. So, active investigations for possible malignancy are required in case of elderly patient with IgA nephropathy. In this case, we found improved proteinuria and hematuria of the patient after tumor resection during following up. This case suggest causal association between early gastric cancer and IgA nephropathy clinically.
Aged* ; Aging ; Delirium ; Depression ; Edema ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoglobulin A* ; Incidence ; Nephrotic Syndrome ; Proteinuria ; Stomach Neoplasms*

OBJECTIVE: We used nucleated erythrocytes in maternal blood for prenatal determination of the fetal gender as the preliminary experiment for the screening of fetal genetic status and the BclI DNA polymorphism in an attempt to clarify the origin of erythrocytes in maternal blood. METHODS: In seventeen pregnant women, venous blood was withdrawn and the nucleated erythrocytes were recovered by magnetic activated cell sorting (MACS) and immunostaining. After isolation of nucleated erythrocytes by micromanipulation, we performed nested PCR for amelogenin gene to identify the fetal gender and performed BclI DNA polymorphism to clarify the origin of erythrocytes. RESULTS: We could amplify the minute DNA in a single cell by primer extension preamplification and nested PCR of amelogenin gene in 94 (48.7%) cells and could identify the fetal gender by 58.8%. BclI DNA polymorphism revealed that the several cells, which did not reveal the specific band of Y chromosome in spite of the pregnancy of male fetuses, must be the cells from mother. CONCLUSION: Through this study, we could conclude that several nucleated erythrocytes in maternal blood circulation can originate from mother, therefore we must develop the new method to identify the nucleated erythrocyte of fetal origin. Considering that we must apply for the larger number of pregnant women to screen, the procedure was multi-step and complex. Therefore, we must design the new scheme to utilize the nucleated erythrocytes in maternal blood.
Amelogenin ; Blood Circulation ; DNA ; Erythroblasts ; Erythrocytes ; Female ; Fetus ; Humans ; Male ; Mass Screening ; Micromanipulation ; Mothers ; Polymerase Chain Reaction ; Pregnancy ; Pregnant Women ; Y Chromosome

PURPOSE: This study was done to explore the essence and meaning of the experience of 'aging,' as a process of 40's and 50's women in Korea by applying the Parse's Human Becoming theory (2002). METHODS: Data was collected from February to April, 2013, using the phenomenological research method. Data was collected through in-depth informal interview and analyzed following Colaizzi method. After IRB permission and informed consent from the participants, all interviews were recorded with MP3 recorder and transcribed for analysis. RESULTS: Data analysis revealed 112 of meanings, 33 key subject words, 8 subject phrases, and 4 categories. The main themes were elaborated as 'going down' ('Being changed of body and mind', 'Being considered on my identity'), 'going up' ('Being expanded of productive role', 'Being transcendent multi-dimensionally'), 'pausing' ('Becoming more thoughtful about family', 'Looking back'), 'going forward again' ('Age is just a number, 'Contemplating of life and death'). Experiences in aging among women in 40's and 50's enlightened with Parse's theory of Human Becoming in terms of 'going down', 'going up', 'pausing', 'going forward again' appeared simultaneously, rather than consecutively. CONCLUSION: Women in 40's and 50's require holistic nursing intervention with physical, psychological, socio-economical, and spiritual aspects, rather than focusing on problematic physical symptom relief and prevention of further conditions. It is recommended to develop various nursing intervention considering on different environment, type of experience, and level of human becoming, individually.
Aging* ; Ethics Committees, Research ; Female ; Holistic Nursing ; Humans ; Informed Consent ; Korea ; Nursing ; Qualitative Research ; Statistics as Topic

BACKGROUNDS: As Korea has advanced into the aging society, Acute Coronary Syndrome is increased in number, especially elderly age group. The symptoms of acutecoronary syndrome in eldery were presented in atypical feature frequently. We studied the relation of the first symptom and diagnosis of acutecoronary syndrome and distribution of risk factor and coronary angiographic finding in elderly patient of korea society. METHODS: The subjects who were under went coronary angiography between 2002.5 and 2003.8 were dividedunder 65 years old group and over 65 years old group. And each group described diagnosis, risk factor, first symptom and coronary angiographic finding retrospectively. RESULTS: The diagnosis of unstable angina are more higher(46.5% vs. 26.1%, p<0.01) in the over 65 years old group and the first significant symptom of typical chest pain was more higher(57.4% vs. 47.6%, p<0.01) in the under 65 years old group and dyspnea was more higher(22.8% vs. 9.2%, p<0.01) in the over 65 years old group. The number of abnormal vessel were more higher(66.3% vs. 46.9%, p<0.01) in the over 65 years old group. CONCLUSION: Over 65 years old group compared with younger age group were prewented more frequently angina equivalent symptom than typical chest pain. And at the diagnosis of Acute Coronary Syndrome, over 65 years old group showed more severe coronary angiographic finding. Consequently, early stage of diagnostic approach and treatment need scrupulous attention in the elderly patients.
Acute Coronary Syndrome* ; Aged* ; Aging ; Angina, Unstable ; Chest Pain ; Coronary Angiography ; Diagnosis* ; Dyspnea ; Humans ; Korea* ; Retrospective Studies ; Risk Factors

BACKGROUND: Metabolic syndrome, a concurrence of disturbed glucose and insulin metabolism, over- weight and abdominal fat distribution, dyslipidemia and hypertension, is associated with subsequent de- velopment of type 2 diabetes mellitus and cardiovascular disease, especially coronary heart disease. The aim of the study is to assess the relationship between metabolic syndrome and coronary heart disease in elderly greater than 65 years old. METHODS: Eighty two elderly patients greater than 65 years old who underwent coronary angiography were divided into two groups with metabolic syndrome or without metabolic syndrome, and assessed the association with coronary angiographic finding. The metabolic syndrome factors and cardiovascular risk factors of JNC 7 were investigated to assess the relationship with coronary heart disease in elderly. Coronary heart disease was defined as 50% or greater diameter in stenosis of coronary artery in coronary angiography. RESULTS: In elderly patients with metabolic syndrome, coronary angiographically abnormal findings(p<0.05) and multi vessel disease findings(p<0.05) were presented significantly higher than non metabolic syndrome patients. In elderly patients with 3 and more cardiovascular risk factors of JNC 7, coronary angiographically abnormal findings(p<0.05) and multi vessel disease findings(p=0.059) were presented more than the other patients. Diabetes mellitus was related significantly with coronary heart disease(p value 0.044). CONCLUSION: In elderly patients, metabolic syndrome was significantly related with coronary heart disease and diabetes mellitus had strong relationship with coronary heart disease. Metabolic syndrome and cardiovascular risk factors of JNC 7 should be further evaluated to assess the relationship with coronary heart disease in the future.
Abdominal Fat ; Aged* ; Cardiovascular Diseases ; Constriction, Pathologic ; Coronary Angiography ; Coronary Disease* ; Coronary Vessels ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Dyslipidemias ; Glucose ; Heart ; Humans ; Hypertension ; Insulin ; Metabolism ; Risk Factors

BACKGROUND: Mediastinoscopy is generally performed to confirm mediastinal lymph node metastasis in lung cancer patients. It still remains controversial whether mediastinoscopy should be performed in all patients with resectable non-small cell lung cancer (NSCLC). We studied the clinical value of mediastinoscopy in preoperative staging in NSCLC. MATERIAL AND METHOD: We retrospectively studied 90 NSCLC patients who underwent radiological evaluation and mediastinoscopy followed by surgical resection from March 2002 to December 2004. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of each evaluation method were assessed and compared. RESULT: Specificity, PPV, NPV, and accuracy of mediastinoscopy were superior to those of radiological evaluation, but there was no significant difference in sensitivity. The sensitivity of mediastinoscopy was 28.6% in 62 patients with radiological N0/1 disease and 72.7% in 28 patients with radiological N2/3 disease. Seven of eight patients in whom positive nodes were not detected by the mediastinoscopy had subcarinal lymph node metastasis. CONCLUSION: Considering its invasiveness, the difficulty to reach certain node stations, and its low sensitivity in radiological N0/1 disease, mediastinoscopy should be selectively performed in radiological N2/3 disease rather than in all radiological cancer stages.
Carcinoma, Non-Small-Cell Lung* ; Humans ; Lung Neoplasms ; Lymph Nodes ; Mediastinoscopy* ; Neoplasm Metastasis ; Retrospective Studies ; Sensitivity and Specificity