Livedo reticularis is a mottled bluish discoloration of the skin which occurs in a netlike pattern and is not a diagnosis in itself, but is a nonspecific reaction pattern. It may be classified as idiopathic and secondary livedo reticularis. Decompression sickness can occur during decompression after diving into deep sea water or during a rapiid ascent from sea level, and is one of the many causes of the secondary livedo reticularis. We report a case of livedo reticulris which developed in a patient with decompression sickness. A biopsy from the purpuric patch revealed an unusual histopathologic finding that resembles those of bullae and sweat gland necrosis in drug induced coma.
Biopsy ; Coma ; Decompression Sickness* ; Decompression* ; Diagnosis ; Diving ; Humans ; Livedo Reticularis* ; Necrosis ; Seawater ; Skin ; Sweat Glands

We herein report a case of transient acrodermatitis enteropathica in a 3-month-old, breast-fed, full-term infant. The patient was presented with a 2-month history of diarrhea and crusted erythema- tous patches on the periorificial area. Similar lesions were seen in his siblings. His serum zinc level and the zinc level in his mother's breast milk were markedly reduced. Diarrhea and skin lesions disappeared promptly with oral zinc supplementation and did not recur when zinc was discontinued after three weeks. Our case indicates that even full-term infants, who feed excl-usively on mothers milk, run a risk of developing zinc deficiency, if the concentration of zinc in the breast milk is very low.
Acrodermatitis* ; Diarrhea ; Humans ; Infant* ; Milk ; Milk, Human ; Mothers ; Siblings ; Skin ; Zinc

BACKGROUND: Pigmented basal cell carcinoma(PBCC) is a clinical and histological variant of BCC, which is known to show better prognosis than non-PBCC. There has been no report about the PBCC among Korean patients. OBJECTIVE: Our purpose was to identify the clinical and histologic characteristics of PBCC and to determine whether this correlated with prognosis. METHODS: A clinical and histological survey was done with 62 lesions of 56 cases of PBCC that visited the Department of Dermatology, Presbyterian Medical Center during the last 10 years(1988 - 1998). Some results were then compared with results of non-PBCC. RESULTS: 1. The frequency of BCC in the total number of new outpatients was 0.34%, and 83.6% of BCC contained pigment histologically. 2. The male-female ratio was 1.24:1, and 92.9% of the patients with PBCC were older than the age of 40 years with the mean age of 62.9 years. 3. 88.7% of the PBCC occurred on the face, especially on the nose(38.7%), cheek(19.4%), and eyelid(17.7%). Clinically, most of the tumors were noduloulcerative(77.4%) and diffuse pigmentation was more common than dotted. 4. The most frequent histologic types were nodulocystic(43.6%) and mixed(43.6%) type followed by superficial(6.4%), micronodular(1.6%), adenoid (1.6%), infiltrative(1.6%), basosquamous(1.6%) types. Histologically 51.6% of the tumors were associated with ulceration, and 71% of the tumors were associated with infiltration of inflammatory cells. 5. Fontana-Masson stains showed pigment is melanin and it was found in both tumor nests and surrounding dermis in most cases(95.0%). Hypertrophic melanocytes with prominent dendrites were seen in the tumor nodule(77.8%) and in the normal epidermis overlying tumor(22.2%). 6. Margins were examined for evidence of residual tumor in 48 lesions that were excised. In 4 lesions(8.3%) were the margin positive for tumor. This was statistically not significant (p>0.05) compared with 10 excisions of non-PBCC in which 2(20%) showed positive margins. CONCLUSION: High incidence of PBCC is a characteristic feature in Korean patients, and PBCC showed better prognosis than non-PBCC because it is more frequently excised with adequate margins.
Adenoids ; Carcinoma, Basal Cell* ; Coloring Agents ; Dendrites ; Dermatology ; Dermis ; Epidermis ; Humans ; Incidence ; Melanins ; Melanocytes ; Neoplasm, Residual ; Outpatients ; Pigmentation ; Prognosis ; Protestantism ; Ulcer

The purpose of this study was to examine the correlation between self-efficacy and self-care of hemodialysis patients. The subjects consisted of 140 hemodialysis patients who underwent hemodialysis at 2 university hospital. The data were collected by used the self-efficacy tool developed by Kim Ju Hyune(1995) and the self-care tool developed by literature review and indepth open openended questions to 10 patients. Also, the questionnaire in cluded phusiologic data which collected through review of the patients' charts. The statistical analysis was used the SPSS program for frequency, mean, t-test, ANOVA and Pearson correlation. The results were as follows: 1. The mean score for general self-efficacy of hemodialysis patients was 3.103(1-4point) and there were significant differences according to perceived health. The mean score for specific self-efficacy of hemodialysis patients was 3.113 (1-4point) and there were significant differences according to perceived health, side effects and complications which related hemodialysis. 2. The mean score for self-care of hemodialysis patients was 3.822(1-5point) and there were significant differences according to marital status and economic level. 3. The relationship between general self-efficacy and self-care was a positive correlation(P=.000). The relationship between specific self-efficacy and self-care was a positive correlation(P=.000). In conclusion, this study revealed the level of self-efficacy and self-care, and the positive correlation between self-efficacy and self-care on hemodialysis patients. Therefore, intervention is needer to promote self-efficacy for self-care of hemodialysis patients. Considering the vulnerable self-care area same as checking blood pressure and weight, fluid restriction, social adjustment, exercise and rest, further studies should develop self-efficacy promoting programs for self-care of hemodialysis patients.
Blood Pressure ; Humans ; Marital Status ; Surveys and Questionnaires ; Renal Dialysis* ; Self Care* ; Social Adjustment

Mycobacterium marinum is a photochromogenic and slowly growing acid-fast organism classified in Runyon's group I of atypical mycobacteria. Infection with M. marinum occurs when the organism is inoculated usually in association with exposure to contaminated water and the disease is characteristically limited to the skin but deep soft tissue may be involved. We report a case of M. marinum infection in a 43-year-old man with erythematous verrucous plaque on his right knee, which was caused by a shell wound on a beach 3 months ago. The skin biopsy specimen showed pseudoepitheliomatous hyperplasia and several small epithelioid granulomas in the dermis. Culture of the tissue specimen revealed slowly growing whitish colonies in the dark, which changed yellowish after exposure to light. The microorganism was identified as M. marinum by biochemical tests, and was confirmed by the DNA-DNA hybridization method. The skin lesion disappeared after 3 moaths of treatment with minocycline, 200mg daily.
Adult ; Biopsy ; Dermis ; Granuloma ; Humans ; Hyperplasia ; Knee ; Minocycline ; Mycobacterium marinum* ; Mycobacterium* ; Nontuberculous Mycobacteria ; Skin ; Wounds and Injuries

PURPOSE: This cross-sectional survey was undertaken to examine the differences of BSE (breast-self examination) performance and health beliefs between Korean and Korean-American women and to identify which factors influence the BSE based on the HBM variables. METHOD: The study subjects were recruited from both Korea(189 women) and Cleveland in Ohio, USA(146 women). The HBM variables were measured using a reliable and valid Health Belief Model Scale. The subjects were also asked whether or not they did a BSE in the last year. RESULT: The Korean-American women who performed the BSE was statistically higher than that of Korean women. Regarding to the BSE-related health belief, the scores of benefits, confidence, and health motivation was significantly higher in Korean-American. After controlling for living places, age, education, and job, barriers and confidence variables significantly explained the BSE performance of Korean and Korean-American women. CONCLUSION: There was a differences in BSE-related health belief and performance between Korean and Korean-American women. Among health belief variables, barriers and confidence were core variables predicting the BSE performance of Korean and Korean-American women together.
Adult ; Aged ; Asian Americans/*psychology ; Attitude to Health/*ethnology ; Breast Neoplasms/*psychology ; Breast Self-Examination/*psychology ; Female ; Humans ; Korea/ethnology ; Middle Aged

Many factors have been identified which to affect the rate of propagation of impulses along motor fibers. These include temperature changes around the nerve, diameter of the axon, degree of myelinization, age of infants, and local environment of the nerve. Motor nerve conduction velocity and Hoffman's reflex latency have been used to assess the degree of myelination and maturation of the nervous system. The conduction velocities in infants of a short gestational age are significantly lower than those of the fullterm infants. The extrauterine myelination and maturation might increase nerve conduction velocity. We measure the median motor nerve conduction velocity, compound muscle action potentials amplitude and H-reflex latency of premature infants to determine the neurological maturation after birth. The premature infants with gestational age above 37 weeks have a significantly higher conduction velocity and a shorter H-reflex latency than those of gestational age below 37 weeks. The premature infants with weight over 2.5 kg have a significantly higher conduction velocity, larger compound muscle action potentials amplitude and a shorter H-reflex latency than those of weight below 2.5 kg. And there is a statistically significant negative correlation of the H-reflex latency with the postmenstrual age. The determination of motor nerve conduction velocities and H-reflex latencies seem to be an additional method in assessing the degree of maturity in infants after birth.
Action Potentials ; Axons ; Gestational Age ; H-Reflex* ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Median Nerve ; Myelin Sheath ; Nervous System ; Neural Conduction* ; Parturition ; Reflex, Abnormal

Uterine anomalies have been reported in 4% of women with infertility and in up to 15% of those with recurrent abortion. One of the major intrauterine disorder associated with infertility and recurrent abortions is intrauterine septum, The reproductive outcome of 41 patients of intrauterine septum (7 complete, 34 incomplete) with repeated abortions or infertility was assessed after the uterine septotomy. 5 of 7 patients with comlete uterine septum undergone uterine septotomy (3; hysteroscopic metroplasty, 2; abdominal metroplasty) had total 6 pregnancies and all of them had live biths. 28 patients with incomplete uterine septum got the hysteroscopic intrauterine septotomy and the viable pregnancy rate was 62% (3 ongoing pregnancies, 13 live biths of total 26 pregnancies). 6 patients with incomplete uterine septum had not the operation and 5 patients had 5 live births after total 6 pregnancies with 1 spontaneus abortion. Even though, the number of cases were small, the live birth rate in the group of septotomy of the patients of complete uterine septum (100%, 6/6) was higher than that in the group of not-done (50%, 1/2). The live birth rate in the group of not-done of the patients with incomplete uterine septum (83%, 5/6) was higher than that in the group of hysteroscopic uterine septotomy (62%, 16/26), but 5 of 6 had short uterine septal length (<1 cm), 1 had 1.5 cm septal length in the group of not-done. All the patients with successful pregnancy outcome had no other co-factors at the diagnostic laparoscopy, but the 5 primary infertility patients with no live birth even after treatment (all were with incomplete septum; 3 undergone hysteroscopic septotomy, 2 not-done with one abortion) had other co-factors such as endometriosis, peritoneal or tubal facor. In conclusion, hysteroscopic uterine septotomy would be useful for the patients with habitutal abortion or infertility and more advanced managemnet protocols should be applied to the patients having other co-factors if there was no pregnancy even after the uterine septotomy.
Abortion, Habitual* ; Endometriosis ; Female ; Humans ; Hysteroscopy* ; Infertility* ; Laparoscopy ; Live Birth ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate

OBJECTIVE: Ovarian hyperstimulation syndrome (OHSS) is one of the well known complication of conttolled ovarian hyperstimulation. Though there have been numerous protocols for the prevention of OHSS, it has not been completely preventable until now. This study was performed to identify clinical predictors for early and late OHSS. METHODS: A retrospective analysis of all IVF cycles in 1993 up to June 1996 was performed. OHSS was diagnosed using the criteria of Rabau modified by Schenker. All cases of OHSS reported in this study presented with marked ovarian enlargement, ascites, oliguria, hemoconcentration and electrolyte disturbance. Ovarian stimulation was carried out using a combination of gonadotrophin releasing hormone-agonist, follicle-stimulation hormone and human menopausal gonadotrophin. 27 patients has moderate or severe OHSS presenting 3-7 days post-human chorionic gonadotrophin (hCG), and 21 patients had severe OHSS presenting 12-17 days post-hCG. RESULTS: No patient with early OHSS went onto develop late OHSS, and no patient with late OHSS had demonstrated early OHSS. Logistic regression showed that early OHSS was predicted by the number of oocytes retrieved and the estradiol concentration on the day hCG injection (P<0.05). Late OHSS was predicted by the transferred embryos, B-hCG on 14 day after hCG injection (P<0.05). CONCLUSION: Early OHSS was an acute effect of the hCG administered prior to egg retrieval in women with high estradiol and large number of retrieved oocytes. Our analysis of the risk factors for early OHSS indicates that cryopreservation of all embryos will not alter the risk of early OHSS even though it should prevent late OHSS. Late OHSS was induced by the rising serum concentration of hCG produced by the early pregnancy, the number of transferred embryos must be adjusted carefully, since it was associated with multiple gestation.
Ascites ; Chorion ; Cryopreservation ; Embryonic Structures ; Estradiol ; Female ; Humans ; Logistic Models ; Oliguria ; Oocytes ; Ovarian Hyperstimulation Syndrome ; Ovulation Induction ; Ovum ; Pregnancy ; Retrospective Studies ; Risk Factors

BACKGROUND: In post-menopausal women, osteoporosis and cardiovascular diseases which are partly due to estrogen deficiency, occur more common than in pre-menopause women. Estrogen action is supposed to be mediated by an estrogen receptor (ER) and two polymorphisms of the ER gene in particular, Pvu II and Xba I, have been described for several years for genetic association studies. Authors have investigated the frequencies and patterns of the ER gene polymorphisms and their association with bone markers and lipid levels. METHODS: For 121 women who visited the health promotion center of Kyungpook National University Hospital, the ER gene polymorphisms were determined by the Pvu II and Xba I restriction enzymes following polymerase chain reaction. RESULTS: The distributions of ER Pvu II and Xba I restriction fragment length polymorphisms were as follows: PP 15.7%, Pp 47.9%, pp 36.4% and XX 5.8%, Xx 31.4%, xx 62.8%, respectively. And in a combination of two polymorphisms, ppxx was the most common, followed by PpXx, Ppxx, PPXx, PPXX and PPxx in that order. No significant genotypic differences were found in bone mineral density, bone markers and menopausal status. LDL cholesterol and triglyceride levels were significantly different by genotypes in premenopausal women (P<0.05). CONCLUSIONS: The results suggest that ER polymorphisms might be associated with LDL cholesterol and triglyceride levels. Further evaluation in a larger population would be helpful to determine the effects of ER polymorphisms on lipid metabolism and therapeutic trial for cardiovascular diseases in women.
Bone Density ; Cardiovascular Diseases ; Cholesterol, LDL ; Estrogens* ; Female ; Genetic Association Studies ; Genotype ; Gyeongsangbuk-do ; Health Promotion ; Humans ; Lipid Metabolism ; Osteoporosis ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Premenopause ; Triglycerides