Microscopic polyangiitis is a systemic small-vessel vasculitis, which may involve multiple organs, but cardiac involvement is relatively rare. We report a case of microscopic polyangiitis with multiple organ involvement, in which myocardial infarction was the early manifestation of the disease. A 53-year-old man presented with sudden papulovesicular eruptions and swellings on the face, posterior neck, dorsa of both hands and fingers, and with diffuse erythematous patches on the back. He had suffered from renal dysfunction, arthralgia, and hypertension for more than 8 years. He had been admitted to the department of cardiology for acute myocardial infarction and had suffered from recurrent gastrointestinal bleeding, renal failure, acute pancreatitis and sepsis during the admission. Histopathologically, small-vessel leukocytoclastic vasculitis with out granuloma was seen. Direct immunofluorescence showed no immune deposite. A high serum level of P-ANCA was detected by ELISA.
Acute Kidney Injury ; Antibodies, Antineutrophil Cytoplasmic ; Arthralgia ; Cardiology ; Enzyme-Linked Immunosorbent Assay ; Fingers ; Fluorescent Antibody Technique, Direct ; Granuloma ; Hand ; Hemorrhage ; Humans ; Hypertension ; Microscopic Polyangiitis* ; Middle Aged ; Myocardial Infarction* ; Neck ; Pancreatitis ; Sepsis ; Vasculitis

BACKGROUND: In eczematous skin it is expected that altered defense mechanisms are employed against an injury, which mechanisms include alterations in the stratum corneum barrier function and lipid contents. OBJECTIVE: To investigaten aspect of pathophysiology of hand eczema by comparing the water holding capacities and transepidermal water loss(TEWL) after injuries on the skin and by comparing the epidermal lipid contents between hand eczema and normal subjects. METHODS: The water holding capacities were checked by corneometer, and the TEWL were checked after epidermal barrie! destruction with acetone or adhesive tapes. The epidermal lipids were extracted with acetone, ther (1: 1 v/v) mixture solvent and analysed by HP- TLC. RESULTS: The water holdingapacities were decreased in eczema of the palm, but the recoveries of TEWL and the lipid content did not differ between hand eczema and normal subjects. CONCLUSION: The water holding capacities were decreased in the eczematous skin. But there were no significant differencies in the recovery of destructed epidermal barrier and the epidermal lipid contents.
Acetone ; Adhesives ; Defense Mechanisms ; Eczema* ; Hand* ; Skin ; Water

In a jaundiced patient, it is important to ascertain as early as possible whether the bile duct is dilated. Ultrasonography, computed tomography & conventional cholangiography are widely accepted methods of determining the size of the extrahepatic bile ducts. But there is a considerable discrepancy among the size of the bile duct as measured from them. So the author analyzed and compared the respective diameters of the bile ducts in Korean normal adults as measured from cadaver, IV cholangiography, ultrasoud and computed tomography. The materials were 45 cases of cadaver, 38 cases of IV cholangiography, 100 cases of ultrasonography & 55 cases of computed tomography. The results were as follows ; 1. The diameters of the bile ducts were 7.58±2.26mm at CHD & 8.04±2.42mm at CBD from cadaver ; 5.38±1.90mm at CHD & 6.58±2.37mm at CBD from IV cholanglography ; 3.24±1.13mm at CHD & 4.71±1.48mm at CBD from ultrasonography ; and 4.56±1.51mm at CHD & 5.87±1.68mm at CBD from computed tomography. 2. The diameter of the bile duct was greatest in cadaver, and then reduced in IV cholangiography, computed tomography and ultrasonography in this orde.r 3. There were no size discrepancy between the diameter of the common hepatic duct and that of the common bile duct. 4. There were no discrepanry of the diameter of the bile duct by sex.
Adult* ; Bile Ducts* ; Bile Ducts, Extrahepatic ; Bile* ; Cadaver ; Cholangiography ; Common Bile Duct ; Hepatic Duct, Common ; Humans ; Ultrasonography

Multiple primary tumors are defined as cases involving primary malignant tumors of different histologic origins in one person. The absolute number of reported cases of double primary malignant tumors has increased in recent years diagnostic procedures. Primary adenocarcinoma of duodenum is a rare disease and represents less than 0.5% of all gastrointestinal malignancies. Therefore, synchronous multiple primary cancers of the stomach and duodenum are very rare. Recently, we experienced a case of triple primary malignant tumors of different site originating from the stomach, duodenum and cervix in 71- year-old woman. She had had radiation therapy and chemotherapy for squamous cell carcinoma of the uterine cervix 8 years previously. We performed subtotal gastrectomy and pancreaticoduodenectomy with radical lymph node dissection. She remained healthy without any evidence of recurrence 12 months after the operation.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Cervix Uteri ; Drug Therapy ; Duodenal Neoplasms* ; Duodenum ; Female ; Gastrectomy ; Humans ; Lymph Node Excision ; Pancreaticoduodenectomy ; Rare Diseases ; Recurrence ; Stomach ; Stomach Neoplasms* ; Uterine Cervical Neoplasms*

The alert regarding the emergence of novel influenza was issued by the WHO on April 24th, and the government has taken immediate actions to respond to the situation since then. Based on the presumption that a pandemic was imminent, countermeasures for the H1N1 influenza pandemic have been prepared by establishing and implementing effective public health crisis strategies over the past few years. Our main strategy during the pandemic influenza crisis has shifted in accord with the corresponding National Disaster Phases. In the Caution (Containment) Phase, our main goal was to contain the influx of disease from overseas. We focused on measures such as entry screening and quarantine inspection while monitoring travelers arriving from affected countries. In the Alert Phase I, our aim was deceleration and prevention of secondary community outbreaks through enhanced early detection. We intensified our surveillance and response system for possible mass outbreaks. During Alert Phase II, as the influenza had spread widely, our tactics switched to minimizing social and economic impact and preventing severe cases with early administration of antiviral agents, especially among high-risk patients. In the current Severe Phase, we are trying to reduce mortality cases with intensive care. Since we have implemented mass vaccination, we predict an early termination of the pandemic.
Antiviral Agents ; Critical Care ; Containment of Biohazards ; Deceleration ; Disasters ; Disease Outbreaks ; Humans ; Influenza, Human ; Mass Screening ; Mass Vaccination ; Pandemics ; Public Health ; Quarantine ; Vaccination

Primary malignant melanoma arising from the leptomeninges is a rare entity. We report two cases of primary intracranial melanoma developed in one aged 65 years female and the other 70 years male. One case died 2 years after the operation, and the other case is still living more than 1 year after operation. Both cases seems to have a relatively long survival. The literature on this subject is briefly reviewed.
Female ; Humans ; Male ; Melanoma*

No abstract available.
Antibodies, Monoclonal* ; Borrelia burgdorferi* ; Borrelia* ; Lyme Disease*

OBJECTIVES: Stigma of schizophrenic patient has a negative effect on the social adaptation of patients to return to society after proper treatment. This study showed the factors affecting the stigma recognized by schizophrenic patient and utilized them as the basic materials to overcome such stigma effectively. SUBJECTS AND METHOD: Total number of subjects were 318, including 278 patients who receive treatment of schizophrenia in NaJu National Hospital and 40 patients of Chonam University Hospital. The evaluation instrument of the stigma refers to 'Wording of Items in the Stigma Scale' developed by Bruce Link, translated into Korean and revised into 20 items after getting through preliminary study. It was consisted of three subscales including secret, prejudice and devaluation. Authors examined the subjects' demographical characteristics, clinical variables and degree of depression through Beck Depression Inventory. Observed were the correlation between these factors and the degree of stigma to understand the factors affecting the degree of stigma. RESULTS: This study showed that there was a significant differences in the degree of stigma according to occupation, degree of family support felt by patients, frequency of family visits and level of depression. In the degree of stigma according to occupation, students, farmers and the unemployee showed relatively higher stigma than professional technicians, especially in devaluation scale. The degree of family support felt by patients and frequency of family visits were reversely correlated with the degree of stigma. The level of depression was correlated with the degree of stigma. There is no significant difference in the degree of the whole stigma, but there is a significant difference in subscales according to the experiences of participation in disease education and treatment in hospitals. Patients who received no psychoeducation showed high scores in secret scale and patients of NaJu National Hospital had higher prejudice than patients of Chonam University Hospital. Such factors as sex, age, education, marital status, religion, residence, family economic status, frequency of hospitalization, experience of open ward, recent regular treatment and duration of illness did not show significant correlations with the degree of stigma. CONCLUSIONS: It is found that family support, regular occupation and frequent patient visits can be factors decreasing the stigma. Psychoeducation about mental illness is related to the reducing the tendency to hide the disease. In addition, coping with derpession can be helpful to reduce the stigma of patients and effective social adaptation.
Depression ; Education ; Hospitalization ; Humans ; Jeollanam-do ; Marital Status ; Occupations ; Prejudice ; Schizophrenia

Intramuscular lipomas are benign soft-tissue mesenchymal tumors which rarely occur in the region of the head. These tumors present as slow-growing, generally painless masses and are easily misdiagnosed initially as epidermal inclusion cysts. We describe a 44-year-old woman who presented with an intramuscular lipoma of the frontalis muscle.
Adult ; Female ; Head ; Humans ; Lipoma*

BACKGROUND: Heparin salts induce negative proportional bias according to anticoagulant concentration for analysis of ionized calcium (iCa) However, D-phenylalanyl -L-prolyl- L-arginine chloromethyl ketone (PPACK), a selective thrombin inhibitor, do not bind to ionized calcium. Therefore, we evaluated PPACK as an alternative anticoagulant to lithium heparin (Li-Hep) for analysis of ira, blood gases and electrolytes. METHODS: The concentration of iCa in whole blood anticoagulated with heparin was compared with that in serum of patients admitted to Chungbuk National University Hospital (n=27). The blood gases, electrolytes and iCa according to each anticoagulant concentration (Ll-Hep or PFACK) were analyzed. The concentrations of anticoagulated whole blood (Li-Hep; 50 kIU/L, PPACK ; 75 mumol/L) were compared with those of nonanticoagulated whole blood for blood gases, electrolytes and iCa (n=17), RESULTS: The results were as follows; whole blood anticoagulated with Li-Hep demonstrated -0.28+/-0.15 mmol/L (26.6%) bias for ira compared with serum. No bias according to each anticoagulated concentrations were observed in analysis of blood gases, potassium and chloride. Negative proportional bias for iCa and sodium in serum anticoagulated with Li-HeP was observed. In comparison, no bias for ira and sodium was observed with PPACK. No bias was observed in analysis of blood gas or electrolytes with each anticoagulated whole blood except for sodium and chloride that had clinically nonsignificant bias. Whole blood anticoagulated with Li-Hep demonstrated a consistent -0.08+/-0.02 mmol/L (6.3%) bias for ira compared with nonanticoagulated whole blood. In comparison, no bias was observed with PPACK-anticoagulated whole blood for iCa. CONCLUSIONS: We concluded that PPACK is an ideal anticoagulant without bias for analysis of iCa, blood gases and electrolytes.
Arginine ; Bias (Epidemiology) ; Calcium* ; Chungcheongbuk-do ; Electrolytes* ; Gases ; Heparin* ; Humans ; Lithium ; Potassium ; Salts* ; Sodium ; Thrombin