No abstract available.
Lipomatosis* ; Neoplasm Metastasis* ; Small Cell Lung Carcinoma*

OBJECTIVES: To investigate the role of ATP-sensitive potassium channel (KATP) during sustained ventricular fibrillation (VF), the effects of gliburide, a specific blocker of KATP channel and PCO400, an KATP opener, were studied in isolated and perfused swine right ventricular free walls (n=). METHODS: Recording of single cell transmembrane potentials was performed and constructed action potential duration restitution (APDR) curve by plotting APD 90%(APD90) versus preceding diastolic interval (DI). RESULTS: All isolated tissues fibrillated spontaneously. In this preparation, stable VF could persist over a 4-hour period if it was allowed to continue undisturbed (n=). Gliburide (1-5 uM) increased DI without significant changes in APD90 during VF, resulting in more regularization of VF. Higher concentration (10-20 uM) increased both APD90 and DI, and converted to monomorphic ventricular tachycardia (MVT) through the transitional period characterized by APD alternans. PCO400 (1-2.5 uM) caused a significant shortening of APD during MVT and a period of APD alternans became more evident before conversion from MVT to VF. Gliburide eliminated profibrillatory effect of PCO400. This antifibrillatory action of gliburide was accompanied by gradual decrease in the maximum slope of APDR curve during VF. CONCLUSION: KATP channel blockade causes a transition from VF to MVT via lengthening of DI and APD alternans, concomitantly with a reduction of the slope of APD restitution curve.
Action Potentials ; Membrane Potentials ; Potassium Channels ; Swine ; Tachycardia, Ventricular ; Ventricular Fibrillation*

No abstract available.
Histiocytosis ; Histiocytosis, Non-Langerhans-Cell ; Stomach* ; Xanthomatosis*

Primary cutaneous anaplastic large cell lymphoma (PCALCL) is a rare cutaneous T-cell lymphoma. Most cases are composed of large anaplastic cells. However, it presents a wide spectrum of histologic patterns. In the small cell variant, a small-sized pleomorphic cell morphology can be seen. A 74-year-old woman presented with an 8-month history of asymptomatic ulcerative plaque and satellite nodule on the right calf. Her past medical history was not specific. The histologic findings on punch biopsy specimens showed a malignant small round cell tumor on both lesions. The tumor cells had large pleomorphic nuclei with multinucleation and some eosinophilic cytoplasm. We performed immunohistochemical staining to rule out neuroectodermal tumor, neuroendocrine tumor, melanoma, lymphoma, and so on. However, the staining results were negative for pancytokeratin, CD3, CD20, CD99, chromogranin A, synaptophysin, CD56, ALK, HMB45, desmin, kappa, lambda, myoglobin, and S-100 protein. CT, MRI, and PET-CT were negative for extracutaneous involvement. Total excision was done, and additional immunohistochemical staining was performed to confirm the origin of the tumor. Staining results for vimentin, LCA, CD4, and CD30 were positive. We concluded that these findings were consistent with the small cell variant CD30+ PCALCL, which occurs rarely.
Aged ; Biopsy ; Chromogranin A ; Cytoplasm ; Desmin ; Eosinophils ; Female ; Humans ; Lymphoma ; Lymphoma, Large-Cell, Anaplastic* ; Lymphoma, Primary Cutaneous Anaplastic Large Cell ; Lymphoma, T-Cell, Cutaneous ; Magnetic Resonance Imaging ; Melanoma ; Myoglobin ; Neuroectodermal Tumors ; Neuroendocrine Tumors ; S100 Proteins ; Synaptophysin ; Ulcer ; Vimentin

Primary cutaneous anaplastic large cell lymphoma (PCALCL) is a rare cutaneous T-cell lymphoma. Most cases are composed of large anaplastic cells. However, it presents a wide spectrum of histologic patterns. In the small cell variant, a small-sized pleomorphic cell morphology can be seen. A 74-year-old woman presented with an 8-month history of asymptomatic ulcerative plaque and satellite nodule on the right calf. Her past medical history was not specific. The histologic findings on punch biopsy specimens showed a malignant small round cell tumor on both lesions. The tumor cells had large pleomorphic nuclei with multinucleation and some eosinophilic cytoplasm. We performed immunohistochemical staining to rule out neuroectodermal tumor, neuroendocrine tumor, melanoma, lymphoma, and so on. However, the staining results were negative for pancytokeratin, CD3, CD20, CD99, chromogranin A, synaptophysin, CD56, ALK, HMB45, desmin, kappa, lambda, myoglobin, and S-100 protein. CT, MRI, and PET-CT were negative for extracutaneous involvement. Total excision was done, and additional immunohistochemical staining was performed to confirm the origin of the tumor. Staining results for vimentin, LCA, CD4, and CD30 were positive. We concluded that these findings were consistent with the small cell variant CD30+ PCALCL, which occurs rarely.
Aged ; Biopsy ; Chromogranin A ; Cytoplasm ; Desmin ; Eosinophils ; Female ; Humans ; Lymphoma ; Lymphoma, Large-Cell, Anaplastic* ; Lymphoma, Primary Cutaneous Anaplastic Large Cell ; Lymphoma, T-Cell, Cutaneous ; Magnetic Resonance Imaging ; Melanoma ; Myoglobin ; Neuroectodermal Tumors ; Neuroendocrine Tumors ; S100 Proteins ; Synaptophysin ; Ulcer ; Vimentin

Pneumococcus is the most frequently encountered causative pathogen in community-acquired pneumonia in elderly patients. The pneumococcal polysaccharide vaccine (PPV23) is widely used for preventing pneumococcal diseases in adults. PPV23 is relatively safe; however, some cutaneous adverse reactions, including localized mild inflammation associated with erythema, a sensation of heat, and tenderness, have been reported. Systemic reactions such as myalgia, arthralgia, and headache have also been reported, though severe adverse reactions are rare. In the Korean literature, a case of localized toxic reaction near the injection site after pneumococcal conjugate vaccine (PCV13) administration was previously reported. However, there are no published reports of a generalized skin rash after PPV23. Herein, we report a case of PPV23-induced generalized skin rash on the face, neck, upper trunk, and both arms with a local adverse reaction at the injection site after vaccination.
Adult ; Aged ; Arm ; Arthralgia ; Drug Eruptions ; Erythema ; Exanthema ; Headache ; Hot Temperature ; Humans ; Inflammation ; Myalgia ; Neck ; Pneumococcal Vaccines ; Pneumonia ; Sensation ; Skin* ; Streptococcus pneumoniae ; Vaccination*

PURPOSE: To survey the current overall quality of mammograms and to improve Korean standards in comparison to the American College of Radiology (ACR) standards for clinical image evaluations. MATERIALS AND METHODS: A total of 104 mammograms, collected from 63 hospitals and clinics, were examined following the revised new Korean standards and ACR standards for clinical image evaluation. The pass and failure rates of the mammogram were evaluated according to each of the standards compared. The pass threshold for the Korean standards was analyzed using the ROC (receiver operating characteristic) curve in association with the ACR standards. The categories of the Korean standards were evaluated in association with failure of the ACR standards. RESULTS: Among the 104 mammograms, 99.0% passed the Korean standards, whereas 86.5% passed the ACR standards. A score of 75.5 was the pass threshold for the Korean standards. Moreover, the Korean standards categories associated with the failure of ACR standards included positioning, compression, and contrast/exposure (p < 0.05). CONCLUSION: The pass rate of the image evaluation for each mammogram following the Korean standards was 99%, compared to 86.5% for the ACR standards. Hence, the Korean standards were not as stringent. Consequently, stricter regulations are suggested for improvement in the quality of mammograms.
Accreditation ; Breast ; Mammography ; Quality Assurance, Health Care ; Social Control, Formal

BACKGROUND: Kidney transplant recipients inevitably take a life-long immunosuppressive medication to prevent graft rejection. Non-compliance to immunosuppressive medication is one of the main causes leading to acute and chronic rejection and diminished renal function, resulting in a return to dialysis, increased morbidity, or mortality with an additional health care cost and poor quality of life. The purpose of this study was to investigate actual medication compliance and its related factors. METHODS: A total of 222 functioning kidney transplant recipients were surveyed in a single center, and 25 patients were excluded due to incomplete responses. We reviewed medical records retrospectively, and the data were statistically analyzed with SPSS version 13.0. RESULTS: Among 197 patients, 113 (57.4%) were compliant to the immunosuppressive agents, and 84 (42.6%) recipients were non-compliant. Non-compliant patients were significantly younger (P=0.004), highly educated (P=0.004), employed (P=0.005), more likely to live alone (P=0.035), and drank more (P=0.001) than the compliant patients. Regarding psychosocial factors, more barriers (P=0.015), weak beliefs about the necessity of taking medications (P=0.001), strong beliefs about specific concerns related to medications (P=0.038), and low self efficacy (P=0.003) were identified in the non-compliant group compared with the compliant group. CONCLUSIONS: This study revealed that multiple factors affected medication compliance in patients taking immunosuppressants. It would be helpful to identify potential recipients with a risk for non-compliance based on their general characteristics and psychosocial factors, so they can be provided a specialized education program to promote compliance. This strategy may help produce more favorable long-term outcomes among kidney transplant recipients.
Compliance ; Dialysis ; Graft Rejection ; Health Care Costs ; Humans ; Immunosuppressive Agents ; Kidney ; Kidney Transplantation ; Medical Records ; Medication Adherence ; Quality of Life ; Rejection (Psychology) ; Retrospective Studies ; Self Efficacy

BACKGROUND: Nevus of Ota (NO) is a relatively common pigmentary disorder in Asians. Tanino's classification is an old but tacit consensus to delineate the disease. Various treatment options have been presented. However, a few studies have been conducted on available laser options and current treatment strategies or the classification of NO. OBJECTIVE: To investigate current laser options and their effectiveness for the treatment of NO, contributing factors to clinical outcomes, and verification of classification. METHODS: A retrospective study of NO was conducted by reviewing medical charts and photographs of sixty-seven patients. Statistical analysis was used to compare excellent and poor outcomes and determine contributing factors. RESULTS: The median age of onset was below the age of 1 (interquartile range [IQR], 0~1). Tanino's and PUMCH classification systems failed to classify patients in 24 (35.8%) and 6 (9.0%) of patients, respectively. A 1,064 nm Q-switched Nd:YAG laser without additional lasers was used most frequently in 42 patients (62.7%). The frequency of treatment was 19.0 (IQR, 10.0~23.0) in the cured group defined as subjects showing 95% improvement or above, compared to 10.0 (IQR, 6.25~13.75) in the unattained group defined as subjects showing less than 95% improvement (p=0.001). CONCLUSION: A 1,064 nm Q-switched Nd:YAG laser is a reliable treatment armamentarium, functioning as a single infallible modality as well as a combination treatment modality for NO. Repetitive laser treatments without interruption seems to be the most suitable in clearing NO. The current classification systems of NO are defective. Thus, a new classification should be developed.
Age of Onset ; Asian Continental Ancestry Group ; Classification* ; Consensus ; Humans ; Laser Therapy ; Nevus of Ota* ; Nevus* ; Pigmentation ; Retrospective Studies

OBJECTIVES: The aim of this study are clinical application of perfusion computed tomography (perfusion CT) in hydrocephalus and comparison its cerebral blood flow parameters with transcranial doppler (TCD) and clinical outcome. METHOD: 25 patients with hydrocephalus took pre- and postoperative perfusion CT and TCD. 15 patients without neurologic deficit were also examined with same protocol as a control. Blood flow parameters of perfusion CT, such as cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) were analyzed according to clinical status and postoperative outcome. So did the TCD parameters, mean flow velocity (mFv) and pulsatility index (PI) with regard to clinical outcome. RESULTS: Perfusion CT parameters of the hydrocephalus showed decrease in CBF (gray matter P=0.035, periventricular region P=0.042) and increase in MTT (gray matter P=0.039, periventricular region P=0.045) compared to control. In postoperative improvement group, there noted reversal of perfusion parameters close to those of the control. TCD parameters showed increase in mFv (P=0.047), and decrease in PI (P=0.042) in cases with improvement. CONCLUSION: Perfusion brain CT and TCD can used as clinically useful tools to predict the postoperative outcome on hydrocephalus.
Blood Volume ; Brain ; Humans ; Hydrocephalus* ; Neurologic Manifestations ; Perfusion*