A case of multiple myeloma associated with adenocarcinoma of the stomach was review. A 59-year, old Korean man had been abmitted to St. Mary's Hospital in January 1984, with chief complaint of posterior neck pain, and intermittent headache for one year prior to amission. Osteo lytic punched-out lesions were noted on skull and other skeletal x-ray films. Bone marrow aspirates revealed diffuse infiltration of mature and immature plasma cells. Laboratory findings revealed anemia and Bence-Jones proteinuria. Immunoelectrophoresis revealed findings consistent with IgA-lamda type multiple myloma. Alkylating agents and steroids were tried with some clinical improvements. In August 1985, the patient revisited outpatient clinic with chief complaints of epigastric pain and neck mass. Endoscopic biopsy and excision biopsy of the cervical lymph node were performed. By microscopic examination, adenocarcinoma of the stomach and metastasis of multiple myeoma to the supraclavicular lymph nodes were confirmed. Subtotal gastrectomy was performed. By gross and microscopic revealed metastasis to the regional lymph nodes.
Male ; Humans ; Adenocarcinoma ; Biopsy ; Neoplasm Metastasis

PURPOSE: This study was conducted to identify the job competencies of HIV counseling nurses and to figure out the importance, level of difficulty, and performance frequency of the competencies. METHODS: The job competencies were drawn from 22 HIV counseling nurses by developing new models and utilizing specialist groups. The importance, level of difficulty, and performance frequency of the competencies were analyzed using the average and deviation. RESULTS: The results of this study identified 6 job competencies such as counseling performance, expertise utilization, cooperation, support, administration, and self-development, 28 sub-competencies, and 48 job descriptions. Out of the 6 job competencies, counseling performance recorded high levels in the importance, level of difficulty, and performance frequency CONCLUSION: The study results will be used as the basic data of the training programs for strengthening the job competencies of HIV counseling nurses. Furthermore, it is expected that the results will contribute to the prevention of HIV/AIDS transmission, the core of the national HIV/AIDS control programmes, and the improved health and quality of life in people living with HIV.
Counseling* ; Education ; HIV* ; Job Description ; Quality of Life ; Specialization

PUPPOSE: This study was to investigate the knowledge, attitudes, and educational needs for sexuality of the elderly. METHOD: This was a descriptive study, in which data were collected from February to April 2002 from 354 elderly who were residing in Chung-Chung province. RESULT: 1. The level of knowledge regarding sexuality was below average. 2. The level of the attitudes toward sexuality of the elderly was neither positive nor negative. 3. The educational needs of the elderly were above average. 4. Higher level of knowledge on sexuality was significantly correlated with more positive attitudes and education needs for sexuality, and more positive attitudes toward sexuality was significantly correlated with more educational needs for sexuality. CONCLUSION: Particularly men, with good health, and those who were in intimate relationships with their spouses and still engaged with active sexual life showed somewhat higher level of knowledge and positive attitudes as well as higher educational needs. Therefore, further development and applying of sexuality promotion programs for healthy elder couples should be considered in the future to enhance the quality of life of elder population. In addition, it is also suggested to develop an alternative intervention program on sexuality for elderly who are women, those with meager health, and the bereaved.
Aged* ; Education ; Family Characteristics ; Female ; Humans ; Male ; Quality of Life ; Sexuality* ; Spouses

Deep palmoplantar warts (Myrmecia) are frequently tender papules or plaques caused by HPV-1. Myrmecia are usually misdiagnosed as paronychia or digital mucous cysts. They occur not only on the palms and soles but also on the lateral aspects and tips of the fingers and toes. We report a rare case of deep palmoplantar wart occurring on proximal nail fold, unusual site of right 5th finger in an 11-year-old girl.
Child ; Female ; Fingers ; Humans ; Paronychia ; Toes ; Warts*

No abstract available.
Cyclosporine* ; Scleredema Adultorum*

OBJECTIVES: Hypertension provokes left ventricular diastolic dysfunction due to decreased elasticity of the ventricular myocardium at first. It has been proposed that the Doppler echocardiography might provide information concerning diastole because of its ability to measure the blood flow velocities across the mitral valve noninvasively. But Doppler mitral velocity may be "normalized" in hypertensive patients in different conditions. The purpose of this study is to evaluate diastolic function in hypertensive hearts using Doppler echocardiography of the pulmonary venous flow in conjunction with mitral flow velocity pattern. METHODS: We measured the mitral flow velocity curves and the pulmonary flow velocity curves in fifty hypertensive patients(mean age : 56.3+/-10.0, man : 19, woman : 31) nad forty healthy adults(mean age : 51.6+/-12.5, man : 14, woman : 26) from March 1995 to December 1995 by using the SONO 1000 of Hewlett Packerd. RESULTS: 1) The mitral flow velocity pattern in 50 hypertensive patients was characterized by the decrease in the peak early diastolic filling velocity(E : 0.59+/-0.12m/sec) and the ratio of E to peak filling velocity(A : 1.00+/-0.46m/sec). Isovolumetric relaxation time and deceleration time were 127.2+/-33.3msec, 258.9+/-40.9msec respectively. They were longer than normotensive patients(P < 0.05). 2) The pulmonary venous flow velocity pattern in hypertensive patients was characterized by the decreased peak diastolic forward velocity(D : 33.7+/-9.8cm/sec) and the ratio of peak systolic forward velocity(S) to D(S/D : 1.60+/-0.5)(P < 0.05). 3) There was no relation between the flow velocity integral parameters and the peak flow velocity parameters of pulmonary venous flow pattern in hypertensive patients. 4) The dofference in the pulmonary venous duration and the mitral A wave duration at atrial contraction (DA-DR) was 20.9+/-29.4 msec in hypertensive patients. DA-DR in normatensive patients was 24.3+/-32.9msec. DA-DR was not significant in hypertensive patients compared with that of the healthy subjects (P < 0.05) CONCLUSION: Analysis of pulmonary venous flow velocity pattern in conjunction with mitral flow velocity pattern in hypertensive patients provides more accurate assessment of left ventricular diastolic function.
Blood Flow Velocity ; Deceleration ; Diastole ; Echocardiography, Doppler ; Elasticity ; Female ; Heart* ; Humans ; Hypertension ; Mitral Valve ; Myocardium ; NAD ; Relaxation

PURPOSE: Growth hormone (GH) plays a key role in the regulation of body composition, lipid metabolism, and quality of life in adults with GH deficiency (GHD). This study investigated changes in laboratory findings and body composition after GH recommencement for adult GHD and analyzed correlation between GH interruption period and endocrine or anthropometric parameters. METHODS: A total of 45 patients (17 females and 28 males) diagnosed with childhood-onset GHD (CO-GHD) were investigated and all patients had organic brain lesions. Patients diagnosed CO-GHD were retested to confirm adult GHD at age 20.4+/-5.0 years (18.0-32.1 years). Recombinant human GH was administered at a dose of 0.44 mg/day. Clinical and laboratory parameters such as weight, height, body mass index (BMI), serum insulin-like growth factor 1 (IGF-1), serum total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglyceride levels, were compared between baseline and 12 months after treatment using paired t-test. In addition, correlation between GH interruption period and clinical parameters including BMI, lipid profile, IGF-1, and IGFBP-3, was analyzed. RESULTS: Of 45 patients, 33 patients had GH interruption period of 4.3+/-3.6 years (0.7-12.5 years). Serum HDL-cholesterol level increased significantly, whereas LDL-cholesterol decreased after 1 year of GH replacement therapy. However, body weight and BMI showed no significant changes after 1 year of GH replacement therapy. There were no significant correlations between GH interruption period and lipid profile or anthropometric parameters. CONCLUSION: BMI and body weight were not affected by GH replacement. However, GH replacement in adults with GHD offers benefits in lipid metabolism.
Adult* ; Body Composition ; Body Height ; Body Mass Index ; Body Weight ; Brain ; Cholesterol ; Dwarfism, Pituitary ; Female ; Growth Hormone* ; Humans ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Lipid Metabolism ; Lipoproteins ; Quality of Life ; Triglycerides

Glanzmann's thrombasthenia is a qualitative platelet disorder characterized by a deficiency in the platelet membrane glycoproteins IIb/IIIa. It belongs to a group of hereditary platelet disorders typified by normal platelet numbers and a prolonged bleeding time. The severity of bleeding does not correlate with the severity of the platelet glycoprotein IIb/IIIa abnormality. The present case report describes the periodontal treatment of a patient with Glanzmann's thrombasthenia. A 30-year-old female with a history of Glanzmann's thrombasthenia was referred for gingival bleeding on tooth brushing and discomforts in #38 area. The periodontal finding revealed a diagnosis of localized slight adult periodontitis. Root planing and extraction of #38 was performed under 12 pack of platelets transfusion and digital compression was done for hemostasis. The gingival bleeding ceased within a day in maxilla and 2 days later in mandible. 42 pack of platelets was administered for 3 days of post-treatment and for iron-deficiency anemia 3 pack of RBCs was transfused 2 days later. 1 week later the inflammation in gingiva disappeared and gingival stippling appeared. The clinical result we got was good and in such a medically compromised patient it is an ability to maintain a proper oral hygiene that is essential both for oral and systemic health.
Adult ; Anemia, Iron-Deficiency ; Bleeding Time ; Blood Platelet Disorders ; Blood Platelets ; Chronic Periodontitis ; Diagnosis ; Female ; Gingiva ; Glycoproteins ; Hemorrhage ; Hemostasis ; Humans ; Inflammation ; Mandible ; Maxilla ; Oral Hygiene ; Platelet Count ; Platelet Membrane Glycoproteins ; Root Planing ; Thrombasthenia* ; Tooth

Background: We hypothesized that intravenous lidocaine mixed with propofol may have an influence on anesthesia induction and hemodynamic responses to propofol induction and endotracheal intubation as well as propofol-induced pain on injection. Methods: Seventy-five patients were allocated to group L1 (2% lidocaine 1.5 mg/kg, n=25), group L2 (2% lidocaine 2 mg/kg, n=25) or group C (normal saline 0.05 mL/kg, n=25) according to the lidocaine dosage mixed with propofol 2 mg/kg. The pain on injection was scored as none, mild, moderate, and severe. The site of pain and recall of pain were also recorded. Loss of verbal response was observed during induction. Mean arterial blood pressure (MAP) and heart rate (HR) were recorded before anesthetic induction (baseline value), immediately before and after endotracheal intubation, and every min until 5 min thereafter. Results: Ninety-two percent of patients reported pain upon injection in group C, whereas 8% of the patients in group L1 and no patient in group L2. Loss of verbal response before injection of total dose of propofol was observed in 44% in group L2, 36% in group L1 and 28% in group C. Lowered MAP caused by propofol increased significantly after endotracheal intubation in all three groups (p<0.05). HR increased immediately and 1 min after endotracheal intubation in all three groups (p<0.05). Conclusions: Our results indicate that intravenous lidocaine 1.5 mg/kg or 2 mg/kg mixed with propofol 2 mg/kg significantly reduces the incidence and the degree of pain, but does not affect anesthesia induction and hemodynamic responses to propofol and tracheal intubation.
Anesthesia ; Arterial Pressure ; Heart Rate ; Hemodynamics* ; Humans ; Incidence ; Intubation* ; Intubation, Intratracheal ; Lidocaine* ; Propofol*

The hypoglycemic effects of four edible plants (Angelicae tenuissimae (A. ten.), Pleurospermum kamtschaticum (P. kam.), Adenophora remotiflora (A. rem.) and Zanthoxylum schinifolium (Z. sch.)) in streptozotocin (STZ)-induced diabetic rats were investigated. Sprague-Dawley male rats weighing 190-230 g were induced diabetes mellitus by the STZ injection (45 mg/kg) into the tail vein and were divided into six groups ; normal, STZ-control and four edible plant groups (A. ten., P kam., A. rem. and Z. sch. groups). Normal and STZ-control groups were fed a AIN-93 diet and four groups of STZ-induced diabetic rats were fed one of each experimental diets containing 10% of the edible plant powder for 4 weeks. Diabetic rats showed the lower weight gain compared to the normal rats. In experimental groups except P. kam., AST activities were close to normal. A. ten. group were lowered ALT activities slightly. The plasma glucose levels of the diabetic experimental groups were significantly decreased at 4th week. The plasma insulin levels in diabetic experimental groups were not significantly different compared to the STZ-control group. The liver glycogen levels in STZ injected rats were significantly lower in compared to the normal rats. However no significant differences were found in response experimental plants intake in diabetic rats. The muscle glycogen were not significantly different among all the groups.
Animals ; Blood Glucose* ; Campanulaceae ; Diabetes Mellitus ; Diet ; Glycogen* ; Humans ; Hypoglycemic Agents ; Insulin ; Liver Glycogen ; Male ; Plants, Edible ; Plants, Medicinal* ; Plasma ; Rats* ; Rats, Sprague-Dawley ; Streptozocin* ; Veins ; Weight Gain ; Zanthoxylum