Eccrine epithelioma is an exceedingly rare cutaneous tumor ancit is believed to represent the maligant counterpart of the eccrine dermal syringoma. It occirs as an infiltrating basaloid growth, usually on the scalp or head, that frequently recur, apparrntly because of inadequate excision. We report a case of this tumor in a 60-year-old female, who showed a well demarcated, tender nodule on her left parietal scalp which had been present for three years. Histopat.hologically, the tumor was composed of strands of darkly staining epithelial cell embedded in a dense fihrcus stroma with ductal differentiation and cyst formation.
Carcinoma* ; Epithelial Cells ; Female ; Head ; Humans ; Middle Aged ; Rabeprazole ; Scalp ; Syringoma

BACKGROUND: Systemic lupus erythematosus(SLE) is a clinical syndrome of unknown causes characterized by inflammat.ion and multisystem involvement. Since Hargravas describe the LE cell in 1948, a profound change has occured in the concept of SLE. Many studies of the large series have been reported in the West, but few collective studies have been reported in Korea. OBJECTIVE: The goal of this study was to elucidate the clinical and laboratory characteristics of SLE in Korean people. METHODS: We carried out retrospective study of 64 patients, who were diagnosed as SLE on the base of the 1982 revised bacteria for the SLE by American Collepe of Rheumatology(formerly, American Rheumatism Association), at Korea University Hospital from 1982 to 1991. The results were compared with those of previous studies in Korea and western countries. RESULTS: 1. In 64 patients with SLE, female patients outnumbered male by 6.1 to 1 and the mean age of onset was 28.6 years. 2. The initial manifestations were arthritis or arthralgia, 25%; fatigue, malaise, weight, loss, 21.8%; facial rash or blush, 12.5%, fever, 12.5%. 3. The major clinical manifastations were hematologic(90.6 %), muccutaneous(89%), musculoskeleta (79.7%), and renal(73.4%) involvemant. 4. The ANA test were positive in 83.9% of the patients, and homoenous pattern was most common. There was no significant difference of organ involvement according to the nuclear patterns of ANA, but cardiopulmonary, renal involvement, hypocomplement,emia and positive anti-ds DNA were less frequent in ANA neghative group. 5. In 73.7% of the patients, the titers of anti-ds DNA antibody was elevated. The amount of anti-ds DNA Ab in serum did not always correlate with disease activity. 6. Photosensitivity, arthritis or arthralgia and CNS manifestatioris were less common, but hematologic findings, including anenia and leukopenia were more common in Korean than western reports. CONCLUSION: Patients with SLE are heterogenous in the natural h story of their disease, which is not an uncommon disease in Korea. Continued efforts to clarify the immunopathologic basis for SLE should eventually lead to more effective treatment.
Age of Onset ; Arthralgia ; Arthritis ; Bacteria ; DNA ; Exanthema ; Fatigue ; Female ; Fever ; Humans ; Korea ; Leukopenia ; Lupus Erythematosus, Systemic* ; Male ; Neutrophils ; Retrospective Studies ; Rheumatic Diseases

PURPOSE: This study was conducted to analyze the change in the obesity index in girls receiving a gonadotropin-releasing hormone agonist (GnRHa), based on treatment duration, and to aid in nutritional counseling by investigating dietary habits and lifestyle. METHODS: Anthropometric examinations were conducted on 62 girls treated with GnRHa from January 2010 through July 2014. Parents were asked to fill out questionnaires on patient dietary habits and lifestyle. RESULTS: The group taking GnRHa for over 1 year had a higher rate of obesity increase than the group taking GnRHa for less than 1 year, but they had common habits related to obesity, which should be corrected. In addition, 69.2% of the normal weight group taking GnRHa for over 1 year gained weight, and needed more intensive programs, which include physical exercise and nutritional education. Although girls with precocious puberty showed a decrease in the intake of high-calorie foods with nutritional intervention regardless of treatment duration, they still had problems that needed improvement, such as shorter meals and lack of exercise. CONCLUSION: Girls with precocious puberty and their parents should emphasize maintenance of proper body weight, especially when treatment for over 1 year is anticipated. Consistent education in nutrition, ways to increase intensity and duration of physical activity, and the need to slow down mealtimes are important in managing obesity; doctors need to perform regular checkups and provide nutritional counseling.
Body Weight ; Counseling ; Education ; Exercise ; Female* ; Food Habits* ; Gonadotropin-Releasing Hormone ; Humans ; Life Style* ; Meals ; Motor Activity ; Obesity ; Parents ; Puberty, Precocious*

BACKGROUND: Adequate evaluation and monitoring for pre-eclamptic paturient and capable assistance before induction for anesthesiologist, must be taken to avoid sudden severe maternal hypertension with intubation during a Rapid Sequence intravenous induction. Such event predispose the paturient to intracranial hemorrhage and pulmonary hypertension with pulmonary edema. To diminish danger of hypertension that can be developed during general anesthesia and facilitate control of blood pressure, 24 women presenting for cesarean section were studied. METHODS: All received 17.9+/-2.6ml of 0.5% bupivacaine, including 3ml of test dose, through the epidural catheter inserted in T12-L1 interspace using 18 gauge Tuohy needle to the patients with a lateral decubitus position. We measured blood pressure and heart rate in 5, 10, 15, 20, 30, 45, and 60 minutes after injection of 0.5% bupivacaine and 15 minutes after transferred to recovery room. RESULTS: The blood pressure of the patients started to decrease in 5 minutes and most decreased in 20 minutes after injection, the heart rate had little change but decreased significantly in 45 minutes. Apgar Scores of the neonates at 1 and 5 minutes were 7.3+/-2.0 and 9.2+/-1.5. The patients used ephedrine and crystalloid solution for correction of hypotension were 6 of 24 women and had no any systemic toxicity or neurologic symptoms by local anesthetics(bupivacaine). CONCLUSION: Continuous epidural anesthesia for cesarean section in preeclamptic patients is recommended for safe anesthesia.
Anesthesia ; Anesthesia, Epidural* ; Anesthesia, General ; Blood Pressure ; Bupivacaine ; Catheters ; Cesarean Section* ; Ephedrine ; Female ; Heart Rate ; Humans ; Hypertension ; Hypertension, Pulmonary ; Hypotension ; Infant, Newborn ; Intracranial Hemorrhages ; Intubation ; Needles ; Neurologic Manifestations ; Pregnancy ; Pulmonary Edema ; Recovery Room

BACKGROUND: To validate Omron HEM 907 XL blood pressure monitor (test device) against auscultatory mercury sphygmomanometer in children aged 7-8 years old in accordance with International Protocol of European Society of Hypertension revised in 2010 (ESH-IP2) and British Hypertension Society (BHS) protocol. METHODS: Seventy-five children and adolescents were recruited for the study. A validation procedure was performed following the protocol which was prepared on the basis of ESH-IP2 and BHS protocol for children and adolescents. Each underwent 7 sequential BP measurements alternatively with a mercury sphygmomanometer and the test device. The results were analyzed according to the validation criteria of ESH-IP2. RESULTS: The mean (blood pressure [BP], +/- standard deviation [SD]) difference of absolute value between the test device and mercury sphygmomanometer readings in all the 75 subjects was 3.26 +/- 3.08 mm Hg for systolic BP and 4.11 +/- 3.50 mm Hg for diastolic BP. These results fulfilled AAMI criterion of mean +/- SD below 5 +/- 8 mm Hg for both systolic and diastolic BP. The proportion of test device-observer mercury sphygmomanometer BP differences within 5, 10 and 15 mm Hg were 81%, 96%, 99% for SBP and 72%, 93%, 99% for diastolic blood pressure (DBP), respectively, in the part 1 analysis, so both systolic blood pressure (SBP) and DBP passed the part 1 criteria. As for the part 2 analysis, SBP passed the criteria, bur DBP failed. CONCLUSIONS: Omron HEM 907 XL BP monitor failed an adapted ESH-IP2, though SBP passed. When comparing the BP readings by oscillometers with mercury sphygmomanometer, the differences between them, particularly in diastolic BP, should be taken into account, because DBP can be underestimated.
Adolescent ; Aged ; Blood Pressure ; Blood Pressure Determination ; Blood Pressure Monitors ; Child ; Humans ; Hypertension ; Organothiophosphorus Compounds ; Oscillometry ; Reading ; Sphygmomanometers

Although an association of Kawasaki disease (KD) with infectious agents has been suggested, none have been proven to cause KD. In this case study, we present a case of KD with concurrent onset of influenza and Mycoplasma pneumoniae (MP) infections. A 27-month-old boy presented with prolonged fever, cough, and rhinorrhea. During the initial testing, influenza A infection was identified, and he was treated with oseltamivir. Despite the antiviral therapy, the fever persisted, and he had cervical lymph node enlargement, bilateral conjunctival injection, fissured red lips, strawberry tongue, and erythematous skin lesions on the Bacillus Calmette-Guérin vaccination site. Thus, the patient was diagnosed with KD and was treated with intravenous immunoglobulin (IVIG). The result of the initial antimycoplasma immunoglobulin M (IgM) antibody testing and was positive, and an increased IgM titer from baseline was found in a repeat test. We reviewed the hypotheses on pathogens known to be associated with KD and the etiology of KD. Based on our findings, we suspect that symptoms of KD and coronary artery lesions can occur from various infections besides those caused by Mycoplasma species and influenza viruses.
Bacillus ; Child, Preschool ; Coronary Vessels ; Cough ; Fever ; Fragaria ; Humans ; Immunoglobulin M ; Immunoglobulins ; Influenza A virus* ; Influenza, Human* ; Lip ; Lymph Nodes ; Male ; Mucocutaneous Lymph Node Syndrome* ; Mycoplasma pneumoniae* ; Mycoplasma* ; Orthomyxoviridae ; Oseltamivir ; Pneumonia, Mycoplasma* ; Skin ; Tongue ; Vaccination

PURPOSE: In order to obtain basic data for treatment plan in radiosurgery, we measured small fields of 6 MV X-rays and compared the measured data with our Monte Carlo simulations for the small fields. MATERIALS AND METHODS: The small fields of 1.0, 2.0 and 3.0 cm in diameter were used in this study. Percentage depth dose (PDD) and beam profiles of those fields were measured and calculated. A small semiconductor detector, water phantoms, and a remote control system were used for the measurement. Monte Carlo simulations were performed using the EGS4 code with the input data prepared for the energy distribution of 6 MV X-rays, beam divergence, circular fields and the geometry of the water phantoms. RESULTS: In the case of PDD values, the calculated values were lower than the measured values for all fields and depths, with the differences being 0.3 to 5.7% at the depths of 2.0 to 20.0 cm and 0.0 to 8.9% at the surface regions. As a result of the analysis of beam profiles for all field sizes at a depth of 10cm in water phantom, the measured 90% dose widths were in good agreement with the calculated values, however, the calculated penumbra radii were 0.1 cm shorter than measured values. CONCLUSION: The measured PDDs and beam profiles agreement with the Monte Carlo calculations approximately. However, it is different when it comes to calculations in the area of phantom surface and penumbra because the Monte Carlo calculations were performed under the simplified geometries. Therefore, we have to study how to include the actual geometries and more precise data for the field area in Monte Carlo calculations. The Monte Carlo calculations will be used as a useful tool for the very complicated conditions in measurement and verification.
Radiosurgery ; Semiconductors ; Water

The compatibility with GammaMed-12i brachytherapy machine for an Ir-192 encapsulated source (IRRS20, KAERI, Korea) manufactured by Korea atomic energy research institute (KAERI) has been investigated. As a mechanical testing of compatibility, precise measurement of step movement with channels, measurement of curvature of radius for wire, and emergency return testing were performed. Periodic measurements of air kerma strength for 45 days were carried out to evaluate decay characteristics of Ir-192 radioisotope and comparison of dose distributions in phantom between KAERI and old sources previously used were performed by film dosimetry. KAERI source has a good compatibility with GammaMed12i machine as a result of mechanical testing. There are in good agreement with calculated values in activity characteristics and there were small differences in dose distributions around the source in comparison between KAERI and old source.
Academies and Institutes ; Brachytherapy ; Emergencies ; Film Dosimetry ; Korea ; Nuclear Energy ; Radius

No abstract available.
Catheters* ; Stents*

BACKGROUND: Home therapy has merits, enabling rapid treatment thereby reducing complications, but difficulty with venous access is a barrier to treatment. There is a paucity of data on this. This study investigated the current status of home therapy for patients with hemophilia, and examined problems and potential solutions.METHODS: Patients and their families who were performing home therapy and who attended the camp of the Korea Hemophilia Association in 2014 were asked to complete questionnaires. The questionnaires pertained to complications of infusion and whether (or not) factor infusion was properly performed. Responses were scored on a scale from 1-5, with a high frequency of complications and adequate performance of infusion being allocated relatively higher scores.RESULTS: The mean score of complications arising from infusion was 1.56±0.46. This was relatively low and was not correlated with the factor infusion training method. The performance of home therapy obtained a relatively high score: 4.46±0.56. The performance score was significantly higher for patients who had practiced infusion with medical personnel, an injection simulator or a video clip.CONCLUSION: Although most patients properly performed home therapy, further improvement is needed in training of infusion and keeping records of bleeds. It is essential to establish guidelines on home therapy, develop a standardized patient and family training program, and reinforce the role of hemophilia treatment centers in educating patients and their families.
Education ; Hemophilia A ; Humans ; Korea ; Methods