Classic Kaposi's sarcoma is a human herpesvirus-8 associated with a multicentric lymphoangioproliferative tumor primarily arising in the lower extremities, but rarely in the head and neck. We herein report a 63-year-old man with primary classic Kaposi's sarcoma on the face. He presented with asymptomatic, erythematous papules on the nasal ala which had been noticed 2 months earlier. Histopathologic examination and nested polymerase chain reaction analysis in the tissue disclosed typical features of Kaposi's sarcoma.
Head ; Humans ; Lower Extremity ; Middle Aged ; Neck ; Polymerase Chain Reaction ; Sarcoma, Kaposi*

OBJECTIVE: The results of the excision of both outer and inner membranes with fenestration to the basal and parasellar cisterns for symptomatic primary middle cranial fossa arachnoid cysts are presented. METHODS: Twenty-three symptomatic cases of middle cranial fossa arachnoid cyst treated by excision with fenestration from 1993 to 2001 at our hospital were analyzed retrospectively. RESULTS: There was no significant morbidity and mortality after surgery and no recurrence of cyst during the follow-up period(mean 40.8 months). We observed reduction of the cyst with expansion of the surrounding brain and clinical improvement in most of the patients. All cases of type III by Galassi classification, 83% of type II cases and half of type I cases were belonged to the excellent group(reduction of the cyst size over 50% during follow-up period). Seventeen cases(74%) were belonged to the excellent group and 6 cases(26%) were the good group(reduction of the cyst size under 50% during follow-up period). CONCLUSION: The results of this study suggest that the excision and fenestration procedure may be considered as the primary shunt-independent procedure in patients with symptomatic middle cranial fossa arachnoid cyst.
Arachnoid Cysts ; Arachnoid* ; Brain ; Classification ; Cranial Fossa, Middle* ; Follow-Up Studies ; Humans ; Membranes ; Mortality ; Recurrence ; Retrospective Studies

BACKGROUND: The automated border detection(ABD) echocardiography has the ability of recognizing the endocardial-blood interface, and therefore, on-line estimation of the left ventricular(LV) volume every cardiac cycle. Compared with the off-line conventional 2-dimensional echocardiographic method that requires tracing the endocardial border manually, the ABDd system can be a convenient and objective method in the estimation of the LV volume and the ejection fraction(EF). The purpose of this study is to compare the LV volume and EF between the on-line ABD system and the convertional off-line echocardiographic method. METHODS: In two weeks, 83 adult patients older than 16 years of age were referred to our echocardiographic laboratory. Among these 83 patients, 64 patients who had a normal sinus rhythm were included to our study. Using the Hewlett-Packard SONOS 1500, a 2.5 MHz transducer was placed dat the cardiac apex. Patients with an apical 4 chamber view of the LV in which at least 75% of the endocardium was clearly seen were selected for study. On that view, the ABD system was turned on, and the reansmit power and the time-gain compensation controls were adjusted in order to approximate the automated border to the visually apparent endocardial surface. The LV end-diastolic volume(LVESV) and LV end-systolic volume(LVESV) were calculated by the method of disc. LVEDV, LVESV, and EF were displayed every cardiac cycle. Also the off-line estimation of the LV volume was performed by the method of disc, after manually tracing the endocardial border on the apical 4 chamber view. RESULTS: 44 patients(69%) of 64 patients had > or =75% of the LV endocardium visualized. LVEDV, LVESV, and Ef with the ABD system were highly correlated with those with the off-line, manually traced method(r=0.95, 0.8, respectively), but LVEDV and EF with toe ABD system were significantly less than those with the latter(p<0.01). The limits of agreement between tow methods(off-line, manually traced method-ABD system) were somewhat wide. Those of LVEDV, LVESV and EF were +22~-10ml(mean 6ml), +15~-14ml(mean 0.1ml), and +19~-12%(mean 3.8%), respectively. CONCLUSION: LVEDV,LVESV, and EF measurements by the ABD system and the off-line manually traced methods thve a strong correlation, The ABD system should habe clinical applications in setting, in which measurements of LV volume and Ef are important, But, the comparison with a more reliable method is necessary.
Adult ; Compensation and Redress ; Echocardiography* ; Endocardium ; Humans ; Toes ; Transducers

PURPOSE: It is presumed that lower urinary tract symptom(LUTS) and hypertension are related to the age-dependent sympathetic activity. Thus, the attempt to elucidate a correlation between these two conditions can be important in their management. We investigated the relationship between LUTS and hypertension. MATERIALS AND METHODS: From 1995 to 1997, 1011 men(422 from routine physical checkup, 288 benign prostatic hyperplasia(BPH) patients, 301 hypertension patients) over 50 years were enrolled. The international prostate symptom score(IPSS) and blood pressure were recorded in all. 422 men from physical checkup were grouped into 4 categories according to the presence of LUTS(IPSS> or =8) or hypertension(systolic> or =140mmHg, diastolic> or =90mmHg). The prevalence of hypertension, and the degree of LUTS were evaluated. Statistical analysis was performed with t-test, chi-square test and Mantel-Haenszel test. RESULTS: The prevalence of hypertension was not significantly different between the LUTS(n=177) and non-LUTS groups(n=245)(38.4% vs 35.9%, p=0.600) in men from physical checkup. There was no difference according to age(p=0.513). The prevalence of hypertension was 39.6% in the BPH group(N=288) and was not different compared to the non-LUTS group(n=245)(p=0.385). No significant difference in the prevalence of LUTS was seen between hypertensives(n=156) and normotensives(n=266)(53.2% vs 48.2%, p=0.447) in the physical checkup group. However, their mean IPSS (8.9+/-6.5 vs 7.6+/-5.6) were significantly different(p=0.030). The mean IPSS between hypertensives(15.21+/-4.5) and normotensives(12.75+/-5.0) from the LUTS group(n=178) were significantly different(p=0.002). The mean IPSS of the patients with hypertension(n=301, 9.6+/-5.9) was significantly higher than normotensive men(n=266, 7.6+/-5.6) from physical checkup(p=0.001). CONCLUSIONS: Hypertension and LUTS including BPH do not correlate prevalence-wise, however, hypertension may affect the degree of IPSS.
Blood Pressure ; Humans ; Hypertension* ; Male ; Prevalence ; Prostate ; Urinary Tract*

Diatomology has provided important evidences for diagnosis of drowning in forensic practice. However, conflicting opinions about the reliability of diatom test still exist. As a part of efforts to end this controversy, it is very important to secure the diatom profile in the water sample of drowning site. Our results obtained in this study show the characteristics of temporal and spatial distribution of diatom collected from the main drowning sites of Han river in Korea. During spring, 111 taxa (98 species and 13 varieties) were identified from 31 genera, and 87 taxa (77 species and 10 varieties) were identified from 22 genera during summer. At the level of genus Achnanthes, Cyclotella, Cymbella, Fragilaria, Navicula, Nitzschia, and Stephanodiscus represented the highest numbers, and were the most widely occurred during two seasons. The centric diatoms, Stephanodiscus hantzschii f. tenuis and Cyclotella atomus were typical of spring and summer, respectively, and identified as dominant indicator species. The commonly occurred species, including dominant species in the seasonal cluster analysis influenced the formation of site - specific groups. As a result, our results will be able to be used not only as the comparison data of diatom found in the drowning victim's tissue but also a reference data to rule out the possibility of contamination.
Diatoms ; Drowning ; Korea ; Rivers ; Seasons ; Water

BACKGROUND AND OBJECTIVES: Videostrobokymography (VSK) has been recently developed in our institute. VSK can select multiple regions of interest and analyze vibratory patterns of vocal folds using video data recorded by the conventional videostroboscopy. But the efficacy of VSK in clinical application needs to be proven. MATERIALS AND METHODS: We compared the preoperative and postoperative VSK patterns of Reinke's edema in 15 cases with some other parameters. RESULTS: Most of the patients showed improvement of voice quality by self-assessment, however, the fundamental frequency and subglottic pressure did not return to the normal range after operation. Preoperative videostroboscopy for Reinke's edema patients revealed greatly irregular patterns of mucosal wave so that kymogram could be obtained only in 3 of the 8 preoperative examinations. However, postoperative vibration of the vocal folds returned to the regular pattern on VSK. CONCLUSION: VSK could serve as one of the effective tools to document the vocal fold vibration objectively in various kinds of benign mucosal diseases of the vocal folds.
Edema* ; Humans ; Reference Values ; Self-Assessment ; Vibration ; Vocal Cords ; Voice Quality

BACKGROUND/AIMS: Cholestatic jaundice caused by a juxtapapillary diverticulum can be treated by excision of the diverticula or endoscopic sphincterotomy(EST). The aim of this study is to evaluate the effectiveness of EST for cholestatic jaundice in patient with juxtapapillary diverticulum with absence of common bile duct stones. METHODS: We recruited patients who underwent Endoscopic Retrograde Cholangio Pancreatography(ERCP) between September 2000 and May 2005. The presence of Juxtapapillary diverticula was seen in 92(29.3%)) out of 315 patients underwent ERCP. Cholestatic jaundice associated with juxtapapillary diverticula was considered when patients have jaundice, elevated serum bilirubin and alkaline phosphatase more than normal, and there are no other obstructive lesion on abdominal ultrasonography or computed tomography(CT) scan. The number of the patients were 13 who had cholestatic jaundice associated with juxtapapillary diverticula without common bile duct stones. All 13 patients underwent EST and had no complications. The patients were followed up to visit outpatient department or interviewed on the telephone. RESULTS: Of the 13 patients, 10 were male and 3 were female. The mean age was 70.4 years and mean duration of follow-up were 28.9 months. All 13 patients who had gallbladder presented RUQ discomfort and jaundice. Seven patients presented gallstone pancreatitis with jaundice. Nine patients had GB stone, 1 patients had GB sludge. In the follow-up period, from 1month to 46 months after EST, 1 patient died of unknown cause within 1 year. One patient had recurred gall stone pancreatitis with jaundice 12 months later. CONCLUSIONS: EST can be considered as a useful therapeutic modality especially in eldery patients with cholestatic jaundice and gallstone pancreatitis associated with juxtapapillary diverticulum.
Alkaline Phosphatase ; Bilirubin ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct* ; Diverticulum* ; Female ; Follow-Up Studies ; Gallbladder ; Gallstones ; Humans ; Jaundice ; Jaundice, Obstructive* ; Male ; Outpatients ; Pancreatitis ; Sewage ; Telephone ; Ultrasonography

PURPOSE: We undertook this study to evaluate the educational benefits at each steps of expository cardiopulmonary resuscitation (CPR) training by immediate remediation for non-healthcare providers in our hospital. METHODS: The 150 office staffs who worked in our hospital participated in this study. Following an educational session consisting of a one-hour video tape and slides, we tested single-rescuer BLS performance (15 checklists) with Fullbody SkillReporter(TM) Resusci(R) Anne and Skillmeter Resusci(R) Anne according to 2005 AHA guidelines for CPR. Three tests and two remediations were given to each person, and data were collected after each trial. A statistical analysis was done using the SPSS statistical software package. A pvalue<0.05 was considered to be statistically significant. RESULTS: Staff pass rates were improved in 13 checklists after remediation of CPR training. In the initial testing, the highest rate of pass was in assessment of responsiveness (0.89+/-0.31) and the lowest rate of pass was in the looking of in the checking-breathing test items (0.23+/-0.42). The highest rate of pass after two remediations was in the checking-breathing within 10 seconds (0.94+/-0.23) and the lowest rate of pass was in the rate of chest compression (0.52+/-0.50). The difference between males and females was in the rate of chest compression (p=0.001), but there is no difference of the educational benefits after two remediations by age-group. CONCLUSION: We found that the rate of passing in each steps of CPR training was improved by two remediations. Therefore, many iterations of remediation of CPR training for non-healthcare providers are necessary.
Cardiopulmonary Resuscitation ; Checklist ; Female ; Humans ; Male ; Thorax

Kidney transplantation (KTP) lowers the mortality and morbidity of patients with end-stage renal disease. Post-transplantation infection and antibody mediated rejection (AMR) are the most common complications. Hepatitis B surface antigen (HBsAg) positive carrier donors and high anti A/B antibody titer ABO incompatible KTP could lead to recipient hepatitis B virus (HBV) infection and AMR. Here, we report a case of successful KTP in a 41-year-old male with a high titer of ABO incompatible and HBsAg positive donor. He underwent seven rounds of plasmapheresis, low dose intravenous immunoglobulin and rituximab treatment to inhibit antibody production and remove antibodies from the serum, after which he was administered anti-viral agent for HBV prophylaxis. The recipient maintained successful allograft function for 6 months after transplantation; therefore, we report that desensitization and anti-viral treatment achieved successful outcome in a 1:512 anti A/B antibody titer ABO incompatible and hepatitis B carrier donor KTP.
Adult ; Allografts ; Antibodies ; Antibody Formation ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B* ; Hepatitis* ; Humans ; Immunoglobulins ; Kidney Failure, Chronic ; Kidney Transplantation* ; Kidney* ; Male ; Mortality ; Plasmapheresis ; Rituximab ; Tissue Donors

BACKGROUND/AIMS: Heart rate variability (HRV) is a method for evaluation of autonomic nervous system activity by expressing the balance of sympathetic and parasympathetic tones. Some studies of HRV in patients with end-stage renal disease (ESRD) have been performed in Korea. However, few have examined kidney transplantation (KT) patients. Therefore, we investigated autonomic nervous system activity by means of HRV in patients with KT due to ESRD. METHODS: We compared the pattern of cardiac sympathetic and parasympathetic activity by time- and frequency-domain analysis of HRV with 24-h Holter monitoring of 23 KT and 56 dialysis patients. Patients underwent KT between January, 2008 and June, 2011. RESULTS: The mean ages of KT and dialysis patients were 54.2 +/- 12.3 and 53.7 +/- 12.6 years, respectively. The KT group showed increased time- and frequency-domain HRV (including HRV index), very low frequency (VLF), means and standard deviations of all normal R-R intervals for all 5-min segments of the entire recording (SDNNi), low frequency (LF), LF in normalized units (LF norm), and LF to high-frequency power ratio, compared with the dialysis group. CONCLUSIONS: Autonomic tone in patients with KT is higher than that in patients with ESRD on dialysis.
Autonomic Nervous System ; Dialysis ; Electrocardiography ; Electrocardiography, Ambulatory ; Heart ; Heart Rate ; Humans ; Kidney ; Kidney Failure, Chronic ; Kidney Transplantation ; Korea