we report a case of elastosis perforans serpiginosa associated with pseudoxanthoma e1asticurn on t:he neck of 27-year-old male patient. The lesions showecl erythematous scaly hyperkeratotic papules forming serpiginous pattern on yellowish elevated plaques. A skin biopsy specimen from the neck lesion revealed dense accurmulations of coarse elastic fibers partly cngulfed by epithelium in the papillary dcrrnis and increase cif short, irregulary clumped and degenerated clastic fibers in the middermis. On funduscopic exarnination, angioid streak is noted around the optic disk.
Adult ; Angioid Streaks ; Biopsy ; Elastic Tissue ; Epithelium ; Humans ; Male ; Neck ; Optic Disk ; Pseudoxanthoma Elasticum* ; Skin

We messured delayed cutaneous hypersensitivity reactions by Multitest CMI Kit. Total 209 normal adults ranging in age from 17 to 55 year(male 106, female 103) were tested. The results were obtained as follows ; 1. Sum of average diameter of positive antigens wss 20.7mm in male and 15.6mm in female. 2. Number of positive antigens was 3.9 in male and 3.4 in female. 3. Rate of anergy was 1.4%(0.9% in male, 1.9% in female). 4. The rate of subjects below warning score(below 10mm in male, below 5mm in female) was 2.8% in male and 5.8% in female. 5. Antigen with the highest response was tuberculin in both sex(male 95.3%, female 89.3%) and antigen with the lowest response was trichophyton(22.5%). 6. Aversge score of positive response of every antigens was highest in tuberculin at both sex(male 2.8mm, female 2,6mm) 7. Average score of total antigens with positive response was 5.5mm in male and 4.6mm in female. 8. The rate of false positive reaction to 70% W/V glycerine was 1.4% totally.
Adult* ; False Positive Reactions ; Female ; Glycerol ; Humans ; Hypersensitivity* ; Korea* ; Male ; Tuberculin

We report a case of 68-year-old male patient who was confirmed as d'emblee type of mycosis fungoides. The skin lesions showed sharply rnargined multiple reddish brown coIarcd papules, ndules, and tumors on the groin, thign, abdomen, and neck. The microscopic findings showed the epidermotropism and pautrier's micruabscess in the epidermis, and the infiltration of atypical cells in the dermis. The electron micrascopic findings showed irregular contour of the nuclear mernbrane within atypical lymphocytes. Thc lesions were gradually diminished by superficial radiation therapy.
Abdomen ; Aged ; Dermis ; Dronabinol ; Epidermis ; Groin ; Humans ; Lymphocytes ; Male ; Mycosis Fungoides* ; Neck ; Skin

PURPOSE: This study aimed to identify sexuality for women with gynecological cancer. METHODS: A total of seven women with gynecological cancer agreed to participate in this study. The data were collected utilizing in-depth semi-structured interviews style. A descriptive study design was used in this study. The interviews were analyzed using inductive content analysis methodology. RESULTS: Three themes identified were: 'women with gynecological cancer who give up their sexual life due to misunderstanding and fear', 'women with gynecological cancer who control their body and mind for recovery', 'women with gynecological cancer resume their sexual life with their partner's will'. CONCLUSION: To improve sexual health and quality of life for women with gynecological cancer, we need to develop programs related to sexual health. An adjusted sexual health program will contribute to increased sexual health and quality of life for women with gynecological cancer.
Female ; Humans ; Quality of Life ; Reproductive Health ; Sexuality

PURPOSE: The purpose of this study was to examine the relationships among sleep disturbance, depression, and quality of life in ovarian cancer during chemotherapy and to identify the influencing effect on quality of life. METHODS: A cross-sectional survey was conducted to measure sleep disturbance, depression and quality of life of 152 ovarian cancer patients between May and July, 2015. The data were analyzed with t-tests, ANOVA, post-hoc comparison (Scheffe), Pearson's correlation coefficients, and multiple regression analysis. RESULTS: The mean age of the participants was 54.2, and most of them were married. 61.8% of the patients were recurrent, and 50.0% had a performance status of < or =1. The prevalence of poor sleepers was 63.8%, and depression among patients was 52.6%. Sleep disturbance and depression were significantly negatively correlated with quality of life. As a result of stepwise multiple regression analysis, depression, sleep disturbance, monthly income and recurrence were discovered to account for 52.0% of variance. Depression and sleep disturbance were the most important influential factors. CONCLUSION: The results of the study indicate that sleep disturbance and depression should be integrated when developing and implementing psychosocial, behavioral intervention to improve quality of life among ovarian cancer patients during chemotherapy.
Cross-Sectional Studies ; Depression* ; Drug Therapy* ; Humans ; Ovarian Neoplasms* ; Prevalence ; Quality of Life* ; Recurrence

No abstract available.
Thromboangiitis Obliterans

Inhibitor development is one of the major adverse events associated with increased morbidity and mortality in patients with congenital hemophilia. Recent treatment for them is immune tolerance induction (ITI), which involves the administration of high doses of factor concentrates over a prolonged period, sometimes combined with immunosuppressive agents. We report a case of inhibitor elimination with Rituximab, and high-dose factor VIII concentrates in a 5-year-old boy with hemophilia A. The patient improved clinically, with fewer bleeding episodes. However, he continued to have low immunoglobulin levels, which led to recurrent infections. After an infusion of intravenous immunoglobulin, inhibitor titers increased rapidly and his ITI was deemed a failure. In conclusion, even though it failed in the present study, Rituximab may be an alternative adjuvant therapy to eliminate the inhibitor in patients with hemophilia. The appropriate schedule and long-term side effects need further investigation.
Appointments and Schedules ; Child, Preschool ; Factor VIII ; Hemophilia A ; Hemorrhage ; Humans ; Immune Tolerance ; Immunoglobulins ; Immunosuppressive Agents ; Male ; Mortality ; Rituximab

Neonatal tension pneumothorax is life-threatening. A tension pneumothorax on the right side was detected on a newborn boy weighing 2,380 g, who was born at 35 weeks of gestation. Given the unavailability of an on-duty thoracic surgeon and appropriately sized chest tubes in the neonatal intensive care unit, an emergency physician performed closed thoracostomy using two 7-French latex catheters. Immediately after the re-expansion of the right lung, left tension pneumothorax was newly detected. Two more 7-French latex catheters were inserted, relieving the left lesion. We consider that the right pneumothorax occurred due to the mixture of spontaneous rupture of the subpleural blebs and barotrauma during the initial positive pressure ventilation, while the left lesion did due to the high-flow oscillatory ventilation. Despite the limited availability of devices in the present case, a favorable outcome was achieved by the use of alternative catheters, which were chosen by the emergency physician.

Authors studied the regulatory mechanism of protein kinase C on the action of acetylcholine in rabbit carotid artery. The arterial rings were myographied isometrically in an isolated organ bath. In this study, acetylcholine relaxed phenylephrine-induced contraction of rabbit carotid artery in the presence of endothelium. In the pretreatment of methylene blue or nitro-L-arginine, the action of acetylchioline was reduced. Pretreatment of phorbol 12-myristate 13-acetate(PMA) attenuated the action of acetylcholine, but PMA did not attenuated it in the presence of staurosporine, suggesting that protein kinase C suppressed the action of acetylcholine. The potency of phorbol ester on the action of acetylcholine was PMA>phorbol 12, 13-dibutyrate(PDBu)>phorbol 12,13-diacetate(PDA), but the direct effect of phorbol on the contraction of arterial rings was PDBu>PMA>PDA. This implied that protein kinase C involved in the contraction of smooth muscle and the attenuation of the action of acetylcholine were different. PMA did not affect on A23187- and sodium nitroprusside-induced vasorelaxation. Acetylcholine increased tissue cGMP contents, which was reduced by PMA. These results suggest that in rabbit carotid artery protein kinase C reduce acetylcholine-stimuated endothelium derived relaxing factor(EDRF) release by affecting membrane receptor, and do not affect on the function of EDRF and cGMP production in the smooth muscle.
Acetylcholine* ; Baths ; Carotid Arteries* ; Endothelium ; Membranes ; Methylene Blue ; Muscle, Smooth ; Protein Kinase C ; Sodium ; Staurosporine ; Vasodilation

PURPOSE: This study provided a sample of self-reported turnover rates and their causes for emergency medicine physicians. METHODS: A questionnaire was distributed to 47 emergency physicians practicing in private clinics via post or e-mail. Self-reported demographic data, workload, causes of turnover, psychosocial and job related stress were collected. 27 emergency physicians participated in this study by completing and returning the questionnaire. RESULTS: Turnover rate for emergency physician was 14.3%. The mean age of the participants was 45.19+/-3.43, and 25 of the 27 participants were male. The length of time working in a private clinic was 7.14+/-4.02 years. Years since acquisition of emergency board certification was 3.38+/-2.97 years. Work hours per week were 52.70+/-8.99. Income satisfaction and personal well-being were higher than compared to their time practicing medicine as emergency physicians. The average scores for APGAR and psychosocial stress were 5.63+/-2.71 and 2.19+/-0.85, respectively. Reported causes of turnover in emergency clinical practice included negative impacts to quality of life, impact of aging, negative effects of shift work, negative "fishbowl" work environment, etc. CONCLUSION: The causes of turnover for emergency physicians include concerns regarding health impacts due to shift work, negative impact on quality of life, and concerns related to job security. In order to decrease emergency physician turnover rates, administrative considerations should be put in place to include a decrease in night shift hours per physician, and frequency for senior emergency physician is most important. Investigation into causes of turnover for physicians should not be limited to private clinic operations but should also include administration, research, teaching, and other duties.
Aging ; Certification ; Electronic Mail ; Emergencies ; Emergency Medicine ; Humans ; Hypogonadism ; Male ; Mitochondrial Diseases ; Ophthalmoplegia ; Quality of Life ; Surveys and Questionnaires