BACKGROUND: Compared to Europe and America neurotic chest pain patients seems to be much more prevalent in Korea. This study was designed to depict various neurotic symptoms of patients with inorganic chest pain. METHOD: In the course of one year(from March, 1997 to March, 1998), 70 subjects were selected among the people who visited the outpatient clinic of department of family medicine with symptom of chest pain. The control group was selected from a healthy population which matched nearly the same number as the chest pain group. Patients were tested by EKG, treadmill, chest X-ray, 2D-UCG and requested to answer SCL-MPD questionnaire. Statistical analysis by means of SPCC/PC+ and for significance using non-parametric Mann-Whitney U test was done. RESULTS: The chest pain group scored significantly higher than the control group in obsessive and compulsive, anger-hostility, depression, anxiety, and somatization scale. male chest pain group scored higher in somatization, anxiety, obsessive-compulsive, hypochondriasis, and depression scale. The female chest pain group scored higher in depression scale. CONCLUSION: Many inorganic chest pain patients complain through various neurotic symptoms. When approaching chest pain patients we should consider the possibility of a psychosocial cause.
Ambulatory Care Facilities ; Americas ; Anxiety ; Chest Pain* ; Depression ; Electrocardiography ; Europe ; Female ; Humans ; Hypochondriasis ; Korea ; Male ; Psychology* ; Thorax* ; Surveys and Questionnaires

Lichen planus (LP) commonly involves the flexor aspects of the wrists, legs, and oral and genital mucous membranes. But it rarely occurs on the palms and/or soles. It mainly affects people in the age range 30~60 years. Childhood LP is reported to constitute only 1~4% of total cases of LP. In the literature, a few cases of LP on the palms and soles of pediatric patients have been reported. Here we report an interesting case of childhood LP with palmoplantar involvement. The patient was a 7-year-old boy who for 6 months had variously sized and shaped, pruritic, violaceous, polygonal papules and plaques on the whole body. The skin biopsy specimens taken from four sites of the patient (dorsum of the hand and foot, sole and chest) showed typical features of LP on histopathology. A diagnosis of generalized LP with palmoplantar involvement was made.
Biopsy ; Child ; Foot ; Hand ; Humans ; Leg ; Lichen Planus ; Lichens ; Mucous Membrane ; Skin ; Wrist

PURPOSE: Connective tissue reattachment to periodontally damaged root surfaces is one of the most important goals of periodontal therapy. The aim of this study was to develop a root conditioning agent that can demineralize and detoxify the infected root surface. METHODS: Dentin slices obtained from human teeth were treated with a novel root planing agent for 2 minutes and then washed with phosphate-buffered saline. Smear layer removal and type I collagen exposure were observed by scanning electron microscopy (SEM) and type I collagen immunostaining, respectively. Cell attachment and lipopolysaccharides (LPS) removal demonstrated the efficiency of the root conditioning agent. RESULTS: SEM revealed that the smear layer was entirely removed and the dentinal tubules were opened by the experimental gel. Type I collagen was exposed on the surfaces of the dentin slices treated by the experimental gel, which were compared with dentin treated with other root planing agents. Dentin slices treated with the experimental gel showed the highest number of attached fibroblasts and flattened cell morphology. The agar diffusion assay demonstrated that the experimental gel also has effective antimicrobial activity. Escherichia coli LPS were effectively removed from well plates by the experimental gel. CONCLUSIONS: These results demonstrated that this experimental gel is a useful tool for root conditioning of infected root surfaces and can also be applied for detoxification of ailing implant surface threads.
Agar ; Collagen ; Collagen Type I ; Connective Tissue ; Dentin ; Diffusion ; Drugs, Chinese Herbal ; Escherichia coli ; Fibroblasts ; Humans ; Lipopolysaccharides ; Microscopy, Electron, Scanning ; Root Planing ; Smear Layer ; Tooth

PURPOSE: The purpose of this study was to assess and compare the clinical and radiographic outcomes of guided tissue regeneration therapy for human periodontal intrabony defects using two different collagen membranes: a porous nonchemical cross-linking collagen membrane (NC) and a bilayer collagen membrane (BC). METHODS: Thirty subjects were randomly assigned and divided into the following 3 groups: a test group (NC+BM), in which a NC was used with xenograft bone mineral (BM), a positive control group (BC+BM), in which a BC was used with xenograft BM, and a negative control group (BM), in which only xenograft BM was used. The following clinical measurements were taken at baseline and 3 months after surgery: plaque index, gingival index, probing pocket depth, gingival recession, and clinical attachment level. Radiographic analysis was performed at baseline, 1 week and 3 months after surgery. RESULTS: Membrane exposure was not observed in any cases. Significant probing depth reduction, attachment-level gain and bone fill were observed for both test and control groups compared to baseline at 3 months after surgery (P<0.05). However, there were no statistically significant differences in clinical improvement and radiographic bone fill between treatment protocols (P>0.05). CONCLUSIONS: Within the limitations of this study, the results suggest that both NC and BC were comparable in terms of clinical and radiographic outcomes for the treatment of periodontal intrabony defects in human subjects.
Chronic Periodontitis ; Clinical Protocols ; Collagen* ; Gingival Recession ; Guided Tissue Regeneration* ; Heterografts ; Humans ; Membranes* ; Periodontal Index

Cutaneous metastasis originating from lung cancer is relatively rare and accounts for only 0.5~6.7% of of lung cancer metastases. In general, there is a histomorphologic resemblance between primary carcinoma and cutaneous metastatic carcinoma. A 45-year-old woman presented with a painless 0.8 cm erythematous nodule on her left shoulder. During the past 3 years, she had been receiving chemotherapy for the treatment of lung adenocarcinoma with bone metastases. A histopathological examination of the skin lesion showed adenocarcinoma and squamous cell carcinoma components, which were compatible with adenosquamous carcinoma. Herein, we report an interesting case of adenosquamous carcinoma showing cutaneous metastasis, which is a different pathologic subtype from primary lung adenocarcinoma.
Adenocarcinoma ; Carcinoma, Adenosquamous ; Carcinoma, Squamous Cell ; Female ; Humans ; Lung ; Lung Neoplasms ; Middle Aged ; Neoplasm Metastasis ; Shoulder ; Skin

Leiomyosarcoma is a rare malignant neoplasm of smooth muscle cells usually found in the uterus, retroperitoneum, gastrointestinal tract, or deep soft tissue. Metastasis of leiomyosarcoma tends to occur through hematogenous routes. Cutaneous metastasis is therefore a rare occurrence. A 57-year-old female presented with several weeks history of a solitary erythematous 0.8x0.8 cm sized firm nodule on the scalp. She had a past history of transabdominal hysterectomy due to primary uterine leiomyosarcoma and pulmonary lobectomy due to metastatic lung nodules. Histopathologic examination of her scalp nodule revealed a poorly circumscribed tumor mass composed of malignant spindle cells with abundant eosinophilic cytoplasm, elongated and blunt ended nuclei, and frequent mitotic activity. Immunohistochemical staining with caldesmon was positive. After 3 weeks, a 1.5x3.5 cm sized tumor had developed at the previous excision site. From these findings, we diagnosed this case of uterine leiomyosarcoma metastasized to the skin as a local recurrence with rapid growth after excision.
Female ; Humans ; Neoplasm Metastasis

Background: Patients with skin barrier dysfunction often coincides with pruritus, creating a ‘vicious cycle’ of dry skin and itching. Recently, Cynanchum atratum (CA) extract and its constituents have demonstrated effects on atopic dermatitis both in vivo and in vitro. Objective: This study aimed to assess the safety and efficacy of a moisturizer infused with CA extract in enhancing epidermal barrier function and reducing pruritus. Methods: A total 36 participants with skin barrier dysfunction with pruritus (mean age: 46.22±12.48 years) applied the CA-containing moisturizer topically twice daily for up to 4 weeks. Treatment efficacy was assessed by the investigator using the erythema scaling induration fissuring (ESIF) scale, transepidermal water loss (TEWL), skin hydration, visual analogue scale (VAS) for pruritus, and overall patient satisfaction assessed via questionnaire. Results: The CA-containing moisturizer demonstrated favorable tolerability, and yielded significant pruritus relief as evidenced by VAS scores after 2 and 4 weeks of application (p＜0.05). Significant decreases in TEWL (p＜0.05) and skin hydration (p＜0.05) were observed after 2 and 4 weeks, indicating enhanced skin barrier function. Moreover, significant relief from pruritus and reductions in ESIF were observed at 2 and 4 weeks of application (p ＜0.05), aligning with the high levels of patient satisfaction was high. Conclusion The CA-infused moisturizer emerged as a safe and effective intervention for restoring skin barrier function and providing itch relief.

A Bezold-Jarisch reflex (BJR) mediated vasovagal syncope is the most common neurally mediated reflex characterized by the sudden failure of the autonomic nervous system and have been reported in patients undergoing a peripheral nerve block. The concomitant administration of a beta-adrenoreceptor antagonist and calcium channel blocker have a synergistic suppressant effect on the autonomic nervous system and interact with the anesthetics significantly. We report a case of a 57-year-old female patient with essential hypertension controlled with lercanidipine and carvedilol. Cardiac arrest developed with spontaneous respiration 50 min after the brachial plexus block to remove a plate in the humerus. Epinephrine was administered and the pulse immediately returned to a normal sinus rhythm. This event might be vasovagal syncope mediated by BJR, and realted to the antihypertensive medication used.
Anesthetics ; Autonomic Nervous System ; Brachial Plexus* ; Calcium Channels* ; Calcium* ; Epinephrine ; Female ; Heart Arrest* ; Humans ; Humerus ; Hypertension ; Middle Aged ; Peripheral Nerves ; Reflex ; Respiration ; Syncope, Vasovagal

The purpose of this study was to evaluate newly fabricated tricalcium phosphate(TCP)/chitosan microgranuls as bone substitutes. TCP/chitosan microgranules were fabricated by dropping TCP-chitosan suspension into the NaOH/ethanol solution. The size of microgranules could be controllable via airflow rate. PDGF-BB was loaded into the fabricated granules via freeze-drying methods(300 ng/20 mg). To evaluate cell proliferation, cultured osteoblasts cell lines(MC3T3-E1) was dropped on the BioOss(R), chitosan microgranules, TCP/chitosan microgranules and cultured for 1, 7, 14, and 28 days. Scanning electron microscopic observation was done after 7 days of culture and light microscopic examination was done after 28 days of culture. PDGF-BB release from the microgranules was tested. Rabbit calvarial defects(8 mm in diameter) were formed and chitosan, TCP/chitosan, PDGF-TCP/chitosan microgranules, and BioGran(R) were grafted to test the ability of new bone formation. At SEM view, the size of prepared microgranules was 250-1000 um and TCP powders were observed at the surface of TCP/chitosan microgranules. TCP powders gave roughness to the granules and this might help the attachment of osteoblasts. The pores formed between microgranules might be able to allow new bone ingrowth and vascularization. There were no significant differences in cell number among BioOss(R) and two microgranules at 28 day. Light and scanning electron microscopic examination showed that seeded osteoblastic cells were well attached to TCP/chitosan microgranules and proliferated in a multi-layer. PDGF-BB released from TCP/chitosan microgranules was at therapeutic concentration for at least 1 week. In rabbit calvarial defect models, PDGF-TCP/chitosan microgranules grafted sites showed thicker bone trabeculae pattern and faster bone maturation than others. These results suggested that the TCP/chitosan microgranules showed the potential as bone substitutes.
Bone Substitutes ; Cell Count ; Cell Proliferation ; Chitosan* ; Osteoblasts ; Osteogenesis* ; Powders ; Transplants

Extrahepatic bile duct can be compressed by right hepatic artery (RHA) and cause a variety of hepatobiliary symptoms. This condition is referred to as RHA syndrome. A 20-year-old man was admitted because of jaundice. No stones or tumor were visible on CT scan and endoscopic retrograde cholangiopancreatography. However, RHA was seen traversing and compressing the mid common bile duct (CBD) with resultant upstream dilatation. The patient was diagnosed with obstructive jaundice due to compression of the CBD by variant RHA originating from gastroduodenal artery. After separation and mobilization of the variant RHA, obstructive jaundice was resolved. Herein, we report a case of a variant form of RHA syndrome that was successfully managed by surgery.
Arteries ; Bile Ducts, Extrahepatic ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct* ; Dilatation ; Hepatic Artery* ; Humans ; Jaundice ; Jaundice, Obstructive* ; Tomography, X-Ray Computed ; Young Adult