Nevus comedonicus is a rare skin abnormality characterized by a unilateral and usually linear distribution of groups of comedones, Histologically, local epidermal invagination and keratin material plugging in invaginated pouch and immatured hair follicles on lower part of the pouch were seen. Two cases are reported at first in the Korean literature. Case 1: A 24 year old man has had black colored comedolike skin lesions on left cheek with 16 years duration without any subjective symptoms. Case 2: A 19 year old girl has had multiple comedolike lesions on right buttock with 2 years duration, acompanied by recurrent suppuration and moderate itching. Our 2 cases, all are typical Nevus Comedonicus Unilateralis case in clinically and histopathologically. Treatment with local application of steroid cream and dermoabrasion resulted good effect, but essentially there is no need to treat untill complication deveoped.
Buttocks ; Cheek ; Female ; Hair Follicle ; Humans ; Nevus* ; Pruritus ; Skin ; Skin Abnormalities ; Suppuration ; Young Adult

To evaluate the results of anesthesia during open heart surgery, the cases of 77 patients in the Department of Anesthesiology, Ewha Womans University Hospital were weviewed from November, 1982 to February, 1985 and from March, 1986 to February 1987. The Results were as follows: 1) Thirty-nine percent of the 77 cases were acyanotic congenital heart anomalies , 18.2% were cyanotic anomalies and 42.8% were valvular heart diseases. The patients' ages ranged from 13 months to 63 years old, and the study included 30 male and 47 female patients. 2) Pethidine given as a premedication in mot cases, also atropine, glycopyrrolate, hydroxyzine, lorazepam and diazepam were utilized. 3) The induction agents included thiopental, ketamine diazepam, and morphine, and were injected singly or in combination. 4) Anesthesia was maintained with diazgepam, pancuronium, ketamine, morphine, and pethidine, N20 inhalation was used in the acyanotic and valvular cases. 5) Serum Na+ and K+ concentrations were lower during bypass than before and after bypass. 6) During bypass, body temperatuer was maintained below 30 degrees C, and the mean values for arterial pressure ranged from 50-80 mmHg. 7) The duration of andsthesia was 481+/- 88.7 minutes in the valvular cases and the duration of bypass was 118+/-18.3 minutes in the cyanotic cases. 8) In the analysis of arterial blood gases, the cyanotic cases displayed a low pH and base excess. In the cyanotic cases, the PaCO2, and PaO2, differed from the other cases before bypass, but not after bypass. 9) Overall mortality was 14.3%, The mortality rate with respect to each disease was 10 10/0% in the acyanotic cases, 28.6% in the cyanotic cases and 12.1% in the valvular cases.
Anesthesia* ; Anesthesiology ; Arterial Pressure ; Atropine ; Diazepam ; Female ; Gases ; Glycopyrrolate ; Heart Valve Diseases ; Heart* ; Humans ; Hydrogen-Ion Concentration ; Hydroxyzine ; Inhalation ; Ketamine ; Lorazepam ; Male ; Meperidine ; Middle Aged ; Morphine ; Mortality ; Pancuronium ; Premedication ; Thiopental ; Thoracic Surgery*

To evaluate the results of anesthesia during open heart surgery, the cases of 77 patients in the Department of Anesthesiology, Ewha Womans University Hospital were weviewed from November, 1982 to February, 1985 and from March, 1986 to February 1987. The Results were as follows: 1) Thirty-nine percent of the 77 cases were acyanotic congenital heart anomalies , 18.2% were cyanotic anomalies and 42.8% were valvular heart diseases. The patients' ages ranged from 13 months to 63 years old, and the study included 30 male and 47 female patients. 2) Pethidine given as a premedication in mot cases, also atropine, glycopyrrolate, hydroxyzine, lorazepam and diazepam were utilized. 3) The induction agents included thiopental, ketamine diazepam, and morphine, and were injected singly or in combination. 4) Anesthesia was maintained with diazgepam, pancuronium, ketamine, morphine, and pethidine, N20 inhalation was used in the acyanotic and valvular cases. 5) Serum Na+ and K+ concentrations were lower during bypass than before and after bypass. 6) During bypass, body temperatuer was maintained below 30 degrees C, and the mean values for arterial pressure ranged from 50-80 mmHg. 7) The duration of andsthesia was 481+/- 88.7 minutes in the valvular cases and the duration of bypass was 118+/-18.3 minutes in the cyanotic cases. 8) In the analysis of arterial blood gases, the cyanotic cases displayed a low pH and base excess. In the cyanotic cases, the PaCO2, and PaO2, differed from the other cases before bypass, but not after bypass. 9) Overall mortality was 14.3%, The mortality rate with respect to each disease was 10 10/0% in the acyanotic cases, 28.6% in the cyanotic cases and 12.1% in the valvular cases.
Anesthesia* ; Anesthesiology ; Arterial Pressure ; Atropine ; Diazepam ; Female ; Gases ; Glycopyrrolate ; Heart Valve Diseases ; Heart* ; Humans ; Hydrogen-Ion Concentration ; Hydroxyzine ; Inhalation ; Ketamine ; Lorazepam ; Male ; Meperidine ; Middle Aged ; Morphine ; Mortality ; Pancuronium ; Premedication ; Thiopental ; Thoracic Surgery*

BACKGROUND: Although maximal exercise stress tests are widely used in the athletic and medical fields, studies on professional soccer players are few. The purpose of our study is to observe the cardiopulmonary response to maximal exercise loading and the AT in professional soccer players. METHODS: Maximal exercise stress tests were carried out by a ramp protocol using a treadmill on 20 professional soccer players with a mean age of 25.2 years and with over 10 career years. The tests were also done on 21 college students majoring in physical education with a mean age of 19.4 years, which served as the control group. The AT was determined by the V-slope method. RESULTS: In the players, the VO2 max, VCO2 max and O2 pulse max were significantly larger than those in the control group, and the HR max was smaller for their ages. The VE max, VT max and RP max showed not much difference between the 2 groups but the VE max/VO2 max and VE max/VCO2 max were significantly lower in the players. The AT was larger in the players but the AT/VO2 max was essentially similar to that of the control group. CONCLUSION: Our study reveals that the professonal soccer players, despite their mean ages were approximately 6 years older than the subjects in the control group, had larger VO2 max and VCO2 max, and smaller HR max for their ages. The VE max was similar in both groups. This suggests that the players have higher aerobic capacity than the control group and exchange respiratiory gases more efficiently.
Architectural Accessibility ; Child ; Exercise Test ; Gases ; Humans ; Physical Education and Training ; Soccer* ; Sports

Primary malignant lymphoma of the uterine cervix is very rare. Lymphomas account for 3.5% of all malignant tumors in the females. Approximately, 25% of all malignant lymphomas arise from extranodal sites, most frequently from gastrointestinal tract and skin. Although the incidence of systemic non-Hodgkin's lymphoma (NHL) and extranodal NHL has increased in recent decades, only 1 to 1.5% arises from female genital tract. Primary pelvic sites include ovary, which is the most common site, uterine corpus, cervix, vagina, and vulva. Primary cervical lymphomas account for 0.12~0.6% of all extranodal lymphomas. However, there is still no consensus on the management of cervical lymphomas due to low incidence of the disease and limited experience in the literature. We experienced two cases of primary malignant lymphoma of the uterine cervix. A 41-year-old woman, Ann Arbor stage IE, was treated with laparoscopically assisted vaginal hysterectomy and both salpingo-oophorectomy and 4 cycles chemotherapy. A second case was a 73-year-old postmenopausal woman, Ann Arbor stage III, received five courses chemotherapy without any surgery. In this article, two cases of uterine cervical lymphoma are presented with a review of the available literature.
Adult ; Aged ; Cervix Uteri ; Consensus ; Female ; Gastrointestinal Tract ; Humans ; Hysterectomy, Vaginal ; Incidence ; Lymphoma ; Lymphoma, Non-Hodgkin ; Ovary ; Skin ; Vagina ; Vulva

BACKGROUND: Sevoflurane is characterized by the lack of an unpleasant odor, airway irritation and its low blood/gas partition coefficient (0.68), which provides rapid and smooth induction. Inhaled induction with sevoflurane is commonly used in pediatric patients, but not in adult patients. This study was designed to investigate the time to completion of LMA insertion and end-tidal sevoflurane concentration during induction with sevoflurane 8% and N2O 50%, after midazolam administration, in adults. METHODS: Twenty eight patients, aged 20(-60) years, were administered intravenous midazolam 30 microgram/kg and after one minute, sevoflurane 8% and N2O 50% were inhaled with tidal-volume breathing. One minute after loss of consciousness, jaw thrust and mouth opening were checked and an LMA was inserted. The end-tidal concentration of sevoflurane, and the times to loss of consciousness and completion of insertion were recorded. The mean arterial pressure and heart rate were also recorded. RESULTS: From initiation of sevoflurane and N2O inhalation, it took 48 +/- 14 seconds until loss of consciousness, and 143 +/- 19 seconds until the completion of LMA insertion. The end-tidal sevoflurane concentration was 4.1 +/- 0.6% at loss of consciousness, 5.0 +/- 0.7% at one min after loss of consciousness, and 4.1 +/- 0.5% after LMA insertion. In all patients LMA insertion was successful and satisfactory. After LMA insertion, compared to baseline, the mean arterial pressure was reduced and the heart rate increased. CONCLUSIONS: After small-dose of midazolam, inhaled induction with sevoflurane 8% and N2O 50% allowed successful and satisfactory LMA insertion in adults.
Adult ; Arterial Pressure ; Heart Rate ; Humans ; Inhalation ; Jaw ; Laryngeal Masks ; Midazolam* ; Mouth ; Nitrous Oxide ; Odors ; Respiration ; Unconsciousness

OBJECTIVES: Despite the fact that determinations of cadiorespiratory fitness levels by exercise stress tests are becoming widely used in healthy individuals as well as in patients with cardiopulmonary diseases, the normal standards in this field have not been well established in Korea. The purpose of this study is to provide normal standards or reference values for the VO2 max, HR max and O2 pulse max for normal Korean adults by age and sex, along with the derivation of regression formulae of these parameters. METHODS: In 1,000 healthy adults (20-66years) consisting of 603men and 397women, symptomlimited maximal exercise was carried out by Bruce protocol, allowing holding on to the hand rail of the treadmill during exercise for the safety purpose. All the subjects were non-athletes and were members of a health center and were more conscious about their health and physical fitness than the ordinary population. RESULTS: The VO2 max and HR max were decreased with age as expected and, as a whole, the values of the VO2 max and HR max of females were approximately 84% and 90% of those of males, respectively. Estimated yearly reductions in the V max for males and females were 0.45 and 0.32mL/kg/min, respectively and those of the HR max were 0.72 and 0.76/min, respectively. The O2 pulse max of the female was approximately 70% of that of the male, and was slightly related to weight and exercise time. The regression equations of the parameters obtained using exercise time (ET, sec), age (A, year), weight (W, kg) and sex (S, O=male; 1= female) were: HR max=215.3-0.74A-5,04S, O2 pulse max= 5.371+0.216W+0.0107ET-1.505S and VO2 max=40.612+1.950ET-0.206A-0.147W-6.060S, CONCLUSION: The VO2 max in our study was higher than hitherto reported. This was primarily due to longer exercise time of the subjects on the treadmill, because they were allowed to hold on to the hand rail during exercise. And also, the fact that our subjects, being members of a health center, might have had higher physical fitness levels than general population could have contributed to the high VO2 max. Thus, we feel that our results could be the ideal target or- reference values to be achieved for those patients or individuals who have to do the tests with holding on to the rail of a treadmill for safety purpose.
Adult ; Exercise Test ; Female ; Hand ; Heart Rate* ; Heart* ; Humans ; Korea ; Male ; Oxygen* ; Physical Fitness ; Reference Values

BACKGROUND: It has been well known that normal leukocyte counts in blood can vary depending on age, gender, other environmental factors and ethnic differe nces. However, the normal white blood cell counts in Koreans has not been settled yet. Over past several years, a large number of patients were referred to the Hematology Clinic of Asan Medical Center (AMC) for evaluation of "leukopenia", and most of them were found to have no medical problems other than leukocyte counts less than 4,000/mm3. We performed this study on persons who visited Health Screening Center to analysis of leukopenic patients and also to establish the normal value of white blood cell counts in Korean. METHOD: We studied 31,307 persons (19,540 men, 11,767 women, aged 15-90), who visited to Health Screening Center of AMC during the period from January through December 1995. We have carried out retrospec tive analysis of complete medical record of 2,406 patients (838 men, 1,568 women, aged 20-81) who were found to have leukocyte counts less than 4,000/ mm3. And we tried to establish the normal values of leukocyte counts and differential counts of 24,079 adults (15,807 men, 8,272 women, aged 19-90), who were assessed to be healthy at Health Screening Center of AMC. RESULTS: 1) Leukopenia (WBC<4,000/mm3) were found in 2,406 subjects (7.7%) among 31,307 persons screened. 2) Among them, 77 subjects (3%) had medical illness; 39 of them had chronic B or C viral hepatitis, 24 of them had iron deficiency anemia, and other diseases were de tected in remaining 14 patients. But other hematologic dis eases or significant infectious diseases were not detected. Follow-up study of them has indicated no increased incidence of infection or other hematologic diseases. 3) The total white blood cell counts of 24,097 healthy Korean adults were 3,640-9,870/mm3 (5,900/ mm3) in men, and 3,270-8,400/mm3 (5,264/mm3) in women. Neutrophil counts ranged 1,288-6,866/mm3 (3,098/mm3) in men, and 1,180-5,985/mm3 (2,816/mm3) in women. Leukocyte counts were significantly lower in female, but no significant variation was found among age groups. CONCLUSION: Normal range of leukocyte counts and neutrophil counts of healthy Korean adults were lower than those of white populations. Thus, a new normal values of leukocyte and neutrophil counts should be established in Koreans. And many persons with leuko cyte counts less than 4,000/mm3 who are otherwise he althy could be normal.
Adult ; Anemia, Iron-Deficiency ; Chungcheongnam-do ; Communicable Diseases ; Female ; Follow-Up Studies ; Hematologic Diseases ; Hematology ; Hepatitis ; Humans ; Incidence ; Leukocyte Count ; Leukocytes ; Leukopenia* ; Male ; Mass Screening ; Medical Records ; Neutropenia* ; Neutrophils ; Reference Values