Panax ginseng C.A. Meyer (Araliacea) has been known for thousands of years in the Far East as a remedy effective against a multitude of ailments. Pharmacological investigations have shown that the basic effect in ginseng action is its capacity to increase nonspecific resistance of the organism to various untoward influences. Ginseng saponin has been considered the active principle for ginsengs most therapeutic properties. Recently, the use of cream and soap with ginseng extract has been gradually increasing. The purpose of this study is to evaluate the efficacy of Panax ginseng to Candida albicans in vitro. During this experiment ginseng saponin and powder of Panax ginseng root were diluted serially in Sabouraud's dextrose agar, and candidial suspensions of isolated strains from candidial intertrigo and female genitalia were inoculated into each medium containing different concentrations of test materials. Then their growth was observed for weeks at 25'C. After that we measured the size of colonies grown in various concentrations and eompared them with those of the Sabourauds dextrose media. For the complementary study Candida albicans strain isolated from vagina were plated on both Sabouraud's dextrose media and 80 mg/cc ginseng root powder. Microscopic examination, germ tube test and sugar fermentation test were then performed to compare the production of budding cells, the growth of pseudo-hyphae and the characteristics of the yeast on each media. Results from this study show that ginseng saponin and roots of Panax ginseng have no significant effect on growth and multiplication and the characteristics of Candida albicans in vitro.
Female ; Humans

Verrucous carcinoma, a distinct variant of well differentiated squamous cell carcinoma, was originally described as an entity by Ackerman. This histologically benign lesion features relentless local growth and little tendency to metastasize. The commonest location of verrucous carcinoma is the oral cavity. Less frequently, the tumor originates in the squarnous mucosa, skin of the genitalia(glans penis, vulava, vagina, scroturn and perineum), nasal fossa, the larynx or the sole. Now we report a case of verrucous carcinoma developed on the retroauricular area in a 49-year-old man. He was treated by surgical excision followed by skin graft. This appears to be the first reported case arising on the retroauricular area.
Carcinoma, Squamous Cell ; Carcinoma, Verrucous* ; Humans ; Larynx ; Male ; Middle Aged ; Mouth ; Mucous Membrane ; Penis ; Skin ; Transplants ; Vagina

The pathogeoesis of papulonecrotic tuberculid had been thought to be the result of hernatogenous dissemination from primary tuberculous focus of other organs. But, today, the existence of papulonecrotic tuberculid as a rare cutaneous reaction to the Mycobacterium bacillus is questioned. Papulonecrotic tuberculid is, however, a real entity in underdeveloped countries where tuberculosis is more common. We report a case having papulonecrotie tuberculid associated with cervical lymph node tuberculosis confirmed by typical histopathology and by clinical response to antituberculous chemotherapy. This case supports Iden et al's view (1) that skepticism regarding the existence of papulonecrotic tuberculid is probably the result of the current decreased prevalence of untreated tuberculosis and consequently increased rarity of this entity.
Bacillus ; Drug Therapy ; Mycobacterium ; Prevalence ; Tuberculosis ; Tuberculosis, Cutaneous* ; Tuberculosis, Lymph Node

Malignant angioendothelioma is an uncommon malignant vascular tumor featuring endothelial cell, and it occurs most frequently in sixth and seventh decade. Most lesions occur over the face and scalp, and may be solitary or multiple, The lesion usally appears as a localized dark red to purplish nodules or plapue with small satellite nodules. Histopatholgic finding shows a nodule eomposed of irregular vascular spaces lined by plump endothelial cells stroma. We present a case of malignant angioendo thelioma on a 42 year-old woman. The patient had purplish nodule with satellite lesions on the right cheek. This case was confirmed by clinical picture, histologic findings and electron microscopic examination.
Adult ; Cheek ; Endothelial Cells ; Female ; Humans ; Scalp

The brief report of Zeisler (1922) of a pregnant woman with scattered telangiectasia in a unilateral distribution is perhaps the first recorded case of this syndrome. The syndrome has been described in association with pregnancy, puberty, alcoholisrn and cirrhosis, hormonal therapy and congenital status. The authors observed in a 17-year-old male unilateral telangiectatic lesions over the left C, C, C, Tl and T, dermatomal regions. The lesions developed at first at his puberty on the anterior part of the chest as speckled bright red discoloration. Thereafter, the lesion has been progressed to involve the left upper extremity, sholder, upper middle part of the chest, eventually. Family history was negative and physical, lahoratory and X-ray examination were all negative or within normal limit. No mucous membrane involvement was observed. On histopathologic examination of the skin lesion, thin walled ectatic vessels lined with single layer of endothelial cells were observed in the upper dermis. The lesions were partly dermabrased with favorable result.
Adolescent ; Dermis ; Endothelial Cells ; Female ; Fibrosis ; Humans ; Male ; Mucous Membrane ; Pregnancy ; Pregnant Women ; Puberty ; Skin ; Telangiectasis* ; Thorax ; Upper Extremity

BACKGROUND: Transcatheter closure of patent ductus arteriosus, using the Rashkind double umbrella occluder system, had been attempted in mulitcenter since non-surgical closure of patent ductus arteriosus by Rashkind. METHODS: Between July 1991 and June 1993, transcatheter closure of patent ductus arterious was attempted in 20 adult patients(21 trials). RESULTS: Seventeen female and 3 male patients was consisted of the study. The patient age ranged from 17 to 54 years(mean 30+/-9 years). Mean pulmonary artery pressure before closure was 18.5+/-6.0mmHg(range from 10mmHg to 30mmHg). The diameter of ductus ranged from 3.5mm to 8.0mm(mean 5.2+/-1.5mm), as determined by contrast injection through 11F Mullin sheath or 7F catheter. There was significant decrease of Qp/Qs from 2.6+/-1.1 to 1.5+/-0.4 immediately after transcatheter closure of ductus(p<0.01). There was significant decrease of left ventricular end-diastolic dimension by echocardiogram from 58.7+/-7.6mm to 53.6+/-6.5mm after transcatheter closure of ductus(p<0.01). Among the 21 cases, 16 cases(76.2%) had the clinical improvement without the support of surgical closure. One 17mm Rashkind umbrella was retrieved because of position and problem of deployment. There was no device embolic experience in 21 cases. There were 2 cases of hemolytic anemia during the follow-up period ; one case was surgically ligated and another 17mm device was implanted in the other case. CONCLUSIONS: Transcatheter closure of patent ductus arteriosus in adult patients can replace the surgical correction in selected patients.
Adult* ; Anemia, Hemolytic ; Catheters ; Ductus Arteriosus, Patent* ; Female ; Follow-Up Studies ; Humans ; Male ; Pulmonary Artery

Primary pulmonary hypertension (PPH) is a rare disease of the pulmonary vasculature which largely affects young women and usually runs a rapidly fatal course. Therapeutic trial has continued to reduce the vascular obstruction, lowering the pulmonary vascular pressure and resistance. However, because the etiology is still unknown, therapy is empiric and most patients are clinically fragile, many physicians refrain from intervening. We analyzed clinical and hemodynamic features of 11 PPH patients, confirmed by echocardiogram and cardiac catheterization, and reviewed the literature. The results were followings: 1) Among 11 patients, 5 were male and 6 female, male to female ratio was 1:1.2. Age ranged from 16 and to 52 years, the mean age was 30.4 years. 2) One patient was associated with scleroderma, the other one case was combined with systemic lupus erythematosus and in two patients, including the latter case, the ANA titer was more than 1:80. 3) Clinical features comprised dyspnea in all, chest pain in 54.5%, palpitation in 45.5%, cyanosis and orthostatic dyspnea in 27.3%, and syncope in 18.2%, respectively. 4) Pulmonic second heart sound was accentuated in all patients. Ejection systolic murmur was heard at pulmonic area in 72.7% and diastolic murmur in 45.5%. Pretibial pitting edema in 36.4%, hepatomegaly and superficial neck vein distension in 27.3% were noted. 5) Right ventricular hypertrophy, right axis deviation, right atrial enlargement and right bundle branch block were common EKG findings. In the chest roentgenogram, prominent pulmonary conus was noted in all and cardiomegaly 9 cases. 6) Echocardiogram showed right ventricular dilatation in all, and the ratio of the thickeness of the interventricular septum and left ventricular posterior wall was 0.88-1.50. Midsystolic notching was demonstrated in 6 patients and abnormal interventricular wall motion in 5. 7) hemodynamic data revealed normal pulmonary wedge pressure or left atriae pressure (ranged 4-14: mean; 8.5+/-3.9mmHg). Meanwhile, pulmonary artery pressure highly elevated: systolic pressure ranged between 60-180 (mean; 107.5+/-30mmHg, diastolic pressure 25-90 (mean; 47.9+/-19.6)mmHg and mean pulmonary artery pressure 40-120(mean; 66.5+/-24.7)mmHg. Pulmonary vascular resistance also elevated between 465-3167 (mean; 1209+/-797) and Rp/Rs was elevated in all. Arterial oxygen desaturation was noted 3 patients.
Axis, Cervical Vertebra ; Blood Pressure ; Bundle-Branch Block ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomegaly ; Chest Pain ; Conus Snail ; Cyanosis ; Dilatation ; Dyspnea ; Edema ; Electrocardiography ; Female ; Heart Murmurs ; Heart Sounds ; Hemodynamics ; Hepatomegaly ; Humans ; Hypertension, Pulmonary* ; Hypertrophy, Right Ventricular ; Lupus Erythematosus, Systemic ; Male ; Neck ; Oxygen ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Rare Diseases ; Syncope ; Systolic Murmurs ; Thorax ; Vascular Resistance ; Veins

PURPOSE: This study was undertaken to describe the clinicopathologic characteristics and evaluate the appropriate management of appendiceal tumors. METHODS: During 5 years between Sep. 2000 and Sep. 2005, 28 appendiceal tumors were identified in a retrospective review of 3,744 cases of appendectomy or right hemicolectomy pathology. RESULTS: Carcinoids were found incidentally as appendicitis. Mucinous cystadenomas were common in women older than 50 aged; half of the cases presented with appendicitis and the other half presented with non-specific abdominal symptoms such as palpable mass, intestinal obstruction and intussusception. Carcinomas were common in the older patients (mean age: 62.8 years) and this presented as periappendiceal abscess. Right hemicolectomy was undertaken when there was evidence of tumor spread beyond the resection margin, and carcinoma and tumors were located in the appendiceal base. Recurrence and metastasis were identified only in the carcinoma cases. CONCLUSION: Most appendiceal tumors presented with appendicitis and periappendiceal abscess. One stage curative resection was possible in more than 76% of the patients, and the prepoperative diagnosis rate was less than 35%. The preoperative diagnosis did not have much impact on the clinical course, and the postoperative pathology was important in determining the additional treatment. Close follow-up is needed for the early detection of recurrence, and all the carcinomas that were advanced as serosal involvement, peritoneal seeding and liver metastasis.
Abscess ; Appendectomy* ; Appendicitis ; Appendix ; Carcinoid Tumor ; Cystadenoma, Mucinous ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Intestinal Obstruction ; Intussusception ; Liver ; Neoplasm Metastasis ; Pathology ; Recurrence ; Retrospective Studies

No definitive recommendation is available concerning optimal antithrombotic therapy in pregnant women with a mechanical heart valve. The purpose of the current study was to evaluate the clinical results of nadroparin treatment with respect to pregnancy outcome and maternal complications. From 1997 to 2005, 31 pregnancies were reviewed in 25 women. Nadroparin (7,500 U, twice daily) was used in 23 pregnancies between 6 and 12 weeks of gestation and close-to-term only, and coumarin derivatives were used with aspirin at other times. Eight pregnant women treated with coumarin derivatives throughout pregnancy were compared to evaluate the safety and efficacy of nadroparin. No maternal death or bleeding complication occurred in either of the two groups, and frequencies of maternal thromboembolism including valve thrombosis (8.7% vs. 12.5%, p>0.05) were similar. However, the frequencies of live born (91.3% vs. 50%, p=0.01) and healthy babies (90.4% vs. 25%, p<0.01) were significantly higher, and the fetal loss rate was significantly lower (8.7% vs. 50%, p=0.01) in the nadroparin-treated group. Regarding the efficacy and safety of antithrombotic treatment in pregnant women with prosthetic heart valves, nadroparin treatment during the first trimester is an acceptable regimen and produces better results than coumarin derivatives.
Treatment Outcome ; Thrombosis/etiology/*prevention & control ; Pregnancy Outcome ; Pregnancy Complications, Cardiovascular/*etiology/*prevention & control ; Pregnancy ; Nadroparin/*administration & dosage/*adverse effects ; Hydrocephalus/chemically induced ; Humans ; Heart Valve Prosthesis/*adverse effects ; Heart Valve Diseases/etiology/*prevention & control ; Female ; Coumarins/administration & dosage ; Adult

BACKGROUND: Pulmonary embolism is a relatively common disease but may also be manifestated as a lethal disease. Most previous studies on pulmonary embolism included hemodynamically stable patients who were able to tolerate a confirmative diagnostic workup, including ventilation-perfusion lung scan or pulmonary angiography. However, in most cases of acute massive pulmonary embolism, patients are unstable to tolerate a confirmative diagnostic workup. Studies of only stable patients with pulmonary embolism may have a bias on evaluating the clinical course and prognosis of pulmonary embolism. Therefore, we designed a study to observe the clinical manifestations, diagnostic methods, treatment modality, and to investigate the prognostic factors of patients with acute pulmonary embolism who present with overt or impending right heart failure using the diagnostic criteria suggested by MAPPET study. METHODS: Among 103 patients diagnosed as pulmonary embolism from 1990 to 1997, 63 patients(male/female : 21/42, mean age : 56 15) were enrolled as acute major pulmonary embolism by MAPPET's diagnostic criteria. Patients were included in the study if they showed clinical, echocardiographic and cardiac catheterization findings signifying acute right heart failure or pulmonary hypertension due to pulmonary embolism, together with: 1) a diagnostic pulmonary angiogram, or 2) a lung scan indicating high probability of pulmonary embolism, or 3) at least 3 of the followings: 1) syncope; 2) tachycardia (heart rate > 100 beats /min); 3) dyspnea or tachypnea (> 24 breaths/min or need for mechanical ventilation); 4) arterial hypoxemia (partial arterial pressure of oxygen < 70mmHg while breathing room air) in the absence of pulmonary infiltrates on chest x-ray; 5) ECG signs of right heart strain. RESULTS: Among the 63 patients, 15 patients(23.8%) did not have an underlying disease. Eleven patients(17.5%) had malignancy, 8 patients had an operation in the recent 20 days, 6 patients had chronic pulmonary disease, 5 patients had a history of congestive heart failure and cerebrovascular accident respectively, 4 patients had a previous history of pulmonary embolism, 3 patients had vasculitis such as Behcets' disease and systemic lupus erythematosus and a history of venous thrombosis, respectively. The main clinical manifestation on the time of diagnosis was dypnea in 55 patients(87.3%), which was the most frequent, and chest pain in 18 patients(28.6%), syncope in 10 patients(15.9%), and tachycardia in 2 patients(3.2%). The diagnostic methods were echocardiography(43 patients, 68.3%), lung perfusion scan(39 patients, 61.9%), chest computed tomography(16 patients, 26.4%), pulmonary angiography(4 patients, 6.3%) and right heart catherization (2 patients, 3.2%). In order to examine deep vein thrombosis, lower extremity Duplex ultrusonography and venography were performed in 11 patients(17.5%) and 7 patients(11.1%) respectively. The overall in-hospital mortality was 38.1%(24 patients). The factors influencing in-hospital mortality were associated malignancy(p< 0.01) and unstable vital sign(systolic blood pressure of less than 90mmHg)(p< 0.05). CONCLUSION: Acute pulmonary embolism with overt or impending right heart failure is a significant lethal disease with a high in-hospital mortality. The predictors of mortality were associated malignancy and unstable vital sign.
Angiography ; Anoxia ; Arterial Pressure ; Bias (Epidemiology) ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Diagnosis ; Dyspnea ; Echocardiography ; Electrocardiography ; Heart ; Heart Failure ; Hospital Mortality* ; Humans ; Hypertension, Pulmonary ; Lower Extremity ; Lung ; Lung Diseases ; Lupus Erythematosus, Systemic ; Mortality ; Oxygen ; Perfusion ; Phlebography ; Prognosis ; Pulmonary Embolism* ; Respiration ; Stroke ; Syncope ; Tachycardia ; Tachypnea ; Thorax ; Vasculitis ; Venous Thrombosis ; Vital Signs