BACKGROUND: There are many suggested methods for the indirect determination of anaerobic threshold(AT) using the changes of ventilatory parameters in respones to ventilatory load accompanying the increase of blood lactic acid level during exercise and the threshold derived from them is called ventilatory threshold( VT). They include ventilatory equivalent method(VEM), End-tidal PO2 method(PETO2), V-slope method(VSM), and respiratory quotient method(RQ). But in the patients with chronic airway ohstruction(CAO), the AT determined by ventilatory methods may not reflect true AT because the patients with GAO show inadequate ventilatory response to the increase of blood lactic acid level during excercise. METHODS: For the investigation of detection rate and reliability of above four VT determination methods in the patients with GAO, we performed the symptom-limited and maximal incremental exercise test in 17 patients with GAO and 12 normal controls. The incremental workload was 10 W/min in GAO group and 25 W/min in control group. The reliability of VT in each group was investigated by the calculation of Spearman correlation coefficient. RESULTS: The detection rates of VT were 100% by RQ, 91.7% by both VEM and POETO2, and 83.3% by VSM in normal control group, while 94.1% by RQ, 64.7% by VEM and PETO2, and 83.3% by VSM in GAO group. Good correlations were noted among VEM, PETO2, and VSM except RQ in normal control group. But there was no significant correlation except between VEM and PETO2 in GAO group. CONCLUSIONS: RQ is very sensitive but crude and VEM is near similar to PETO2. The clinical usefulness of VT determined by ventilatory method might be limited in patients with severe GAO.
Airway Obstruction* ; Exercise Test ; Humans ; Lactic Acid

BACKGROUND: Normal humans meet the increased ventilatory need during exercise initially by the increase of tidal volume (TV) and later by the increase of respiratory frequency (Rf). And the inspiratory duty cycle (Ti/Ttot) is also increased more than 50% for the compensation of the decrease of respiratory cycle provoked by the increase of respiratory frequency. The patients with chronic airflow obstruction show rapid and shallow breathing pattern during exorcise because of the degreased ventilatory capacity and the increased dead space ventilation. However, the studies about the change of inspiratory duty cycle are only a few and there is no literature about the relationship between the change of inspiratory duty cycle and the degree of airflow obstruction. METHODS: The subjects were the twelve patients with chronic airflow obstruction (CAO) and ten normal people. The incremental exercise test was done. The increase of work load was 10 Win CAO group and 25 Win normal control group. The analysis of the results was done by the comparison of the parameters such as minute ventilation (VE), TV, Rf, physiologic dead space (Vd/vt), and inspiratory duty cycle between the two groups. Each parameters were compared after transformation into % control duration base that means dividing the total exercise time into five fractons and % control duration data were obtained at rest, 20%, 40%, 60%, 80%, and max. Statistical analysis was done by repeated measure ANOVA using SAS program. RESULTS: The changes of VE and TV were significantly different between two groups while the change of Rf was not significant. The decrease of Vd/vt was significantly low in CAO group. Ti/Ttot was markedly increased from 38.4+3.0% at rest to 48.6+4.5% at max in normal control group while Ti/Ttot showed little change from 40.5+2.2% at rest to 42.6+3.5% at max. And the change of inspiratory duty cycle showed highly good correlation with the degree of airflow obstruction (FEVl%). (r=0.8151, p<0.05) CONCLUSIONS: The increase of Ti/Ttot during exercise observed in normal humans is absent in the patients with CAO and the change of Ti/TtDt is well correlated with the degree of airflow obstruction.
Compensation and Redress ; Exercise Test* ; Humans ; Pulmonary Disease, Chronic Obstructive* ; Respiration* ; Tidal Volume ; Ventilation

A 62-year-old man presented with a tender, solitary nodule on the left upper arm. He had no specific family history of the lesion. A biopsy specimen showed various sized irregular vascular lumens in the upper dermis. The vascular walls consisted of an endothelial cell layer and rim of one to three layers of glomus cell nests outside the endothelial cells. The cell nests consisted of round shaped epitheloid cells with relatively uniform round or oval shaped nuclei and pale cytoplasm. These tumor cells were strongly positive for vimentin, and a-smooth muscle actin. On electron microscopic examination, the cytoplasm of these tumor cells contained fine filamentous components and many electron dense bodies were found at the plasma membrane and the cytoplasm. We report a case of a solitary glomus tumor(glomangioma) that showed the histological features of the multiple type of glomus tumor. In addition we describe the results of an immunohistochemical and electron microscopic study.
Actins ; Arm ; Biopsy ; Cell Membrane ; Cytoplasm ; Dermis ; Endothelial Cells ; Glomus Tumor ; Humans ; Middle Aged ; Vimentin

Trichost.asis Spinulosa consists of several fasciles of reta ned vellus hairs in the hyperkeratotic sebaceous follicles, resulting in a dark slightly raied horny follicular spines, resembling comedones on the trunk and face. The condition is relatively common, particulary among the age, but is usually overlooked on routine skin examination as the patient is rarely aware of it.. We report 6 cases of trichostasis spinulosa, which showed numerous asymptomatic tiny black comedo-like dots on their backs. We obtained the follicular material by tweezer, which consised of several vellus hairs surrounded by a keratinous plug. Histologic examination was done in 3 patients, one of whom showed a rarely reproted double follicle and double papilla. With scanning electron microscopy, we observed multiple vellu hairs embedded in a keratotic plug, emerging from a hair follicle opening.
Hair ; Hair Follicle ; Humans ; Microscopy, Electron, Scanning ; Skin ; Spine

Apocrine hidrocystoma is an uncommon benign tumor derived from the secretory segment of apocrine sweat glands and another name for it is apocrine cystadenoma. A 48-year-old female patient had a solitary, translucent red-brownish cystic nodule, 10 × 6 × 7mm in size, on the periorbital area of her left eye. The lesion had enlarged very slowly for 25 years. We excised the lesion and identified it as apocrine hidrocystoma. This is a case of apocrine hidrocystoma with typical clinical and histopathological findings.
Cystadenoma ; Female ; Hidrocystoma* ; Humans ; Middle Aged ; Sweat Glands

PURPOSE: The purpose of this study was to examine the training effectiveness and behavior towards the elderly of 180 caregiver trainees. METHODS: Data were collected from five caregiver training institutions located in G city. All subjects were surveyed about the training effectiveness and behavior towards the elderly by using the Training Effectiveness Scale and the Behavior towards the Elderly Scale. Data were analyzed by SPSS/WIN 12.0 program. RESULTS: The study subjects gained a training effectiveness score of 3.84 out of 5 points and a behavior towards the elderly score 3.40 out of 4 points. The training effectiveness differed significantly depending on subject's characteristics, intention to work as a caregiver, and hours of training. There were significant differences in behavior towards the elderly depending on their age and hours of training. The training effectiveness was significantly correlated with the level of behavior towards the elderly. CONCLUSION: These findings demonstrated the necessity of developing a level of educational training that will help improve caregiver trainees' care by positively changing their behavior towards the elderly.
Aged ; Caregivers ; Humans ; Intention

No abstract available.
Administration, Oral* ; Animals ; Intestine, Large* ; Rats*

No abstract available.
Administration, Oral* ; Animals ; Intestine, Large* ; Rats*

We report a patient who had been initially diagnosed as a myelodysplastic syndrome in 1998 presenting purpuric patches on the left arm that started to develop about a year prior. The purpuric lesions were diagnosed as leukemia cutis by skin biopsy. Her subsequent bone marrow biopsy showed progression into an atypical chronic myeloid leukemia with increased numbers of leukocytes in the peripheral blood. Leukemia cutis typically is regarded as a sign of progression of disease or a manifestation of recurrent disease in treated patients with an established diagnosis of leukemia. We suggest that the skin lesion in this patient could have been a sign of con-version into atypical chronic myeloid leukemia.
Arm ; Biopsy ; Bone Marrow ; Diagnosis ; Humans ; Leukemia* ; Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative* ; Leukocytes ; Myelodysplastic Syndromes* ; Skin

BACKGROUND: Laser resurfacing has beneficial effects for the treatment of several skin conditions. Recently, the pulsed erbium:YAG laser has been shown to be a highly effective treatment for several kinds of pitted facial scars. OBJECTIVE: The purpose of this study was to assess the efficacy and safety of pulsed erbium:YAG laser skin resurfacing at the setting of low or high energy for pitted acne scars. METHODS: 65 patients with pitted acne scars were included in this study. All patients had skin types III or IV. All patients were instructed to use tretinoin cream 0.05% nightly for 2-4 weeks prior to the laser treatment. The pulsed erbium:YAG laser with a 2 mm handpiece at the setting of 500 mJ/pulse, 3.5-5 W in 45 patients and 1,000 mJ/pulse, 7-10 W in 20 patients was used. Two weeks after laser treatment, topical application of hydroquinone 4%, tretinoin 0.05%, and hydrocortisone 1% cream was recommended for 2-4 weeks. Facial photographs were obtained at baseline and 2 week intervals postoperatively. The results of treatment were evaluated for the changes of skin texture and color at 1 month, 3 months, and 6 months. RESULTS: In 45 cases treated with 500 mJ/pulse energy, pitted acne scars were improved about 46.7 % on average and no erythema and postinflammatory hyperpigmentation was observed after 6 months. In 20 cases treated with 1,000 mJ/pulse energy, pitted acne scars were improved about 64% on average and erythema in two patients and postinflammatory hyperpigmentation in one patient were observed after 6 months. CONCLUSION: The results of laser treatment for pitted facial acne scars at the setting of high energy are better than those of laser treatment at the setting of low energy.
Acne Vulgaris* ; Cicatrix* ; Erbium* ; Erythema ; Humans ; Hydrocortisone ; Hyperpigmentation ; Lasers, Solid-State* ; Skin ; Tretinoin