OBJECTIVES: To assess the relationship between ST segment elevation during exercise testing and coronary artery disease. METHODS: Treadmill exercise electrocardiography and coronary angiography were performed in 137 patients with angina with no Q waves. The J point elevation of > 0.03mV(0.3mm) measured from baseline, the elevation of ST segment at 80msec. from J point(ST80) measured larger in lead V1than in aV1, or both the elevation of ST segment at J point and at ST80 developed earlier than or concomitantly with ST depression were considered as abnormal responses. RESULTS: 1) There was no clinical significance of ST elevation in lead aV1. 2) Exercise-induced ST elevation in lead V1occurred in 29 of 137 patients with angina. 3) Abnormal St elevation in V1was detected in 26 of 86 patients with coronary artery disease, for a specificity of 98%. The patients with left anterior descending coronary artery or left main coronary artery stenosis were observed in 3 of 5(60%) patients with single-vessel disease, in 7 of 9(79%) with two-vessel disease, and in 9 of 10(90%) with three-vessel disease. 4) The standard ST depression yielded a specificity of 55% in the patients with isolated or predominant ST depression in inferior leads(II. III, and aVF) and of 81% in the patients with isolated or predominat ST depressin in precordial leads(p<0.001). 5) Abnormal exercise-induced ST elevation in V1was detected in 13 of 39(33%) patients with isolated or predominat ST depression in inferior leads and yielded a specificity of 94% for coronary artery disease. CONCLUSION: Abnormal ST segment elevation in V1may increase the specificity in isolated or predominat ST segment depression in inferior leads and may predict left anterior descending or left main coronary artery disease.
Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Depression ; Electrocardiography ; Exercise Test* ; Hexamethonium ; Humans ; Sensitivity and Specificity

Myxoinflammatory fibroblastic sarcoma (MIFS) is a recently defined rare tumor. It is mainly found in the upper and lower extremities of adults. Due to its high local recurrence rate and low metastatic rate, it is classified as a low grade-malignancy. Accurate diagnosis and early, wide excision are important for prognosis. Herein, we report a case of MIFS in a 35-year-old male patient that presented in an unusual location, the left chest wall. To our knowledge, this is the first reported case of MIFS in Korea and the second case to be reported within the global scientific literature involving the chest wall.
Adult ; Fibroblasts ; Humans ; Korea ; Lower Extremity ; Male ; Prognosis ; Recurrence ; Sarcoma ; Thoracic Wall ; Thorax

A fourteen-year female Jindo dog showing signs of hemoperitoneum was diagnosed with hemangiosarcoma through abdominal radiography and histopathological examination. In the abdominal radiographs, a circular mass was observed on the posterior of the spleen. When the splenic mass was removed via laparotomy, it was spherical, poorly circumscribed, and showed signs of necrosis, with white spots present on the outer side of the mass. Microscopically, the mass showed that hemorrhage was widespread and extensive infiltration of neoplastic cells was found throughout. There was hypercellularity, including occasional pleomorphic cells and mitotic figures. Inflammation at the edge of the mass, along with necrosis, was also found. In this report, we describe the gross and histopathological findings of a case of canine hemangiosarcoma.
Animals ; Dental Caries ; Dogs ; Female ; Hemangiosarcoma ; Hemoperitoneum ; Hemorrhage ; Humans ; Inflammation ; Laparotomy ; Necrosis ; Radiography, Abdominal ; Spleen

BACKGROUND: The serious problems in retreatment of pulmonary tuberculosis are a significant proportion of drug resistance. Preferably retreatment should contain the drugs which has never used before, so drug retreatment is limited in selection. A new antibacterial substance, ofloxacin(OFX) is the activity against mycobacterium tuberculosis and it has been used in the treatment of pulmonary tuberculosis. The present report concerns the result of retreatment of pulmonary tuberculosis patients containing OFX treated at National Kongju Tuberculosis Hospital. METHOD: A retrospective study was made through the regular follow up of 92 smear positive cases, who were treated by four drugs regimen between Mar 1991 and June 1994 at National Kongju Tuberculosis Hospital. Four drugs were, namely prothionamide, cycloserine, ofloxacin and streptomycin(kanamycin or tuberactinomycin). The duration of follow up was over one year. RESULTS: 1) Out of 92 cases with positive sputum AFB smear, 67(73%) achieved the negative conversion. 2) Considering the negative sputum conversion in all the groups, the vast majority(85%) of sputum conversion occurred within the first 4 months. 3) The roentgenological improvement occurred in 49 percent on the whole and when the extent of disease was minimal, moderately, far advanced pulmonary tuberculosis, sputum AFB smear negative response to retreatment was 100%, 93%, 68%, respectively. 4) When the duration of patient's illness was less than 1 year, 1 to 3 years, 3 to 5 years and more than 5 years, sputum AFB smear negative response to retreatment was 87%, 76%, 65% and 55%, respectively. 5) Adverse reaction to prothionamide, with complaints of gastrointestinal troubles was common and hepatic dysfunction without jaundice was observed in 7 percent, convulsion in 1 percent, that to cycloserine occurred renal dysfunction & psycosis & convulsion, 2%, 1%, 1%, respectively. Tinnitus with KM occurred in 1% and dirrhea with OFX in 4%. CONCLUSION: The duration of patient's illness was shorter, sputum AFB smear negative response rate was better. Radiologic responses were not remarkable, but extent of disease by national tuberculosis association was smaller, the result of retreatment was better. Adverse reaction of the secondary antituberculosis agent was mainly observed gastrointestinal troubles, as regard to tolerance to the secondary drugs the role of the physician is of very important value and toxic effects can be overcome by the strong confidence.
Chungcheongnam-do ; Cycloserine* ; Drug Resistance ; Follow-Up Studies ; Hospitals, Chronic Disease ; Humans ; Jaundice ; Mycobacterium tuberculosis ; Ofloxacin* ; Prothionamide* ; Retreatment* ; Retrospective Studies ; Seizures ; Sputum ; Streptomycin* ; Tinnitus ; Tuberculosis ; Tuberculosis, Pulmonary*

In Korea, kerion celsi caused by Trichophyton(T.) verrucosum was first reported in the Honam area in 1986. Since then, more cases have been reported in the Youngnam and Chungcheong areas but there has been no report in Seoul and Kyonggido until now. Recently, two patients with kerion celsi visited Seoul National University Hospital and T. verrucosum was isolated from the scalp lesions of these patients. Case 1 was 52 year-old female living in Kapyoung, Kyonggido and she showed 10x10 cm and 5x3 cm sized, indurated alopecic masses on the scalp which were developed 2 months ago. Case 2 was a 50 year-old female living in Youngju, Kyongsangbukdo and a 10x7 cm sized, purulent alopecic plaque was developed on the scalp 1 month ago. They were farmers raising cows with gray or whitish plaques on their skins. These patients were successfully treated with terbinafine 250 mg per for 7 weeks and 8 weeds, respectively. We report these cases to call more attention to detect this species even in urban areas such as in Seoul. Therapeutic effect of terbinafine on kerion celsi has not been reported in Korea so far and our cases demonstrated the excellent therapeutic effect of terbinafine on kerion celsi cause by T.verrucosum.
Female ; Gyeonggi-do ; Humans ; Korea ; Middle Aged ; Scalp ; Seoul ; Skin ; Tinea Capitis* ; Trichophyton*

PURPOSE: Dutasteride affects the prostate by reducing intraprostatic dihydrotestosterone and prostate tissue vascularity. We evaluated the effect of pretreatment with dutasteride for two weeks on perioperative and postoperative bleeding during transurethral resection of the prostate (TURP). MATERIALS AND METHODS: Eighty-three patients who had benign prostatic hyperplasia together with the criteria for eligibility for TURP were included. The dutasteride group consisted of 40 patients who were treated with dutasteride (0.5 mg/d) for two weeks before surgery, and the control group consisted of 43 patients who did not receive dutasteride. Blood loss was evaluated in terms of reduction in serum hemoglobin (Hb) and hematocrit (Hct) levels, which were measured before, immediately after, and 24 hours after surgery. We also measured the durations of indwelling urethral catheter use, continuous saline bladder irrigation, and hospitalization. RESULTS: Lower mean blood loss was observed in the dutasteride group than the control group immediately after and 24 hours after surgery (DeltaHb=0.65+/-1.27 g/dL vs. 1.16+/-0.73 g/dL, 1.30+/-1.00 g/dL vs. 1.86+/-1.05 g/dL respectively, p=0.019, p=0.011; DeltaHct=1.89%+/-3.83% vs. 3.47%+/-2.09%, 3.69%+/-2.95% vs. 5.39%+/-3.23% respectively, p=0.016, p=0.011). In addition, there were fewer days of indwelling urethral catheter use (2.95+/-1.02 d vs. 3.92+/-1.14 d, p=0.000), continuous saline bladder irrigation (1.81+/-1.08 d vs. 2.36+/-1.06 d, p=0.016), and hospitalization after TURP (3.95+/-1.09 d vs. 4.76+/-1.19 d, p=0.001) in the dutasteride group. CONCLUSIONS: Preoperative treatment with dutasteride for two weeks before TURP reduces surgical bleeding and length of hospitalization after TURP. This pretreatment can be used to decrease surgical bleeding associated with TURP.
Dihydrotestosterone ; Hematocrit ; Hemorrhage* ; Hospitalization ; Humans ; Prostate* ; Prostatic Hyperplasia ; Transurethral Resection of Prostate ; Urinary Bladder ; Urinary Catheters ; Dutasteride

The incidence of a primary central nervous system (CNS) lymphoma in western countries is about 1% of all the intracranial tumors and has increased 2.2% over the last decade. A similar pattern of increased frequency is observed in Korea. Although most CNS lymphomas in western countries are high grade tumors carrying poor prognosis, the clinicopathologic features of the Korean CNS lymphoma have not been well studied. We report clinicopathological features of 18 cases of histologically proven primary brain lymphoma. The mean age of the patients was 50 years and there was no sex difference. The clinical and radiological characteristics included multiple site of occurrence, infrequent extracranial spread, and frequent seeding via cerebrospinal fluid. No patients were immune-compromised host. Of 18 cases, 15 cases were of B-lineage and 2 cases were of T-lineage. According to REAL classification, there were 12 cases of diffuse large B cell lymphoma, two cases of B cell lymphomas of small lymphoid cell, and two cases of peripheral T cell lymphoma, unspecified. The remaining subtypes were not subclassified because of inadequate material. Pleomorphic cytologic features and necrosis of varying extent were frequent in the cases of diffuse large B-cell lymphoma. These results suggest that overall clinicopathologic features of primary malignant lymphomas of the central nervous system in Korea are similar to those of western countries.
Brain ; Central Nervous System* ; Cerebrospinal Fluid ; Classification ; Humans ; Incidence ; Korea ; Lymphocytes ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, T-Cell, Peripheral ; Necrosis ; Prognosis ; Sex Characteristics

A 12-year-old female Maltese dog brought to a local veterinary clinic with two nodules in the subcutis of left shoulder. The nodules were grown gradually from 2 years ago. The nodules were removed surgically under anesthesia and examined histopathologically. They were 15x26 mm in diameter (oval form) and 12x15 mm in diameter (round form), respectively. Histopathologically, the lesions consisted of multilayered basaloid cells in the peripheral of the mass and ghost cells in the central region. Typical findings of these two nodules were gradually keratinized basaloid cell toward central area result in forming anuclear ghost cells. These microscopic features of cutaneous nodules were diagnosed as pilomatrixoma and the identified findings were similar to fully developed stage of human pilomatrixoma. This report may assist in the categorizing of canine pilomatrixoma using histopathological features.
Anesthesia ; Animals ; Child ; Dogs ; Female ; Humans ; Keratins ; Pilomatrixoma ; Shoulder

A 19-month-old male German shepherd dog was presented with a hindlimb footpad mass. The mass was excised and histopathology was performed. Grossly, the cut section of the mass had multiple well-circumscribed nodules with a chalky appearance. Histopathologically, basophilic-stained calcium deposits of various sizes were distributed from dermis to subcutis, surrounded by epithelioid cells, multinucleated giant cells, and reactive fibroblasts. Myxoid metaplasia, calcium deposits in hair follicles, and psammoma-like bodies were also found. These histopathologic observations will greatly help to understand the pathogenesis of calcinosis circumscripta.
Animals ; Calcinosis* ; Calcium ; Dermis ; Dogs* ; Epithelioid Cells ; Fibroblasts ; Giant Cells ; Hair Follicle ; Hindlimb ; Humans ; Infant ; Male ; Metaplasia

PURPOSE: A low quality clinical trial could produce errors, and these errors could, in turn, distort the results of the clinical trial. To avoid applying distorted results of trials clinically, a quality analysis of clinical trials is needed. MATERIALS AND METHODS: We selected randomized controlled trials (RCTs) about erectile dysfunction (ED) conducted in Korea using Medline and KoreaMed. Quality assessment of selected RCTs was performed using three assessment tools (Jadad scales, van Tulder scale, Cochrane Collaboration Risk of Bias Tool [CCRBT]). RESULTS: The first RCT about ED conducted in Korea was published in 2002. Since 2002, a total of 20 RCTs have been published in medical journals. Among the 20 articles, only 1 article was found to have a low risk of bias according to the CCRBT. On the Jadad scale, there were 17 high quality articles, while 19 articles were assessed as high quality by the VTS. Only 2 RCTs described the randomization method adequately. Only 1 RCT presented allocation concealment. CONCLUSIONS: A low quality clinical trial could produce errors, and these errors could, in turn, distort the results of the clinical trial. To avoid applying distorted results of trials clinically, a quality analysis of clinical trials is needed. The quality of RCTs was found to be high because almost all of the selected RCTs were double blinded studies. However, the quality of RCTs was inadequate with regard to the lack of randomization and absence of allocation concealment. Therefore, performing adequate randomization and adding a description of the appropriate concealment of allocation may improve the quality of RCTs.
Bias (Epidemiology) ; Erectile Dysfunction ; Korea ; Male ; Random Allocation