BACKGROUND: This is a study of the prevalence of chronic obstructive pulmonary disease (COPD), which shows high mortality worldwide, and the effects of smoking on COPD by using data from the Korea National Health and Nutrition Examination Survey V. METHODS: FEV1/FEV6<0.73 was used as a diagnostic criterion of COPD. Frequency analysis for prevalence, descriptive statistics for general characteristics and ventilation rate according to age-specifications, and complex sample logistic regression analysis for the effect of smoking on COPD prevalence were used. IBM SPSS Statistics 21 Standard, Complex Samples for Medical Science(Windows) was used for data analysis(alpha=0.05). RESULTS: Prevalence of COPD was 11.6+/-0.5% of Koreans in their forties or over, and 17.5+/-0.8% in males, and 6.2+/-0.5% in females. There was significant increase of COPD prevalence with age increment. Before adjusting for age and smoking index(SI), the COPD possibilities of past and current-smokers compared with non-smoking males were (odds ratio [OR] 2.112 [95% confidence interval [CI] 1.551-2.875]) and (OR 1.834 [95% CI 1.319-2.551]) respectively. After adjustments with age and SI, the COPD possibility of current-smoking was 2.099 (1.382-3.188) times higher and for past-smoking was 1.463 (1.012-2.115) times higher than non-smoking. The P-value of each group was significant. The regression coefficients (B) of current-smoking and past-smoking were 0.741 and 0.380 respectively. The prevalence of COPD increased 1.102 (1.090-1.115) times for every 1 year of age increase, and 1.012 (1.007-1.018) times for every 1 SI increase (P<0.001). CONCLUSIONS: After adjusting for age and SI, the prevalence of COPD in smokers was higher than non-smokers. And current-smoking had a higher OR and higher B than past-smoking.
Female ; Humans ; Korea ; Logistic Models ; Male ; Mortality ; Nutrition Surveys* ; Prevalence* ; Pulmonary Disease, Chronic Obstructive* ; Smoke* ; Smoking* ; Ventilation

No abstract available.
Leg*

Tailgut cyst is a rare congenital anomaly arising in the retrorectal space. Malignancy arising from the tailgut cyst is very rare. We experienced a case of adenocarcinoma arising from the tailgut cyst. The findings of this rare tumor are bony destruction of the sacrum on plain radiograph, a cystic mass on ultrasound, a low attenuation mass with calcification and enhancement on CT, and a multiseptated cystic mass containing solid component on MRI.
Adenocarcinoma* ; Magnetic Resonance Imaging ; Sacrum ; Ultrasonography

No abstract available.
Education, Medical* ; Humans ; Students, Medical*

No abstract available.
Brain Neoplasms* ; Brain* ; Humans ; Immunocompetence*

BACKGROUND: It is difficult to evaluate the effectiveness of ongoing cardiopulmonary resuscitation(CPR). Recent studies suggest that continuous end-tidal carbon dioxide(ETC02) monitoring may be useful non-invasive indicator of CPR. The purpose of this study is to determine whether ETC02 monitoring during CPR could be used as a prognostic indicator of resuscitation and survival. METHOD: A prospective, clinical study was performed from May 1997 to April 1998 at the department of emergency medicine, Ewha Womans University Mokdong hospital. All patients were immediately connected to mainstream capnometer sensor between the tube and the bag after endotracheal intubation using infrared capnometer. RESULT: The study included 70 patients (39 were men) with a mean age of 55+/-16 years. 37 patients with return of spontaneous circulation(ROSC) had higher maximal ETCO2 during CPR than 33 Patients without ROSC (26.9+/-19.4 vs 10.2+/- 9.0mmHg, p=0.0001). The ETCO2 was not significantly different in relation to age, gender, initial rhythm, and survival time after ROSC. But there was significant difference in immediate cause of arrest in ROSC group (P=0.0016). When maximal ETC02 was less than 10mmHg, we observed sensitivity of 83.8%, specificity of 54.5% in predicting ROSC. There were 6 patients with ROSC in spite of maximal ETCO2 was less than 10mmHg. CONCLUSION: Continuous ETCOB monitoring during CPR may be useful, noninvasive, and valuable predictor of successful resuscitation and survival from cardiac arrest. But ETCO2 should lot be used as a single indicator for the withdrawal of CPR.
Carbon Dioxide* ; Carbon* ; Cardiopulmonary Resuscitation* ; Emergency Medicine ; Female ; Heart Arrest ; Humans ; Intubation, Intratracheal ; Prospective Studies ; Resuscitation ; Sensitivity and Specificity

Clear cell hidradenoma is a much less common primary cutaneous tumor originated from sweat gland. Clinically this tumor occurs more frequently in female than in male and in patients of any age although there is a predilection for the middle and older age groups. The lesion is solitary and represents a cutaneous nodular and cystic mass of slow expansible growth. By light microscopy the lesion has been characterized as a solid cataneous tumor composed of clear epithelial cells which are focally arranged in glandular and cystic patterns. We observed a 37-year-old housewife who had suffered from a tumor on her back for 3 years. The tumor was a pedunculated, soft, fixed mass and 3. 5 * 3 * 1. 5 cm in size. Histopathologic finding showed the tumor to be composed of two main types of cells, fusiform and clear cells.
Acrospiroma* ; Adult ; Epithelial Cells ; Female ; Humans ; Male ; Microscopy ; Sweat Glands

BACKGROUND: The relationship and differentiation among various dendritic cells of the dermis are unclear. Recently it has hecome possible to identify different subpopulat,ions of dermal dendritic cells using anti-CD34 and anti-factor XIIIa antibodies. OBJECTIVE: To elucidate which cell types the fibrous dermal turnors consist of we compared the staining patterns of these antibodies as well as of anti-Mac 387 antibody which are labeled as inflammatory cells of the monocyte-macrophage lineage. METHODS: Tumors studied included dermatofibrosarcoma protuberans(DFSP, n=2), dermato-fibroma(n=22), neurofibroma, n=27), acrochordon(n=15), keloid, hypertrophic scar(n=10), juvenile xanthogranuloma(n=1, and malignant fibrous histiocytoma (MFH, n=1). We performed immunoperoxidase staining(AUSC technique) with polyclonal anti FXIIIa antibody, monoclonal anti-CD34 antibody, and monoclonal anti-Mac 387 antibody on the formalin-fixed-paraffin-embedded tissue specimens of these fibrous tumors. The intensity of staining was graded as negative, weakly staining, or strongly stainiring. RESULTS: FXIIIa reactivity was strongly present in dendritic and spindle-shaped cells of all dermatofibromas and some nurofibromas(11 of 27 specimens), but absent from the other fibrous tumors. Among these tumors, one of the two DFSPs was uniquely expressed CD34. Dendritic and spindle-shaped cells within tiese tumors were MAC 387 negative. In inflammatory conditions, variable numbers of MAC 38 positive cells were observed, corresponding to histiocytes and mac-rophages, but the labeling of ipithelioid cells and multinucleated foreign body giant cells were variable. CONCLUSION: The findings of significant numbers of FXIIIa positive cells in dermal fibrous tumors studied suggest that thet may be diagnostic utility associated with the use of this antit)ody. In addition, CD 34 expression by the tumor cells can be an extremely useful marker in establishing a definitive diagnosis of IFSP.
Antibodies ; Dendritic Cells ; Dermatofibrosarcoma ; Dermis ; Diagnosis ; Factor XIIIa* ; Giant Cells, Foreign-Body ; Histiocytes ; Histiocytoma, Benign Fibrous ; Histiocytoma, Malignant Fibrous ; Keloid ; Langerhans Cells ; Neurofibroma

No abstract available.
Curriculum* ; Emergencies* ; Emergency Medical Technicians* ; Humans

There are numerous drug interactions related to many psychotropic and cardiovascular medications. Firstly, the principles in predicting drug interactions are discussed. Cytochrome P (CYP) 450 plays a significant role in the metabolism of these drugs that are substrates, inhibitors, or inducers of CYP450 enzymes. The two most significant enzymes are CYP2D6 and CYP3A4. The ability of psychotropic drugs to act as inhibitors for the enzymes may lead to altered efficacy or toxicity of co-administered cardiovascular agents as a substrate for the enzymes. The following is also a review of the known interactions between many commonly prescribed cardiovascular agents and psychotropic drugs. Most beta blockers are metabolized by CYP2D6, which may lead to drug toxicity when they use in combination with potent CYP2D6 inhibitors including bupropion, chlorpromazine, haloperidol, selective serotonin reuptake inhibitors, and quinidine. Concomitant administration of lithium with angiotensin converting enzyme inhibitors, angiotensin receptor blockers, and diuretics may increase serum lithium concentrations and toxicity. Calcium channel blockers and cholesterol lowering agents are subject to interactions with potent inhibitors of CYP3A4, such as amiodarone, diltiazem, fluvoxamine, nefazodone, and verapamil. Prescribing antiarrhythmic drugs in conjunction with medications are known to prolong QT interval and/or inhibitors on a relevant CYP450 enzyme is generally not recommended, or needs watchful monitoring. Digoxin and warfarin also have warrant careful monitoring if co-administered with psychotropic drugs.
Amiodarone ; Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors ; Anti-Arrhythmia Agents ; Bupropion ; Calcium Channel Blockers ; Cardiovascular Agents ; Chlorpromazine ; Cholesterol ; Cytochrome P-450 CYP2D6 ; Cytochrome P-450 Enzyme System ; Cytochromes ; Digoxin ; Diltiazem ; Diuretics ; Drug Interactions ; Drug Toxicity ; Fluvoxamine ; Haloperidol ; Lithium ; Psychotropic Drugs ; Quinidine ; Serotonin Uptake Inhibitors ; Triazoles ; Verapamil ; Warfarin