BACKGROUND: Recently, cardiopulmonary exercise testing (CPX) has become a popular diagnostic method for differentiating the main cause of exertional dyspnea or exercise limitation. We evaluated the difference in the CPX results according to interpretative algorithms and the methods of exercise in Korea. METHOD: Sixty-six patients with chronic lung disease and 48 adults with dyspneic symptoms, but with no abnormalities in a spirometry performed symptom limited CPX, were included in this study. The results were interpreted using both Wasserman's(WA) and Eschenbacher's algorithm (EA), and a comparison between both algorithms was made. Thirty-three healthy medical students performed the CPX with a cycle ergometer and treadmill. The results were interpreted with EA and the concurrenec in interpretations was evaluated according to the methods of exercise. RESULTS: 1. In patients with chronic lung disease, the overall concordance rate between the two algorithms was 63.6%. The concordance rates were 69.8% in patients with obstructive, 25.0% in those with restrictive, and 66.7% in those with mixed pulmonary insufficiency. In patients with dyspneic symptoms but normal findings in resting spirometry, the concordance rate was 60.4%. 2. In healthy medical students, in results interpreted with EA, the concordance rate between the cycle ergometer and treadmill exercise was 25.0%. CONCLUSION: Both interpretative algorithms and methods of exercise may affect the CPX results. In using CPX as a diagnostic test for the causes of dyspnea in the Korean population, the interpretative algorithms and method of exercise need to be standardized, and a predictive VO2max equation needs to be established.
Adult ; Diagnostic Tests, Routine ; Dyspnea ; Exercise Test* ; Humans ; Korea ; Lung Diseases ; Methods* ; Spirometry ; Students, Medical

Pseudoatrophoderma colli is a symptomless, persistent, persistent, pigmentary disorder involving the neck and upper thorax first described by Becker and Muir in. 1934 The lesion is usually localized to the neck and upper part of the thorax. It consists of macules or papules which show pigmentation or papules which show pigmentation or depigmentation and look atrophic. Histological examination shows hyperkeratosis, hypogranulosis, focal acanthosis and perivascular lymphocytic infiltration. We present herein a case of pseudoatrophoderma colli which showed symptomless, mottled, pigmentated macules involving the neck clinically and compatible findings histopathologically.
Neck ; Pigmentation ; Thorax

No abstract available.
Biofeedback, Psychology* ; Electric Stimulation* ; Pelvic Floor* ; Urinary Incontinence*

Basal cell carcinoma is the most common skin cancer, but it rarely metastasizes. Metastatic basal cell carcinoma (MBCC) is rare in terms of incidence as well as absolute numbers. We present a case of 67-year-old woman who had a dirty oozing, ulcerated, tumor mass on the vertex and suffered from dyspnea and mild lumbago. The diagnosis of MBCC was based on clinical, radiological, and histopathological findings. To our knowledge, the occurrence of MBCC has not been reported in the Korean literatures. So we reported herein this case of MBCC of the lung and the bone.
Aged ; Carcinoma, Basal Cell* ; Diagnosis ; Dyspnea ; Female ; Humans ; Incidence ; Low Back Pain ; Lung ; Skin Neoplasms ; Ulcer

BACKGROUND: Specified clinical observations regarding skin changes in viral hepatitis have not yet been accomplished in Korea, especially in view of serotypes. OBJECTIVE: This study was conducted to identify various cutaneous manifestations of viral hepatitis according to viral serotypes and the stages of the disease. METHODS: We performed a clinical observation of cutaneous manifestations in 450 patients who were diagnosed with viral hepatitis. RESULTS: 1. Cutaneous manifestations were found in 383(85.1%) patients. Patients with a longer duration seemed to have skin lesions more frequently. 2. The frequency of cutaneous manifestations was highest in HAV(94.4%) and HBV(84.9%) serotypes. The most common cutaneous manifestation was pruritus(32.4%) in all studied subjects. In HBV hepatitic patients, the most common cutaneous manifestation was pruritus(35.4%), in HCV hepatitic patients, vasculitic purpura(74.5%), in HAV hepatitic patients, urticaria(88.8%), in the hepatitic patients with the mixed form, spider angioma(30.2%) and vasculitic purpura(30.2%). 3. Urticarial lesions in non-HCV hepatitis were of the lymphocytic vasculitis type but HCV hepatitis was associated with neutrophilic vasculitis. The purpuric lesions with HCV hepatitis were of the neutrophilic vasculitis type while lymphocytic vasculitis was present in non-HCV hepatitis. 4. The most severe pruritus was present in HBV hepatitic patients. CONCLUSION: The cutaneous manifestations in viral hepatitis have different clinical features depending on the viral types.
Hepatitis* ; Humans ; Korea ; Neutrophils ; Pruritus ; Skin ; Spiders ; Vasculitis

ICAM-l(Intercellular adhesion molecule-1) is an important early marker of immune activation and response. ICAM-1 is expressed on varous cell types and observed in a variety of diseases, including patients with asthma, melanoma, prostatic cancer, ovarian and colon cancer. Some authors demonstrated the expression of ICAM-1 protein in high-grade intraepithelial squamous neoplasia of cervix by immunohistochemistry and suggested that the expression was related to human papillomavirus infection. The aim of this study was to determine the serum levels of soluble intercellular adhesion molecule-1(sICAM-1) in patients with squamous cell carcinoma of the cervix, Serum levels of sICAM-1 were measured by enzyme-linked immunosorbent assay(ELISA), We evaluate invasive squamous cell carcinoma of the cervix (40), carcinoma in situ (16) and control (15) patients. Serum levels of sICAM-1 in healthy volunteers, in parients with carcinoma in situ and invasive cervical cancer were 150.1+/-41.3, 182.7+/-105.9, 189.8+/-60.0 ng/ml, respectively. Although the serum levels of sICAM-1 in patients with carcinoma in situ did not increase, serum levels of ICAM-1 in patients with invasive cervical cancer were significantly increased (control vs invasive cervical cancer, p < 0,05). From the above results, sICAM-1 is shed from the cancerous tissue in patients with squamous cell carcinoma of the cervix.
Asthma ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Cervix Uteri ; Colonic Neoplasms ; Enzyme-Linked Immunosorbent Assay ; Female ; Healthy Volunteers ; Humans ; Immunohistochemistry ; Intercellular Adhesion Molecule-1 ; Melanoma ; Papillomavirus Infections ; Prostatic Neoplasms ; Uterine Cervical Neoplasms*

Concomitant with progressive rise in incidence of loosening of conventional total hip replacement arthroplasty which is mainly due to improper surgical technique and cement fixation, has been increased the incidence of revision. In addition to technical failure, there are many risk factors that effect the loosening, such as young active person, obesity, men, osteopomsis, those with bone stock deficiencies as congenital dysplasia of the hip, and those with previous hemiarthroplasties, etc.. Many experimental and clinical studies have been tried to decrease the incidence of loosening in conventional total hip replacement arthroplasty. One of these trials is the cementless total hip replacement arthroplasty with its simplicity of the surgical procedure. We have experienced 426 hips of the total hip replacement arthmplasty in 396 patients from January 1973 to December 1982, among whom 21 hips in 20 patients who had been undertaken revisional arthroplasty were followed up. The longest follow-up was 7 years and 3 months and the shortest was 2 years, the average being 2 years and 4 months. 1. Ankylosis of the hip and sequeale of the infected hip were most common in primary diseases of our revision cases. 2. Revision with cementless total hip replacement arthroplasty of a loosened conventional total hip replacement arthroplasty appears to be available as an effective alternative. 3. Initial attempt with cementlass total hip replacement arthroplasty to prevent loosening after conventional total hip replacement arthroplasty seems to be preferable for patients with ankylosis of the hip or sequeale of the infected hip, especially who are active and young.
Ankylosis ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Follow-Up Studies ; Hemiarthroplasty ; Hip ; Hip Dislocation, Congenital ; Humans ; Incidence ; Male ; Obesity ; Risk Factors

BACKGROUND AND OBJECTIVES: Approximately 10–15% of children with Kawasaki disease (KD) do not respond to initial intravenous immunoglobulin (IVIG) and have higher risk for coronary artery lesion (CAL). The aim of this study was to identify predictive factors from laboratory findings in patients who do not respond to IVIG treatment and develop CAL from KD. METHODS: We retrospectively collected nationwide multicenter data from the Korean Society of Kawasaki Disease and included 5,151 patients with KD between 2012 and 2014 from 38 hospitals. RESULTS: Among 5,151 patients with KD, 524 patients belonged to the IVIG-resistant group. The patients in the IVIG-resistant group had a significantly higher serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level (1,573.91±3,166.46 vs. 940.62±2,326.10 pg/mL; p < 0.001) and a higher percentage of polymorphonuclear neutrophils (PMNs) (70.89±15.75% vs. 62.38±32.94%; p < 0.001). Multivariate logistic regression analyses revealed that significantly increased PMN, NT-proBNP, C-reactive protein (CRP), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were the predictors of IVIG resistance (p < 0.05). Multivariate logistic regression analyses also showed that only CRP was associated with the risk of CAL (p < 0.01), while PMN, NT-proBNP, AST, and ALT were not. CONCLUSIONS: Elevated PMN, serum NT-proBNP, CRP, AST, and ALT levels are significantly associated with IVIG resistance in patients with KD. Moreover, serum CRP is significantly increased in patients with KD with CAL.
Alanine Transaminase ; Aspartate Aminotransferases ; C-Reactive Protein ; Child ; Coronary Artery Disease ; Coronary Vessels ; Humans ; Immunoglobulins ; Immunoglobulins, Intravenous ; Logistic Models ; Mucocutaneous Lymph Node Syndrome ; Natriuretic Peptide, Brain ; Neutrophils ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Approximately 10–15% of children with Kawasaki disease (KD) do not respond to initial intravenous immunoglobulin (IVIG) and have higher risk for coronary artery lesion (CAL). The aim of this study was to identify predictive factors from laboratory findings in patients who do not respond to IVIG treatment and develop CAL from KD. METHODS: We retrospectively collected nationwide multicenter data from the Korean Society of Kawasaki Disease and included 5,151 patients with KD between 2012 and 2014 from 38 hospitals. RESULTS: Among 5,151 patients with KD, 524 patients belonged to the IVIG-resistant group. The patients in the IVIG-resistant group had a significantly higher serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level (1,573.91±3,166.46 vs. 940.62±2,326.10 pg/mL; p < 0.001) and a higher percentage of polymorphonuclear neutrophils (PMNs) (70.89±15.75% vs. 62.38±32.94%; p < 0.001). Multivariate logistic regression analyses revealed that significantly increased PMN, NT-proBNP, C-reactive protein (CRP), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were the predictors of IVIG resistance (p < 0.05). Multivariate logistic regression analyses also showed that only CRP was associated with the risk of CAL (p < 0.01), while PMN, NT-proBNP, AST, and ALT were not. CONCLUSIONS Elevated PMN, serum NT-proBNP, CRP, AST, and ALT levels are significantly associated with IVIG resistance in patients with KD. Moreover, serum CRP is significantly increased in patients with KD with CAL.

BACKGROUND: Peak expiratory flow (PEF) provides a simple, quantitative, and reproducible measure of the existence and severity of airflow obstructions. Peak flow meters are designed to monitor the condition asthma patients. There are many reports showing the normal predicted value of PEF in other countries. studies on healthy Korean adults have been performed in a relatively small sample number and a lower limit for the normal value was not reported. therefore, an attempt to provide normal predictive PEF value with a lower limit was made. METHOD: The PEF(Mini-Wright peak Flow Meter) measurements and spirometry were done in 233 men and 631 woman without history of respiratory disease. all subjects were non-smokers with no respiratory symptoms. the normal predictive value and its lower limit were developed by multiple regression analysis. The result was compared with regression equations in other reports. RESULTS: The regression equation for the normal PEF predictive value(L/min) is 25.117+4.587×Age(year)-0.064×Age2+2.931×Height(cm) in men in men(R2=0.25), and 146.942-0.011×Age2+1.795×Height(cm)+0.836×Weight (kg) in women(R2=0.21). The regression equation for the lower limit of this value (L/min) is 25.117+4.587×Age(year)-0.064×Age2+1.936×Height (cm) in men, and 146.942-0.011×Age2+1.232× Height (cm)+0.481×Weight (kg) in women. The residuals were normally distributed. The PEF in Korean males was similar to those reported in British and Japanese subjects. The PEF in Korean females was similar to that in British subjects, But higher than the PEF in Japanese subjects. The lower limit of normal value was 71% of normal predictive PEF value in men and 76% in women. CONCLUSION: The normal predictive PEF value and its lower limit was measured from 233 male and 631 female asymptomatic, lifelong non-smoking participants. The normal predictive value was different from those of other studies on Korean subjects. Therefore, further studies are required.
Adult ; Asian Continental Ancestry Group ; Asthma ; Female ; Humans ; Male ; Reference Values ; Spirometry