This report presents a case of a 17-year-old-girl who developed a, Kaposis varicelliforrn eruption(eczema herpeticum) during oral prednisolone therapy in order to control pemphigus foliaceus. Diagnosis was made by the history, clinical feature and histologic examination. Within 24 hours after the initiation of therapy with ribavirin(Viramid), new lesions had ceased to develop.
Diagnosis ; Kaposi Varicelliform Eruption* ; Pemphigus* ; Prednisolone

OBJECTIVE: The patients of endometriosis may complain of dysmenorrhea, pelvic pain, and dyspareunia, but may be asymptomatic. We studied on the correlation between the pain and the psychologic stress, Also, we studied on the correlation between serum CA-l25 levels and the psychologic stress. METHODS: The data was obtained from il7 endometriosis patients. Psychological stress was studied with STAI(Stait-Trait Anxiety Inventory) and BDI(Beck Depression Inventory). We compared the degree of anxiety and depression according to existence of pain and the duration of pain. Also we examed the scores of STAI and BDI according to the level of serum CA-125. RESULTS: The pain group had more depression and anxiety, in comparison to the pain-free group. And the depression and anxiety significantly increased in long-term pain group. There was no correlation between the level of serum CA-125 and the depression,or axiety. CONCLUSION: The pain of endometriosis may play a role of pychological stress to the patients, so it seems to increase depression and anxiety.
Anxiety ; Depression ; Dysmenorrhea ; Dyspareunia ; Endometriosis* ; Female ; Humans ; Interleukin-7 ; Pelvic Pain ; Stress, Psychological*

No abstract available.
Interleukin-2*

Cardiovascular disease is the most important cause of unexpected sudden death. Although ischemic heart disease by coronary atherosclerosis is the most common cause of sudden cardiac death, other diseases such as cardiomyopathy, congenital heart disease, valvular heart disease and rarely myocarditis can produce sudden cardiac death. Myocarditis is an inflammatory process of the myocardium characterized by an interstitial inflammatory infiltrate and an injury to myocytes adjacent to the inflammatory cells. The clinical expression of myocarditis ranges from the asymptomatic state to fulminant fatal congestive heart failure. Because myocardial involvement is subclinical in most acute infectious disease, the majority of patients have no specific complaints referable to the cardiovascular system. It is possible that it causes a medicolegal problems in case of sudden death. Therefore, author reviewed the clinical and pathological findings of 18 myocarditis autopsy cases. The victims 'age was varied 4-month-59-year olds. 5 (28%) were male and 13 (72%) were female. 15 cases received medical treatment due to clinical symptoms(URI symptoms: 2 cases, tonsillitis and tonsillar abcess: 3 cases, GI symptoms: 5 cases, URI & GI symptoms: 3 cases, pneumonia: 1 case, operation due to ovarian tumor: 1 case) and were associated with medicolegal problem. By the results of this study, important gross findings were pericardial effusions, characteristic cardiomegaly, and pulmonary edema.
Asymptomatic Diseases ; Autopsy ; Cardiomegaly ; Cardiomyopathies ; Cardiovascular Diseases ; Cardiovascular System ; Communicable Diseases ; Coronary Artery Disease ; Death, Sudden ; Death, Sudden, Cardiac ; Female ; Heart Defects, Congenital ; Heart Failure ; Heart Valve Diseases ; Humans ; Male ; Muscle Cells ; Myocardial Ischemia ; Myocarditis* ; Myocardium ; Palatine Tonsil ; Pericardial Effusion ; Pneumonia ; Pulmonary Edema ; Tonsillitis

Many authors have been reported that the abdominal trauma, especially injury of the liver and spleen, is frequently found with lower rib fractures, below the ninth rib fractures and the incidence was about 20 to 30%. In cases of rib fractures, Intra- abdominal organs may be injured in the higher rib fractures than the ninth because the diaphragm is elevated at the level of filth intercostal space in expiration period and the intra-abdominal lesions are often delayed evaluated due to the pain of the fractures and masked by the other injuries of the head and the extremities. So above reasons, we were often questioned what the level of rib fracture we must evaluate the intra-abdominal injury was? So we investigated 452 patients with rib fractures who visited our emergency medical center from 1995, January to 1996, December and divided into two groups according to the prescience of intra-abdominal organ injuries by each the level of rib fractures. The number of patients with intra-abdominal organ injuries were 75(16.6%) and the most frequently damaged organ was the liver(25 cases, 33.3%). We calculated the statistical values of each level of rib fractures by the Chi-Square method and got a result that the level of rib fracture we must evaluate the intra-abdominal injuries was the sixth rib fracture. Therefore, if we will meet the patients with rib fracture below the sixth, we must have attentions to the intra-abdominal injuries and evaluate the abdomen closely with various diagnostic methods.
Abdomen ; Attention ; Diaphragm ; Emergencies ; Extremities ; Head ; Humans ; Incidence ; Liver ; Masks ; Rib Fractures* ; Ribs* ; Spleen

BACKGROUND: It has recently been clarified that epidermal growth factor receptor (EGFR), which is a receptor tyrosine kinase of the erbB family, is abnormally activated in non-small cell lung carcinomas (NSCLC) and this fact is being utilized for creating targeted therapy. In this study, we aimed to identify the frequency of the EGFR expression and gene mutation in NSCLC, and to determine the correlation between them. METHODS: Immunohistochemical staining for EGFR, C-erbB-2, cytokeratin 7, p53 and thyroid transcription factor-1, and EGFR mutation analysis were performed using paraffin-embedded archival tissue from 228 cases of NSCLC; this included 112 squamous cell carcinomas and 116 adenocarcinomas. RESULTS: An EGFR expression and gene mutation occurred in 112 casees (53.5%) and 52 cases (22.8%), respectively. EGRF mutation was more frequent in the adenocarcinomas than in the squamous cell carcinomas, in non-smokers than in smokers, and in females than in males. EGFR mutation was significantly associated with an EGFR protein expression, and especially in adenocarcinomas. CONCLUSION: The EGFR expression in NSCLC was associated with EGFR mutation, and especially in adenocarcinomas. More studies are needed to prove the clinical significance of the EGFR expression for creating targeted therapy to treat NSCLC.
Female ; Male ; Humans ; Adenocarcinoma

BACKGROUND: The purpose of our study was to evaluate the functional and radiologic outcomes of additive augmentation sutures through rotator cuff for proximal humeral fractures stabilized locking plate in elderly patients. METHODS: We enrolled 74 patients over the age of 60 years who received internal fixation using locking plates for proximal humeral fractures. Of these, 50 patients had additive augmentation sutures through rotator cuff. The mean age at the time of surgery was 72.1 years (range, 60-89 years), and the mean follow-up period was 17.5 months (range, 12-62 months). The humeral neck-shaft angle and humeral head height were used as radiological markers to assess the effect of additive augmentation sutures through rotator cuff. We allocated the patients who received additive augmentation sutures into group A and those who did not into group B. RESULTS: At the final follow-up, the mean Korean Showlder Society score and Constant scores were 88.96 +/- 12.1 and 86.6 +/- 11.9, respectively, in group A and 86.21 +/- 11.8 and 85.3 +/- 11.7, respectively, in group B (p=0.368, 0.271). At the final follow-up, the mean loss in humeral neck-shaft angle from the time of immediate postoperative measurement was 1.6degrees in group A and 4.8degrees in group B, whereas the mean loss in humeral head height was 0.82 mm in group A and 0.52 mm in group B (p=0.029, 0.178). CONCLUSIONS: The surgical outcomes of internal fixation using locking plates for proximal humeral fractures were clinically and radiologically good in elderly patients over the age of 60 years without any observable complications. Further, the loss of humeral head shaft angle at the final follow-up from its initial postoperative measurement was significantly smaller in patients who received an additive augmentation suture than in those who did not. Thus, we conclude that augmentation sutures are a beneficial option for elderly patients that clinicians can consider at the time of surgical decision making.
Aged* ; Decision Making ; Follow-Up Studies ; Humans ; Humeral Head ; Rotator Cuff ; Shoulder Fractures* ; Sutures*

Gatric duplication is a rare congenital anomaly. Thus for about 90 cases of gastric duplication have been recorded in the literature. It is less frequent than small intestinal or eosphageal duplication, and accounts for only 3.8% of all gastrointestinal tract duplication. Most gastric duplications are seen during the first year of life. Palpable abdominal mass and gastric outlet obstruction in infancy are most common presentation. We experienced a case of non-communicating gastric duplication. A 12-year-old girl visited St. Mary's Hospital because of indigestion, intermittent vomiting, and left upper quandrant pain for about 40 days. She have had intemittent abdominal pain with concomitant increased level of amylase since 5 years old. Physical examination showed a hen's egg sized palpable mass on left upper quadrant of the abdomen. Upper GI series and barium enema revealed only indentation of duodenal C-loop, and sonogram and abdominal CT demonstrated isolated cystic mass along the greater curvature of gastric antrum. She had taken an operation under the impression of pancreatic pseudocyst. Operation revealed a cystic mass, located along the greater curvature. There was no pathologic change in the pancreas. Microscopic findings of the cyst wall revealed normal gastric mucosal lining and common muscle layer, shared with gastric antral muscle layer.
Cysts

PURPOSE: The purpose of this study was to investigate the severity of subjective sleep quality and factors related to sleep disturbances in breast and gynecologic cancer patients undergoing radiotherapy. METHODS: Ninety four women (68 breast cancer and 26 gynecologic cancer) undergoing radiotherapy were recruited and asked to complete the Pittsburg Sleep Quality Index (PSQI), Piper Fatigue Scale, and Hospital Anxiety Depression Scale. The data were analyzed using χ2-test, t-test, ANOVA and logistic regression. RESULTS: The average global PSQI score was 8.34±4.41 and 70.2% of the patients reported poor sleep quality (PSQI>5). There were significant differences between the poor sleepers and the good sleepers in concurrent chemo-radiotherapy (p=.022), number of radiation treatments (p=.013), total amount of radiation dosage (p=.048), sleeping pills (p=.030), fatigue (p<.001), anxiety (p<.001), and depression (p=.024). Logistic regression showed that significant predictors for poor sleep quality were fatigue and concurrent chemo-radiotherapy. CONCLUSION: These findings suggest that sleep disturbance was a significant health problem in patients with breast and gynecologic cancer who were receiving radiotherapy. Also that fatigue and concurrent chemo-radiotherapy were highly associated with sleep disturbance. However, limited evidence was found for the role of radiotherapy in the sleep disturbance of these patients.
Anxiety ; Breast ; Breast Neoplasms ; Depression ; Fatigue ; Female ; Humans ; Logistic Models ; Piper ; Radiation Dosage ; Radiotherapy*

BACKGROUND: Management of massive rotator cuff tears can be challenging because of the less satisfactory results and a higher retear rate regardless of the use of open or arthroscopic repair technique. METHODS: We retrospectively analyzed 102 cases of massive rotator cuff tear treated with either open or arthroscopic repair. Open repair was performed in 38 patients; and arthroscopic repair, in 64 patients. The mean age at the time of surgery was 59.7 years in the open group and 57.6 years in the arthroscopic group. RESULTS: The Constant score increased from the preoperative mean of 55.9 to 73.2 at the last follow-up in the open repair group and from 53.8 to 67.6 in the arthroscopic repair group (p<0.001 and <0.001, respectively). The University of California at Los Angeles (UCLA) score increased from a preoperative mean of 17.7 to 30.8 at the last follow-up in the open group and from 17.5 to 28.7 in the arthroscopic group (p<0.001 and <0.001, respectively). No statistically significant difference in the Constant and UCLA scores was observed between the two groups at the last follow-up (p=0.128 and 0.087, respectively). Retear was found in 14 patients (36.8%) in the open group and 39 patients (60.9%) in the arthroscopic group (p=0.024). CONCLUSIONS: Open and arthroscopic repairs of massive rotator cuff tears may provide satisfactory clinical results with no significant difference. However, a significantly lower retear rate was observed for the open repair group compared with the arthroscopic repair group.
Arthroscopy ; California ; Follow-Up Studies ; Humans ; Retrospective Studies ; Rotator Cuff* ; Shoulder ; Tears* ; Tendon Injuries