No abstract available.
Anxiety* ; Depression* ; Epilepsy, Temporal Lobe* ; Temporal Lobe*

Takayasu,s arteritis is a systemic disease characterized by occlusion of aorta and its major branches because of a panaortitis with thickening of the adventitia. Coronary artery narrowing is due to extension of inflammations that occur in aorta. Angina pectoris may be the first symptom of the disease if the coronary arteries are the initial site of severe arterial narrowing. We present a case of bilateral coronary ostial stenosis where Takayasu,s arteritis was pathologically proved as an etiology. The patient was taken coronary ostial angioplasty with good result.
Adventitia ; Angina Pectoris ; Angioplasty ; Aorta ; Arteritis ; Constriction, Pathologic* ; Coronary Vessels ; Humans ; Inflammation ; Takayasu Arteritis*

No abstract available.
Dendritic Cells

The World Health Organization (WHO) Classification of Tumors of Hematopoietic and Lymphoid Tissues was revised in 2017 on the basis of recent high-throughput sequencing and gene expression data on hematologic malignancies. This review explores the current WHO classification of acute myeloid leukemia (AML) and related precursor neoplasms, highlighting the changes made in the current edition and focusing on the diagnosis of AML.

BACKGROUND: Evaluation of clinical performance is an essential area for the students who are preparing their career as a medical doctor. However the clinical skills has neither been taught with balanced proportion nor adequately being assessed their abilities. Yet no significant studies on this issue has been reported in Korea so far. The present study was done as a part of preliminary study to seek a model that would be introduced clinical performance assessment in Korean Medical Licensure Examination system. Purpose: The objectives of this study is to develop items of clinical performance and the effective methods to carry out the clinical performance assessment in Korean Medical Licensure Examination system. METHODS: Primary list of clinical performances which was generated through discussion between researchers and medical experts has been distributed to the physicians of various levels. Six hundred ninety seven medical doctors including professors, family physicians, and public health doctors were asked to express their opinion by mail questionnaire. Final items were selected after the reaction of questionnaires and each item has been carefully studied its validity, achievability, and practicality. RESULTS: Thirty five items were selected among fifty one items presented according to the checked number of "essential" and "frequently useful". Seven items were added according to the higher rate of recommendation by open questionnaire. The forty two items were confirmed as a final list which the students should be expected to demonstrate prior to graduation from undergraduate medical school("exit objective"). The OSCE was performed without any serious logistic problems and both examinees and evaluators thought the experience positively. CONCLUSION: To look at the present environment and the readiness it is recommendable to apply the items of psychomotor skills at the beginning for Medical Licensure Examination. For that purpose various medical dolls, kits and subjects can be used.
Clinical Competence ; Humans ; Korea ; Licensure, Medical* ; Physicians, Family ; Postal Service ; Public Health ; Surveys and Questionnaires

We report a 26-yr-old female patient with bilateral breast cancer who was clinically diagnosed with Li-Fraumeni like syndrome (LFL) and subsequently found to have a germline mutation of the TP53 gene. The patient was initially diagnosed with right breast cancer at age 24 yr and then with left breast cancer at age 25 yr. Surgery and radiotherapy were performed accordingly. The patient had a family history of various types of early onset cancers and was referred to a genetic counseling clinic. She was clinically diagnosed with LFL. Genetic analysis of the TP53 tumor suppressor gene was performed with the patient's consent. Direct sequencing of TP53 gene exons 5, 6, 8, 9, and 11 revealed a ermline missense mutation, resulting in an amino acid change from an arginine to a histidine (g.13203G>A, p.R175H). Considering the family history, individualized cancer surveillance was performed including a gastroscopy and a brain MRI. Even though the patient had not shown any neurological symptoms, a huge mass on the temporal lobe was incidentally found and the patient received surgery and radiotherapy. Although the residual mass required further treatment, the patient decided on supportive care alone and was discharged. We report a case of LFL, with a germline TP53 mutation, which was confirmed by gene sequencing in Korea. This case shows how genetic predisposition screening and counseling in patients, suspected of having a familial cancer syndrome, can influence the course of the patient.
Adult ; Amino Acid Substitution ; Brain Neoplasms/radiotherapy/surgery ; Breast Neoplasms/diagnosis/radiotherapy/surgery ; Female ; *Genetic Counseling ; Genetic Predisposition to Disease ; *Germ-Line Mutation ; Humans ; Li-Fraumeni Syndrome/*diagnosis/genetics/therapy ; Mutation, Missense ; Pedigree ; Tumor Suppressor Protein p53/*genetics

Cyclosporine nephropathy was induced by intraperitoneal injection of cyclosporine 25 mg/kg in Sprague-Dawley rats daily for 1, 4, 8, and 12 weeks to clarify the relationship between cyclosporine nephropathy and the expression of TGF-beta1 with extracellular matrix deposition. On light microscopic examination, the kidneys in the 12 week cyclosporine-treated rats showed focal or striped fibrosis, vacuolization of tubular cells, and injury of endothelial cells. Immunohistochemically, TGF-beta1 protein was strongly expressed in the cyclosporine-treated rat kidneys, especially in the glomerular endothelial cells, interstitial endothelial cells, tubular epithelial cells, and parietal cells in the Bowman's capsule of the glomerulus as well as the periglomerular arterioles. The amount of TGF-beta1 expression was correlated with the morphological change in the cyclosporine-treated rats. Extracellular matrix, such as fibronectin and collagen IV, was also expressed in the endothelial cells of the glomerulus and the interstitium. It can be concluded, therefore that TGF-beta1 protein is probably involved in the early stage of fibrogenesis in cyclosporine nephropathy. It can be postulated that cyclosporine nephropathy results from the accumulation of extracellular matrix associated with the increase of TGF-beta1 transcription. Therefore, these results could be used in reducing fibrosis in cyclosporine nephropathy.
Animals ; Arterioles ; Bowman Capsule ; Collagen ; Cyclosporine ; Endothelial Cells ; Epithelial Cells ; Extracellular Matrix ; Fibronectins ; Fibrosis ; Injections, Intraperitoneal ; Kidney ; Rabeprazole ; Rats* ; Rats, Sprague-Dawley ; Transforming Growth Factor beta1

Typhoid fever is one of the important contagious diseases. Typhoid fever of severe category is defined as the condition in which a febrile patient shows shocks or an altered state of consciousness ranging from delirium to coma. High dose dexarnethasone therapy is considered very effective in these life-threatening conditions. We report two severe hrphoid fever cases, which were treated with high dose dexarnethasone (dexamethasone 3mg/kg IV and lmg/kg q6hrs for 48 hrs) with a great success and we believe that one of the two cases is the first Korean case in the literature who had cerebellar ataxia and cortical tremor as a manifestation of the CNS involvement of typhoid fever.
Cerebellar Ataxia ; Coma ; Consciousness ; Delirium ; Dexamethasone* ; Encephalitis* ; Fever ; Humans ; Shock ; Tremor ; Typhoid Fever*

Ninety two strains of Streptococcus pyogenes were isolated from patients with pharyngitis, scarlet fever, skin infection, and invasive streptococcal infections in Seoul, Korea from January to December, 1998. All isolates were epidemiologically characterized by T protein serotype, and serum opacity factor (OF) detection to phenotypes. To analyze the genetic relationship, fifty two isolates including 32 erythromycin-clindamycin (Em-Cm) resistant strains, 20 antimicrobial susceptible strains were attempted to the pulsed-field gel electrophoresis (PFGE). T protein serotype showed 16 kinds in distribution including T12 and T4. Among the total isolates, 40 strains (43.5%) belonged to the T12 serotype and twenty strains (21.7%) to T4 serotype. On the other hand, when infection aspect of S. pyogenes isolates were analysed by T serotype distribution, T12 type was predominant for pharyngitidis which contributed to 21 strains (53%) and for skin infection isolates which contributed to 11 strains (28%), respectively. In case of T4 type, it was the most predominant pharyngitidis isolates which contributed to 8 strains (40%). In T serotype distribution of Em-Cm resistant strains, 27 strains (84%) of the thirty two showed T12 serotype. In minimum inhibitory concentration (MIC) values of Em-Cm resistance isolates, thirty two isolates showed resistant to erythromycin 27 strains (84%), had high MIC of >128 mug/ml. And also to clindamycin, twenty two strains (69%) had high MIC of >128 mug/ml. When OF detection of Em-Cm resistance of S. pyogenes isolates were analyzed by T serotype distribution, T12 serotype isolates revealed that all of the isolates except one strain were OF negative. In PFGE profile analysis to Em-Cm resistance isolates, of the twenty seven, Em-Cm resistance of T12 serotype isolates, 26 strains showed identical PFGE profile and all of these isolates revealed that OF negative. Eighty four percent of Em-Cm resistance S. pyogenes isolates had identical phenotype and PFGE profile. These results strongly suggested that the Em-Cm resistant S. pyogenes isolates from Seoul area showed close genetic correlation and PFGE could be available tool for molecular epidemiology.
Clindamycin ; Electrophoresis, Gel, Pulsed-Field* ; Erythromycin ; Hand ; Humans ; Korea* ; Microbial Sensitivity Tests ; Molecular Epidemiology ; Pharyngitis ; Phenotype ; Scarlet Fever ; Seoul ; Skin ; Streptococcal Infections ; Streptococcus pyogenes* ; Streptococcus*

BACKGROUND: Lipids in the stratum corneum which acts as a barrier prevents transepidermal water loss and percutaneous absorption of a substance differs at different anatomic sites of skin. No study has yet been done on the recovery rate of the skin barrier after its destruction in relation to anatomic sites. OBJECTIVES: The purpose of this study was to measure the recovery rate of the skin barrier after its disruption in relation to anatomic sites and also to examine the lipid composition of skin surface lipids at different anatomic sites of skin. METHODS: The study population consisted of 20 healthy male subjects. We used 3M Scotch tapes to remove the stratum corneum and examined the recovery rate by measuring the TEWL using an evaporimeter after 2.5, 6, 10, 24, 48 and 72 hours at eight different anatomic sites consisting of the post-auricular area, chest, abdomen, back, forearm, thigh and calf. The skin surface lipids were extracted using 99% ethanol at ten different anatomic sites including the face, chest, abdomen, back, upper arm, forearm, palm, thigh, shin and sole. The composition of skin surface lipids was determined by thin layer chromatography. RESULTS: 1. The transepidermal water loss was highest in the post-auricular area and ahdomen, back, thigh, forearm, upper arm, thieh and chest in a decreasing order, although there was no statistical significance(p>0.05). 2. The recovery rate was highest in the post-auricular area after 2.5 hours with a statistical significance compared to other sites except for the abdomen(p<0.05). 3. The recovery rate was also highest in the post-auricular area after 6, 10, 24, 48 and 72hrs compared with other sites with a statistical significance (p<0.01). 4. Lipid analysis of ten anatomic sites demonstrated that the concentration of cholesterol sulfate was highest on the face, that of cholesterol was highest on the back and that of sphingolipid was highest on the abdomen but there was no statistical significance. CONCLUSION: The post-auricular area showed the fastest recovery rate after its barrier disruption which can be applied in the percutaneous absorption of substances. Also the composition of human skin surface lipids, especially epidermal lipids at different anatomic sites was not statistically different.
Abdomen ; Arm ; Cholesterol ; Chromatography, Thin Layer ; Ethanol ; Forearm ; Humans* ; Male ; Skin Absorption ; Skin* ; Thigh ; Thorax