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

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*

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

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

Genital mycoplasmas are rare in extraintestinal specimens, but can cause disseminated infections in immunocompromised patients and wound infections after surgery or injury. We report two cases of Myoplasma hominis wound infections after lung lobectomy and kidney transplantation, and a case of M. salivarium wound infection after aortic graft replacement. Mycoplasmas grew in aerobic and anaerobic cultures as tiny colonies but were not observed by gram- or acid fast stain and were confirmed by MYCOFAST EvolutioN 2 kit or 16S rRNA sequencing. These cases indicated that mycoplasmas were probably underestimated in wound infections because they were not in suspicion. We suggest that Mycoplasma should be suspected when microorganisms are not readily observable in Gram stains but can be cultured.
Coloring Agents ; Immunocompromised Host ; Kidney Transplantation ; Lung ; Mycoplasma ; Mycoplasma hominis ; Mycoplasma salivarium ; Transplants ; Wound Infection