Generalized pustular psorissis which is originary described by von Zumbusch in 1910, is the most intense form of the acute exanthematic variant among psoriasis and it is to be occured as a rare disease. We presented a case of generalized pustular psoriasis of a 16 year-old girl, who suddenly developed wide spread pustules during the acute exacerbating course of the psoriasis which had started from the primary plaque on her left anterior chest one month ago. She was free from subjective symptom. As the objective sign, the leukocytosis was only one of the significant laboratory findings. All skin lesions were almost eleared by the oral administration of methotrexate in 3 months.
Administration, Oral ; Adolescent ; Female ; Humans ; Leukocytosis ; Methotrexate ; Psoriasis* ; Rare Diseases ; Skin ; Thorax

BACKGROUND: As an airplane has been developed, the man could experienced the new environment. In these circumstances, the research of human's physical changes in the air was commended. About 80% of airplane's accidents was occurred by human factors and about 4% was related to the pilot's physical state. According to the many studies, the most common cause of the permanent grounding of the pilot is coronary artery disease(CAD). Therefore the tool of prevention and early detection for CAD was needed. PURPOSE: The purpose of this study is to evaluate the effect of routine and regular Exercise Treadmill Test(ETT) to the civil airline pilots especially 1) in decreasing the correctable risk factors of coronary artery disease 2) in reducing the medical disqualification rate of pilots. METHOD: Routine ETT has been performed to the Asiana Airlines' pilot during his regular physical check up. When the pilot showed abnormal resting ECG or abnormal ETT results, Echocardiography, 24hour Holter monitoring, Cardiac SPECT or Coronary angiography were done to rule out coronary artery disease. Review the medical records from June 1993 through December 1998. Compare the medical disqualification rate between Asiana Airlines pilot & other pilot groups. Compare the individual correctable risk factors of coronary artery disease and the numbers of risk factors between pilot and non-pilot group using SPSS 8.0 t-test. RESULTS: 1. The results showed no evidence of CAD and there was no case of CAD as a pilot's disqualifying conditions. 2. The levels of cholesterol and the numbers of risk factors of pilot had a statistically significantly lower than non-pilot group. CONCLUSIONS: Routine and regular ETT will be effective in educating the pilot to do his best to decrease the correctable risk factors of CAD.
Aircraft ; Cholesterol ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Echocardiography ; Electrocardiography ; Electrocardiography, Ambulatory ; Exercise Test* ; Humans ; Medical Records ; Risk Factors ; Tomography, Emission-Computed, Single-Photon

A case of urticaria pigmentosa, the first case of nodulo-bullous variety in Korea, is herein, described. A 4-mo#nth old female baby was brought: to our hospital by her mother with the presenting signs of darkish brown infiltrated macules and nodules scattered on the trunk, neck, and extremities. The first lesion was noticed by her mother as a pea sized flat macule of pinkish brown, which was seated on the right shin at birth For the period of 4 months, it has developed into multiple similar macules on the above mentioned areas, and most of them became gradually to the nodules with lichenoid surface, She also experienced frequent bullae on them and occasional facial flushing without any specific cause. A strong stroke, performed on the nodule, produced a severe whea1ing reaction followed by marked erythema around it. and facial flushing ensued, The histologic findings of the nodule revealed massive infiltration of cuboidal cells throughout the entire dermis which proved to be mast cells on toluidine blue staining. Oral administration of the reserpine and periactin proved to be effective in this case.
Administration, Oral ; Cyproheptadine ; Dermis ; Erythema ; Extremities ; Female ; Flushing ; Humans ; Korea ; Mast Cells ; Mothers ; Neck ; Parturition ; Peas ; Reserpine ; Stroke ; Tolonium Chloride ; Urticaria Pigmentosa* ; Urticaria*

No abstract available.
Cesarean Section* ; Female ; Pregnancy

No abstract available.
Cesarean Section* ; Female ; Pregnancy

OBJECTIVES: The multiple sleep latency test (MSLT) is commonly used as a valid objective measure of sleepiness. The procedure of MSLT is well standardized but the sleep onset criterion is somewhat variable. One epoch of stage 1 sleep is the most commonly used criterion, and the criterion of three epochs of stage 1 sleep is also used. The purpose of this study was to compare the two criteria used to determine sleep onset. METHODS: We retrospectively analyzed 60 consecutive MSLT that were performed according to a standaridized protocol. We scored each test using the two different criteria for sleep onset and then statistically analyed the results. RESULTS: Using the different criteria, 20 patients among 60 showed changes in mean sleep latency (33.3%). The extent of change ranged from 1.3% to 38.5% (mean 15.9%). Non-narcoleptic patients showed a significantly higher incidence of change than other sleep disorder patients. CONCLUSION: Changes in mean sleep latency occurred according to the different criteria of sleep onset. But the difference arising from different criteria was statistically not significant in patients with moderate to severe sleepiness. Considering that 1 epoch criterion for sleep onset is more sensitive in detecting clinically significant sleepiness, the authors suggest that the 1 epoch criterion is more reliable than the 3 epochs criterion.
Humans ; Incidence ; Retrospective Studies

Sleep disturbance is a very common complaint among patients with posttraumatic stress disorder (PTSD). Recent studies suggest that sleep disturbances such as nightmare and insomnia are important in predicting later development of PTSD as well as diagnosing PTSD. Despite of its clinical significance and importance, consistent characterization of the neurophysiology underlying sleep symptoms in PTSD has been elusive. However, hyperarousal by increased noradrenergic activity in symphathetic nervous system and/or dysregulation and fragmentation of REM sleep seem to have a significant role in mediating sleep disturbances of this disorder. In this article, the authors reviewed various literatures on sleep of PTSD and emphasized the importance of evaluating sleep disturbances in PTSD.
Dreams ; Humans ; Negotiating ; Nervous System ; Neurophysiology ; Sleep Initiation and Maintenance Disorders ; Sleep, REM ; Stress Disorders, Post-Traumatic*

Despite the rather widespread interest in appendicoliths, we know of very few papers on this subject in the urological literature. If the roentgtnogram shows an opacity in the region of the right lower ureter, it becomes the responsibility of the urologist, general surgeon and radiologist to determine its correct diagnosis. Mark and Seelig have each reported a case of appendiceal stone with symptoms of ureteral colic, dysuria and an opacity, alone the course of the lower right ureter. The purpose of this paper is to report a case of appendical concretion which was diagnosed as an ureteral calculus preoperatively in our urology department. The patient was 57 years old woman who was admitted to St. Mary's Hospital because of pain on right lower quadrant associated with urological symptoms consisting of frequency, painful urination and microscopic hematuria. Radiological examination revealed an opaque shadow measuring 2.1 X 0.9 cm in the right lower quadrant along the ureteral course. On I. V. P. hydronephrotic change was noted on the right side associated with the opaque hadow, as seen in the K. U. B. Upon retrograde catheterization of the right ureter, obstruction was met at the site of apparent calcification and a catheter could not be passed above this area confirming an right ureteral calculus. At the operation, right lower ureter was found to be densely adhesive with retroperitoneum and calculus was not found in the ureter but in the appendix. Finally, appenectomy was performed through retroperitoneum and all of the adhesive areas were separated from the ureter.
Adhesives ; Appendix ; Calculi ; Catheterization ; Catheters ; Diagnosis ; Dysuria ; Female ; Hematuria ; Humans ; Middle Aged ; Renal Colic ; Ureter* ; Ureteral Calculi* ; Urination ; Urology

The objective of this study was to investigate the relationship between insomnia severity, depression, anxiety, and anxiety sensitivity and to find out the explanatory variables that account for the insomnia severity among depression, anxiety, and anxiety sensitivity in general population. 95 mentally healthy volunteers who visit health promotion center of Kangbuk Samsung hospital for their regular medical examination were requested to complete Athens Insomnia Scale, Beck Depression Inventory, State-Trait Anxiety Inventory, and Anxiety Sensitivity Index. Association between total scores of Athens Insomnia scale and other variables (total scores of Beck Depression Inventory excluded item 16, total scores of State Anxiety, total scores of Trait Anxiety, and total scores of Anxiety Sensitivity Scale) was assessed individually with partial correlations adjusted by age and then together using multiple regression analysis. The total scores of Athens Insomnia Scale were significantly associated with total scores of Beck Depression Inventory excluded item 16(r = 0.541, p<0.001), total scores of Trait Anxiety(r = 0.642, p<0.001), total scores of State Anxiety(r = 0.267, p<0.05), and total scores of Anxiety Sensitivity Index(r = 0.312, p<0.01). Total scores of trait anxiety showed the highest correlation with the total scores of Athens Insomnia Scale and was the significant predictor to total scores of Athens Insomnia Scale among the other predictor variables (p<0.001). These results show that insomnia severity is positively correlated with depression, anxiety, and anxiety sensitivity. The correlation was strongest with trait anxiety. In addition, our results suggest that trait anxiety is associated with insomnia severity in general populations.
Anxiety* ; Depression* ; Health Promotion ; Healthy Volunteers ; Sleep Initiation and Maintenance Disorders*

Sleep can be easily disrupted by variety of conditions. Most of medical illnesses could be a primary condition causing secondary insomnia. The common underlying mechanism of secondary insomnia is presumed to be stress effects on sleep. The assessment and treatment of secondary insomnia are often complicated. Establishing an causal inference between primary condition and insomnia is the key to assessment. However, it can be difficult even for experienced clinicians due to diagnostic ambiguity of secondary insomnia. Therefore, through medical evaluation and integrative understanding of primary condition is essential to manage secondary insomnia properly. Although treatment have been usually focused on the primary medical illnesses per se, nonpharmacologic interventions, such as sleep hygiene, might be effective in many cases.
Hygiene ; Sleep Initiation and Maintenance Disorders*