BACKGROUND: Wheezing which is defined as a continuous sound with a musical quality is commonly auscultated in patients with chronic obstructive airway diseases. The correlation between wheezing and airway obstruction is unclear. OBJECTIVE: This study was designed to evaluate the relationships among wheezing, severity of airway obstruction, and pulmonary function tests. METHOD: Forty-one subjects were examined by the same observer. Wheezing during normal breathing and maximal forced exhalation, was auscultated respectively. Posterior lung bases were auscultated bilaterally with the seated patient taking repeated inspiratory capacity breaths through an open mouth. To quantify wheezing intensity, a regional score was assigned for each area after a minimum of 3 breaths, according to the following scale: zero, no wheezing heard: one, faint or intermittent wheezes: two, moderate wheezing during every expiration: three, loud wheezing during every expiration. The lung function tests by standard pneumotachograph were performed by skilled technicians. RESULTS: Wheezing was auscultated more in forced exhalation than in normal breathing in patients with asthma and COPD [8/9(88%) vs 1/9(11%), p<0.01 ll/15(73%) vs 1/15(6%), p<0.05)]. Forced expiratory wheezes group (n=25) compared to no wheezes group (n=16) had significantly lower FEVl (75+-5.8% vs 95.6+-6.6%, p<0.05). Compared to no wheezes group, the group with forced expiratory wheezes had lower FEV1 and FEV1/FVC (50.4+- 21.3% vs 81.15+-27.7%, 70.4+-22.4% vs 92.5+-19.3%, respectively, p<0.05). Bronchial asthma compared with COPD tended to have higher wheezing scores (Wheeze scores Bronchial asthma 3.5 vs COPD 2.4, p=0.08). Wheezing scores were correlated to FEV1 (normal breathing: r=-0.35, p<0.05: forced exhalation: r=-0.45, p<0.05), but no differences were found in wheezing incidence according to severity of airway obstruction. CONCLUSION: These findings suggest that wheezing on maximal forced exhalation may be a useful physical indicator for evaluating the severity of airway obstruction.
Airway Obstruction ; Asthma ; Exhalation ; Humans ; Incidence ; Inspiratory Capacity ; Lung ; Mouth ; Music ; Pulmonary Disease, Chronic Obstructive* ; Respiration ; Respiratory Function Tests ; Respiratory Sounds*

We described a case of diffuse biphasic cutaneous amyloidosis, a unique form of localized cutaneous amyloidosis. A 41-year-old man has gradually developed a lichenoid papular and a grouped spotted pigmented macular eruption on the trunk and upper extremities over the past 15 years. Histopathologic examination revealed that amyloid deposits were present in the papillary dermis. It was confirmed by Congo red staining, immunohistochemistry and electron microscopy. There was no evidence of systemic amyloidosis.
Adult ; Amyloidosis* ; Congo Red ; Dermis ; Humans ; Immunohistochemistry ; Microscopy, Electron ; Plaque, Amyloid ; Upper Extremity

Milia en plaque is characterixed by multiple milia-like lesions within an erythematous edematous plaque in the postauricular area. The histopathological findings are those of milia. We report a case of milia en plaque occurring on the scapha's fossa of the left auricle in a 3-year-old boy.
Child, Preschool ; Humans ; Male

Juvenile spring eruption(JSE) of the ears is an unusual type of photodermatosis, which develops on the light exposed areas of the ears of boys and young male adults in the early spring months. JSE has received little attention in the literature, and to our knowledge no cases have been reported in Korea until now. Herein we report a case of JSE occurring in a 17-year-old man who has suffered from a recurrent pruritic erythematous papulovesicular eruption of both helix, followed by crusting and healing without scarring within one to two months early each spring for six years.
Adolescent ; Adult ; Cicatrix ; Ear* ; Humans ; Korea ; Male

OBJECTIVE: The purpose of this study was to determine the important factors affecting survival and pregnancy rate in frozen-thawed embryo transfer cycles. METHODS: we performed reprospective analysis in 738 cycles of frozen-thawed embryo transfers, in relation to the insemination methods, the freezing stage of embryo, patient's age, infertility factors and the origin of injected sperm in ICSI cycles. After conventional IVF or ICSI, the supernumerary PN stage zygotes or multicellular embryos were cryopreserved by slow freezing protocol with 1,2-propandiol (PROH) as a cryoprotectant. RESULTS: The survival rates of thawed embryos were 69.3% (1585/2287) in conventional IVF group and 71.7&% (1645/2295) in ICSI group. After frozen-thawed embryo transfers, 27.0% (92/341) and 32.0% (109/341) of pregnancy rates were achieved in conventional IVF and ICSI group, respectively. There were no significant difference in the survival and pregnancy rates according to the insemination methods, the freezing stage and patient's age. However, the pregnancy rate (36.2%) of male factor infertility (22.9%). In ICSI group, the origin of injected sperm did not affect the outcome of frozen-thawed embryo transfer cycles. CONCLUSION: The present study demonstrates that acceptable clinical outcomes can be achieved after the transfer of frozen-thawed embryos regardless of the stage of embryos for freezing, the patient's age and the origin of injected sperm.
Embryo Transfer* ; Embryonic Structures* ; Freezing ; Humans ; Infertility ; Insemination ; Male ; Pregnancy Rate* ; Pregnancy* ; Sperm Injections, Intracytoplasmic ; Spermatozoa ; Survival Rate ; Zygote

Because the risk of adverse reactions is lower with nonionic radiocontrast media than with conventional ionic agent, it is recommended that high-risk patients receive lower osmolality, a nonionic radiocontrast for their examination. However, the occurrence of a severe, life-threatening anaphylactoid reaction to even a small dose of nonionic radiocontrast has been reported. We report the first case in Korea of near-fatal anaphylactoid reaction to a nonionic contrast media. A 21-year-old lady with an abdominal mass due to benign mucinous cystadenoma received an injection of iopromide (Ultravist ) for abdominal computerized tomogram. Two minutes after the injection, perioral swelling and erythema, vomiting, seizure, and cardiopulmonary arrests developed. Immediate cardiopulmonary resuscitation and administrations of antihistamine, steroid, and sympathomimetics were performed with successful recovery. She had a history of allergic rhinitis and showed mild airway hyperresponsiveness on histamine bronchoprovocation test. Since a pretreatment with corticosteroid & antihistamine regimen in addition to use of nonionic agent helped to reduce the further occurrence of anaphylactoid reactions in previous contrast reactors, this near-fatal anaphylactoid reaction in an atopic individual suggests that a use of pretreatment plus nonionic agent is desirable in all patients with atopy or asthma.
Asthma ; Cardiopulmonary Resuscitation ; Contrast Media* ; Cystadenoma, Mucinous ; Erythema ; Heart Arrest ; Histamine ; Humans ; Korea ; Osmolar Concentration ; Rhinitis ; Seizures ; Sympathomimetics ; Vomiting ; Young Adult

PURPOSE: Since a significant number of patients with locally invasive bladder tumor(T3a/T3b) subsequently develop distant metastases, there have been lots of controversies in deciding treatment modalities. In the past decade, progress has been made in the development of effective chemotherapy for the treatment of advanced transitional cell carcinoma of the urothelium. Thus, we reviewed the effectiveness of the M-VAC(methotrexate, vinblastine, adriamycin, and cisplatin) chemotherapy for locally invasive transitional cell carcinoma (TCC) of the bladder. MATERIALS AND METHODS: We reviewed 36 patients who were diagnosed as T3a/T3b TCC and treated with aggressive transurethral resection of the bladder tumor(TURBt) and M-VAC chemotherapy Remission was defined in case of complete disappearance of the tumor or downstaging, and progression was defined in case of persistent disease or upstaging. RESULTS: Mean age of the patients was 60.4 years old(33 males; 3 females), and mean follow up was 12.2 +/- 8.9 months. Response rate considering loss of follow up according to the Kaplan-Meyer's method, was 79, 49, 44, 37% at 6, 12, 18, 24th month, respectively. Disease progressions were found in 19 patients during follow up, and the mean duration to progression was 9.2 +/- 5.0(1-19)months. 79% of the patients with disease progression showed progression within 12 months. Lymph node metastases or distant metastases were confirmed in 68% of progressed patients. CONCLUSIONS: M-VAC chemotherapy after aggressive TURBt is limited, but erective treatment modality, and it is also useful in deciding the prognosis of cancer with its responsiveness.
Carcinoma, Transitional Cell* ; Disease Progression ; Doxorubicin* ; Drug Therapy* ; Follow-Up Studies ; Humans ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Prognosis ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urothelium ; Vinblastine*

PABAP (Palindrome Analysis by BLAST Program) is an analysis system that identifies palindromic sequences from a large genome sequence up to several megabases long. It uses NCBI BLAST as a searching engine, and data processing such as alignment filtration and detection of inverted repeats which satisfy user- defined parameters is performed by manipulating data after populating into a MySQL database. PABAP outperforms publicly available palindrome search program in that it can detect large palindrome with internal spacer at a faster speed from bacterial genomes. It is a standalone application and is freely available for noncommercial users. AVAILABILITY: This application was implemented with free software (Perl, Apache, MySQL, and NCBI BLAST) and is freely available to noncommercial users upon request. Analysis of user data can be carried out directly at http://chimp.kribb.re.kr/~javamint/palindrome.
APACHE ; Filtration ; Genome* ; Genome, Bacterial

The purpose of this study was to investigate the feasibility of sentinel node frozen biopsy to minimize the extensive pelvic lymph nodes dissection in early stage cervical cancer patients on the basis that the risk of skip metastasis to the paraaortic area is negligible. Twenty-six patients with early stage cervical cancer were enrolled in this study. Technetium-99m colloid albumin (Tc(99m)) was injected intradermally around the tumor for allowing preoperative lymphoscintigraphy and intraoperative hand-held gama probe detection of seninel nodes. For visual detection, isosulfan blue dye was injected into the peritumoral sites before peritoneal opening. Postoperative morbidity and negative predictive value were the endpoints of this study. The 26 patients, ranging in age from 32 to 71 yr, underwent intraoperative sentinel nodes mapping. All the patients underwent complete pelvic lymph nodes dissection including para-aortic nodes. There was one case with positive non-sentinel nodes despite the negative sentinel node by frozen biopsy (negative predictive value, 95.2%). This new technique of sentinel node mapping is safe and simple to perform. Further clinical trials using the combination of Tc(99m) and isosulfan blue dye are warranted and this technique will make a true advance for less aggressive management of patients with early stage cervical cancer.
Adult ; Aged ; Female ; Humans ; *Lymph Node Excision ; Lymph Nodes/pathology/radionuclide imaging/*surgery ; Middle Aged ; Pelvic Neoplasms/*pathology/radionuclide imaging/surgery ; Pelvis ; Predictive Value of Tests ; Rosaniline Dyes/metabolism ; Sensitivity and Specificity ; *Sentinel Lymph Node Biopsy ; Technetium Tc 99m Aggregated Albumin/diagnostic use ; Uterine Cervical Neoplasms/*pathology/radionuclide imaging/surgery

The auricle develops from six auricular tubercles which originate from the mesenchyme of the first and second branchial arch. If a defective fusion of these tubercles occur, a preauricular fistula may be formed. We report two cases of congenital preauricular fistula manifested by soft nodules with external openings on the left preauricular area. Histologically, the fistulas are lined by stratified squamous epithelium, and elastic cartilage. and chronic inflammatory cell infiltration are also present.
Branchial Region ; Elastic Cartilage ; Epithelium ; Fistula* ; Mesoderm