A 6-year-old boy with porokeratotic eccrine ostial and dermal duct nevus on the left sole is reported. The patient was born with keratotic plugs, each measuring 1-2 mm in diameter, on the left sole. Light-microscopic examination revealed epidermal invagination and cornoid lamella, which was found to be connected with hyperplastic intraepidermal and dermal eccrine duct. The present case can be histologically differentiated from nevus comedonicus and punctate porokeratotis.
Child ; Humans ; Male ; Nevus*

No abstract available.
Neoplasm Metastasis* ; Vertebroplasty*

In 2008, Korea has enacted new ordinances about the role of estheticians, but this law can be interpreted ambiguously, restricting hiring of estheticians in medical clinics. The purpose of the study is to obtain information about medical-esthetic systems in other countries. We have taken a survey of this object from 30 OECD & Asian countries, and the questionnaires returned from a total of 22 countries (Australia, Austria, Canada, Denmark, Finland, France, Germany, Hungary, Japan, Netherlands, New Zealand, Norway, Portugal, Slovak Republic, Spain, Switzerland, Turkey, United Kingdom, United States, Singapore, Israel, and Thailand), were used for the final analysis. The results are summarized as follows. In most countries, estheticians working independently deal with only healthy, normal skin. In most countries, estheticians working independently have no right to operate any medical instruments. In all 17 countries that returned the questionnaires medical clinics can employ estheticians, and only theses estheticians who belong to the medical clinics can handle the non-invasive medical instruments under the supervision of doctors. In 17 countries that have related legal regulations, nurses, under the control of doctors, can perform wider range of duties in various settings than estheticians. The survey concludes that the duties of estheticians are closely related with medical skin care services and estheticians can perform various non-invasive medical procedures only under the control of doctors. From consulting a variety of medical-esthetic systems in other countries, we propose that the estheticians be allowed to work in medical clinics to provide better medical services for the patients and to make more chances of employment for themselves.
Asian Continental Ancestry Group ; Austria ; Canada ; Denmark ; Employment ; Finland ; France ; Germany ; Great Britain ; Humans ; Hungary ; Israel ; Japan ; Jurisprudence ; Korea ; Netherlands ; New Zealand ; Norway ; Organization and Administration ; Portugal ; Questionnaires ; Singapore ; Skin ; Skin Care ; Slovakia ; Social Control, Formal ; Spain ; Switzerland ; Turkey ; United States

Biofeedback is the treatment of choice for functional defecation disorders such as idiopathic chronic constipation and neurogenic fecal incontinence. The pre-existing biofeedback systems have many disadvantages. The aims of current project are, first, to develop the biofeedback system into the application software in the Windows environment, and, second, to assess the possibility of clinical usage for patients with functional defecation disorders. The hardware and software of the BASCO (Biofeedback Anal Sphincter Control) system were based on the signal measurement and signal processing of anal sphincter EMG (Electromyography). BASCO system was applied to 5 normal healthy controls and 20 patients with functional defecation disorders. Patients group was categorized as constipation group (N1=15) and incontinence group (N2=5). With use of current system, EMG-based biofeedback therapy was performed, and the outcome was analysed. Anal EMG signal data was processed by the software, and displayed in the monitor of personal computer. The software of EMG-display and database management were adequately operated. In N1 group, a paradoxical elevation or equalized activity of anal EMG pattern was shown in the simulated defecation. In N2 group, low electrical activity was shown. These findings were used for the EMG-based biofeedback therapy as a pilot study. The clinical symptoms were improved in 12 of N1 group and 3 of N2 group in the period of 3.7 (range, 1~12) months follow-up. In Conclusion, newly-developed BASCO system was adequately operated in the volunteer and patients groups. The multi-tasking and multi-processing functions were adequately shown in the real time. Current results could be used for clinical appraisal. Specifically, this system could be used for the practical application of biofeedback therapy in the patients with chronic constipation or fecal incontinence.
Anal Canal* ; Biofeedback, Psychology* ; Constipation ; Defecation* ; Fecal Incontinence ; Follow-Up Studies ; Humans ; Microcomputers ; Pilot Projects ; Volunteers

No abstract available.
Leukemia, Myeloid, Acute* ; Sarcoma, Myeloid*

The frequency of stab wounds is gradually increasing and patients with stab wounds visit the hospital through the emergency room. Management options for patients with stab wound include mandatory exploration and selective observation, but recently many authors have emphasized the importance of selective conservation with development of diagnostic procedure and controversy still exists concerning the management of patients with stab wounds. We retrospectively analysed the clinical data of 78 patients with stab wounds who visited the emergency room of St. Paul's Hospital over 5 years from January 1 1992 to December 31 1996. The following results were obtained. 1) The most prevalent age group were the twenties & the thirties(58.9% of patient) and then most patients were of young age. The male to female ratio was 2.9: 1. 2) Most injuries occurred at night between 8p.m. and 4a.m.(61.5%) and during September injuries were most frequent. 3) The most common causes of stab wound were fighting(55.1%) followed by suicide (21.8%), then accidents including traffic accidents(16.7%) and robbery(6.4%). 4) The instruments most commonly used were knives(53.8%) and broken glass(28.2%). 5) Half of patients were drunk from alcohol and in 3 cases from an antipsychotic drug. 6) In 11 cases(14.1%), there were multiple wound sites and in 8 cases(10.3%) superficial wounds into subcutaneous fatty tissue. 7) According to stab wound sites, the extremities were wounded in 36 cases(46.2%), chest in 21 cases(26.9%), abdomen in 15 cases(19.2%) and neck in 7 cases(9.0%). 8) Emergency explorations were performed in 43 cases(55.1%) under general or regional anesthesia, which included neck in 4 cases(9.3%), chest in 3 cases(7.0%), abdomen in 11 cases(25.6%) and extremity in 25 cases(58.1%). In exploratory laparotomy, negative exploration rate was 18.2%. 9) Death occurred in 2 cases(2.6%). One died due to sepsis with multiple colon perforation and the other due to hypovolemic shock with Superior Vena Cava injury.
Abdomen ; Adipose Tissue ; Anesthesia, Conduction ; Colon ; Emergencies ; Emergency Service, Hospital ; Extremities ; Female ; Humans ; Laparotomy ; Male ; Multiple Trauma ; Neck ; Retrospective Studies ; Sepsis ; Shock ; Suicide ; Thorax ; Vena Cava, Superior ; Wounds and Injuries ; Wounds, Stab*

BACKGROUND: The relation between treadmill exercise testing and ambulatory ST segment monitoring in detection of ischemia in patients with coronary artery disease has not been well established, with pathophysiologic mechanisms underlying the development of ischemia in the ambulatory setting not being well elucidated. This study was performed to determine the relation between myocardial ischemic indexes on exercise testing and on Holter monitoring. METHODS: We analized 25 patients with stable angina and angiographically documented coronary artery disease, who exhibited ischemia both on a Bruce protocol exercise test and on 24-hr Holter monitoring while receiving routine antianginal medications. RESULTS: Mean heart rate at the onset of 1mm ST segment depression during exercise testing(74.4 VS 114.1 beats/min, p<0.01). Overall the correlations between ischemic indexes on both test were weak. But heart rate at the onset of ischemic episodes during Holter monitoring had a good correlation with heart rate at 1mm ST depression during exercise test. And the number of ischemic episodes on Holter monitoring revealed a weak negative correlation with duration of exercise during treadmill test. CONCLUSION: Ischemic indexes on exercise testing cannot accurately predict ischemic indexes on Holter monitoring in patients with coronary artery disease. In that regard, Holter monitoring may provide other clinical information in addition to that obtained by exercise testing in selected patients.
Angina, Stable ; Coronary Artery Disease ; Depression ; Electrocardiography, Ambulatory* ; Exercise Test* ; Heart Rate ; Humans ; Ischemia* ; Myocardial Ischemia

No abstract available.
Gonadotropin-Releasing Hormone* ; Gonads* ; Steroids* ; Trophoblasts*

BACKGROUND: Several abnormalities of the autonomic regulation of the heart have been noted after acute myocardial infarction(AMI). Measurement of heart rate(HR) variability has been reported to provide indirect, noninvasive estimate of the cardiac efferent parasympathetic activity. The purposes of this study were to get the information on heart rate variability after AMI and to determine its relation to clinical and hemodynamic data. METHODS: We measured HR variability in 28 patients(23 men and 5 women : mean age, 56.6+/-10.4 years) 3-15days after AMI, in 25 patients with unstable angina and in 21 normal subjects by using triangular interpolation of the frequency distribution histogram om normalto-normal RR intervals from Holter tapes. RESULTS: HR variability was lower in AMI than unstable angina patients(357.9+/-118.6 versus 426.1+/-122.5 msec : p<0.05) and normal subjects(525.1+/-137.4 msec : p<0.025). There was no difference for infarct site, thrombolytic therapy, presence of Q-wave. HR variability was significantly related to mean 24-hour HR, left ventricular ejection fraction(all p<0.0001), left ventricular end diastolic diameter(p<0.05). HR varability was lower in patients belonging to Killip class 2-4 and who reqired the use of diuretics or digitalis(all p<0.05). CONCLUSION: After AMI, HR variabillity was reduced and significantly related to clinical and hemodynamic indexes of severity. Measurement of HR variability early after AMI may offer important clinical information for the early high stratification of patients.
Angina, Unstable ; Autonomic Nervous System ; Diuretics ; Female ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Male ; Myocardial Infarction* ; Thrombolytic Therapy

BACKGROUND: The atrial repolarization waves might contribute to ST segment depression during the exercise loading test. As atrial repolarization waves are opposite in direction to P waves, they could shift the ST segment in the absence of myocardial ischemia. METHODS: The exercise test in 20 patients was seemed false positive because of normal coronary angiogram. Twenty-six patients with at least one coronary stenosis > or =50% served as a true positive group. The P waves, PR segments and ST segment were studied in leads II, III, aVF and V4 to V6 in those 46 patients whose exercise ECG suggested ischemia. RESULTS: The finding of steeply downsloping PR segment, particularly in the inferior ECG leads, in patients with longer exercise time and higher exercise heart rate might predict a false positive exercise test in those with a normal rest ECG and no apparent reason for a false positive test. The combination of downsloping PR segments in two of three inferior leads plus either exercise duration > or =5 min or peak heart rate > or =130 bests/min idenified false positive tests with a sesitivity of 75% and a specificity of 81% to 89%. CONCLUSIONS: Atrial repolarization waves might play a role in exercise induced ST segment depression.
Coronary Stenosis ; Depression ; Electrocardiography ; Exercise Test ; Heart Rate ; Humans ; Ischemia ; Myocardial Ischemia ; Sensitivity and Specificity