We report a case of congenital giant pigmented nevus with malignant melanoma of brain in a 14-year-old male patient. He had giant pigmented nevus on the back and neck, and multiple satellite lesions over the whole body since birth. One year prior to visit to our hospital, the patient suffered from various neurologie symptoms including headache, nausea, vomiting, seizure and right side motor weakness. Flistologic findings of skin lesions were benign nevocytic nevi. Computed tomogram of brain demonstrated increased densities in the both fronto-parietal leptameninges and brain parenchyme. Histologic findings of brain parenchyme by stereotaxic long needle biopsy showed the infiltration of melanin containing atypical melanocytes. There was no evidence of malignant melanoma at other organs. All of these findings suggested that origin of malignant melanoma of brain parenchyme was leptomeninges rather than skin.
Adolescent ; Biopsy, Needle ; Brain* ; Headache ; Humans ; Male ; Melanins ; Melanocytes ; Melanoma* ; Nausea ; Neck ; Nevus ; Nevus, Pigmented* ; Parturition ; Seizures ; Skin ; Vomiting

For the purpose of evaluating the effect of both direct retainer design and bony absorption degree around abutment of indirect retainer on the supporting tissue of abutment of indirect retainer, dislodging force was transmitted to unilateral distal extension RPD bases. Analysis of stress distributed within the supporting tissue around abutment of indirect retainer was carried out. Using three-dimensional photoelastic stress analysis method and the conclusion is a follows. 1. According to the extent of force which the direct retainer of the most distal abutment tooth, the amount of force transmitted to the abutment tooth of indirect retainer was small. 2. Of all the cases, Mandibular first premolar which was used abutment tooth of indirect retainer, buccal, mesial and distal sides represented compression stress and lingual side represented tensile stress. 3. The more bone resorption of abutment tooth of indirect retainer, the more distortion of buccal and distal side of abutment tooth was existed and the extent of compression stress which was existed and distal side to abutment tooth was large. 4. When the alveolar bone around the abutment with indircet retainer is normal. The amount of force transmitted on abutment with indirect retainer was small in the order of Akers clasp, RPA clasp, RPI clasp. 5. When the alveolar bone around the abutment with indirect retainer has been absorbed 20% and 30%, the amount of force transmitted on abutment with indirect retainer was small in the order of RPA calsp, RPI clasp, Akers clasp. 6. When denture is displaced, shape of the direct retainer reciprocating abutment affect much the function of indirect retainer.
Absorption ; Bicuspid ; Bone Resorption* ; Dentures ; Tooth*

No abstract available.
Leiomyoma*

BACKGROUND: The aim of this study was to compare the cardiovascular changes followed by laryngoscopy with the McCoy laryngoscope blade with those followed by laryngoscopy with the Macintosh laryngoscope blade. METHODS: Forty eight patients were randomly divided into two groups. Following induction with fentanyl 2 mcg/kg and thiopental 5 mg/kg, and muscle relaxation with vecuronium 0.1 mg/kg, the vocal cords were visualized with either the McCoy or the Macintosh laryngoscope blade, then tracheal intubation was performed. Heart rate and arterial blood pressure were measured just before and after laryngoscopy, and 1, 3 and 5 min later. RESULTS: There was a significant increase in both heart rate and arterial blood pressure after tracheal intubation using the Macintosh laryngoscope. Also, use of the McCoy blade resulted in a significant increase in both heart rate and arterial blood pressure. CONCLUSIONS: There was no significant difference on arterial pressure and heart rate to laryngoscopy and tracheal intubation with either the McCoy blade or the Macintosh.
Arterial Pressure ; Blood Pressure* ; Fentanyl ; Heart Rate* ; Heart* ; Humans ; Intubation* ; Laryngoscopes* ; Laryngoscopy ; Muscle Relaxation ; Thiopental ; Vecuronium Bromide ; Vocal Cords

Brain size is a useful parameter describing ontogenic character and function. Despite its potential contribution to functional study and diagnosis of disease, it has been hampered by poor assessment tools in vivo and postmortem changes. Recent development of medical imaging techniques such as MRI and CT enable us to understand brain structures in vivo. Many morphometirc studies of the brain has given us new insights in the field of functional neuroanatomy and neuropsychiatric diseases. In spite of these advances, volumetric data of normal Korean brain is not available yet. As an initial approach to Korean standard brain size, we measured the cerebellar volume between 20 and 80 years old Koreans. The MRI films free from lesions in brain was analyzed and measured by NIH image program. The Korean cerebellar volume were ranged between 86.2cm(3) and 141.3 cm(3) and average male cerebellum volume was significantly larger than that of female[male : 118.2+/-11.2cm(3)] > female : 108.0+/-9.6cm(3), P=0.1021E-07<0.05]. And we could not find volume change according to aging process. This is the first report on normal Korean cerebellar volume and the presence of gender difference in the Korean cerebellar volume. These data will be used for the standard useful in studying cerebellar function and cerebellum associated disorders in the future.
Aged, 80 and over ; Aging ; Brain ; Cerebellum ; Diagnosis ; Diagnostic Imaging ; Female ; Humans ; Magnetic Resonance Imaging* ; Male ; Neuroanatomy ; Postmortem Changes

PURPOSE: This study aimed to explain what are the experiences of patients with renal disease who are just begun hemodialysis in the end-stage. METHODS: The data were collected from February to December in 2017 through individual in-depth interviews using open-ended questions. For data analysis, a phenomenological method suggested by Colaizzi was applied. A total of 8 hemodialysis patients with end-stage renal disease (ESRD) participated in this study. RESULTS: According to the analysis, five theme clusters emerged: ‘I go into darkness’, ‘Being disappearing from others’, ‘Baby bird living with love’, ‘Dawn in darkness’ and ‘A life longing for the absolute’. CONCLUSION: Patients undergoing hemodialysis experienced fear and anxiety at the beginning of hemodialysis. Therefore, counseling and social supports were needed for patients with ESRD in their early stage of hemodialysis. In addition, a multidisciplinary education program should be implemented in the future research. It may help to overcome for the patients who are experiencing complicated health problems in their early stage of hemodialysis treatment.
Anxiety ; Birds ; Counseling ; Education ; Humans ; Kidney Failure, Chronic* ; Methods ; Qualitative Research ; Renal Dialysis* ; Statistics as Topic

Forth-nine patients with clinically nonfunctioning pituitary adenomas were evaluated clinically, endocrinologically and morphologically in this study.The results obtained were as follows.1) The mean age was 47.1 years(range 23 to 76 years), and 22 were male(44.9%) and 27(55.1%) female.2) The major clinical manifestations of male patients were visual disturbance(72.7%), headache(54.5%), loss of libido(45.5%), but those of female visual disturbance(59.6%), headache(48.1%), amenorrhea(48.1%), loss of body hair(25.9%), and galactorrhea(22.2%).3) All were macroadenomas evaluated by CT scan, and in the male patients 16(72.7%) were grade III and 6(27.3%) grade IV by Hardy classification, and in the female patients 6(22.2%) were grade II, 12(44.4%) grade III, and 9(33.3%) grade IV.4) The elevation of serum prolactin were observed 7(31.8%) out of male, and 24(88.9%) of female.5) Combined stimulation test revealed that GH insufficiency was 89.6%, ACTH 58.9%, LH 58.7%, FSH 51.1 %, and TSH 50.0% and hormone insufficiency more than 4 pituitary hormone was 54.2%.6) Prolactin response to TRH decreased in 12(70.6%) of 17 patients with normal basal prolactin, and 19(76.0%) of 25 with elevated prolactin.7) Immunohistochemistry revealed that null cell adenoma was 57.1%, gonadotrope adenoma 26.5%, plurihormonal adenoma 8.0%, silent corticotrope adenoma 4.0%, thyrotrope adenoma(2.0%), and lactotrope adenoma(2.0%).8) The ultrastructural characteristics examined by electron-microscopy were similar despite of immunohistochemical differences.In summary, the prevalance of clinically nonfunctioning pituitary adenoma was middle aged men and women, and their main symptoms were visual disturbance and headache. Hyperprolactinemia and pituitary hormone insufficiency more than 4 hormone were observed commonly. Most of them were null cell adenoma and gonadotrope adenoma examined by immunohistochemistry. Further study using modern techniques: cell culture, subunit-immunostaining. And Northern blot analysis of mRNA for pituitary hormone or subunit, will be needed to clarify null cell adenomas.
Adenoma ; Adrenocorticotropic Hormone ; Blotting, Northern ; Cell Culture Techniques ; Classification ; Female ; Headache ; Humans ; Hyperprolactinemia ; Immunohistochemistry ; Lymphocytes, Null ; Male ; Middle Aged ; Pituitary Neoplasms ; Prolactin ; RNA, Messenger ; Tomography, X-Ray Computed

PURPOSE: The purpose of this study was to examine the effects of the motivational interviewing (MI) dementia preventive intervention on dementia preventive behaviors, depression and cognitive function among elderly over 75 years of age in nursing homes. METHODS: A nonequivalent control group pretest-posttest design was used. A total of 57 participants were divided into three groups; 18 in the MI dementia preventive intervention (Group A), 20 in the dementia preventive program (Group B) and 19 in the control group. Dementia preventive behaviors, depression, and cognitive function were assessed at pre, post, and 1 month after the intervention. Data were analyzed using descriptive statistics, t-test, ANOVA and repeated measure ANOVA. RESULTS: The results reported that there were significant differences in dementia preventive behaviors and depression among Group A, B, and C. Also, there were significant differences in dementia preventive behaviors and cognitive function during time periods. There was a significant interaction between groups and times in relation to depression. Results suggested that the effects of MI dementia preventive program was persistent after 1 month following the intervention. CONCLUSION: Further research needs to develop dementia preventive programs considering physical and mental traits of the elderly in late years staying at nursing homes.
Aged* ; Cognition ; Dementia* ; Depression ; Humans ; Motivational Interviewing* ; Nursing Homes* ; Nursing*

PURPOSE: The purpose of this study was to identify the retention effects of an individualized dietary education program for hemodialysis patients on diet knowledge, diet self-care compliance, and physiological indices, thus to find the most effective time period for re-education. Method: This study utilized one-group repeated pretest-posttest design. The participants were 52 hemodialysis patients in C hospital, Gyeonggi-Do. Data were collected at 4 and 12 weeks after the education from January through April 2016. RESULTS: There was significant increases in diet knowledge even 12 weeks after the education (p=.007). Diet self-care compliance showed a significant increase at 4 weeks (p=.001), but a decrease at 12 weeks after the education. The level of blood natrium was significantly decreased between 4 and 12 weeks after the education (p=.006). The weight was significantly decreased at 12 weeks after the education. CONCLUSION: It has been identified that re-education for hemodialysis patients should be implemented between 4 and 12 weeks after education in order to maintain patients' diet self-care compliance, an ultimate aim of diet education. By helping them with their self-care compliance, the patients would maintain their physical and psychological function optimally, thus contributing to a better quality of life among hemodialysis patients.
Compliance* ; Diet* ; Education* ; Gyeonggi-do ; Humans ; Methods ; Quality of Life ; Renal Dialysis* ; Self Care*

Hypertension is a well known causative factor of congestive heart failure and other cardiovascular disease, and usually induce myocardial hypertrophy. Recent study shows that some antihypertensive drugs may reduce the hypertrophied cardiac mass reversibly. And over the past some decades, increasing attention was focused on these drugs. These drugs include methyldopa, angiotensin converting enzyme inhibitor, calcium channel inhibitor, beta-adrenergic blocker, but diuretics and vasodilators were known not to reduce the hypertrophied ventricular mass. In this study, 46 hypertensive patients were managed by captopril, atenolol, or hydrochlorothiazide monotherapy. And wer estimated and follow up LV mass by echocardiography during 3 months. Captopril and atenolol group showed LV mass reduced, but hydrochlorothiazide group did not. LV mass was reduced more in captopril group than in atenolo group. In conclusion, we have been impressed by this study that diuretics monotherapy for hypertension shoud be reconsidered. And we concluded that drugs which can reduce myocardial mass shoud be chosen to control hypertension as a monotherapeutic drug or a additive drug.
Antihypertensive Agents ; Atenolol ; Calcium Channels ; Captopril ; Cardiovascular Diseases ; Diuretics ; Echocardiography ; Follow-Up Studies ; Heart Failure ; Humans ; Hydrochlorothiazide ; Hypertension* ; Hypertrophy ; Methyldopa ; Peptidyl-Dipeptidase A ; Vasodilator Agents