Sick sinus syndrome comprises a variety of conditions involving sinus node dysfunction and commonly affects elderly persons. Though sudden cardiac death accounts for as much as 15% of all cause mortality in uremia, requiring permanent cardiac pacing in end-stage renal disease hemodialysed patients are very few. Most cases of sick sinus syndrome are idiopathic, and the cause can be multifac- torial. A-V conducton defects were attributed to extensive metastatic calcifications, involving the cardiac skeleton, conservative to severe hyperparathyroidism and inadvertent use of calcitriol and calcium carbonate as phosphate binders. If optimal hemodialysis is provided, benefits of permanent pacing are equal in uremic or non uremic patients and pacemaker implantation should be instituted. We report a case of sick sinus syndrome derived in elderly patient on hemodialysis.
Aged* ; Calcitriol ; Calcium Carbonate ; Death, Sudden, Cardiac ; Humans ; Hyperparathyroidism ; Kidney Failure, Chronic ; Mortality ; Renal Dialysis* ; Sick Sinus Syndrome* ; Skeleton ; Uremia

A 69-year-old man presented with annular lichen planus involving both forearms, hand dorsa, wrists, inner sides of the thighs, knees and ankles. He was treated initially with systemic corticosteroids and etretinate, but rernission and recurr ence of the skin lesions were observed. During the follow-up, we found erythrasma on all his toewebs and both soles. After administration of erythromycin for the treatment of erythrasma, lesions of the lichen planus rapidly improved. Five months later, some lesions of lihen planus and erythrasma had recurred. After administration of erythromycin, the lesions of lichen planus improved again. No recurrence was observed for the following 8 months. We suspect that eradication of the chronic focus of infection and the anti-inflammatory effect, of erythromycin may lead to supression of abnormal immunological reactions and resolution of lichen planus.
Acitretin ; Adrenal Cortex Hormones ; Aged ; Ankle ; Erythrasma ; Erythromycin* ; Etretinate ; Follow-Up Studies ; Forearm ; Hand ; Humans ; Knee ; Lichen Planus* ; Lichens* ; Recurrence ; Skin ; Thigh ; Wrist

A 26-year-old Korean man had an erythematous scaly plaque on his right thigh for fifteen years. He was diagnosed with chronic eczema and treated with topical steroid, but no clinical improvement was obtained for 15 years. Laboratory studies including complete blood cell count, urinalysis, liver and renal function test, and peripheral blood smear were normal. A biopsy specimen showed hyperkeratosis, acanthosis, and mononuclear cellular infiltration in the epidermis. These cells had a perinuclear halo and showed a Pautrier's microabscess like configuration. In the dermis, there was a band like infiltration of inflammatory cells. Infiltrates of the epidermis were negative for leukocyte common antigen(CD45) and positive for Pan T cell(CD45RO). He was treated with topical PUVA twice a week for twelve weeks. Clinical and pathological improvements were obtained. We propose PUVA may be a useful therapeutic modality to treat Woringer Kolopp disease.
Adult ; Biopsy ; Blood Cell Count ; Dermis ; Eczema ; Epidermis ; Humans ; Leukocytes ; Liver ; Pagetoid Reticulosis* ; Thigh ; Urinalysis

The presnt study was carried out to find out any difference in terms of the rate of rebleeding, mortality and of the occurrence of vasopasm and hydrocephalus between the two groups of patients with subarachnoid hemorrhage : a group of 225 cases which were administered with epsilon aminocaproic acid(EACA) (antifibrinolytic agent) and the other a group of 221 cases without EACA treatment. Both groups were chosen from 476 patients admitted to the Department of Neurosurgery, Kyung-Hee University Medical Center within 7 days after the onset of subarachnoid hemorrhage during a period from January 1982 to December 1987. The clinical observation was done during acute period following subarachnoid hemorrhage. The major findings obtained were as follows : 1) The occurrence of rebleeding was higher within 3 days after the onset of subarachnoid hemorrhage. The rate of rebleeding was 8.4% in treated group whereas the rate was 13.1% in control group. This may suggest that administration of EACA is effective to prevent rebleeding. 2) the occurrence of vasopasm was higher within on the 7th and 8th day after the onset of subarachnoid hemorrhage. The rate of vasospasm was 28.9% in treated group whereas the rate was 12.4% in control group. This means that the rate of occurrence of vasospasm was two times higer in EACA treated group. 3) the rate of occurrence of hydrocephalus was 18.3% in treated group whereas the rate lower in control group(11.6%). 4) Within-two-weeks mortality and within-one-month mortality were 14.7% and 22.2% respectively in treated group whereas the two rates in control group were 15.1% and 24.1% respectively. No significant difference between the two groups was observed. 5) The causes of death in treated group were found to be vasospasm(55.5%) and rebleeding(28.0%) in order, whereas in control group the causes of deaths were rebleeding(40.2%) and vasospasm(21.3%). In other words, the main cause of death was vasospasm in treated and that in control group was rebleeding.
Academic Medical Centers ; Cause of Death ; Humans ; Hydrocephalus ; Mortality ; Neurosurgery ; Subarachnoid Hemorrhage*

No abstract available.
Electrocardiography* ; Humans

PURPOSE: As the National Health Insurance Service (NHIS) began to cover home oxygen therapy (HOT) services from 2006, it is expected that the new services have contributed to overall positive outcome of patients with chronic obstructive pulmonary disease (COPD). We examined whether the usage of HOT has helped slow down the progression of COPD. METHODS: We examined hospital claim data (N=10,798) of COPD inpatients who were treated in 2007~2012. We performed chi2 tests to analyze the differences in the changes to respiratory impairment grades. Multiple logistic regression analysis was used to identify factors that are associated with the use of HOT. Finally, a generalized linear mixed model was used to examine association between the HOT treatment and changes to respiratory impairment grades. RESULTS: A total of 2,490 patients had grade 1 respiratory impairment, and patients with grades 2 or 3 totaled 8,308. The OR for use of HOT was lower in grade 3 patients than others (OR: 0.33, 95% CI: 0.30~0.37). The maintenance/mitigation in all grades, those who used HOT had a higher OR than non-users (OR: 1.41, 95% CI: 1.23~1.61). CONCLUSION: HOT was effective in maintaining or mitigating the respiratory impairment in COPD patients.
Home Care Services ; Humans ; Inpatients ; Logistic Models ; Lung Diseases, Obstructive* ; National Health Programs ; Oxygen Inhalation Therapy ; Oxygen* ; Pulmonary Disease, Chronic Obstructive ; Respiratory Mechanics

In order to investigate the effect of chronic alcohol drinking upon the gastric mucosa of rats, Sprague-Dawley rats (200~235 g) had drunken 10% alcohol in stead of water and were maintained on regular feed. They drank about 20cc of 10% alcohol a day. The experimental groups sacrificed in 1, 2, 4 and 8 weeks. The gastric mucosa from the gastric body near by the fundus and the gastric body in the vicinity of the pylorus were fixed in neutral formalin, dehydrated in graded ethanol and embedded in paraffin. They were sectioned and stained with hematoxylin and eosin, and stained with alcian blue pH 2.5. The results were as follows: 1. Mucosal epithelium of the rat destroyed a little in some place, but the damage was not severe in all the experimental groups. Migrating cells and parietal cells covered the damaged places. 2. In the mucosa of the gastric body near by the fundus, the cells of the gastric gland showed positive reaction with alcian blue pH 2.5 and increased in number at 1 week. The number and reactivity of the cells decreased at 4 and 8 weeks of the experiment. 3. The surface mucous cells of the gastric pits in the body near by the pylorus decreased in number. The mucous neck cells of the gastric gland also decreased in number with time. 4. The cells in the base of the gastric gland showed alcian blue pH 2.5 positive at 4 and 8 weeks of the experiment. 5. The thickness of the gastric mucosa in all the experimental groups decreased in comparison with that of normal gastric mucosa.
Alcian Blue ; Alcohol Drinking* ; Animals ; Eosine Yellowish-(YS) ; Epithelium ; Ethanol ; Formaldehyde ; Gastric Mucosa* ; Hematoxylin ; Hydrogen-Ion Concentration ; Mucous Membrane ; Neck ; Paraffin ; Pylorus ; Rabeprazole ; Rats* ; Rats, Sprague-Dawley

Tinea capitis is a dermatophytosis of the scalp and associated hairs that is caused by the species of genera Mecrosporum and Trichophyton. It commonly affects children. Black dot ringworm (BDR) can be caused by Trichophyton tonsurans and Trichophyton violaceum. We report a 82-year-old woman with diffuse hair loss and black dots on the frontal scalp, and an erythematous annular scaly patches on the forehead. Endothrix invasion of the hair was shown on the 20% KOH mount. In fungus culture, slow growing violaceous verrucous colonies were obtained from the scalp and face. Microscopic findings revealed irregular branching hyphae and numerous chlamydospores. Histologic findings of the scalp showed numerous PAS positive fungal elements in the hair. Griseofulvin was administrated at the dose of daily 1000mg for 3 weeks, but no clinical and mycological improvement were obtained and tenderness and pustules were developed. Terbinafine at the dose of daily 250mg was administrated for 6 weeks, and clinical and mycologic improvement were obtained and damaged scalp hairs were replaced by intact hair shaft. There has been no recurrence for 8 months. To our best knowledge, this is the first case of BDR caused by T. violaceum in the Korean literature.
Aged, 80 and over ; Child ; Female ; Forehead ; Fungi ; Griseofulvin ; Hair ; Humans ; Hyphae ; Recurrence ; Scalp ; Tinea Capitis ; Tinea* ; Trichophyton*

BACKGROUND: Onychomycosis is a common fungal nail infection. Characteristic features include ungual and subungual hyperkeratosis, discoloration, onycholysis, nail dystrophy, and periungal pain which may cause cosmetic, social, and psychologic problem to the patients. OBJECTIVE: Our purpose is to evaluate quality of life in patients with onychomycosis. METHOD: We interviewed 100 patients with onychomycosis which was diagnosed by clinical finding and KOH preparation. RESULT: Frequently observed signs and symptoms of onychomycosis were discoloration of nail, hyperkeratosis, nail dystrophy, onycholysis, periungual pain, and periungual inflammation, in descending order Source of infection suspected by patients included military service, shoes, tines pedis, prolonged contact with water, trauma, etc. Most patients suffered from problems with daily and social activity, and psychologic problem at the rate of 64%, 58%, 66%, respectively. Patients who wanted to take medication or treatment were 73%, but they also had several worries about treatment. CONCLUSION: Many patients with onychomycosis suffered from problems with daily and social activity, and psychologic problem. Therefore, more attention should be paid to the patients with onychomycosis as the development of cultural, social, and economic status.
Humans ; Inflammation ; Military Personnel ; Onycholysis ; Onychomycosis* ; Quality of Life* ; Shoes ; Water

STATEMENT OF PROBLEM: There have been few studies about the marginal fit of Auro Galvano Crowns. PURPOSE: The purpose of this study was to compare the marginal fit of the anterior single restorations. MATERIAL AND METHODS: The in vitro marginal discrepancies of metal-ceramic, Auro Galvano Crown and coping were evaluated and compared. The Auro Gavano Crowns were made from one extracted maxillary central incisor prepared by milling machine. 30crowns per each system were fabricated. Measurements of a crown were recorded at 50 points that were randomly selected for marginal gap evaluation. Parametric statistical analysis was performed for the results. RESULTS: Mean marginal gap dimensions and standard deviations at the marginal opening for the anterior single crowns were 74+/-21micrometer for the control (metal-ceramic restoration), 45+/-11 micrometer for Auro Galvano Crown coping, and 51+/-9 micrometer for the Auro Galvano Crown. CONCLUSIONS: Auro Galvano Crown showed significantly smaller (P< .05) marginal gap than the control. Ceramic application did not significantly affected the marginal fit of Auro Galvano Crown. (P> .05)
Ceramics ; Crowns* ; Incisor