BACKGROUND AND OBJECTIVES: Residual platelet reactivity in patients who are taking clopidogrel is commonly measured with VerifyNow assay, which is based on the principle of light transmission aggregometry. However, to evaluate the residual platelet reactivity, it would be more accurate if the reactivity of platelet glycoprotein (GP) IIb/IIIa is directly monitored. In this study, PAC1, a monoclonal antibody against activated platelet GP IIb/IIIa, was used to measure the residual platelet reactivity. SUBJECTS AND METHODS: Twenty seven patients with coronary artery disease taking clopidogrel were enrolled. Platelets in whole blood were stained with fluorescein isothiocyanate (FITC)-conjugated PAC1. Mean fluorescence intensity (MFI) and % positive platelets (PP) were measured with flow cytometry, and the binding index (BI; MFI x %PP/100) was calculated. P2Y12 reaction unit (PRU) and % inhibition of VerifyNow assay were also measured in the usual manner. RESULTS: PRU of VerifyNow assay correlated significantly with MFI, %PP, and BI at 10 microM (r=0.59, 0.73, and 0.60, respectively, all p<0.005) and 20 microM of adenosine diphosphate (ADP; r=0.61, 0.75, and 0.63, respectively, all p<0.005). The % inhibition also correlated significantly with MFI, %PP, and BI at 10 microM (r=-0.60, -0.69, and -0.59, respectively, all p<0.005) and 20 microM of ADP (r=-0.63, -0.71, and -0.62, respectively, all p<0.005). CONCLUSION: Direct measurements of the reactivity of platelet GP IIb/IIIa were feasible using PAC1 and flow cytometry in patients taking clopidogrel. Further clinical studies are required to determine the cut-off values which would define high residual platelet reactivity in patients on this treatment protocol.
Adenosine Diphosphate ; Blood Platelets* ; Coronary Artery Disease ; Flow Cytometry ; Fluorescein ; Fluorescence ; Glycoproteins* ; Humans ; Platelet Function Tests

OBJECTIVES: To investigate the nature of emotional responsiveness in normal adults, we exam the emotional responses to emotional pictures in an evaluative space defined by arousal and valence. METHODS: Subjects were instructed to rate the arousal and valence that they experienced from the presentation of one of two sets of 60 emotional pictures. These two picture sets were comprised of 107 pictures: 101 selected from International Affective Pictures System and six pictures from our own collection. According to "evaluative space model", the authors set an evaluative space defined by the arousal scores as independent variable and the valence scores as dependent variable. In this evaluative space, one-hundred-and-seven pairs of coordinates representing respective emotional pictures were plotted. With regression analyses, the steepness of the regression lines on the plots with positive emotional responsiveness (n=51) and those with negative emotional responsiveness (n=56) were compared. RESULTS: In the evaluative space, the regression line of negative emotional responsiveness was significantly different from that of positive responsiveness. The slope of negative responsiviveness was significantly steeper than that of positive responsiveness. At a low arousal level, the absolute valence of a positive stimuli was larger than that of a negative picture. CONCLUSION: This finding indicates that the function of the negative affective responsiveness might be different from that of the positive responsitiveness. IAPS also seems applicable to Korean subjects.
Adult ; Arousal ; Humans

Tuberculosis generally affects the respiratory tract. In developing nations, the pericardium is the most common location of extrapulmonary tuberculosis; however, tuberculous pericarditis rarely appears as a localized mass or tuberculoma. We present here a case of a 62-year-old woman with pericardial tuberculoma. She had a history of effusive tuberculous pericarditis and drainage. Because she had taken regular medication over a period of six months, the pericardial mass with an adjacent lung nodule newly detected on the chest radiogram was initially suspected of being invasive lung cancer. Prior to pathologic confirmation, precise information from imaging tests, including computed tomography, magnetic resonance imaging, and positron emission tomography-computed tomography are helpful when making decisions regarding which methods should be used for surgical approach and treatment. Through imaging, our case showed typical features of pericardial tuberculoma and a favorable clinical course after two months with a change in antituberculous therapy.
Developing Countries ; Drainage ; Electrons ; Female ; Humans ; Lung ; Lung Neoplasms ; Magnetic Resonance Imaging ; Middle Aged ; Pericarditis, Tuberculous ; Pericardium ; Respiratory System ; Thorax ; Tuberculoma ; Tuberculosis

PURPOSE: The prevalence and treatment patterns of abdominal aortic aneurysm (AAA) vary according to ethnicity and region. This study analyzed nationwide data on the epidemiology, practice patterns, and mortality rates of AAA in Korea.MATERIALS AND METHODS: Data from patients treated for AAA from 2012 to 2016 were extracted from the Korean Health Insurance Review and Assessment (HIRA) database.RESULTS: A total of 30,766 patients in Korea had treatment codes for AAA and 2,618 patients were treated for ruptured AAA. Of the 6,356 patients treated surgically, 1,849 and 4,507 underwent open surgical aneurysmal repairs (OSAR) or endovascular aneurysmal repairs (EVAR), respectively. The number of surgical treatments performed annually for AAA increased from 1,129 cases in 2012 to 1,501 cases in 2016. The number of EVAR cases increased from 753 to 1,109 during these five years, while the number of OSAR cases remained similar, at 376 and 392, respectively. The 30-day mortality rates after EVAR and OSAR were 4.2% and 10.6%, respectively. The mortality rates were significantly higher in patients with hypertension, dyslipidemia, chronic renal disease, diabetes mellitus, and congestive heart failure. There were significant differences in the prevalence, proportion of EVAR, and mortality rates according to the regional area.CONCLUSION: The prevalence of AAA and the proportion of EVAR in Korea increased in the past 5 years, while the rupture rate and the proportion of OSAR remained similar. To minimize mortality and regional discrepancies, nationwide registry and treatment standardization are needed.
Aneurysm ; Aortic Aneurysm, Abdominal ; Cross-Sectional Studies ; Diabetes Mellitus ; Dyslipidemias ; Epidemiologic Studies ; Epidemiology ; Heart Failure ; Humans ; Hypertension ; Insurance, Health ; Korea ; Mortality ; National Health Programs ; Prevalence ; Renal Insufficiency, Chronic ; Rupture

Angioleiomyoma is a benign solitary tumor that arises from muscle layer of the vein walls and mainly develops on the lower extremities of middle-aged women. But it is rarely found on the lip. We report an unusual case of angioleiomyoma in a 27-year-old male who showed an asymptomatic, 0.3 X 0.5 cm sized mass on the upper lip for 3 years. Histopathologically, various sized, numerous vessels and bundles of smooth muscle fibers were observed in the dermis.
Adult ; Angiomyoma* ; Dermis ; Female ; Humans ; Lip* ; Lower Extremity ; Male ; Muscle, Smooth ; Veins

Although dermatophytes are still the main etiologic agents of onychomycosis, some species of nondermatophytic molds and yeasts are also capable of invading the nails. Scopulariopsis (S.) brevicaulis is a nondermatophytic mold which is saprophytic fungus in soil. We report four cases of toenail onychomycosis caused by S. brevicaulis in a 42-year-old male, a 46-year-old male, a 37-year-old male, and a 64-year-old male. Three patients presented with a typical distal subungual onychomycosis and one case was proximal subungual onychomycosis. Direct microscopic examination of scrapings on the potassium hydroxide preparation revealed fungal elements in all cases. Cultures from toenail lesions of the all patients on Sabouraud dextrose agar showed a typical brown colony with powdery surface of S. brevicaulis. Numerous branched conidiophores with chains of lemon-shaped conidia with rough walled were observed in slide culture and scanning electron microscopy (SEM). We confirmed S. brevicaulis by colony, light microscopic morphology and SEM.
Adult ; Agar ; Arthrodermataceae ; Fungi ; Glucose ; Humans ; Male ; Microscopy, Electron, Scanning ; Middle Aged ; Nails* ; Onychomycosis* ; Potassium ; Scopulariopsis* ; Soil ; Spores, Fungal ; Yeasts

Microsporum (M.) gypseum is geophilic and abundant in soil throughout the world. The source of human infection has been traced to soil or animals. But tinea corporis caused by M. gypseum is rare. We report 4 cases of tinea corporis caused by M. gypseum in a 38 year-old female, a 7 year-old girl, a 2 year-old boy, and a 18 year-old female. The lesions were manifested by localized pruritic fine scaly erythematous annular patches on the shin, forearm, neck, and antecubital fossa. Direct microscopic examination of scales on the potassium hydroxide preparation showed hyphae and spores in 3 cases. But cultures from the skin lesion of all patients on Sabouraud dextrose agar showed typical colonies of M. gypseum. The patients were treated with topical ketoconazole application and/or oral antifungal agents.
Adolescent ; Adult ; Agar ; Animals ; Antifungal Agents ; Child ; Child, Preschool ; Female ; Forearm ; Glucose ; Humans ; Hyphae ; Ketoconazole ; Male ; Microsporum* ; Neck ; Potassium ; Skin ; Soil ; Spores ; Tinea* ; Weights and Measures

Psoriasis vulgaris, a disorder of partially genetic origin, affects 1-3% of the general population. Vitiligo, generally considered an autoimmune disease, affects 0.5% of the general population. Despite the relatively common occurrence of each disease, the concurrence of each disease in a patient has been considered unusual. It is difficult to discern any particular relationship between vitiligo and psoriasis. Assuming that vitiligo and psoriasis are pathogenetically distinct and are grouped independently of each other. We report a case of psoriasis vulgaris associated with vitiligo in a 19-year-old man. Diagnosis was confirmed by clinical and histopathological findings. He is being treated with narrow band UVB phototherapy.
Autoimmune Diseases ; Diagnosis ; Humans ; Phototherapy ; Psoriasis* ; Vitiligo* ; Young Adult

Trichilemmal carcinoma is a rare malignant neoplasm of hair follicle which is derived from or differentiates towards the outer root sheath. Despite the frequent presence of histologically malignant features, it has a relatively benign clinical behavior. We report a case of trichilemmal carcinoma in an 87-year-old woman who showed a solitary slightly tender, 1.5X2cm-sized, verrucous, erythematous nodule with crust on the vertex of scalp. In her past medical history, it had been excised at a private clinic without a histopathological evaluation and recurred 1 year later. Histopathologically, tumor cells showed PAS-positive cytoplasms and cytologic atypia with a few mitotic figures. The patient was treated with a wide surgical excision. She has had no evidence of recurrence or metastasis.
Aged, 80 and over ; Cytoplasm ; Female ; Hair Follicle ; Humans ; Neoplasm Metastasis ; Recurrence ; Scalp

Although dermatophytes are still the main etiologic agents of onychomycosis, some species of nondermatophytic molds and yeasts are also capable of invading the nails. Fusarium (F.) solani is a nondermatophytic mold which is saprophytic fungus in soil. Onychomycosis due to Fusarium species almost always involve the great toenails, particularly in the presence of traumatic or dystrophic abnormalities. We report a case of toenail onychomycosis caused by F. solani in a 42-year-old female. The patient presented with typical distal subungual onychomycosis. Direct microscopic examination of scrapings on the potassium hydroxide preparation revealed fungal elements and repeated cultures on Sabouraud's dextrose agar showed the same whitish to cream-colored, cottony colonies. Multiple, sickle-shaped, multiseptate macroconidia and long, slender monophialides were observed in the slide culture. We confirmed F. solani by gross and light microscopic morphology of the colony. The patient was treated with 250 mg of terbinafine daily for 3 months.
Adult ; Agar ; Arthrodermataceae ; Female ; Fungi ; Fusarium* ; Glucose ; Humans ; Nails ; Onychomycosis* ; Potassium ; Soil ; Yeasts