No abstract available.
Cytogenetic Analysis* ; Cytogenetics* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

The pathogenesis of cerebral aneurysm until now is a subject of continuing debate. Some authors stress the important role of hemodynamics in the pathogenesis of cerebral aneurysm by confirming it with experimental work, pathological study, autopsy study and review of angiograms. With the findings of cerebral angiograms and operations, the authors had studied the difference in size and shape between ruptured and unruptured aneurysms, the relationship between afferent arteries from afferent arteries. 103 patients were admitted to the Keimyung University Dong San Hospital during the period from September 1982 to August 1985. According to studies on individual sizes of aneurysms, 52% of unruptured aneurysms were smaller than 5mm, but 68% of ruptured aneurysms were over 5mm but below 10mm. Moreover, the mean size of unruptured aneurysms was 4.87mm and ruptured aneurysms was 9.38mm. 53% of unruptured aneurysms were spherical in shape and combined daughter aneurysms in unruptured were 13%. However, in case of ruptured aneurysms, 34% were spherical and combined daughter aneurysms were 35%. The origin of daughter aneurysms in the dome was 59%, waist 29% and neck 12% in order. The direction of aneurysms was variable, but most of them pointed in the direction of blood flow in afferent arteries. We infer with this study that the hemodynamics of blood flow plays an important role in the pathogenesis of cerebral aneurysms.
Aneurysm ; Aneurysm, Ruptured ; Arteries ; Autopsy ; Hemodynamics ; Humans ; Intracranial Aneurysm* ; Neck ; Nuclear Family

BACKGROUND: Although there have been many studies about onychomycosis due to nondermatophytic molds (NDM), few studies about etiologic agents including NDM in onychomycosis have been reported in Korea. Objective: This study investigated onychomycosis due to NDM in the Gyeongju area of Korea. OBJECTIVE: This study investigated onychomycosis due to NDM in the Gyeongju area of Korea. METHODS: In the 10-year period from 1999~2009, we reviewed 59 patients with onychomycosis due to NDM. The etiologic agents were identified by cultures on Sabouraud's Dextrose agar with and without cycloheximide. In some cases, internal transcribed spacer sequence analysis was done. NDM isolated considered pathogens when the presence of fungal elements was identified by direct microscopy observation and in follow-up cultures yielding the same fungi. RESULTS: Onychomycosis due to NDM comprised 2.3% of all onychomycosis. Of the 59 patients with onychomycosis due to NDM, 84.7% were toenail onychomycosis and 15.3% were fingernail onychomycosis. The incidence rate was highest in the fifth decade (27.1%). The ratio of male to female patients was 1:1.6. The frequency of associated diseases, in descending order, was hypertension, diabetes mellitus, and cerebral hematoma. Distal and lateral subungual onychomycosis (86.4%) was the most common clinical type of onychomycosis. Aspergillus spp. was the most frequently isolated etiologic agent of onychomycosis due to NDM (83.0%). Other causative agents were Scopulariopsis brevicaulis (10.2%), Acremonium spp. (3.4%), Fusarium solani (1.7%), and Chaetomium globosum (1.7%). CONCLUSION: Because of the increase in onychomycosis due to NDM, we suggest the need of a careful mycological examination in patients with onychomycosis.
Acremonium ; Agar ; Aspergillus ; Chaetomium ; Cycloheximide ; Diabetes Mellitus ; Female ; Follow-Up Studies ; Fungi ; Fusarium ; Glucose ; Hematoma ; Humans ; Hypertension ; Incidence ; Korea ; Male ; Microscopy ; Nails ; Onychomycosis ; Scopulariopsis ; Sequence Analysis

PURPOSE: We examined the relationship and concordance between end-tidal carbon dioxide (Petco2) and arterial CO2 (Paco2) in acute asthmatic patients presenting to emergency department. METHODS: This was prospective observational cohort study of acutely ill adult asthmatic patients observed March 2005 to February 2006. Data Collected were age, sex, vital sign, treatment, simultaneous Paco2 and Petco2 value and peak expiratory flow rate (PEFR). Concordance between Paco2 and Petco2 was represented by Bland-Altman plot, using pre-specified limits of agreement of +/-6 mmHg difference and described by interclass correlation coefficient. RESULTS: The study population consisted 51 adult asthma patients admitted during the study period. There was 92 Paco2 and Petco2 pairs. The Pearson correlation coefficient was 0.773 (p=0.000). The mean GAP (The difference Paco2 and Petco2) is 6.04mmHg. PEFR and GAP were negative correlation (R=-0.370). We obtained a Receiver operating characteristic (ROC) curve from PEFR and GAP, using a PEFR cutoff value of 30.5%. The interclass correlation coefficient between Paco2 and Petco2 was 0.652 for patients with PEFR above 30.5%, 0.362 for patients with PEFR below 30.5%, and 0.575 for patients with undetectable PEFR. CONCLUSION: Good correlation exists between Paco2 and Petco2, butr concordance is poor (among all patients the interclass correlation coefficient was 0.508). We attribute this to ventilation-perfusion mismatch. We concluded that in severely asthmatic patients with low PEFR or mechanical ventilation, end-tidal carbon dioxide is not concordant with arterial carbon dioxide.
Adult ; Asthma* ; Capnography ; Carbon Dioxide* ; Carbon* ; Cohort Studies ; Emergency Service, Hospital ; Humans ; Peak Expiratory Flow Rate ; Prospective Studies ; Respiration, Artificial ; ROC Curve ; Vital Signs

No abstract available.
Hypertension, Renovascular* ; Pheochromocytoma*

Kerion celsi is a severe inflammatory type of tinea capitis that presents as an inflammatory, boggy plaque studded with broken hairs. It usually occurrs in children between the age of 4 and 14 years which is caused by zoophilic pathogens such as Microsporum(M.) canis, Trichophyton(T.) mentagrophytes, and T. verrucosum. Recently various mammals have become a pet in Korea and there has been increase in reports of dermatophytosis transmitted from these pets sporadically. We report a case of kerion celsi caused by T. mentagrophytes probably transmitted from rabbit in a 34-year-old adult male patient. The patient had localized, tender to mild pruritic, erythematous plaque with pustular nodules and irregular hair loss on the right temporal scalp for 2 months. Culture from a scalp lesion of patient on Sabouraud's dextrose agar showed typical T. mentagrophytes. He was treated with 250 mg of terbinafine daily for 12 weeks and short term therapy of low dose of prednisolone. He was cured without recurrence.
Adult ; Agar ; Child ; Glucose ; Hair ; Humans ; Korea ; Male ; Mammals ; Naphthalenes ; Prednisolone ; Recurrence ; Scalp ; Tinea ; Tinea Capitis ; Trichophyton

Tinea corporis is dermatophytosis of trunk and extremities except terminal hair present region. We report a case of psoriasiform tinea corporis in a 11-year-old girl. The lesions were showed multiple, pruritic, thick scaly erythematous macules and patches on the left forearm and trunk. She had been treated with topical and oral corticosteroid for 5 months. Direct microscopic examination and fungal culture were positive for hyphae and colonies of Microsporum canis. Histopathologic examination of the skin lesion revealed parakeratosis, psoriasiform epidermal hyperplasia and perivascular inflammatory infiltration in upper dermis with presence of fungal hyphae in stratum corneum. She was treated with 250mg of terbinafine daily and topical lanoconazole for 1 month. Skin lesions cured without recurrence.
Child ; Dermis ; Extremities ; Forearm ; Hair ; Humans ; Hyperplasia ; Hyphae ; Imidazoles ; Microsporum ; Naphthalenes ; Parakeratosis ; Recurrence ; Skin ; Tinea

Tinea incognito is the dermatophytosis of atypical clinical presentation that induced by topical and systemic corticosteroid treatment or new class of topical non-steroidal agent such as tacrolimus or pimecrolimus. We report a case of eczema-like tinea incognito in a 15-year-old girl. The lesions were manifested by pruritic to tender, scaly well-demarcated erythematous macules and patches with pustules on the lateral side of right shin. She had been treated with topical corticosteroid and pimecrolimus for 6 months. Direct microscopic examination of the lesion was positive for hyphae and fungal culture revealed colonies of Trichophyton(T.) rubrum. Histopathologic examination of the skin lesion showed mild perivascular inflammation with presence of fungal hyphae in the horney layer of the epidermis. The patient was treated with 250 mg of terbinafine daily for 1 month and topical lanoconazole application. Skin lesions improved one month after the treatment, and no recurrence was observed.
Adolescent ; Epidermis ; Humans ; Hyphae ; Imidazoles ; Inflammation ; Leg ; Naphthalenes ; Recurrence ; Skin ; Tacrolimus ; Tinea

Mycobacterium (M.) fortuitum is a rapidly growing mycobacterium. It is classified as Runyon's group IV with M. abcessus and M. chelonae that are mostly found in water and soil. M. fortuitum infection usually occurs after trauma, surgery or procedures such as acupuncture that cause cutaneous or soft tissue manifestations. We report a case of cutaneous infection due to M. fortuitum in a 72-year-old woman with erythematous deep-seated nodules on her left hand. She inflicted a minor injury to her left hand in a farm. Culture from skin biopsy specimens on 3% Ogawa medium yielded bacterial colonies after 5 days. The microorganism was subsequently identified as M. fortuitum by PCR-restriction fragment length polymorphism analysis. The skin lesions were improved by antibiotic therapy with clarithromycin for 6 months.
Acupuncture ; Aged ; Biopsy ; Clarithromycin ; Female ; Hand ; Humans ; Mycobacterium ; Mycobacterium fortuitum ; Skin ; Soil

PURPOSE: Spindle cell lipoma(SCL) is an uncommon subcutaneous soft tissue neoplasm that arises in the shoulder and posterior neck of older male patients. The imaging appearance of SCL is not pathognomonic and can display some features overlapping with liposarcoma. We report a case of SCL on the posterior neck. METHODS: The patient is a 50-year-old man with a slowly enlarging subcutaneous mass on the right side of posterior neck. Computed tomographic imaging revealed a 7.0cm sized, well-circumscribed, heterogenous and fatty mass with enhanced solid components. Whole body Fluorine-18 Fluorodeoxyglucose Positron emission tomogram(FDG PET-CT) showed little increase of FDG uptake on the right posterior neck and there was no distant metastasis. RESULTS: The mass was surgically removed. The resection margin was free of tumor on frozen biopsy. Histopathologic examination indicated spindle cell lipoma consisting of a mixture of mature adipocytes and uniform spindle cells within a matrix of mucinous material. CONCLUSION: Although CT image of the solitary mass in posterior neck is similar with the one of liposarcoma, we should consider that it may be a spindle cell lipoma if PET-CT and other systemic studies reveal no distant metastasis. And we should perform fine needle aspiration to differentiate SCL from malignant lesions.
Adipocytes ; Biopsy ; Biopsy, Fine-Needle ; Electrons ; Humans ; Lipoma ; Liposarcoma ; Male ; Middle Aged ; Mucins ; Neck ; Neoplasm Metastasis ; Shoulder ; Soft Tissue Neoplasms