There are several EKG changes in cerebrovascular disease(CVD). The wide prominent of inverted T wave is frequently developed in patients with CVD. There were case reports for CVD in patient with ST-segment elevation without myocardial infarction, but the exact mechanism is unknown. EKG abnormalities associated with subarachnoid hemorrhage were first described by Byer et al, in 1947.1 We report the case of 72 years old female patient who developed subarachnoid hemorrhage and intraventricular hemorrhage with ST-segment elevation.
Aged ; Electrocardiography ; Female ; Hemorrhage ; Humans ; Myocardial Infarction ; Subarachnoid Hemorrhage*

No abstract available.
Coronary Artery Bypass* ; Coronary Vessels*

BACKGROUND: Diagnosis of paucibacillary leprosy is difficult owing to lack of sensitive diagnostic tools. Recently, several investigators have studied the use of polymerase chain reaction(PCR) to detect Mycabacterium leprae. Using nested-PCR the sensitivity and specif city of DNA amplification is considerably improved. OBJECTIVE: The purpose on investigation is to assess the efficacy if nested-PCR which is applied to formalin-fixed, paraffin-embedded biopsies material of patients with 1 prosy. METHODS: Biopsy samples were taken from patients with lepremc tous(11 patients) and tuberculoid (10 patients) leprosy, fixed in formalin, and embedded in parafin. The DNA from samples was extracted and amplified through 25 cycles by using the outside pairs of primer(L and L). The second amplification was allowed thproceed through 15 cycles using insice gairs of primer(L and L4). RESULTS: All twenty one samples showed 347-base-pair products. To confirm that the 347-bp product did correspond to the expected portion of the M. leprae groE gene, the amplified product was digested with Pst I. Pst I dipestion yielded 254-and 93-bp fragmerts, as predicted from the sequence of the M. leprae gene. The senilivity was that a single organism was idntified by nested-PCR. CONCLUSION: The nested-PCR is sensitive, specific, and simple diagiostic tool for leprosy.
Biopsy ; Diagnosis ; DNA ; Formaldehyde ; Humans* ; Keratinocytes* ; Leprosy ; Leprosy, Paucibacillary ; Melanocytes* ; Panax* ; Research Personnel ; Saponins* ; Water*

Nevus lipomatosus cutaneous superficialis is a very rare skin disease, which usually is present at birth. The lesion shows groups of asymptomatic soft papules or nodules, which have a smooth or folded surface and are skin colored or yellowish. The area of predilection is the pelvic girdle (especially the buttock and sacrococcygeal areas). Microscopically, nevus lipomatosus cutaneous superficialis reveals groups of etopic fat cell nests within the dermis. Only one case was reported in Korea(1969). The authors observed a case of typical nevus lipomatosus cutaneous superficialis. The patient was 19 year-old male, who ha,ve had asymptomatic soft papules and nodules on the buttock, lower back and scalp since 14 years of his age. Routine laboratory findings were within normal limit. Histopathological findings showed etopic fat cell nests within mid and lower dermis (Fig. 3) Diagnosis was confirmed by clinical and histopathological findings. Litercature was briefly reviewed for the discussion.
Adipocytes ; Buttocks ; Dermis ; Diagnosis ; Humans ; Male ; Nevus* ; Parturition ; Scalp ; Skin ; Skin Diseases ; Young Adult

Anetoderma or macular atrophies is a localized laxity of the skin, resulting from defect in the elastie tissue of the dermis. This defect produces a clinical picture consisting of circumscribed area of soft, thin and wrinkled skin, which can be pushed easily into the subcutaneous tissue by the examining finger. When the lesions appear without any preceding recognizable disorder, they considered to be primary macular atrophies. In this group, based on whether an inflammatory reaction has occurred before the appearance of macular atrophy, two types aer generally acknowledged: Anetoderma of Jadassohn-Pellizali has a preceding inflammatory reaction, whereas anetoderma of Schweninger-Buzzi has had no preceding discemible inflammatory changes. The authors observed a case of anetoderma of Jadassohn-Pellizali in a 34 year old male when showed bean to coin sized rovnd or oval, thin, soft and wrinkled macules on the trunk, shoulder and upper extremities. About 3 years ago, erythematous macules developed which extended for several months to reach a size of l.5 to 2.5 cm. Slowly each lesion faded from the cener to outward Ieaving soft and wrinkled macules(Fig.l). Routine physical and laboratory findings were within-normal-limit. Histopathological findings showed scanty and fragmentation of the elastic fiber of the dermis and perivascular non-specific inflammatory cell infiltration. (Fig. 2, 3 & 4) Diagnosis was confirmed by clinical and histopathological findings. Literature was briefly reviewed for the discussion,
Adult ; Anetoderma* ; Atrophy ; Dermis ; Diagnosis ; Elastic Tissue ; Fingers ; Humans ; Male ; Numismatics ; Shoulder ; Skin ; Subcutaneous Tissue ; Upper Extremity

The cutaneous synthesis of vitamin D in response to ultraviolet radiation exposure is the most important factor in maintaining vitamin D balance in Man. The skin is not only the site of vitamin D synthesis, but also a target organ for calcitriol(1, 25-dihydroxy-vitamin D) which is naturally occuriag, hormonally active form of vitamin E. It is now known that calcitriol inhibits the proliferation of epidermal cells and induces her differentiation. In this study, epidermal keratinocytes and melanocytes were isilated from the neonatal foreskin, and were culturod using a MCDB 153 and modified TIC media, respectively. And then various concentratioris of calcipotriol(MC 903), a synthetic aralogue of calcitriol, were added to each culture. The effects of calcipotriol on the growth of human keratinocytes and melanocytes were investigated. The results were as follows : 1. The addition of calopotriol to human keratinocyte and melalocyte cultures inhibited their proliferation in a dosdependent manner. 2. Calcipotriol had no effects on the melanization process of the melanocyte. 3. Calcipotriol was found to inhibit the proliferation, however it induced the terminal differentiation of cultured keratinocytes, as judged by morphologicai changes. The decreased density of kerationcytes, The formation of cornified cells, and the cellular destruction in a concentration of 10 M of calcipotriol were observed. 4. By using the light atid the electron microscope, we observed that the epidermal thickness was decreased and terminal differentiation was facilitateir. Living Skin Equivalent (LSE) according to the increasing concentration of calcipotriol. A]i)parent cytotoxic effects were observed in 10 M, 10 M of calcipotriol. In summary, the above results indicate that the addition of calcipotriol to the in vitro culture system of human keratinocyte and melanocyte induces the biologic process of terminal differentiation of keratinocytes and inhibits proliferation of keratinoytes and melanocytes in a dose-dependent manner.
Calcitriol ; Cholecalciferol* ; Foreskin ; Humans* ; Keratinocytes* ; Melanocytes* ; Skin ; Tics ; Vitamin D ; Vitamin E ; Vitamins*

Background: Ambulatory care represents the first point of contact between the patient and the hospital.Kindness is strongly emphasized for ambulatory care nurses in customer-centered medical services. The purpose of this study was to investigate the relationship among surface acting, deep acting, and emotional dissonance of emotional labor and to identify the influencing factors on emotional dissonance of ambulatory care nurses in a tertiary hospital. Methods: This study is a correlational study. The data was collected using emotional labor scales from 163 nurses in March 2017. Results: The surface acting, deep acting of emotional labor, and emotional dissonance were 3.71±0.69, 3.76±0.57, and 3.36±0.90 respectively in the ambulatory care nurses. The result of the multiple regressions indicates that surface (β=0.77,P<0.001) and deep acting (β=0.12, P=0.009) of emotional labor predict 67.6% (F=188.99,P<0.001) in emotional dissonance of ambulatory care nurses. Conclusions To improve emotional dissonance for ambulatory care nurses, it is necessary to develop and utilize emotional labor management program and effective emotional labor management.

Deep vein thrombosis is a frequently lethal complication following musculoskeletal surgery and skeletal trauma. For this study on incidence of deep vein thrombosis, we examined the data on 40 patients with contrast venography. Thrombosis limited to the veins in the calf of the leg was shown in 10 patients by venography. None of these patients had clinical symptoms of deep vein thrombosis or indicating embolism. We therefore concluded that the incidence of deep vein thrombosis of the lower extremity after injury or operation in Korea is not so rare as was considered before.
Embolism ; Humans ; Incidence ; Korea ; Leg ; Lower Extremity ; Phlebography ; Thrombosis ; Veins ; Venous Thrombosis

BACKGROUND: The exercise stress testing(Treadmill Test) is one of the preferred noninvasive methods of identifying patients with coronary artery disease. ST-segment elevation during or immediately after exercise is uncommon and in most patients, it was associated with prior infarction, left ventricular hypertrophy or left bundle branch block, Exercise-induced ST-segment elevation has been attributed to ventricular wall motion abnormalities, and ischemia due to either coronary vasospasm or ervere proximal coronary stenosis. We examined the clinical, angiographic, and prognostic significance of 16 patients with exercise induced ST-segment elevation. METHODS: 16 patients with exercise-induced ST-segment elevation were retrospectively reviewed. The symptom-limited exercis testing was performedn using a modified Bruce protocol and in patients with acute myocardial infarction(AMI), low level exercise testing(Myocardial infarction protocol) was used. The significant ST-segment elecation was defined as a > or =1mm change present in >1 lead measured at 0.08 sec after J point and in > or =3 consecutive beats. Coronary arteriogram and percutaneous transluminal coronary angioplasty(PTCA) was performed using standard techniques within 7 days of initial exercise testing and a luminal diameter stenosis of >50% was considered significant. RESULTS: 1) We have studied 2076 exercise tests and 16 patients(M/F:15/1, Mean age : 58 years) developed exercise-induced ST-segment elevation. The initial diagnosis were acute myoca rdial infarction(AMI) in 12, variant angina in 2, effort angina in 1 and unstable angina in 1 patient. 9 of 12 patients with AMI were treated with thrombolytic agent(Urokinase 2.5 to 3 million unit) within 6 hours from the onset of chest pain. 2) Mean maximal ST-segment elevation was 2.6mm(range 1-5mm). The leads which showed exercise-induced ST-segment elevation were corresponded to the location of severe coronary stenosis in typical effort angina, to spasm site in variant angina, and to infarction site in AMI. 11 Patients had follow-up exercise testing and showed abolition of exercise-induced ST-segment elevation in 4 of 5 patients with AMI and 1 patient with effort angina after PTCA, and 1 patient with variant angina and 3 of 4 patient with AMI after medication. 3) In 12 patients, coronary angiography was performed, and showed 95% and 90% stenosis at proximal LAD in 2 patients with effort angina and >80% stenosis at proximal or mid lesion of infarct-related artery in 7 patients with AMI. In variant angina, one patient showed normal coronary artery and another patient showed 60% stenosis at mid LAD. On LV angiogram, there were moderate to severe hypokinesia instead of akinesia or dyskinesia at infarction site in all patients with AMI and showed normal LV contractility in patients with effort or variant angina. PTCA were successfully performed in 7 patients(effort angina 2, AMI 5). 4) The clinical follow up for 16 patients were obtained for mean follow-up duration of 17 months and during the clinical follow-up, 1 variant angina patient with mild stenosis at proximal LAD was died with ventricular fibrillation after discontinution of medication. There were CABG due to restenosis in 1 patient and cerebrovascular accident in 1 patient. CONCLUSION: 1) The exercise-induced ST-segment elevation signifies severe ischemia due to either severe proximal coronary stenosis or coronary arterial spasm. In AMI, this findings suggests the residual ischemia(or residual viable myocardium) in addition to left ventricular dyssynergy or aneurysm. 2) Adverse cardiac events can be provented by revascularization in patients who had critical coronary stenosis and by medical therapy in those with coronary vasospasm or mild coronary stenosis.
Aneurysm ; Angina, Unstable ; Arteries ; Bundle-Branch Block ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vasospasm ; Coronary Vessels ; Diagnosis ; Dyskinesias ; Exercise Test ; Follow-Up Studies ; Humans ; Hypertrophy, Left Ventricular ; Hypokinesia ; Infarction ; Ischemia ; Phenobarbital ; Retrospective Studies ; Spasm ; Stroke ; Ventricular Fibrillation

Spontaneous regression is extremely rare in lung cancer and this in spite of its global high incidence. So far, less than 30 such cases have been reported in the literature. We report here on the case of a 68-year-old man who had the diagnosis of adenocarcinoma and in absence of any medical therapy, he had a partial spontaneous regression of tumor.
Adenocarcinoma ; Aged ; Carcinoma, Non-Small-Cell Lung ; Humans ; Incidence ; Lung Neoplasms