BACKGROUND: The peak flowmeter is very useful in monitoring of out-patients as well as those in emergency departments because of its convenience and simplicity with low cost. There have been many studies aimed at determining the accuracy and reproducibility of the peak flow meter in normal population. However, there is a paucity of reports regarding its accuracy in patients with chronic obstructive pulmonary disease(COPD) or asthma. The accuracy of the peak expiratory flow(PEF) measured with a mini-Wright peak flowmeter was assessed by a comparison with the results of a mass flow sensor. METHODS: The PEF measurements were performed in 108 patients aged 19-82 years presenting with either a chronic obstructive lung disease or asthma before and after inhaling salbutamol. The PEF measurements from the mini-Wright flowmeter were compared with those obtained by the calibrated mass flow sensor. RESULTS: The average of the readings taken by the mini-Wright meter were 37-39 l/min higher than those taken by the mass flow sensor. The average percentage error of the mini-Wright meter were higher, ranging less than 300 l/min. The mean of the differences between the values obtained using both instruments (the bias)±limits of agreement(±2 SD) were 37.1±90 l/min for the PEF(p<0.001). CONCLUSIONS: The mini-Wright peak flowmeter overestimated the flows in patients with COPD or asthma. It was also found that the accuracy of the mini-Wright peak flowmeter decreased in its mid to low range. The limits of agreement are wide and the difference between the two instruments is signigicant. Therefore, the measurements made between the two types of machines in patients with asthma or COPD cannot be used in terchangeably.
Albuterol ; Asthma* ; Emergency Service, Hospital ; Flowmeters* ; Humans ; Inhalation ; Outpatients ; Pulmonary Disease, Chronic Obstructive* ; Reading

A case of multiple myeloma associated with adenocarcinoma of the stomach was review. A 59-year, old Korean man had been abmitted to St. Mary's Hospital in January 1984, with chief complaint of posterior neck pain, and intermittent headache for one year prior to amission. Osteo lytic punched-out lesions were noted on skull and other skeletal x-ray films. Bone marrow aspirates revealed diffuse infiltration of mature and immature plasma cells. Laboratory findings revealed anemia and Bence-Jones proteinuria. Immunoelectrophoresis revealed findings consistent with IgA-lamda type multiple myloma. Alkylating agents and steroids were tried with some clinical improvements. In August 1985, the patient revisited outpatient clinic with chief complaints of epigastric pain and neck mass. Endoscopic biopsy and excision biopsy of the cervical lymph node were performed. By microscopic examination, adenocarcinoma of the stomach and metastasis of multiple myeoma to the supraclavicular lymph nodes were confirmed. Subtotal gastrectomy was performed. By gross and microscopic revealed metastasis to the regional lymph nodes.
Male ; Humans ; Adenocarcinoma ; Biopsy ; Neoplasm Metastasis

A 31-year-old female patient has had a translucent cystic papule on the genitalia since 2 years ago. The diagnosis was confirmed by clinical and histopathological findings. This is the rare case of apocrine hidrocystoma occring in the fernale genitalia in the literature.
Adult ; Diagnosis ; Female ; Female* ; Genitalia ; Genitalia, Female* ; Hidrocystoma* ; Humans

Tricilemmoma is a benign, solitary tumor that may be clinically misdiagnosed as basal cell carcinoma or verruca. It affects frequently the face of elderly rnen. We present herein a case of trichilemrnoma in a 70-year-old Korean wornan who had a slowly growing tumor on the scalp for 50 years. The histopathologic findings revealed lobular acanthosis of glycogeri rich clear cells and palisade of columnar cells resting on prominent basement membrane.
Aged ; Basement Membrane ; Carcinoma, Basal Cell ; Humans ; Scalp* ; Warts

The cutaneous metastaaes from carcinoma of breast produce four definite clinical types: inflammatory carcinoma, telangiectatic carcinoma, nodular carcinoma, and carcinoma en cuirasse. We present a case of 51-year-old woman who had purpuric, hard, sclerotic plaque with ulceration, crust and. several pea-sized hemorrhagic papulovesicular eruptions on the right chest wall for one year. Histopathological findings show metastatic ductal carcinoma but, the primary focus was not determined.
Breast ; Carcinoma, Ductal ; Female ; Humans ; Middle Aged ; Thoracic Wall ; Ulcer

Benign epiepsy of childhood with centrotemporal spikes (BECCT) is an electroclinical syndrome characterized by noctural seizure that remit spontaneoully before adulthood, and belong to idiopathic age and location related epilepsies. We reviewed the medical records to analyse the seizure the seizure pattern, and also inspect the EEG recording to identify topography of the epileptiform discharge of 24 patient who met the following criteria: 1) presence of nocturnal seizure or partial seizure confined to the face, 2) normal intecual and development, 3) normal background EEG feature, 4) monomormhic spikes or sharp wave that increase in the frequency during sleep if those state were achieved. The result as follow: 1) The age of seizure onset were 3 to 11 years old (7.08 1.89) and male to female ratio was 1, 4:1. 2) Past history of birth trauma, CNS infection and other diseases involving CNS, were not found. There was past history of febrile convulsoin 33.3% of patient and epilepsy in 8.3%. One of paient's sister had childhood abscence epilepsy and never a nocturnal partial seizure, also and had centrotemporal spikes in EEG. 3) In 91.7% of Seizures occurred during sleep, especially short after sleep onset and the symptomatology of seizure was shown 66.7% of oropharyngeal sign, such as hypersalivation and gargle sound, and 54.2% of hemifacial involvement, 33.3% of speech arrest, 25.5% of upper limb involement, 18.3% of lower limb involvement, and 45.8% of general seizure. 4) In 91.5% of patients had on location of epileptiform discharge that located central (37.5%) midtemporal (33.3%), parietal and frontal. We could observe tangental dipole in 16.7% of patients.
Child ; Electroencephalography ; Epilepsy ; Epilepsy, Rolandic* ; Female ; Humans ; Lower Extremity ; Male ; Medical Records ; Parturition ; Rabeprazole ; Seizures ; Sialorrhea ; Siblings ; Upper Extremity

No abstract available.
Anesthesia* ; Anesthesia, General* ; Humans

Detection of tears of the posterior cruciate ligament (PCL) with MRI is usually based on the appearance of the ligament. However, other MRI findings may be useful in establishing the diagnosis. We assessed these associated injuries in the cases of complete tears of the PCL, reviewing MRls. We evaluated 26 patients who received PCL reconstruction with complete tear of posterior cruciate ligament from Feb 1995 to May 1997 retrospectively. We studied associated findings with PCL injuries. Anterior tibial plateau lesions were found in 15 of 26 cases (57.7%). Meniscal injuries were found in 8 of 26 cases (30.8%). Popliteus muscular injuries was found in 7 of 26 cases (26.9%). Capsular injuries were found in 2 of 26 cases (7.7%). Retinacular injury which has never been described in PCL injuries, was found in 7 cases (26.9%, P>0.05), Other ligamentous injuries were associated in 22 of 26 cases (84.6%). Medial collateral ligament injuries were found in 16 of 22 (61.5%, P<0.05) cases. The frequency of associated ligamentous injury and meniscal tear correlated well with results reported by other authors. The presence and location of bone contusions and fractures correlated with the mechanisms of injury; the anterior tibial plateau was the most commonly affected site. We concluded that the associated injuries were very helpful in diagnosing PCL injuries with MRI.
Collateral Ligaments ; Contusions ; Diagnosis* ; Humans ; Knee* ; Ligaments ; Magnetic Resonance Imaging* ; Posterior Cruciate Ligament* ; Retrospective Studies

The purpose of this study is to determine whether magnetic resonance imaging(MRI) can assist in deci- sion-making in the treatment of acute posterolateral complex injuries. We reviewed retrospectively seven patients with acute posterolateral complex injury, among the 79 cases that had taken cruciate ligament recon- struction. MRI findings were then correlated with the results of examination under anesthesia or operi lateral reconstruction. Based on surgical and clinical findings, there were six complete and four partial posterolateral complex injuries. MRI was able to accurately describe the extent of injury in each case. All ten patients had concomitant anterior cruciate ligament tears, and seven were three posterior cruciate ligament injuries. The iliotibial band was avulsed from Gerdys tubercle in seven patients. In knees with complete tears, separation of the coronary ligament of the lateral meniscus was noted on MRI. A characteristic bone contusion on the anteromedial femoral condyle was present in nine patients. Popliteal tendon tearing was observed in eight cases, and biceps femoris was torn in six patients. In knee with complete tears, tears of the lateral collateral ligament complex was noted both on MRI and intraoperatively. A high-quality MRI in patients sustaining these injuries will assist the surgeon in directly applying surgical techniques in a timely fashion.
Anesthesia ; Anterior Cruciate Ligament ; Contusions ; Humans ; Knee* ; Lateral Ligament, Ankle ; Ligaments ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Posterior Cruciate Ligament ; Retrospective Studies ; Tendons

The pretent study was performed to study the epiderrnal changes of ultraviolet irradiation and PUVA treatment in the black mice. The following results were obtained: 1) The histologic changes of the epidermis, number of DOPA positive melanocytes and ultrastructural changes of keratinocytes due to UVB and PUVA were rnore prominent than those of UVA irradiation. 2) The histological changes after 8-MOP photosensitization closely mirnic those of UVR irradiation, and constant, finding was hyperkeratosis. 3) Early histological change after UVL irradiation & IUVA treatment was appearance of dytkeratotic cells. 4) Pro]onged exposure to UVB & PUVA resulted in transient epidermal hyperplasia, and epidermal atrophy occurred 3 weeks after PUVA treatment. 5) Early electron microscopic changes was perinuclear edema, juxtanuclear vacuoles and clumping of tonofilament.
Animals ; Atrophy ; Dihydroxyphenylalanine ; Edema ; Epidermis ; Hyperplasia ; Intermediate Filaments ; Keratinocytes ; Melanocytes ; Methoxsalen ; Mice* ; Photosensitivity Disorders ; Ultraviolet Rays ; Vacuoles