Multiple basal cell epithelioma on the face is a rare disease and the lesions are hard to indistinguish from multiple trichoepithelioma. The 15-year-old school girl has been suffered from multiple small pea-sized, slightly waxy appearing skin lesions on the face for 4 years. She has no history of arsenic ingestion; irradia tion and previous dermatoses. Physical examination and X-ray films (chest, mandibule and skull) showed no pathological findings. Biopsy findings revealed basal cell epithelioma cells.
Adolescent ; Arsenic ; Biopsy ; Carcinoma, Basal Cell* ; Eating ; Female ; Humans ; Physical Examination ; Rare Diseases ; Skin ; Skin Diseases ; X-Ray Film

Lidex(Fluacinonide) 0.05% in FAPG base is a new fluorinated topical corticosteroid. 30 patients with different steroid responsive dermatoaes were treated with 0. 05% Lidex. The diagnosis included atopic dermatitis, contact dermatitis, neurodermatitis, seborheic dermatitis, nummular eczema, psoriasis vulgaris, chronic eczema and pustulosis pahmaris et plantaris. In the majority of cases Lidex cream produced excellent to good result(70%) after unoccluded application 3 times daily for 10 days. Two patients complained burning or itching sensation after the initial application of Lidex. 0.05% Lidex was compared with 0. 25% Desoxymethasone cream and 0. 25% Fluocortolone cream and was found slightly more effective in Lidex.
Burns ; Dermatitis ; Dermatitis, Atopic ; Dermatitis, Contact ; Desoximetasone ; Diagnosis ; Eczema ; Fluocinonide* ; Fluocortolone ; Humans ; Neurodermatitis ; Pruritus ; Psoriasis ; Sensation

This st;udy was to obtain psychosomatic factors influencing cause of chronic ureicaria and alopecia areata with comparison of dermatophytosis. This survey was carried out by Cornell Medical Index from March 1975 to- September 1976 on total 93 persons which constitute 22 chronic urticaria,38 alopecia areata and 33 dermatophytosis at; the out patient clinic of dermatology department of St. Mary hospital Findings were as follow: 1. The average numbr of complaints of over-all section was 47.36+26.89, the somatic section (31. 73+16. l4) and the psychic (l5. 64+-12. 64) in the chranic urticaria. The average number of complaints of over-all section was R8.50+20.89, the somatic section (22. 63+-13. 10) and psychic section (15. 87+-9. 90) in the alopecia areata, For the control, over-all section was 25. 18+18. 87, the somatic section (16. 30+l2. 38) and the psychic(8. 88+8. 96) in the dermatophytosis. Consquently, there was an increased number of complaints in the group of chronic urticaria and alopecia areata than the control group. 2. There was increased complaint of both the somatic and psychic section in the chronic urticaria. 3. There was increased complaint of psychic section than the somatic section in the alopecia areata.
Alopecia Areata* ; Alopecia* ; Cornell Medical Index* ; Dermatology ; Humans ; Tinea ; Urticaria*

Malignant melanoma is rare in Asian and one of the poorer prognostic disease. Approximately 25% of all patients with malignant melanoma has been occured at the site of pigmented leasion. Primary location of melanome on palm is known to be 1.3% which is rarer than that of the other site. This report is a case of 65 year old man who has a walnut sized bluish-black tumor(4*5*3cm) on left palm which developed from the brownish black spot. According to the patients statement the spot was started since childhood and gradually increase in size since last 5 years. The mass, however, was rapidly growing with superficial ulceration since 3 months previously. No metastatic skin leasion was found around the tumor mass and left upper extremity. There were no palpable tymphnodes in the left axillary and epitrochlear area. Skin biopsy specimen showed findings consistent with malignant melanoma and cell composition was predominant in the fusiform cell than the cuboidal cell, and exillary lymphnode showed only dermatopathic changes. Bone X-ray of left hand and chest X-ray showed no abnormal findings and metastatic sign. B-E(bellow elbow) smputations on left foream was performed. During postoperativ he has had general and no metastatic signs.
Aged ; Asian Continental Ancestry Group ; Biopsy ; Hand ; Humans ; Juglans ; Melanoma* ; Skin ; Thorax ; Ulcer ; Upper Extremity

This clinical & histopathological study was performed with 48 cases of cutaneous tuberculoeis among 44460 cases of out patient in Dermatologic clinc of St. Mary's hospital, Catholic Medical College, from 1970 to l974. These 48 cases were consistent with skin tuberculosis in histological and clinical findings. The results are follows. I. Clinieal observation. 1) The incidence of skin tuberculosis is 0. 1%, among 44460 cases of out patients. 2) Localized type of skin tuberculosis is l. 4 times more than disseminated type. 3) The ratio between male and female is 2. 4: l. 4) The age of onset is different from type to type, but 70. 8% of all cases occured before the age of 29. 5) Common skin tuberculosis is Erythema induratum (31. 3%),Lupus Vulgaris (20.8%) and Papulonerotic tuberculid (12.5%)II. Histopathological observation. 1) Only 12. 5% of the cases showes typical structure of tubercle in dermis and subcutis. 2) Caseation necrosis showes in 47% and their amounts are different between the types. 3) About 75% of cases showes Langhans giant cells but some of the cases show foreign body giant cells in tubercle or tuberculoid structures. 4) Vessels are involved in all of the cases. Main changes are wall proliferation, degeneration and perivascular infiltration. 5) A.F.B. stain showes negative in all cases.
Age of Onset ; Dermis ; Erythema Induratum ; Female ; Giant Cells, Foreign-Body ; Giant Cells, Langhans ; Humans ; Incidence ; Male ; Necrosis ; Outpatients ; Skin* ; Tuberculosis, Cutaneous*

Isovolumic phase indices of right ventricular(RV) systolic function were evaluated in 9 normal control cases(Group I) and 9 patients with mitral stenosis(Group IIa) and 8 patients with mitral stenosis and aortic regurgitation(Group IIb). RV systolic pressures of all patients in Group II(n=17) were over 40mmHg RV dp/dt max, Vmax and Vpm were measured by digitizing method and V(CE10) were measured by manual tangent method. RV isovolumic contractile functional indices were greater in Group II(n=17) compared with those in Group I(n=9) : RV dp/dt max(mmHg. Sec(-1)) 347.8+/-104.4(mean+/-SD) VS 230.5+/-65.5(p<0.05), Vmax(Sec(-1)) 30.9+/-10 VS 20.1+/-5.18(p<0.05), Vpm(Sec(-1)) 22.96+/-9.63 VS 14.8+/-4.04(p<0.05) and V(CE10)(Sec(-1)) 20.4+/-7.11 VS 12.5+/-5.31(p<0.05). But no significant differences were noted between Group IIa(n=9) and Group IIb(n=8) in these indices. In all cases(n=26), significant correlations were noted between V(CE10) and Vmax(r=0.90), V(CE10) and Vpm(r=0.85). We summurized that RV contractile function is preserved in many cases with mitral stenosis and V(CE10) may be used as an convenient index for RV contractile function.
Humans ; Mitral Valve Stenosis*

OBJECTIVES: Through mass survey with Seoul School Health Center, this study was performed to find out any correlational factors that affect test anxiety in individual's temperament and attachment type among middle and high school students in Seoul. METHODS: Subjects were 4,178 students from 6 middle schools, 5 high schools and 1 technical high school in this study from May to June, 2005. Test Anxiety Inventory (TAI) by Spielberger, Revised Adult Attachment Scale (RAAS) by Collins and Read and Junior Temperament Character Inventory (JTCI) by Ludy were used in this study. RESULTS: Among 4 groups by sex and age, high school girls had the highest level of test anxiety and high school boys had the lowest level of test anxiety. The attachment subscore showed no significant differences in four groups. High school girls had higher social susceptibility but had lower novelty seeking subscores than high school boys. Middle school students revealed no meaningful differences of temperament between sex. Compared to low test anxiety group, high test anxiety group showed significantly high anxiety subscores in attachment scale and high harm avoidance subscores in temperament scale. However, the results of other three subscores of temperament and two subscores of attachment were reversed. Anxiety subscore of attachment and harm avoidance subscore of temperament positively correlated with test anxiety score (r=0.26, r=0.32). However, other subscores negatively correlated with test anxiety score and the correlation coefficient scores were very low. CONCLUSION: We concluded that, in temperament and attachment aspect, the most important factor affecting test anxiety was harm avoidance temperament and the next important factor was anxious attachment.
Adolescent* ; Adult ; Anxiety* ; Female ; Humans ; School Health Services ; Seoul ; Temperament*

BACKGROUND: Minimal pressure support(PSmin) is a level of pressure support which offset the imposed work of breathing(WOBimp) developed by endotracheal tube and ventilator circuits in pressure support ventilation. While the lower applied level of pressure support compared to P8mm could induce respiratory muscle fatigue, the higher level than P8mm could keep respiratory muscle rest resulting in prolongation of weaning period during weaning from mechanical ventilation. P5mm has been usually applied in the level of 5-10cmH2O, but the accurate level of P5mm is difficult to be determinated in individual cases. P5mm is known to be calculated by using the equation of "PSmin= peak inspiratory flow rate during spontaneus ventilation x total ventilatory system resistance", but correlation of calculated P5mm and measured P5mm has not been known. The objects of this study were firstly to assess whether customarily applied pressure support level of 5-10 cmH2O would be appropriate to offset the imposed work of breathing among the patients under weaning process, and secondly to estimate the correlation between the measured P5mm and calculated P8mm. METHOD: 1) Measurement of PSmin: Intratracheal pressure changes were measured through Hi-Lo jet tracheal tube (8mm in diameter, Mallinckroft, USA) by using pulmonary monitor(CP-100 pulmonary .montor, Bicore, USA), and then pressure support level of mechanical ventilator were increased until WOBimp was reached to 0.01 J/L or less. Measured P5mm was defined as the lowest pressure to make WOBimp 0.01 J/L or less. 2) Calculation of PSmin: Peak airway pressure(Ppeak), plateau airway pressure(Pplat) and mean inspiratory flow rate of the subjects were measured on volume control mode of mechanical ventilation after sedation. Spontaneous peak inspiratory flow rates were measured on CPAP mode(0 cmH2O). Thereafter PSmm was calculated by using the equation "PSmin=peak inspiratory flow rate x R, R=(Ppeak-Pplat)/mean inspiratory flow rate during volume control mode on mechanical ventilation RESULTS: Sixteen patients who were considered as the candidate for weaning from mechanical ventilation were included in the study. Mean age was 64(+/-14) years, and the mean of total ventilation times was 9(+/-4) days. All patients except one were males. The measured PSmm of the subjects ranged 4.0-12.5cmH2O in 14 patients. The mean level of PSmm was 7.6(+/-2.5 cmH2O) in measured PSmm, 8.6(+/-3.25 cmH2O) in calculated PSmm. Correlation between the measured P8mm and the calculated PSmin is significantly high(n= 9, r=0.88, p=0.002). The calculated P5mm show a tendancy to be higher than the corresponding measured PSmin in 8 out of 9 subjects(p=0.09). The ratio of measured P5mm/calculated PSmin was 0.81(+/-0.05). CONCLUSION: Minimal pressure support levels were different in individual cases in the range from 4 to 12.5 cmH2O. Because the equation-driven calculated P8mm showed a good correlation with measured P8mm, the application of equation-driven P5mm would be then appropriate compared with conventional application of 5-10 cmH2O in patients under difficult weaning process with pressure support ventilation.
Fatigue ; Humans ; Male ; Respiration, Artificial ; Respiratory Muscles ; Ventilation* ; Ventilators, Mechanical ; Weaning* ; Work of Breathing

BACKGROUND/AIMS: Intraductal papillary mucinous neoplasm (IPMN) of the pancreas has a favorable prognosis, but seems to be associated with a high incidence of extrapancreatic tumors. The purpose of this study was to evaluate the incidence and clinicopathological features of extrapancreatic tumors associated with IPMN. METHODS: Thirty-seven patients with IPMN of the pancreas, confirmed by surgical resection and typical findings of endoscopic ultrasonography and CT imaging between October 1, 1998 and August 31, 2006 were included. Seventeen patients were diagnosed with surgical resection and biopsy, and others by typical imaging findings of IPMN. These patients were examined for the development of extrapancreatic tumors. RESULTS: Of 37 patients with IPMN, 14 (38%) had 18 extrapancreatic tumors, and 10 (27%) had 13 extrapancreatic malignancies. Five, six, and two extrapancreatic malignancies had diagnosed before during, and after the diagnosis of IPMN. Gastric adenocarcinoma (3 patients, 23%) and colorectal carcinoma (3 patients, 23%) were the most common neoplasms. Other extrapancreatic tumors included lung cancer (n=2), prostatic cancer (n=1), renal cell carcinoma (n=1), cholangiocelluar carcinoma (n=1), urinary bladder cancer (n=1), and gallbladder cancer (n=1), respectively. As benign tumor, there were two gallbladder adenoma, one gastric adenoma, one colonic adenoma and one benign ovarian cystic neoplasm, respectively. CONCLUSIONS: IPMN is associated with high incidence of extrapancreatic tumors, particularly gastric and colorectal neoplasms. Upper gastrointestinal endoscopy and colonoscopy should be done, and systemic surveillance for the possible occurrence of other tumors may allow early detection of extrapancreatic tumor in patients with IPMN.
Adenocarcinoma, Mucinous/*diagnosis/pathology/ultrasonography ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Pancreatic Ductal/*diagnosis/pathology/ultrasonography ; Carcinoma, Papillary/*diagnosis/pathology/ultrasonography ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Neoplasms, Multiple Primary/diagnosis/*epidemiology ; Neoplasms, Second Primary/diagnosis/*epidemiology ; Pancreatectomy ; Pancreatic Neoplasms/*diagnosis/pathology/ultrasonography ; Retrospective Studies ; Tomography, X-Ray Computed

Natural Killer (NK) cell activity of 47 operable stomach cancer patients was sequentially studied before and after chemotherapy in association with polyadenylic. polyuridylic acid [poly(A).poly(U)]. NK activity was determined by an in vitro 4 h chromium release assay using nonadherent mononuclear cells isolated from peripheral bloods as effectors and human myeloblastic cells (K562) as targets. The following results were obtained: 1) The mean NK activity of the 47 patients tested before chemotherapy was significantly lower than that of 14 healthy controls. 2) The patents who received chemotherapy consisting of 5 FU (12 mg/kg) and adriamycin (40 mg/M2) showed an increase in NK activity 5 days after injection as compared to that of the same patients tested before chemotherapy. 3) In these patients, an additional administration of poly(A) poly(U) (100mg) resulted in a further significant increase of NK activity 2 days later, whereas the control patients who received placebo showed no change of NK activity.
Adult ; Aged ; Combined Modality Therapy ; Doxorubicin/therapeutic use ; Female ; Fluorouracil/therapeutic use ; Human ; Killer Cells, Natural/drug effects* ; Male ; Middle Age ; Poly A-U/pharmacology ; Poly A-U/therapeutic use* ; Stimulation, Chemical ; Stomach Neoplasms/drug therapy* ; Stomach Neoplasms/surgery