No abstract available.
Diagnosis* ; Hirschsprung Disease* ; Manometry*

Merkel cell carcinoma (MCC) is an unusual primary cutaneous tumor, occasionally found con-current with other malignancies. A case of MCC with coexisting squamous cell carcinoma (SCC) was studied histologically, immunohistochemically and ultrastructurally. The MCC and SCC occured at the same site, but each preserved its identity and transition between the two was not identified.
Carcinoma, Merkel Cell* ; Carcinoma, Squamous Cell

No abstract available.
Bone Density* ; Child* ; Humans

Vocal cord dysfunction is a recently described entity in which paradoxical adduction of the vocal cords produces airflow obstruction at the level of the larynx. Recurrent wheezing results, which may imitate asthma. Inspiratory closure of the cords can also cause stridor, commonly misdiagnosed as an upper airway obstruction of undefined cause. The acute presentation is often dramatic and has led to inappropriate treatment, including intubation, tracheotomy, or high doses of steroids. We present the case of a 9 yr old boy with allergic rhinitis who was referred to us for the evaluation of wheezing and dyspnea which did not respond to asthma management. Pulmonary function tests had abnormal inspiratory phases and laryngoscopy revealed typical adduction of the vocal cord during inspiration. Psychological tests suggested anxiety and tension with repressed aggression. There have been no further episodes, possibly due to counseling and education of relaxed throat breathing as well as avoidance of inhaled medication.
Aggression ; Airway Obstruction ; Anxiety ; Asthma ; Counseling ; Dyspnea ; Education ; Humans ; Intubation ; Laryngoscopy ; Larynx ; Male ; Pharynx ; Psychological Tests ; Respiration ; Respiratory Function Tests ; Respiratory Sounds ; Rhinitis ; Spirometry ; Steroids ; Tracheotomy ; Vocal Cord Dysfunction* ; Vocal Cords*

PURPOSE: To determine whether the refractive change obtained using the Orbscan-derived power maps is in concordance with the manifest refractive change produced after photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK). METHODS: Forty eyes of 21 PRK patients and 40 of 21 LASIK patients were included in the study. Orbscan topographical analysis and manifest refraction were performed preoperatively and 1 month postoperatively. This study evaluated the concordance between the change in manifest refraction (corrected to the corneal plane) and the change measured by Orbscan power maps before and after PRK and LASIK. We also compared the concordance of the change in manifest refraction (corrected to the corneal plane) with the change calculated using the Gaussian optics formula, radius of anterior and posterior corneal surface , and corneal thickness measured by ultrasound pachymetry. RESULTS: The 3.0-mm zone axial power anterior map gave the best correlation between manifest refractive change, and Orbscan-measured corneal power change in PRK (r =0.733, P<0.001). The 4.0-mm zone of calculated refractive change using Gaussian optic formula map gave the best correlation with manifest refractive change in LASIK (r =0.531 , P<0.001). The change of anterior corneal surface maps in PRK and the change of total power maps in LASIK represented the best correlation with the change in manifest refraction, but they did not reliably represent the changes in manifest refraction due to high standard deviation value. CONCLUSIONS: The 3.0-mm zone axial power anterior map gave the best correlation between manifest refractive change, and Orbscan-measured corneal power change in PRK. The 4.0-mm zone of calculated refractive change using Gaussian optic formula map gave the best correlation with manifest refractive change in LASIK. Nevertheless, these maps did not reliably represent the changes in manifest refraction because of the high standard deviation value.
Humans ; Keratomileusis, Laser In Situ* ; Photorefractive Keratectomy* ; Radius ; Ultrasonography

PURPOSE: Lactate dehydrogenase-5 (LDH-5) is one of five isoenzymes and is the most important for anaerobic glycolysis. LDH-5 is transcriptionally regulated by hypoxia-inducible factor (HIF). HIF plays a role in the response to hypoxia by activating genes involved in vascular remodeling, cell proliferation, and erythropoiesis. In this study, we investigated the clinicopathologic significance and angiogenesis of LDH-5 expression in colorectal cancer. METHODS: We retrospectively reviewed the medical records of 83 patients with colorectal cancer who underwent a surgical resection at Soonchunhyang Cheonan Hospital from January 2001 to December 2003. LDH-5 and HIF-1alpha protein expressions were evaluated in 83 human colorectal cancer specimens. These factors were related to TNM stage, lymph node metastasis, vascular, neural, and lymphatic invasion, and prognosis. RESULTS: LDH-5 was positive in 66% (55 patients) of the tumors, and HIF-1alpha was positive in 66% (55 patients) of the tumors. LDH-5 expression was significantly associated with HIF-1alpha protein expression (P<0.001). Also, LDH-5 expression was significantly associated with TNM stage and lymph node metastasis (P<0.001) while HIF-1alpha expression was significantly associated with TNM stage (P<0.001), lymph node metastasis (P<0.001), vascular invasion (P=0.011), and lymphatic invasion (P=0.005). The survival of the patients with high LDH-5 expression was worse than that of patients with low LDH-5 expression (P=0.032). CONCLUSION: Our study shows a high expression of LDH-5 in colorectal cancer. The up-regulation of LDH-5 parallels an increase in HIF-1alpha expression. The immunohistochemical assessment of tissue LDH-5 and HIF-1alpha provides important prognostic information for colorectal carcinomas.
Anoxia ; Cell Proliferation ; Colonic Neoplasms ; Colorectal Neoplasms ; Erythropoiesis ; Glycolysis ; Humans ; Isoenzymes ; Lactic Acid ; Lymph Nodes ; Medical Records ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Up-Regulation

BACKGROUND AND OBJECTIVES: The restoration of infarct-related coronary artery (IRA) patency in acute myocardial infarction (AMI) linked to a significant improvement in survival. Because of microvascular and cellular injury, patent IRA does not always represent successful reperfusion. With progress of myocardial ischemia, standard 12 lead ECG shows evolutional changes of ST-segment, R wave and Q wave. But their relations to myocardial perfusion were uncertain. METHODS: Total 41 patients of the first anterior wall AMI were enrolled and serial ECGs were taken to measure sum of ST-segment elevation (sigma ST), sum of Q wave (sigma Q), sum of R wave (sigma R), and QRS score (QRSs) proposed by Selvester in each patients before thrombolytic therapy (i), after coronary angiography at 90 minutes of thrombolytic therapy (a), and before discharge (d). Myocardial contrast echocardiography was performed within 10 days of AMI to estimate opacification score (OS) and opacification index (OI) in segments of LAD territory. We investigate the relation between evolution of ECG changes and perfusion status of infarcted myocardium. RESULTS: 1) There was no relation between OI and sigma ST, but sigma R and QRSs showed significant relation with OI before discharge (r=0.59, - 0.33, p<0.05, respectively), post thrombolytic therapy (r=0.51, - 0.61, p<0.05), and baseline ECG (r=0.53, - 0.51, p<0.05). 2) The number of segments with OS (0.5) showed no singificant relation to the degree of sigma ST and sigma Q, but number of segments with OS (0) showed singinficant relation to that of sigma R and QRSs (r of sigma Ri, sigma Ra, sigma Rd vs number of segments with OS (0)= - 0.59, - 0.66, - 0.43, p<0.05, QRSi, QRSa, QRSd vs number of segments with OS (0)=0.58, 0.58, 0.57, p<0.05). CONCLUSION: These findings suggest that the ECG changes of R wave and QRS scores could be useful markers of perfusion state in thrombolytic era.
Coronary Angiography ; Coronary Vessels ; Echocardiography ; Electrocardiography ; Humans ; Myocardial Infarction* ; Myocardial Ischemia ; Myocardium ; Perfusion* ; Reperfusion ; Thrombolytic Therapy

Doxepin hydrochloride cream with potent H1 and H2 blocker activity is a tricyclic antidepressant, which is structurally similar to phenothiazines, and also known to be a contact sensitizer and photosensitizer. We report a case of allergic contact dermatitis due to doxepin hydrochloride cream in a 75-year-old-man, who developed facial edema and eczema at the application sites (face, neck and upper trunk) within several hours of application of doxepin hydrochloride cream. Clinicians should be aware of the possibility of allergic contact dermatitis to doxepin cream, if the condition worsens with use of this medication.
Dermatitis, Allergic Contact* ; Dermatitis, Contact ; Doxepin* ; Eczema ; Edema ; Neck ; Phenothiazines

PURPOSE: To evaluate the efficacy and toxicity of combination chemotherapy with vinorelbine, ifosfamide, and cisplatin in patients with advanced non-small cell lung cancer. MATERIALS AND METHODS: Patients with unresectable, pathologically proven non-small cell lung cancer who had no prior chemotherapy were eligible. Patients received vinorelbine (25 mg/m2, iv., D1 & 8), ifosfamide (1.5 g/m2, iv., D1-3 with mesna), and cisplatin (60 mg/m2, iv., D1). The treatment was repeated every 3 weeks. RESULTS: Between degrees Ctober, 1997 and June, 1999, 26 patients were enrolled. Median age was 61. 1 patient had stage IIIA, 13 had stage IIIB, and 12 had stage IV. Patients with adendegrees Carcinoma were 15, squamous cell carcinoma were 11. Of 22 evaluable patients, objective responses were observed in 9 patients (response rate: 40.9%, CR: 1 (4.5%), PR 8 (36.4%)). Median duration of response was 48 weeks. Median overall survival was 52 weeks. Grade 3-4 leukopenia was observed in 10.2% of the 88 courses. There was 1 death related to febrile neutropenia. Non- hematologic toxicities were mild. CONCLUSION: We concluded that combination chemotherapy with vinorelbine, ifosfamide, and cisplatin was effective and tolerable in patients with advanced non-small cell lung cancer, and phase III randomized trial is needed to compare this regimen to other cisplatin-based regimens.
Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Cisplatin* ; Drug Therapy ; Drug Therapy, Combination* ; Febrile Neutropenia ; Humans ; Ifosfamide* ; Leukopenia

BACKGROUND AND OBJECTIVES: We evaluated the two-year clinical outcomes in patients with angiographically intermediate lesions according to the plaque burden and treatment strategy. SUBJECTS AND METHODS: We prospectively enrolled patients with angiographically intermediate lesions (diameter stenosis 30-70%) with an intravascular ultrasound (IVUS) minimum lumen area (MLA) <4 mm2 with 50-70% plaque burden of 16 Korean percutaneous coronary intervention centers. Patients were divided into medical therapy group (n=85) and zotarolimus-eluting stent group (ZES; Resolute) group (n=74). We evaluated the incidences of two-year major adverse cardiovascular events (MACE). RESULTS: A two-year clinical follow-up was completed in 143 patients and MACE occurred in 12 patients. There were no significant differences in the incidences of death (1.3% vs. 3.0%, p=0.471), target vessel-related non-fatal myocardial infarction (0.0% vs. 0.0%, p=1.000) and target vessel revascularizations (7.8% vs. 4.5%, p=0.425) between medical and ZES groups. Independent predictors of two-year MACE included acute myocardial infarction {odds ratio (OR)=2.87; 95% confidence interval (CI) 1.43-6.12, p=0.014}, diabetes mellitus (OR=2.46; 95% CI 1.24-5.56, p=0.028) and non-statin therapy (OR=2.32; 95% CI 1.18-5.24, p=0.034). CONCLUSION: Medical therapy shows comparable results with ZES, and myocardial infarction, diabetes mellitus and non-statin therapy were associated with the occurrence of two-year MACE in patients with intermediate lesion with IVUS MLA <4 mm2 with 50-70% of plaque burden.
Constriction, Pathologic ; Coronary Artery Disease ; Coronary Stenosis* ; Diabetes Mellitus ; Follow-Up Studies ; Humans ; Incidence ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Plaque, Atherosclerotic ; Prospective Studies ; Research Personnel* ; Stents ; Ultrasonography ; Ultrasonography, Interventional