We report a case of childhood dermatomyositis t.hat developed in a 10-year-old boy. Skin lesion showed malar erythema, Gottron's papule, and poikiloderma those were compatible with dermatomyositis. And other clinical, laboratory, and histopathologic findings supported the diagnosis of derrnatomyositis. We treated him with oral corticosteroid, the lesion was improved and regular periodic follow up was attempted. From summary of all data of patient, this case was typical Brunsting type of childhood dermatomyositis.
Child ; Dermatomyositis* ; Diagnosis ; Erythema ; Follow-Up Studies ; Humans ; Male ; Skin

BACKGROUND: Oxygen free radicals have been implicated as a cause of deleterious effects in the setting of coronary reperfusion, and they are believed to be generated by the xanthine oxidase system, from activated neutrophiles and from mitochondria. We evaluate the contribution of mitochondria to the production of oxygen free radicals and clarify the mechanism of cellular damage in ischemic reperfused hearts. METHODS: Mitochondria isolated from the ischemic rabbit hearts were incubated in the reaction conditions with different oxygen tensions. Generation of superoxide anion and activities of defensive enzymes aginst oxidative stress were mesured. RESULTS: Superoxide anion genertion by mitochondria incubated in 21% oxygen condition were 0.54+/-0.09 and 0.27+/-0.04(O2./min/mg protein) in ischemic mitochondria and in control respectively(P<0.05). Activites of defensive enzymes against oxidative stress, superoxide dismutase and glutathione peroxidase, were significantly reduced in mitochondria isolated from either ischemic or reperfused hearts. With the lapse of respiration in 21% oxygen condition, ADP-stimulated state 3 oxygen consumption(306.4+/-31.5 vs 214.4+/-11.4n atoms O/min/mg protein) at 30 minutes, P : O ratio and phosphorylation rate were significantly decreased in ischemic mitochondria. CONCLUSION: Elevation of oxygen free radical generation as well as the reduction of defensive enzyme activities in ischemic reperfused mitochondria are injurious to mitochondrial respiratory function. It may contribute to the mechanism of cellular damage in ischemic reperfused hearts.
Free Radicals ; Glutathione Peroxidase ; Heart* ; Mitochondria* ; Myocardial Reperfusion ; Neutrophils ; Oxidative Stress ; Oxygen ; Phosphorylation ; Respiration ; Superoxide Dismutase ; Superoxides* ; Xanthine Oxidase

It now appears that in addition to being a target for immunologic injury, the epidermis actively participate in various immunologic processes and thus may serve as the peripheral limb of the immune system. For example, keratinocytes produce the cytokines including IL-1 and in certain inflammatory diseases characterized by accumulation of T lymphocytes, kerationchtes aberrantly express HLA-DR antigen. In this study, the effect of interferon-gamma on keratinocytes IL-1alpha production were invesigated by radioimmunoassay, using as a model cultured keratinocytes stimulated with 30U/ml of recombinant-Interferon-gamma(IFN), IFN and 1microgram/ml of PMA(IFN-PMA), IFN-gamma and 25microgram/ml of LPS(IFN-LPS), PMA, and LPS. The expression of HLA-DR antigen and the effect of IFN-gammaon the proliferation of kerationcytes were also evaluated. The results were as follows: 1. The proliferation of keratinocytes was significantly inhibited in the IFN, IFN-PMA, and IFN-LPS groups compared with the control. The proliferation of kerationcytes in PMA and LPS groups was not inhibited. 2. The percent of HLA-DR positive kerationcytes was 62.5+/-3.1%, and 65.8+/-2.6% in IFN, IFN-PMA, and IFN-LPS group, respectively. There were no HLA-DR expression in the control, PMA, and LPS groups. 3. The amounts of IL-lalpha were 22.58+/-8.41, 49.32+/-13.01, 57.02+/-14.99, 96.98+/-43.17, 22.30+/-4.26, and 44.60+/-20.51 fmol in supernatant of control, IFN, IFN-PMA, IFN-LPS, PMA, and LPS group, respectively. The differences between IFN and control, IFN-PMA and PMA, and IFN-LPS and LPS were significant (P<0.05). The produciton of IL-1alphawas enhanced by IFN, but not PMA and LPS. The IL-1alpha induced by IFN and PMA was higher than that induced by IFN or PMA alone. The IL-1alpha induced by IFN and LPS was higher tthan that induced by IFN or LPS alone. 4. The amounts of IL-1alpha were 59.82+/-11.57, 70.15+/-25.22, 73.50+/-17.15, 63.67+/-32.38, 48.62+/-4.81, and 50.92+/-15.01 fmol in cell lysate of control, IFN, IFN-PMA, IFN-LPS, PMA, PMA, and LPS groups, respectively. The amount of IL-1alpha in IFN-PMA was significantly increased as compared to PMA(P<0.05). 5. The total amounts of IL-1alpha were 82.40+/-8.98, 119.47+/-21.88, 130.52+/-8.12, 160.66+/-34.51, 70.92+/-1.15, and 95.53+/-27.89 fmol in the control, IFN, IFN-PMA, IFN-LPS, Pma, and LPS groups, respectively, The differences between IFN and control, control, IFN-PMA and PMA and IFN-LPS and LPS were signigicant (P<0.05) the production of IL-1alpha was enhanced by IFN, but not PMA and LPS. The IL-1alpha induced by IFN and PMA was higher than that induced by PMA. The IL-1alpha induced by IFN and LPS was higher than that induced by IFN or LPS alone. In summary, the results indicate that when kerationcytes are activated by IFN-gamma, they are actively participating in the immunologic reaction by the increasing production of IL-1alpha.
Cytokines ; Epidermis ; Extremities ; HLA-DR Antigens ; Immune System ; Interferon-gamma ; Interleukin-1 ; Keratinocytes* ; Radioimmunoassay ; T-Lymphocytes

No abstract available.
Diaphragm* ; Ultrasonography*

No abstract available.
Intubation, Intratracheal ; Temporomandibular Joint

PURPOSE: The instruction of cardiopulmonary resuscitation (CPR) to students has been advocated in many countries. To formulate an effective policy for high school students in Korea, data on attitudes toward CPR and the levels of knowledge in this technique for this population are needed. METHODS: A thirty-question questionnaire was given to Korean high school juniors to assess their attitudes toward and knowledge level of CPR. Two hundred seventy one of 341 students (79.5%) responded to the questionnaire and their male to female ratio was 1:2.2. RESULTS: Most students (n=262, 96.7%) had heard of CPR, mainly through television (n=193, 71.2%) or a school activity (160, 59.0%). Only 50(18.5%) and 15(5.5%) students responded that they would be willing to provide CPR to a "family or friend" and "stranger", respectively. One hundred twunty four students (45.8%) had received some form of education on CPR, but only 10(3.7%) had received an advanced education (although most were willing to be educated further on CPR). The most common reason for not receiving CPR training was a lack of knowledge for training resources (n=79, 53.7%). Only 88(32.4%) students understood the purpose of an automated external defibrillator. Although half of the students (147, 54.2%) correctly chose the location for CPR chest compression, only 19.2% and 16.6% correctly responded to questions on the appropriate compression speed and depth, respectively. CONCLUSION: Although students receive some exposure on the importance of CPR, their willingness to perform CPR and their knowledge level of AEDs and CPR is not adequate. A systemic approach for educating and training students in CPR is needed.
Cardiopulmonary Resuscitation ; Defibrillators ; Female ; Humans ; Korea ; Male ; Surveys and Questionnaires ; Television ; Thorax

STATEMENT OF PROBLEM: Die materials require abrasion resistance, dimensional stability with time, and high surface wettability for adequate material properties. Wear of gypsum materials is a significant problem in the fabrication of accurately fitting cast prosthetic devices. So It has been recommended that the use of die hardener before carving or burnishing ofthe wax pattern. PURPOSE: The purpose of this study was to compare the abrasion resistance and surface microhardness(Knoop) with 3 commonly used gypsum die materials(MG Crystal Rock, Super plumstone, GC FUJIROCK(R) EP) with and without the application of 2 die hardeners. MATERIAL AND METHODS: Three die materials were evaluated for abrasion resistance and surface microhardness after application of 2 die hardeners(Die hardener and Stone die & plaster hardener). Thirty specimens of each gypsum material were fabricated using an impression of resin die(Pattern resin; GC Corporation, Japan) with 1-mm high ridges, sloped 90 degrees. Gypsum materials were mixed according to manufacturer's recommendations and allowed to set 24 hours before coating. Specimens were arbitrary assigned to 1 of 3 treatment subgroups (n=10/subgroup): no treatment(control), coated with Die hardener, and coated with Stone die & plaster hardener. Abrasion resistance(measured by weight loss) was evaluated using device in 50g mass perpendicular to the ridges. Knoop hardness was determined by loading each specimen face 5 times for 15 seconds with a force of 50g. A scanning electron microscope was used to evaluate the surface of specimens in each treatment subgroup. Conclusions: The obtained results were as follows: 1. 3 types of die stone evaluated in this study did not show significant differences in surface hardness and abrasive resistance(P<.05). 2. In the abrasive resistance test, there were no significant differences between GC FUJIROCK(R) EP and MG Crystal Rock with or without 2 die hardener(P<.05). 3. Super plumstone treated with Stone die & plaster hardener showed increased wear loss(P<.05). 4. Die hardener coatings used in this study decreased the surface hardness of the gypsum material(P<.05).
Calcium Sulfate* ; Hardness ; Wettability

No abstract available.
Colon* ; Gastrointestinal Hemorrhage* ; Varicose Veins*

Antidepressants discontinuation syndrome means a wide variety of somatic and psychological reactions due to stopping antidepressants after long term administration. The main features of antidepressants discontinuation syndrome are gastrointestinal complaints, dizziness, flu-like symptoms, sleep disorders, balance and sensory disorders, and affective symptoms. It has been postulated that multiple neuronal systems including the serotonin, norepinephrine, and cholinergic systems, and the possible interactions among them are likely to be engaged. They were reported with nearly all antidepressants but the symptoms are somewhat different among the antidepressant classes owing to the different mechanism of action and the pharmacologic properties such as half-life and active metabolite. The symptoms of discontinuation are usually mild and transient, but can range widely in severity. They commence within a few days of stopping medication or reducing the dosage rapidly, resolves spontaneously within 2 weeks. It is important to recognize the symptoms of discontinuation and distinguish them from relapse because misdiagnosis can lead to inappropriate treatment and adversely effect future antidepressant compliance.
Affective Symptoms ; Antidepressive Agents ; Compliance ; Diagnostic Errors ; Dizziness ; Half-Life ; Neurons ; Norepinephrine ; Recurrence ; Sensation Disorders ; Serotonin ; Sleep Wake Disorders

The purpose of this study is to present an actual example for procedures for developing a PBL package based on philosophical backgrounds derived from Problem-based learning. To perform a systemic study on the operations of an intergrated curricula under multi-disciplines, a research team made up of several professors with different academic backgrounds was formed. Among the four situations for the patients with perception-adjustment disorder, especially a procedure for the development of PBL package which can be used in the emergency room situation has been proposed. The little(2000)'s PBL package model has been applied for this study. Tha package includes course objectives, learning objectives, concept map, situation scenario, tutor guide, and evaluation method. It is believed that learning objectives achievement procedures designed as a part of a problem-based learning package development procedures for the nursing of patients with perception-adjustment can be achieved at the same level as the learning objectives for the science of nursing founded by the Korean Nurses Association.
Curriculum ; Emergency Service, Hospital ; Humans ; Learning ; Nursing ; Problem-Based Learning*