This report aimed to discuss two nearly identical cases of primary conjunctival mucosa-associated lymphoid tissue (MALT) lymphoma mimicking allergic conjunctivitis. Two patients were referred to the Department of Ophthalmology, Ilsan Paik Hospital, Inje University because of the intractability to conventional treatment for initially diagnosed allergic conjunctivitis. On ocular examinations, normally pigmented, giant papillae-like lesions were found in the bilateral upper conjunctivae. Excisional biopsies were performed. Histopathologic and immunohistochemical examinations of the conjunctival biopsies revealed MALT lymphoma in both patients. The patients subsequently received radiation therapy and achieved complete remission with no evidence of recurrence during the follow-up periods of 13 and 11 months, respectively. Ophthalmologists should be reminded that a primary conjunctival low-grade malignant lymphoma may masquerade as allergic conjunctivitis with similar clinical features.
Biopsy ; Conjunctiva ; Conjunctivitis, Allergic* ; Follow-Up Studies ; Humans ; Lymphoid Tissue* ; Lymphoma* ; Lymphoma, B-Cell, Marginal Zone ; Ophthalmology ; Recurrence

Building-related illness is an increasingly common problem. The disease fall into two categories : those that have an identifiable cause-such as legionellosis, humidifier fever, and conditions resulting from exposure to known substances such as asbestos, lead in paint, formaldehyde, etc-and those that have no readily identifiable cause but can be described only by a group of symptoms known as sick building syndrome (SBS). Although objective physiologic abnormalities are generally not found and permanent sequelae are rare, the symptoms of SBS can be uncomfortable, even disabling, and whole workplaces may be rendered non-functional. In assessment of patients with SBS complaints, specific building-related illnesses should be ruled out by history or physical examination. On-site assessment of buildings is extremely useful. Symptoms of non-specific building-related illnesses are common ; their heterogeneity suggests that they do not represent a single disorder. Although there is little convincing, direct evidence to implicate specific causative agents, there is sufficient indirect evidence to support a number of recommendations. For example, it seems prudent to maintain an outdoor-air supply of more than 10 liters per second per person ; to select the building materials, furnishings, and equipments that are least likely to release pollutants such as formaldehyde or volatile organic compounds ; to ensure proper maintenance and cleaning ; and to avoid materials that may act as substrates for the proliferation of microbes or dust mites.
Asbestos ; Construction Materials ; Dust ; Fever ; Formaldehyde ; Humans ; Humidifiers ; Legionellosis ; Mites ; Paint ; Physical Examination ; Population Characteristics ; Sick Building Syndrome ; Volatile Organic Compounds

No abstract available.
Humans ; Pulmonary Disease, Chronic Obstructive*

No abstract available.
Hypertension, Pulmonary*

No abstract available.

The reciprocal interaction between sleep and pain has been reported by numerous studies. Patients with acute or chronic pain often complain of difficulty falling asleep, frequent awakenings, shorter sleep duration, unrefreshing sleep, and poor sleep quality in general. According to the majority of the experimental human studies, sleep deprivation may produce hyperalgesic changes. The selective disruption of slow wave sleep has shown this effect more consistently, while results after selective REM sleep deprivation remain unclear. Patients with chronic pain have a marked alteration of sleep structure and continuity, such as frequent sleep-stage shifts, increased nocturnal awakenings, decreased slow wave sleep (SWS), decreased rapid eye movement (REM) sleep, and alpha-delta sleep. Many analgesic medications can alter sleep architecture in a manner similar to the effects of acute and chronic pain, suppressing SWS and REM sleep.
Chronic Pain ; Humans ; Sleep Deprivation ; Sleep, REM

Emergency medicine(EM) is the specialty of evaluating, stabilizing and initiating treatment for patients with life or limb-threatening illnesses or injuries. Techniques unique to the specialty of EM are the triage systems, quick stabilization methods, and emergency surgery procedures. The field of EM encompasses areas such as emergency department management, disaster planning and management, the management of emergency medical service(EMS) systems, research into such areas as brain and heart resuscitation, trauma and disaster management, survival medicine, and environmental emergencies(cold and heat injuries, poisioning, decompression sickness and barotrauma). Today, in addition to providing emergency care, the emergency specialists have moral and legal obligations to assess and report probable cases of child and spouse abuse, sexual assault, and alcohol and drug abuse. Future, the EM should provide surveillance, identification, intervention, and evaluation of injury and disease, therefore EM will remain as a key component of evolving community health care system.
Brain ; Child ; Community Health Services ; Decompression Sickness ; Disaster Planning ; Disasters ; Emergencies* ; Emergency Medical Services ; Emergency Medicine* ; Emergency Service, Hospital ; Heart ; Hot Temperature ; Humans ; Jurisprudence ; Resuscitation ; Specialization ; Spouse Abuse ; Substance-Related Disorders ; Triage

BACKGROUND: The medicolegal problems can be occurred in all medical field, Especially ED can be more exposed to the legal claims due to the very nature of ED business and characteristics of ED patient (or their family member). All emergency physicians, as a ED manager, should be concerned about the law associated with emergency cairo for handling the medicolegal problem. So they can deal with and prevent the legally risky situations that may be occurred in ED practice. Ultimately we can reduce the risk of a malpractice lawsuit and provide good emergency care services. SUGGESTION: The authors would like to suggest several items that we have thought the ED physicians and managers always have to remember to manage the medicolegally risky situations. 1. Every member of ED health care team must be trained in understanding the patients' wants and desires. 2. The emergency physicians and nurses must realize that they are the best risk management tools in the hospital. 3. ED physician should have the knowledge of the law associated with emergency health care. 4. Develop the system that can share the informations about the medicolegal events which were experienced by each ED health care providers of every health care institutes. 5. We should never forget the time honored sentences, 'Good medicine is good law'.
Academies and Institutes ; Commerce ; Delivery of Health Care ; Emergencies ; Emergency Medical Services ; Empathy* ; Health Personnel ; Humans ; Jurisprudence ; Malpractice ; Patient Care Team ; Risk Management

BACKGROUND: Plasmodium vivax malaria was recently re-presenting infectious disease in Korea since was being controlled for about 10 years age, but has been increasing years by year in the soldiers or farmers working at the near Demilitarized Zone(DMZ). So we analyzed the Characteristics of the patients diagnosed as malaria since 1997 in Yeungnam university hospital. METHODS: From January 1997 to August 1999, the 23 patients complainted of the febrile and chilly sense were diagnosed as Plasmodium vivax malaria in Yeungnam university hospital. We analyzed the patient's records for clinical findings(i.e. clinical symptoms and signs), occupation and regions of working or visiting, laboratory findings, treatment and its results, etc. RESULTS: Male patients were 21 and female patients were 2 among the total 23 patients, the 19 of 21 male patients were soldiers discharged from military services. All patients had been visited or worked near the DMZ, as the northern part of Kyungki-do(21 cases) or Kangwon-do(2 cases). And all patients complainted of delayed onset(means 6 months) of fever and chills after working or visiting at this zones. On physical examination, liver or spleen were palpated initially at least 1 finger breadth in 9 cases(39.1%), and peripheral blood smears showed the infected RBCs(i.e. gametocyte, ring form, schizont, trophozoite) in all cases, and 21 cases(91.3%) showed thrombocytopenia. All patients were treated by the combined regimen of 2-days hydroxychloroquine and 14-days primaquine. All cases showed clinical and laboratory improvement initially, but 5 cases were recurred after 2 months and showed re-improvement. And none of 23 cases showed the significant complications and deaths after medical treatment. CONCLUSION: Plasmodium vivax malarial infection is currently re-presenting disease near the DMZ. So we should consider the active prevention and management of malaria.
Chills ; Communicable Diseases ; Female ; Fever ; Fingers ; Humans ; Hydroxychloroquine ; Korea ; Liver ; Malaria ; Malaria, Vivax* ; Male ; Military Personnel ; Occupations ; Physical Examination ; Plasmodium vivax* ; Plasmodium* ; Primaquine ; Schizonts ; Spleen ; Thrombocytopenia

Epidemiological studies are important in both the prevention and treatment of mycobacterial infections. This study was initiated to establish the pulsed-field gel electrophoresis (PFGE) method, which are not yet extensively studied. The most apprpriate restriction endonucleases included Dral, AsnI, and XbaI. The optimal PFGE condition was different according to the enzymes used. Two stage PFGE was performed, in case of DraI first stage was performed with 10 seconds of initial pulse and 15 seconds of findA pulse, while the second stage was performed with 60 seconds of initial pulse and 70 seconds of final pu',se. The electrophoresis time for DraI-PFGE was 14 hours for each stage. Electrophoresis was performed for 22 hours, in case of XbaI, with 3 seconds of initial pulse and 12 seconds of final pulse. Electrophoresis was performed for 22 hours, in case of AsnI, with 5 seconds of initial pulse and 25 seconds of final pulse. In all cases the voltage of the electrophoresis was maintained constantly at 200 voltage. Standard mycobacterial strains, which included Mycobacterium bovis BCG, M. tuberculosis, and M. fortuitum, could not be differentiated by PFGE analysis. PFGE analysis was performed to differentiate 9 clinically isolated M. fortuitum strains using AsnI. All M. fortuitum strains showed different genotypes except 2 strains. Cluster analysis divided M. fortuitum strains into 2 large groups. PFGE analysis was performed to further differentiate M. fortuitum isolates using XbaI. The undifferentiated 2 M. fortuitum strains showed different PFGE patterns with Xba I. Cluster analysis of the XbaI-PFGE patterns showed more complex grouping than AsnI-PFGE patterns, which showed that XbaI-PFGE analysis was better than AsnI-PFGE in M. fortuitum genotyping. The top dissimilarity values of AsnI-PFGE and XbaI-PFGE were 0.74 and 0.75, respectively. This value was higher than that of arbitrarily primed polymerase chain reaction (AP-PCR) analysis and lower than that of restriction fragment length polymorphism (RFLP) analysis. This suggested that PFGE can be used as a supportive or alternative genotyping method to RFLP analysis.
DNA Restriction Enzymes ; Electrophoresis* ; Electrophoresis, Gel, Pulsed-Field ; Epidemiologic Studies ; Genotype ; Mycobacterium bovis ; Mycobacterium* ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Tuberculosis