A 24-year-old female was seen with multiple, pinkish to skin colored and brownish to black pigmented macules, papules, patch and plaque on the face, neck, upper chest, extensor surface of both forearms and dorsal hands. Histopathological diagnoses from the 75 skin biopsy specimens taken during the follow-up period of 22 months include 29 skin tumors : one malignant melanoma, one precancerous melanosis, 16 basal cell carcinamas, four squamous cell carcinomas, four actinic keratoses, one melanoacanthoma, one keratoacanthoma and one angiofibroma. It was discussed that melanoacanthoma would be considered as the one of the associated beniign skin tumors in xeroderma pigmentosum.
Angiofibroma ; Biopsy ; Carcinoma, Squamous Cell ; Diagnosis ; Female ; Follow-Up Studies ; Forearm ; Hand ; Humans ; Ichthyosis* ; Keratoacanthoma ; Keratosis, Actinic ; Melanoma ; Melanosis ; Neck ; Skin* ; Thorax ; Xeroderma Pigmentosum* ; Young Adult

PURPOSE: Implant surface modification and implant design are the principle targets for achieving successful primary stability. The aim of this study was to measure implant stability quotient (ISQ) values of sandblasted, large-grit, acid-etched (SLA) implants with tapered straight body design during the healing period, and to determine the various factors affecting implant stability. MATERIALS AND METHODS: To measure implant stability, resonance frequency analysis (RFA) was performed in 26 patients (13 women and 13 men) with 44 SLA implants with tapered straight body design. Implant stability (ISQ values) was evaluated at baseline and healing abutment connection (12 weeks), and the correlations between RFA and insertion torque (IT), bone quality, and jawbone were determined. RESULTS: The mean ISQ value of the implants was 69.4 ± 10.2 at the time of implant placement (baseline) and 81.4 ± 6.9 at the time of healing abutment connection (P < 0.05). Significant differences were found between RFA and bone quality and between RFA and jawbone (P < 0.05). No significant differences were found between RFA and IT, insertion area, fixture diameter, and implant length (P > 0.05). CONCLUSION: ISQ values of SLA implants with tapered straight body design were high at baseline and healing abutment connection. It was concluded that SLA implants with tapered straight body design show improved primary and secondary stability, and that immediate or early loading may be applicable.
Female ; Humans ; Torque

One hundred and three patients with strabismus who were undergoing extraocular muscle surgery were studied to compare the incidence of arrhythmia following the traction of ex- traocular muscles under halothane and sevoflurane anesthesia. Fifty four patients were anesthetized with O2-halothane(halothane group) and forty nine patients with O2-sevoflurane (sevoflurane group). The incidences of arrhythmia were 74.1% and 71.4% in halothane and sevoflurane group, respectively. There was no significant change of blood pressure in either group when arrhythmia occurred. The incidence of arrhythmias in female patients of the sevoflurane group was higher than that in male patients, while not in the halothane group. In the sevoflurane group, the incidence of arrhythmia followed by the traction of medial rectus muscle was significantly higher than that of lateral rectus muscle. In conclusion, there was no significant difference in the incidence of arrhythmia following the traction of extraocular muscles between halothane and sevoflurane anesthesia, and sinus bradycardia was the most common arrhythmia with either anesthetic.
Anesthesia ; Anesthetics* ; Arrhythmias, Cardiac ; Blood Pressure ; Bradycardia ; Female ; Halothane ; Humans ; Incidence ; Male ; Muscles ; Solubility* ; Strabismus ; Traction

A simple and sensitive assay method was developed for cefepime in human plasma using high performance liquid chromatography (HPLC). Cefepime and cefadroxil (the internal standard) were extracted from heparinized human plasma by simple deproteination with perchloric acid. The extract was injected into an Atlantis dC18 column (250 X 4.6 mm; particle size 5micrometer, Waters) and the column was eluted with methanol and 0.01 M dihydrogen phosphate at pH 3.0 (15 : 85 v : v) as a mobile phase at a flow rate of 0.7 mL/min. Linearity was confirmed for the range 0.25 to 200 micro L/mL and the limit of quantitation was 0.25 micro L/mL. The retention times were 10.2 min and 13.4 min for cefepime and cefadroxil, respectively. This method was successfully applied to a pharmacokinetic study of cefepime in plasma from bone marrow transplant patients.
Bone Marrow ; Cefadroxil ; Chromatography, High Pressure Liquid ; Chromatography, Liquid* ; Heparin ; Humans* ; Hydrogen-Ion Concentration ; Methanol ; Particle Size ; Plasma*

BACKGROUNDS: Toenail dermatophytosis is a common disease caused by dermatophytes. As it may cause not only a cosmetic disfigurement but also the physical, psychological, and social limitations, the need for the treatment has been increased. Recently, itraconazole and terbinafine have been popularly used with less serious side effects than before. OBJECTIVE: We performed a retrospective study to observe the mycological results of antifungal therapy after the treatment of toenail dermatophytosis for 12 weeks. METHOD: The study population consisted of 169 patients with toenail dermatophytosis in Catholic Skin Clinic from June, 2003 to October, 2005. RESULTS: Threre was no significant difference in mycological cure rate between the oral itraconazole group and the oral terbinafine group (52.2% vs 52.0%; p=0.985). Mycological cure rate of the oral terbinafine with 5% amorolfine nail lacquer group was insignificantly higher than that of the oral itraconazole with 5% amorolfine nail lacquer group (55.6% vs 40.6%; p=0.309). There were no significant difference between the different age groups, sexes, and cultured organisms. CONCLUSION: In toenail dermatophytosis, both of the oral itraconazole therapy and the oral terbinafine therapy are very effective and there was no significant difference in the mycological results after the 12 weeks therapy of toenail dermatophytosis.
Arthrodermataceae ; Humans ; Itraconazole ; Lacquer ; Nails* ; Retrospective Studies ; Skin ; Tinea*

No abstract available.
Humans* ; Leukemia*

Extrahepatic bile duct can be compressed by right hepatic artery (RHA) and cause a variety of hepatobiliary symptoms. This condition is referred to as RHA syndrome. A 20-year-old man was admitted because of jaundice. No stones or tumor were visible on CT scan and endoscopic retrograde cholangiopancreatography. However, RHA was seen traversing and compressing the mid common bile duct (CBD) with resultant upstream dilatation. The patient was diagnosed with obstructive jaundice due to compression of the CBD by variant RHA originating from gastroduodenal artery. After separation and mobilization of the variant RHA, obstructive jaundice was resolved. Herein, we report a case of a variant form of RHA syndrome that was successfully managed by surgery.
Arteries ; Bile Ducts, Extrahepatic ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct* ; Dilatation ; Hepatic Artery* ; Humans ; Jaundice ; Jaundice, Obstructive* ; Tomography, X-Ray Computed ; Young Adult

PURPOSE: The purpose of this article was to evaluate the efficiency of an automated prescription program serving pediatric patients who visited our emergency department. We expected that the program would reduce pediatric patient prescription errors and shorten the length of stay in the emergency department. METHODS: We developed the computerized physician order entry system to serve the pediatric patients visiting the emergency department and recommended that the emergency medicine residents use this program. We compared the rate of error as it affected prescription dosage and length of stay in the emergency department, before and after the program was deployed. We also performed a survey with 20 emergency medicine residents that have used the program. RESULTS: Of the total number of prescriptions filled, the number of prescription dosing errors observed was 40(4.5%) before and 22(2.8%) after the program was deployed. The results of the survey revealed high system usability and satisfaction. However, the length of stay in the emergency department was not affected. CONCLUSION: The computerized physician order entry system for pediatric patients visiting the emergency department was effective in reducing prescription related medical errors.
Emergencies ; Emergency Medicine ; Humans ; Length of Stay ; Medical Errors ; Medical Order Entry Systems ; Prescriptions

PURPOSE : E-cadherin is a tumor suppressor adhesion molecule that has an anti-invasive role and it is often considered as a useful marker for differentiating the lobular types from the ductal types of breast cancer. Yet the biological functions of E-cadherin in the invasive ductal types of breast cancers are unclear. METHODS : The E-cadherin expression was assessed immunohistochemically in 84 case of surgically resected invasive ductal carcinoma. Only the membranous expression of E-cadherin was considered and its expression was categorized as positive (>95% stained) or negative (<95% stained). The relationship between the E-cadherin expression and tumor size, the lymph node status, the histologic grade, the ER and PR status, The HER2/neu and p53 expressions was studied by performing prospective aspect. RESULTS : We analyzed 84 invasive ductal carcinomas for the E-cadherin expressions. Variable degrees of E-cadherin expression were noted in 79 cases and the complete absence of its expression was noted in 5 cases(5.9%) which showed all HER2/neu positive and p53 negative. Positive expression of E-cadherin was noted in 66cases(78.5%). Significant associations were found between the E-cadherin expression and the tumor size and the estrogen receptor status. The expression of E-cadherin was not found to be related to the lymph node status, histologic grade, the progesteron receptor status, the HER2/neu and p53 expressions. CONCLUSION: We confirmed that there was a strong correlation between the negative membrane expressions of E-cadherin and the T-stages and a negative estrogen receptor status. E-cadherin immunostaining appears to have a minimal prognostic value and it can be efficiently used for determining tumor progression of invasive ductal carcinomas of the breast.
Breast Neoplasms ; Breast* ; Cadherins* ; Carcinoma, Ductal* ; Estrogens ; Immunohistochemistry ; Lymph Nodes ; Membranes ; Prospective Studies

Background: Hematopyometra, an accumulation of bloody, purulent material in the ute-rine cavity, is a relatively uncommon event. The incidence is almost 0.01~0.5% in gynec-ologic patients. The most common cause of this condition is interference with the normal drainage of the uterus;endocervical obstruction by malignant disease. Other obstructive causes are the benign tumors in uterus, senile endocervicitis, long-term use of intrauterine device, cervical occlusion after surgery or radiation, intrauterinel infection, and congenital cervical anomaly. Methods: This report was performed to evaluate the hematopyometra patients, who were diagnosed and treated at Catholic University Medical College Hospitals from 1991 to 1995. Forty cases of hematopyometra were retrospectively reviewed by charts, radiologic and pathologic findings concerning with the clinical features. Results: 1) The most frequent age of hematopyometra patients was 50 to 59 years(45 %) and mean age was 63 years old. 2) Four patients(10 %) were at premenopausal period, and remaining 36 patients(90 %) were at the period of menopause(p<0.01). 3) The clinical manifestations of the patients were variable;profuse vaginal discharge(75 %), vaginal ble- eding or spotting(40 %), and lower abdominal pain(30 %). 4) The associating medical cond- itions or possible risk factors of hematopyometra are senile atrophic change(52.5 %), IUD inserted condition(25 %), genital malignant diseases(17.5 %), and uterine myoma(5 %). 5) The bacterial infection are frequently associated with hematopyometra and the causative ag ents are streptococci(50 %), E. coli(42 %), and mixed type(17 %). 6) Eight cases of them showed generalized peritonitis in the preoperative clinical course and three patients had been serious condition by septicemia. 7) The genital malignant diseases are associated with he- matopyomerta in 7 cases(17.5 %) of them(cervical cancer;4 cases, endometrial cancer;2 cases, and ovarian cancer;1 case). 8) All the cancer patients could be followed-up at le-ast for 2 years. Two patients, who were diagnosed for cervical cancer in the stage IIb and III, died of the persistent or recurrent disease in the period of following-up after the pri-mary treatment.
Bacterial Infections ; Drainage ; Female ; Humans ; Incidence ; Intrauterine Devices ; Menopause ; Middle Aged ; Peritonitis ; Premenopause ; Retrospective Studies ; Risk Factors ; Sepsis ; Uterine Cervical Neoplasms ; Uterus*