Decubitus ulcer is often seen in the skin and underlying tissue of debilitated or immobilized patients as the result of prolonged pressure and impaired circulation. It manifests chiefly as an ulcer over bony prominences, but tumefaction is an extremely unusual presentation. A 53-year old male, a paralytic of the lower extremity for 18 years, developed a recurrent decubital ulcer despite repeated surgical repair, from which a rapidly growing, large fungating mass grew within a month. The last resected mass was bosselated and measured 15x9x3 cm with a major area of cicatrix-like induration, interdigitated with skeletal muscle bundles at the central area. Microscopically, the mass was composed of an upper half of active granulation tissue layer and a deeper half of dense, poorly cellular, fibrocollagenous bundles admixed with florid proliferation of atypical fibroblasts, but the absence of mitosis and the multifocal admixture of active inflammatory process-granulation tissue formation seemed to help exclude genuine fibromatosis, nodular fasciitis or proliferative myositis. We assume that this rapidly growing pseudofibromatosis is an additional manifestation of a prolonged decubitus ulcer, possibly related to the modified reparative process of decubitus ulcer following repeated excisions, for which we propose a term of decubitoma.

A case of right-sided infective endocarditis in a 22-year-old male with ventricular septal defect of perimembranous type, right ventricular(RV) infundibular and pulmonic valve stenosis was reported. The vegetations were found on the mural endocardium of RV infundibulum and pulmonic valve. Streptococcus viridans was identified in 5 consecutive blood cultures, Pulmonary embolism and septic infarction in the lung was associated with systemic embolization, which was manifested by left renal infarction. The RV infundibular stenosis was due to anomalous muscle bundle at the proximal portion. Therefore, we thought that the mechanism of RV infundibular vegetation was probably due to 'Venturi effect and turbulence'. Several clinical features which were found in this case were also reviewed.
Constriction, Pathologic ; Endocarditis* ; Endocardium ; Heart Septal Defects, Ventricular ; Humans ; Infarction ; Lung ; Male ; Pulmonary Embolism ; Viridans Streptococci ; Young Adult

Computed Tomograms of 45 patients with or without lung mass were reviewed to determine the characteristics of the major and minor fissures. Also pulmonary vascular distibutions were analyzed to localize each pulmonary lobe. The results were as follows; 1. Each major fissure area was imaged frequently as lucent band, less frequently dense band. 2. The minor fissure areas were imaged as oval or triangular lucent zones. The oval or triangularlucent zones were as same frequency. 3. Avascular planes without above mentioned lucent zones were also correspond to minor fissure areas. 4. Slices of avascular zones were observated between pulmonary arteries to posterior segment or apicoposterior segment of upper lobe and to superior segement of lower lobe on both lungs.
Humans ; Lung ; Pulmonary Artery

BACKGROUND: There is a long-standing controversy whether melanocytes in vitiligo of more than 1 year duration are actually lost or still present. Resolving this matter is essential in understanding the underlying pathology and for the development of the treatment. On previous immunohistochemical and ultrastructural studies of vitiligo lesions, damage of melanocyte and keratinocyte in early lesions were reported and complete absence of melanocyte in long standing lesions were known. OBJECTIVE: This study aimed to determine the existence of the differences in pathologic changes in melanocytes according to the duration of the lesion. METHODS: We investigated the vitiliginous skin samples from 31 patients with early(less than 1 year duration) vitiligo and 30 patients with long standing(l to 5 years duration) vitiligo under the electron microscopy. RESULTS: Multiple degenerative changes in melanocytes were observed in the early and long standing lesions. In long standing lesions, degeneration of melanocytes including pyknotic, in-dented nuclei, vacuolated cytoplasms and blunted dendrites were more pronounced than early lesions. Even in long standing lesions, definite or presumptive melanocytes were observed in 16(53.3%) of 30 cases. CONCLUSION: Our results suggest that the melanocytes of vitiligo lesions were damaged and that the percentage of degenerative changes increase in accordance with the duration of the lesion. However, in long standing lesions as well as in early lesions, some residual melanocytes can be observed ultrastructurally.
Cytoplasm ; Dendrites ; Humans ; Keratinocytes ; Melanocytes ; Microscopy, Electron ; Pathology ; Skin ; Vitiligo*

PURPOSE: The purpose of this study was to explore the meaning of pregnant women's experiences with drinking alcohol during first trimester of pregnancy METHODS: The data were collected through in-depth interviews of 7 pregnant women who drank alcohol in the first trimester. Giorgi's phenomenological method was used for data analysis. RESULTS: Findings included 6 main themes and 14 themes. The main themes concerning pregnancy and drinking were: ‘Open attitude in drinking, History of drinking in family or spouse, Seeking information in how drinking affects pregnancy, Regret not doing planned pregnancy and not quitting drinking before pregnancy, Willing to stop drinking until the child birth, Awareness about importance of preconception care. CONCLUSION: The results of this study provide a deeper understanding of pregnant women's experiences of drinking alcohol during the first trimester of pregnancy. These results can be used in the development of strategies to prevent drinking alcohol during first trimester and to support preconception care and prenatal care.
Binge Drinking ; Child ; Drinking* ; Family Planning Services ; Female ; Humans ; Methods ; Parturition ; Preconception Care ; Pregnancy ; Pregnancy Trimester, First* ; Pregnancy* ; Pregnant Women* ; Prenatal Care ; Spouses ; Statistics as Topic

No abstract available.
Lymphedema*

PURPOSE: This study aimed to investigate trends in home-visit nursing care by agencies' characteristics under the national long-term care insurance system. METHODS: Cochran-Mantel-Haenzel tests were conducted, using data drawn from the nationwide long-term care insurance claim database of the Korean National Health Insurance Corporation from 2009 to 2011. RESULTS: The number of home-visit nursing care agencies has decreased continuously since 2009. There were also similar trends in the total amount of service provided by home-visit nursing care agencies, the number of recipients, the number of employees, and payments. This study showed that there were statistically significant differences in the trends in home-visit nursing care by agencies' characteristics. Despite the overall downward trend, there were some increases in the percentage of home-visit nursing care provided by agencies which were established by individuals, located in large cities, and which combined home-visit care with home-visit bathing. CONCLUSION: Home-visit nursing care agencies are responsible for providing community-based healthcare services. For past three years, however, they have not been utilized to their full potential. Understanding the trends in home-visit nursing care by agencies' characteristics is important to develop utilization strategies for home-visit nursing care.
Delivery of Health Care ; Home Nursing ; Insurance, Long-Term Care ; Long-Term Care ; National Health Programs ; Nursing Care

Tatbion is a tripeptide, reduced form of Glutathione(GSH or p-glutamyl-cysteiny1 -glycine). Glutathione(SH compound)is believed to inhibit melanin formation by combining witb the copper in tyrnsinase whicb is essential in the conversion of tyrosine to DOPA (3, 4-dihydroxyphenylalanine) and DOPA to DOPA-quinone or by forming cornplex with the intermediate in the tyrosine-to-melaa.in reaction. The effect of Tathion in the treatment of melasma has not been reported in Korea. We have observed the effect of Tatbion in 150 patients with melasma. After the average duration of Gwks of treatment(50-100mg tree tirnes/daily), we were abIe to grade the results as follow. Excellent(Pigmentation almost disappeared): 17. 4 % Good (Pigmentation markedly improved): 56. 7% Fair (Pigmentation slightly improved: 7. 3% None (No effect) : 18.6% The result showed relatively good effects of Tathion in the treatment of 122pts (81.4%) with melasma in total. The brief review of literature on the treatment of melasma was undertaken.
Copper ; Dihydroxyphenylalanine ; Glutathione* ; Humans ; Korea ; Melanins ; Melanosis* ; Tyrosine

The present study was performed to evaluate the effect of sulfhydryl compounds, cysteine and glutathione, on the size of melanosomes and the ratio of melanosormai stages of epidermal melanocytes in UV-irradiated black mice. The results were as follows; 1. Both of cysteine and glutathione showed significant diminution in the short axis of melanosomes and the percentage of stage 4 melanosomes of epidermal melanocytes in C57BL black mice skin. 2. The length of short axis of melanosomes in glutathione-treated group is smaller than those in cysteine-treated group at the end of 3rd week of intraperitoneal injection. The percentage of stage IV melanosomes significantly decreased in glutathione-treated group and cysteine-treated group at the end of 3rd week and 5th week respectively. 3. In glutathione-treated group, the short axis of melanosomes and the percentage of stage 4 melanosomes both decreased in proportional to the period of intraperitoneal in]ection.
Animals ; Axis, Cervical Vertebra ; Cysteine ; Glutathione ; Injections, Intraperitoneal ; Melanocytes* ; Melanosomes ; Mice* ; Skin ; Sulfhydryl Compounds*

No abstract available.
Free Tissue Flaps* ; Maxilla*