Ninety-one cases of genitourinary tract injuries which were admitted to Severance Hospital during the period from Jan. 1960 to Aug. 1968 were analyzed clinically and statistically. And it was investigated compared with previous papers 1) The rate of genitourinary injuries accounted for 7.3 per cent to the total admission patients during eight years sixty-nine per cent of all injuries were in men and thirty-one per cent in women. The age distribution was much the same as that found in previous literature. Most favorable age was in from 20 to50 years for 72.5 percent 2) The meet common involvement site was in urethra for32.9 per cent while external genitalia showing most common site in war wound Also iatrogenic ureteral injuries was relatively high in spite of most less commonest incidence in previous paper 3) Thirty-six per cent of all injuries weredue to traffic or vehicular accident and twenty-four per cent 'due to iatrogenic. Majority of these iatrogenic injuries occurred in pelvic operation. Falls kick and blow were listed not less frequently. 4) On observation of kidney injuries. predisposed hydronephrotic kidney was injured more frequently due to mild external forces and three cases of sixteen kidney injuries had hydronephrosis dueto stone and congenital ureteral stricture in this series 5) An incidence of ureteral injury during radical hysterectomy was variable in literature. but it was noted around 10 percent generally. In reviewing 197 cases of radical hysterectomy for carcinoma of cervix, incidence of ureteral injuries was 12 cases(7.3 per cent) and it was listed 9.3 percent including bladder injuries. 6) In investigating bladder injuries, 53 percent of injuries were associated with pelvic bone fracture And 87 per cent was extraperitoneal type and 13 per cent wasin intraperitoneal rupture. 7) Also majority of urethral injuries were associatedwith pelvic bone fracture especially in car accident cases and then involved posterior urethra for 85 per cent. And bulbous urethra was injured by straddle injury for 70 per cent.
Age Distribution ; Cervix Uteri ; Constriction, Pathologic ; Female ; Genitalia ; Humans ; Hydronephrosis ; Hysterectomy ; Incidence ; Kidney ; Male ; Pelvic Bones ; Rupture ; Ureter ; Urethra ; Urinary Bladder ; Wounds and Injuries

BACKGROUND: The distribution of Malassezia yeasts on normal human skin was varied according to the age and race of the volunteers and the methodologies used. In Korea, most reports of Malassezia yeast distribution have relied on direct skin smears rather than culture methods. OBJECTIVE: The aim of this work was to perform a comprehensive survey of the distribution of Malassezia yeasts on normal human skin to provide a base line for a companion study of Malassezia yeasts in patients with various dermatoses. METHODS: Malassezia yeasts were cultured using the swabbing technique from the scalp, forehead, chest, upper back, upper arm and upper thigh in 137 subjects, infancy to 80 years of age. RESULTS: Malassezia yeasts were present in the lowest incidence(0-30%) on six sites of infants and present in 60.0-66.7% on the sebum-rich sites (scalp, forehead, chest, upper back) of children aged 1-9. Malassezia yeasts were present in 80.0-86.7% on the sebum-rich sites of the elderly group(over 60 years of age), about the same frequency as in the middle-aged groups. The population density of these organisms was significantly higher on the upper back than on the forehead, chest, upper arm and upper thigh in all age groups except the infant group and the group aged 1 to 9 (p<0.05). There were no regular quantitative variations in the distribution of Malassezia yeasts on a given site between age groups. On Leeming and Notman media, besides three morphotypes of Malassezia yeasts reported by Cunningham et al(1990), one additional type was identified. CONCLUSION: The results showed regional variations in the distribution of Malassezia yeasts in all ages except infancy and no regular age variations on a given site. Additionally, four colony types of Malassezia yeasts were found. The findings of our study coold help to investigate the role of Malassezia yeasts in related disorders.
Aged ; Arm ; Child ; Continental Population Groups ; Forehead ; Friends ; Humans* ; Infant ; Korea ; Malassezia* ; Population Density ; Scalp ; Skin Diseases ; Skin* ; Thigh ; Thorax ; Volunteers ; Yeasts*

BACKGROUND: Cutaneous vasculitis associated with viral hepatitis seems to occur as a hypersensitivity reaction against the circulating viral antigens. Hepatitis B virus(HBV)-encoded X antigen(HBxAg) is known to participate in the carcinogenesis of hepatocellular carcinoma(HCC) by the inactivation of p53. However, HBxAg has been found in chronic infiammatory lesions without the overexpression of p53. Accordingly, not only EBsAg and HBcAg but also HBxAg may be involved in HCC-associated cutaneous vasculitis, regardless of the alteration of p53. OBJECTIVE: This study was conducted to investigate the expression of HBV-encoded antigens in cutaneous vasculitis accompanied by HBV hepatopathy. Additionally, we have compared the expression of 3 HBV antigens and p53 between vasculitic patients with HCC and in others showing HCC-non-associated vasculitis. METHODS: Immunohistochemically, we examined the expression of HBsAg, HBcAg, and HBxAg in the tissue specimens taken from the vasculitic lesions of the 33 HBsAg-positive enrolled patients with cutaneous vasculitis proven by skin biopsy. RESULTS: 1. The immunohistochemical positivity rate to HBsAg in vasculitic patients with HBV hepatopathy was 66.7% overall. It was 90% in HCC-associated vasculitic subjects and 56.5% in the vasculitic subjects without HCC, respectively. 2. We found the expression of HBxAg in 80% of the vasculitic subjects showing HCC. The vasculitic patients without HCC showed 17,3% of the positivity rate to HBxAg. 3. We could not find the overexpression of p53 in the vasculitic tissue specimens of the HCC patients without the cutaneous metastasis from primary HCC. CONCLUSION: HBsAg, HBcAg and HBxAg may participate in the pathogenesis of cutaneous vasculitis with HBV hepatopathy, regardless of tumorigenesis.
Antigens, Viral ; Biopsy ; Carcinogenesis ; Hepatitis ; Hepatitis B ; Hepatitis B Core Antigens ; Hepatitis B Surface Antigens ; Humans* ; Hypersensitivity ; Malassezia* ; Neoplasm Metastasis ; Skin* ; Vasculitis ; Yeasts*

Solitary cutaneous reticulohistiocytoma is a type of reticulohistiocytosis. The cytoplasm of tumo cells characteristically shows abundant eosinophilic "ground-glass" appearance. We report a case of this rare cutaneous tumor in a 54-year-old woman. It was present as a single nodule on the right index finger of the patient for seven years.
Cytoplasm ; Eosinophils ; Female ; Fingers ; Histiocytosis, Non-Langerhans-Cell* ; Humans ; Middle Aged

Pityriasis lichenoides chronica is characterized by unknown etiology, chronicity and by being essentially asymptomatic and refractory to therapy. Nine patients with pityriasis lichenoides chronica were treated with orally administrated 8-Methoxypsoralen and UVA irradiation(PUVA Therapy). After S-45 PUVA treatments, lesions were completely cleared.
Humans ; Methoxsalen ; Pityriasis Lichenoides* ; Pityriasis* ; PUVA Therapy*

This study examined the effects of referral requirements for insurance patients which have been enforced since July 1, 1989 when medical insurance coverage was extended to the whole population except beneficiaries of medical assistance program. The requirements are mainly aimed at discourag - ing the use of to Vii; ry care hospitals by imposing restrictions on the patient's choice of a medical service facility. The expectation is that such change in the pattern of medical care utilization would produce several desirable effects including increased efficiency in patient care and balanced development of various types of medical service facilities. In this study, these effects were assessed by the change in the number of out-patient visits and bed-days per illness episode and the share of each type of facility in the volume of services and the amount of expenditures after the implementation of the new referral system. The data for analysis were obtained from the claims to the insurance for government and school employees. The sample was drawn from the claims for the patients treated during the first six months of 1989, prior to the enforcement of referral requirements, and those of the patients treated during the first six months of 1990, after the enforcement. The 1989 sample included 299,824 claims (3.6% of total) and the 1990 sample included 332,131(3.7% of total). The data were processed to make the unit of analysis an illness episode instead of an insurance claim. The facilities and types of care utilized for a given illness episode are defined to make up the pathway of medical care uti lization. This pathway was conceived of as a Markov Chain process for further analysis. The conclusion emerged from the analysis is that the enforcement of referral requirements resulted in less use of tertiary care hospitals, and thereby decreased the volume of services and the amount of insurance expenses per illness episode. However, there are a few points that have to be taken into account in relation to the conclusion. The new referral system is likely to increase the use of medical services not covered by insurance, so that its impact on national health expenditures would be different from. that on insurance expenditures. The extension of insurance coverage must have inereased patient load for all types of medical service organizations, and this increase may be partly responsible for producing the effects attributed to the new referral system. For example, excessive patient load for tertiary care hospitals may lead to the transfer of their patients to other types of facilities. Another point is that the data for this study correspond to very early phase of the new system. But both patients and medical care providers would adapt themselves to the new system to avoid or overcome its disadvantages for them, so as that its effects could change over time. Therefore, it is still necessary to closely monitor the impact of the referral requirements.
Health Expenditures ; Humans ; Insurance Coverage ; Insurance* ; Markov Chains ; Medical Assistance ; Outpatients ; Patient Care ; Referral and Consultation* ; Tertiary Healthcare

No abstract available.
Antigens, Surface*

No abstract available.
Peroneal Nerve*

Since the myofascial trigger point(MFTrP) has been described fifty years ago, its underlying pathophysiology has been remained unclear. The diagnosis also depends on the characteristic pain, tenderness and physical findin gs, which is yery subjective. In recent years, some physicians investigated the objective findings of MFTrP, using the pressure algometer and thermography. We investigated the electromyographic findings of MFTrP to evaluate the clinical usefulness of local twitch response(LTR) and sympathetic skin response (SSR), and to evaluate the electrophysiologic characteristics of MFTrP. 21 patients, diagnosed as myofascial trigger point syndrome on upper trapezius and so on, were evaluated for the triggering pain with visual analog scale(VAS), pressure threshold(THpr) using pressure algometer(Dolorimeter), LTP with concentric needle electrode and SSR on the palm. There was a significant negative correlation between VAS and THpr, but no significant correlation with electromyographic findings of LTR. Thus LTR could support the existence of MFTrP electrodiagnostically, but, could not explain the clinically correlated severity of MFTrP. There were only 3 patients showing abnormal SSR, who were all complaining the sympathetic sympathetic symptoms on the affected arm with reffered pain. Even though referred pain to arm and hand existed. SSR was normal because suggested autonomic dysfunction of MFTrP is localized mechanism. Among the 13 patients underwent the trigger point block, 8 patients who showed no residual LTR immediate after MFTrP block, had a great symptomatic improvement of MFTrP in a week, but 5 patients who showed the residual LTR did not, Regardless of complaint of pain and soreness immediate after block, loss of LTR would be predicted as a good treatment result. In some cases, spontaneous EMG activity exist within the 3-4mm sized focus of MFTrP. although the taut band of MFTrP is 3-4cm length and depth. But this focus of MFTrP is a electrophysiologic changes within a muscle, not a structural changes seen by ultrasonography.
Arm ; Diagnosis ; Electrodes ; Electromyography ; Hand ; Humans ; Needles ; Pain, Referred ; Skin ; Superficial Back Muscles ; Thermography ; Trigger Points* ; Ultrasonography

No abstract available.
Anencephaly* ; Autopsy*