Recently radiation and radioisotope are being used widely in many fields such as medicine and industry. But only a few papers were reported about the radio dermatitis due to industrial use of radiation. Authors experienced 4 cases of occupational radiodermatitis due to Ir-192 occur red during the radioisotope traspierce test. All 4 patients noticed painful swelling, erythema, and bullae on their fingers or palms 1-2 weeks after exposure. All laboratory tests to detect ystemic effects of radiation were normal. Three patients recovered after treatment with systemic and topical corticosteroid and emollient cream for 2-4 weeks. But one patient suffered from complication of fibrosis and recurrent cellulitis on his fingers. We discussed about the working situation of our patients and reviewed the literatures about the radiodermatitis.
Cellulitis ; Dermatitis ; Erythema ; Fibrosis ; Fingers ; Humans ; Radiodermatitis

BACKGROUND: Pulmonary complications including pneumonia and pulmonary edema frequently develop in critically ill surgical patients. Lung ultrasound (LUS) is increasingly used as a powerful diagnostic tool for pulmonary complications. The purpose of this study was to report how LUS is used in a surgical intensive care unit (ICU). METHODS: This study retrospectively reviewed the medical records of 67 patients who underwent LUS in surgical ICU between May 2016 and December 2016. RESULTS: The indication for LUS included hypoxemia (n = 44, 65.7%), abnormal chest radiographs without hypoxemia (n = 17, 25.4%), fever without both hypoxemia and abnormal chest radiographs (n = 4, 6.0%), and difficult weaning (n = 2, 3.0%). Among 67 patients, 55 patients were diagnosed with pulmonary edema (n = 27, 41.8%), pneumonia (n = 20, 29.9%), diffuse interstitial pattern with anterior consolidation (n = 6, 10.9%), pneumothorax with effusion (n = 1, 1.5%), and diaphragm dysfunction (n = 1, 1.5%), respectively, via LUS. LUS results did not indicate lung complications for 12 patients. Based on the location of space opacification on the chest radiographs, among 45 patients with bilateral abnormality and normal findings, three (6.7%) and two (4.4%) patients were finally diagnosed with pneumonia and atelectasis, respectively. Furthermore, among 34 patients with unilateral abnormality and normal findings, two patients (5.9%) were finally diagnosed with pulmonary edema. There were 27 patients who were initially diagnosed with pulmonary edema via LUS. This diagnosis was later confirmed by other tests. There were 20 patients who were initially diagnosed with pneumonia via LUS. Among them, 16 and 4 patients were finally diagnosed with pneumonia and atelectasis, respectively. CONCLUSIONS: LUS is useful to detect pulmonary complications including pulmonary edema and pneumonia in surgically ill patients.
Anoxia ; Critical Care* ; Critical Illness ; Diagnosis ; Diaphragm ; Fever ; Humans ; Lung* ; Medical Records ; Pneumonia ; Pneumothorax ; Pulmonary Atelectasis ; Pulmonary Edema ; Radiography, Thoracic ; Retrospective Studies ; Ultrasonography* ; Weaning

The importance of garlic as a cause of hand eczema has been a matter of debate. Diallyldisulfide is considered as the main allergen in garlic. Twentv two antigens of the modified European standard series and diallyldisulfide of 5%, 2%, 1%, 0.5%, 0.1% in petrolatum were patch tested in 44 patients with hand eczema. Diallylclisi.!lfide was also tested in 13 women as a control. The results were summerized as follows. l. In patch testing with the European standard series, nickel sulfate (22.7%), cobalt chloride (18.2%), fragrance mix (13.6%), balsam of Peru (9.1%) and termerosal (6.8%) were the cornmon allergens which showed positive reactions. The overal positive rate was 59.1 % (26/44). 2.5% diallyldisulfide showed an irritant reaction in 6 (46.2%) out of 13 controls and in 16 (36.4% ) out of 44 patients. 2% diallyldisulfide showed an irritant reaction in 2/13 (15.4 %) in the control group and 6/44 (13.6%) in the patient group. All 13 controls and 44 patients were negative iin tests with diallyldisulfide of 1%, 0.5%, 0.1%. Our results indicate that patch testing with diallyldisulfide of 1% petrolatum is reommended in order to avoid an irritant reaction when contact allergy to garlic is suspetel. 3. Garlic is suspected as an irritant in provoking hand eczema. True contact allergy to garlic in hand eczema seems to be rare.
Allergens ; Cobalt ; Eczema* ; Female ; Garlic* ; Hand* ; Humans ; Hypersensitivity ; Nickel ; Patch Tests ; Peru ; Petrolatum

PURPOSE: To investigate the levels of radiation exposure of an operator which may be influenced by the wearing an apron, type of procedure, duration of fluoroscopy and operator's skill during various interventional procedures MATERIALS AND METHODS: Radiation doses were measured both inside and outside the apron(0.5mm lead equivalent) of the operator by a film badge monitoring method and the duration of fluoroscopy was measured in 96 procedures prospectively. The procedures were 30 transcatheter arterial embolizations (TAE), 25 percutaneous transhepatic biliary drainages (PTBD), 16 stone removals (SR), 15 percutaneous needle aspirations (PCNA) and 10 percutaneous nephrostomies(PCN). To assess the difference of exposure by the operator's skill, the procedures of TAE and PTBD were done separately by groups of staffs and residents. RESULTS: Average protective effect of the apron was 72.8%. Average radiation exposure(unit:micro Sv/procedure) was 23.3 in PTBD by residents, 10.0 in PTBD by staffs, 10.0 in SR, 8.7 in TAE by residents, 7.3 in TAE by staffs, 9.0 in PCN and 6.0 in PCNA. Average radiation exposure of residents were 1.9 times greater than those of staffs. CONCLUSION: Radiation exposure was not proportionally related to the duration of fiuoroscopy, but influenced by wearing an apron, various types o[procedure and operator's skills.
Aspirations (Psychology) ; Film Dosimetry ; Fluoroscopy ; Needles ; Pregnenolone Carbonitrile ; Proliferating Cell Nuclear Antigen ; Prospective Studies

OBJECTIVES: Pneumonia is one of the leading causes of death in the intensive care unit (ICU). Many biomarkers for predicted prognosis have been suggested; among these, procalcitonin (PCT) is known to increase in cases of bacterial infection. However, there have been many debates regarding whether PCT is an appropriate prognostic marker for pneumonia. Therefore, we investigated whether PCT can serve as a biomarker for pneumonia, and compared it with CURB-65, which is a known tool for predicting the prognosis of pneumonia. METHODS: Levels of PCT and CURB-65 scores were compared between 30-day non-survival (n = 30) and survival (n = 101) patients. Relationships between PCT and CURB-65 were determined by using linear regression analysis, as well as by using receiver operating characteristic (ROC) curve analysis and calculation of the area under the curve (AUC). High and low PCT groups were compared. RESULTS: High PCT and high CURB-65 score were positively associated with 30-day mortality. For the prediction of 30-day mortality, initial PCT and CURB-65 exhibited AUCs of 0.63 and 0.66; these were not significantly different (P = 0.132). We found that the high PCT group had a higher rate of initial treatment failure (91%, P = 0.004). CONCLUSIONS: Initial PCT can be a prognostic biomarker for mortality in severe pneumonia, similar to the CURB-65 score. Initial high PCT was positively associated with initial treatment failure.
Area Under Curve ; Bacterial Infections ; Biomarkers ; Cause of Death ; Critical Care ; Humans ; Intensive Care Units ; Linear Models ; Mortality ; Pneumonia ; Prognosis ; ROC Curve ; Treatment Failure

Purpose: Three years of adjuvant imatinib is the standard treatment for resected gastrointestinal stromal tumors (GISTs) with rupture, but the recurrence rate is prominently high. We aimed to investigate the efficacy and safety of 5-year adjuvant imatinib compared with 3-year treatment in patients with a ruptured GIST following surgical resection. Materials and Methods: A total of 51 patients were included in the analysis. The assessment of GIST rupture was based on Nishida’s classification. Twenty patients who were diagnosed before November 2013 were treated with 5 years of imatinib, and 31 patients who were diagnosed after November 2013 were treated with 3 years of imatinib. We retrospectively compared the clinical outcomes of the two groups. Results: Baseline characteristics and the incidence of the adverse events were generally comparable between the two groups. During a median follow-up duration of 43.8 months and 104.2 months in the 3- and 5-year group, 8 and 9 patients had a disease recurrence, respectively. The 5-year group showed better recurrence-free survival (RFS) than the 3-year group. In multivariate analysis, low mitotic index was a significant independent favorable prognostic factor for RFS, while 5-year imatinib treatment was marginally associated with a favorable RFS. Conclusion Five years of adjuvant imatinib treatment in patients with ruptured GIST was associated with favorable survival outcomes with manageable toxicity profiles. Our findings warrant validation and confirmation in future studies.

Mauriac syndrome consists of a triad of poorly controlled diabetes, profound growth retardation and hepatomegaly. We experienced a case of Mauriac syndrome in an 18-year-old girl who had poorly controlled diabetes mellitus, short stature, hepatomegaly and central obesity. Also at the time of examination, she had complications of diabetic cataract and nephropathy. Fourteen years prior to admission, she was diagnosed as diabetes mellitus at a hospital. Thereafter, she had been managed with irregular insulin injection. On physical examination at admission, her height was 135cm(<3 percentile) and her weight was 39kg(<3 percetile). She was short and obese. The liver was 5 cm palpable below the right subcostal margin. Her sexual maturation was Tanner stage I. On ophthalmologic examination, the cataracts were observed on both eyes and diabetic retinopathy was absent. Diabetic nephropathy could not be confirrned by kidney biopsy due to her mother's refusal. We studied the hormonal, radiographic and histological abnormalities. The hormonal study was normal and the bone age was by delayed as much as 10 years. The liver biopsy revealed glycogen accumulation in hepatocyte. She was consistent with Mauriac syndrome. She was managed by strict diabetic control with insulin therapy, diabetic diet and intensive education. She was discharged with well controlled blood glucose. Five months later, growth acceleration and sexual maturation have not been observed, but hepatomegaly subsided. (J Korean Pediatr Soc 2000;43-837-841)
Acceleration ; Adolescent ; Biopsy ; Blood Glucose ; Cataract ; Diabetes Mellitus* ; Diet, Diabetic ; Diabetic Nephropathies ; Diabetic Retinopathy ; Disulfiram ; Education ; Female ; Glycogen ; Hepatocytes ; Hepatomegaly ; Humans ; Insulin ; Kidney ; Liver ; Obesity, Abdominal ; Physical Examination ; Sexual Maturation

Congenital absence of the gallbladder is a rare anomaly and an interesting subject. The overall incidence of gallbladder agenesis is said to approximately 0.035% to 0.065%. It is extremely difficult to make the correct diagnosis of gallbladder agenesis preoperatively in symptomatic patients because its clinical and radiological features are like those of cholecystitis, cholelithiasis, or choledocholithiasis in patients with anatomically normal biliary tracts. Gallbladder agenesis is suspected when the surgeon or the pathologist has failed to identify the gallbladder in its usual position but ectopic location or necrosis of the gallbladder from any causes should be ruled out. Recently, two cases of gallbladder agenesis were encountered in adult patients. We summarize our experience and give a brief review of the literature.
Adult ; Biliary Tract ; Cholecystitis ; Choledocholithiasis ; Cholelithiasis ; Diagnosis ; Gallbladder* ; Humans ; Incidence ; Necrosis

Occupational allergic contact dermatitis cases who had visited the patch test clinics of Seoul National University Hospital(1984-1988) and Koryo General Hospital(1982-1988) were analyzed in this study. Patch test was performed with either Hollister-Stier standard battery or European standard battery in addition to the patients own materials and other commercially available antigens. Patch test was peformed according to the recommendation of International Contact Dermatitis Research Group. The result is summarized as follows. 1. Out of 946 cases 65 (6.9%) were suspected as having occupational dermatoses clinically and 35 (3.7%) were diagnosed as occupational allergic contact dermtitis after patch test. 2. Sixteen (45.7%) out of the 35 patients were male and 19 (54.3%) were female. Twenty one (60.0%) patients were in the age of 20 to 40 years. 3. The occupational distribution of 35 patients were medical personnels (8), cement workers (7), industrial workers (5), hair dressers (5), farmers (3), merchants (3), cooks (2) and painters (2). 4. Potassium dichromate, nickel sulfate and rubber chemicals were the most common occupational allergens. We also reviewed the Korean literatures related to the occupational dermatoses.
Allergens ; Dermatitis, Allergic Contact ; Dermatitis, Contact* ; Dermatitis, Occupational ; Female ; Hair ; Hospitals, General* ; Humans ; Male ; Nickel ; Patch Tests* ; Potassium Dichromate ; Rubber ; Seoul ; Skin Diseases

There is the trend of increasing number of outpatients who are requiring surgical intervention because of medical insurance and general improvement of economic state. Ambulatory surgical clinics are prospering in the United States. Thus we have analyzed 1957 cases of outpatient anesthesia excluding local infiltration performed by surgeons from total of 4302 cases o fout patient surgery during the 5 year period between 1975 and 1979. The results of this analysis were as follows: 1) Ketamine IM or IV was used as a sole agent in 500 cases who were under 12 years of age and mean operation and recovery time were 19.95 and 58. 45 minutes, respectively. 2) Mean operation and recovery time for 1,125 cases of pentothal+N2O+O2, anesthesia were 15. 55 and 108. 23 minutes, respectively. 3) For 321 cases of halothane+N2O+O2, anesthesia, mean operation and recovery time were 40.67 and 145. 94 minutes, respectively. 4) During recovery period there were no serious complications or mortality. 5) The majority of 1,125 among 1,957cases were gynecological outpatients and the rest were distributed among the surgical departments and dermatology, 6) Pentothal, nitrous oxide, halothane and ketamine were used safely for the outpatient anesthesia according to our experiences.
Anesthesia* ; Clinical Study* ; Dermatology ; Halothane ; Humans ; Insurance ; Ketamine ; Mortality ; Nitrous Oxide ; Outpatients ; Surgeons ; Thiopental ; United States