Ota's nevus is a mongolian spot-like macular blue-black or gray-brown patchy pigmentation that most commonly occurs unilaterally in areas innervated by the first and second division of the trigeminal nerve. We report a case of Ota's nevus treated by combination therapy with cryosurgery and a Q-switched Alexandrite laser. A 48-year-old female had had a type III Ota's nevus from birth. Cryosurgery was tried at first using hard chalk dry ice on the lesion of the forehead and cheek. After that, The Q-switched Alexandrite laser was used three times at twelve week intervals at the site of the eyelid. Good therapeutic effects were gained and our patient was very satisfied. There were no complications or scarring. A Biopsy of the area treated revealed a similar histological pattern with significantly less melanin indicating melanin removal. Combination therapy with cryosurgery and an Alexandrite laser on the Ota's nevus may be cheaper, more effective and a safer method. It may also reduce the limitation of the two methods when used individually.
Biopsy ; Calcium Carbonate ; Cheek ; Cicatrix ; Cryosurgery* ; Dry Ice ; Eyelids ; Female ; Forehead ; Humans ; Lasers, Solid-State ; Melanins ; Middle Aged ; Nevus of Ota* ; Parturition ; Pigmentation ; Trigeminal Nerve

Despite recent advances in the development of novel targeted chemotherapies, the prognosis of malignant glioma remains dismal. The chemo-resistance of this tumor is attributed to tumor heterogeneity. To explain this unique chemo- resistance, the concept of cancer stem cells has been evoked. Cancer stem cells, a subpopulation of whole tumor cells, are now regarded as candidate therapeutic targets. Here, the author reviews and discusses the cancer stem cell concept.
Brain ; Brain Neoplasms ; Glioma ; Neoplastic Stem Cells ; Population Characteristics ; Prognosis

Emergency Medical Services, more commonly known as Emergency Medical Services (EMS), is a system that provides emergency medical care and public safety. EMS is infamous as a market failure, which cannot reach the break-even point financially due to operation of 24 hours and 365 days, and maintenance personnel. Thus, government's intervention is inevitable to balance the allocation of medical resources. Vulnerable area still exists for transport and patient care, and quality of EMS is behind the advanced countries. Furthermore, professionalism of 119 ambulance service is below par, also survival rate of cardiac arrest patient is low in Korea. To solve these problems, the Ministry of Health and Welfare plans to provide EMS within 30minutes by resolving of emergency vulnerable area for EMS. To improve quality of emergency medical centers, criteria of evaluation will be changed from structure to process and outcome. According to the result, differential financial support will be applied. To lower the preventable death rate as of advanced countries, 6 regional trauma centers will be run 24-hours operation for severe trauma patients. Professional education programs for emergency medical technician such as 119 providers will be reinforced. The quality management of medical consulting will be improved by appointment of medical consultants in 119 situation rooms. Also, medical safety for individuals suffering from sudden cardiac arrest will be provided in the place where large numbers of people gather by installing 1,000 Automatic External Defibrillator equipment every year.
Ambulances ; Consultants ; Death, Sudden, Cardiac ; Defibrillators ; Delivery of Health Care ; Education, Professional ; Emergencies ; Emergency Medical Services ; Emergency Medical Technicians ; Financial Support ; Heart Arrest ; Humans ; Hypogonadism ; Korea ; Mitochondrial Diseases ; Ophthalmoplegia ; Patient Care ; Public Health ; Stress, Psychological ; Survival Rate ; Trauma Centers

No abstract available.
Cytomegalovirus Infections*

Vesiculobullous eruptions are a rare cutaneous manifestation of systemic lupus erythematosus (SLE). They are related to intense inflammation within the cutaneous lesions and subsequent blister formation. We report a case of vesiculobullous eruption of SLE in a 23-year-old male. The bullous eruptions were present ori the lip, forehead, both feet and hands. He met ARA(American Rheumatism Association) is criteria for a diagnosis of SLE and the eruptions developed during a systemic attack of the disease. Routine histology of the lesion showed subepidermal blisters with intact epidermis and dense neutrophilic infiltration in the upper dermis. Direct immunofluorescence of lesional skin showed a linear-granular pattern of immune deposits at the dermoepidermal junction. Electronmicroscopy of the lesional skin showing subepidermal bullae are located beneath the lamina densa. Combination therapy of prednisolone and hydrochloroquine showed complete clearing of the lesions within several weeks. We observed a good response without evidence of recurrence.
Blister ; Dermis ; Diagnosis ; Epidermis ; Fluorescent Antibody Technique, Direct ; Foot ; Forehead ; Hand ; Humans ; Inflammation ; Lip ; Lupus Erythematosus, Systemic* ; Male ; Neutrophils ; Prednisolone ; Recurrence ; Rheumatic Diseases ; Skin ; Young Adult

No abstract available.
Hydranencephaly*

PURPOSE: In order to provide a systematic and standardized treatment course for MVD patients, a critical pathway (CP) program was developed and the results of its long term application were analyzed. METHODS: This was a methodological study. The CP was established and applied to 75 (step I) and 1,216 (step II). Another group of 56 with similar features was used as a control group. RESULTS: The application of CP turned out to be useful in many regards: the rate of hearing loss was reduced from 1.8% to 0% (step I) and 0.5% (step II), and low cranial nerve palsy was reduced from 1.8% to 1.3% and 0.7%, respectively. The length of hospitalization decreased by 2.56 days (25.2%) for step I and 3.05 days (30.0%) for step II. Days of ICU stay were reduced by 7.9% and 1.8%. The total cost per patient was reduced by 14.8% (step I). The cost per day was increased by 13.7% and 52.4%. An increase in the patient satisfaction index was noted, as shown in the ICU information guide (p=.002). CONCLUSION: The development and application of CP was found to improve the quality of medical treatment and the efficacy of hospital management in MVD patients. Well organized and efficient system and multidisciplinary teamwork are the key component of the successful application of CP.
Cranial Nerve Diseases ; Critical Pathways* ; Hearing Loss ; Hospitalization ; Humans ; Methods ; Microvascular Decompression Surgery* ; Patient Satisfaction ; Quality Control

No abstract available.
Animals ; Horns* ; Pregnancy*

No abstract available.
Seizures*

A clinical study was made on 108 patients with pelvic bone fractures and 37 patients with lower urinary tract injury in the Capital Armed Forces General Hospital during the period of 3 years from January, 1978 to December, 1980. Emphasis was placed on the mechanism of the bladder and urethral injuries. The results were summarized as follows: 1. The most common cause of pelvic bone fractures was traffic accident (88.0%). 2. 37 cases (34.3%) of the pelvic bone fractures were associated with lower urinary tract injuries. These included 17 ruptures of the urethra, 14 bladder injury and 6 bladder and urethral injuries. 3. Among the total bladder injuries (20 cases), we found 14 extraperitoneal ruptures of the bladder. 4 intraperitoneal ruptures and 2 bladder contusion. 4. Among the 23 urethral injuries, membranous urethral injuries were prominent, 19 membranous urethral ruptures and 4 bulbous urethral ruptures.
Accidents, Traffic ; Arm ; Contusions ; Hospitals, General ; Humans ; Pelvic Bones* ; Rupture ; Urethra ; Urinary Bladder ; Urinary Tract*