Bart's syndrome was initially described as a genodermatosis characterized by congenital localized absence of the skin with blistering and nail deformities 1-3. However, it is considered as any type of epidermolysis bullosa(EB) with localized congenital absence of the skin on the extremities. A 33-day-old fbmale baby was presented with congenital absence of the skin over the left shin and dorsa of both feet which were covered with the thin, translucent, and brown-red glistening membranes. Blistering of the right calf and left great toe nail deformity were also noted. She was diagnosed as a recessive dystrophic EB by the histopathological, ultra- structural and immunomapping studies.
Blister ; Congenital Abnormalities ; Extremities ; Foot ; Membranes ; Skin ; Toes

Asian People/genetics* ; Gene Frequency ; Genetics, Population ; Humans ; Microsatellite Repeats/genetics* ; Phylogeny ; Polymorphism, Genetic/genetics*

Background: Hypotension following spinal anesthesia of Cesarean section is mainly caused by peripheral vasodilation and venous pooling due to sympathetic blockade. The degree of sympathetic blockade is known to affect the occurrence of hypotension after spinal anesthesia. The perfusion index (PI) and plethysmographic variability index (PVI) are non-invasive tools for measuring the vasomotor tone and volume status, respectively. The purpose of this study is to compare the trends of PI and PVI values between hypotension and normotension groups during Cesarean section following spinal anesthesia. Methods: Fifty-one parturients were divided into two groups whether they developed hypotension or maintained normotension after spinal anesthesia. Spinal anesthesia was performed with 0.5% hyperbaric bupivacaine (10 mg) and fentanyl (15 μg) at the L3-4 intervertebral space. The data of blood pressure, heart rate, PI and PVI were recorded every minute until delivery of baby. Results: Hypotension occurred in 61% of parturients during Cesarean section. The overall PI and PVI value after spinal anesthesia have gradually increased and decreased, respectively. The degree of increase and decrease in PI (p = 0.31) and PVI value (p = 0.35) was not significant between hypotension and normotension groups. Conclusions The trend of PI value has gradually increased while the PVI value has decreased, regardless of whether the parturient has experienced hypotension or not.

Background: Hypotension following spinal anesthesia of Cesarean section is mainly caused by peripheral vasodilation and venous pooling due to sympathetic blockade. The degree of sympathetic blockade is known to affect the occurrence of hypotension after spinal anesthesia. The perfusion index (PI) and plethysmographic variability index (PVI) are non-invasive tools for measuring the vasomotor tone and volume status, respectively. The purpose of this study is to compare the trends of PI and PVI values between hypotension and normotension groups during Cesarean section following spinal anesthesia. Methods: Fifty-one parturients were divided into two groups whether they developed hypotension or maintained normotension after spinal anesthesia. Spinal anesthesia was performed with 0.5% hyperbaric bupivacaine (10 mg) and fentanyl (15 μg) at the L3-4 intervertebral space. The data of blood pressure, heart rate, PI and PVI were recorded every minute until delivery of baby. Results: Hypotension occurred in 61% of parturients during Cesarean section. The overall PI and PVI value after spinal anesthesia have gradually increased and decreased, respectively. The degree of increase and decrease in PI (p = 0.31) and PVI value (p = 0.35) was not significant between hypotension and normotension groups. Conclusions The trend of PI value has gradually increased while the PVI value has decreased, regardless of whether the parturient has experienced hypotension or not.

BACKGROUND: Nationwide evaluation of physicians' smoking rate may be helpful to predict future trend of smoking in a general population. Thus, we investigated physicians' smoking rate and their habits in Korea. METHODS: Ten percent of physicians among the registered members of the Korean Medical Association were chosen by stratified random sampling and a mail questionnaire survey was conducted in 2000. Of the 2,977 physicians to whom the questionnaires were delivered, 1,248 (41.9%) responded. RESULTS: Overall smoking rate among Korean doctors was 29.9%. Smoking rate of males was 34.9% and that of females was 2.3%. In the current smokers, the most frequently reported age when they had begun smoking were 15~20 years (60.3%), the majority of daily smoking amount was less than or equal to 1 pack (92.5%), and those who were planning to quit smoking within 1 month were 11.9%. In the ex-smokers, the most frequently reported age when they had begun smoking were in their 20s (67.7%) and the most frequently reported age when they had stopped smoking were in their 30s (38.0%). CONCLUSION: The smoking rate of Korean physicians was estimated to be less than that of the general Korean population, but higher than that of physicians in major developed countries. More efforts to lower smoking rate of physicians and regular follow up is needed.
Developed Countries ; Female ; Humans ; Korea* ; Male ; Postal Service* ; Prevalence* ; Smoke* ; Smoking* ; Surveys and Questionnaires

Alpha-fetoprotein (AFP) is a well-known tumor marker for hepatocellular carcinoma, hepatoblastoma, and yolk sac tumors. There are several studies on AFP-producing tumors that arose from the gastrointestinal tract, pancreas, lung, kidney, and urachal tract. AFP-producing carcinoma of the gallbladder is extremely rare. We report a case of AFP-producing carcinoma of the gallbladder without liver involvement in a 58-year-old man with a gallstone, on which clinical, morphologic, and immunohistochemical studies were performed.
Male ; Humans ; Carcinoma, Hepatocellular ; Tumor Markers, Biological

Background: Studies have reported on the usefulness of whole spine magnetic resonance imaging (MRI) in evaluating specific diseases such as spinal tuberculosis, spinal trauma, spondyloarthropathies, and multiple myeloma. In studies concerning degenerative spinal disease, sample sizes were small and some did not provide information on how symptomatic coexisting lesions were treated. We evaluated the types and prevalence of coexisting spine lesions found on whole spine T2 sagittal screening performed at the time of routine cervical and lumbar spine MRI and evaluated the efficacy of such screening in degenerative diseases of the cervical and lumbar spine. Methods: We reviewed 1,757 and 2,266 consecutive cases where whole spine T2 sagittal screening had been performed with routine cervical and lumbar spine MRI, respectively, in patients with cervical and lumbar spinal degenerative diseases. Coexisting spine lesions were documented and statistical analysis was performed to investigate significant differences according to sex, age, and initial diagnosis. Electronic medical records were reviewed to determine whether additional interventions were necessary following such findings. Results: We reviewed 1,252 and 1,689 consecutive cases of routine cervical and lumbar spine MRI respectively, with whole spine T2 sagittal screening. Of the 1,252, 419 (33.5%) patients with cervical spinal degenerative disease had coexisting lesions in the thoracolumbar spine.Patients with ligament ossification disease of the cervical spine showed a higher prevalence of coexisting spine lesions. Sixty of the 419 (14.3%) patients with coexisting spine lesions warranted additional intervention or surgical treatment. Four hundred and eighty-one of 1,689 (28.5%) patients with lumbar degenerative disease had coexisting spine lesions in the cervicothoracic spine. Forty-eight of the 481 (10.0%) patients with coexisting spine lesions warranted additional intervention. In both patient groups, older patients showed a significantly higher prevalence of coexisting spine lesions than younger patients. Conclusion Considering the minimal extra time and cost in performing whole spine screening, its application to routine spine MRI can be considered in evaluating cervical and lumbar spinal degenerative diseases.

Background: Studies have reported on the usefulness of whole spine magnetic resonance imaging (MRI) in evaluating specific diseases such as spinal tuberculosis, spinal trauma, spondyloarthropathies, and multiple myeloma. In studies concerning degenerative spinal disease, sample sizes were small and some did not provide information on how symptomatic coexisting lesions were treated. We evaluated the types and prevalence of coexisting spine lesions found on whole spine T2 sagittal screening performed at the time of routine cervical and lumbar spine MRI and evaluated the efficacy of such screening in degenerative diseases of the cervical and lumbar spine. Methods: We reviewed 1,757 and 2,266 consecutive cases where whole spine T2 sagittal screening had been performed with routine cervical and lumbar spine MRI, respectively, in patients with cervical and lumbar spinal degenerative diseases. Coexisting spine lesions were documented and statistical analysis was performed to investigate significant differences according to sex, age, and initial diagnosis. Electronic medical records were reviewed to determine whether additional interventions were necessary following such findings. Results: We reviewed 1,252 and 1,689 consecutive cases of routine cervical and lumbar spine MRI respectively, with whole spine T2 sagittal screening. Of the 1,252, 419 (33.5%) patients with cervical spinal degenerative disease had coexisting lesions in the thoracolumbar spine.Patients with ligament ossification disease of the cervical spine showed a higher prevalence of coexisting spine lesions. Sixty of the 419 (14.3%) patients with coexisting spine lesions warranted additional intervention or surgical treatment. Four hundred and eighty-one of 1,689 (28.5%) patients with lumbar degenerative disease had coexisting spine lesions in the cervicothoracic spine. Forty-eight of the 481 (10.0%) patients with coexisting spine lesions warranted additional intervention. In both patient groups, older patients showed a significantly higher prevalence of coexisting spine lesions than younger patients. Conclusion Considering the minimal extra time and cost in performing whole spine screening, its application to routine spine MRI can be considered in evaluating cervical and lumbar spinal degenerative diseases.

Brown syndrome is known as limited elevation of the affected eye during adduction. It is caused by a disorder of the superior oblique tendon, which makes it difficult for the eyeball to look upward, especially during adduction. It is classified into congenital true sheath Brown syndrome and acquired simulated Brown syndrome. Acquired simulated Brown syndrome can be caused by trauma, infection, or inflammatory conditions. The surgical restoration of blowout fractures can also lead to limitations of ocular motility, including Brown syndrome. We report on three patients with acquired simulated Brown syndrome, who complained of diplopia and limitation of ocular motility after operations to treat blowout fractures.
Brown-Sequard Syndrome ; Diplopia ; Humans ; Ocular Motility Disorders ; Tendons

In treating deep second degree burn, it is important to induce reepithelization as soon as possible. So it is crucial to remove eschar after appropriate anesthesia. But in case of extensive wound area or anxiety of needle, we have been used topical anesthetics alternative to lidocaine injection based on its efficacy and safety. Even though it is rare but, we experienced a patient who suffered Central nervous system toxicity following topical anesthetics of lidocaine application. So we report a case with review of related articles.
Anesthesia ; Anesthetics* ; Anxiety ; Burns ; Central Nervous System* ; Humans ; Lidocaine ; Needles ; Wounds and Injuries