BACKGROUND: Polyarteritis nodosa(PAN) is a disease of necrotzing vasculitis which has a clinical spectrum encompassing those cases of multisystem involveme it and skin-limited variant. The clinical course of cutaneous PAN has been considered to be a benign one, however there is sorne controversy regarding its nosological entity. OBJECTIVE: To characten the clinical course of the patients with cutaneous PAN and determine whether or not it is a benign disease or something more sever. METHODS: Clinical and laboratory findings in 8 patients with Logy-proven cutaneous PAN but without any detectable visceral involvement were observed periochelly during a follow-up period over 18 months. Meticulous physical and pertinent laboratory earinations were performed each time during their visits. RESULTS: Livedo reticulari, on the lower legs was the mostorenon cutaneous findings with these patients. During the follow-up periods there were no suspected abnormal physical and laboratory findings to have other organ involvement in all 8 patients Serologic examinations for antineutrophil cytoplasmic antibody and hepatitis-B surface antigen revealed negative in all patients tested. CONCLUSION: The follow-up periods of 2 years or so does not seem to be long enough in characterizing the clinical features of PAN. However, the cutaneous: on of PAN can be regarded as a benign cutaneous variant of the disease having no visceral lesion of arteritis, even though mild degrees of constitutional symptoms and a few laboratory abnormlites could be seen.
Antibodies, Antineutrophil Cytoplasmic ; Antigens, Surface ; Arteritis ; Follow-Up Studies ; Humans ; Leg ; Polyarteritis Nodosa* ; Vasculitis

This is an autopsy case of a 6 month old girl who suddenly died of respiratory distress during sleep. She had suffered from mild but frequent episodes of common cold and was treated for eczema for several days. At autopsy, the heart was enlarged and weighed 100 gm. A firm and gray-white tumor, measuring 4.5 x 3.8 x 2.8 cm, was located in the interventricular septum and encroached upon the wall of left ventricle. The mass was well demarcated but was not encapsulated. Neither necrosis nor calcification was present. Microscopically the tumor was composed of haphazardly arranged bundles of collagen fibers and fibroblasts. Myocardial cells are intermingled with the fibroblasts at the margin of the tumor. Massive edema of the lung and congestion of the liver and spleen were pronounced.

PURPOSE: To evaluate the role of CT in the diagnosis of bowel and mesenteric injury we studied the CT findings and its usefulness in patients of abdominal trauma. MATERIALS AND METHODS: CT scans of 27 patients who were confirmed to have bowel and/or mesenteric injury due to abdominal trauma were analyzed retrospectively. Of these 27 patients 15 had bowel injury only and 12 had both bowel and mesenteric injury. CT findings analysed were bowel wall thickening, presence or absence of highly attenuated bowel wall, sentinel clot, mesenteric infiltration, peritoneal fluid collection and free intraabdominal air in cases with bowel injury only and with both bowel and mesenteric injury respectively. Ten patients had other accompanying abdominal injuries, such as liver, spleen, pancreas, kidney, bladder injuries, intraperitoneal abscess or retroperitoneal hemorrhage. RESULTS: Findings observed were bowel wall thickening in 23 cases(85%), peritoneal fluid collection in 21 (78%), highly attenuated bowel wall in 19(70%), mesenteric infiltration in 17(63%), free intraperitoneal air in 10 (37%) and sentinel clot in 7(26%). Pneumoperioneum were observed in 10 of 24 patients(41.7%) having bowel perforation. Two cases did not show any CT findings suggesting bowel and/or mesenteric injury. There was no significant difference in the prevalence of the CT findings between the patient group with bowel injury only and the patient group with both bowel and meseneric injury. CONCLUSION: CT scan is a useful tool in evaluating the degree and extent of bowel and/or mesenteric injury as well as in planning the patient's management.
Abdominal Injuries ; Abscess ; Ascitic Fluid ; Diagnosis ; Hemorrhage ; Humans ; Kidney ; Liver ; Pancreas ; Prevalence ; Retrospective Studies ; Spleen ; Tomography, X-Ray Computed ; Urinary Bladder

There is a wide array of designation for cutaneous vascular disorders based on clinical characteristics, histology, embryology, cellular biology, and hemodynamics. The cutaneous vascular disorders can be divided into hemangioma and vascular malformation according to the biologic classification based on cell kinetics i.e. endothelial hyperplasia. There are clinical and histologic differences between them. In this study, clinical, histologic and im-munohistochemical evaluations were attempted on 40 cases of cutaneous vascular disorders diagnosed the period between 1985 and 1993. The results are as follows: 1) Twenty-three out of forty cases were immunoreacive for proliferating cell nuclear antigen(PCNA). The lesions composed of capillary-sized blood vessels with endothelial hyperplasia were diffusely reactive, whereas those composed largely of dilated blood vessels with or without focal endothelial hyperplasia were only focally reactive. 2) Each groups of the classic classification contained both reactive and nonreactive cases except nevus flammeus and juvenfle hemangioma. 3) In contrast to the cases nonreactive for PCNA, those reactive for PCNA contained areas of proliferating small vessels, which showed reactivity for PCNA. In conclusion, the cutaneous vascular disorders diagnosed by the classic classification are heterogeneous in the pattern of the endothelial hyperplasia and the PCNA staining. Therefore it should be classified by the clinical and the histologic characteristics.
Hemangioma

OBJECTIVE: Written information could be helpful for senior population to adhere to complex medication therapies, but must be well prepared and empirically assessed to achieve such end. We purposed to develop a drug information leaflet for senior citizens by applying 'performance-based user-testing.' METHODS: We employed a user-testing, a mixed method to figure difficulties out with patients' leaflets from the user perspective. The cycle made of test and revision can be repeated as necessary. We recruited senior citizens with age of 65 or above who were taking antihypertensive medications at the point of participating and excluded the elderly who suffered illiteracy. We firstly rectified a drug information leaflet of antihypertensive medications for the general public distributed by the Korean authority based on focus group interviews (9 participants). The revised leaflets were tested four times with 8~12 participants in each round (40 seniors in total). We targeted to develop a leaflet which more than 80% of participants understood 10 key information. Main outcomes measures were to be able to find information and be able to understand information. This study was approved by the Yeungnam University Research Ethics Committee. RESULTS: Focus group interviews identified difficulties with small font of words, professional language, long information, and a poor structure. The leaflet was revised and in the first round questionnaire found problems with 4/10 information points; interviews disclosed all but one (normal blood pressure range) were ill-understood. The second round questionnaire and interview found fewer problems but the comprehensiveness of participants was still poor in several points. For the third and fourth rounds we revised the leaflets in the individual-targeted manner. Finally, the fourth round showed all key information found and understood by at least 80% of participants except one question about drug name. CONCLUSION: The drug leaflets need to be developed in a personalized mode for the seniors. There was a limit for Korean seniors to understand nonproprietary name of their drugs because they used to producers' trade names which the Korean health system predominantly works with.
Aged ; Antihypertensive Agents* ; Blood Pressure ; Ethics Committees, Research ; Focus Groups ; Health Literacy ; Humans ; Literacy ; Methods

OBJECTIVES: The purpose of this study was to investigate effects of structural and functional characteristics of social network on social adjustment in people with mental illness. METHODS: 236 members of the people with mental illness who were enrolled in day hospital, community mental health center and social rehabilitation center participated in the survey. RESULTS: Of structural and functional characteristics of social network, the influenced factors on social adjustment were network size of professional, social support (family, friend and professional) and conflict with professional. When controlling socio-demographic and disorder characteristics, this regression model affected significantly on social adjustment but the power of influence reduced slightly. CONCLUSION: In order to improve the social adjustment of people with mental illness, it is necessary for social network to provide them with more emotional and social resources. Especially, it is important for mental health professionals to build active partnership with the people with mental illness as consumer. For people with mental illness, the economic stability through guaranteed income such as disability benefits, and occupational rehabilitation is very important.
Friends ; Hospitals, Community ; Humans ; Mental Health ; Rehabilitation Centers ; Social Adjustment

No abstract available.
Meningitis, Aseptic*

Hemangioblastomas comprise 1 to 2% of all intracranial neoplasm, and 8 to 12% of tumors within the posterior fossa. They are composed of admixtures of three different cell types; endothelial cells, pericytes and stromal cells. Although most hemangioblastomas arise sporadically, they are associated with von Hippel-Lindau disease in about 20% cases. We have experienced a case of multiple hemangioblastomas occuiing in the cerebellum, medulla oblongata and cervical spinal cord simultaneously in a 55-year-old male. He had complained of headache, dizziness, generalized weakness and gait disturbance for 2 weeks. The patient had neither specific family history nor increased hematocrit. MRI showed a nonenhancing cystic lesion with an enhancing mural nodule in the right cerebellar hemisphere and two separate enhancing nodules in the medulla oblongata and dorsal cervical spinal cord at the 5-6th. Grossly, the excised mass of the cerebellum, 2.5 x 2 x 1.8cm, was solid to partly cystic, and that of spinal cord, lcm in diameter, was mostly solid. Microscopically, the tumor was composed of thin-walled blood vessels in variable size and interspersed stromal cells. The stromal cells revealed dimorphic cytoplasm that were either homogeneous and eosinophilic, or clear and vacuolated. Immunohistochemically, the endothelial cells reacted positively for glial fibrfllaty acidic protein(GFAP) and vimentin. The stromal cells reacted diffusely positively for vimentin, focally positively for GFAP and S-100 protein near the periphery of the tumor, focally positivel for neuro specipic enolase(NSE), and negatively for lysozyme, desmin and chromogranin. Ultrastructurally, the stromal cells contained numerous microfilaments and lipid droplets.

Hemangioblastomas comprise 1 to 2% of all intracranial neoplasm, and 8 to 12% of tumors within the posterior fossa. They are composed of admixtures of three different cell types; endothelial cells, pericytes and stromal cells. Although most hemangioblastomas arise sporadically, they are associated with von Hippel-Lindau disease in about 20% cases. We have experienced a case of multiple hemangioblastomas occuiing in the cerebellum, medulla oblongata and cervical spinal cord simultaneously in a 55-year-old male. He had complained of headache, dizziness, generalized weakness and gait disturbance for 2 weeks. The patient had neither specific family history nor increased hematocrit. MRI showed a nonenhancing cystic lesion with an enhancing mural nodule in the right cerebellar hemisphere and two separate enhancing nodules in the medulla oblongata and dorsal cervical spinal cord at the 5-6th. Grossly, the excised mass of the cerebellum, 2.5 x 2 x 1.8cm, was solid to partly cystic, and that of spinal cord, lcm in diameter, was mostly solid. Microscopically, the tumor was composed of thin-walled blood vessels in variable size and interspersed stromal cells. The stromal cells revealed dimorphic cytoplasm that were either homogeneous and eosinophilic, or clear and vacuolated. Immunohistochemically, the endothelial cells reacted positively for glial fibrfllaty acidic protein(GFAP) and vimentin. The stromal cells reacted diffusely positively for vimentin, focally positively for GFAP and S-100 protein near the periphery of the tumor, focally positivel for neuro specipic enolase(NSE), and negatively for lysozyme, desmin and chromogranin. Ultrastructurally, the stromal cells contained numerous microfilaments and lipid droplets.

Vibrio damsela is a halophilic bacterium that has been reported to cause skin ulcers and death in damselfish (Chromis punctipinnis) as well as wound and soft-tissue infections in human. Most of the previously reported cases in humans haute involved wound infections associated with exposure to seawater or handling fish. We experienced a case of primary septicemia due to V. damsela after eating raw fists in a healthy 66-year-old woman who had neither wounds nor history of exposure to sea- water. She presented fever and diarrhea followed by rapidly pregressive bullae and painful edema on left band and forearm. The patient was Improved by intensive surgical debrldement of necrotic tissue and antibiotic therapy.
Aged ; Diarrhea ; Eating ; Edema ; Female ; Fever ; Forearm ; Humans ; Seawater ; Sepsis* ; Skin Ulcer ; Vibrio* ; Wound Infection ; Wounds and Injuries