A case of znelanotic whitlow is presented which resembles clinically as chronic paronichia. Patient was 71 years old man and he has had a single brownish pigmented spot on left mid. finger since 3 years ago which was progressively grow and skin biopsy could be established the pathological diagnosis of superficial malignant melanoma.
Aged ; Biopsy ; Diagnosis ; Fingers ; Humans ; Melanoma ; Skin

PURPOSE: The aim of this study was to develop a baptist electronic Nutritional Screening Program (B-eNSP) that could be easily used to identify patients with nutrition at risk or malnutrition on their admission to hospital using an integrated medical information system and to evaluate validity, reliability and efficiency of B-eNSP. METHODS: From June 1 2009 to June 21 2009, we enrolled 496 patients for prospective research. We analyzed age, sex, weight, height, weight loss in the last 3 months, serum albumin, alteration of dietary intake, gastrointestinal symptom, functional capacity, diagnosis and its relationship to nutritional requirements, physical examination and Subjective Global Assessment (SGA). B-eNSP included body mass index (BMI), weight loss in the last 3 months, serum albumin. Each component was scored. Sensitivity and specificity were calculated to evaluate the validity of the B-eNSP. The receiver operating characteristic (ROC) curve was drawn by using B-eNSP to choose a cut-off value that maximizes sensitivity and specificity and Yoden Index. Comparison with SGA and the reliability of the B-eNSP was done using kappa statistics. RESULTS: The maximum Yoden Index was 0.866 and the cut-off value of the ROC curve was 2. A B-eNSP score higher than 2 was defined as nutrition at risk or malnutrition. Reliability of the B-eNSP was in accordance with SGA by kappa 0.845. CONCLUSION: The B-eNSP can be used efficiently to identify patients with nutrition at risk or malnutrition by simply using an integrated medical information system.
Body Mass Index ; Electronics ; Electrons ; Humans ; Information Systems ; Malnutrition ; Mass Screening ; Nutritional Requirements ; Physical Examination ; Prospective Studies ; Protestantism ; ROC Curve ; Sensitivity and Specificity ; Serum Albumin ; Weight Loss

In recent years, the rate of the thracolumbar and lumbar fractures rends to be increasing as the traffic accidents and industrial accidents frequently occurs. The purpose of this study is to review the results of conservative treatment for 73 patients with thoracolumbar and lumbar fractures and to review the failed 6 cases after conservative treatment, who were admitted and treated at National Medical Center during the period the period from January 1986 to June 1992. The following results were obtained: 1. Among the 65 cases of compression fracture, we performed hyperextension body cast in patient with height loss more than 30% and bed rest & brace in patient with height loss less than 30%, And in 63 cases, it showed good results. But two cases treated by bed & brace showed complaint such as radicular pain and persisdent back pain. 2. Among the 6 cases of burst fracture without neurological involvement, two cases treated by casting showed good result, but four cases treated by bed rest & brace showed complaint such as claudication and persistent back pain. 3. All cases of Chance fracture treated by casting showed good result. 4. There was no correlation between loss of correction of kyphotic angle and overall result. 5. Among the cases of poor result, we operated four cases which included two cases of instability & two cases of spinal stenosis and their results were good.
Accidents, Occupational ; Accidents, Traffic ; Back Pain ; Bed Rest ; Braces ; Fractures, Compression ; Humans ; Spinal Stenosis ; Spine

Although the incidence of leprosy is decreased considerably, the deformity and disability of it is serioues. In the hand, combined median and ulnar nerve affection is most common, and it leads to many problems including opposition dysfunction and claw hand deformity. And opposition dysfunction is most significant disability in the hand function, so its correction or reconstruction is mandatory We performed 20 cases of opponensplasty from Oct. 91 to Apr. 94 at National Medical Center, and analyzed its results according to new assessment criteria invented by authors, and evaluated the efficacy of the operative treatments. The results were as follows: 1. The patients were 9 males and 11 females, average age was 48 years old, and average duration of paralysis was 28 years. The mean follow-up period was 2.8 years. And most common type of nerve affection was combined low median and high ulnar nerves. 2. We performed 18 cases of Burkhalter opponensplasty using extensor indicis proprius and 2 cases of Riordan opponensplasty using ring finger sublimis at the leprosy hands. 3. According to authors assessment criteria for leprosy hand, the result of operative treatment was excellent in two, good in ten, fair in seven, and poor in two patients. So we obtained more than good results in 50% patients. 4. We could obtain good result with Burkhalter opponensplasty in leprosy hand, especially when combined with proper preoperative physical therapy and adjuvant operation for release of contracture and joint stiffness.
Animals ; Congenital Abnormalities ; Contracture ; Female ; Fingers ; Follow-Up Studies ; Hand ; Hand Deformities ; Hoof and Claw ; Humans ; Incidence ; Joints ; Leprosy ; Male ; Paralysis ; Tendon Transfer ; Ulnar Nerve

Chronic recurrent multifocal osteomyelitis (CRMO) is a rare and recently recognized disease of unknown etiology, characterized by remission and exacerbation of multiple bone lesions which radiologically and pathologically have the appearance of hematogenous osteomyelitis. The natural history appears to be slow and spontaneous resolution of the osseous lesions without specific treatment. And antimicrobial agents seem to have no beneficial effect. In proper clinical setting, CRMO should be considered, because recognition of this entity would help us to avoid costly and potentially harmful diagnostic and therapeutic interventions. We report a case of a 48-year-old adult who had chronic recurrent multifocal osteomyelitis.
Adult ; Anti-Infective Agents ; Humans ; Middle Aged ; Natural History ; Osteomyelitis

Clinical study was carried out on the 64 hemodialysis patients(HD) with chronic renal failure who had been treated from December 1992 to July 1993 in Yeungnam University Hospital. The following results were obitained. In hematologic parameters, MCH was 28.8±2.0pg, and MCV was 92.4±4.7fl. Result revealed normochromic and normocytic anemia. Mean values of serum ferritin were 657.4±292.0ng/ml in men and 511.5±370g in women. Mean values of serum iron were 145.5±63.7µg/dl. Mean values of transferrin saturation was 61.6±28.4%. Serum frerritin, serum iron and transferrin saturation were higher in HD group than normal reference. In erythropoeitin treatment group, Hb and Hct were significantly higher than non-erythropoietin treatment group. Amount of transfusion was significantly higher in non-erythropoietin treatment group than erythropoeitin treatment group(p<0.05). Values of iron, transferrin saturation were significantly higher in abnormal liver function test(LFT0 hemodialysis group than normal LFT group(p<0.05). Transfusion amounts revealed positive correlation with ferritin(r=0.4675), transferrin satruation (r=0.3823) and iron(r=0.3386) (p<0.05).
Anemia* ; Clinical Study ; Erythropoietin* ; Female ; Ferritins ; Humans ; Iron ; Kidney Failure, Chronic ; Liver ; Male ; Renal Dialysis ; Transferrin

Coenzyme Q is concentrated in Golgi apparatus membranes and mitochondria, but not in other membranes. Although it is difficult to prove the metabolic action of coenzyme Q administered exogenously in clinical cases, the effect of this substance can be evaluated by criteria based on clinical findings. In an attempt to evaluate the effect of coenzyme Q for the treatment of 67 patients(male 26 cases, female 41 cases) of congestive heart failure, we administered Coenzyme Q1030mg daily for 4 to 8 weeks. Most of them were valvular heart disease(74.6%) and hypertension (14.9%). Clinical effects were evaluated at least 4 weeks later by the criteria using a scoring method of severity of congestive heart failure which was devised by Ishiyama, etc. In summary, a definite effect was found in 13 cases(19%) and a mild effect was observed in 46 cases(69%). During treatment there were no significant side effects, and also no significant changes in heart rate and blood pressure.
Blood Pressure ; Estrogens, Conjugated (USP)* ; Female ; Golgi Apparatus ; Heart ; Heart Failure* ; Heart Rate ; Humans ; Hypertension ; Membranes ; Mitochondria ; Research Design ; Ubiquinone

No abstract available.
Family Practice* ; Follow-Up Studies* ; Humans ; Internship and Residency*

Fewer than one half of patients with acute myocardial infarction is a candidate for thrombolytic therapy. Current data revealed that primary coronary stenting may be useful alternative to intravenous thrombolytic therapy for acute myocardial infarction in these subset of patients. We experienced a patient presenting with acute myocardial infarction and acute promyelocytic leukemia in whom thrombolytic therapy was thought be not eligible due to hemorrhagic tendency. Primary coronary stenting was performed successfully without complications. Follow-up angiography revealed no evidence of restenosis or stent occlusion.
Angiography ; Follow-Up Studies ; Humans ; Leukemia, Promyelocytic, Acute ; Myocardial Infarction ; Stents* ; Thrombolytic Therapy

To evaluate the features of pyuria related to the bacteriuria, 140subjects were studied from Jan. 1987 to Dec. 1987. They pyuria was frequently developed from the age 30 to 60 years old, and male to female ratio was 1:1.41. The most common disease was urethrocystitis that was shown 42.8%. Common precipitating factors were urethral catheterization (25%) and urinary tract obstruction (11.4%). Through the observation, symptomatic pyuric patients were 66 subjects (47.1%), and the subjects with significant urine culture were 121 subjects (86.4%). In the urine culture, the most common bacteria was E. coli (41.4%), and the next was Pseudomonas (19.3%). A large percentage of E. coli and Pseudomonas was susceptible of amikin. The pyuria due to S. epidermidis and Accinatobacter was well treated. High therapeutic rate was observed in the acute pyelonephritis (71%) and urethrocystitis (67%). In the persistent urinary tract infection, there were relapsing (22 cases) and recurrent urinary tract infection (16 cases).
Amikacin ; Bacteria ; Bacteriuria ; Clinical Study* ; Female ; Humans ; Male ; Precipitating Factors ; Pseudomonas ; Pyelonephritis ; Pyuria* ; Urinary Catheterization ; Urinary Catheters ; Urinary Tract ; Urinary Tract Infections