Emergency nursing intervention should be provided to patients under fatal status with much quickness and accuracy. To improve the quality of emergency medical service, triage nurse systems, being implemented in advanced hospitals which successfully provide effective emergency services, are considered in this thesis. A triage nurse is defined as a nurse who first and immediately meets the patient at the very entrance of emergency department, and performs proper intervention according to the extent of injury. Triage functions include interviewing patients, physical evaluation, classifying patients, assigning nurses/doctors, and beds, performing preliminarily required tests and remedies, re-evaluation of waiting patients, emotional supports, arranging future medical services, and education. In Korea, triage nurse systems have not yet been introduced, however, some prleminary types of triage systems are being practised. The purpose of this thesis was to review the triage functions implemented in Korean emergency department and then to suggest a model of triage nurse system for Korean emergency departments. For field study, 10 emergency departments in Seoul, which have more than 13 nurses, are selected, and a nurse who have more than 1 year experience in emergency department was interviewed from each workshift, i.e. day, evening, and night. Data collection taken 17 days from Apr. 8 to Apr. 30, 1996. In the field study, we reviewed the triage functions performed in Korean emergency departments. 40.9% of interviewed nurses show that the triage functions are performed by general nurses, 18.42% and 10.15% indicate that the functions were performed by charge nurses and assigned nurses, respectively. Thus, triage nurse systems where pre-assigned nurses consistently perform triage functions were not yet introduced in Korean emergency departments. However, 96.7% of the nurses answered that triage systems are needed in their emergency departments and 82.77% showed that triage functions would be performed at the entrance of emergency department. A triage nurse systems will unload stresses which both patients and supporters cope with, provide secure and comfortable medical environments, and reduce the waiting time. Finally, it may be improve the patients' and supporters' satisfaction. Therefore, this study provides basic data to enhance emergency medical services and leads to a future study to implement and extend specialized nursing systems in emergency departments.
Data Collection ; Education ; Emergencies* ; Emergency Medical Services ; Emergency Nursing ; Emergency Service, Hospital* ; Humans ; Korea ; Nursing ; Nursing, Supervisory ; Seoul ; Triage*

Alopecia areata(AA) is a common dermatologic disease, the origin of which is still unknown. At least, it has been associated with some genetic influences in the etiopathogenesis. We have now evaluated AA patients to study the actual association of the genetic role by fingerprint analysis. The incidences of six or more arches were determined in 74 female and 86 male patients excluding alopecia totalis and universalis, and in healthy 167 female controls, based on Selmanowitz's thesis (1974). The results of this study are follows: 1. The difference between the frequency in AA patients(7. 5%) and in controls (3.3%) reaches the statistical significance(p<0.05 by x2-test). 2. The association of genetic background in AA is strengthened in the group of female patients(p<0. 01), recurrent episode(p<0.01). and multiplex farm (p<0.01). 3. Twenty patients(12. 5%) have family history. The incidence in 3(15.0%) of these patients is considerably common but not statistically significant. A correlation of biologic relevance and family predisposition in AA is not precluded. 4. The frequency of arches in patients and in controls is increased on both second fingers and decreased on both fourth fingers. It is more common on both second and left third fingers in female patients. The incidence of arches averages about 6 67% in patients and 4. 58% in controls.
Alopecia Areata* ; Alopecia* ; Dermatoglyphics* ; Female ; Fingers ; Humans ; Incidence ; Male

We experienced a case of granulation tissue occuring in lateral sulci of the right thumb, index, middle and left thumb, middle finger nails in 71-year-old psoriatic male patient taking 5pmg daily(0.6mg/kg/day) during 4th week of etretinate therapy. The excision of the granulation lesion and partial nail ablation was performed and his doses was lowered to 25mg daily (0. 3mg/kg/day). The condition were resolved with no recurrence 4 weeks later after the operation.
Acitretin* ; Aged ; Etretinate* ; Fingers ; Granulation Tissue* ; Humans ; Male ; Nails ; Recurrence ; Thumb

No abstract available.
Denture, Partial, Fixed*

We report herein a case of polymorphic pemphigoid in a 65-year-old woman, who had one-year history of generlized polymorphic eruption with intensely pruritic excoriated vesicobiullous lesions and residual pigmentation. Face and oral mucosa were spared. The skin biopsy specimen showed a subepidermal blister containing many eosinophils. Linear deposition of 1gG and C3 along the basement membrane was noticed on direct irnmunofluorescerice. Polyclonal garnmopathy with a tendency of beta-gamma bridging and increased IgG, IgA and kappachain, was frund on serum protein electrophoresis and immunoelectrophoresis. Skin lesions were well coritrolled by a combined therapy of prednisolone(20 mg/d), dapsone(100 mg/d) and cyclophosphamide(100 mg/d) for 4 months. Direct immunofluorescence performed 11 rnonths after the cnmpletion of the therapy was negative.
Aged ; Basement Membrane ; Biopsy ; Blister ; Electrophoresis ; Eosinophils ; Female ; Fluorescent Antibody Technique, Direct ; Humans ; Immunoelectrophoresis ; Immunoglobulin A ; Immunoglobulin G ; Mouth Mucosa ; Pemphigoid, Bullous* ; Pigmentation ; Skin

PURPOSE: The chemoembolization with Lipiodol and doxorubicin hydrochloride is used in patients with hepatocellular carcinoma. What condition is the ideal emulsion of Lipiodol and doxorubicin for excellent anticancer effect? METHOD AND MATERIALS: Microscopic evaluation was performed on the emulsions, which were varied with different specific gravities of doxorubicin solutions, degrees in mixing of the emulsion, and amount of Lipiodol. RESULT: 1. Maximal amount of doxorubicin solution was contained in Lipiodol droplets and the release of doxorubicin from the droplets were delayed, when specific gravity of doxorubicin was equal to that of Lipiodol (SG, 1.28). 2. The optimal therapertic ratio of Lipiodol and doxorubicin was 3:2 at least, as in the emulsion less than 3:2, unmixed free forms of doxorubicin solution were increased. 3. The emulsion mixed by pumping 50--100 times had smaller Lipiodol droplets and contained larger amount of doxorubicin solution in the droplets than by pumping 20 times. CONCLUSION: We recommend the emulsion with specific gravity of doxorubicin equal to Lipiodol (SG. 1.28), the ratio of Lipiodol and doxorubicin closo to 3:2, and the mixture prepased with puming 50--100 times.
Carcinoma, Hepatocellular* ; Doxorubicin ; Emulsions ; Ethiodized Oil ; Humans ; Specific Gravity

No abstract available.

Creutzfeldt-Jakob disease(CJD) is characterized clinically by rapidly progressive dementia with pyramidal, extrapyramidal, and cerebellar symptoms and signs, and histologically by spongiform change, neuronal loss and reactive gliosis. We have experienced 2 cases of CJD. Case 1 was a 36-year-old male who had suffered from myoclonus and cerebellar symptoms including sluggish speech, gait and balance disturbance. Case 2 was a 70-year-old female who had showed cognitive dysfunction, ataxic gait and disturbance of extraocular movement. Both patients, underwent brain biopsy. Case 1 revealed marked cortical atrophy, 2mm in thickness, with neuronal loss and astrocytic proliferation extending into white matter. The spongiform change, made up of many small, usually rounded or oval, vacuoles was noted mainly in the neuropil. Case 2 revealed remarkable spongiform change throughout the cortex and cytoplasmic vacuoles compressing the nuclei of neuronal cells were numerous. Neuronal loss and gliosis were also found without considerable change in the white matter. On double immunostaining against GFAP and PrP(Prion Protein), there was a weak positive reaction for PrP in the perinuclear cytoplasm in case 1, and a strongly positive reaction in case 2. The electron microscopic examination showed numerous membrane-bound vacuoles in neuropil and perikarya of neurons. The majority of the vacuoles were multiseptated by thin membranous structures. They demonstrated curled, or disrupted membrane, that had foldings and protrusions into the vacuolar clear spaces. There were neither identifiable virus-like particles nor amyloid deposition.
Female ; Male ; Humans

Primary germ cell tumor of the testis is rare, which occupies 1 to 2% of all reported malignant male neoplasms. Combined primary germ cell tumor of the testis composed of embryonal carcinoma and seminoma is more rare tumor. The authors experienced a case of 50-year old male who presented with painless enlargement of right testicle. He has had radical orchiectomy and diagnosed by pathologically as combined germ cell tumor of testis. The testicle is measuring 180 gm in weight and 9×6×5 cm in dimension, and almostly replaced by tumor mass. Grossly the tumor is rubbery solid smooth tumor mass, with variegated cut surface with geographically outlined diffuse necrotic area. Histologically the tumor is composed of two components of tumor, which are solid growth pattern of large round to polyhedral cells with clear or granular cytoplasm and distinct cell border, and anastomosing glandular and papillary arrangement of anaplastic epithelial cells. The former corresponds to seminoma, and the latter to embryonal carcinoma. Each tumor lobule is separated by abundant fibrous stroma.
Carcinoma, Embryonal ; Cytoplasm ; Epithelial Cells ; Germ Cells* ; Humans ; Male ; Neoplasms, Germ Cell and Embryonal* ; Orchiectomy ; Seminoma ; Testis*

Histiocytosis X(Langerhans cell histiocytosis) is a rare prolifertive disorder of Langerhans cells that includes Lettere-Siwe disease, Hand-Shiiller-Christian his ase and eosinophilic granuloma. Since many authors have reported in anintermediate and poarl classified form histiocytosis X has a namenclatural had nosologic problem. We report a case benign cutaneous variant of histiocytisis X. A four-month-old boy had shown multiple skin-colour papules on the trunk, head and nik for one month. Extensive in- vestigations failed to detcct any systemic involvement. The clixron microscopic findings of the skin biopsy specimen were Qefinitely diagnostic for histiocytosi. X Since he did not sbow evidence of internal organ involvernent and any further progression of he skin lesion, no therapy was given. Over the next two months the disease underwent spontane us and complete remission.
Biopsy ; Eosinophilic Granuloma ; Head ; Histiocytosis* ; Histiocytosis, Langerhans-Cell* ; Humans ; Langerhans Cells ; Male ; Remission, Spontaneous* ; Skin