No abstract available.
Cleft Lip* ; Congenital Abnormalities* ; Nose* ; Transplants*

No abstract available.
Humans ; Multiple Birth Offspring ; Twins*

Stable angina is a chronic, systemic disease with a wide range of associated symptoms and clinical outcomes. Prompt diagnosis can be challenging for clinicians. Typical chest pain caused by stable angina occurs when the myocardium receives inadequate oxygen, resulting in myocardial ischemia. Various diagnostic tools including non-invasive tests such as coronary computed tomographic angiography and image-based stress tests have evolved over the last decade. An important factor in the selection of the proper diagnostic test for stable angina is assessment of the pre-test probability in the event of possible coronary arterial stenosis.

Stable angina is a chronic, systemic disease with a wide range of associated symptoms and clinical outcomes. Prompt diagnosis can be challenging for clinicians. Typical chest pain caused by stable angina occurs when the myocardium receives inadequate oxygen, resulting in myocardial ischemia. Various diagnostic tools including non-invasive tests such as coronary computed tomographic angiography and image-based stress tests have evolved over the last decade. An important factor in the selection of the proper diagnostic test for stable angina is assessment of the pre-test probability in the event of possible coronary arterial stenosis.

No abstract available.
Humans ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia* ; Pneumonia, Mycoplasma*

In modem medical industries as in others, it has been emphasized by many experts such as Dr. Mayer and Dr. Donabedean that there should be quality assurance activities applying statistical knowledges in the processes of medical management and medical staff themselves for the better medical care and customer satisfaction. Three of our quality assurance programs for the purpose of shortening the treatment time In the department of emergency medicine in Keimyung University, Dong-San Medical Center had been carried out during the period of June 94 through December 95. Our methodology was mainly the process emphasized ; finding the causes of delaying factors in various processes related to the works of nurses, doctors, laboratory services, radiology services etc. in the emergency room, holding various meetings among the related groups with genuine discussions, notifying the new results in each step, encouraging the positive ones and also applying the new leadership technics. During the period of June 94 through December 95(for 1.5 years), the average E.R. patient treatment time from registrations to dispositions had been reduced by about 2 hours (from 5 hours 3 minutes to 2 hours 5 minutes) and its variations among the different specialities had been narrowed down to significant degree (p<0.05) revealing the preprogram base line standard deviation of 2.43 to 1.28 in post program through continuous quality assurance programs. It was also noted that the successful results of Q/A program have been closely related to the fact that the process should be designed and redesigned repeatly as needed and that all the participants related were actively involved in the planning and redesigning processes.
Emergency Medicine ; Emergency Service, Hospital ; Humans ; Leadership ; Medical Staff ; Modems

BACKGROUND: Although the histologic picture of epidermolytic hyperkeratosis is diagnostic for bullous congenital ichthyosiform erythrokerma (BCIE), it is not specific for it. It is found also in several other conditions, that is, linear epidermal nevus, epidermolytic keratisis palmaris et plantaris and epidermolytic acnthoma. Among these, BCIE is caused by mutations of the defferentiation s0pecific keratins K1 and K1-. These mutations produce a weakened cytoskeleton that is prone to collapse resulting I cell fragility and lysis. But the pathogenesis of epidermal nevus showing the similar histologic feature with BCIE is not known. OBJECTIVE: The purpose of our study is to conpare the electron microscopic picture and the immunohistochemical features, and to find the possible pathogenesis of both diseases. METHODS: We evaluated the clinical, histopathologic nd electron microscopic features of 5 BCIE cases and 14 epidermal nevus cases which were histologically diagnosed with epidermolytic hyperkeratosis at the department of dermatology at Wonju Christian Hospital, Shinchon Severance Hospital and Yongdong Severance Hospital, from January 1981 to June 1994. The immunohistochemical staining(PAP method) using monoclonal antibody against cytokeratin was performed on BCIE and epidermal nevus. RESULTS: Light microscopy of both BCIE and epidermal nevus showed the same histologic changes including hyperkeratosis, increased keratohyaline granules, acanthosis and perinuclear vacuolization of upper malpighia layer. Electron mioroscopic findings in both diseases were similar. Aggregation of tonofilaments is noted in the squamous cells, but is not evident in basal cells.In immunohistochemical study of both diseases, 34betaE12 is stained in the whole epidermis and is stuonger ex0ressed in the basal layer tan suprabasal layers. LP34 staining is evident in suprabasal cell layers up to the cornified cell layer. CONCLUSION: Electron microscopy and immunohistochemical study of both diseases showed the same finding. We thind that a defect in the differentiation specific keratins, K1 and K10 is perhaps involved in epidermal nevus histologically showing epidermolytic hyperkeratosis as in BCIE.
Cytoskeleton ; Dermatology ; Epidermis ; Gangwon-do ; Hyperkeratosis, Epidermolytic* ; Intermediate Filaments ; Keratins ; Microscopy ; Microscopy, Electron ; Nevus* ; Triacetoneamine-N-Oxyl

A 28-year-old female devei,oped five rice-sized erythematous telaniectatic solid papules of her left side of cheek and numerous light brownish flat papules of her face two years before visiting our department of dermatology. Biopsy results of the erythematous papule vere dermal infiltration by well-differentiated, however, somewhat atypical and varying sized plasma cells involving epidermis, and the flat papule was that of verwca plana. Bone marrow aspirate was essentially normal. Primary cutaneous plasmacytoma is a rare disease. A significant proportion of patients with this ent on to develop systemic disease with a poor prognosis. Our patient was not treatead, bit only excised partially for biopsy. All skin lesions involuted two years later spontaneously and rema ns well until now six years later without recurring.
Adult ; Biopsy ; Bone Marrow ; Cheek ; Dermatology ; Epidermis ; Female ; Humans ; Plasma Cells ; Plasmacytoma* ; Prognosis ; Rare Diseases ; Skin

Cytophagic histiocytic panniculitis is a histiocytic disorder which is characterized by recurrent subcutaneous nodules, fever, pancytopenia, and abnormal hepatocyte function. Most patients had systemic involvement with hepatosplenomegaly and pancytopenia and, after a chronic course, usually developed a hemorrhagic diathesis that led to death. Rarely reported cases were shown to have had a non-fatal course. We report herein a case of cytophagic histiocytic panniculitis in the trunk and both upper arms of 34-year-old woman who had a benign course and also showed histopatholoigcally lipomembranous change in the subcutaneous lesion.
Adult ; Arm ; Female ; Fever ; Hemorrhagic Disorders ; Hepatocytes ; Humans ; Pancytopenia ; Panniculitis*

BACKGROUND: Differential diagnosis of lichen sclerosus et atrophicus( SA) and scleroderma is occasionally difficult. OBJECTIVE: The purpose of this study was to attempt differentiation between the two diseases using imrnunohistochemical stain and lectins. MEHTODS: Paraffin-embeddred sections of 4 cases of LSA and 11 cases of scleroderma were evaluated for this study. Using lectins, such as peanut agglutinin(PNA), siybean agglutinin(SBA), Ulex europaeus agglutinin-I(UEA-I) and Dolichos biflorus agglutinin(DBA) and the avidin-biotin-peroxi-dase complex(ABC) technique, differential lectin binding patterns betv een the two diseases were examined. RESULTS: In the case of LSA, PNA and SBA stained the upper and lower spinous layer of the epidermis, and UEA I also stained the spinous layer of the epidermis weakly, but no DBA was stained. In the case of scleroderma, PNA stained not only the spinous layer but also the basal layer, SBA stained the upper half of the spinous layer but not the lower half of the pinous layer of epidermis. But UEA-I stained the vascular endothelial cells of dermis instead of epidermis, and DBA stained only the basal layer of epidermis. CONCLUSION: Staining of these 4 lectins on paraffin-embedded sectians using ABC teehnique could be helpful in differenting LSA and scleroderma.
Dermis ; Diagnosis, Differential ; Dolichos ; Endothelial Cells ; Epidermis ; Lectins* ; Lichen Sclerosus et Atrophicus* ; Lichens* ; Ulex