This study was undertaken to investigate to compare the ratio of positive reactions to benzoic acid(BA), sorbic acid(SA) and cinnamic acid(CA) which are well known materials producing non-immunologic contact urticaria. Various concentrations(0.l% to 5%) and different vehicles(petrolatum, water, hydrophilic ointment base) were used in open and 20 minutes closed test using Finn chamber on Scanpor tape. One hundred total subjects were consisted of nonallergic patients and normal persons. The results were as follows ; 1. Total numbers of positive reactions were 69 in closed test(CT) and 60 in open test(OT), regardless of the materials and vehicles. 2. Total riumbers of positive reactions in BA, SA and CA were 68, 31, 35 in CT and 59, 20, 14 in OT respectably. 3. CT showed much more positive reactions than OT with all materials tested except 0.l% SA in water. 4. Hydrophilic ointment base showed a better reactivity than any other vehicles in CT. But in OT, petrolatum, water, hydrophilic ointment base showed better reactivity in BA, SA, CA respectably. 5. Almost all the reactions appeared within 45 minutes and disappeared within 3 hours. Erythema preceded edema and persisted 30 minutes to 1 hour after dissappearance of edema. 6 Itching, burning and tingling sensation were the only symptoms observed except. localized erythema and edema.
Benzoic Acid ; Burns ; Edema ; Erythema ; Humans ; Petrolatum ; Pruritus ; Sensation ; Sorbic Acid ; Urticaria* ; Water

No abstract available.
Humans ; Microcomputers*

We report a case of Becker's nevus associated with smooth muscle hamartoma, in a 21-year-old male patient, which shows clinically match-head sized, flat topped, round to oval, grouped papules with hairs on the outer surface of the right arm, and microscopically reveals numerous bundles of smooth muscle fiber in the dermis.
Arm ; Dermis ; Hair ; Hamartoma* ; Humans ; Male ; Muscle, Smooth* ; Nevus* ; Young Adult

No abstract available.
Female ; HELLP Syndrome* ; Pregnancy

BACKGROUND: Target Controlled Infusion (TCI) is designed to achieve a predicted target blood concentration based on population pharmacokinetics and it provides the closest approximation for any individual patients. This study determined which target is appropriate for propofol induction using a TCI in korean adullt patients premedicated with midazolam. METHODS: Sixty six patients (ASA I or II, 18~55 years) premedicated with midazolam were allocated randomly to receive an infusion to achieve and maintain a target blood concentration of 3, 4, 5 and 6 microgram/ml using a TCI. Induction time was measured as the interval from the start of the infusion to loss of verbal contact and induction within 3 min was considered as successful. Calculated concentration, induction dose, context sensitive decrement time, vital signs, pain score and side effects were checked and compared each other during induction period. RESULTS: The success rate when the target was 3 microgram/ml was 25%, 58.8%, 77.8% and 100% when targets were 4 microgram/ml, 5 microgram/ml and 6 microgram/ml respectively. EC50 for induction was 3.87 microgram/ml and EC95 was 5.71 microgram/ml. Calculated concentration, induction dose, context sensitive decrement time in 3, 4, 5 microgram/ml group showed no differences among groups, but 6 microgram/ml group showed statistically significant differences compared with other groups. Vital signs, pain score and side effects showed no differences among groups. CONCLUSIONS: Target concentration of 5~6 microgram/ml would successfully induce anesthesia in the majority of patients premedicated with midazolam without major hemodynamic changes.
Anesthesia* ; Hemodynamics ; Humans ; Midazolam ; Pharmacokinetics ; Propofol* ; Vital Signs

Essential thrombocythemia is one type of the related chronic myeloproliferative disorders that also include poly-cythemia vera, chronic myelogenous leukemia, and idiopathic myelofibrosis. It is a rare disorder of unknown origin characterized by thrombocytosis, excessive megakaryocytes, hemorrhage, and thrombotic complication. Several cases of ischemic stroke in essential thrombocythemia have been reported, but cerebral infarction combined with cerebral hemorrhage has been very rare and has not been reported in Korea. We report a case of cerebral infarction and chronic subdural hematoma in a pateint with essential thrombocythemia. A 59-year-old woman with essential thrombocythemia was admitted with mild left hemiparesis that developed 3 days prior. She had a history of minor trauma 15 days prior. A brain MRI showed an infarction in the right temporal lobe and a chronic subdural hematoma in the right frontoparietal area. A cerebral angiography revealed an occlusion of the M2 portion of the right middle cerebral artery.
Brain ; Cerebral Angiography ; Cerebral Hemorrhage ; Cerebral Infarction* ; Female ; Hematoma, Subdural, Chronic* ; Hemorrhage ; Humans ; Infarction ; Korea ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Magnetic Resonance Imaging ; Megakaryocytes ; Middle Aged ; Middle Cerebral Artery ; Myeloproliferative Disorders ; Paresis ; Primary Myelofibrosis ; Stroke ; Temporal Lobe ; Thrombocythemia, Essential* ; Thrombocytosis

PURPOSE: Observation of operations is believed to be a major part in the clinical clerkship of surgery, but it is very hard to be performed effectively due to the difficulty of providing an appropriate view of surgical field for many students. To overcome this problem, we have started to provide a tele-video system for clinical clerkship of surgery since 2001. The aim of this study was to evaluate the effectiveness of educational program of surgery using tele-video system. METHODS: We provided the tele-video system with camera systems in two operating rooms and 2 video projection systems in the teaching room to the third year medical students as a curriculum of clinical clerkship of surgery. Education using tele-video system was performed in the form of the interrogatory teaching between the teacher (operator) and students using microphone. The questionnaires about the program of clinical clerkship of surgery and the education with tele-video system were filled up by 190 students who had completed the 4 weeks clerkship schedule. After then, items in the questionnaires were analyzed in September and in December to evaluate the change of the students' response for the education with tele-video system. RESULTS: Eighty-eight percent of students had experienced the education with tele-video system. Most students (96%) recommended this system to their juniors, and 78% of students wanted this system to be also used in other departments' clinical clerkship. The advantages of tele-video system were revealed as the better view of surgical field, followed by clear explanation for the surgical procedure, interrogatory teaching between the operator and the students, and so on. The most effective teaching methods were revealed as direct participating in the operation (33%), followed by tele-video system (32%), reading of textbook (19%), and simple observation of the operation (15%). General satisfaction for tele-video system were scored with five (11%), four (48%), three (25%), two (7%), and one (1%) (5=excellent, 1=very poor). General satisfaction rate about tele-video system was markedly improved from September to December. CONCLUSIONS: The education with tele-video system in the clinical clerkship of surgery seems to be very effective method for teaching the medical students.
Appointments and Schedules ; Clinical Clerkship ; Curriculum ; Education ; Humans ; Operating Rooms ; Students, Medical* ; Teaching ; Surveys and Questionnaires

Near-infrared (NIR) fluorescence imaging is a promising method for image-guided surgery, providing robust functional images with relatively good cost-effectiveness. A cyanine vital dye indocyanine green (ICG) is a safe NIR fluorophore emitting 800~840 nm of light and has been used in numerous surgical procedures. The technique has been applied to lymph node navigation of gastric cancer surgery with an expectation of better visualization of lymphatic structures without any risk of radio-hazard compared with a “dual method” using both vital dyes and radioisotopes. Given the characteristics of ICG, such as fast distribution and quenching effect, diluted concentrations, such as 0.05~0.1 mg/ml, are thought to be optimal for sentinel node navigation. Injection into the subserosal layer is feasible; however, endoscopic submucosal injection has advantages of improved accuracy of the injection site and feasibility of injection one day prior to surgery; these advantages are preferred by some investigators due to a smaller number of sentinel nodes compared with injection in the operation theatre. The technology requires evaluation of the sensitivity and specificity, as well as the non-inferiority, compared with the dual method in a large cohort for justification as a safe node navigation method.
Cohort Studies ; Coloring Agents ; Fluorescence* ; Humans ; Indocyanine Green* ; Lymph Nodes* ; Methods ; Optical Imaging ; Radioisotopes ; Research Personnel ; Sensitivity and Specificity ; Sentinel Lymph Node Biopsy ; Stomach Neoplasms* ; Surgery, Computer-Assisted

BACKGROUND: The aim of this study was to assess the relationship between acute physiologic and chronic health examination (APACHE) II and sequential organ failure assessment (SOFA) scores and outcomes of post-cardiac arrest patients treated with therapeutic hypothermia (TH). METHODS: Out-of-hospital cardiac arrest (OHCA) survivors treated with TH between January 2010 and December 2012 were retrospectively evaluated. We captured all components of the APACHE II and SOFA scores over the first 48 hours after intensive care unit (ICU) admission (0 h). The primary outcome measure was in-hospital mortality and the secondary outcome measure was neurologic outcomes at the time of hospital discharge. Receiver-operating characteristic and logistic regression analysis were used to determine the predictability of outcomes with serial APACHE II and SOFA scores. RESULTS: A total of 138 patients were enrolled in this study. The area under the curve (AUC) for APACHE II scores at 0 h for predicting in-hospital mortality and poor neurologic outcomes (cerebral performance category: 3-5) was more than 0.7, and for SOFA scores from 0 h to 48 h the AUC was less than 0.7. Odds ratios used to determine associations between APACHE II scores from 0 h to 48 h and in-hospital mortality were 1.12 (95% confidence interval [CI], 1.03-1.23), 1.13 (95% CI, 1.04-1.23), and 1.18 (95% CI, 1.07-1.30). CONCLUSIONS: APACHE II, but not SOFA score, at the time of ICU admission is a modest predictor of in-hospital mortality and poor neurologic outcomes at the time of hospital discharge for patients who have undergone TH after return of spontaneous circulation following OHCA.
APACHE ; Area Under Curve ; Cardiopulmonary Resuscitation ; Hospital Mortality ; Humans ; Hypothermia* ; Hypothermia, Induced ; Intensive Care Units ; Logistic Models ; Odds Ratio ; Organ Dysfunction Scores* ; Out-of-Hospital Cardiac Arrest* ; Outcome Assessment (Health Care) ; Retrospective Studies ; Survivors

No abstract available.
Leiomyosarcoma* ; Rectum*