Congenital pulmonary lymphangiectasis is a rare cause of severe respiratory distress in the newborn period and most of these patient die, usually within the first 24 hours of life. The light microscopic characteristics of the lungs are a network of partly tubular, partly cystically enlarged lymph vessels within large areas of connective tissue and they have thin wall lined by endothelium. Also congenital pulmonary lymphangiectasis is closely associated with cardiovascular malformation, and most frequently occurs in the clinical setting of congenital heart disease with or without pulmonary venous obstruction(total anomalous venous return, atresia of large pulmonary veins) The authors describe three typical cases of congenital pulmonary lymphangiectasis.
Connective Tissue ; Endothelium ; Heart Defects, Congenital ; Humans ; Infant, Newborn ; Lung ; Lymphangiectasis* ; Lymphangioleiomyomatosis

The clinical review was done on 17 cases with the foreign body in the upper gastrointestinal tract who underwent endoscopic removal of foreign body at Kang Nam Sacred Heart Hospital from Dec. 1981 to Dec. 1991. The results were as follows: 1) The age distribution varies from 3 months to 72 years of age, being most prevalent under 5 years of age. 2) The incidence of foreign body in the order of frequency was coin, fish bone, safety pinring, peanut, keyring, food bolus, artificial teeth and medal. Among 17 cases, 9 cases(53.0%) were lodged in the esophagus and 8 cases(47.0%) were lodged in the stomach. 3) Dysphagia or globus was the common symptom in 8 cases(47.2%), followed by absence of symptom in 7 cases(41.2%), upper abdominal discomfort in 1 case(5.8%) and vomiting in 1 case (5.8%). 4) l0 cases(58.8%) of foreign body were removed within 72 hours and 7 cases(41.2%) of foreign body were removed after 72 hours.
Age Distribution ; Deglutition Disorders ; Esophagus ; Foreign Bodies* ; Heart ; Incidence ; Numismatics ; Stomach ; Tooth, Artificial ; Upper Gastrointestinal Tract* ; Vomiting

No abstract available.
Crowns* ; Glass*

A 56-year-old woman presenting a 10-year history of atrophic discoid patches with underlying subcutaneous nodules was seen. These skin lesions were distributed on the upper arms bilaterally. Biopsy specimens taken from the lesional skin showed epidermal and dermal changes consistent with the discoid lesions of the cutaneous lupus erythematosus. Deep dermis and subcutaneous fat tissue revealed sclerosis and fibrinoid alterations of the collagen and necrosis of fat cells, the features corresponding to the lupus ei ythematosus profundus. She had no laboratory evidences suspective of systemic lupus erythematosus or other connective tissue diseases. This patient with lupus erythernatosus profundus which cleveloped subsequent to the discoid lesion is consiclered to be a rarely encounteririg observation in lupus erythematosus.
Adipocytes ; Arm ; Biopsy ; Collagen ; Connective Tissue Diseases* ; Connective Tissue* ; Dermis ; Female ; Humans ; Lupus Erythematosus, Cutaneous ; Lupus Erythematosus, Systemic ; Middle Aged ; Necrosis ; Panniculitis, Lupus Erythematosus* ; Sclerosis ; Skin ; Subcutaneous Fat

Service diversification is recognized as an important strategy against turbulent environmental change. This study is designed to find out the trend of service diversification in Korean health care organizations and also to identify factors associated with the degree of service diversification. Data were collected from 69 hospitals out of 71 hospitals with over 300 beds. Important findings are summarized below. 1. Types of diversification are closely related to hospital size. Large hospitals have a tendency to provide sophisticated service requiring specialized skills and equipment, while small hospital have concentrated their efforts on health screening programs. 2. The more competitive and bigger hospitals are, the greater number of services that provide. Also, hospitals operating rational management information systems provide more services. Contrary to the expectation, hospitals with a low performance during last 3 years showed more service diversification. 3. A trend of more diversification was observed in hospitals whose chief executive officer used a prospector strategy. 4. A multiple regression analysis revealed that bed size, competitive environment, degree of rational management, and the growth pattern were significantly associated with teh service diversification.
Delivery of Health Care ; Health Facility Size ; Hospital Bed Capacity ; Management Information Systems ; Mass Screening

Anti-T cell monoclonal antibodies(OKT series. OKT4a, OKTSA, OKT)1) immunoperoxidase technique study for the presence of T cells in cutaneous lesions from four patients with erythema multiforme showed that most dermal and epidermal lymphoid cells were reactive with monoclonal antibodies to anti-pan T cell (l3KT11) in this semiquantitative assay. In the dermis most of the perivascular lirmphoid infiltrates were reactive with anti-helper/inducer T cell antibody, but in the epidermis and in the derrnopidermal interface the predominant cells were identified as suppressor/cytotoxic T cells. The histologic and immunopathologic changes in erythema multiforme appear to be due in part to cellular immune rnechanisms with the lyrnphocyte as the predominant effector cell. But complex interplays with other humoral immune mechanisms might be in work for the development of erythema multiforme.
Antibodies, Monoclonal ; Dermis ; Epidermis ; Erythema Multiforme* ; Erythema* ; Humans ; Immunoenzyme Techniques ; Lymphocytes ; T-Lymphocytes*

There are increasing interest and need for information on health care consumer with the significance of hospital marketing and strategic planning being increasingly emphasized. This study was conducted to investigate the criteria for selection of medical facilities according to the characteristics of health care consumer by the types of medical services on a sample of 1,500 population aged 20 years and above. Major findings are as follows; 1. When considering the criteria for selection of medical facilities into two factors, namely, quality or convenience factors, convenience factor was the major contributor for outpatient and dental services whereas it was quality factor for inpatient services. 2. Females and those residing in large cities selected medical facilities based on convenience factor in the outpatient services. In the case of inpatient service, persons who considered their present health status to be good and whose ages were 50 years old and above choose medical facilities based on quality factor. 3. Persons who considered medical facilities to be profit-making tended to choose medical facilities based on convenience factor for outpatient services. There were no differences in the cases of inpatient and dental services. 4. There was no significant difference on the criteria for selection of medical facilities according to the decision maker for selection or trust on medical facilities. On the use of health service information, selection of medical facilities was based on qPality factor for those who made more use of the information in the cases of outpatient and dental services. 5. Analysis using the logistic regression model on the criteria for the selection of medical facilities with the characteristics of health care consumer as independent variables was performed. The selection of medical facilities was significantly related with residential area, sex, and use of information on medical facilities for outpatient services and with age, average monthly income, and perception of health status for inpatient services. For dental services significant association with residential area and use of information on medical facilities was seen. The results of this study, despite some limitations, can be used as baseline data for marketing and strategic planning of hospital management.
Delivery of Health Care ; Female ; Health Services ; Humans ; Inpatients ; Logistic Models ; Marketing ; Middle Aged ; Outpatients ; Patient Selection

Majocchi's disease is one of chronic vascular disorders of the skin, histologically showing capillaritis with lymphoid cell infiltration. Although the hypothesis of delayed type hypersensitivity reaction against foreign antigen is proposed as the mechanism producing this condition, there are much yet to be defined. We tried to examine the lesional skin of five patients with Majocchi's disease by the direct immunofluorescence with anti-human immunoglobulins, C 3, and fibrin. As a result we found the deposition of immunoglobulins (M, and G) in papillary blood vessels in four patients, and C 3 and fibrin were found in all five patients. C3 was also found at the dermoepidermal junction in three patients. These findings suggest the posssibility that antibody mediated immunologic processes may alsobe involved in the pathogenesis of this disorder. With this observation Majocchis disease could be considered as a chronic immune vasculitis.
Blood Vessels ; Fibrin ; Fluorescent Antibody Technique, Direct ; Humans ; Hypersensitivity ; Immunoglobulins ; Lymphocytes ; Skin ; Vasculitis

BACKGROUND: Adenosine 5'-tetraphosphate(ATPP), an endogenous nucleotide, is stored in cells and released into the extracellular space upon stimulation. Some of the biological responses to ATPP were reported, but characteristics of its receptor were not well known. Present study was conducted to investigate the effects of ATPP on mechanical contractility, resting membrane potential and action potential of rat left atrium. METHODS: Left atrium was isolated from Sprague-Dawley rat. Mechanical contraction induced by electrical field stimulation(EFS) was recorded on polygraph using force transducer. With glass microelectrodes(10 MOmega), potential difference across the membrane was measured and recorded on an oscilloscope and a polygraph. RESULTS: ATPP reduced the left atrial contractility with concentration-dependent manner. ATPP also hyperpolarized the resting membrane potential and decreased the action potential duration of the left atrial cell. Nucleotides other than ATPP, such as ATP, ADP, AMP and adenosine, have the same effect as ATPP. However, there is no difference among the nucleotides. Prior treatment of DPCPX, a P1-purinoceptor blocker, inhibited the ATPP-induced negative inotropism and changes of the membrane potential. But suramin, a nonselective P2-purinoceptor blocker, did not alter the effects of ATPP. alpha, beta methylene ADP and adenosine deaminase, which attenuates hydrolysis of adenine nucleotides and inactivates adenosine respectively, did not influence the effects of adenine nucleotides except for adenosine. CONCLUSION: ATPP reduced the mechanical contractility, hyperpolarized the resting membrance potential and decreased duration of action potential of rat left atrium. These effects were induced by ATPP directly, not by adenosine from hydrolyzed ATPP.
Action Potentials ; Adenine Nucleotides ; Adenosine Deaminase ; Adenosine Diphosphate ; Adenosine Triphosphate ; Adenosine* ; Animals ; Extracellular Space ; Glass ; Heart Atria ; Hydrolysis ; Membrane Potentials ; Membranes ; Muscle Contraction ; Nucleotides ; Rats ; Rats, Sprague-Dawley ; Receptors, Purinergic ; Suramin ; Transducers

Cardiac relaxation is impaired in many cardiac disorders and is the subject of extensive investigation. Though measurement of isovolumic relaxation time ought to prove a simple means of quantifying such abnormalities in clinical practice, the problem of defining the timing of mitral valve opening at the onset of ventricular filling has been a difficulty. previous studies have used the 'O' point of the apexcardiogram, but more recently it has been shown that this may be open to considerable error. It was the purpose of the present study to determine the duration of true isovolumic relaxation and the factors influencing its duration, and to evaluate its use as a simple noninvasive measurement of cardiac dynamics in terms of the present approach. True isovolumic relaxation time (IRT) was measured noninvasively from the onset of the aortic component of the second heart sound to the onset of rapid opening of the mitral leaflets from simultaneous recording of echocardiogram, phonocardiogram, electrocardiogram and carotid tracing in 60 normal subjects, 30 male and 30 female and in 50 with hypertension, 28 male and 22 female ranging in age from 20 to 45 years. 1. The duration of IRT was 53.6+/-9.9 msec in normal subjects with no relation to sex. 2. IRT was related to heart rate, systemic blood pressure, and systolic and diastolic time intervals. 1) IRT tended to decrease with increasing heart rate and a regression equation for predicting it in relation to heart rate was 'IRT(msec)=88.97-0.466xH.R.(beats/min)' (P<0.01). 2) IRT tended to increase with increasing systemic blood pressure and a regression equation for predicting it in relation to aortic closing pressure was 'IRT(msec)=5.09+0.459xaortic closing pressure(mmHg)' (P<0.01). IRT was prolonged in patient with hypertension. 3) IRT was in close relation to left ventricular contraction indices such as preejection period(PEP), isovolumic contraction time and preejection period/left ventricular ejection time ratio. 4) There was no relation between IRT and left ventricular pump performance indices such as stroke volume, ejection fraction, fractional shortening and left ventricular dimension. 5) There was strong association between IRT and diastolic time intervals. Authors were impressed through this study that IRT is a useful measurement of left ventricular dynamics in early diastole.
Blood Pressure ; Diastole ; Electrocardiography ; Female ; Heart Rate ; Heart Sounds ; Humans ; Hypertension ; Male ; Mitral Valve ; Relaxation* ; Stroke Volume