Simultaneous occurrence of remote intracerebral hemorrhage (ICH) and intracranial aneurysmal subarachnoid hemorrhage is very rare. We report on a case of concurrent hypertensive ICH at the left thalamus and rupture of an intracranial aneurysm at the bifurcation of the single A2 segment of the anterior cerebral artery in a 64-year-old woman, which was clipped previously, with review of the literature. To our knowledge, this is the first case report demonstrating bleeding of previously clipped aneurysm with simultaneous hypertensive ICH. Hypertensive crisis following ICH seems to have provoked rupture of the residual aneurysm.
Aneurysm ; Anterior Cerebral Artery ; Cerebral Hemorrhage ; Female ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Intracranial Hemorrhage, Hypertensive ; Middle Aged ; Rupture ; Subarachnoid Hemorrhage ; Thalamus

An analysis was performed to evaluate the problems in Emegency Medical Service System(EMSS) through the review of the 119 transport chart of 1,229 patients who visited to emergency center of Chonnam University Hospital via 119 system during the period from January 1998 to December 1998. The results were obtained as follows: 1) 1,229(4.9%) of the 25,253 patients were transported to emergency center via 119 system. Among 1.229 patients, male were 691(56%) and female 538(44%), and nontraumatic patients were 946(77%) and traumatic patients 283(23%). The peak age was 5th to 6th decades. 2) Mean arrival time to scene(ambulance response time) was 4.8 +/-.8minutes and mean arrival time to hospital 19.6 +/-0.1minutes. In the distribution of the requested place for ambulance, 73% was house and 23% was field. 3) In the severity of patients, 154(12.5%) patients were classified into emergent, 442(36%) into urgent, and 633(51.5%) into non-emergent. Among 1,229 patients, number of patients admitted were 419cases(34.1%), operated 85(6.9%), discharged in emergency department 536(43.6%), dead 70(5.7%), and transferred 119(9.7%), respectively. 4) The assessment of prehospital treatment by Emergency Medical Technician(EMT) revealed that checking the vital sign was only 49.5%, and prehospital care was limited to airway management, O2 inhalation and immobilization. There was no case of the notification to medical institute or the consultation to doctor. These results show that over the half of patients transported to level III emergency center via 119 system were classified into non-emergent and the prehospital management of the patient by EMT was not adequate. This study suggests the need of more simple and objective triage guideline for patient transport, the improvement of prehospital care system, and reconstruction of the computerized communication system.
Airway Management ; Ambulances ; Emergencies ; Emergency Service, Hospital ; Female ; Humans ; Immobilization ; Inhalation ; Jeollanam-do ; Male ; Triage ; Vital Signs

Bullous systemic lupus erythematosus (bullous SLE) is an uncommon, distinctive clinical variant of systemic lupus erythematosus (SLE), histopathologically characterized by subepidermal blisters with neutrophil infiltration and immunopathologically linear IgG depositon at the dermoepidermal junction. A blistering eruption may occur during flares of SLE such as lupus nephritis. We report two cases of bullous SLE, confirmed by the clinical, histopathological and immunopathological features. In one patient who has been diagnosed as SLE with diffuse proliferative lupus nephritis (WHO class IV), a blistering eruption occurred during the course of treatment of SLE. In the other patient, the bullous eruption was the initial manifestation of SLE and then she was diagnosed as SLE. We review the recent literature and describe the distinctive features of this rare disorder.
Blister ; Humans ; Immunoglobulin G ; Lupus Erythematosus, Systemic* ; Lupus Nephritis ; Neutrophil Infiltration

PURPOSE: The optimal initial treatment for burn wound is generally applying cold running tap water of temperature 12~18degrees C for approximately 20 minutes. But most of the patients are not susceptible to this initial treatment because they are likely to get embarrassed in such situation. According to statistics of our hospital, 92.2% of patients who visited ER (emergency room) had less than 10 minutes of water cooling. In this study, our aim was to find out the clinical effect of biocellulose sheet (Bestian M(R) pack) as an emergent treatment. METHODS: Between November 2010 and October 2011, 93 patients with burn wound showing first or superficial second degree at first inspection were evaluated in our study. Biocellulose sheet (Bestian M(R) pack) was applied at the wound as soon as possible for 25 minutes and second inspection was done. Routine moisture dressing was done thereafter and patients were followed as outpatient. RESULTS: Among 93 patients, 28 were male and 65 were female. Scalding burn, contact burn, flame burn and other causes were 78, 6, 4 and 5 patients respectively. Average complete healing time was 7.99 days and average follow-up time was 5.49. CONCLUSION: Biocellulose sheet has the effect of cooling down the skin temperature up to 6~8degrees C after 10 minutes of its application. Recent studies reported that appropriate cooling in burn wound improves the zone of stasis and zone of erythema histologically eventually reducing the chance of skin graft. Therefore, biocellulose sheet has the effect of improving initial pain, histologic status, healing time and cost in patients with burn wound whose depth is not deep. Furthermore it reduces the risk of scar formation.
Bandages ; Burns ; Cicatrix ; Cold Temperature ; Erythema ; Female ; Follow-Up Studies ; Humans ; Male ; Running ; Skin ; Skin Temperature ; Transplants ; Water

BACKGROUND: Varicose vein is the most common venous disease of the lower extremities. The treatment of varicose vein is commonly performed for cosmetic improvement, although most patients are symptomatic as well. Sclerotherapy is a useful adjunct to large vein surgery as well as a highly effective primary treatment for telangiectasia and reticular vein. OBJECTIVE: The purpose of this study was to elucidate the clinical characteristics of varicose vein of Korean and to evaluate the efficacy and the side effect of sclerotherapy. METHODS: We reviewed 100 outpatients treated by sclerotherapy for varicose vein at department of dermatology of Pusan National University Hospital from January, 1999 to December, 2000. RESULTS: The results obtained were summarized as follows; 1) The distribution of age was the first 5th decade(44%), followed by 4th decade and 6th decade. The median age was 47.6 years-old. 2)The duration of illness was less than 5 years in 34 patients(34%), and 6 to 10 years in 25 patients(25%). 3) Presumed etiologic factors were occupations requiring long period of standing in 43 patients(43%), and pregnancy in 28 patients(28%). 4) The aims in treating varicose vein were cosmetic problem(88%), pain(47%) and fatigue(32%). 5) According to the CEAP classification, the most common type of varicose vein was C1sEpAs(46%). 6) The frequency of injections were 2 times in 31 patients(31%), 3 times in 30 patients(30%), and one in 22 patients(22%). 7) Most of the patients were satisfied with the results and the clinical efficacy in varicose vein was more than moderate clearance in 64 patients(64%). Transient adverse effects were observed in a few patients. CONCLUSION: Sclerotherapy is a simple, safe, and cosmetically acceptable alternative treatment for varicose vein and can be easily performed in outpatient fields.
Busan ; Classification ; Dermatology ; Humans ; Lower Extremity ; Occupations ; Outpatients ; Pregnancy ; Sclerotherapy* ; Telangiectasis ; Varicose Veins* ; Veins

Homozygous protein C deficiency is a rare hereditary coagulation disorder that occurs most often in childhood and is characterized by widespread thrombosis of capillaries and venules, abrupt onset of ecchymoses and necrosis. The hematological feature corresponds with disseminated intravascular coagulation. Protein C is a natural anticoagulant and also has important anti-inflammatory activity. For confirmation of homozygous protein C deficiency, the infant should have undetectable protein C activity and both parents should be heterozygous for protein C deficiency. We experienced a case of purpura fulminans in the newborn infant in whom we identifed homozygosity for familial protein C deficiency. Fresh frozen plasma for replacement of protein C, early debridement and full-thickness skin graft induced a remission. Administration of warfarin was used to prevent recurrence of attacks. This report emphasizes the need for early diagnosis and adequate replacement therapy in patient with purpura fulminans.
Blood Coagulation Disorders, Inherited ; Capillaries ; Debridement ; Disseminated Intravascular Coagulation ; Early Diagnosis ; Ecchymosis ; Humans ; Infant ; Infant, Newborn ; Necrosis ; Parents ; Plasma ; Protein C Deficiency* ; Protein C* ; Purpura Fulminans* ; Purpura* ; Recurrence ; Skin ; Thrombosis ; Transplants ; Venules ; Warfarin

No abstract available.
Bleomycin* ; Drug Therapy* ; Humans ; Uterine Cervical Neoplasms*

BACKGROUND: Biologic markers such as the p16 protein, p53 protein and Ki-67 antigen, as well as factor VIII-related antigen have been explored in various malignancies as potential prognostic factors. OBJECTIVE: The aims of this study are to examine the expression of biologic markers and to assess their correlation with conventional clinicopathological prognostic factors in malignant melanoma. METHODS: Immunohistochemical stains for p16, p53, Ki-67 and factor VIII-related antigen were performed in twenty formalin-fixed, paraffin-embedded tissues of primary and metastatic malignant melanomas. We compared the expression of biologic markers with conventional clinicopathologic factors, such as the presence of metastasis, ulceration, Breslow thickness, Clark level and American Joint Commission on Cancer(AJCC) TNM staging. RESULTS: Loss of p16 expression was significantly higher for the metastatic melanomas(90%) than the nonmetastatic(50%). But the results were not correlated with the clinicopathologic prognostic factors. The p53 expression was found in 7/10(70%) of the metastatic melanomas and in 3/10(30%) of the primary melanomas. Statistically, p53 expression was positively correlated with Breslow thickness(p=0.017), Clark level(p=0.003) and TNM staging(p=0.009). Furthermore, statistically significant trends were observed towards increasing expression of Ki-67 with metastatic dissemination(p=0.014), increasing Breslow thickness(p=0.008), Clark level(p=0.012) and TNM staging(p=0.009). Positive correlation was present between TNM staging and factor VIII-related antigen expression(p=0.014). CONCLUSION: p53 protein and Ki-67 antigen may be more useful independent predictors than p16 protein and factor VIII-related antigen in Korean patients with malignant melanoma.
Biomarkers ; Coloring Agents ; Humans ; Joints ; Ki-67 Antigen* ; Melanoma* ; Neoplasm Metastasis ; Neoplasm Staging ; Ulcer ; von Willebrand Factor*

Keratosis follicularis squamosa(Dohi) is an acquired keratinizing disorder , which is particularly common among Japanese and rarely reported in other countries . It is characterized by multiple small brownish atrophic patches with follicular plug and collarette scales on the trunk and thighs . The scaly patches, which look like lotus leaves on the water as described by Dohi in the first report, is very characteristic. We report a case of keratosis follicularis squamosa(Dohi) in a 39-year-old woman, who showed a clearance of the skin lesion after 4-week minocycline administration.
Adult ; Asian Continental Ancestry Group ; Darier Disease* ; Female ; Humans ; Keratosis* ; Lotus ; Minocycline ; Skin ; Thigh ; Water ; Weights and Measures

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*