Oral mucositis continues to be a major complaint of patients who have chemotherapy for the acute leukemia. An innovative and inexpensive remedy which produces favorable results for those afficted is not yet introduced. So we tried to develop two oral care protocols for reducing the level of oral mucositis during cytotoxic therapy through literature review and our clinical experience. The one is sodium bicarbonate-normal saline gargling, and the other consists of chlorhexidine gargling. This quasi-experimental study was performed to compare the efficacy of these two different oral care protocols. Twenty subjects were assigned to one of the two specific diagnosis of leukemia, aim of the chemotherapy. The Oral Assessment Guide(OAG), the Beck's perception of oral comfort, WHO Grading system fot mucositis and the discomfort of oral gargling solution were used to assess oral status and subject's oral discomfort during chemotherapy. Each subjects were observed daily from the start of the chemotherapy until Absolute Neutrophil Count(ANC) reached 1,000. It continued about 2-4 weeks. The data analyzed by Mann-Whittney U test and ANCOVA. The result was follows as: The patient who used sodium bicarbonate-normal saline gargling showed significantly higher mean score of the discomfort of oral gargling solution than chlorhexidine gargling. The other scores were not significantly different between two groups. However the subjects using the sodium bicarbonate-normal saline gargling showed a lower level of oral mucositis. We concluded that oral using sodium bicarbonate-normal saline gargling was between to reduce the level of oral mucositis during chemotherapy and nursing assessments of the oral cavity seemed to promote patient's compliance with the oral care regimen.
Chlorhexidine* ; Compliance ; Diagnosis ; Drug Therapy ; Humans ; Leukemia* ; Mouth ; Mucositis ; Neutrophils ; Nursing Assessment ; Sodium* ; Stomatitis*

No abstract available.
Hematuria* ; Humans

We observed clinical and histopathological findings of porokeratosis in 16 cases which comprised 2 linear types, 4 superficial disseminat:ed forms, 4 disseminated superficial actinic porokeratosis and 6 plaque types. From the observation, the following results were obtained. l. Clinical results 1) Eleven cases were men, 5 cases were women, and the sex ratio was 2. 2 to 1, age distribution was from 6 to 61 years (mean age: 34. 2years), and the distribution of age of onsets was from 2 to 52 years(mean age of onset' 23. lyears). 2) Four cases had family history of porokeratosis, but linear forms did not. 3) Nine cases had pruritus especially, all cases of DSAP and DSP except 1 case complained pruritus. 4) Tmo cases of DSAP had tendency of summer exacerbations. 2. Histopathological results 1) Cornoid lamellae were prominent in all cases of plaque types and linear types, and minimal in all cases of DSAP and DSP except 1 case. 2) Epidermis between the cornoid lamellae were normal or acanthotic in all cases except 1 case of plaque types and linear types, and were atrophic in 5 cases of 8 cases in DSAP and DSP.
Age Distribution ; Age of Onset ; Epidermis ; Female ; Humans ; Male ; Porokeratosis* ; Pruritus ; Sex Ratio

Eczema herpeticum occurred in a patient with pemphigus foliaceus and esophageal cancer. The patient's initial skin lesions composed of large flaccid bullaes showed subcorneal bullae with typical acantholytic cells. Subsequent grouped small vesicles appeared widely on the erythematous base were diagnosed herpes simplex virus infection by Tzanck smear and histopathological findings. The patient died one week after the development of the widespread herpes virus infection.
Eczema* ; Esophageal Neoplasms ; Humans ; Kaposi Varicelliform Eruption* ; Pemphigus* ; Simplexvirus ; Skin

We observed 17 cases of cafe au lait spots histopathplogi ally. Out of 17 cases, 9 cases were neurofibromatosis with neurofibromas, 6 cases were neurofibromatosis without neurofibroma, and 2 cases were normal healthy persons. The results were as follows. l. In all 17 cases, melanin pigment was increased in melanocytes and keratinocytes. 2. Griant pigment granules were identified only in 3 cases of neurofibromatosis with neurofibromas.
Cafe-au-Lait Spots* ; Humans ; Keratinocytes ; Melanins ; Melanocytes ; Neurofibroma ; Neurofibromatoses

BACKGROUND: This study investigated the effectiveness of reinforced contact precautions and active surveillance cultures (ASCs) in reducing the incidence of methicillin-resistant Staphylococcus aureus (MRSA) and other healthcare-associated infections (HAIs). METHODS: A before- and after-experimental study was performed at the intensive care unit (ICU) in a university-affiliated hospital. Reinforced contact precautions were applied to all patients, and ASCs for MRSA were performed for newly admitted patients at the time of admission and once a week thereafter. The HAIs were investigated in accordance with the National Nosocomial Infections Surveillance (NNIS) definitions and compared before and after the interventions. The data were analyzed using descriptive statistics. RESULTS: The number of HAIs caused by MRSA decreased from 2.2 to 0.5 per 100 patients discharged (P=0.02) and from 3.6 to 1.0 per 1,000 patient-days (P=0.032). The number of overall HAIs decreased from 7.6 to 4.0 per 100 patients discharged (P=0.011) and from 12.7 to 7.3 per 1,000 patient-days (P=0.034). The invasive device-associated infections caused by MRSA and other pathogens decreased, but the decrease was not statistically significant. CONCLUSION: Reinforced contact precautions and ASCs were effective in decreasing both MRSA infections and overall HAIs in the ICU. Further, it was assumed that the incidence of device-associated infections would have decreased if the intervention period was extended.
Cross Infection ; Humans ; Incidence ; Critical Care ; Intensive Care Units ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus

PURPOSE: The purpose of this study was to evaluate the relationship between radiation-induced activation of DNA repair genes and radiation induced apoptosis in A431 cell line. MATERALS AND METHODS: Five and 25 Gys of gamma radiation were given to A431 cells by a Cs-137 cell irradiator. Apoptosis was evaluated by flow cytometry using annexin V-fluorescein isothiocyanate and propidium iodide staining. The expression of DNA repair genes was evaluated by both Northern and Western blot analyses. RESULTS: The number of apoptotic cells increased with the increased radiation dose. It increased most significantly at 12 hours after irradiation. Expression of p53, p21, and hRAD50 reached the highest level at 12 hours after 5 Gy irradiation. In response to 25 Gy irradiation, hRAD50 and p21 were expressed maximally at 12 hours, but p53 and GADD45 genes showed the highest expression level after 12 hours. CONCLUSION: Induction of apoptosis and DNA repair by ionizing radiation were closely correlated. The peak time of inducing apoptosis and DNA repair was 12 hours in this study model. hRAD50, a recently discovered DNA repair gene, was also associated with radiation-induced apoptosis.
Apoptosis* ; Blotting, Western ; Cell Line* ; DNA Repair* ; DNA* ; Flow Cytometry ; Gamma Rays ; Humans* ; Propidium ; Radiation, Ionizing

The persistent left superior vena cava (LSVC) is not rare cardiovascular developmental anomaly occurring both in association with congenital heart disease and as an isolated anomaly of no hemodynamic importance. We have studied 73 cases of the LSCV out of 1,060 cases of congenital heart disease catheterized at Yonsei Cardiovascular Center. We conducted the study with a view point of position of the heart and abdominal organs and segmental analysis of the underlying congenital heart disease. We also analysed the associated extracardiac vascular anomalies. The following results were obtained: 1) The incidence of this anomaly among congenital heart disease was 6.9% and 41 cases(56.2%) had cyanosis. 2) We observed 20 cases(27.3%) with the malposition of the heart and 17 cases(23.3%) with malposition of the abdominal organs. The ventricular loops revealed D-loop in 60 cases, L-loop in 7 cases and in the remaining 6 cases, it was uncertain. 3) With a view point of type of LSVC by Lucas & Krabill, type A was in 50 cases(68.5%), type D in 14 cases(19.2%), type B in 5 cases(6.8%) and type C in 4 cases(5.5%). 4) Associated cardiovascular anomalies were as follows: ventricular septal defect; 42 cases(57.5%), atrial septal defect; 33 cases(45.2%), patent ductus arteriosus; 27 cases(36.9%), and tetralogy of Fallot; 18 cases(24.7%). In conclusion, LSVC usually has no hemodynamic importance, but this cardiac anomaly is frequently combined with complex intracardiac anomalies. Therefore, it is important to making accurate diagnosis and successful management for preventing the risk of it.
Catheters ; Classification* ; Cyanosis ; Diagnosis ; Ductus Arteriosus, Patent ; Heart ; Heart Defects, Congenital ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Hemodynamics ; Incidence ; Tetralogy of Fallot ; Vena Cava, Superior*

No abstract available.

A 32-year-old housewife who resides in Taegu was admitted in Yeungman University Hospital due to right upper quadrant abdminal pain of 2 mounths'duration. An abdomical CT and ultrasonography revealed a relatively well demarcated low density mass in the right lobe of liver. Right hepatic lobectomy was performed on the clinical impression of hepatoma. On the light microscopic study, the lobulated liver mass showed extensive central necrosis and fibrosis, with large numbers of pseudotubercles therein. The pseudotubercles have distorted helminthic eggs frequently. The submitted common bile duct lymph node also showed a few pseudotubercles. The eggs recovered from the tissue homogenate measured 140~152 micrometer by 75~85 micrometer in size and were unembryonated and light yellow to brown. The eggs were determined as those of Fasciola species. We reported the present case as 11th one of human fascioliasis in korea.
Humans