BACKGROUND: In patients with systemic lupus erythematosus(SLE), LE-specific cutaneous lesions include malar rashes, widespread/morbilliform erythema, oral ulcer and bullous lesions. OBJECTIVE: Clinical observations were carried out to define cutaneous features of morbilliform erythema and to see possible relevancy of this erythema to disease activity of SLE. METHODS: Examinations were performed on 7 SLE patients with morbilliform erythema regarding the distribution and course of the cutaneous lesions; some SLE-activity related hematologic/immunologic data taken during/around the time of this skin disease were also assessed in each patient. RESULTS: In most of those patients with morbilliform erythema, which covered the trunk and extremities, the skin lesions lasted for about 2 weeks until their disappearance. At or around the time of suffering from this skin disease of acute eutaneous LE, activities of systemic disease were recognized as "in a state of flare-up or aggravation" with hypocomplementemia and high titers of anti-nDNA autoantibodies. CONCLUSION: As with malar rashes, morbilliform erythema of acute cutaneous LE seems to develop more frequently at the time of severe systemic involvement of immunopathological processes of SLE.
Autoantibodies ; Blister ; Erythema* ; Exanthema ; Extremities ; Humans ; Lupus Erythematosus, Systemic* ; Oral Ulcer ; Skin ; Skin Diseases

A 74-year-old man presented with recurrent vomiting and aspiration pneumonia in the left lower lobe. He entered the intensive care unit to manage the pneumonia and septic shock. Although a percutaneous endoscopic gastrostomy tube was implanted for recurrent vomiting, vomiting and aspiration recurred frequently during admission. Subsequently, he complained of neck pain when in an upright position. A videofluoroscopic swallowing study showed compression of the esophagus by cervical osteophytes and tracheal aspiration caused by an abnormality at the laryngeal inlet. Cervical spine X-rays and computed tomography showed anterior cervical osteophytes at the C3-6 levels. Surgical decompression was scheduled, but was cancelled due to his frailty. Unfortunately, further recurrent vomiting and aspiration resulted in respiratory arrest leading to hypoxic brain damage and death. Physicians should consider cervical spine disease, such as diffuse skeletal hyperostosis as an uncommon cause of recurrent aspiration pneumonia.
Aged ; Bays ; Decompression, Surgical ; Deglutition ; Esophagus ; Gastrostomy ; Humans ; Hyperostosis ; Hypoxia, Brain ; Intensive Care Units ; Neck Pain ; Osteophyte* ; Pneumonia ; Pneumonia, Aspiration* ; Shock, Septic ; Spine ; Vomiting

BACKGROUND: Some research viewed that effective dietary therapy was enough to control proper blood glucose level, but in the most patient, dietary therapy was not practiced and the most difficult part of managing their diabetes. The purpose of this research study was to investigate dietary practice adherence and perceived barriers among the elderly diabetes. METHODS: The survey was mailed to 852 persons with diabetes member via diabetic educator of 156 hospitals or clinics and 24 health centers. Questionnaire had background information of patients, meal regularity, food intake as a dietary practice adherence, barriers of 36 items which have 3 areas such as motive/attitude, knowledge, authority/resource. We asked the person with diabetes to rate barrier to dietary practice adherence. 432 questionnaire were returned the response. we selected 69 persons who were over 65 year old. RESULTS: 1) meal regularity was more satisfactory than food intake. 2) deficit of meal regularity were evening snack and resonable spacing between evening meal and evening snack. 3) deficit of food intake was serving of milk. 4) main barrier to dietary practice adherence was that of knowledge. CONCLUSION: For practice effectively dietary therapy to elderly diabetes, individual consultation or small group education must be pursued and more easily educational skills should be required.
Aged* ; Blood Glucose ; Eating ; Education ; Humans ; Meals ; Milk ; Postal Service ; Surveys and Questionnaires ; Snacks

No abstract available.
Depression*

No abstract available.
Family Practice* ; Humans ; Smoke* ; Smoking*

No abstract available.
Flail Chest*

A 42-year old man was admitted for treatment of a fracture of the medial condyle of the left femur. After 10 days of cast immbilization of the above mentioned extremity, erythematous papulo-vesicular eruption was noted under the external splintage. We concluded that this was an unusual allergic contact dermatitis which is caused by CaSO4.1/2H20, and proved it by patch test in our clinic.
Calcium Sulfate ; Dermatitis, Allergic Contact ; Extremities ; Femur ; Patch Tests

In femorsl neck fracture, viability of the femoral head depends on the revascularization of the femoral head. The purpose of this study is to observe the effect of early fixation and anatomical reduction by measuring the Tc-99m-MDP uptake ratio of the femoral head in experimental animsls. Femoral neck region of 20 mature rabbits were osteotomized completely and divided into 2 groups ; each group consisted of 10 rsbbits. Group 1 had two Kirschner wire fixation after osteotomy and anatomic reduction. Group 2 had no fixation after osteotomy. The uptake ratio of Tc-99m-MDP of the femoral head in each group were measured st the intervals of 24 hours, 48 hours, 1 week, 2 weeks, 3 weeks, and 4 weeks, respectively. The results obtained were as follows ; 1. In experimental group 1, the mean uptake ratio of the femoral head was 0.72±0.13 at 1 day after operation, increased to a level of 1.44±0.14 at 1 week, increased to a maximal value of 2. 90±0.36 at 3 weeks and decreased to a level of 1.10+0.12 at 4 weeks. 2. In experimental group 2, the mean uptake ratio of the femoral head was 0.70±0.10 at 1 day, 0.64±0.13 at 1 week, decreased to a maximal value of 0.33±0.05 at 3 weeks and 0.47±0.05 at 4 weeks, showing decreased level below 1.0. The results suggest that early anatomicsl reduction and rigid fixation of femoral neck fracture is helpful for revascularization of the femoral head and prevention of non union.
Femoral Neck Fractures ; Femur Neck ; Head ; Neck ; Osteotomy ; Rabbits

We recently encountered a case of pemphigus vulgaris, which was localized within the oral mucosa and esophagus. The patient was a 62-year-old women, who had had a few recurrent erosions on the oral mucosa for 1 year. Newly developed erythematous erosions on the esophagus appeared 7 days pre previously. Histopathological findings showed suprabasal blisters in the epithelium of the buccal and esophageal mucosa. On direct immunofluorescence, intercellular IgG and C3 bindings were found in the epithelium of the buccal mucosa. Treatment with oral steroids resulted in a remission of the lesions and the other skin lesions were not found for a period of 6 months.
Blister ; Epithelium ; Esophagus* ; Female ; Fluorescent Antibody Technique, Direct ; Humans ; Immunoglobulin G ; Middle Aged ; Mouth Mucosa* ; Mucous Membrane ; Pemphigus* ; Skin ; Steroids

PURPOSE: To evaluate the anatomy of the hepatic artery and normal variants using oblique thick-slab maximal intensity projection (MIP) 3-D CT angiography and multidetector helical CT technology. MATERIALS AND METHODS: In 70 patients, axial three-phase CT together with multidetector helical CT and a non-ionic contrast agent was used to evaluate liver disease. During the early arterial phase, the parameters were as follow: slice thickness, 2.5 mm; table speed, 15 mm/rotation, pitch, 6; contrast material, 4 ml/sec; total 120 ml. Using the MIP technique and an Advantage window voxtal 3.03 system (GE), the images obtained were reconstructed as 3D angiograms. In each case, the arterial anatomy and its variants were recorded. RESULTS: A typical anatomy was found in 53 cases (75.7 %). Common variants were a left hepatic artery arising from the left gastric artery(8 cases, 11.4 %) and a right hepatic artery arising from the superior mesenteric artery(3 cases, 4.3 %). Other variant cases were a right hepatic artery arising from the gastroduodenal artery(2 cases, 2.9%), a proper hepatic artery arising from the left gastric artery (1 case, 1.4%), a hepatomesenteric trunk (1 case), a hepatogastric / splenomesenteric trunk(1 case), and a celiomesenteric trunk (1 case). CONCLUSION: 3-D hepatic angiography using multidetector helical CT technology is non-invasive and as accurate as conventional angiography for the evaluation of hepatic arterial anatomy. It is thus considered that 3-D CT angiography is very helpful for the evaluation of hepatic arterial anatomy prior to liver surgery such as transplantation or the treatment of hepatocellular carcinoma.
Angiography ; Arteries ; Carcinoma, Hepatocellular ; Hepatic Artery ; Humans ; Liver ; Liver Diseases ; Tomography, Spiral Computed