The increase of the eosinophil leukocytes can be taken as a sign of an allergic reaction it might be a helpful means for obtaining information on the etiology of diseases, therefore, examinations for eosinophil leukocytes in Cantharidin blisters was undertaken in normals and with various skin disorders. 1. In 30 healthy suhjects, blister eontained 56.47+42.5/mm3 of eosinophil leucocytes, and 80% of them never exceeded 66/mm3 of eosinophil leucocytes. 2. The highest eosinophil leukocytes among the various dermatoses was seen contact dermatitis (93.07+40.3/mm3) and drug eruption (92.17+21.1/mm3), atopic dermatitis (75.37+41.0/mm3), and chronic urticaria (72.28+24.2/mm3) were followed in order. 3. The eosinophil leukocytes were slightly increased in psoriasis vulgaris (69.14+29.9/mm3) and herpes zoster (63.25+20.4/mm3). 4. The eosinophil leucocytes were markedly increased in the skin disorders of allergic nature and slightly in non-allergic skin disorders.
Blister* ; Cantharidin* ; Dermatitis, Atopic ; Dermatitis, Contact ; Drug Eruptions ; Eosinophils* ; Herpes Zoster ; Humans ; Hypersensitivity ; Leukocytes ; Psoriasis ; Skin ; Skin Diseases ; Urticaria

Keratosis punctata of the palmar creases (KPPC) is rare skin condition characterized by punctiform hyperkeratotic pits confined to the palmar and digital creases. Although this condition has been regarded as a variant of classical punctate keratoses, there are some differences between classical punctate keratosis and KPPC. We herein report a case of KPPC in a 22-year-old man who had numerous, tiny, hyperkeratotic pits limited to the palmar creases of both hands with typical histologic findings.
Hand ; Humans ; Keratosis* ; Skin ; Young Adult

No abstract available.
Retroperitoneal Fibrosis*

PURPOSE: Combined androgen blockade(CAB) is often used in the management of advanced adenocarcinoma of the prostate. Recent case reports indicated that hypogonadism from CAB therapy is associated with osteoporosis and related fracture. The effect of CAB on bone mineral density(BMD) has not been adequately studied in men with prostate cancer. In this study, the possibility, frequency and severity of osteoporosis following CAB in prostate cancer patient was investigated. MATERIALS AND METHODS: A total of 19 men with advanced prostate cancer receiving CAB were evaluated for the presence of osteoporosis defined as bone mass 2.5 standard deviation below peak bone mass of young normal men(T-score). The BMB of the femoral neck and lumbar spine were measured. The BMD was then compared to the age-matched control value and reported as the Z-score. BMD measurements were compared to duration of CAB and Gleason score. RESULTS: Osteoporosis occurred in 10 of 15 patients in lumbar spine, and 4 of 18 patients in femoral neck. Osteoporosis was unrelated to the type of the CAB(orchiectomy, or LHRH-agonist). CAB caused a decrease in mean BMD of lumbar spine and femoral neck. There is a negative linear relation between mean BMD and duration of CAB(lumber spine; R2=0.059, Y=-2.368-0.016X, p>0.05, femoral neck; R2=0.089, Y=-1.923-0.020x, p>0.05). There is a statistically significant negative linear relationship between Gleason score and mean T-score of femoral neck(lumbar spine; R2=0.391, Y=-0.08-0.371X, p<0.05, femoral neck; R2=0.517, Y=0.855-0.450x, p<0.005). CONCLUSIONS: Our study provide evidence for acceleration of osteoporosis among men whose prostate cancers were treated with CAB. This study indicates a need for bone mineral density determination at the onset of CAB and at periodic intervals there after to begin appropriate therapy, undefined at this point, for prevention of osteoporosis and its complications aggravated by this therapy.
Acceleration ; Adenocarcinoma ; Bone Density ; Femur Neck ; Humans ; Hypogonadism ; Male ; Neoplasm Grading ; Osteoporosis* ; Prostate* ; Prostatic Neoplasms* ; Spine

BACKGROUND: Recently, patients' demands for emergency medicine are increasing, and most of prehospital medical care, including basic life support, cardiopulmonary resuscitation and triage, are provided by paramedics or emergency medical technicians. Evaluation of the adequacy of prehospital management and triage has become important for improving the quality and the effectiveness of the emergency medical system. METHODS: The 202 patients who were transferred by ambulance with paramedics, nurses, or emergency medical technicians to the Emergency Department in Gil Medical Center from July 1, 1999, to September 31, 1999, were enrolled. This study was conducted prospectively by using the emergency physician's log and newly devised protocols recorded by paramedics or nurses. RESULTS: 1) Male to female ratio was 1:0.8, and the peak age of the patients were the 4th(18.8%) and 6th decade(15.3%). 2) Of the 202 patients, 84 patients were transferred for trauma and 118 for medical problems. The mean transfer time was 6+/-1.73 minutes. 3) The validities of prehospital triage and decisions using the trauma severity measure and the disease severity measure, were 33.3% in trauma patients and 57.6% in medical patients. 4) The results for the adequacy rate in prehospital management analyzed by using the rate of necessity of treatment, performance of treatment, and adequate treatment were as follows: oxygen supply, 38.1/41.6/93.8; wound dressing, 19.3/71.8/92.9; immobilization of the cervical spine, 15.8/56.3/92.9; application of a spinal board, 12.9/42.3/72.7; application of a splint, 9.9/50.0/60.0; manual maintenance of an airway, 9.9/55.0/63.6; and CPR, 4.5/66.7/0.5) Kind of ALS(Advanced Life Support) were not conducted(peripheral IV, EKG, intubation medical administration, defibrillation, pacing). The rates of necessity of treatment were as follows: peripheral IV, 40.6%; ECG monitoring, 23.3%; endotracheal intubation, 8.9%; medical administration, 8.9%; defibrillation, 3.5%; and pacing, 1.5%. CONCLUSION: The adequacy of prehospital triage and decisions using trauma and disease severity measures was relatively low. To improve the adequacy of BLS(Basic Life Support) and to increase the performance of ALS(Advanced Life Support), we must create challenges to develop new protocols and to supplement new equipment.
Allied Health Personnel ; Ambulances ; Bandages ; Cardiopulmonary Resuscitation ; Electrocardiography ; Emergencies ; Emergency Medical Technicians ; Emergency Medicine ; Emergency Service, Hospital ; Female ; Humans ; Immobilization ; Intubation ; Intubation, Intratracheal ; Male ; Oxygen ; Prospective Studies ; Spine ; Splints ; Triage* ; Wounds and Injuries

OBJECTIVES: Public release of and feedback (here after public release) on institutional (clinics and hospitals) cesarean section rates has had the effect of reducing cesarean section rates. However, compared to the isolated intervention, there was scant evidence of the effect of repeated public releases (RPR) on cesarean section rates. The objectives of this study were to evaluate the effect of RPR for reducing cesarean section rates. METHODS: From January 2003 to July 2007, the nationwide monthly institutional cesarean section rates data (1 951 303 deliveries at 1194 institutions) were analyzed. We used autoregressive integrated moving average (ARIMA) time-series intervention models to assess the effect of the RPR on cesarean section rates and ordinal logistic regression model to determine the characteristics of the change in cesarean section rates. RESULTS: Among four RPR, we found that only the first one (August 29, 2005) decreased the cesarean section rate (by 0.81 percent) and continued to have an impact period through the last observation in May 2007. Baseline cesarean section rates (OR, 4.7; 95% CI, 3.1 to 7.1) and annual number of deliveries (OR, 2.8; 95% CI, 1.6 to 4.7) of institutions in the upper third of each category at before first intervention had a significant contribution to the decrease of cesarean section rates. CONCLUSIONS: We could not found the evidence that RPR has had the significant effect of reducing cesarean section rates. Institutions with upper baseline cesarean section rates and annual number of deliveries were more responsive to RPR.
Cesarean Section/standards/trends/*utilization ; Disclosure ; Female ; Hospitals/classification/statistics & numerical data ; Humans ; *Information Dissemination ; Logistic Models ; Pregnancy ; Program Evaluation ; *Quality of Health Care ; Republic of Korea

PURPOSE: Myocutaneous flap was widely used for trochanteric pressure sore but it had many drawbacks such as donor site morbidity, dog-ear deformity and functional muscle sacrifice. We have performed fasciocutaneous flap based on perforating vessels and succeeded in overcoming its drawbacks. METHODS: We experienced 11 cases of perforator-based fasciocutaneous flap for the coverage of trochanteric pressure sore in 9 patients, 2 cases of which were bilateral. The ambulatory status of patient group is as follows: 6 of them used a wheelchair, 2 of them are free walking, 1 of them use a wheelchair or crutches. Flap was supplied by cutaneous perforating vessel of descending branch of the lateral circumflex femoral artery and the third perforating artery of the deep femoral artery. The size of wounds were from 4x6.5cm to 10x13cm. RESULTS: We did not find any flap loss or congestion except 2 partial wound dehiscences and 1 wound infection. Donor site morbidity was not found. We observed no recurrence of the pressure sore during the 2.5 year follow-up period. CONCLUSION: We considered that perforator-based fasciocutaneous flap could overcome the traditional drawbacks of the conventional myocutaneous flap and its modified flap for trochanteric pressure sore. And this flap has many advantages for covering trochanteric pressure sore without any donor site deformity and morbidity, which would greatly improve the aesthetic result.
Arteries ; Congenital Abnormalities ; Crutches ; Estrogens, Conjugated (USP) ; Femoral Artery ; Femur* ; Follow-Up Studies ; Humans ; Myocutaneous Flap ; Pressure Ulcer* ; Recurrence ; Tissue Donors ; Walking ; Wheelchairs ; Wound Infection ; Wounds and Injuries

BACKGROUND/AIMS: The liver function tests (LFTs), such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyltranspeptidase (gamma-GT), have been widely used as screening tests but their low positive predictive value can cause many false positive results. To evaluate the clinical usefulness of these tests, we analyzed the serial LFT results for factory workers, and we compared the risk factors for the groups that were divided according to the serial LFT results. METHODS: From June 2001 to October 2001, 1223 consecutive healthy workers in a single factory were enrolled in our study; a questionnaire, LFT and liver ultrasonography were done for all the subjects. The previous LFT results were collected from the Annual health examination survey. According to the abnormalities on the serial LFT, the participants were classified into three groups (abnormal-in-both, alternating or, normal-in-both) and the risk factors were compared among these groups using multiple logistic regression analysis. RESULTS: The prevalence of LFT abnormality on a single test was 16.8%, but on the serial LFT, only 5% of the study participants showed consistent abnormality. The risk factors for the abnormal-in-both group, compared with the alternating group, were liver ultrasonography abnormality such as a fatty liver (odds ratio, 2.2; P=0.026) and a heavy alcohol intake (more than 210 g/week) (odds ratio, 7.2; P=0.064). HBsAg was not a significant risk factor for any of the three groups. CONCLUSIONS: In factory workers having serial LFT abnormalities, alcoholic liver disease could be the principal cause of abnormal LFT. Even if the HBsAg were positive in patients with abnormal LFT, there is the possibility of another causes for LFT abnormalities such as alcoholic liver disease and non-alcoholic steatosis or steatohepatitis.
Adult ; English Abstract ; Female ; Humans ; Korea ; Liver/*enzymology ; Liver Diseases/*diagnosis ; *Liver Function Tests ; Male ; Middle Aged ; Occupational Health Services ; Risk Factors

PURPOSE: We have investigated the prognostic significance of the expression of basal markers for triple-negative (estrogen receptor-negative, progesterone receptor-negative and human epidermal growth factor receptor-2-negative) breast cancers (TNBCs). METHODS: An immunohistochemical study was performed on tissue microarrays constructed with 643 invasive breast carcinoma samples. We subclassified the TNBCs into basal phenotype (BP) and non-BP groups by the use of four different criteria according to the immunprofiles for cytokeratin5/6 (CK5/6), epidermal growth factor receptor (EGFR), vimentin, c-Kit, p63 and P-cadherin. The criteria consisted of criterion 1: CK5/6+ only, criterion 2: CK5/6+ and/or EGFR+, criterion 3: CK5/6+ and/or EGFR+ and/or vimentin+ and criterion 4: one or more marker(s) positive among the six basal markers. Each of these criteria, as well as the status of each individual marker, was evaluated to estimate prognosis for TNBC patients. RESULTS: Of the breast carcinomas, 165 cases (25.7%) were TNBCs. As compared with the non-TNBCs, TNBCs were associated with a larger tumor size (p=0.001), higher histological grade (p<0.001) and shorter overall survival (OS) (p=0.002) and disease-free survival (DFS) (p=0.05). Lymph node status, tumor size and expression of EGFR or c-Kit were independent prognostic factors for patients with TNBC. As compared with the non-BP, BP as defined by criterion 2 was an independent poor prognostic factor for OS and DFS among patients with a lymph node metastasis (p=0.044 and p=0.01) and among patients who received anthracycline-based adjuvant chemotherapy (p=0.009 and p=0.01, respectively). CONCLUSION: Patients with TNBCs showed a poorer prognosis as compared to patients with non-TNBCs. Selected group of the basal-like breast cancers (BLBCs) defined by the immunohistochemical profiles of basal markers showed survival differences from non-BLBCs in subgroups of TNBCs with a homogeneous clinical finding.
Breast ; Breast Neoplasms ; Cadherins ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Epidermal Growth Factor ; Humans ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Phenotype ; Progesterone ; Prognosis ; Receptor, Epidermal Growth Factor ; Vimentin

This study aimed to investigate the frequent intraoperative and postoperative complications and visual outcome of phacoemulsification or extracapsular cataract extraction after vitrectomy. The authors reviewed the medical records of 30 paitients who had undergone pars palana vitrectomy and followed by cataract extraction from January, 1996 to January, 1998, and had been followed up for 3 months or longer. Associated retinal diseases included complication of diabetic retinopathy (11 cases,36.7%), vitreous hemorrhage from branch retinal vein occlusion (6 cases, 20.0%), proliferative vitreoretinopathy (4 cases,13.3%). Mean interval between two operations was 21.0 months. The most commom intraoperative complication was anterior chamber depth fluctuation (4 cases).In a few cases,we had radial tear (3 cases) in lens capsule or miosis (2 cases). The most common early postoperative complication was corneal edema and late complication was posterior capsular opacity.Postoperative visual acuity remained still or improved in 28 cases (93.37%) at postoperative 3 months. In conclusion cataract extraction after vitrectomy may be performed safely with few complications. Visual outcome was favarable but was mainly dependent on previous vitreoretinal patholgy.
Anterior Chamber ; Cataract Extraction ; Cataract* ; Corneal Edema ; Diabetic Retinopathy ; Intraoperative Complications ; Medical Records ; Miosis ; Phacoemulsification ; Postoperative Complications ; Retinal Diseases ; Retinal Vein Occlusion ; Visual Acuity ; Vitrectomy* ; Vitreoretinopathy, Proliferative ; Vitreous Hemorrhage