No abstract available.
alpha-Fetoproteins* ; Humans ; Infant* ; Infant, Newborn*

No abstract available.
Erythema Infectiosum*

BACKGROUND: Emergency Medical Technicians can do emergency care only under the control of the physicians. Emergency medical services system(EMSS) in Korea is now extended from the level of basic life support(BLS) to advanced life support(ALS). Unfortunately we don't have any official medical control system yet. We and regional EMSS, 119 rescue team(BLS), have had monthly joint meeting to validate and improve the prehospital care since August, 1998. METHODS: From August, 1998 to February, 1999, 1,708 patients were transported to Ewha Mokdong Hospital by regional 119 rescue team. Eight hundred and six(47.2%) run record were collected and analyzed. The appropriateness of the prehospital care were evaluated based on the comparison of assessment data and treatment data in each run record. The run record were divided into 5 groups; 1) necessary-adequate, 2) necessary-inadequate, 3) necessary-undo, 4) unnecessary-done, and 5) unnecessary-undo. 1) and 5) were judged as acceptable, and 2), 3), and 4) as unacceptable. RESULTS: Among 806 transported patients, 60.8% required one or more emergency care. 21.0% of required care were not provided, and 20.7% of provided care were not adequate. 78.8% of unprovided and 75.9% of inadequate care were 'airway and oxygen supply'. Overall unacceptable rate was decreased from 31.7% to 17.0% during first 5 months, but it rose up again to 24.7% after 2 months. Cardiopulmonary resuscitation(CPR) was performed in 29 prehospital cardiac arrest victims and admitted to ICU in 5 cases. CPR was not provided in 8 necessary situations, and unnecessary CPR was done in 3 cases. CONCLUSION: EMSS in Korea also need a kind of medical control system, even for BLS level. Major portion of the quality assurance program could be 'airway and oxygen supply', but attention should be focused in cardiac arrest victims and CPR. Record keeping and reliance of run record data are now pending problems. Fire department should develop a formal medical control system and the referring hospital should have an organization for maintaining the quality of prehospital care.
Cardiopulmonary Resuscitation ; Emergency Medical Services* ; Emergency Medical Technicians ; Fires ; Heart Arrest ; Humans ; Joints ; Korea ; Oxygen ; Retrospective Studies*

Eosinophilic fasciitis is a syndrome which is characterized by scleroderma-like skin involvement, eosinophilia and hypergammaglobulinemia without significant systemic changes. The primary pathological alterations are thickening and inflammation of the deep fascia. The majority of the cases that have been reportecd respond to systemic corticosteroids. We describe a 19-year-old male patient with eosinophilic fasciitis. On physical examination, he showed tender, edematous, indurated and tight skin in the back and both lower legs, and the laboratory findings showed eosinophilia and mild hypergammaglobulinemia. He also had Raynaud phenomenon, mild dyspnea, abdominal pain, pulmonary function abnormalities and roentgenographic evidence of pulmonary fibrosis. Result of a biopsy showed sclerosis of dermia and intense infiltrations of eosinophils, lymphocytes and histiocytes and fibroais of panniculus and fascia. Treatment with systemic corticosteroids showed complete resolution of the skin lesions, but after withdrawal new scleroderma-like skin lesions developed in the dorsum of feet.
Abdominal Pain ; Adrenal Cortex Hormones ; Biopsy ; Dyspnea ; Eosinophilia ; Eosinophils ; Fascia ; Fasciitis* ; Foot ; Histiocytes ; Humans ; Hypergammaglobulinemia ; Inflammation ; Leg ; Lymphocytes ; Male ; Physical Examination ; Pulmonary Fibrosis ; Raynaud Disease ; Sclerosis ; Skin ; Young Adult

We report a case of inflammatory linear verrucous epidermal nevus which was treated with an aromatic analog of vitamin A acid, Ro 10-9359, with significant effect, The patient is a 17-year-old woman who has had linear verrucous patches involving the entire length of the extensor surface of the right arm, right scapular area and anterior upper part of the right chest with persistent itching sensation of 10 years' duration. The patient was treated with oral Ro 10-9359 75mg daily, and showed marked improvement of the skin lesions after seven days of treatment, but the patient was lost to follow up.
Adolescent ; Arm ; Etretinate ; Female ; Humans ; Lost to Follow-Up ; Nevus, Sebaceous of Jadassohn* ; Pruritus ; Sensation ; Skin ; Thorax ; Tretinoin

No abstract available.
Growth and Development*

Lipodystrophia centrifugalis abdominalis infantilis, an typical form of progressive lipodystrophy, is a disease mainly decribed in japanese infants. We report a case of lipodystrophia centrifugalis abdominals infantilis in Korean infant. The patient is a 2 year-old-girl with a coin sized well defined depressed lesion with surrounding redness and scaly changes in the right inguinal region. The skin from the depressed lesion revealed changes similar to those originally described by Imamura et al.
Infant ; Male ; Female ; Humans

No abstract available.
Histiocytosis*

Atypical condyloma is a variant of flat condyloma characterized by the presence of atypical koilocytes having large hyperchromatic, smudged and often bizarre nuclei. Atypical condyloma can be frequently misdiagnosed on cytologic smear and on tissue sections by its marked cellular atypia, as high grade dysplasia, in situ or even invasive squamous cell carcinoma. We described two cases of atypical condyloma of the female genital tract. The cytologic features and histologic changes were reminiscent of those of invasive squamous cell carcinoma and severe degree of dysplasia of the uterine cervix. The differential findings between atypical condyloma and squamous cell carcinoma were discussed in detail.
Female ; Humans

The Dichloromethane(methylene chloride) is a highly volatile liquid used as a solvent, extraction medium, and paint remover. The most significant route of intoxication to dichloromethane is generally inhalation at work site or home, but ingestion is rare. The main toxicological harvard insults from in vivo conversion of dichloromethane to carbon monoxide. We present a case of dichloromethane intoxication following ingestion. A 71 years old male patient ingested 60-70cc of dichloromethane was brought to emergency department after stomach washout via nasogastric tube at other hospital. On arrival at emergency department(approximately 19 hours after ingestion), he was stuporous with a blood pressure 140/90mmHg, heart rate of 92 beats/min, dyspneic, respiratory rate of 24/min and body temperature 36.8 degrees C. His Pupils were isocoric, miotic, and sluggishly reactive. There were mucosal bums and significant secretion in oral cavity. On auscultation, breathing sound was coarse without role on both lung field. The COHb levels were 6.3%at 32 hours after ingestion and normalized to 0.6%at 44 hours after ingestion. Patient was transfered to intensive care unit and supportive care was started with 100% oxygen. On ingestion 4th day, chest X-ray showed pulmonary edema and acute respiratory distress syndrome developed. Patient regained the consciousness on the 11th day. On the 30th day, respiratory function improved and the ventilator was removed. Alveolitis and mild pulmonary fibrosis developed and mild dyspnea was continued. On the 36th day, gastroscopic examinations showed ulceration of esophagus and stomach. On the 76th day, patient was discharged after pulmonary rehabilitation.
Aged ; Auscultation ; Blood Pressure ; Body Temperature ; Carbon Monoxide ; Consciousness ; Dyspnea ; Eating* ; Emergencies ; Emergency Service, Hospital ; Esophagus ; Heart Rate ; Humans ; Inhalation ; Intensive Care Units ; Lung ; Male ; Methylene Chloride* ; Mouth ; Oxygen ; Paint ; Pulmonary Edema ; Pulmonary Fibrosis ; Pupil ; Rehabilitation ; Respiratory Distress Syndrome, Adult ; Respiratory Rate ; Respiratory Sounds ; Stomach ; Stupor ; Thorax ; Ulcer ; Ventilators, Mechanical ; Workplace