A case of eavernous hemangiomatosis involving alI tendon sheath of flexors and median nerve of the right forearm is reported. This case was a 22 year old Korean male who complained of painful swelling of the flexor side of right wrist region, limited motion of wrist joint, loss of pinching and opposition with tingling sensation on the admission. Roentgenographic examination revealed fusiform swelling of the soft tissues in flexor aspect of the right wrist region, with phlebolith, 3mm. in diameter. The tumor mass looked like strawberry in shape, and was scattered into all tendon sheath of flexors of the forearm, median nerve, the distal half of pronator quadrtus and other surrounding soft tissues. The specimen was confirmed as cavernous hemangioma in microscopic examination. The right long arm splint was applied for 3 weeks, and then the patient was treated with physical therapy for 4 months. Pinching, opposition, and motion of the right wrist joint recovered almost completly, and no evidence of the recurrence of hemangiomatosis was seen until 8 months after surgery.
Arm ; Forearm ; Fragaria ; Hemangioma, Cavernous ; Humans ; Male ; Median Nerve ; Recurrence ; Sensation ; Splints ; Tendons ; Wrist ; Wrist Joint

Eccrine chromhidrosis(colored sweating), resulting from the contamination of the sweat by dyes, pigment from microorganisms such as those of Piedraia or Corynebacterium, or other chernicals, is a very rare disease. We report a case of eccrine chromhidrosis which revealed dark-brown colored pigmented spots analyzed by energy dispersive X-ray microassay and scanning electron microscopy, which were thought to be composed of silver iodide(AgI) formed by the conjugation of silver components from outside and iodide components of eccrine sweat, on the face, postauricular area, legs, and finger tips.
Coloring Agents ; Corynebacterium ; Fingers ; Leg ; Microscopy, Electron, Scanning ; Rare Diseases ; Silver* ; Sweat

This clinical study is based on review of records of 87 patients with postoperative adhesive intestinal obstruction who were managed at the Department of Surgery of Dongbu City Hospital during 5 years from September, 1992 to August, 1997. The results of study were as follows: 1) The most prevalent age group was 5th decade(44.8%) and male to female ratio was 1.7:1. 2) The previous operations were operation for appendicitis(32.2%), operations for peritonitis due to peptic ulcer perforation(24.1%), gynecologic operations(13.8%), operation for gastric malignancy(8.1%). 3) The mean value of duration between previous operations and postoperative adhsive intestinal obstruction was 36 months and the mean value of duration of symptoms was two days. 4) 42(49.2%) of 87 patients were admitted under 24 hours after onset of symptoms. 5) The chief complaints on admission were abdominal pain(98.8%), vomiting(81.6%), abdominal distension(78.2%), failure to flatus(55.2%). 6) 23 cases(45.1%) of 51 cases having one or more abnormal physical and laboratory finding(fever, abdominal tenderness, abscence of defecation or gas out, or leukocytosis) were operated, and 5 cases(13.9%) of 36 cases having no physical finding were operated (p value < 0.05). 7) Emergency operation was performed in 9 cases, elective operation was performed in 19 cases which had deteriorating clinical course despite of conservative management for 48 hours, and conservative treatement was performed in 59 cases. 8) The postoperative complications were observed in 6 cases and the most common complication was wound infection(14.3%). In conclusions, The longer symptom duration and the longer interval between previous operation and onset of symptoms, the higer probability of surgical treatment is expected. The need for surgical treatment was increased acording the number of physical and laboratory findings(fever, abdominal tenderness, abscence of defecation or gas out, or leukocytosis). For the cases which have unimproving and deteriorating clinical course despite of conservative management for 72 hours, surgical operation shoud be considered.
Adhesives* ; Defecation ; Emergencies ; Female ; Hospitals, Urban ; Humans ; Intestinal Obstruction* ; Male ; Peptic Ulcer ; Peritonitis ; Postoperative Complications ; Wounds and Injuries

Objective: The purpose of the present study was to screen the prevalence of aneurysms in migraineurs; to differentiate presenting features in migraineurs with and without aneurysm; and also to correlate the locations of aneurysm to the clinical features of migraine. Methods: A total of 4,416 subjects were interviewed and completed self-reported questionnaires on headache. Of these, 1,773 subjects diagnosed to have migraines based on the International Classification of Headache Disorders II (ICHD-II) criteria were screened for aneurysm by magnetic resonance angiography (MRA). When aneurysm was suspected, further investigation with trans femoral cerebral angiography (TFCA) or three dimensional computerized tomography (CT) angiography was performed. Based upon MRA findings, subjects were grouped into unruptured aneurysm migraine patients (UAMP) and no aneurysm migraine patients (NAMP). Results: The prevalence of aneurysm was 3.6% (63 of 1,773) with the mean age of 56.0 years, which were not different from those of general population. There was no difference in migraine subtypes between UAMP and NAMP. Aggravation of headache by estrogen replacement therapy during menopause (p=.039), history of migraine in young age (p= .021), diplopia (p=.026), and retroauricular pain (p=.025) were significantly associated with presence of aneurysm. Although aneurysms were detected more in anterior circulation, there was no correlation between aneurysm site and headache location. The average size of aneurysm was 3.5 ± 2.1 mm and none were ruptured. Interventional therapy of aneurysm did not alter the feature of migraine. Conclusions: The incidence of aneurysm was not different in migraine patients as compared to the general population. Some features which significantly differentiate whether migrainuers have aneurysm or not warrant further study to have a predictive and localizing value.

PURPOSE: To determine the necessity of site-specific bone mineral density(BMD) measurement and the difference between the BMD of the two femora using DXA in the evaluation of osteoporosis. MATERIALS & METHODS: Total BMD and regional BMD(Lumbar spine, femoral neck, Ward's area, intertrochanter area) were measured on seventy-eight healthy persons without previons diseases, and the statistical significance analyzed. RESULTS: Total BMD did not reliably reflect the site-specific BMD. There was a high correlation between BMD in opposing femora. Correlation coefficients between the femoral neck, Ward's area, trochanter area were 0. 939, 0.874 and 0.916 respectively. CONCLUSION: We conclude that a measuremnt of site-specific BMD is necessory because the total BMD can not reliably predict the regional BMD. The measurement of BMD in one femur can predict the BMD of the contralateral femur. If there is no history of femoral neck disease, unilateral BMD measurement is recommended for femoral evaluation.
Absorptiometry, Photon* ; Femur ; Femur Neck ; Humans ; Osteoporosis ; Spine

BACKGROUND: The skin prick test and in vitro allergen-specific IgE assays are commonly used to diagnose atopic diseases. However, there is still a need for comparison of their diagnostic efficiency. Objective and METHOD: To evaluate their clinical efficiency, the results of UniCAP and multiple antigen simultaneous test (MAST) were compared with skin prick test results. After 51 allergic patients completed skin prick test (SPT), serum sample was collected and UniCAP and MAST were performed to determine specific IgE to house dust mite (Dermatophagoides pteronyssinus : Dp and D. farinae. Df). Result : When SPT was used as a reference standard, UniCAP depicted higher sensitivity of 88.8% to Dp IgE and 91.4% to Df - IgE, but lower specificity of 73.3% to Dp IgE and 75.0% to Df - IgE. However, MAST had lower sensitivity of 75.1% to Dp-IgE and 71.4% to Df - IgE, higher specificity of 93.3% to Dp-IgE and 93.7% to Df - IgE. The values of UniCAP and MAST were significantly correlated with the reactivity grade of skin prick test, respectively. Additionally, the response of SPT was not apparently associated with ECP levels. CONCLUSION: These study results may suggest that both UniCAP and MAST are generally feasible for measuring house dust mite - specific IgE and that they are both replicable.
Dust* ; Humans ; Immunoglobulin E* ; Pyroglyphidae* ; Sensitivity and Specificity ; Skin*

The eye is a common target organ of the allergy, and allergic conjunctivitis is the most common of eye diseases. Clinical manifestations of allergic conjunctivitis are acute bilateral red, itchy, and watery eyes. The presence of conjuncitival eosinophilia may be consided to be a diagnostic indicator of allergic conjunctivitis. ECP is a quantifiable toxic product secreted by activated cosinc phils. VCAM-1 promotes adhesion of leukocytes to endothelium in vitro and may promote imflammation in vivo. The objective of this study is to measure eosinophil count, ECP and sVCAM-1 levels of tears and sera in patients with acute allergic conjunctivitis and normal subjects and to assess the correlation of these mediators with the severity of the disease and the clinical usefulness. Seventeen subjects were selected on the basis of clinical manifestations, history, skin prick test, total IgE. A microcapillary tube was used to collect the tears from the inner canthus, conjunctival epithelia were obtained for eosinophil count by scraping the upper tarsal conjunctiva. The level of ECP was measured by CAP system (Kabi-Pharmacia, Sweden), sVCAM-1 was measured by ELISA (R&D, USA). Serum IgE and eosinophil count were in creased in 10 patients, allergic skin prick test were positive in 11 subjects (D.p: 9, D.f: 8), eosinophilia in conjunctival epithelium were present in 11 subjects (4 patients: > 3/HPF, 7 patients: 1-3/HPF). ECP in tears were increased in patients significantly (12.0+8.0 vs 3.9+3.8 ng/ml, p=0.01), but not in serum (52.5+43.1 vs 28.3+25.9 ng/ml). There is no significant correlation between eosinophil count and ECP in serum and tears (p>0.05, r-=0.19). Serum sVCA-M-1 level is significant different between patients and controls (1916.5+756.0 vs 1147.2+146.1 micro gram/ml, p=0.01), sVCAM-1 is significantly correlated to eosinophil count (p=0.01, r=0.56) and ECP (p<0.05, r=0.65). In conclusion, eosinophil and ECP in tears may be very important role in allergic conjunctivitis and are useful indicators of the disease. The elevation of sVCAM-1 in serum may be interpreted simply as marker of the presence of non-specific inflammation.
Cell Adhesion* ; Child* ; Conjunctiva ; Conjunctivitis, Allergic* ; Endothelium ; Enzyme-Linked Immunosorbent Assay ; Eosinophilia ; Eosinophils* ; Epithelium ; Eye Diseases ; Humans ; Hypersensitivity ; Immunoglobulin E ; Inflammation ; Leukocytes ; Skin ; Tears* ; Vascular Cell Adhesion Molecule-1

A retrospective study was made of the previous medical records of 32 infants with congenital syphilis borne from mothers with untreated syphilis at Severence Hospital, Yonsei University College of Medicine during the years 1,972 through 19g3, These infants had a VDRL titer higher than 1: 8 with reactive FTA-ABS test and were also subjected to radiologic examinations. Radiologic changes and clinical features were analyzed, The following results were obtained: Of the total of 32 infants with congenital syphilis under 5 months of age, those under 1 month of age, were the most common group numbering a total of twelve. Of 32 infants with congenital syphilis, twenty-nine(91%) showed skeletal changes upon radiologic examination, Among them the different sites of bone involvernent revealed that the femur(92%) was the most commonly affected bone, followed by the humerus(88%), tibia(81%,), fibula(80%), ulna(72%), radius (68%). Among the same 29 infants a study of the presence of various abnormal bone changes showed that periostitis was the most common, being involved in 83%, the others being metaphysitis and periostitis(72%), metaphysitis(66%). 3. Among the clinicaI features presented in the 32 infants with congenital syphilis, hepatomegaly was the most common(63%,), followed by erythema with desquamation(47%), pneumonia(38%), maulopapules(34%).
Erythema ; Fluorescent Treponemal Antibody-Absorption Test ; Hepatomegaly ; Humans ; Infant ; Medical Records ; Mothers ; Periostitis ; Radius ; Retrospective Studies ; Syphilis ; Syphilis, Congenital*

bcl-2 and c-myc protein expression were studied in 44 epidermal (8 seborrheic keratoses, 21 squamous cell carcinomas, and 15 basal cell carcinomas), and 26 melanocytic tumors(8 nevi, and malignant melanomas) by immunohistochemistry using the specific anti-bcl-2 and anti-c-myc monoclonal antibodies. 14 out of 15 basal cell carcinomas(BCC) (93.3%) showed expression of bcl-2 protein, 12 of which (85.7%) showed coexpression of c-myc protein. In the melanocytic tumors, 7 out of 8 nevi showed bcl-2 expression (87.5%). Five of these 7 cases (62.5%) also showed c-myc protein expression. Eight of 18 malignant melanomas(MM) (44.4%) showed expression of bcl-2 protein and 7 of these 8 cases (38.9%) also showed c-myc protein expression. All seborrheic keratoses and squamous cell carcinoma(SCC) were negative for bcl-2 proteins. 12 of 15 SCCs(80%) were positive for c-myc protein. In conclusion, bcl-2 and c-myc proteins were coexpressed in BCCs, nevi, and MMs. Coexpression of bcl-2 and c-myc proteins in these tumors was statistically significant(p<0.01), while no considerable differences of bcl-2 and c-myc expression were found between nevi and MMs. These results suggests that bcl-2 may cooperate with c-myc to promote tumorigenesis of BCCs, nevi, and MMs(p<0.01).
Cell Transformation, Neoplastic

PURPOSE: The purpose of this study was to suggest the projected manpower of hospice and palliative care nurses & APNs(advanced practice nurses)needed in the future. METHOD: Need model, ratio model and expert opinion were used for projecting the number of hospice and palliative care nurses & APNs. RESULT: 1. The number of Korean hospice facilities was 64 in 2002. The number of hospice nurses in 2001 was 194 and that of beds was 407. 2. The number of hospice target patients was estimated at a minimum of 16,415 to a maximum of 25,254 in 2002, 12,366 to 26,389 in 2005, and 14,057 to 30,000 in 2020. 3. The number of hospice and palliative nurses needed to meet the demands in 2002, 2005 and 2020 was estimated at a minimum of 1,136 to maximum of 1,748, 1,187 to 1,826, and 1,349 to 2,076, respectively. 4. The number of hospice & palliative care APNs needed to meet the demands in 2002, 2005 and 2020 was estimated at 232, 242, and 274, respectively. CONCLUSION: The legalization of hospice is expected to increase demands for hospice nurses and advanced practice hospice and palliative care nurses in the future.
Expert Testimony ; Hospices* ; Humans ; Korea* ; Palliative Care*