Dissecting aortic aneurysm is an emergency condition which requires prompt diagnosis and management. From January 1992 to December 1996, 54 patients were admitted to our department. Patients were categorized according to the Stanford classification of aortic dissection and investigation of the clinical records utilized the retrospective method. Male constituted the majority, according for 38(70.4%) of the total number of patients, whereas females accounted for 16(29.6%). Mean age was 52.1+/-2.2 years old (range:25~82). Clinical findings included chest pain in 46 cases(85.2%), renal failure in 11(20.4%), aortic insufficiency in 10(18.5%) and stroke in 9(16.7%). Predisposing factors were hypertension in 48 cases(88.9%), Marfan's syndrome in 5(9.3%) and diabetes mellitus in 1(1.8%). 21 patients(type A:12, type B:9) underwent surgical treatment. There were three(2 in type A and 1 in type B) deaths in the surgical treatment group and nine(5 in type A and 4 in type B) deaths in the medical treatment group. These results reflect our current policy in the management of dissecting aortic aneurysm.
Aortic Aneurysm* ; Causality ; Chest Pain ; Classification ; Diabetes Mellitus ; Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Hypertension ; Male ; Marfan Syndrome ; Renal Insufficiency ; Retrospective Studies ; Stroke

We deacribe herein a case of Darier-White disease occurring to a 50-year-old man who had a characteristic lesions limited to the sun exposed area and no skin lesion in the sun protected area for 40 years. The akin lesions recurred in summer time and aggravated after sun exposure and disappeared spontaneously in winter time. Histologic findings from the neck lesions revealed hyperkeratosis, parakeratosis, supirabasal lacunae, acantholytic cells, villi, corps ronds and grains.
Edible Grain ; Darier Disease ; Humans ; Middle Aged ; Neck ; Parakeratosis ; Skin ; Solar System*

BACKGROUND: Trauma is the third leading cause of death, irrespective of age, and the leading cause of death in persons under 40 years of age. Computed tomography (CT) is an effective technique in the initial emergent evaluation of the abdomen and head following blunt trauma. Most chest indies are not seen on conventional chest radiography, or may be underestimated. But routine use of CT in the initial emergent evaluation of chest trauma is controversial. CT, however, has been shown to be useful in the diagnosis of unsuspected chest injuries and in directing therapeutic interventions. This review discusses the efficacy of emergent CT in patients with blunt trauma on the chest. METHODS: To evaluate the efficacy of CT of the thorax, a retrospective study comparing early thoracic CT scanning with initial chest roentgenogram(CXR) was carried out on 121 patients with blunt trauma on the chest. The interval between CXR and CT was less than 1 hour. RESULTS: Among 121 patients, 42 patients had normal initial chest roentgenogram in whom 19 patients showed normal CT findings. Sensitivities of diagnosing pneumothorax and pleural effusion by CXR were low (49.3%and 45.1%respectively), whereas 65.7% (44/67) of patients had thoracostomy only by CXR. CONCLUSIONS : Although sometimes abused in patients with chest trauma, CT of the thorax is an effective method of detecting thoracic injuries and provides accurate information regarding their pattern and extent in the initial emergent diagnosis.
Abdomen ; Cause of Death ; Diagnosis ; Emergencies* ; Head ; Humans ; Pleural Effusion ; Pneumothorax ; Radiography ; Retrospective Studies ; Thoracic Injuries ; Thoracostomy ; Thorax* ; Tomography, X-Ray Computed

No abstract available.

No abstract available.
Leukemia, Myelogenous, Chronic, BCR-ABL Positive*

Peroxisome proliferator-activated receptor-gamma (PPARgamma) has been implicated in the growth inhibition of a number of cancer cells. In the present study, we investigated the antitumor effect of the PPARgamma agonist rosiglitazone in U87MG human glioma cells. Rosiglitazone treatment in vitro reduced cell proliferation without induction of cell death in a dose- and time-dependent manner. Rosiglitazone decreased cell migration and mRNA level of MMP-9. Rosiglitazone treatment also induced marked changes in glioma cell morphology. Oral administration of rosiglitazone in animals with subcutaneous U87MG glioma cells reduced tumor volume. Subsequent tumor tissue analysis showed that rosiglitazone decreased the number of PCNA-positive staining cells and MMP-9 expression and induced apoptosis of tumor cells. These data suggest that rosiglitazone exerts antineoplastic effect in U87MG cells and may serve as potential therapeutic agent for malignant human gliomas.
Administration, Oral ; Animals ; Apoptosis ; Cell Death ; Cell Movement ; Cell Proliferation ; Glioma ; Humans ; Peroxisomes ; PPAR gamma ; RNA, Messenger ; Thiazolidinediones ; Tumor Burden

Malignant fibrous histiocytoma (MFH) of the heart is a very rare disease. It is difficult to distinguish from myxoma which is most common benign cardiac tumor. Prognosis of malignant fibrous histiocytoma (MFH) of the heart is known to be fatal despite of medical and surgical treatment in contrast to benign tumors. A primary myxoid malignant fibrous histiocytoma of the left atrium was diagnosed in a 58 years old woman. The mass was removed incompletely by operation. The patient did not receive either chemotherapy or radiotherapy. However, the patient is still alive for more than fifteen months after the initial presentation. We report a case of malignant fi brous histiocytoma (MFH) with reviewing the current references.
Drug Therapy ; Echocardiography ; Female ; Heart Atria ; Heart Neoplasms ; Heart* ; Histiocytoma ; Histiocytoma, Malignant Fibrous* ; Humans ; Middle Aged ; Myxoma ; Prognosis ; Radiotherapy ; Rare Diseases

Gastric tuberculosis is a rare disease and the diagnoeis of gastric tuberculosis is based on either positive histological or bacteriological study. We experienced a case of gastric tuberculosis with pleural effuaion in 59 year-old woman, diagnosed by the histological study of the endoscopic biopsy specimen. Follow up endoscopic finding revealed marked improvement of gastric lesion after anti-tubercadoua medication. We reported the case with review of literature.
Biopsy ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Rare Diseases ; Tuberculosis*

OBJECTIVES: We design and develop an electronic claim system based on an integrated electronic health record (EHR) platform. This system is designed to be used for ambulatory care by office-based physicians in the United States. This is achieved by integrating various medical standard technologies for interoperability between heterogeneous information systems. METHODS: The developed system serves as a simple clinical data repository, it automatically fills out the Centers for Medicare and Medicaid Services (CMS)-1500 form based on information regarding the patients and physicians' clinical activities. It supports electronic insurance claims by creating reimbursement charges. It also contains an HL7 interface engine to exchange clinical messages between heterogeneous devices. RESULTS: The system partially prevents physician malpractice by suggesting proper treatments according to patient diagnoses and supports physicians by easily preparing documents for reimbursement and submitting claim documents to insurance organizations electronically, without additional effort by the user. To show the usability of the developed system, we performed an experiment that compares the time spent filling out the CMS-1500 form directly and time required create electronic claim data using the developed system. From the experimental results, we conclude that the system could save considerable time for physicians in making claim documents. CONCLUSIONS: The developed system might be particularly useful for those who need a reimbursement-specialized EHR system, even though the proposed system does not completely satisfy all criteria requested by the CMS and Office of the National Coordinator for Health Information Technology (ONC). This is because the criteria are not sufficient but necessary condition for the implementation of EHR systems. The system will be upgraded continuously to implement the criteria and to offer more stable and transparent transmission of electronic claim data.
Ambulatory Care ; Centers for Medicare and Medicaid Services (U.S.) ; Electronic Health Records ; Electronics ; Electrons ; Fees and Charges ; Health Level Seven ; Humans ; Insurance ; Malpractice ; Medical Informatics ; Relative Value Scales ; United States

The cellular alteration following the electric welding light on the rabbit corneal epithelial cells were studied in several conditions wearing various corneal contact lenses on the corneal surface exposed to the light for 5 minutes at 50 cm in each. The enucleated rabbit eyes 5 hours following the application of electric welding light were histopathologically investigated on the cellular structures of the cornea. The result were as follows: 1. The cellular alterations in a group of soft contact lens wearing consisted of multiple vacuole enlargement, separation of interdigitation and Desmosome, intracellular edema, and loss of organelles in superficial and wing cells layer. Loss of microvilli of the corneal superficial cells were observed. 2. Loss of cytoplasmic microorganelles and microvilli intercellular edema in superficial cell layer, and slight vacuoles enlargement in wing cells layer were demonstrated in a group of the direct light exposure group without contact lenses. 3. Loss of microvilli and intercellular edema with separation of interdigitation in superficial cell layer but no specific changes in wing cells layer were exhibited in a group of hard contact lens wearing. 4. The most destructive features of the corneal epithelial cells were observed in a group of soft contact lens wearing, and it was suggested that the doubtful effects of protection on the corneal superficial tissue in the case of soft contact lens wearing were noteworthy.
Cellular Structures ; Contact Lenses ; Contact Lenses, Hydrophilic ; Cornea* ; Cytoplasm ; Desmosomes ; Edema ; Epithelial Cells ; Microvilli ; Organelles ; Vacuoles ; Welding*