Recently radiation and radioisotope are being used widely in many fields such as medicine and industry. But only a few papers were reported about the radio dermatitis due to industrial use of radiation. Authors experienced 4 cases of occupational radiodermatitis due to Ir-192 occur red during the radioisotope traspierce test. All 4 patients noticed painful swelling, erythema, and bullae on their fingers or palms 1-2 weeks after exposure. All laboratory tests to detect ystemic effects of radiation were normal. Three patients recovered after treatment with systemic and topical corticosteroid and emollient cream for 2-4 weeks. But one patient suffered from complication of fibrosis and recurrent cellulitis on his fingers. We discussed about the working situation of our patients and reviewed the literatures about the radiodermatitis.
Cellulitis ; Dermatitis ; Erythema ; Fibrosis ; Fingers ; Humans ; Radiodermatitis

The importance of garlic as a cause of hand eczema has been a matter of debate. Diallyldisulfide is considered as the main allergen in garlic. Twentv two antigens of the modified European standard series and diallyldisulfide of 5%, 2%, 1%, 0.5%, 0.1% in petrolatum were patch tested in 44 patients with hand eczema. Diallylclisi.!lfide was also tested in 13 women as a control. The results were summerized as follows. l. In patch testing with the European standard series, nickel sulfate (22.7%), cobalt chloride (18.2%), fragrance mix (13.6%), balsam of Peru (9.1%) and termerosal (6.8%) were the cornmon allergens which showed positive reactions. The overal positive rate was 59.1 % (26/44). 2.5% diallyldisulfide showed an irritant reaction in 6 (46.2%) out of 13 controls and in 16 (36.4% ) out of 44 patients. 2% diallyldisulfide showed an irritant reaction in 2/13 (15.4 %) in the control group and 6/44 (13.6%) in the patient group. All 13 controls and 44 patients were negative iin tests with diallyldisulfide of 1%, 0.5%, 0.1%. Our results indicate that patch testing with diallyldisulfide of 1% petrolatum is reommended in order to avoid an irritant reaction when contact allergy to garlic is suspetel. 3. Garlic is suspected as an irritant in provoking hand eczema. True contact allergy to garlic in hand eczema seems to be rare.
Allergens ; Cobalt ; Eczema* ; Female ; Garlic* ; Hand* ; Humans ; Hypersensitivity ; Nickel ; Patch Tests ; Peru ; Petrolatum

Occupational allergic contact dermatitis cases who had visited the patch test clinics of Seoul National University Hospital(1984-1988) and Koryo General Hospital(1982-1988) were analyzed in this study. Patch test was performed with either Hollister-Stier standard battery or European standard battery in addition to the patients own materials and other commercially available antigens. Patch test was peformed according to the recommendation of International Contact Dermatitis Research Group. The result is summarized as follows. 1. Out of 946 cases 65 (6.9%) were suspected as having occupational dermatoses clinically and 35 (3.7%) were diagnosed as occupational allergic contact dermtitis after patch test. 2. Sixteen (45.7%) out of the 35 patients were male and 19 (54.3%) were female. Twenty one (60.0%) patients were in the age of 20 to 40 years. 3. The occupational distribution of 35 patients were medical personnels (8), cement workers (7), industrial workers (5), hair dressers (5), farmers (3), merchants (3), cooks (2) and painters (2). 4. Potassium dichromate, nickel sulfate and rubber chemicals were the most common occupational allergens. We also reviewed the Korean literatures related to the occupational dermatoses.
Allergens ; Dermatitis, Allergic Contact ; Dermatitis, Contact* ; Dermatitis, Occupational ; Female ; Hair ; Hospitals, General* ; Humans ; Male ; Nickel ; Patch Tests* ; Potassium Dichromate ; Rubber ; Seoul ; Skin Diseases

No abstract available.
Colon* ; Colonic Neoplasms*

Vertigo due to primary cardiac disease, known as cardiogenic vertigo, has been rarely reported. We report one case showing recurrent vertigo episodes due to sick sinus syndrome. A 77-year-old female presented to our department because of long history of intermittent brief episodes of rotatory vertigo and non-vertiginous dizziness. She had no past medical history. There was no abnormal sign in neurological examination. Cardiac murmur, finally confirmed as grade 4 ejection systolic and grade 3 decrescendo diastolic murmurs, was found on physical examination. Brain magnetic resonance imaging and auditory evoked potential did not show any abnormal findings. She was consulted to a cardiologist for the evaluation of cardiac murmur. After the evaluation using electrocardiogram, echocardiography, and holter monitoring, she was diagnosed as sick sinus syndrome. After then, a ventricle ventricle inhibited (VVI) pacemaker was inserted. She did not complain of vertigo and dizziness for 3 months after the insertion of a VVI pacemaker. This case shows the need of auscultation for patients with recurrent vertigo episodes although there is rare cardiogenic vertigo.
Aged ; Auscultation ; Brain ; Dizziness ; Echocardiography ; Electrocardiography ; Electrocardiography, Ambulatory ; Evoked Potentials, Auditory ; Female ; Heart Diseases ; Heart Murmurs ; Humans ; Magnetic Resonance Imaging ; Neurologic Examination ; Physical Examination ; Sick Sinus Syndrome ; Vertigo

A 71-year-old woman with minimal change disease visited our clinic complaining of pleuritic chest pain. Cefepime was given under the impression that she had pneumonia. Three days after cefepime administration, she became unconscious. A brain MRI scan was non-revealing and an EEG showed triphasic waves. As there was no evidence of septic, uremic or hepatic encephalopathy, we suspected cefepime-induced neurotoxicity. Cefepime was stopped and she underwent hemodialysis to decrease the blood levels of the drug. Following hemodialysis, she regained consciousness.
Aged ; Brain ; Cephalosporins ; Chest Pain ; Consciousness ; Electroencephalography ; Female ; Hepatic Encephalopathy ; Humans ; Magnetic Resonance Imaging ; Nephrosis, Lipoid ; Neurotoxicity Syndromes ; Pneumonia ; Renal Dialysis ; Unconscious (Psychology)

The quality factors (kQ,Q0) were evaluated by appling the results recently studied for the effect of central electrode in TRS-398 protocol. The PTW-31010 and IBA-CC13 chambers were used in this study. The quality factors were calculated as a function of beam quality for high energy electron and photon beams and compared with data currently used in TRS-398 protocol. In the PTW-31010 chamber using aluminium electrode, appling the new central electrode collections, the quality factors were 0.4% and 0.9% higher than current TRS-398 data for high energy photon and electron beams respectively. In the IBA-CC13 chamber using C-552 electrode, there are no variations in quality factors compared to TRS-398 data currently used.
Electrodes ; Electrons

Hereditary nonpolyposis colon cancer(HNPCC) accounts for 1~6% of colorectal cancer. Mutations in the DNA mismatch repair genes(hMSH2, hMLH1 and hPMS1, hPMS2 and hMSH6) are responsible for HNPCC. To evaluate the clinical characteristics of Korean HNPCC patients, analysis were performed on the 176 patients from 40 HNPCC families registered in the Korean Hereditary Tumor Registry. All the families in this study fulfilled the ICG-HNPCC criteria. The control group consisted of 1,204 patients of nonhereditary colorectal cancer operated at SNUH between 1991 and 1995. The mean age of patients at diagnosis was significantly lower than the control group (44.5 vs 56.1 years old). Thirty three percent of cancers were located proximal to splenic flexure compared to 23% in control group. Among the 71 patients whose pathological reports were available, 14 patients(20%) had synchronous colorectal cancer compared to 4% in control. Also 15 patients(21%) had synchronous adenomatous polyp and 3 patients had both the synchronous cancer and polyp. Thus, overall 26 patients (36%) had multiple colorectal cancer including polyp. The cancers in HNPCC patients were detected at significantly earlier stage than control(67% of HNPCC patients were Dukes A or B compared to 48% in control). Statis tically significant difference was not observed in tumor differentiation between HNPCC and control group. In terms of treatment, 64% of patients received an extensive surgery over subtotal colectomy between 1995~1997 compared to 31% in the period of 1991~1994. In this series, we confirmed that Korean HNPCC patients have similar characteristics with western countries in that an early age of onset, a proclivity for the proximal colon and excess of synchronous colorectal cancers. However, relatively low incidence of proximal colonic involvement and low rate of mucinous or poorly differentiated carcinoma differed from the reports from the western countries.
Adenomatous Polyps ; Age of Onset ; Colectomy ; Colon ; Colon, Transverse ; Colorectal Neoplasms ; Colorectal Neoplasms, Hereditary Nonpolyposis* ; Diagnosis ; DNA Mismatch Repair ; Humans ; Incidence ; Mucins ; Polyps

Stent thrombosis (ST) is one of the major complications that occur in percutaneous coronary interventions (PCIs) with stents. Various factors have been attributed to the development of ST, and several strategies have been recommended for its management. We report the case of a patient suffering from recurrent subacute STs after recurrent PCIs. The patient was treated by coronary artery bypass graft (CABG).
Coronary Artery Bypass ; Humans ; Percutaneous Coronary Intervention ; Stents ; Stress, Psychological ; Thrombosis ; Transplants

BACKGROUND: The use of tourniquet is associated with severe hemodynamic changes, particularly in elderly patients. This study examined the effects of continuously infused remifentanil or nicardipine with esmolol on the attenuation of the hemodynamic changes with enflurane inhalation during total knee arthroplasty in elderly patients. METHODS: Thirty elderly female patients undergoing total knee arthroplasty were enrolled into this randomized, prospective study. Remifentanil (group R) or nicardipine with esmolol (group EN) was infused using a titration method to maintain a mean arterial pressure (MAP) of 90 mmHg to 70 mmHg during tourniquet inflation. In addition, the inhalation of enflurane was adjusted to guarantee a hypnotic state based on entropy. The hemodynamic variables, inhaled concentration of enflurane, recovery time, and postoperative pain characteristics were measured and compared. RESULTS: Following tourniquet inflation, the MAP was increased and maintained in the target since 20 min after that in both group. Following tourniquet deflation the MAP was decreased significantly in both groups and more patients in group R required a vasopressor. Group R inhaled a lower enflurane concentration and showed more rapid recovery than group EN. There were no significant differences in the level of postoperative pain between the two groups. CONCLUSIONS: These results suggest that remifentanil is more likely to be associated with hypotension after tourniquet deflation and require more attention than nicardipine with esmolol.
Aged* ; Arterial Pressure ; Arthroplasty* ; Enflurane ; Entropy ; Female ; Hemodynamics* ; Humans ; Hypotension ; Inflation, Economic ; Inhalation ; Knee* ; Nicardipine* ; Pain, Postoperative ; Prospective Studies ; Tourniquets