The vermilion border of the lips has a modifed epithelium, which is much more likely to develop allergic contact sensitivity reactions than oral mucosa. Allergens in contact with both the oral mucosa and the lips oftens produce only cheilitis. Allergic contact cheilitis may result from topical medicaments, dentifrices, cosmetics, foods, plants or metals. We present six cases of allergic contact cheilitis confirmed by patch test. The toot4paste was incriminated in 2 cases, the lipstick in 3 cases and the bubble gum in one rase as producing chelitis respectively.
Allergens ; Cheilitis* ; Dentifrices ; Dermatitis, Contact ; Epithelium ; Gingiva ; Lip ; Metals ; Mouth Mucosa ; Patch Tests

No abstract available.
Pancreatitis, Chronic*

Right atrial myxoma is a rare primay intra cardiac tumor and it presents various clinical manifestations mimicking Tricuspid stenosis, Constricive Pericarditis, and Subacute Bacte rial Endocarditis A 10 years old boy with exertioal dysyonea and general weakness for 40days was admitted to our hospital under the impressionof right atrial myxoma.clincal diagnosis was made by echocardiogram, cardiac catheterization and right artiograhpy We present a case of right atrial myxoma with a review of the literatures.
Cardiac Catheterization ; Cardiac Catheters ; Child ; Constriction, Pathologic ; Diagnosis ; Endocarditis ; Heart Neoplasms ; Humans ; Male ; Myxoma* ; Pericarditis

A 18-month-old girl was seen because of an yellowish brown papular eruptions on the face, earlobes and neck of one year duration. A skin biopsy specimen revealed circumscribed cellular infiltrates composed of predorninantly pleornorphic histiocytes. Electron microscopy of biopsy material disclosed numerous worm like particles and coated vescles in limited area of the cell cytoplasm, consistent with the findinga described in benign cephalic histiocytosis. After six months of her first visit, the individual papules became flattened.
Biopsy ; Coated Vesicles ; Cytoplasm ; Female ; Histiocytes ; Histiocytosis* ; Humans ; Infant ; Microscopy, Electron ; Neck ; Skin

No abstract available.
Delivery of Health Care*

No abstract available.
Animals ; Cytochrome P-450 Enzyme System* ; Cytochromes* ; Gene Expression* ; Mice*

A case of pancreatic pseudocysts and bloody pancreatic ascites as complications of chronic pancreatitis in eleven-year-old girl was reported. She was admitted to the pediatric ward with chief complaints of abdominal distension and bloody ascites. About nine months prior to admission, when she was stuck by a bicycle, she had sustained a blow on her abdomen. She has been apparently well until four months prior to admission, when she began to feel colidy and intermittent abdominal pain and her appetits became poor. About a week prior to admission, her mother noticed that the girl's abdomen was distended. One day prior to admission, bloody ascites was revealed by paracenteis at a local clinic. Clinical and laboratory pictures were observed for 3 months. Ascites amylase at preoperative state were 496~705 u/dl and 740~772 u/dl Protein in ascites was 2,390mg%~4,820mg%. On the fifty fifth hospital day, an exploratory laparotomy was performed. About 7,000cc of bloody ascites was drained. A 30 x 20cm sized pseudocyst with thin wall was found between stomach and transverse colon. The portion of disrupted pancreatic duct was drained with sump tube. Abdomen distension and pain was markedly relieved after operation. On the 60 th postoperative day, ultrasonography of abdomen revealed no cysts. So sump tube was removed. A brief review of the literature was done.
Abdomen ; Abdominal Pain ; Amylases ; Ascites* ; Colon, Transverse ; Female ; Humans ; Laparotomy ; Mothers ; Pancreatic Ducts ; Pancreatic Pseudocyst* ; Pancreatitis, Chronic* ; Stomach ; Ultrasonography

OBJECTIVES: To examine the prophylactic antibiotic use in reducing surgical site infection. METHODS: This was a retrospective study for patients aged 18 years and older who underwent gastrectomy, cholecystectomy, colectomy, cesarean section and hysterectomy. The data source was quality assessment data of the Health Insurance Review & Assessment Service gathered from medical records of 302 national hospitals. Prophylactic antibiotic use was defined as: timely antibiotic administration or inappropriate antibiotic selection. We performed hierarchical logistic regression to examine the association between prophylactic antibiotic use and surgical site infection with adjustment for covariates. RESULTS: The study population consisted of 16 348 patients (1588 gastrectomies, 2327 cholecystectomies, 1,384 colectomies, 3977 hysterectomies and 7072 cesarean sections) and surgical site infection was identified in 351 (2.1%) patients. The rates of timely antibiotic administration and inappropriate antibiotic selection varied according to procedures. Cholecystectomy patients who received timely prophylactic antibiotic had a significantly reduced risk of surgical site infection compared with those who did not receive a timely prophylactic antibiotics (OR 0.64, 95% CI=0.50-0.83), but no significant reduction was observed for other procedures. When inappropriate prophylactic antibiotics were given, the risk of surgical site infection significantly increased: 8.26-fold (95% CI=4.34-15.7) for gastrectomy, 4.73-fold (95% CI=2.09-10.7) for colectomy, 2.34-fold (95% CI=1.14-4.80) for cesarean section, 4.03-fold (95% CI=1.93-8.42) for hysterectomy. CONCLUSIONS: This study examines the association among timely antibiotic administration, inappropriate antibiotic selection and surgical site infection. Patients who received timely and appropriate antibiotics had a decreased risk of surgical site infection. Efforts to improve the timing of antibiotic administration and use of appropriate antibiotic are needed to lower the risk of surgical site infection.
Adolescent ; Adult ; Antibiotic Prophylaxis/*standards ; Female ; Humans ; Male ; *Quality Indicators, Health Care ; Republic of Korea ; Retrospective Studies ; Surgical Wound Infection/*prevention & control ; Young Adult

PURPOSE:This study was a pilot study to develop structure, clinical performance and outcome measurement and criteria for increasing number of dialysis facilities and patients to provide quality of care. METHODS:The six components of developing quality indicators for hemodialysis were as follows: 1) Organizing expert panel members. 2) Selecting the area: to reflect stakeholders' opinion, structured interviews were done. And literature reviews were performed to investigate guidelines and quality measurements of foreign countries. 3) Selecting clinical performance indicators: From experts' opinions and literature review. 4) Developing candidate indicators. 5) Performing demonstration survey: Systemic sampling was performed and 43 facilities were participated in self-answered medical record survey. 6) Based on preliminary evaluation model, final indicators were selected from expert panel reviews. RESULTS:Eleven measures of structure, thirteen performance measures of process and nine monitoring measures of outcome were developed based on literature review and clinical practice guideline. As for criterion-related validity, those of process and outcome were most high and in case of face validity, those of structure and process were most high. The most valid quality indicators were the rate of internal medicine specialist, dialysis frequency per doctor, whether or not keeping emergency equipment, examination of water quality, hemodialysis adequacy (Kt/V), monitoring arterial venous graft for stenosis maintenance of iron storage, and administration of supplemental iron. CONCLUSION:By developing quality indicators of hemodialysis and performing demonstration evaluation, quality of care for hemodialysis patients is expected to be improved, so as to promote hemodialysis patients' health and improve on quality of life.
Constriction, Pathologic ; Delivery of Health Care ; Dialysis ; Emergencies ; Humans ; Internal Medicine ; Iron ; Medical Records ; Pilot Projects ; Quality Indicators, Health Care ; Quality of Health Care ; Quality of Life ; Renal Dialysis ; Specialization ; Transplants ; Water Quality

BACKGROUND: Topical steroid treatment induces diverse local Wand systemic adverse effects. Several approaches have been tried to reduce the steroid-induced adverse effects. Simultaneous application of physiological lipid mixture is also suggested. OBJECTIVE: Novel vehicles for topical glucocorticoids formulation were evaluated for the efficacy of reducing side-effects and the drug delivery properties of desonide, a low potency topical steroid. METHODS: Transcutaneous permeation and skin residual amount of desonide were measured using Franz diffusion cells. The in vivo anti-inflammatory activity was evaluated using murine model. RESULTS: Topical steroids formulation containing desonide, in either cream or lotion form, were prepared using multi-lamellar emulsion (MLE), and conventional desonide formulations were employed for comparison. MLE formulations did not affect the anti-inflammatory activity of the desonide in phobol ester-induced skin inflammation model, compared with conventional formulations. While the penetrated amounts of desonide were similar for all the tested formulations at 24 hours after application, the increased lag time was observed for the MLE formulations. Interestingly, residual amount of desonide in epidermis was significantly higher in lotion type MLE formulation. Steroid-induced adverse effects, including permeability barrier function impairment, were partially prevented by MLE formulation. CONCLUSION: Topical desonide formulation using MLE as a vehicle showed a better drug delivery with increased epidermal retention. MLE also partially prevented the steroid-induced side effects, such as skin barrier impairment.
Desonide ; Diffusion ; Epidermis ; Glucocorticoids ; Inflammation ; Permeability ; Retention (Psychology) ; Skin ; Steroids