Among the patients visting Department of Dermatology, Chungman National University, 58 cases had various side effects due to the malpractice of skin disorders. We analysed these 58 cases and the results can be summerized as follows ; 1. 37 cases(64%) were in the second and third decades and 11 cases(19%) were under 19 years-old. 2. Drug medication from pharmacy was the most common(79%), and then local clinics(12%), herb clinics(9%) in decreasing orders. 3. In the route of administration, oral ingestion(38%) was the most common, and 47 cases (81%) were medicated with adrenocorticoids. 4. In motivation to the visit, 31 cases(53%)were by advice, 15 cases by advertizement and 12 cases (21%) by themselves. 5. Acne and psoriasis were about a half of pre-existing skin diseases. 6. Side effects due to malpractice may be divided into 5 items : systemic side effects due to adrenocorticoids (59%), aggravation of pre-existing skin diseases (22%), topical side effects due to adrenocorticoids (10%), chemical irritation and burn (7%), and mercury intoxication (2%) in decreasing orders.
Acne Vulgaris ; Administration, Oral ; Burns ; Dermatology ; Humans ; Malpractice* ; Motivation ; Pharmacy ; Psoriasis ; Skin Diseases* ; Skin* ; Young Adult

No abstract available.
Ankle* ; Foot* ; Free Tissue Flaps* ; Rectus Abdominis* ; Tibia*

BACKGROUND: Ota's nevus is not an uncommon pigmenta y disorder in Asian people including Koreans. OBJECTIVE: The purpose of this study was to examine the clinical features of the patients and to determine the existince of any relevance between them. METHODS: We arrid out a retrospective study with cialreviews and phone interviews or direct examinatior. for clinical features of the lesions in acesible patients. RESULTS: The peak age of onset was at birth, pubertyed adolescence in decreasing order. The most frequen1,ly involved site was the eyelid, and the type I was the most common. Bluish black color was pie edorninant. The lesions which did not inili the eyelid or the lesions which developed after birtten were more likely to be light brown in cilc(p<0.05). CONCLUSION: The clrical features of Otas nevus were revwed and analyzed statistically.
Adolescent ; Age of Onset ; Asian Continental Ancestry Group ; Eyelids ; Humans ; Nevus of Ota* ; Parturition ; Retrospective Studies*

No abstract available.
Drainage* ; Lung Abscess* ; Lung* ; Pneumothorax* ; Suppuration*

VSD is the most common congenital carciac malformation and the natural history depends not only on the age ofpatients and the size of defect but the subtype of VSD as well, important factor in clinical management or thosepatients. In 110 patients, with surgically repaired VSD in Yonsei Medical Center in 1984, the subtype of VSDs evaluated by surgical observation were correlated with LV angiogram findings to verify the incidence of subtype inKorean and the diagnostic accuracy to predict the subtype by angiogram. 1. 110 patients included 64 boys and 46 girls, the age ranged from 3 months to 14 years(average 4.6 years old) 2. Angiographic findings were interpretedas follows; a. Perimembranous defects were profiled in LAO 60 degrees LV angiogram and located below the aorticvalve. In inlet excavation the shunted blood opacified the recess between septal leaflet of tricuspid valve and interventricular septum in early phase, in infundibular excavation opacified the recess between anterior leafletof TV and anterior free wall of RV and in travecular excavation the shunted blood traversed anterior portion of TVring, opacified trabecular portion of RV cavity. b. Subarterial type were profilled in RAO 30degrees LV angiogram,just below aortic valve as well as pulmonic valve. Total infundibular defects were profilled in RAO 30degrees andLAO 60 degrees LV angiogram subaortic in location in both views. c. In muscular VSD the profilled angle was variedaccording to the subtype but the defects were separated from the aortic valve as muscular septum interposedbetween the aortic valve and the defect. 3. The incedence of subtype of VSDs evaluated by surgical observationwere as follows. Subaterial type 32 cases(29.1%) Total infundibular defect 5 cases( 4.5%) Perimembranous type 73cases(66.3%) Infundibular excavation 32 cases(29.1%) Trabecular excavation 28 cases(25.5%) Inlet excavation 10cases(9.1%) Mixed 3 cases(2.7%) Muscular type 1 cases(0.9%) Total 63.6% of VSD, were the varieties of theinfundibular septum type. 4. The prediction of VSD subtype accoridng to the angiographic findings described above,were compared to the surgical observation. Diagnostic rate was 100% in perimembranous type, 75% in subarterialtype, 0% in total infundibular type, so 88% of cases were in accordance with the surgical findings.
Aortic Valve ; Bays ; Female ; Humans ; Incidence ; Natural History ; Tricuspid Valve

We studied the angiographic findings in 65 patients wtih congenital pulmonary atresia, ages 4 days to 14 years(mean 3.3 yrs), form 1981 to 1986 at Severance Hospital Yonsei University. 1. 6 had pulmonary atresia with anintact interventricular septum, 38 had it with cardiac anomaly Renodynamically simulating TOF, and 21 associatedwith more complicated cardiac anomalies. 2. In the group with an intact ventricular septum, 5 showed confluentintrapericardial pulmonary artery, all segmental pulmonary arteries connceted to intrapericardial pulmoanryartery. 3. In the group simulating TOF, aorta arose from RV with or without overriding in 35. In 27 patients withconfluent intrapericardial pulmonary artery, 23 had more than 10 segmental pulmoanry arteries connceted tointrapericardial artery and 5 had severely hypoplastic hilar pulmonary arteries. In 11 with nonconfluentintrapericardial pulmonary artery, 4 had more than 10 segmental pulmonary arteries connected to central pulmonaryartery and 9 had severely hypoplastic hilar pulmonary arteries. 4. In the group associated with more complicatedcardiac anomaly, included 8 patients with atrioventricular discordance, 7 with univentricular heart and 6 withtricuspid atresia. In 17 patients with confluent intrapericardial artery, 16 had more than 10 segmental pulmoanryarteries conncected to intrapeircardial artery, one showed severe hypoplasia of hilar pulmonary arteries. Inanother 4 with nonconfluence, no one showed more than 10 segmental arteries conncted to intraperdicardial or hilarpulmonary artery.
Aorta ; Arteries ; Heart ; Humans ; Pulmonary Artery ; Pulmonary Atresia ; Ventricular Septum

Purpura fulminans is a potentially disabling and life-threatening disorder characterized by acute onset of progressive cutaneous hemorrhage and necrosis on distal extremities, and disseminated intravascular coagulopathy. We experienced a case of purpura fulminans due to Streptococcus pneumoniae. A 42-year-old women presented with skin petechiae, ecchymosis and gangrene on distal extremities with laboratory evidence of DIC. The latex agglutination test with CSF was positive at Streptococcus pneumoniae. To our knowledge, this is the first report of purpura fulminans caused by Streptococcus pneumoniae in Korea.
Adult ; Dacarbazine ; Ecchymosis ; Extremities ; Female ; Gangrene ; Hemorrhage ; Humans ; Korea ; Latex Fixation Tests ; Necrosis ; Purpura Fulminans* ; Purpura* ; Sepsis ; Skin ; Streptococcus pneumoniae* ; Streptococcus*

To evaluate the diagnostic accuracy of two-dimensional echocardiogrphy(2-D echo) in ventricular septal defect, location and size of the defects, estimated right ventricular systolic pressure and associated cardiac anomaly were compared to the operative findings in 139 children operated for correction of ventricular septal defect at Severance Hospital from Jan. 1983 to June 1987. In addition, postoperative complications and mortality cases were anlysed. The following results were obtained; 1) Perimembranous defects were 82 cases(66.1%), subarterial infundibular defects 33 cases(26.6%), and muscular defect was found in only 1 case(0.8%). The accuracy of 2-D echo in localizing the defects was 84.2%. 2) In 79.2% of the patients, the defects were moderate to large in size, and actual size measured at operation was larger than that obtained by echocardography in general. 3) The estimated right ventricular systolic pressure was correlated(r=0.650) with that measured at the operating field. 4) Combined cardiac anomalies were patent ductus arteriosus(22 cases), atrial septal defect(3 cases), valvular pulmonic stenosis(2 cases) and interventricular septal aneurysm(2 cases). The sensitivity of 2-D echo in detecting these anomalies was 65.5% and the specificity was 96.4%. 5) Among 32 patients who had postoperative complications, in two thirds, there were pulmonary complication including lung atelectasis(16 cases), pleural effusion(5 cases)and pneumonia(5 cases). 6) Operative mortality was 2.9%(4 cases). The causes of death were low cardiac output state due to left ventricular myocardial failure in 3 patients and respiratory failure from asphyxia in one case. In conclusion, with close cooperation with cardiac surgeons, there will be few problems in diagnosing and operating patients with ventricular septal defect on the basis of two-dimensional echocardiographic findings without invasive procedures, such as cardiac catheterization, even with pulmonary hypertension, unless Eisenmenger syndrome is complicated.
Asphyxia ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Cardiac Output, Low ; Catheterization* ; Catheters* ; Cause of Death ; Child* ; Echocardiography* ; Eisenmenger Complex ; Heart Failure ; Heart Septal Defects, Ventricular* ; Humans ; Hypertension, Pulmonary ; Lung ; Mortality ; Postoperative Complications ; Respiratory Insufficiency ; Sensitivity and Specificity

The pure epithelioid malignant schwanoma is a rare form of malignant schwanoma and differs from the ordinary epithelioid malignant schwanoma because of the absence of a spindle cell component. We present a case of purely epithelioid malignant schwanoma arising in the parapharyngeal area from vagus nerve without difinite evidence of von Recklinghausen's disease. The patient was a 28-year-old man with palpable right neck mass and swallowing difficulty during 2 years. The mass was an ovoid encapsulated tumor and measured 5x3x3 cm in dimension. The cut surface showed brownish tan homogeneous nodular appearance with partly myxoid area. Microscopically the tumor showed nodular pattern composed of epitheliod cells which were arranged in both tight clusters and stringy cords. The cells were ovoid in shape and had vesicular nuclei with single prominent eosinophilic nucleolei and sometimes abundant intracytoplasmic mucin. Mitoses were infrequent. Ultrastructural study showed rudimentary cell junction and degenerated cytoplasmic organelles including scattered mitochondriae, short segments of rough endoplasmic reticulum and lipid droplets. There were no definite basement membrane and melanosome. Immunohistochemical study showed the cells being positive for S100 protein, neuron specific enolase and myelin basic protein and negative for cytokeratin.
Male ; Humans

We report two cases of murine typhus diagnosed by indirect immunofluorescent test. The patients showed cardinal symptoms and signs such as fever and chill, general myalgia, intractable headache and typical rash. Laboratory values and histopathologic findings were compatible with murine typhus. The oral administration of doxycycline improved dramatically the clinical manifestations of the two CCLSPS.
Administration, Oral ; Doxycycline ; Exanthema ; Fever ; Headache Disorders ; Humans ; Myalgia ; Typhus, Endemic Flea-Borne*