Progressive cribriform and zosteriform hyperpigmentaion (PCZP) is a pigmentary disorder of the skin which was first described by Rower et al in 1978. The disorder is characterized clinically by uniformalyptan cribriform macular pigmentation in a zosteriform distibution and histopathologically by absence of nevus cells and increased melanin in the basal cells. The authors have experienced a case of PCZP in 21 year old Korean man which we believe is the first documented case in Korea. The patient noted light brown macules on his left inguinal area at the age of 17 which has gradually extended to become cribriform macular pigmentation in a zosteriform distribution. Histopathologic examination of the lesion showed an increase in basal melanin pigmentation. No nevus cells were present.
Humans ; Hyperpigmentation* ; Korea ; Melanins ; Nevus ; Pigmentation ; Skin ; Young Adult

Only several stages of conventional operation have been able to treat the open fracture of the limb with extensive bone and soft tissue loss. So we, authors, reviewed 25 cases of vascularized osteocutaneous fibulat transfer which were performed to the extensive bone defect of the limb and associated soft tissue injury(from May 13, 1982 to September 30, 1988). In 25 cases, one case was a chronic osteomyelitis combined pseudocarcinomatous epithelial hyperplasia of surrounding soft tissue, the other(24 cases) were the open comminuted fractures with the extensive bone and soft tissue loss of the limbs. The average size of the skin flap was 12.33 × 5.83cm, the average length of vascularized fibula was 16.5cm in length. The complications were fractures of grafted fibula, partial necrosis of both ends of the skin flap and uncontrolled infection of proximal end of grafted fibula. During postoperative period, the patency of the anastomoses were monitored by observing the color of the skin of buoy skin flap. The average amounts hypertrophied fibula at 12 months after operation were 20.6cm. And the following remarkable result were obtained. 1. With the uncontrolled bone infection, the vascularized osteocutaneous fibular transfer was able to be performed. 2. During the follow up period, the grafted fibula had been hypertrophied. 3. In roentgenogram, as compared with conventional bone graft, grafted bone was not resorbed and early united. 4. In adult, free fibula can be obtained and grafted as 23cm as long and the skin flap with fibula can be obtained and grafted as 21 × 7cm as large in or experience. 5. In the vascularized osteocutaneous fibula transfer, the patency of anastomoses was monitored indirectly by confirming skin flap. 6. The fractured fibula was united early by cast immobilization, and it was hypertrophied at the fracture site. 7. The vascularized osteocutaneous fibula transfer is also useful in application of the other long bones.
Adult ; Extremities ; Fibula ; Follow-Up Studies ; Fractures, Comminuted ; Fractures, Open ; Humans ; Hyperplasia ; Immobilization ; Microsurgery ; Necrosis ; Osteomyelitis ; Postoperative Period ; Skin ; Transplants

No abstract available.
Decompression* ; Head* ; Osteonecrosis*

No abstract available.
Aged* ; Child* ; Dislocations* ; Hip* ; Humans

It has been proposed that action spectrum in polymorphous light eruption lies predominantly in the sunburn range, but reaches through the long-wave ultraviolet (UV) into visible part of the spectrum. We examined the efficacy of UUB, UVA and visible light in reproducing skin lesions, and found that the UVA was most suitable in provoking the typical skin lesions in our 3 cases with polymorphous light eruption, Plewig and his associates reproduced the clinical lesions with megadoses of UVA,(60J/cm2); in our experiment, 5 to 10 J/cm2 was sufficient. The reason for this discrepancy is not clear but the method of phototest, light source and energy, the different susceptibility in different races and other factors may influence the phototest results.

OBJECTIVE: To evaluate the degree of streptococcal colonization in Korean pregnant women. METHODS: The study comprised of 153 singleton pregnant women who visited Severance Hospital for delivery, and their neonates. Specimens for GBS culture were collected by a sterile cotton swab from lower vagina and cervix of pregnant women, and from ear canal and throat of neonates. They were first cultured for 48 hours in Todd-Hewitt broth and then subcultured onto Tryptose blood agar plates(Difco). Group B streptococci were confirmed by the presence of beta-hemolysis and a positive reaction with Phadebact group B Streptococci reagent(Karo Biodiagnostics AB, Huddinge, Sweden). RESULTS: The prevalence of positive cultures in pregnant women and neonates were 2.61%(4/153) and 0%(0/4), respectively. In the study population there was a case of suspicious group B streptococcual sepsis in an infant whose mother was colonized. CONCLUSIONS: In our study the GBS colonization rate in Korean pregnant women was significantly lower than that of other countries. The reason for this difference may be associated with a racial differences, or social factors such as socio-economic status or a life style.
Agar ; Cervix Uteri ; Colon ; Ear Canal ; Female ; Humans ; Infant ; Infant, Newborn ; Life Style ; Mothers ; Pharynx ; Pregnancy ; Pregnant Women* ; Prevalence ; Sepsis ; Streptococcal Infections* ; Vagina

No abstract available.
Colon*

BACKGROUND: The usage of appropriate disinfectants is essential for infection control in a hospital. Inadequate use of disinfectants is the cause of human or environmental toxicity and is a waste of cost. The objective of this study was to describe the status of the usage of disinfectants in Korean hospitals. METHOD: One hundred and eighty three hospitals of over 300 beds were investigated by a questionnaire distributed by mall. Data collection was done on November 1999. The questionnaire was made by the Association of Infection Control Nurses in Korea, based on references and protocols of the Korean Society of Nosocomial Infection Control. Numerical and percentage data were analyzed by SPSS. RESULTS: The collection rate of the questionnaire was 43.7% (80/300). Thirty five hospitals (46.7%) had an official process in selecting disinfectants in their hospitals. Regarding skin antiseptics, 10% povidone iodine and 70% alcohol were commonly used in skin preparation for intravenous catheterization or pre-operative skin disinfection, For disinfection of mucosal membranes such as mouth and periurethral area, 3% boric acid solution or 3% H202 were used. Most of the hospitals decontaminated contaminated medical instruments manually with dodecyl diamino ethyl glycine (20.8%). glutaraldehyde (15.6%). quaternary ammonium compounds (13.8%), virkon (12.3%) and sodium hypochlorites (11.7%). Glutaraldehyde and virkon were frequently used for disinfection of endoscopes. Sodium hypochlorites (48.9%) and quaternary ammonium compounds (19.8%) were the most commonly used environmental disinfectants. Some noticeable problems in disinfectants were as follows. First, for mouth care, many hospitals (41.7%) over-used boric acid, which has cumulative toxicity for humans. Second, many hospitals had an incorrect protocol of disinfecting endoscopes. Third, for environmental decontamination and instrument cleaning, some hospitals used high level disinfectants such as glutaraldehyde, which is too costly and provides unnecessary safety problems. Fourth, after patient discharge, many hospitals did not use disinfectants at all. Considering the specific Korean medical environment of high incidence of multi-drug resistant microorganisms, use of disinfectants for discharged environments may be warranted. CONCLUSION: This study included only hospitals of over 300 beds, which has a limitation in representing the status of disinfectants usage in a country. However, significant problems from misunderstanding the basic principles of disinfectants and misusages of disinfectants were observed in this investigation. These observations will provide useful information for designing a guideline for the appropriate uses and for efficient education of disinfectants, and also for planning a national control program for proper disinfectants usage in this country.
Anti-Infective Agents, Local ; Catheterization ; Catheters ; Cross Infection ; Data Collection ; Decontamination ; Disinfectants* ; Disinfection ; Education ; Endoscopes ; Glutaral ; Glycine ; Humans ; Incidence ; Infection Control ; Korea* ; Membranes ; Mouth ; Patient Discharge ; Povidone-Iodine ; Quaternary Ammonium Compounds ; Skin ; Sodium ; Surveys and Questionnaires

The authors reviewed 3145 pediatric patients who visited the emergecy room in this hospital during 3yrs period from Jan. 1989 to Dec. 1991. 1) Among the patients visiting the emergency room, the patients under 15 years of age were 26.4% (3145) of total emergency patients (11930). 2) yearly distribution of patients were decreased 17% between 1989 and 1991. 3) Monthly distribution of visits showed higher incidence in June and July. The male to female ratio was 1.5:1. 4) Weekly distribution of visits showed higher incidence on Sunday and Saturday, relatively. 5) Most popular time of visiting the emergency room was between 8:00 PM to 12:00 PM during which time 29.5% of all pediatric patient were seen. 6) Distribution of age showed peak incidence between 6 and 12 years of age (30.9%). 7) 65.18% of total emergency room isits were pediatric patients. 8) Distribution of cases was as follows: Respiratory disease 37%, accident, GI disease in turn listed respectively in ecreasing order of freqency. 9) The admission rate through emergency was 8.5% of total pediatric emergency patients. 10) 82.3% of total emergency visits had medical insurance coverage, 7% had no insurance and 10.7% were on medical aid program.
Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Incidence ; Insurance ; Insurance Coverage ; Male

The TRAM flap provides the safe creation of a durable, soft, natural-appearing breast mound and has thus become the most popular method of breast reconstruction. On the other hand, the rectus muscle can be used as a good donor site for a flap reconstruction in trauma or osteomyelitis cases on the lower extremity. The abdominal sequelae, including abdominal wall dysfunction after free rectus muscle transfer, was evaluated. Thirty-seven patients underwent free TRAM (n=29) or rectus abdominis muscular free flap(n = 8) operations between 1994 and 1997. In harvesting of the TRAM flap, a muscle-splitting technique was used and thus one-quarter of the muscle was preserved. In rectus muscular free flap, the entire width of the rectus abdominis muscle was harvested. Among the 37 patients, 26 patients (20 free TRAM flap and 6 rectus muscular free flap) were studied, for they were followed up postoperatively for at least 6 months and had provided preoperative data of abdominal strength. Cosmetic results of the abdomem were appraised by four independent judges on photographs taken of 26 patients. The global appearance of the abdomen was rated as "natural" in 75%. The scar on the umbilicus and lower abdomen was rated as acceptable or not visible in 65%. The replies to questionnaires were analyzed Patient self-assessment showed general satisfaction. In 24 of 26 answers, they said they would recommend the operation to others, and 70% of the patients found their abdominal strength and sports ability the same or improved. Thirty percent of the patients complained that back pain developed or became aggravated after surgery. Abdominal muscular strength was tested both preoperatively and 6 months to 1 year period after surgery according to Lacote. The abdominal wall function was impaired, especially in the upper rectus and external oblique muscle. In conclusion even though the abdominal sequelae after free TRAM or rectus muscular free flap reconstruction should not be urderestimated, no problem of clinical significance was encountered, and patients showed a high degree of satisfaction with the operation
Abdomen ; Abdominal Wall ; Back Pain ; Breast ; Cicatrix ; Female ; Free Tissue Flaps* ; Hand ; Humans ; Lower Extremity ; Mammaplasty ; Osteomyelitis ; Surveys and Questionnaires ; Rectus Abdominis* ; Self-Assessment ; Sports ; Tissue Donors ; Umbilicus