Two cases of leukemia cutis associated with leukemia has been demonstrated. Case 1: 24 year old man had been fever, arthralgia and leproma like hard infiltrated nodular lesion with hemorrhagic macules was noted on face and upper arms and trunk, Monocytic Jeukemia has been presented. In peripheral blood and bone marrow finding, immature blood cells was counted in about 80%, Case 2: 64 yearold woman, had been erythematous papule with itching on lower extremities and coin ized ulcerated nodule was noted on lumbosacral region. Myeloid leukemia has been presented. In peripheral blood and bone marrow finding, immature blood cells was counted in about 7.2%. Diagnosis of cutaneous lesions was by clinical apperance and histopathological change. By laboratory examination, monocytic leukemia and myeloid leukemia was revealed in peripheral blood and bone marrow preparation.
Arm ; Arthralgia ; Blood Cells ; Bone Marrow ; Diagnosis ; Female ; Fever ; Humans ; Leukemia* ; Leukemia, Myeloid ; Lower Extremity ; Lumbosacral Region ; Numismatics ; Pruritus ; Ulcer ; Young Adult

Traditionally, the gingko nut is used for enhancing liver function, skin immunity, pulmonary function, and antitussive action in chronic asthma. However, when overused, it can induce central nervous system dysfunction, and the following symptoms can manifest themselves: vomiting, dizziness, convulsion, insomnia, and confusion. We experienced a case of suspected cyanide intoxication that was manifested by convulsion and metabolic dysfunction after consuming a large number of ginko nuts. We report that case, together with a review of the literature.
Asthma ; Central Nervous System ; Cyanides ; Dizziness ; Ginkgo biloba* ; Liver ; Nuts* ; Poisoning* ; Seizures ; Skin ; Sleep Initiation and Maintenance Disorders ; Vomiting

PURPOSE: A general analysis of patients in the Emergency Department (ED) and the Intensive Care Unit (ICU) was performed to evaluate the effectiveness of a noninvasive ventilator (NIV) for the effective treatment of patients in respiratory distress without using endotracheal intubation. METHODS: The 38 patients who were treated with a NIV from December 1, 2001, to September 31, 2002, were studied. The ER doctors investigated prospectively sex, age, the causes of disease, the main symptoms, the duration of treatment, the mode of ventilation, the vital signs and the arterial blood gas analysis at the time of admission and after 30 minutes of NIV use, adaptation of patients, complications, and the success or failure of the treatment. RESULTS: 1) General features: Out of 38 cases, 25 males and 13 females, the average age was 60.61 years old. In group X (treatment success), the average age was significantly lower than it was in group Y (treatment failures). 2) The causes of disease and symptoms: The causes of disease were as follows: asthma and chronic obstructive pulmonary disease, 13 patients; drug intoxication, 8 patients; pulmonary edema, 8 patients; respiratory failure, 2 patients; lung contusion, 3 patients; pneumonia, 2 patients. 3) Adaptation and complications: 11 patients adapted well, 18 patients adapted normally, and 11 patients failed. Complications were minimal and included gastric distension in 2 patients and xerophthalmia in another 2. 4)Vital signs and arterial blood gas analysis results: The arterial blood gas analysis performed after 30 minutes in treatment showed improved results, but only the pH had any effect on success or failure. CONCLUSION: NIV had a success rate of 72%. The factors influencing success were surveyed according age, pH level before treatment, pH P a C O2 S a O2 30 minutes after treatment, and adaptation.
Asthma ; Blood Gas Analysis ; Contusions ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Hydrogen-Ion Concentration ; Intensive Care Units ; Intubation, Intratracheal ; Lung ; Male ; Pneumonia ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive ; Pulmonary Edema ; Respiratory Insufficiency ; Ventilation ; Ventilators, Mechanical* ; Vital Signs ; Xerophthalmia

PURPOSE: In Korea, 119 rescue plays the largest role in treating emergency patients on the scene and in transferring them to the emergency department. We wanted to find out the perception of and the satisfaction with 119 rescue, as well as its future, in the view of medical service-consumers, that is, patients and their guardians. METHODS: The subjects were patients and their guardians who came to Chosun University Hospital by means of 119 rescue between July 1 and September 31, 2002. Responders were asked their age, sex, academic background and relation to the patient. RESULTS: Perception and satisfaction - They recognized treatment on the scene (66.6%) rather then transport to the hospital (17.2%) as the most important duty of 119 rescue. Seventy percent answered that 119 rescue came to mind right away in an emergency situation, which reflects a high perception of 119 rescue. As to the time to arrive at the scene after a report, many people showed satisfaction (55%), answering that it was fast. Responsibility and rights - As to the question of whether they should hold 119 rescue responsible if the patient's condition is aggravated after treatment by 119, 48.9% answered that they shouldn't because 119 was acting with a good intention. Direction of future development - If the 119 services if to be improved, regular intensive training and testing (39.5%) intensive hospital experience (33.3%) and hiring 1st degree EMTs (27.2%) are believed to be necessary. CONCLUSION: 119 rescue was recognized as a comfortable and reliable means of emergency service. In general, most people were satisfied with the service provided by 119 rescue, but demanded experience with patient care.
Emergencies ; Emergency Service, Hospital ; Human Rights ; Humans ; Intention ; Korea ; Patient Care

PURPOSE: This study was performed to evaluate the usefulness of propofol in radiology studies by comparing propofol sedation with midazolam for patients who do not comply with their doctor's requests and need an injection of a sedative to be treated for a safe and quick recovery without complications. METHODS: Among adult patients who were admitted and checked using CT and MRI in our emergency medical center from February 2001 to August 2001, the patients who required sedation because of the lack of cooperation with ER doctors were studied. Of 49 patients, 23 patients (Group M) were injected with midazolam, and 26 patients (Group P) were injected with propofol. RESULTS: In both groups, the systolic BP and the diastolic BP decreased, but group P's BP decreased more than group M's (p<0.05). In group M, the decrease of SPO2 w a s statistically significant, but neither of the groups required emergency care. Although, Group M didn't require emergency care for SpO2, they did require more emergency care for apnea than Group P did. Group P's time required for an examination to be performed was shorter than group M's. Group P's duration for occurrence of movement was shorter than Group M's, but this difference was not statistically significant. Regardless of which sedative was used, there was no difference in the satisfaction of the radiology technician with regards to group M and group P. CONCLUSION: When the patients were injected with a lowdosage of propofol, they showed effects similar to those observed in patients in injected with midazolam, and there were no complications that required emergency care. The usage of propofol is thought to be a good choice, except for contraindications, for short-time radiology examinations.
Adult ; Apnea ; Emergencies* ; Emergency Medical Services ; Humans ; Magnetic Resonance Imaging ; Midazolam* ; Propofol*

Tetanus is a neurologic disorder, characterized by increased muscle tone and spasms, that is caused by tetanospasmin, a powerful protein toxin elaborated by Clostridium tetani. In the modern society, tetanus is a rare disease, but it has a high mortality on attack and it 's diagnosis depends on the clinical symptoms. The treatment for tetanus is an injection of human tetanus immunoglobulin (HTIG) to neutralize the circulating tetanospasmin, to control breathing, and to provide systemic supportive care. Recently, the 500 unit of HTIG is recommended. We report one case of generalized tetanus that was treated with 500 units of HTIG. The patient was discharged without complications.
Clostridium tetani ; Diagnosis ; Humans* ; Immunoglobulins* ; Mortality ; Nervous System Diseases ; Rare Diseases ; Respiration ; Spasm ; Tetanus*

No abstract available.

PURPOSE: Preterm formula used in Korea, theoretically does not supply the recommended mineral intake for optimal bone metabolism in very low birth weight infants(Formula 500-700 mg Ca/L, 300~370mg P/L, and 440IU of vitamin D/L). The purpose of this study is to identify th e possible etiologic factors and clinical course of rickets in these infants. METHODS: We recently identified radiographic rickets or osteopenia in 16 VLBW infants over a 30-month period from January 1990, to July 1992. We performed a retrospective case analysis to evaluate the clinical features, nutritional status, biochemical and radiological findings o f metabolic disease in preterm infants. RESULTS: Mean gestational age and birth weight were 29+/-2.1wks, and 1172+/-245gm. All infants received parenteral nutrition and 11 infants needed assisted ventilation. Enteral feeding w as started at a mean age of 9.4+/-11.0d and mean total calorie intakes were 62+/-16.2kcal/kg /d in the first 2wks and 111+/-26.9kcal/kg/d at 2-4 wks of age. Oral Ca/P intakes were severely restricted during the first month of life, and they were about 20% of recommended intakes of Ca /P for VLBW infants. At diagnosis of active rickets, serum Ca was high in 19% and serum P wa s low in 69% of infants. Serum alkaline phosphatase was increased in 56% and serum 25-hydroxyvitamin D was low in 67%. Active rickets was diagnosed at mean age of 38+/-14.7 d; 12 infants had overt rickets(grade 2), including 3 infants with fractures(grade 3). Healing rickets was diagnosed on follow-up at mean age of 67.3+/-22.0 days. Thus, metabolic bone disease of VLB W infants was associated with low mineral intakes compared to recommended intakes, and signs of P deficiency occurred at about 2 wks of age and persisted to 8 wks of age; hypercalcemia occurred initially, and these biochemical abnormalities precede the radiological abnormalities about 2 or 3 weeks. CONCLUSIONS: Many factors are related to the development of metabolic hone disease of prematurity; one of the most important factor in our study was nutritional deficiency, especially m ineral(phosphorus) and vitamin D. In preterm VLBW infants whose adequate enteral feeding is restricted, mineral(calcium and phosphorus) and vitamin D supplementation would be needed t o reduce the development of metabolic bone disease in preterm infants.
Alkaline Phosphatase ; Birth Weight ; Bone Diseases, Metabolic* ; Diagnosis ; Enteral Nutrition ; Follow-Up Studies ; Gestational Age ; Humans ; Hypercalcemia ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Korea ; Malnutrition ; Metabolic Diseases ; Metabolism ; Nutritional Status ; Parenteral Nutrition ; Retrospective Studies ; Rickets ; Ventilation ; Vitamin D ; Vitamins

Purpose: Junctional adhesion molecule (JAM)-A is an immunoglobulin-like molecule that colocalizes with tight junctions (TJs) in the endothelium and epithelium. It is also found in blood leukocytes and platelets. The biological significance of JAM-A in asthma, as well as its clinical potential as a therapeutic target, are not well understood. The aim of this study was to elucidate the role of JAM-A in a mouse model of asthma, and to determine blood levels of JAM-A in asthmatic patients. Materials and Methods: Mice sensitized and challenged with ovalbumin (OVA) or saline were used to investigate the role of JAM-A in the pathogenesis of bronchial asthma. In addition, JAM-A levels were measured in the plasma of asthmatic patients and healthy controls. The relationships between JAM-A and clinical variables in patients with asthma were also examined. Results: Plasma JAM-A levels were higher in asthma patients (n=19) than in healthy controls (n=12). In asthma patients, the JAM-A levels correlated with forced expiratory volume in 1 second (FEV1%), FEV1/forced vital capacity (FVC), and the blood lymphocyte proportion. JAM-A, phospho-JNK, and phospho-ERK protein expressions in lung tissue were significantly higher in OVA/OVA mice than in control mice. In human bronchial epithelial cells treated with house dust mite extracts for 4 h, 8 h, and 24 h, the JAMA, phospho-JNK, and phospho-ERK expressions were increased, as shown by Western blotting, while the transepithelial electrical resistance was reduced. Conclusion These results suggest that JAM-A is involved in the pathogenesis of asthma, and may be a marker for asthma.

PURPOSE: Both the beta-catenin and p53 play a crucial role in the process of colon carcinogenesis. The expression of beta-catenin and/or p53 has been reported to be associated with pathologic features of tumor and prognosis of patients. In addition, several recent studies have suggested a close biological association between p53 expression and nuclear beta-catenin level. We analyzed the pathologic variables and p53 expression according to the intra-nuclear beta-catenin expression in colon cancer to make such assumptions more clear since they are still controversial issues. METHODS: The expressions of beta-catenin, p53 and Ki-67 protein in colon cancer were determined by immunohistochemical staining. The relationship between these protein expressions and tumor characteristics was statistically analyzed. RESULTS: The intra-nuclear beta-catenin accumulation was not associated with any of the pathological variables including lymph node metastasis and tumor differentiation, but it was correlated with higher level of Ki-67 proliferation index (P=0.006) and negative staining of p53 (P=0.015). Positive p53 staining was significantly associated with lymph node metastasis (P=0.006), lymphatic invasion (P=0.03) and venous invasion (P=0.02). CONCLUSION: These results support the suggestion that intra-nuclear accumulation of beta-catenin may regulate the p53 activity in colorectal cancer. In addition, positive staining of p53 may be used as a valuable prognostic indicator since it was strongly associated with lymph node metastasis, lymphatic and venous invasion.
beta Catenin* ; Carcinogenesis ; Colon ; Colonic Neoplasms ; Colorectal Neoplasms* ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Negative Staining ; Neoplasm Metastasis ; Prognosis