A case of Epidermolysis Bullosa Dystrophica is reported with review of pathogenesis with literatures. Epidermolysis Bulloaa Dystrophica is a rare genetic disease which is characterized by the formation of blister upon the minor trauma or friction to the skin. A 7-year old boy was referred to our dept. in Aug. 1976 because of a severe bullous eruption primarily on his hands and feet. On admission tense bullae were noted on the dorsa of hands and feet which is usually serous but may be hermorhagic tendency. Soon thereafter tbis bullous lesion tend to break down into painful shallow denudation which may leave depigmented scars and milia after healing. Family history was negative for skin disorders.
Blister ; Child ; Cicatrix ; Epidermolysis Bullosa Dystrophica* ; Epidermolysis Bullosa* ; Foot ; Friction ; Hand ; Humans ; Male ; Skin ; Transcutaneous Electric Nerve Stimulation

Williams syndrome is a progressive and multisystemic disorder. We experienced one case of Willams syndrome which was characterized by elfin facies, mental retardation, diffuse aortic hypoplasia, mitral regurgitation and chronic nonparoxysmal sinus tachycardia. The tachycardia has been managing with beta-blocker successfully. We presented a case of unusual form of Williams syndrome with a reivew of literatures.
Facies ; Intellectual Disability ; Mitral Valve Insufficiency ; Tachycardia ; Tachycardia, Sinus ; Williams Syndrome*

Esperson(R), a new topical steroid ointment containing 0. 05% 17-Desoxymethasone,. was used in several kinds of dermatoses. Framycetin which was isolated and uientified by the research organisation of Roussel Laboratories (SOFRAPEN) in 1950 from culture broths of a strain of Streptomyces species is a wide spectrum antibiotics on various bacterial infectious diseases. Total 50 patients including 10 cases of 2ndary infected Atopic dermatitis, 10 of infected Contact dermatitis, 6 of infected Seborrheic dermatitis, 7 of infected Neurodermatitis, 3 of infected Chronic dermatitis, 5 of lmpetigo, 2 of infected Nummular eczema, 2 of infected Infantile ecze;na, 1 of infected Intertrigo, 1 of Eczematoid Otitis extema, 1 of 2nd degree Bum, 1 of infected Pruritis ani, 1 of infeeted 1nsect bite. were treated with Frason(R) (0.05% 17-desoxymethasone & 0.5% Framycetin combination). Among these 50 patiants, we observed excellent effects in 7 patients (14%), good effect in 29 patients (58%), fair effect in 10 patients (20%), Totally 36 patients (72%) revealed excellent to good therapeutic effects on their skin conditione after unoccluded application of Frason(R). 3 times daily for about 14 days. There was no sid ffect in all subjects after application of Esperson-F.
Anti-Bacterial Agents ; Communicable Diseases ; Dermatitis ; Dermatitis, Atopic ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Desoximetasone ; Eczema ; Framycetin ; Humans ; Intertrigo ; Neurodermatitis ; Otitis ; Pruritus ; Skin ; Skin Diseases* ; Streptomyces ; Sudden Infant Death

Carcinoma of the parathyroid gland is rare, comprising only 0.1% to 5% of all patients with primary hyperparathyroidism. It presents with severe hypercalcemia, bone disease, palpable neck mass, renal involvement and etc. Since the initial operation offers the best chance for cure, preoperative localization and intraoperative recognition of parathyroid cancer are essential. Recently parathyroid imaging has been described with 99mTc-sestamibi as an alternative to 201Tl. This newer agent has many physical and dosirnetric advantages and represents higher detection sensitivity than 201Tl-99mTc subtraction scan. We experienced a 41-year-old man presenting with recurrent hyperparathyroidism in spite of 2 previous operations. In preoperative localization, there was no abnormal uptake in 201Tl-99mTc subtraction scan but 99mTc-sestamibi scan revealed metastatic foci on right cervical area. He was successfully treated with modified radical neck dissection.
Adult ; Bone Diseases ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Hyperparathyroidism, Primary ; Neck ; Neck Dissection ; Parathyroid Glands ; Parathyroid Neoplasms* ; Technetium Tc 99m Sestamibi*

Abdominal aortic aneurysm is included in the differential diagnosis of lower back pain. Although rare, this important disease can cause potentially lethal complications. In this case, expanding abdominal aortic aneurysm coexisted with intervertebral disc extrusion. The diagnosis of abdominal aortic aneurysm was delayed, putting the patient at risk of aneurysmal rupture. In the management of patients with degenerative spinal diseases, we should not overlook the possibility of comorbidities such as an abdominal aortic aneurysm. We also suggest the importance of interpreting images more carefully, especially for elderly male patients.
Aged ; Aneurysm ; Aortic Aneurysm, Abdominal* ; Comorbidity ; Diagnosis, Differential ; Humans ; Intervertebral Disc* ; Low Back Pain ; Male ; Rupture ; Spinal Diseases

PURPOSE: Developing a curriculum(DACUM) is a method of analyzing job focused competency, which is obtained from the data of an expert belonging to a certain career. In this study the DACUM method was used to analyze the jobs of operating room nurses. METHOD: Through the DACUM workshop which was arranged by two DACUM facillitators, a definition of the role of operating room nurses was developed and then duties and tasks of operating room nurses' were identified. For the workshop, a DACUM committee with 10 operating room nurses was organized. Finally, the duties and tasks which were identified were validated by 422 nurses for importance, difficulty, and frequency. RESULTS: Thirteen duties and 105 tasks were identified on the DACUM chart, where importance, difficulty, and frequency of tasks were represented by alphabet letters A, B, and C as higher degree of importance. The determinant coefficient(DC) showed that the most important duty was assisting with operations(DC=6.61), and the least, managing operating materials(DC=4.22). For tasks, the most important ones were assisting in orthostatic surgery(DC=7.60), and assisting in thoracic surgery(DC=7.38), and the least important making gauze ball(DC=2.39), and saving of operation site((DC=3.27). CONCLUSION: The results suggest a need to develop an education program using the DACUM chart as a basis for the development and as a clinical career ladder and for curriculum of operating room nursing.
Career Mobility ; Curriculum ; Job Description ; Operating Room Nursing ; Operating Rooms

Insulinoma is a functional endocrine tumor arising from the beta cells of islets of Langerhans of pancreas. The only effective treatment of insulinoma was surgical removal of the tumor. Recently, laparoscopic surgery for islet cell tumors of the pancreas is introduced. Laparoscopic enucleation or resection of benign islet tumors results in a shorter hospital recovery and is a good alternative to open surgery We report a case of insulinoma that was treated sucessfully by laparoscopic enucleation.
Adenoma, Islet Cell ; Insulinoma* ; Islets of Langerhans ; Laparoscopy ; Pancreas

No abstract available.
Puberty, Precocious* ; Sertoli-Leydig Cell Tumor*

Simultaneous oceurrence of adrenocortical tumor and pheochromocytoma is extremely rare. Coexistence of adrenal tumor and pheochromocytoma was first reported by Cope in 1952 and some other cases were reported after that. But there was no report about coexistence of adrenocortical carcinoma and paragangliomas. Recently, we experienced a case of adrenocortical carcinoma associated with multiple paragangliomas. A 35-year-old woman was admitted to the hospital because of left upper abdominal pain. A palm-sized fum tender mass was palpated at left upper quadrant. Hormonal studies revealed pheochromocytomas feature. Fmergency operation was performed because of the possibility of intemal hemorrhage of the tumor. Operator found 10 cm sized mass in left adrenal area and also the other 5 small tumors adjacent to IVC. Pathologic report revealed that adrenal mass was adrenocortical carcinoma with hemorrhagic necrosis and tumors adjacent to IVC were paragangliomas. This patient was the first case of adrenocortical carcinoma with multiple paragangliomas in the world. So we report this case with a review of literature.
Abdominal Pain ; Adrenocortical Carcinoma ; Adult ; Female ; Hemorrhage ; Humans ; Necrosis ; Paraganglioma* ; Pheochromocytoma