Pityriasis rotunda is characterized by perfectly circular to oval brownish scaly patch on the trunk and extremities. This disease is considered to be a form of acquired ichtkyosis of unknown etiology and develops usually in association with certain systemic diseases, such as tuberculosis, malignant neoplasrn, leprosy, ovarian cyst and uterine myoma etc, We experienced 2 cases of pityriasis rotunda on the abdomen, chest and back associated with liver cirrhosis in 66 year old man 43 year old woman and clinical presentation was made with review of related literatures.
Abdomen ; Adult ; Aged ; Extremities ; Female ; Humans ; Leiomyoma ; Leprosy ; Liver Cirrhosis* ; Liver* ; Ovarian Cysts ; Pityriasis* ; Thorax ; Tuberculosis

A 22-year-old-male patient has numerous brownish-black, soft follicular papules which compatible with acne are scattered on the chest, scapular regions, back and buttocks for 4 5 years duration. Biopsy specimen revealed cystic structures in the mid-dermis lined by squamous cell epithelium w4ich contained laminated keratinous material and varying number of vellus hairs, histopathologically, compatible with diagnosis of eruptive vellus hair cysts. Related literatures and histogenesis were discussed,
Acne Vulgaris ; Biopsy ; Buttocks ; Diagnosis ; Epithelium ; Hair* ; Humans ; Thorax

Benign symmetric lipomatosis is characterized by massive symmetric fat deposition, predominantly in the neck and shoulder girdle ares. We present a case of benign symmetric lipomatosis with alcoholic liver cirrhosis in a 54-year-old man. About two years ago, solitary skin-colored, non-tender swelling on the right upper arm was developed. The lesion had been aggravsted abruptly and rapidly in size and distribution since about one month ago. Histopathologic findings showed completely replaced reticular dermis and invaded subcutaneous tissue by mature fat cells.
Adipocytes ; Arm ; Dermis ; Humans ; Lipomatosis* ; Liver Cirrhosis, Alcoholic ; Middle Aged ; Neck ; Shoulder ; Subcutaneous Tissue

Calcaneus is the largest tarsal bone and serves weight bearing of the body. The calcaneus has a pattern of cancellous bone enclosed with a very thin cortical shell. It is difficult to reduce the bony fragments accurately when there are comminution and displacement on the calcaneal fractures. Retrospective study was carried out of 18 patients(21 feet) of calcaneus fractures after axial fixation in Soonchunhyang University Hospital from July, 1982 to July, 1988. Minimum follow up period was 8 months(average 2 years 6 months). The clinical analysis of them are reported with a review of the literature and the results are follows:l. According to the Rowe's unit system, the results of treatment were excellent or good in 9 cases of 13 tongue types and 5 cases of 8 joint depression types. 2. The results were satisfactory in the calcaneal fractures of well reestablished Bohler angle to 21-30 degrees. 3. The results were excellent or good in 5 cases operated within post-trauma 1 week and in 9 cases operated from 1 week to 2 weeks. 4. The results were poor in the 2 joint depression type with severe comminution. And subtalar joint fusion was performed on the previous 2 cases. Then pain on the lateral malleolar area was subsided.
Calcaneus ; Depression ; Follow-Up Studies ; Joints ; Retrospective Studies ; Subtalar Joint ; Tarsal Bones ; Tongue ; Weight-Bearing

BACKGROUND: Ketamine use in emergency room has been increased. It has rapid onset of action and appropriate duration of action. It does not need endotracheal intubation and produces potent analgesia, sedation, and amnesia. The object of this study is to determine the safety and the degree of physician's satisfaction in relation to ketamine use. MATERIALS AND METHODS: This is a prospective study using protocol. Pediatric trauma patients who need sedation were given IM ketamine(4mg/kg) and atropine(0.01mg/kg) in a same syringe. Monitoring of patients was done by EM residents and complications of ketamine use were recorded. Physician's satisfaction was also recorded after the procedure. RESULTS: Intramuscular ketamine was administered 54 times, mainly for laceration repair. Physicians completed protocol for 51 of treated children. The median time for onset of sedation was 6.5+/-2.4 min, and duration of action was 32.4+/-10.8 min. Hypersalivation occurred in 9.8%(n=5); random movement 3.9%(n=2), emesis during procedure(n=1), emesis at home(n=1), and transient oxygen desaturation(n=1). All were quickly identified and treated without specific airway management and sequelae. Of 84% of physicians was satisfied with ketamine use for pediatric sedation. CONCLUSION: Intramuscular ketamine can be administered safely and satisfactorily in emergency room to facilitate pediatric procedures in conjunction with a defined protocol and appropriate monitoring.
Airway Management ; Amnesia ; Analgesia ; Child ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Intubation, Intratracheal ; Ketamine* ; Lacerations ; Oxygen ; Prospective Studies ; Sialorrhea ; Syringes ; Vomiting

No Abstract Available.
Health Behavior*

Many authors have been reported that the abdominal trauma, especially injury of the liver and spleen, is frequently found with lower rib fractures, below the ninth rib fractures and the incidence was about 20 to 30%. In cases of rib fractures, Intra- abdominal organs may be injured in the higher rib fractures than the ninth because the diaphragm is elevated at the level of filth intercostal space in expiration period and the intra-abdominal lesions are often delayed evaluated due to the pain of the fractures and masked by the other injuries of the head and the extremities. So above reasons, we were often questioned what the level of rib fracture we must evaluate the intra-abdominal injury was? So we investigated 452 patients with rib fractures who visited our emergency medical center from 1995, January to 1996, December and divided into two groups according to the prescience of intra-abdominal organ injuries by each the level of rib fractures. The number of patients with intra-abdominal organ injuries were 75(16.6%) and the most frequently damaged organ was the liver(25 cases, 33.3%). We calculated the statistical values of each level of rib fractures by the Chi-Square method and got a result that the level of rib fracture we must evaluate the intra-abdominal injuries was the sixth rib fracture. Therefore, if we will meet the patients with rib fracture below the sixth, we must have attentions to the intra-abdominal injuries and evaluate the abdomen closely with various diagnostic methods.
Abdomen ; Attention ; Diaphragm ; Emergencies ; Extremities ; Head ; Humans ; Incidence ; Liver ; Masks ; Rib Fractures* ; Ribs* ; Spleen

Although many kinds of operation for rectal prolapse exist, generally they could be divided into the transabdominal and transperineal approach. The former has low recurrence rate as compared with the latter, but needs laparotomy. Unfortunately, many patients with rectal prolapse are old and debilitated. So they are not suitable candidates for a major abdominal operation. For those patient, a transperineal method may be proper, but the recurrence rate may be high and continence is not always achieved. We reviewed 12 patients who were older than 70 years of age and treated by the Thiersch operation among the 52 cases of rectal prolapse from Feb. 1992 to Mar. 1997 at Kwangju Christian Hospital. The results were summarized as follows; 1) The male to female ratio was 1 : 1.4. 2) Durations of rectal prolapse were distributed from 6 months to 30 years. Seven cases had duration of longer than 10 years. 3) The preoperative incidence of incontience was 8 (67%) of 12 cases. Among the 8 patients with incontinence, the male was 3 (37.5%) and female was 5 (62.5%). 4) Postoperative review of incontinence revealed complete disappearance in 4 cases (50%), improvement in 3 cases (37.5%), and no improvement in 1 case (12.5%). 5) After the Thiersch operation, rectal prolapse recurred in only 1 of the 12 cases (8.3%), a wound infection developed in 1 case (8.3%), defecation difficulty due to the small Thiersch ring was present in 3 cases (25%). The results of this study show that the Thiersch operation may be an effective method in treating rectal prolapse, especially in patient who are old or have poor general condition and manifested incontinence.
Defecation ; Female ; Gwangju ; Humans ; Incidence ; Laparotomy ; Male ; Rectal Prolapse* ; Recurrence ; Wound Infection

Pulmonary Fibrosis*

PURPOSE: The main issue with the current ultrasonography (US) guidelines is the overestimation of malignant and indeterminate nodules as they do not aid in making decisions to treat patients. To overcome this, new US guidelines for thyroid nodules that have been shown to be better correlated with cytologic results have been proposed. We also suggested specific indications for US-guided fine needle aspiration (FNA) using the new US guidelines. METHODS: Clinical and pathologic data from 925 patients and 1,419 thyroid nodules were retrospectively collected. All subjects underwent US- and US-guided FNA at Department of Surgery, Wonju Christian Hospital, between March 2010 and July 2011. Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were calculated for both the current guidelines and the new guidelines. RESULTS: The accuracy, sensitivity, specificity, PPV, and NPV for the current guidelines in predicting malignancy were 24.1%, 99.3%, 62.2%, 25.0%, and 99.8%, respectively. The accuracy, sensitivity, specificity, PPV, and NPV for the new guidelines in predicting malignancy were 66.0%, 96.0%, 86.7%, 47.7%, and 99.4%, respectively. CONCLUSION: The use of the new US guidelines allow for a more accurate and specific diagnosis and a better treatment plan than the current guidelines. Additionally, the use of the new FNA guidelines may help prevent unnecessary FNAs and promote cost-effective follow-up for patients.
Biopsy, Fine-Needle ; Follow-Up Studies ; Humans ; Retrospective Studies ; Sensitivity and Specificity ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule