Clinicalstudies on thirty patients with lichen planus seen during the past 9 years from 1968 to 1976 at the Department of Dermatology, Busan National University Hospital were ma,de;particularly, varied clinical types of the disease and significance of histological findings were emphasized. The results obtained were as follows; 1. The incidence of lichen planus was 0.17% patients to total number of dermatologic 2. There were 19 males and 11 females in this series. The age at the first visit varied from 16 years to 71 years, and the pitients between 21 and 50 years occupied 76.7% of all. 3. The most common site of the initial lesion was extremities(66.7%), and flexor surface was rather common than extensor surface. And lesions of trunk, oral mucosa, extemal genitalia were also noticed. 4. The most common clinical type was chronic localized type(11), and hypertrophic type(4), Iichen planus of mucous membrane(4), annular type(4), acute widesprearead type(3), vesicobulIous type(2), linear type(2), follicular type(l) were also noticed. 5. Pruritus developed in 22 patints(73.3%) an@d Koebners phenomenon was noticed only in R cases(10%). 6. Histopathological examination of 25 biopsy specimens showed epidermal changes of hyperkeratosis(24), acanthosis(22), hypergranulosis(21), elongation of rete ridge(8) and liquefaction degeneration of hasal cells(25). Dermal changes include bandlike infiltration of infIammatory cells(24), melanophages in upper dermis(18), colloid or eosinophilic body(9), and dermo-epidermal separation(3).
Biopsy ; Busan ; Colloids ; Dermatology ; Eosinophils ; Female ; Genitalia ; Humans ; Incidence ; Lichen Planus* ; Lichens* ; Male ; Mouth Mucosa ; Pruritus

Atrophie blanche which was first described by Milian in 1929 is a sistinct entity and not a variation of stasis dermatitis. We reported a case of atrophie blanche which occurred in 21 year-old female. She had erythematous patches, telangiectaic purpuric areas, small 1 to 2mm ectasias suggestive of small angiomas with central ulcer, pustules and crusts on both lower legs and dorsa of feet without severe painful sensation. Histopathologic findings showed endothelial proliferation of the capillary blood vessele of dermis, presence of fibrinoid material on the superficial blood vessels and storma, and infarction of the epidermis and superficial corium. Response to treatment was not satisfactory with antibiotics and corticosteroid.
Anti-Bacterial Agents ; Blood Vessels ; Capillaries ; Dermatitis ; Dermis ; Dilatation, Pathologic ; Epidermis ; Female ; Foot ; Hemangioma ; Humans ; Infarction ; Leg ; Sensation ; Ulcer ; Young Adult

BACKGROUND: Recently, the commercial kits for measurement of the absolute number of CD34+ cells have been introduced as a standard method. The aims of this study was to investigated optimal timing of peripheral blood progenitor cell(PBPC) collection and optimal CD34+ cells dose transplanted by measurement of the absolute CD34+ cells. METHODS: We measured total leukocyte count, mononuclear cell count and the absolute number of CD34+ cells using ProCOUNT(Becton Dickinson, USA) in peripheral blood from 54 patients and 7 normal donors who underwent 101 leukapheresis for PBPC collection. We studied correlations among the absolute number of circulating CD34+ cells, other predictors and harvesting yields. We investigated relationships between the posttransplant hematopoietic recovery and CD34+ cells dose in 30 patients. RESULTS: The total number of CD34+ cells in harvesting products could be mostly predicted from the absolute number of circulating CD34+ cells. From 4 to 6 day after G-CSF mobilization, the absolute number of circulating CD34+ cells was peaked. A number of circulating CD34+ cells more than 20/microliter ensured 2.5x106 CD34+ cells/Kg in harvesting products. The patients received CD34+ cells dose >3.5x106/Kg led to a significantly faster recovery of platelets, compared with the patients receiving <3.5x106 CD34+ cells/Kg(P<0.05). CONCLUSIONS: These results suggest that PBPC collection should be started at day of circulating CD34+ cells more than 20/microliter or 4-6 days after G-CSF mobilization for successful leukapheresis and the CD34+ cell dose more than 3.5x106/Kg for PBPC transplantation could predicted rapid hematopoietic recovery.
Cell Count ; Granulocyte Colony-Stimulating Factor ; Humans ; Leukapheresis ; Leukocyte Count ; Stem Cells* ; Tissue Donors

Intractable diarrhea associated with secondary amyloidosis in rheumatoid arthritis (RA) is a serious clinical entity with poor prognosis. We describe a 39-year-old male RA patient who presented with intractable diarrhea. Biopsy findings of terminal ileum and colon revealed amyloidosis secondary to RA. Effective treatment of rheumatoid arthritis resulted in remission of intractable diarrhea caused by amyloid protein deposition.
Adult ; Amyloid ; Amyloidosis* ; Arthritis, Rheumatoid* ; Biopsy ; Colon ; Diarrhea* ; Humans ; Ileum ; Male ; Prognosis

Catastrophic antiphospholipid syndrome is a highly fatal condition characterized by widespread thromboembolism subsequent to a triggering factor (e.g., infection, trauma, and neoplasia) in antiphospholipid antibody-positive patients. This paper reports a case of a 29-year-old male without the underlying disease who developed extensive mesenteric thromboembolism and jejunal necrosis during the treatment for acute enteritis. The patient’s condition was improved with low-molecular-weight heparin and an intravenous Ig treatment with emergency surgery. The serum antiphospholipid (anticardiolipin IgM) and lupus anticoagulant antibody tests showed positive results. Acute infectious enterocolitis is generally considered a mild disease. On the other hand, aggressive evaluation and treatment should be considered if the clinical conditions do not improve and deteriorate rapidly despite appropriate antibiotic treatment because of the possibility of acute immunological complications, such as catastrophic antiphospholipid syndrome.

Catastrophic antiphospholipid syndrome is a highly fatal condition characterized by widespread thromboembolism subsequent to a triggering factor (e.g., infection, trauma, and neoplasia) in antiphospholipid antibody-positive patients. This paper reports a case of a 29-year-old male without the underlying disease who developed extensive mesenteric thromboembolism and jejunal necrosis during the treatment for acute enteritis. The patient’s condition was improved with low-molecular-weight heparin and an intravenous Ig treatment with emergency surgery. The serum antiphospholipid (anticardiolipin IgM) and lupus anticoagulant antibody tests showed positive results. Acute infectious enterocolitis is generally considered a mild disease. On the other hand, aggressive evaluation and treatment should be considered if the clinical conditions do not improve and deteriorate rapidly despite appropriate antibiotic treatment because of the possibility of acute immunological complications, such as catastrophic antiphospholipid syndrome.

BACKGROUND: We reviewed the guidelines for the transfusion of red cells, platelets, and fresh frozen plasma (FFP) of the Korean Society of Blood Transfusion and modified the previous guidelines for transfusions at our hospital. We evaluated the appropriateness of the current hospital transfusions with these algorithms based on these guidelines. METHODS: The medical records of 266 transfusion episodes of patients receiving transfusions of red cells (144), platelets (61), and FFP (61), were reviewed retrospectively at Ewha Womans University Mokdong Hospital during 2002. RESULTS: Inappropriateness rates for transfusion episodes were 2.8% for red cells, 4.9% for platelets, and 44.3% for FFP. 144 red cell transfusions comprised 73 episodes (50.7%) in acute blood loss and 71 (49.3%) in chronic anemia. Among them, 2 episodes in each condition were assessed as inappropriate, respectively. 61 platelet transfusions comprised 32 episodes (52.5%) for a prophylaxis in marrow failure and 13 (21.3%) for active bleeding and 6 (9.8%) for acute disseminated intravascular coagulation (DIC) and 10 (16.4%) for others. Among them, 3 episodes for clinical bleeding were assessed as inappropriate. Out of 61 FFP transfusions, 34 episodes (56%) (16 liver disease with complications, 11 acute DIC, and 7 others) were assessed as appropriate and 27 episodes (44%) (8 liver diseases without complications, 10 surgical procedures and 9 others) were assessed as inappropriate. CONCLUSIONS: We modified our previous guidelines for transfusions according to the transfusion guidelines proposed by the Korean Society of Blood Transfusions. These guidelines could be easily applied to evaluate the appropriateness of transfusions performed at our hospital and to specify the cases of inappropriate transfusions.
Anemia ; Blood Transfusion ; Bone Marrow ; Dacarbazine ; Disseminated Intravascular Coagulation ; Female ; Hemorrhage ; Humans ; Liver Diseases ; Medical Records ; Plasma* ; Platelet Transfusion ; Retrospective Studies

BACKGROUND/AIMS: Gastroesophageal reflux disease (GERD) may contribute to the development of sleep disturbance, which may, in turn, provoke or worsen GERD. We evaluated the prevalence of GERD, non-erosive reflux disease (NERD), and extra-esophageal syndrome in subjects with self-reported sleep disturbance. METHODS: Subjects presenting for a health check-up were enrolled. Valid self-administered questionnaires provided information about reflux symptoms and sleep disturbances. We defined insomnia as self-reported sleep disturbance that occurred at least twice a week. GERD was defined as at least weekly symptoms of heartburn or acid regurgitation. Factors affecting sleep disturbance were revealed by a logistic regression analysis. RESULTS: We recruited 1,701 subjects (men 57.5%; mean age 45.0 +/- 15.0 years). The prevalence of sleep disturbance was 16.3%. GERD was reported in 14.8% of the subjects with insomnia and 7.1% of controls (p < 0.001). The prevalence of NERD was 13.7% in subjects with insomnia and 6.2% in controls (p < 0.001). The prevalence of extra-esophageal symptoms was higher in the insomniacs than controls. There was a significant correlation between the number of extra-esophageal symptoms and the frequency of sleep disturbance. Multivariate analysis showed that having GERD, NERD, extra-esophageal symptoms, and high depression and anxiety scores were predictors of sleep disturbance. CONCLUSIONS: The prevalence of GERD is higher in subjects with sleep disturbance. The number of extra-esophageal symptoms was correlated with the severity of poor sleep quality, regardless of the presence of erosive change. These findings have therapeutic implications for GERD, NERD, and extra-esophageal syndrome in patients with sleep disturbance, and future trials are warranted.
Anxiety ; Depression ; Gastroesophageal Reflux ; Heartburn ; Humans ; Logistic Models ; Multivariate Analysis ; Prevalence ; Surveys and Questionnaires ; Sleep Initiation and Maintenance Disorders

PURPOSE: After cataracts, eye injuries are the second leading cause of visual impairment worldwide. But most eye injuries are preventable simply by wearing appropriate eye protection. In this study we evaluate factors leading to eye injury in a sample of emergency department (ED) patients. METHODS: This study was conducted with 424 isolated eye injury patients who visited our ED from January to December of 2008. The following data were reviewed; date of visit, characteristics of subjects, existing use of eyewear, relationship of injury to work, causative activity, location where the injury occurred, type of injury, disposition at ED discharge, length of hospital stay, and the existence of sequelae. Severe eye injuries were classified based on the type of injury, disposition at ED, remaining visual loss, and sequelae. RESULTS: Among the total 424 isolated eye injury patients, 411 cases were analyzed. Eye injuries occurred most frequently at home (22.6%), in a factory workplace (21.2%), or an outdoor agricultural workplace (18.2%). The incidence of eye injuries peaked in the fifth decade of life. Among the 306 (74.5%) cases that were workplace unrelated, the main causative activities were assault (18.0%), injury associated with play (14.1%), sports (11.1%), and lawn mowing (9.2%). CONCLUSION: The most common location where the eye injury occurred was at home. Eye injuries prevention in the workplace is well promoted, but in fact, eye injuries were more common at home and during non-occupational activities. We suggest that public education programs which highlight non-occupational eye injury risk and prevention measures should be instituted to reduce preventable eye injuries.
Cataract ; Emergencies ; Eye ; Eye Injuries ; Humans ; Incidence ; Length of Stay ; Risk Factors ; Sports ; Vision Disorders

BACKGROUND: One quarter to one third of patients with NSCLC present with primary tumors that although confined to the thorax are too extensive for surgical resection. Until resently standard treatment for these patients had been thoracic radiation, which produces tumor regression in most patients but few cures and dismal 5-year survival rate. The fact that death for most patients with stage III tumors is caused by distant metastases has promped a reevaluation of combined modality treatment approaches that include systemic chemotherapy. Therefore, we report the results observed in a study to evaluate the effect of multimodality treatment in locally advanced non-small cell lung cancer from 1/91 to 8/93 in CNUH. METHOD: We grouped the patients according to the treatment modalities and evaluated response rate, median survival and the effect of prognostic variables. Among 67 patients evaluated, twenty seven patients classified with group A, received cisplatin and etoposide containing combination chemotherapy alone, eighteen patients, classified with group B, received chemotherapy and radiotherapy, fifteen patients, group C, received neoadjuvant or adjuvant chemotherapy and surgery with/without radiation therapy, seven patients, group D, received only supportive care. RESULT: The major response rate for group A and B was 37% and 61% respectively. There was no statistically significant difference in response rate between A and B groups(p=0.97). The analysis of prognostic factors showed that differences of age, sex, pathology, blood type, smoking year, stage and ECOG performance did not related to improvement in survival. Median survival time was 8.6 months for group A, 13.4 months for group B, 19.2 months for group C, and 5.4 months for group D, respectively and there was statistically significant difference(p=0.003), suggesting that multimodality therapy was associated with signigicant improvement in survival. Subset survival analysis showed a significant therapeutic effect for earlier stage and good performance state(p=0.007, 0.009, respectively). A possible survival advantages were observed for major response groups. CONCLUSION: It was suggested that multimodality therapy for the management of patients who had stage III disease, has yielded good median survival and long survival for seleted patients. But, it is necessory to validate above result with further investigation in large scale and in prospective randomized trials.
Carcinoma, Non-Small-Cell Lung* ; Chemotherapy, Adjuvant ; Cisplatin ; Drug Therapy ; Drug Therapy, Combination ; Etoposide ; Humans ; Neoplasm Metastasis ; Pathology ; Prospective Studies ; Radiotherapy ; Smoke ; Smoking ; Survival Rate ; Thorax