The nevus sebaceus is an organoid nevus generally noted on the scalp or the face as a single lesion. The frequent association of nevus sebaceus with other appendage tumors and with apocrine glands suggests that nevus sebaceus is derived from the primary epithelial germ. We report a 20-day-old boy with multiple nevus sebaceus on his face, scalp and external ear. The lesions were symmetrical and midline involved yellowish plaques. On the microscopic view of biopsy specimen from the face and scalp, there is a dilated keratin-filled infundibula showing a few buds of undifferentiated cells representing malformed hair germs. The dermis contains many fibroblasts and immature hair structures. Numerous sebaceous glands and eccrine glands lie in upper dermis. Diagnosis was confirmed by clinical appearance and histological picture.
Apocrine Glands ; Biopsy ; Dermis ; Diagnosis ; Ear, External ; Eccrine Glands ; Fibroblasts ; Hair ; Humans ; Male ; Nevus* ; Organoids ; Scalp ; Sebaceous Glands

In order to investigate of the effects of rapid rotating shift work on physiological stress, the activities of urinary Na+, K+, Cl- were measured in 14 rotational shift nurses, during day shifts(8AM-4PM, n=4), evening shifts(4PM-12MN, n=5), and night shifts(12MN-8AM, n=5) in hospital twenty students attending nursing college a used as control group. Urine specimens were collected in 30 minutes before and after work on the second day of shift work. In day shift nurses, Na+ activity was 137mM at 8AM and increased to 206mM at 4PM, whereas K+ activity was 42mM at 8AM and no significant change at 4PM. Cl- activity was changed from 234mM to 344mM at 4PM at 8AM. In the evening shift, Na+ activity was 117mM at 4PM and 140mM at 12MN, K+ activity was 22mM and 32mM, respectively. Cl- activity was 169mM and changed to 270mM. During the night shift, Na+ activity was 128mM at 12MN and changed to 161mM at 8AM, K+ activity was 42mM at 12MN and 8AM, and Cl- activity was from 303mM and changed to 355mM. In general, the urinary ion activities seemed to increase after work, however there were no significant changes in ion activities except the Na+ increase in day shift. The mean of the activities of K+ and Cl- before and after work during the day and night shift were significantly higher than those in control group(P<0.05). K+ activities were also higher than that of evening shift(P<0.05). However, there was no difference in Na+ activity among the control group and three shifts. There was a significant relationship among urinary Na+, Cl- and K+ in the control group and rotating shift nurses except between Na+ and K+ in shift. The relationship between Na+ and Cl- was low in shift work and there was no significant relationship between Na+ and K+ in shift, suggesting that the active regulation K+ and/or Na+ in response to stress upon the shift work disrupted the ratio of urinary Na+ to K+ and also lowered the relationship between K+ and Cl-. These results suggest that nurses working the day shift were overloaded and under stress, and the night shift interfered with the physiological rhythm of the nurses.
Humans ; Nursing ; Stress, Physiological

In this animal study, comedones were induced by topical application of oleic acid onto the rabbit ear canal and the histopathologic and ultrastructural changes in response to topical application of HO and hexane extracts of red ginseng, and saponin were measured. No microscopical difference was observed between treatment groups. Nucle ir remnants were observed in the horny cell layer as well as the thinning of the granular cell layer. Scattered and decreased keratohyaline granules were also noted. Six weeks after initiation of treatment, we observed the thinning of epidermis and veappearance of granular cell layer with normal keratohyaline granules. After treatment, scanning electron microscopy showed a decrease in the size of comedones, and loosened and desquamating horny cells in the comedones. From the above results, it could be concluded that Panax ginseng extracts might have effects on the keratinization process of the skin.
Animals ; Ear Canal ; Epidermis ; Microscopy, Electron, Scanning ; Oleic Acid ; Panax* ; Saponins ; Skin

BACKGROUND: Recently, it has been suggested that autoantibodis face of melanocytes are prevent in the sera of vitiligo patients. However, these autoantibodies exist, whether they are specific for vitiligo a vitiligo patients possess them. In addition, the specificity of the iti lecular weight of the antigen are all unsolved areas demanding further. OBJECTIVE: To investigate the possible role of autoimmune microvitiligo, this study was designed to verify the presence of auto and vitiligo antigen from the surface of melanocytes, the specificity of gene specific antigens on the sunever, it is not known whether ents, and what percentage of goantigen and the exact moier research. anisms in the development of bodies in vitiligo patients, the utoantibodies and vitiligo anti. METHODS: Indirect immuvofluorescent microscopy, flow cytoriiety, and ELISA was done to compare the reactions between melanocytes and sera. SDS-PAC island immunoblotting were used for the identification of vitiligo antigen. RESULTS: Vitiligo sera showed more prominent fluorescence and higher optical density on the surface of melanocytes than normal sera. Forty-four percent of vitiligo sera was directed to melanocytic surface antigen with a molecular weight of 65kDa. The sition assay using rabbit antimelanocytic antibody showed an inhibition of the reaction betw er vitiligo sera and melanocytes in ELISA and immunoblotting. CONCLUSION: A surface antigen of 65kd was identified from melanocytes and 44.4% of the vitiligo sera showed positive reactions to this antigen.
Antigens, Surface ; Autoantibodies* ; Enzyme-Linked Immunosorbent Assay ; Fluorescence ; Humans ; Immunoblotting ; Melanocytes* ; Microscopy ; Molecular Weight ; Sensitivity and Specificity ; Vitiligo*

Objective: A displaced fracture in the anterior cranial base may be complicated by cerebrospinal fluid (CSF) rhinorrhea and enophthalmos. This study introduces a reconstruction technique with direct dural repair and reduction and fixation of the autologous fractured fragments. Methods: Displaced fractures in the anterior cranial base were reconstructed using a stitching-up technique: A bicoronal scalp incision and frontal craniotomy was performed and the displaced bone was withdrawn. The lacerated dura was repaired primarily using a graft.Small holes were created in the intact cranial bones and the displaced harvest bone. Black silk was passed through the holes and the displaced bone was repositioned on tying the silk.Lumbar drain was not placed in any of the cases. The feasibility and outcome were evaluated. Results: Five patients with displaced skull fractures of the anterior cranial base were included. All cases were men who had a direct impact on the forehead and/or eye. All the displaced fractures occurred in the orbital roof, and ethmoid bone fractures were present in 4 cases. Dural laceration was involved in 4 cases and repaired by placing artificial dura in 3 cases and a pericranial graft in 1 case. Following surgery, all cases were uneventful, and the anterior cranial fossa was well reconstructed. CSF leakage or enophthalmos did not occur in any of the cases. Conclusion Direct dural repair and autologous stitching-up reconstruction using the fractured fragment could be an effective method to prevent CSF leakage and enophthalmos in displaced fractures of the anterior cranial base.

PURPOSE: This study was to examine the relationships between knowledge with same sub-areas of education needs and adherence to self-management guidelines, and to investigate the factors that influence adherence. METHOD: One hundred eleven patients with terminal stage of kidney failure were conveniently selected from a university hospital in Incheon. RESULTS: The level of knowledge was high, with a mean score of 15.25. The level of adherence to self-management guidelines was low, with a mean score of 64.53. The patients' education needs were high. The significant influencing factors on adherence were gender, educational level, and two sub-areas of knowledge, 'exercise and daily life' and 'follow-up care and treatment'. CONCLUSION: Relationships between knowledge, education needs, and adherence should be further examined before developing and implementing intervention programs for adherence to treatment guideline in hemodialysis patients.
Humans ; Renal Dialysis ; Renal Insufficiency ; Self Care

OBJECTIVE: Although twist-drill craniostomy (TDC) has a number of procedural advantages and an equivalent outcome compared to burr hole craniostomy (BHC) for the treatment of chronic subdural hematomas (CSDHs), the latter technique remains the preferred method. We analyzed symptomatic CSDHs in whom TDC at the pre-coronal suture entry point (PCSEP) was the primary method for hematoma drainage and BHC on the parietal was the secondary option. METHODS: CSDHs in 86 consecutive patients were included. TDC at the PCSEP, which is 1 cm anterior to coronal suture at the level of the superior temporal line, was the primary operational technique when the hematoma thickness was suitable, and BHC was performed via the parietal when TDC was unreasonable or failed. The clinical feasibility and outcomes of these approaches were analyzed. RESULTS: Of the 86 patients, 68 (79.1%) were treated by TDC, and 18 (20.9%) by BHC. All patients showed improvements in their symptoms after hematoma drainage. Neither morbidity nor mortality was associated with either technique, and there were no differences in drainage days between the groups. Ten patients had bilateral hematomas and were treated using TDC. Two patients were not sufficiently treated by TDC and, as a result, BHC was applied. Only six hematomas (7% of 86 hematomas) exhibited insufficient thickness on the computed tomography to perform TDC. CONCLUSION: When the hematoma was thick enough, a majority of the CSDHs were drained using TDC at the PCSEP as the first procedure, which was especially useful for bilateral hematomas and in elderly patients.
Aged ; Drainage* ; Hematoma ; Hematoma, Subdural, Chronic* ; Humans ; Methods ; Mortality ; Rabeprazole ; Sutures

Insulin therapy is indicated in the treatment of gestational diabetic women and overt diabetic pregnant women for hyperglycemia after failure to respond to the diets and exercise regimens. The insulin is administered to mimic normal pancreatic function. The normal pancreas secretes 50% of the total daily insulin as mealtime boluses. This delivery may be mimicked by four-injection-per-day of combination of NPH and regular insulin (RI). Hypoglycemia is a well-recognized complication of intensive insulin therapy in patients with Type II diabetes. Recently, it has been reported that insulin-lispro, an analogue of regular human insulin with a peak insulin action achieved with a 1 hour after injection improves postprandial glucose concentration in non-pregnant diabetic patients. Treatment of gestational or diabetic pregnant women with NPH and insulin-lispro has significantly lower postprandial glucose levels without an increase in hypoglycemic events. Here, we report 2 cases of hyperglycemic control with four times daily administration of NPH & insulin-lispro on diabetes in pregnancy, with brief reviews.
Diabetes Mellitus ; Diet ; Female ; Glucose ; Humans ; Hyperglycemia ; Hypoglycemia* ; Insulin Lispro* ; Insulin* ; Meals ; Pancreas ; Pregnancy* ; Pregnant Women

Aretrospective study of 45 patients with cervical spine injury who underwent skull traction was conducted to evaluate the neurological changes after closed reduction. Motor function during the traction improved in 5 (11.1%), no change in 37(82.2%), and aggravated in 3(6.7%) of the patients. Three patients who deteriorated neurologically during the traction were found to have locked facets and herniated disc materials demonstrated by MR imaging study. Authors believe that MRI should be carried out as soon as possible in patients with cervical spine injury, even before traction is attempted, and any neurological changes should be checked and evaluated carefully during the traction. And if there is a herniated discs compressing the spinal cord at the injured level, anterior discectomy with interbody fusion is recommended before closed or open reduction.
Diskectomy ; Humans ; Intervertebral Disc Displacement ; Magnetic Resonance Imaging ; Skull* ; Spinal Cord ; Spine* ; Traction*

We report a case of acute lymphoblastic leukemia (ALL) in a 7-year-old female patient who had complained of limitation of motion and pain on knee and ankle joints 5 months ago. She had been initially diagnosed as juvenile rheumatoid arthritis (JRA) and received prednisone (PDS), which delayed the accurate diagnosis of the disease. But finally she has been diagnosed with ALL by the bone marrow aspiration and biopsy being done after the discontinuation of PDS with the help of leukemic suspicion of radiologic study.
Ankle Joint ; Arthritis, Juvenile ; Biopsy ; Bone Marrow ; Child ; Diagnosis ; Female ; Humans ; Knee ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Prednisone