The main trend moves towards early excision and skin grafting as treatment for the deep second degree burns and the third degree burns. The ability to excision & skin grafting. This study prospectively evaluated the ability of laser doppler flow measurements obtained within 72 hours after burn injury to predict the depth of burn wounds. A Periflux system 4001 laser doppler flowmetry had been used to measure cutaneous microflow circulation of 100 selected points of burn wounds in 44 admitted patients from March 1993 to February 1994. The mean value of superficial second degree burn checked by laser doppler was 194.6 perfusion unit(PU). The deep second degree burn was 59.7 PU and third degree burn was 5.1 PU. The blood flow of more than 100 PU reliably predicted the superficial second degree burn with 90.2 percents accuracy. The blood flow between 100 PU and 10 PU predict the deep second degree dermal burn with 96.2 percents accuracy. That of less than 10 PU predict the third degree burn with 100 percents accuracy. There was also a significant correlation between initial flow measurements and the depth of burn wounds. We conclude that laser doppler flow measurements performed early after burn injury are useful in predicting the depth of burn wounds. The laser doppler flowmetry has the advantage of being easy to use, noninvasive, provide immediate result for early determination of burn depth. The laser doppler flowmetry is useful in selecting patients for early excision and grafting of burn wounds.
Burns* ; Humans ; Laser-Doppler Flowmetry* ; Perfusion ; Prospective Studies ; Skin Transplantation ; Transplants ; Wounds and Injuries

In the era of government 3.0, the availability of open government-owned public data and data sharing with the private sector are important. We surveyed the status of public data openness in the healthcare domain and of compliance with the standard open data format based on the “5 stars of linked data” model. We examined healthcare data on the Open Data Portal (https://www.data.go.kr). We also surveyed data on the websites of the public institutions and state administrative agencies that provided healthcare data on the Portal. In terms of data on the Portal, all public institutions except the National Medical Center, the Korea Institute of Science and Technology Information, and the Korea Environment Corporation were found to have provided data in the 3-stars format corresponding to the Public Data Open Standard Maintenance Guide. All data provided by state administrative agencies met the 3-stars format. Only 2 institutions (the Health Insurance Review & Assessment Service and the Korea Health Industry Development Institute) released data in the 3-stars format on their websites. Among the major state administrative agencies providing data on the Portal, none released data in the 3-stars format on their websites. Government-owned data should be provided in a standard format both on the Open Data Portal and on data-holders' websites to facilitate communication and collaboration. Considering the huge potential of linked healthcare data from a single national health insurance system, providing open data in compliance with the standard open format will promote the opening and sharing of public data.
Compliance* ; Cooperative Behavior ; Delivery of Health Care* ; Information Dissemination ; Information Storage and Retrieval ; Insurance, Health ; Korea* ; National Health Programs ; Private Sector ; Public Sector ; Vital Statistics

BACKGROUND: Recently the clinical significance of several mycobacterial species has been increased and there is a growing need to identify mycobacteria to the species level. We evaluated multiplex polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) assay for identification of mycobacterial isolates. METHODS: Reference strains of 6 species of mycobacteria and 88 clinical isolates were lysed by boiling method. The lysates were used for multiplex PCR reactions incorporating three pairs of PCR primers, which were expected to amplify fragments from the 65-kDa gene common to all mycobacteria, genes of M. tuberculosis complex and M. avium, respectively. The resultant amplicons were digested with the restric-tion enzymes PspEI and HaeIII. Multiplex PCR products and digested products were visualized by electrophoresis on agarose gels. RESULTS: Six reference strains yielded compatible results. Eighty-eight clinical isolates were identified as M. tuberculosis complex (81 strains), M. avium (2 strains), M. intracellulare (2 strains), M. fortuitum biovariant peregrinum (2 strains), and M. gordonae III (1 strain). CONCLUSION: Multiplex PCR-RFLP assay appears to be a reliable method for rapid identification of mycobacteria to species level.
Electrophoresis ; Gels ; Gordonia Bacterium ; Multiplex Polymerase Chain Reaction ; Mycobacterium* ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Sepharose ; Tuberculosis

Idiopathic hypereosinophilic syndrome is a rare systemic, leukoproliferative disorder characterized by eosinophil- mediated tissue injury causing multiple organ failure, including the heart. Cardiac involvement occurs in more than 75% of patients with hypereosinophilic syndrome. Cardiac manifestations include subendocardial fibrosis, thrombus leading to peripheral emboli, restrictive cardiomyopathy, and valvular dysfunction. It is more common in men than in women (9:1), and trends to present between the ages of 20 and 50 years. Presentation in childhood is unusual. We report for the first time a case of a 58-year-old man with idiopathic hypereosinophilic syndrome manifested by prosthetic aortic valve dysfunction that was successfully treated by steroid and hydroxyurea therapy after surgical valvular replacement.
Aortic Valve* ; Cardiomyopathy, Restrictive ; Female ; Fibrosis ; Heart ; Humans ; Hydroxyurea ; Hypereosinophilic Syndrome* ; Male ; Middle Aged ; Multiple Organ Failure ; Thrombosis

PURPOSE: Genomic instability of microsatellite in patients with defects in the mismatch repair system of DNA resulting in replication error (RER) has a high risk of accumulating mutations in oncogene and tumor suppressor gene. In this study, we evaluated the incidence of microsatellite instability (MI) in renal cell carcinoma (RCC) by comparing polymerase chain reaction (PCR)-amplified sequences from frozen samples of normal and tumor tissue from affected patients. MATERIALS AND METHODS: Analysis of MI using the PCR based assay was performed in total 25 cases of RCC, including 21 clear cell types and 4 papillary types. MI of tumor DNA was observed as the occurrence of additional or absence of constitutional autoradiographic signals, or as at least a two to threefold increase or decrease of intensity of the autographic signals in comparison to the corresponding normal tissue DNA. Total 11 microsatellite loci were studied; 4 loci at 3p (D3S1274, D3S1296, D3S1300, D3S1313), 3 loci at 9p (IFNA, D9S1747, D9S171) and 4 loci at 17p (D17S513, D17S695, TP53, D17S261). RESULTS: Twenty-one of 25 RCC (84%) displayed MI in at least one informative locus. MI was found in 15 of 25 cases (60%) at 3p region and 7 of 25 cases (28%) at 9p region. All of them were clear cell type of RCC. MI was detected in 11 cases (44%) at 17p region, 7 of them were clear cell type. In all 4 cases of papillary type, MI was observed only at 17p region. CONCLUSIONS: These results suggest that alterations of 3p region might occur in the early stage of tumorigenesis in RCC. The DNA mismatch repair system may play an important role in tumorigenesis of RCC and MI analysis could be a useful method to detect early genetic alterations in RCC. Genetic alterations in tumorigenesis of RCC may have some differences according to the histologic characteristics.
Carcinogenesis ; Carcinoma, Renal Cell* ; DNA ; DNA Mismatch Repair ; Genes, Tumor Suppressor ; Genomic Instability ; Humans ; Incidence ; Microsatellite Instability ; Microsatellite Repeats* ; Oncogenes ; Polymerase Chain Reaction

No abstract available.
Finasteride* ; Risk Factors ; Venous Thrombosis*

PURPOSE: Arterial stiffness is a major independent risk factor for cardiovascular morbidity and mortality in hemodialysis patients. It is hypothesized that arterial stiffness factor is attributable to the structural and functional changes of left ventricle (LV) caused by increased cardiac workload. So we investigated the relationship between brachial-ankle pulse wave velocity (baPWV) and diastolic dysfunction of left ventricle using echoardiographic transmitral blood flow pattern. METHODS: For 96 subjects (48 control patients, 48 hemodialysis patients), baPWV and echocardiographic indices for diastolic function, i.e. transmitral E, A, E/A, DT, IVRT were measured just before hemodialysis session. Role of baPWV was tested in a multiple regression model including age, gender, body mass index, predialysis blood pressure, heart rate, LV mass index and interdialysis weight gain. RESULTS: In the control group, LV mass index (beta=-0.350) and rbaPWV (beta=-0.403) had an independently correlation with E/A ratio. Rt-baPWV was independently correlated with DT (beta=-0.410) and IVRT (beta=0.500). In the hemodialysis group, systolic blood pressure (beta=-0.389) and heart rate (beta=-0.403) were the factors of E/A ratio. Rt-baPWV (beta=-0.557) was the factor determining E/A ratio only in female hemodialysis patients. CONCLUSION: PWV is independently correlated with E/A ratio only in female hemodialysis patients. Their relationship is limited or weak compared to normal control group.
Blood Pressure ; Body Mass Index ; Compliance ; Echocardiography ; Female ; Fibrinogen ; Heart Rate ; Heart Ventricles ; Humans ; Mortality ; Pulse Wave Analysis* ; Renal Dialysis* ; Risk Factors ; Vascular Stiffness ; Ventricular Function, Left ; Weight Gain

An inflammatory pseudotumor of the liver is a rare benign tumor, which is frequently misdiagnosed as malignant. A 63 year-old man presented with a 4-month history of weight loss and a 2-month history of intermittent fever and chills. A computed tomographic (CT) scan and magnetic resonance imaging of the abdomen demonstrated a large tumor in segment 8 of the liver. An ultrasound-guided core biopsy confirmed an inflammatory pseudotumor of the liver. His fever persisted for 3 months, despite the administration of Naproxen and antibiotics. A right trisegmentectomy was carried out, after which the fever subsided. The patient has remaineds well for the last 7 months.
Abdomen ; Anti-Bacterial Agents ; Biopsy ; Chills ; Fever ; Granuloma, Plasma Cell* ; Humans ; Liver* ; Magnetic Resonance Imaging ; Middle Aged ; Naproxen ; Weight Loss

Inflammatory pseudotumor (IPT) of the liver is rare benign tumor. When the diagnosis of IPT is established with biopsy, simple observation or conservative therapy is preferred because of the possibility of regression. But IPT is unresponsive to the conservative treatment, surgical resection should be considered. We experienced a 63-year-old male, who was suspected hepatocellular carcinoma in abdominal computed tomography (CT) and magnetic resonance image (MRI) scan, presented with 2-month history of intermittent fever and weight loss. Percutaneous ultrasound guided core biopsy confirmed IPT of the liver. Non-steroidal anti-inflammatory drugs and antibiotics were administered for 8 and 4 weeks, respectively, but fever continued. So, extended right hepatectomy was performed for IPT of the liver and then fever subsided. The patient remains well during a follow-up period of 12 months.
Middle Aged ; Male ; Magnetic Resonance Imaging ; Liver Diseases/*diagnosis/pathology/*surgery ; Liver/pathology/surgery ; Humans ; *Hepatectomy ; Granuloma, Plasma Cell/*diagnosis/pathology/*surgery ; Diagnosis, Differential

BACKGROUND: Bronchial anthracofibrosis (BAF) is a dark black or brown pigmentation of multiple large bronchi associated with a fibrotic stenosis or obliteration that is incidentally found during a diagnostic bronchoscopy. Some reporters have suggested endobronchial tuberculosis or tuberculous lymphadenitis as a possible cause of BAF. However, some BAF patients do not have any medical history of tuberculosis. The aim of this study was to elucidate the clinical features of simple BAF patients, which were not associated with tuberculosis. METHODS: We reviewed the patients' charts retrospectively and interviewed all BAF patients who were followed up for 1 year or more. Among the 114 BAF patients, 43 patents (38 %) had no associated tuberculosis, cancer and pneumoconiosis. The clinical characteristics, radiological findings and associated pulmonary diseases of these patients were evaluated. RESULTS: Most patients were non-smokers, old aged, housewifes who resided in a farming village. The common respiratory symptoms were dyspnea, cough and hemoptysis. The predominant X-ray findings were a multiple bronchial wall thickening(89%), bronchial narrowing or atelectasis (76%) and a mediastinal lymph node enlargement with/without calcification (78%). Pulmonary function test usually showed mild obstructive ventilatory abnormalities but no patient showed a restrictive ventilatory pattern and the patients were frequently affected with chronic bronchitis(51%), post-obstructive pneumonia(40%) and chronic asthma(4%). CONCLUSION: Because BAF is frequently associated with chronic bronchitis and obstructive pneumonia as well as tuberculosis, a careful clinical evaluation and accurate differential diagnosis is more essential than empirical anti-tuberculous medication.
Diagnosis, Differential ; Pneumoconiosis