The authors analysed 53 cases of sudden cardiac death(SCD) without prominent structural abnormalies of heart out of witnessed 300 cases. Thirty four cases were associated with sleep and 19 with activity or rest. Twenty one cases were classified as having normal hearts, and the rest as structurally mild abnormal ones. Male was predominant, and almost of the victims were suffered in their twenties or thirties. All cases collapsed instantaneously or in very short time with various and not specific terminal symptoms. Inducing or trigger factors are not clarified in almost of the cases. Mechanisms or causes of death could not be defined clearly. We concluded that careful heart examination with detailed clinical history under the appropriate postmortem investigation system is only effective approach for the true mechanism and cause of death.
Adult* ; Cause of Death ; Death, Sudden, Cardiac* ; Heart* ; Humans ; Male

BACKGROUND: As part of medicine's shift in emphasis toward primary patient care, clinical curriculum is very important in the education of medical students. There are excellent opportunities for general learning of clinical skills especially in dermatological clinical clerkship course. OBJECTIVE: The purpose of this study is to evaluate the dermatological clerkship with questionnaire by students. We would like to find out and look into the way how to improve the clerkship course. METHODS: 103 students filled in well-structured questionnaires after they had finished a 2 week-clinical clerkship course of Department of Dermatology. The questionnaire consisted of overall evaluation of clinical clerkship, of subtypes of clinical clerkship course, and the way how to evaluate students. After finishing the clinical clerkship course, 10 students were interviewed with the results of the questionnaire. RESULTS: Most students were generally pleased with the didactic quality of clerkship. The course of observation of outpatient clinic among various subtypes of clinical clerkship were favored most by the students. The newly developed educational contents revealed not to be properly used. Faculty activity was also scored to be better than average. The test for clinical clerkship was regarded a little difficult to the students. CONCLUSION: The evaluation of didactic quality of clinical clerkship seems very important in the improvement of medical education. The development of the more valid and reliable questionnaire is needed. The overall evaluation of clerkship by various perspectives such as students, faculties, patients and institutions will provide more improvement of quality of clerkship at Dermatology department.
Ambulatory Care Facilities ; Clinical Clerkship ; Clinical Competence ; Curriculum ; Dermatology* ; Education ; Education, Medical ; Humans ; Learning ; Patient Care ; Surveys and Questionnaires ; Students, Medical

Hemophagocytic lymphohistiocytosis (HLH) is a rare disorder characterized by fever, pancytopenia, hyperferritinemia, and phagocytosis of hematopoietic cells in bone marrow, liver, or lymph nodes. HLH can occur during the course of systemic lupus erythematosus (SLE), but can also be a presenting manifestation. Because development of pancytopenia occurs in less than 10 percent of SLE cases, investigation for HLH is necessary when otherwise unexplained pancytopenia persists despite adequate treatment. We experienced three cases of secondary HLH associated with SLE. Among the three patients, two patients developed HLH during the clinical course of SLE. The other patient who presented with pancytopenia was first diagnosed with HLH, and later with SLE. In her case, HLH turned out to be a presenting manifestation of SLE. We report on three successfully treated cases, and discuss the prevalence, characteristics, treatments, and prognosis of secondary HLH associated with SLE.
Bone Marrow ; Fever ; Humans ; Liver ; Lupus Erythematosus, Systemic ; Lymph Nodes ; Lymphohistiocytosis, Hemophagocytic* ; Pancytopenia ; Phagocytosis ; Prevalence ; Prognosis