A case of stasis dermatitis with hepatomegaly is reported. The patient is 50 year old male. About 3 years ago a dark-brownish macule on the left shin was appeared with the severe itching sensation and spread to the margin with edema, ulceration, and appeared the varricous veins on the margin, Biopsy on the ulceration revealed the hemociderin deposition and fibrosis in the dermis. The physical examination revealed that the liver was enlarged 3cm, below the right costal margin and liver biopsy showed early cirrhotic change, but without impairment of liver function. He was treated with massage, elastic bandage for 2 weeks with good response.
Biopsy ; Compression Bandages ; Dermatitis* ; Dermis ; Edema ; Fibrosis ; Hepatomegaly ; Humans ; Liver ; Male ; Massage ; Middle Aged ; Physical Examination ; Pruritus ; Sensation ; Ulcer ; Veins

The purpose of this study was to examine the trends of length of hospital stay (LOS), which is most likely to be a major attribute to hospital performance From 1984 to 1994, an average LOS of each hospital was analyzed by factors such as medical departments, bed size, occupancy rate, region and ownership. This study was analyzed changing rate of LOS during 11 years. This rate was calculated by simple regression, which was used only with hospital without missing data during 11 years. This study findings are as follows. 1. The results indicated that the average LOS was steadily increased until 1990 but it was slightly decreased after 1990. 2. This trend could be found in all hospital scale and all group of occupancy rate. Specifically this trends of LOS were found in internal medicine, corporate owned hospitals, and hospitals in major city. But LOS of individual owned hospital was continuously increased until 1994. 3. Means of changing rates of LOS were calculated from 1984 to 1994. If we divided it into two parts, before 1990 and after 1990, most changing rates of LOS before 1990 except individual owned hospital were found positive sign. The changing rates after 1990 were negative sign but small hospital(lesser then 200 bed), individual owned hospital, national & public hospital and hospital in small urban have little change of LOS after 1990. Finally from this results we thought that most hospitals in korea began to be concerned with LOS. Nevertheless LOS of several hospital such as small hospital or individual owned hospital was increased. And this trend may be caused by a few patients, low occupancy rate, or low profit. This trend of LOS is different from that of other countries. Perhaps this phenomenon is resulted from the reimbursement method. Because of fee for service reimbursement system in korea the hospitals didn't need to shorten LOS in order to save the cost and increase the profit. Therefore reform of hospital cost reimbursement method will be reduced to reduce hospital cost in korea. we thought that the korean health authority should consider the reimbursement method by unit of bundle of services, for example DRG and prepayment in the united states. This study presents some limitations such as on insight of severity of disease, case-mix measurement of hospital, and other clinical characteristics that can possibly affect LOS, However, this study reports an important trend in LOS from 1984 to 1994.
Diagnosis-Related Groups ; Fee-for-Service Plans ; Hospital Bed Capacity ; Hospital Costs ; Hospitals, Public ; Humans ; Internal Medicine ; Korea* ; Length of Stay* ; Ownership ; United States

Herpes zoster is generally believed to be caused by the activation of varicella-zoster virus present in the body since an original infection with varicella. According to the thesis, the virus remairis in a latent state in the cells of the sensory ganglia until immunity has waned sufficiently to pezmit multiplication of the virus and clinical infection. There are a number of reports that in patient with malignant disease, especially Jymphoma, a frequenry af association of zoster is greater and severity of its symptom is increased to be marked contrast to the benign uneventful course of zoster seen in healthy person. The author observed one case of zoster seen in patient with malignant disorder, and frequency of association of zoster in malignant disease and its etiological factors are reviewed in the literature.
Chickenpox ; Ganglia, Sensory ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Lymphoma, Non-Hodgkin*

One case of subungual glomus tumor was reported which had characteristic clinical manifestations of paroxysmal pain and tenderness for about 20 years. Histopathologically it was confirmed as subungual glomus tumor. This case was treated completely with simple surgics,l excision of the mass.
Glomus Tumor*

A case of dermatitis herpetiformis resembling atopic dermatitis is reported. The patient is 45 year-o1d male, who 6 months ago developed the pruritic erythematous vesicular eruptions on the left side of back and it gradually spread to the margin. He was treated with steroid but the lession had undergone exacerbation and remissions. Biopsy was performed on the vesicular lesion and revealed non-acantholytic subepidermal bulla with mild inflammatory cells infiltration and then he was treated with DDS for 2 months with good response.
Biopsy ; Dermatitis Herpetiformis* ; Dermatitis* ; Dermatitis, Atopic* ; Humans ; Male

Congenital ichthyosiform erythroderma is most severe type of ichthyosis. This disease is characterized clinically by generallized erythroderma covered with flaccid bullae and verruciform scales which are especially prominent on the flexural areas. This disease demonstrates an autosomal dominant mode of inheritance. The distinctive histologic change is the extreme hyperkeratosis associated with granular and vacuolar degeneration of the mid and upper malphigian layers. Cell kinetic studies indicate an increase in the epidermal mitotic turnover tirne. This 8 months old male patient visited to Dermatologic Department of Severance Hospital on April-28, 1973. Seven days after birth the scales were appeared on his flexural region of limbs and shed to leave a raw surface which forms scales anew. And there were the intermittent appearance of flaccid bullae prominantly involve the flexural area of limb but thereafter appearing the other region of body. Skin biopsy shows that of bullous type of congenital ichthyosiform erythroderma. This baby was expired 4 days after the admission day in spite of vigorous systemic and local trea- tments. The autopsy findings had exhibited fatty necrotic degenerative changes of hepatic cells and septic inflammatory changes of meningeal vessels and meninges itself as the causes of death of this pitiful victim.
Autopsy ; Biopsy ; Cause of Death ; Dermatitis, Exfoliative ; Extremities ; Hepatocytes ; Humans ; Ichthyosiform Erythroderma, Congenital ; Ichthyosis ; Infant ; Male ; Meninges ; Parturition ; Skin ; Weights and Measures ; Wills

Urticaria is a common disease and a well known reaction pattern of the skin eharacterized by erythema or wheals and edema, that is the results of a local leakage ef plasma, from minute vessels into the connective tissue of the dermis. Seven hundred and sixty cases of urticaria visited to this department from January 1973 to December 1974 were studied clinically in various ways. Patients were classified as acute and chronic urticaria-acute form when the hives have been present for less than 8 weeks and chronic form when the hives lasted longer. In all patients, a detailed history, a complete physical examination, a total and differential leukocyte count, erythrocyte sedimentation rate and routine stool examination were performed. Foods were incriminated as the exciting causes of urticaria by history, diet elimination test and ingestion test. An ice cube test was done for corroboration of cold allergy. Cholinergic urticaria, was diagnosed by the appearance of small wheals surrounded by erythema after exercise, emotional disturbances or hot drinks. The diagnosis of urticaria due to drug was based on the history of urticaria following the taking of a certain drug. Infection as the inciting cause was determined by history and physical examination. The results: 1. The incidence of urticaria is 4. 6% to total number of dermatologic patients. 2. Among the 760 urticaria patients, acute cases were 498 which were 2 times more than chronic cases, and female patients were 474 cases that revealed marked high incidences than male patients. 3. The age of the patients ranged from 2 months to 87 years, and the patients between 20 and 39 years occupied more than half of the all patients. 4. Abnormal hematologic findings were more marked in acute form; leukocytosis and neutrophilia were dominate in acute form, and lymphocytosis and eosinophilia were more marked in chronic form. 5. Among the etiologic factors, the bacterial infection was the most frequent which occupied 22. 4% of the all urticaria patients. 6. Seven cases of urticaria due to parasites were clonorchis sinensis, in which I had experienced the complete recovery with the treatment of subcutaneous injection of clonorchis sinensis antigen (1: 10,000) 0.01- 0.1ml at the interval of one week. 7. In this study, the inciting or perpetuating causes could not be found in 50.8% of patients-46.2% of acute form and 59.5% of chronic form.
Affective Symptoms ; Bacterial Infections ; Blood Sedimentation ; Clonorchis sinensis ; Connective Tissue ; Dermis ; Diagnosis ; Diet ; Eating ; Edema ; Eosinophilia ; Erythema ; Female ; Humans ; Hypersensitivity ; Ice ; Incidence ; Injections, Subcutaneous ; Leukocyte Count ; Leukocytosis ; Lymphocytosis ; Male ; Parasites ; Physical Examination ; Plasma ; Skin ; Urticaria*

: In order to know the species and frequency of human parasitic infection diagnosed by biopsy, 149 cases (0.18%) of parasitic infection were reviwed, which were selected from 80,947 biopsied materials submitted for routine histopathological examination during a period of 10 years from 1980 to 1989 at Department of Pathology, Chonnam National University Hospital. They consisted of 112 cases of cysticercosis, 17 paragonimiasis, 7 clonorchiasis, 4 amebiasis, 1 sparganosis, 1 enterbiasis, 1 aniskiasis, and 1 fascioliasis respectively. Based on morphological preservation of cysticercus, they could be divided into mild (20.2%), morderate (40.4%), and severe (39.4%) degeneration. Except 2 cases biopsied at the lungs, 15 cases of ectopic paragonimiasis were located at abdominal cavity (8 cases) and central nervous system (7 cases). One case of intrahepatic fascioliasis was observed. This is the 13th human fascioliasis reported in Korea. From the above results, the frequency of parasitic infections found in biopsied specimens was on the decrease as the cysticercosis and ectopic paragonimiasis.
parasitology-helminth-cestoda-nematoda-trematoda ; biopsy ; histopathology ; tissue parasite ; cysticercose ; ectopic ; Enterobius vermicularis ; Taenia solium ; Paragonimus westermani ; Clonorchis sinensis ; Entamoeba histolytica ; Anisakis ; Fasciola sp. ; paragonimiasis ; fascioliasis

Alzheimer's disease(AD) is associated with a characteristic neuropathology. The major hallmarks of AD are senile plaques(SPs) and neurofibrillary tangles(NFTs). beta-amyloid protein(Abeta) is derived from the proteolysis of amyloid precursor protein(APP) and then converted to SPs. Mature SPs produce cytotoxicity through direct toxic effects and activation of microglia and complement. NFTs are composed of paired helical filaments(PHFs) including abnormally phosphorylated form of the microtubule-associated protein(MAP) tau and increased tau level in cerebrospinal fluid may be observed in most AD. The aggregation of Abeta and tau formation are thought to be a final common pathway of AD. Acetycholine, dopamine, serotonin, GABA and their receptors are associated with AD. Especially, decreased nicotinic acetylcholine receptors(nAChRs) in AD are reported. Genetic lesions associated with AD are mutations in the structural genes for the APP located on chromosome 21, presenilin(PSN)1 located on chromosome 14 and PSN2 located on chromosome 1. Also, trisomy 21, Apo-E gene located on chromosome 19, PMF locus, low density lipoprotein receptor-related protein and alpha-macroglobulin increase risk of AD. In this article, we will review about the neurobioloby of AD and some newly developed research areas.
Acetylcholine ; Alzheimer Disease* ; Amyloid ; Amyloid beta-Peptides ; Apolipoproteins E ; Cerebrospinal Fluid ; Chromosomes, Human, Pair 1 ; Chromosomes, Human, Pair 14 ; Chromosomes, Human, Pair 19 ; Chromosomes, Human, Pair 21 ; Complement System Proteins ; Dopamine ; Down Syndrome ; gamma-Aminobutyric Acid ; Genetics ; Lipoproteins ; Microglia ; Neurobiology* ; Proteolysis ; Serotonin

In an attempt to treat the cold urticaria, a new bradykinin inhibitor, homoclomin was administered orally and effective result were obtained. The urticaria was confirmed by the employing the ice cube test on the patient and the positive reaction was appeared generally 10 sec. to 15 min. after application of ice cube on the forearm. After oral administration for 3 days (40mg/day) clinical symptoms were relieved temporarily and weakly positive or negative reaction observed in repeated ice cube test.
Administration, Oral ; Bradykinin ; Forearm ; Humans ; Ice* ; Urticaria*