Seborrheic dermatitis is a chronic recurrent inflammatory disorder presumed to be caused by increased sebaceous gland secretion, metabolic changes in the cutaneous microflora, and changes in the host immune function. Stellate ganglion block (SGB) is known to increase the blood flow rate without altering the blood pressure, heart rate, or cardiac output, to stabilize hypertonic conditions of the sympathetic nerves, and to affect the endocrine and immune systems. It is used in the differential diagnosis and treatment of autonomic nervous system disorders of the head, neck, and upper limbs. The authors report the first case of successful treatment of a patient with seborrheic dermatitis through repeated SGB trials.
Autonomic Nervous System Diseases ; Blood Pressure ; Cardiac Output ; Dermatitis, Seborrheic* ; Diagnosis, Differential ; Head ; Heart Rate ; Humans ; Immune System ; Neck ; Nerve Block ; Sebaceous Glands ; Stellate Ganglion* ; Upper Extremity

BACKGROUND: In an effort t enhance long term patency of coronary bypass grafts, utilization of arterial conduits have been on an icrease. With the same objective, we have been using the right gastroepiploic artery (RGEA) in coronary artery bypass procedures since 1998. The current paper has been undertaken with the aim of assessing the apropriateness, problems, and short term results of using the RGEA as an arterial graft conduit by studying the postoperative clinical results of 100 patients than received coronary artery bypass grafting (CARG) with this artery. MATERIAL AND METHOD: Between May of 1998 and May of 1999, an analysis of the mortality, postoperative myocardial infarction, and the need for IABP insertion as a result of low cardiac output were made between 100 consecutive patients undergoing CABG with the RGEA. There was one postoperative death due to cerebral infarction. Postoperative complications/morbidity comprised myocardial infarction in 2, cerebral infarct in 3, reoperation due to bleeding in 1, mediastinitis in 1, and low cardiac output syndrome necessitating IABP in 3 patients. Complicatons related to harvesting of the arterial grafts were not experienced in any of the patients. CONCLUSION: The results of the current data show that utilization of the RGEA in CABG is not associated with increased mortality/morbidity and demonstrates satisfactory short term results suggesting the usefulnessof this conduit as an arterial graft.
Arteries ; Cardiac Output, Low ; Cerebral Infarction ; Coronary Artery Bypass* ; Coronary Vessels* ; Gastroepiploic Artery* ; Hemorrhage ; Humans ; Mediastinitis ; Mortality ; Myocardial Infarction ; Reoperation ; Transplants

PURPOSE: Crowding causes dysfunction in the emergency department (ED) and is associated with poor quality of patient care, dissatisfaction of the physicians, and increased financial burden of medical care. Frequent use is often considered a major contributor to ED crowding. The present study sought to verify the relationship between the frequent ED users and ED crowding, and to ascertain the severity of the frequent ED users. METHODS: One-year ED visit data from a tertiary teaching hospital located in an urban area were analyzed. Frequent ED users were defined as four or more ED visits per year. Crowding indicators were defined as the length of stay and the percentage of patients staying over 6 hours. Severity indicators were defined as operation within 24 h, admission to intensive care unit, and expiry in the ED. RESULTS: The 2.7% of patients who had four or more ED visits were responsible for 11.9% of visits. The median length of stay of frequent users was significantly longer (6.18 h) than that of infrequent users (3.42 h). The percentage of patients who stayed more than 6 h was significantly larger in the frequent user group than infrequent user group (51.4% vs. 32.9%, respectively; OR=2.158; 95% CI, 2.041~2.281). However, the severity of frequent users was lower than that of infrequent users (3.0% vs. 5.3%, respectively; OR=0.553; 95% CI, 0.472~0.648). CONCLUSION: Frequent users presenting to an ED located in an urban area were more likely to stay longer in the ED, and were less likely to be severe. Active interventions to reduce ED crowding are required.
Crowding ; Emergencies ; Emergency Medical Services ; Health Services Misuse ; Hospitals, Teaching ; Humans ; Intensive Care Units ; Length of Stay ; Patient Care

PURPOSE: Crowding causes dysfunction in the emergency department (ED) and is associated with poor quality of patient care, dissatisfaction of the physicians, and increased financial burden of medical care. Frequent use is often considered a major contributor to ED crowding. The present study sought to verify the relationship between the frequent ED users and ED crowding, and to ascertain the severity of the frequent ED users. METHODS: One-year ED visit data from a tertiary teaching hospital located in an urban area were analyzed. Frequent ED users were defined as four or more ED visits per year. Crowding indicators were defined as the length of stay and the percentage of patients staying over 6 hours. Severity indicators were defined as operation within 24 h, admission to intensive care unit, and expiry in the ED. RESULTS: The 2.7% of patients who had four or more ED visits were responsible for 11.9% of visits. The median length of stay of frequent users was significantly longer (6.18 h) than that of infrequent users (3.42 h). The percentage of patients who stayed more than 6 h was significantly larger in the frequent user group than infrequent user group (51.4% vs. 32.9%, respectively; OR=2.158; 95% CI, 2.041~2.281). However, the severity of frequent users was lower than that of infrequent users (3.0% vs. 5.3%, respectively; OR=0.553; 95% CI, 0.472~0.648). CONCLUSION: Frequent users presenting to an ED located in an urban area were more likely to stay longer in the ED, and were less likely to be severe. Active interventions to reduce ED crowding are required.
Crowding ; Emergencies ; Emergency Medical Services ; Health Services Misuse ; Hospitals, Teaching ; Humans ; Intensive Care Units ; Length of Stay ; Patient Care

Coronary artery aneurysm is an uncommon disease. The optimal medical or surgical treatment for this disease remains obscure. The causes of coronary artery aneurysms include atherosclerosis, Kawasaki disease, infectious vascular disease, connective tissue disorder and congenital malformation. A 50 year old man visit our institution for chest pain that had started 3 days previously. After coronary angiography, multiple coronary aneurysms were diagnosed and successful surgical intervention was performed.
Aneurysm ; Angina, Unstable ; Atherosclerosis ; Chest Pain ; Connective Tissue ; Coronary Aneurysm ; Coronary Angiography ; Coronary Artery Bypass ; Coronary Vessels ; Mucocutaneous Lymph Node Syndrome ; Vascular Diseases

No abstract available.
Acinar Cells* ; Arthritis* ; Carcinoma, Acinar Cell* ; Humans ; Panniculitis*

BACKGROUND: Hepatitis B virus (HBV) is major source of chronic liver disease in Korea. However this virus might have different nucleotide sequence according to races, different region, etc. Recently the novel method that allows sensitive amplification with dramatically decreased mis-incorporation has developed. We determined to get the major form of HBV nucleotide sequence from whole sequencing data of 26 Korean HBV carriers. METHODS: HBV DNA were collected from 26 Korean chronic HBV carriers. We used the novel PCR with pfu for the amplification of HBV DNA, and specific primers were made with combination sequence bases of non-HBV part and HBV parts which were located head and tail in the virion. Then whole length of HBV were directly sequenced and analysed. RESULT: HBV DNA was consisted of 3215 bases in 20 cases of 26 Korean chronic HBV carriers. And the remainder had smaller or larger number due to deletion, insertion or both in pre-S2 and S gene. They were 99.03% homology of their nucleotide sequence and belong to genotype C. The variability of nucleotide sequence was significantly higher in the singly coding region (SCR) than doubly coding region (DCR), and also high in pre-S1 and pre-S2 gene among the DCR. Hot-spots were more frequently found in the SCR, pre-S1 and pre-S2 gene. CONCLUSION: In Korean chronic HBV carriers, HBV is consisted of 3215 nucleotides, and belongs to genotype C. And it might exist one genotype with the variability in Korea.
Base Sequence* ; Clinical Coding ; Continental Population Groups ; DNA ; Genome* ; Genotype* ; Head ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Korea ; Liver Diseases ; Nucleotides ; Polymerase Chain Reaction ; Polymerization* ; Polymers* ; Virion

Recurrent peritonitis is the major complication of continuous ambulatory peritoneal dialysis (CAPD) and a common reason for discontinuation of this form of therapy. Polymicrobial peritonitis by gram- negative organisms suggests intraabdominal pathology not directly associated with CAPD, necessitating early removal of catheter and/or abdominal exploration. The source of infection may still be gastrointestinal, especially in light of the polymicrobial gram-negative peritonitis and rarely be gastrointestinal malignancy. We recently experienced a case of 64-year-old woman with recurrent CAPD peritonitis by polymicrobial gram-negative organisms, originated from colon cancer. Colon cancer was confirmed by barium enema, abdominal CT and colonoscopic biopsy. She underwent right hemicolectomy and removal of catheter simultaneously. The biopsy revealed a moderately to poorly differentiated adenocarcinoma with abundant mucin production.
Adenocarcinoma ; Barium ; Biopsy ; Catheters ; Colon* ; Colonic Neoplasms* ; Enema ; Female ; Humans ; Middle Aged ; Mucins ; Pathology ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Tomography, X-Ray Computed

Though leiomyosarcoma usually occurs in the gastrointestinal tract and uterus, it rarely occurs in the wall of large veins and arteries. We present a case of primary leiomyosarcoma arising in the great saphenous vein of the left inner thigh and spreading for some extent along the vein in a 54 year old female. Diagnosis was confirmed by desmin stain and electron microscopy. Postoperative course was fine. This is the first report of this in Korean literature.
Female ; Humans ; Leiomyosarcoma/*pathology ; Middle Aged ; *Saphenous Vein ; Soft Tissue Neoplasms/*pathology ; Vascular Diseases/pathology

No abstract available.
Airway Management* ; Gastric Bypass* ; Humans