Granuloma gluteale infantum may be considered a complication oi the primary irritant type of diaper dermatitis and a modern disease due to the change in tae are of the napkin area. Most patients were infants who had worn plastic diapers and were treated with fluorinated topical corticasteroid cream for their diaper dermatitis. The lesions comorise one or several, soft and reddish brown or livid purple nodules on the napkin area. We report a typical case of granuloma gluteale infantum in a 13-month old female who had been treated with topical cortieosteroid crearn for her diaper derniat;lis. The granuloma regressed spontaneously after withdrawl of the topical corticosteroid and restricted use of the occlusive plastic diaper.
Dermatitis ; Female ; Granuloma* ; Humans ; Infant ; Plastics

STUDY OBJECT: To date, the study of critical illness in the emergency department has been limited. The purpose of this study was to determine the length of stay and procedures performed on critical care patient in ED, and to be help to establish Emergency physicians' education program. METHOD: We reviewed patient's medical record, who visited ED, Korea Univ. Hospital from Jan. 1996 to Jun. 1996 and admitted to ICU. We analyzed data to age, sex, clinical diagnosis, length of stay, and critical procedures in ED. RESULTS: The 12,721 patients visited ED during the study period, the 441 of 12,721 (3.50%) patients admitted to ICU. 56 patients were excluded whose medical re cords were incomplete. The study populations consisted of 165 women and 220 men. The mean age were 52 year old (median,58 year old). The mean length of stays were 606.1 (1445.9 minutes (median, 180 minutes)). One hundred sixty one of these patients (41.8 %) received one or more critical procedures. The medical critical patients were 252 cases, and surgical critical patients were 133 cases. The mean length of stay of medical critical patients was 738.8 (1748.9 minutes (median, 177.5 minutes)) in medical department,44.0% of them received critical procedures in ED. The surgical critical patients averaged 354.9 (410.7 minutes (median, 190 minutes)) and 37.6% received critical procedures. CONCLUSION: Critical ill patients stay in the ED with a substantial amount of time, before addition to the ICU. Critical ill patients who have hemodynamiccal unstable conditions, compromised cardiopulmonary functions, and neurologic deficities, were managed in ED frequently. Typical critical care procedures are commonly performed by emergency physicians. Therefore, it is important for emergency physician to prepare to critical ill patients.
Critical Care* ; Critical Illness ; Diagnosis ; Education ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Korea ; Length of Stay ; Male ; Medical Records ; Middle Aged

BACKGROUND: Domestic violence once considered an infrequently occurring event existing only in deviant relationships, it has been more recently recognized as a widely distributed phenomenon resulting from multiple cultural, social, psycological factors. According to declining world economics, family violence rises with a simultaneous curtailment of agencies available to assist battered persons and there is increasing pressure on emergency departments to serve those who might otherwise have sought help from public agency. In Korea, we don't have any clinical data about domestic violence, and authors analysed clinical pictures of domestic violence victims who came to the emergency department of Korean University medical center. METHOD: We reviewed the victims of the domestic violence retrospectively, who visited in ED, Korean Univ. Hospital from Jan. 1996 to the Dec. 1996. We Analysed data to Age, sex, Injury severity score, location of injury, mechanism, perpetrator. RESULTS: During the study period, total 134 domestic violence victims were identified. The young, females were predominantly victimized. And married women were more commonly violated. (about 70%). ISS was relatively mild (2.491), face and head were mainly injured by punching and objects throwing. The Prevalence of domestic violence victims almost presented at Emergency department between 6:00/P.M. and 8:00 A.M.. CONCLUSION: Emergency physicians suspect domestic violence victims who injured at face and head by punching or hitted would. In these patients, we need more detail history and physical exam. And in case of repeated domestic violence, refer to neuropychatry dept and social workers with perpetratrs, and need mere concerte social programs for domestic violence.
Academic Medical Centers ; Domestic Violence* ; Emergencies* ; Emergency Service, Hospital* ; Female ; Head ; Humans ; Injury Severity Score ; Korea ; Prevalence ; Retrospective Studies ; Social Workers

PURPOSE: Epiretinal membrane in proliferative vitreoretinopathy (PVR) may cause tractional retinal detachment after vitreoretinal surgery. It has been thought that the proliferative membrane is mainly composed of choroidal fibroblasts and retinal pigment epithelial cells. Inspite of the technical advances, the treatment of PVR is still difficult. Therefore, the need for phamarcologic treatment of proliferative vitreoretinopathy is increasing. METHODS: In vitro models of proliferative vitreoretinopathy allow to identify the factors which may inhibit proliferation and contraction of collagen matrix by choroidal fibroblast and retinal pigment epithelial cells. Cultured choroidal fibroblasts and the RPE cells were plated to the collagen matrix and antiproliferative drugs was tested. RESULTS: Each antiproliferative drug showed the inhibition of collagen matrix contraction at following concentration: colchicine(0.1 microgram/ml), puromycin(1~10 microgram/ml), cytochalasin B(0.05 microgram/ml). Transmission electron micrograph of collagen matrices showed dense collagen fibers surrounding choroidal fibroblast and fine collagen fibers surrounding RPE cell. Scanning electron micrograph of collagen matrices contaning colchicine, puromycin, or cytochalasin B showed that collagen fibers were well preserved without distortion. All collagen matrices containing RPE cells showed more fine collagen fibers than those containing choroidal fibroblasts. CONCLUSION: Colchicine, puromycin, cytochalasin B showed inhibitory effect on cell mediated contraction in addition to potent antiproliferative effect. Retinal pigment epithelial cell played less significant role in causing PVR than choroidal fibroblast.
Choroid* ; Colchicine ; Collagen* ; Cytochalasin B ; Epiretinal Membrane ; Epithelial Cells* ; Fibroblasts* ; Membranes ; Puromycin ; Retinal Detachment ; Retinaldehyde* ; Traction ; Vitreoretinal Surgery ; Vitreoretinopathy, Proliferative

BACKGROUND: North Korea's economic and public health problems began in the early 1990s as a result of the gradual loss of economic support from its communist allies, combined with an inordinate number of natural disasters. The decline in public health has increased the incidence of tuberculosis in North Koreans and refugees. This study investigated tuberculosis situation in North Korean refugees in order to prepare for the future impact of tuberculosis control in Korea. MATERIAL AND METHODS: From 2001 to 2005, tuberculosis patients among North Korean refugees who were diagnosed before or after arriving in South Korea, based on the official records of OO hospital, were enrolled in this study. The demographic and clinical data of the cases were evaluated retrospectively. RESULTS: A total of 42 TB cases were reviewed during the study period. Of these, 37 (88.1%) cases were pulmonary TB. based on the cases identified among the number of North Korean refugees' arriving each year, the annual incidence of pulmonary TB were 900 per 100,000 in 2004, 700 in 2003, The number of smear-positive patients was 20 (47.6%) and the number of culture-positive patients was 18 (42.9%). Of the M. tuberculosis isolates, 2 cases were found to be susceptible to all anti-TB drugs available, 4 were resistant to isoniazid, and 3 were multi-drug resistant. CONCLUSION: The prevalence of pulmonary TB in North Korean Refugees is high. In addition, North Korean refugees suffer from more severe tuberculosis in bacteriological and radiological aspects.
Disasters ; Humans ; Incidence ; Isoniazid ; Korea ; Prevalence ; Public Health ; Refugees* ; Retrospective Studies ; Tuberculosis*

Basal cell carcinomas usually arise from the epidermis and show some epidermal connections. It is very unusual that basal celi carcinomas occur as subderrnal mass without epidermal connections. A 51 year-old female h;d an asymptomatic skin colored indurated plaque with linear old scar on the left side of nose fcr about 20 years. She had had a tumor that supposed to be a epidermal cyst, on the same site and the lesion was excised about 20 years ago. We performed the punch biopsy on her first visit which revealed hypertrophic scar. She was treated with intralesional injection of triamcinolone acetonide to reduce the size of hypertrophic scar. However, the lesion had not been reduced. She underwent the surgery to remove the scar at plastic surgery and the excisional biopsy showed a subdermal basal cell carcinoma. We recommend that the newly developed skin tumor in the pre-excised region should be required excisional biopsy instead of punch and close observation
Biopsy ; Carcinoma, Basal Cell* ; Cicatrix ; Cicatrix, Hypertrophic ; Epidermal Cyst ; Epidermis ; Female ; Humans ; Injections, Intralesional ; Middle Aged ; Nose ; Skin ; Surgery, Plastic ; Triamcinolone Acetonide

PURPOSE: There are some disagreements about the optimal dosages of intravenous gammaglobulin(IVGG) and oral aspirin(ASA) in the treatment of Kawasaki disease. So authors performed a prospective clinical study to evaluate the efficacy of IVGG 1g/kg plus ASA 50mg/kg/day. METHODS: We treated 29 patients who were admitted to Inha University Hospital from June 1993 through May 1994 with IVGG 1g/kg plus ASA 50mg/kg/d. We compared the outcomes of above patients with those of two other groups of patients, group A and B in authors' previous study. Group A(20 patients) had been treated with IVGG 2g/kg plus ASA 50mg/kg/d and group B(19 patients) with IVGG 2g/kg plus ASA 100mg/kg/d. The outcomes had been similar in group A and B, which was published on this journal in 1995 (vol. 38:378-385). RESULTS: 1) Twenty five patients(86.2%; group C) were given only one dose of IVGG 1g/kg, and remaining 4 patients(13.8%; group D) were given two doses of IVGG 1g/kg because of persistent high fever. 2) The age and sex distributions, durations of fever before treatment, and durations of ASA therapy in group C were not significantly different from those in group A and B (p>0.05). 3) Laboratory findings on admission in group C were not significantly different from those in group A and B, except that the mean ESR was lower in group C than in group A and B (35.1+/-19.8 vs 55.5+/-5.95 & 50.2+/-11.4mm/hr; p<0.01, respectively). 4) The durations of fever after treatment in group C were not significantly different from those in group A and B (1.32+/-1.07 vs 2.65+/-3.28 & 1.74+/-1.52 days; p>0.05, respectively). 5) In group C, the mean hemoglobin concentration at the 3rd week of illness was higher than in group A (11.1+/-0.98 vs 10.1+/-1.24g/dl; p<0.05), the mean platelet count at the 2nd week of illness was lower than in group A (59.4+/-18.0x10(4) vs 73.6+/-19.0x10(4)/ l; p<0.05), and the mean ESRs at the 2nd and 3rd week of illness were lower than in group A (43.3+/-14.7 vs 54.0+/-9.16, 31.9+/-19.0 vs 47.7+/-13.0mm/hr; p<0.05, respectively). Other follow-up laboratory findings in group C were not significantly different from those in group A and B. 6) Echocardiography was done 2 and 4 weeks after onset of illness. Coronary arterial dilation was observed in four(4/25; 16%) and two(2/23; 8.7%) patients respectively in group C, and the proportions were not significantly different from those in group A(40% & 25%) and B(31.6% & 10.5%) (p>0.05, respectively). In follow-up examinations, coronary aneurysm was observed in only one(1/23; 4.3%) in group C, which was similar to group A(1/18; 5.5%) and B(1/19; 5.2%) (p>0.05, respectively). Giant aneurysm was not observed in any patients. 7) Four patients(group D) were given one more dose of IVGG 1g/kg because high fever persisted 48 hours after injection of the first dose of IVGG. Afterthen fever subsided within 1 to 7 days. Echocardiography revealed mild coronary arterial dilation in two patients initially, but follow-up examinations revealed no coronary aneurysm. CONCLUSIONS: The medium-dose combined regimen with IVGG 1g/kg plus ASA 50mg/kg/d seems to be more cost-effective than the high-dose regimen with IVGG 2g/kg plus ASA 50-100mg/kg/d. If high fever persists 48 hours or more after the first dose of IVGG 1g/kg, it is desirable to give one more dose of IVGG 1g/kg.
Aneurysm ; Aspirin* ; Coronary Aneurysm ; Echocardiography ; Fever ; Follow-Up Studies ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Platelet Count ; Prospective Studies ; Sex Distribution

BACKGROUND: Sialic acid residues are known to play a key role in the normal function of the glycoconjugates. Recently, with the development of specific sialic acid binding lectins such as Maackia seed agglutinin(MAA) and Sambucus nigra agglutinin(SNA), it has made easier to localize the sialic acid residues by the histochemical staining methods. OBJECTIVES: We were to observe the expression of sialic acids according to the differentiation of cultured human nasal epithelial cells by the immunohistochemistry method using Wheat germ agglutinin(WGA), MAA, and SNA. MATERIALS AND METHODS: Human nasal epithelial cell culture was done as floating method for the induction of differentiation. The cultured cells were fixed with 2.5% glutaraldehyde and the epon 812 was used as embedding material. The immunohistochemistry was done as Lim's method. RESULTS: The WGA and MAA positive reactions were noted from the floating zero day through the fourteenth day. The reactions were positive to the squamous-like cells and differentiating cells(ciliated and secretory epithelial cells). The WGA binding patterns were homogeneous but MAA binding patterns were inhomogeneous. The SNA positive reaction was noted only in the fourteenth day and the reaction was inhomogeneous. These results meant that N-acetyl glucosamine and N-acetyl neuraminic acid(alpha 2,3) galactose were expressed from the floating zero day and N-acetyl neuraminic acid(alpha 2,6) galactose was expressed from the floating fourteenth day. CONCLUSION: N-acetyl neuraminic acid(alpha 2,3) galactose may be more important to the primary defence of human nasal epithelial cell. Due to the inhomogeneity of the reaction, the further study using Lowicryl K4M will be needed.
Cells, Cultured ; Epithelial Cells* ; Galactose ; Glucosamine ; Glutaral ; Glycoconjugates ; Humans* ; Immunohistochemistry ; Lectins ; Maackia ; N-Acetylneuraminic Acid* ; Sambucus nigra ; Sialic Acids* ; Triticum

BACKGROUND: In spite of frequent nasal surgery, the importance of preoperative medication has not been examined carefully(CAREFULLY). OBJECTIVE: To identify the effect of premedication, we investigated the effect of premedication on postoperative pain in nasal surgery under local anesthesia. MATERIALS AND METHOD: We studied 120 cases, composed of 60 cases of unilateral sinus surgery and 60 cases of septoplasty. The patients were divided into four groups. We analysed 4 groups each consisted of 30 patients(N=120). The first group consisted of patients who received atropine preoperatively. The second group received atropine and ketolorac tromethamine. The third group received atopine and diazepam. The fourth group received atropine, ketorolac trimethamine and atropine. To evaluate the postoperative pain, we made the protocol listed according to Verbal Rating Pain Scores(VRP), Visual Analogue Pain Scores(VAS), -2, 4, 6, 12, 24 and 48 hours- and a global postoperative pain using the VAS. RESULTS: In septoplasty group, pain-relief effects showed postoperative pain of ketorolac tromethamine during postoperative 6-hours in the second & fourth groups. In sinus surgery group, Ketorolac tromethamine was effective on postoperative pain at postoperative 2-hour. CONCLUSION: We concluded that preoperative ketorolac tromethamine was effctive on septoplasty group than sinus surgery group.
Anesthesia, Local ; Atropine ; Diazepam ; Humans ; Ketorolac ; Ketorolac Tromethamine ; Nasal Surgical Procedures* ; Pain, Postoperative* ; Premedication* ; Tromethamine

Background: To overcome the limitations of relying on data from a single institution, many researchers have studied data linkage methodologies. Data linkage includes errors owing to legal issues surrounding personal information and technical issues related to data processing. Linkage errors affect selection bias, and external and internal validity. Therefore, quality verification for each connection method with adherence to personal information protection is an important issue. This study evaluated the linkage quality of linked data and analyzed the potential bias resulting from linkage errors. Methods: This study analyzed claims data submitted to the Health Insurance Review and Assessment Service (HIRA DATA). The linkage errors of the two deterministic linkage methods were evaluated based on the use of the match key. The first deterministic linkage uses a unique identification number, and the second deterministic linkage uses the name, gender, and date of birth as a set of partial identifiers. The linkage error included in this deterministic linkage method was compared with the absolute standardized difference (ASD) of Cohen’s according to the baseline characteristics, and the linkage quality was evaluated through the following indicators: linked rate, false match rate, missed match rate, positive predictive value, sensitivity, specificity, and F1-score. Results: For the deterministic linkage method that used the name, gender, and date of birth as a set of partial identifiers, the true match rate was 83.5 and the missed match rate was 16.5.Although there was bias in some characteristics of the data, most of the ASD values were less than 0.1, with no case greater than 0.5. Therefore, it is difficult to determine whether linked data constructed with deterministic linkages have substantial differences. Conclusion This study confirms the possibility of building health and medical data at the national level as the first data linkage quality verification study using big data from the HIRA. Analyzing the quality of linkages is crucial for comprehending linkage errors and generating reliable analytical outcomes. Linkers should increase the reliability of linked data by providing linkage error-related information to researchers. The results of this study will serve as reference data to increase the reliability of multicenter data linkage studies.