Angioma serpiginosum is a rare acquired naevoid disorder, characterized by minute red or purple punta that are frequently arranged in serpiginous patterns in the lower extremities and buttocks. It usually begins in childhood and is more common in females. Histopathologically, thin-walled capillaries in the dermal papillae and the superficial reticular dermis are widely dilated without extravasation of red blood cells. We report a case of angioma serpiginosum on the lateral aspect of the right arm along the lines of Blaschko in a 36-year-old woman.
Adult ; Arm ; Buttocks ; Capillaries ; Dermis ; Erythrocytes ; Female ; Hemangioma* ; Humans ; Lower Extremity

The purpose of this study presents the model of Entity-Relationship Diagram on CPR. The specific purpose of this study as follows; The first goal is to identify the content and logical structure of the CPR. The second goal is to define the relationship of data coming from diverse systems(for example, clinical laboratory information systems, order entry systems) and the data stored in the CPR. The 22 kinds forms on Medical Record were collected from 10 hospitals. The Clinical heart of the CPR is the core of entities: patient, provider, problem, encounter order, service, history, etc.
Cardiopulmonary Resuscitation ; Clinical Laboratory Information Systems ; Heart ; Humans ; Logic ; Medical Records

BACKGROUND: Korea is an epidemic area of hepatitis B. There are needs for longitudinal study to measure quantity of hepatitis B infection status in Korea. This study was designed to observe natural course of hepatitis B markers in the same person for three years. The objective of this study was to investigate incidence of new infection and persistence of previous infection. METHODS: The study subjects were clients who visited a health examination center in Seoul twice with an interval of three years, from 1995 to 2000. They replied as nonvaccinee on both occasions for hepatitis B by self-administered questionnaire. Hepatits B markers were measured by radioimmunoassay on all visits. There were 103 subjects with 61 men and 42 women. RESULTS: The positive rate of hepatitis B surface antigen was 20.4% initially, which changed to 18.5% after three years. The positive rate of hepatitis B surface antigen was 20.4% initially, that was changed as 18.5% after three years. The positive rate of hepatitis B surface antibody was 61.2% initially, which increased to 66.0% after three years. The positive rates of hepatitis B surface antibody in men were 63.9% initially and 68.9% after three years, which showed statistically significant trend. (P=0.08). The positive rate of hepatitis B core antibody was 89.3%, which remained the same after three years. There was no positive conversion case of hepatitis B surface antigen. The negative conversion rate of hepatitis B surface antigen was 2/63(3.2%). The positive conversion rate of hepatitis B surface antibody was 7/40(17.5%), and negative conversion rate of that was 2/63(3.2%). The positive conversion rate of hepatitis B core antibody was 3/11(27.3%), and negative conversion rate of that was 3/92(3.3%). CONCLUSION: Hepatitis B markers changed in the direction of increase of infection incidence, rather than natural disappearance of markers in nonvaccinees. The mechanism was postulated as occurrence of new infection mainly, but the possibility of double infection by variants of hepatitis B virus could not be ruled out. We confirmed that positive rate of hepatitis B marker in males was not only higher cross-sectionally, but also increased higher longitudinally. We suggest a follow-up study of hepatits B markers to be performed because hepatits B markers showed dynamic changes. We think the high risk groups of hepatitis B infection have a priority in follow-up study.
Female ; Follow-Up Studies* ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B* ; Hepatitis* ; Humans ; Incidence ; Korea ; Longitudinal Studies ; Male ; Radioimmunoassay ; Seoul ; Surveys and Questionnaires

OBJECTIVE: Symptomatic neuropathy is uncommon in rheumatoid arthritis (RA) but, compression neuropathy and vascular neuropathy were reported in longstanding RA. To investigate the occurrence of electrophysiologically evident peripheral nerve involvement in RA patients without a clinical manifestation of peripheral nerve involvement, we studied nerve conduction velocity study (NCV) in RA patients without symptomatic neuropathy. Twenty-five RA patients were evaluated neurological examination and by NCV. We compared clinical parameters between electrophysiologic positive group and negative group. There was no patient who had neurologic symptoms or signs of peripheral involvement. Eleven patients (44%) of all exhibited NCV findings consistent with distal symmetrical sensorimotor polyneuropathy, 5 patients (20%) had entrapment neuropathy, 2 patients (8%) showed distal symmetrical sensory polyneuropathy, 1 patient (4%) had digital neuropathy, and 6 patients (24%) had normal NCV. CONCLUSION: Patients with RA may have electrophysiologic peripheral nerve damage, even in the absence of clinical evidence of peripheral nerve involvement. There was no correlation with any clinical parameters. The inclusion of electrophysiologic examination of the RA patients is recommended in routine diagnostic procedures.
Arthritis, Rheumatoid* ; Humans ; Neural Conduction ; Neurologic Examination ; Neurologic Manifestations ; Peripheral Nerves ; Peripheral Nervous System Diseases* ; Polyneuropathies

BACKGROUND: Although native radiocephalic arteriovenous fistula provides the best possible vascular access for hemodialysis, available veins for this fistula are limited. Ulnobasilic arteriovenous fistula (UBF) is alternative method for native fistula of forearm. But this method is not commonly used because detection of the vein is difficult and cannulation for hemodialysis id uncomfortable. This study was performed to evaluate clinical usefulness of UBF. METHODS: From June 1999 to April 2000 and from September 2001 to February 2002, 256 arteriovenous fistulae were made in 239 patients with chronic renal failure and among them, 26 UBF were made by one surgeon. At April 2002, a total of 26 UBF were reviewed. RESULTS: The results were as follows : There were 17 men and 9 women, aged 31 to 72 years. There were 7 diabetic patients. 22 patients of them had previous history of arteriovenous fistula operation. There were six failures : one delayed occlusion; one venous hypertension due to proximal stenosis during hemodialysis; four inadequate maturation. The 20 patients showed good patency. CONCLUSION: This study shows that UBF can be useful method in patients with failed radiocephalic arteriovenous fistula or poor cephalic vein and preserve upper arm vein for future operation.
Arm ; Arteriovenous Fistula* ; Catheterization ; Constriction, Pathologic ; Female ; Fistula ; Forearm ; Humans ; Hypertension ; Kidney Failure, Chronic ; Male ; Renal Dialysis* ; Veins

Dermatophytes infect the human hair, skin, nail and cause the dermatophytosis. The extracellular and intracellular proteinases of the dermatophytes commonly occur in the genus Trichophyton like T. rubrum, T. mentagrophytes, and T. granulosum. These enzymes play a prominent role in growth, multiplication and infection of the host tissue. Extracellular proteinases have been purified from the species of Trichophyton and Microsporum. We purified the proteinase partially from the culture filtrate of the Trichophyton tonsurans through Mono-Q and Superose 12 column and investigated its biochemical and enzymatic characters. The molecular size of the proteinase was estimated to be 41 kDa by SDS-PAGE. And pI was 3.2. The optimal temperature and pH for an enzymatic activity were 27C and 7.5, respectively. The purified porteinase degraded the keratin, bovine serum albumin, hemoglobin. The serine proteinase inhibitor like PMSF and DFP inhibited the proteolytic activity of the purified enzyme whereas the cysteinase inhibitor did not. These results demonstrated that the purified proteinase is a serine proteinase and can contribute the tissue invasion.
Arthrodermataceae ; Electrophoresis, Polyacrylamide Gel ; Hair ; Humans ; Hydrogen-Ion Concentration ; Isoflurophate ; Microsporum ; Peptide Hydrolases ; Serine Proteases* ; Serine* ; Serum Albumin, Bovine ; Skin ; Tinea ; Trichophyton*

BACKGROUND: The major risk factors such as hypercholesterolemia, hypertension, diabetes melitus and cigarrete smoking have not been studied in an attempt to provide a composition of major risk factors in Korea. Also we have met with some patients without major risk factors. METHODS: A Retrospective Study was done on 160 patients of acute myocardial infarction who had been admitted to National Medical Center within 48 hours from onset, from January 1948 to December 1992 and studied on major risk factors of acute myocardial infarction. RESULTS: 1) Among major risk factors, smoking was found in 50%, hypertension in 49%, diabetes in 25% and hypercholesterolemia in 21%. 2) The percentage of patients without major risk factors was 19%. 3) Among major risk factors, hypertension, hypercholesterolemia and diabetes were increasing tendencies, recentely. CONCLUSION: Some patients with acute myocardial infarction don't have any major risk factors. Also hypertension, hypercholesterolemia and diabetes were increasing tendencies. So further study for other risk factors is needed and preventive management should require a commitment to behavior modification and alteration in life-style.
Behavior Therapy ; Humans ; Hypercholesterolemia ; Hypertension ; Korea ; Myocardial Infarction* ; Retrospective Studies ; Risk Factors* ; Smoke ; Smoking

No abstract available.
Child* ; Humans ; Measles*

Diabetic insipidus may first present before, during or immediately after pregnancy. Pregnancy serves as a physiologic provocation test that unmasks latent diabetes insipidus. It may explain the very rare first occurrence of diabetes insipidus in the pureperium. Central diabetes insipidus occurring after delivery associated with a catastrophic delivery and postpartum hypopituitarism is more frequent entity. We recently experienced central diabetes insipidus patient, aggrevated polyuria and polydipsia after total hysterectomy due to cervical carcinoma, who had interesting past history of severe polyuria and polydipsia developed during puerperium of 1st pregnancy, 14 years ago. She have had quiet normal pregnancy and there was no definite postpartum complication of pregnancy at that time. There were no change of polyuria and polydipsia during and after second pregnancy and 2 another pregnancy terminated artificially compare to puerperium of 1st delivery. She has intact anterior pituitary gland functinally and anatomically, but the posterior pituitary hyperintense signal with pre-enhance Tl-weighted imaging was absent on MRI.
Diabetes Insipidus ; Diabetes Insipidus, Neurogenic* ; Humans ; Hypopituitarism ; Hysterectomy ; Magnetic Resonance Imaging ; Pituitary Gland, Anterior ; Polydipsia ; Polyuria ; Postpartum Period* ; Pregnancy

Syndrome of inappropriate antidiutetic hormone(SIADH) secretion is the most common cause of hyponatremia in clinical medicine. Before diagnosis of the SIADH is made, other causes for a decreased diluting capacity and nonosmotic stimuli for AVP release need to be rule out. Disorders associated with SIADH can be divided into 4 major etiologic groups: malignancies, pulmonary diseases, central nervous disorders, and drugs. A 45-year-old woman was admitted due to maculopapular skin eruption and fever after taking medications for fever and myalgia. Generalized tonic clonic seizure was developed nine days later, and laboratory results showed marked hyponatremia. During the evaluation, treatment, and subsequent follow-up, the diagnosis of SIADH was confirmed, but the definitive cause was obscure. With fluid restriction, sodium replacement and demeclocycline therapy, she recovered completely 6 months later. We suggest that the SIADH might be related to drug-induced generalized maculopapular rash via menmgitis-like reaction in CSF as one of systemic adverse side effects to drugs rather than direct effect of related drugs.
Clinical Medicine ; Demeclocycline ; Diagnosis ; Exanthema* ; Female ; Fever ; Follow-Up Studies ; Humans ; Hyponatremia ; Inappropriate ADH Syndrome* ; Lung Diseases ; Middle Aged ; Myalgia ; Seizures ; Skin ; Sodium