We performed analysis of 79 childhood patients diagnosed as vitiligo and nevus depigmentosus in Tediatric Dermatologie Department of Seoul National University Hospital from March 1987 to September 1987. The results were as follows : 1. Of the 79 patients, 31 patients(39.2%) were vitiligo 21 patients(26.6% )were nevus depigmentosus and 27 patients(34.2%)were uncertain by cliniral diagnostic ctriteri.. 2. Viiligo began rarely in infancy(6.4% )and most appeared evenly in all childhood over 1 year old. Nevus clepigmentosus was present at birth in 57.1% of patients and was discovered within the first 6 months after birth in 42.9% of patients. 3. In vitiligo, most lesions were multiple. The most common site of involvement was the face, and there was this tendency of periorficial predisposition. In nevus ciepigmentosus, most lesions were solitary. The most, common aites of involvement were the lowed limbs and trunk, but there was no tendency of periorfcial presposition. 4. We found focal type of vitiligo in,51,6% of patients, vulgaris type in 32. 3 % acrofacial type in 9.6% and segmerital type in 6.5%. We also found isolated pattern of nevus clepigrnento us in 76.2% of patients, ciermatomal p<:ttern in 19.0ki and whorlec1 pattern in 4.8% The contrast enhiancement between the hypopigmented skin and nomal surrounding skin by Wood's light, examinatior reflected the epiclermal melanin pig merit, i. e., the more marked loss of pigmentation, the more accentuatian of the contrast The before, Wood's light examination without I:3OPA staining could help to ciiagnose the atisculte type of vitiligo showing eidermal melanocytes and nevu c.Iepigmeritosus.
Child* ; Dihydroxyphenylalanine* ; Extremities ; Humans ; Melanins ; Melanocytes ; Nevus* ; Parturition ; Pigmentation ; Seoul ; Skin ; Vitiligo*

No abstract available.
Dialysis* ; Peritonitis* ; Salmonella*

No abstract available.
Dialysis* ; Peritonitis* ; Salmonella*

BACKGROUND: There were many studies about the changes of cognitive or non-cognitive domain and behavioral and psychological symptoms with the progression of Alzheimer's disease. But they assessed the changes individually so could not explain comprehensively the global change of disease progression. Also they studied by clinical dementia rating scale(CDR) which could not successfully explain the latest stage. So we have evaluated the cognitive, non-cognitive domain and behavioral and psychological symptoms at the same time and evaluated the changes with the expanded clinical dementia rating scale. Also we evaluated the relationship of each scale and assessed sensitivity change at the different stage of disease. METHODS: Twenty-three mild cognitive impairment(MCI) subjects and eighty-seven patients with Alzheimer's disease were recruited. The Korean version of Mini-Mental State Examination(K-MMSE), the Korean version of the neuropsychiatric inventory(NPI), the Extended version of the Korean Clinical Dementia Rating Scale(CDR), the Activity of Daily Living(ADL), the Severe Dementia Scale(SDS) and the Short form of Samsung Dementia Questionnaire(S-SDQ) were performed. RESULTS: It was found that all of them were well correlated each other(r>-0.73 and p<0.05) except NPI. Physical activity of daily living(P-ADL) was most related to Korean version of instrumental activity of daily living(K-IADL) (r=0.86 and p<0.01), SDS to K-MMSE(r=0.93 and p<0.01) and S-SDQ to K-IADL(r=0.86 and p<0.01). P-ADL and S-SDQ revealed the ceiling effect at CDR 4 and K-IADL at CDR 3. CONCLUSION: The cognitive and non-cognitive function were declined according to disease progression. The changes of behavioral and psychological symptoms were relatively independent of cognitive function. SDS, P-ADL and CDR were proved to be more sensitive in advanced stage of dementia and K-IADL, S-SDQ were more adequate in milder stage of dementia or MCI.
Alzheimer Disease ; Dementia ; Disease Progression ; Humans ; Motor Activity

Before the completion of the Human Genome Project (HGP), the genetics tended to be reserved only to the experts in research fields. Now genetic information has become a matter of grave concern to consumers. Among other changes, genetic testing has increased our ability to understand and treat disease; it is increasing our understanding of the causes of diseases and is creating new challenges in relation to the delivery of health care. Consumers and health-care professionals have raised issues about the current status of the implementation and oversight of genetic testing, including the need to provide a line of evidence to establish the efficacy and cost-effectiveness before the tests become commercialized. In addition, as consumers' interests in and demand for new genomic technologies continue to rise, the need for timely and reliable information becomes increasingly crucial. The application of the principles of evidence-based medicine (EBM) seems to be difficult in clinical genetic testing for health-care providers, although practically relevant. This is because the demand for rapid advances in the diagnosis and treatment of disease is often at odds with the slow evolution of sound evidence. However, genetic information is inherently unique in that it runs through generations, can be predictive of future disease, can be used to stigmatize and discriminate individuals, and has potential psychological impacts. This is why genetic information deserves special considerations and should be dealt with differently from other medical information.
Delivery of Health Care ; Diagnosis ; Evidence-Based Medicine ; Family Characteristics ; Genetic Testing* ; Genetics ; Human Genome Project

Febrile ulceronecrotic PLEVA is an unusually severe from of PLEVA, characterized by the sudden onset of diffuse ulceronecrotic eruption aasociated with high fever. A mild eruption precede the acute fulminating course, We observed a 13-year-old boy presenting the form of febrile ulceronecrotic PLEVA. The histologic features were those of PLEVA. He received the systemic corticosteroids with aupportive care. To recognize this disorder is important because of a possibly fatal outcome, So close attention and vigorous therapy are necessary.
Adolescent ; Adrenal Cortex Hormones ; Fatal Outcome ; Fever ; Humans ; Male ; Pityriasis Lichenoides* ; Pityriasis*

No abstract available.
Blood Group Incompatibility* ; Bromelains*

No abstract available.
Chlamydia trachomatis* ; Chlamydia* ; Female ; Humans ; Infant, Newborn* ; Nasal Cavity* ; Polymers* ; Pregnancy ; Pregnancy Trimester, Third* ; Pregnancy*

While communicable diseases still pose a serious health threat in developing countries, previously neglected health issues caused by non-communicable diseases such as stroke are rapidly becoming a major burden to these countries. In this review we will discuss the features and current status of stroke in low- and middle-income countries (LMICs). Overall the global burden of hemorrhagic stroke is larger than ischemic stroke, with a disproportionately greater burden, measured in incidence and disability-adjusted life-years, regionally localized in LMICs. Patients in poorer countries suffer due to insufficient primary care needed to control risk factors such as hypertension, and inadequate emergency care systems through which sudden events should be managed. In light of these situations, we emphasize two strategic points for development assistance. First, assistance should be provided for bolstering, integrating, and coordinating both the primary health and emergency care systems, in order to prevent stroke and strengthen stroke management, respectively. Second, the assistance needs to focus on programs at the community level, to reduce life-style risks of stroke in a more sustainable manner, and to improve stroke outcomes more effectively.
Delivery of Health Care/*organization & administration ; Developing Countries/*economics ; *Economic Development ; Global Health ; Health Promotion/*organization & administration ; Humans ; Incidence ; International Cooperation ; Models, Organizational ; Prevalence ; Risk Factors ; Stroke/economics/*epidemiology/*prevention & control

Most clinicians understand clinical trials as the evaluation process for new medicine before their use. However, clinical trials can also be applied to laboratory diagnostic tests (LDTs) to verify diagnostic accuracy and efficacy before their clinical laboratory implementation for patients. The clinical trial of LDT has two distinctive characteristics that are different from the case of pharmaceuticals and thus worth special consideration. One of them is the level of evidence. The well-designed randomized controlled trials (RCTs) are known to provide the best evidence to prove the clinical efficacy of any pharmaceutical products. However, RCTs lose practicality when applied to LDTs due to various issues including ethical complications. For this reason, comparative study format is considered more feasible approach for LDTs. In addition pharmaceuticals and LDTs are different in that the user's intervention is not required for the former but critical to the latter. Moreover, in the case of pharmaceuticals, end-products are produced by manufacturers before being used by clinicians. However, in LDTs, once reagents and instruments are provided by manufacturers, they are first utilized by clinical laboratories to produce test results in order for clinicians to use them later. In other words, when it comes to LDTs, clinical laboratories play the role of manufacturers, providing reliable test results with improved quality assurance. Considering the distinctive characteristics of LDTs, we would like to offer detailed suggestions to successfully perform clinical trials in LDTs, which include analytical performance measures, clinical test performance measures, diagnostic test accuracy measures, clinical effectiveness measures, and post-implementation surveillance.
Diagnostic Tests, Routine ; Humans ; Indicators and Reagents ; Pharmaceutical Preparations