Pseudohypoparathyroidism(PHP) is an inherited metabolic disorder characterized by hypocalcemia, hyperphosphatemia and an impaired phosphaturic response to exogenous parathormone(PTH), which are caused by end organ resistance to the action of PTH. Most of these patients have, in addition, the skeletal abnormalities of Albright hereditary osteodystrophy. We report two cases of PHP, suspicious type Ia, in sibling who were presented with multiple subcutaneous soft tissue calcification similar to that seen in tumoral calcinosis and had short stature, round face, brachydactyly and metabolic abnormalities(hypocalcemia, hyperphosphatemia, increased serum PTH, and decreased 24hr urinary basal cAMP)
Brachydactyly ; Calcinosis ; Humans ; Hyperphosphatemia ; Hypocalcemia ; Pseudohypoparathyroidism* ; Siblings*

PURPOSE: To report the clinical manifestations and prognoses in 5 cases of mixed Candida and bacterial keratitis and present a literature review on mixed fungal and bacterial keratitis. CASE SUMMARY: Five eyes of 5 patients (1 male, 4 female) diagnosed as mixed Candida and bacterial keratitis by corneal smear and culture were included in the present study. Patient mean age was 62.80 years. All patients had preexisting ocular or systemic conditions as predisposing factors for mixed Candida and bacterial keratitis. The most common Candida species isolated was Candida albicans (3 eyes, 60%), while Staphylococcus (3 eyes, 60%) was the most common mixed bacterial species. The average size of ulceration was 7.02 mm2. In 2 eyes (40%), the lesions were located at the corneal center. The depth of the infiltration was significant in all cases, and hypopyon was present in 2 eyes (40%). On the initial visit, the visual acuity was counting fingers or worse in all cases. Four eyes (80%) unresponsive to the topical and systemic treatment underwent surgical intervention but only 1 eye (20%), which had responded to the topical and systemic treatment, showed acuity improvement of more than 1 line on the final visit. CONCLUSIONS: In managing chronically compromised cornea, the possibility of mixed infections with Candida and bacterial organisms should be considered as keratitis shows poor prognosis.
Bacteria ; Candida ; Candida albicans ; Coinfection ; Cornea ; Eye ; Fingers ; Humans ; Keratitis ; Male ; Prognosis ; Staphylococcus ; Ulcer ; Visual Acuity

No abstract available.
Darier Disease*

BACKGROUND: Linear lichen planus (LLP) and Lichen striatus (LS) are rare disorder that can be confused because they can share similar clinical and histopathologic features. OBJECTIVE: The purpose of this study was to evaluate the characteristic differences and common features between the two disorders histopathologically. METHODS: We reviewed the clinical records of patients who had been diagnosed as LLP or LS in our dermatology clinic during the 15-year period between 1985 and 1999. We classified twenty seven cases, which were differentiated from other possible linear dermatoses, into LLP and LS on the basis of clinical features, and then compared them histopathologically, and appreciated the characteristic differences or common features of the two disorders. RESULTS: In cases diagnosed as LLP clinically, epidermal changes were mainly composed of hyperkeratosis (78%), acanthosis (78%), basal degeneration (78%), granular layer thickening (67%) and saw-toothed appearance of rete ridges (44%). In dermis, colloid bodies (78%), band-like inflammatory cell infiltration with pigmentary incontinence (78%) were strik-,ting findings. In cases with clinical features of LS, parakeratosis (50%), dyskeratotic cells scattered in the epidermis (61%) and intercellular edema (39%) were noted in the epidermis. Dermal cellular deposits were focally band-like infiltration(89%), more frequently perivascular in-filtration (83%) and often involved deep dermis (50%), hair follicles (44%) and eccrine glands (22%) in contrast to LLP. CONCLUSION: This study presents a comparative histopathologic features of LLP and LS. Three cases of LLP with overlapping histopathologic features suggest the possibility that there may be an intermediate form between either end of a spectrum, LLP and LS.
Colloids ; Dermatology ; Dermis ; Eccrine Glands ; Edema ; Epidermis ; Hair Follicle ; Humans ; Lichen Planus* ; Lichens* ; Parakeratosis ; Skin Diseases

OBJECTIVES: Both organized and opportunistic screening programs have been widely used in Korea. This paper examined the determinants of the use of opportunistic screening programs in Korea. METHODS: The subjects were a national stratified random sample of 10,254 people aged 45 or older from the first wave of the Korean Longitudinal Study of Ageing in 2006. A logit model was used to examine the determinants of the use of opportunistic screening programs in terms of the demographic and socioeconomic characteristics, the type of health insurance and the health status. RESULTS: Thirteen point seven percent of the individuals received opportunistic screening programs within 2 years from the time the survey was conducted in 2006. The individuals who graduated from college or who had even more education were 3.0 times more likely to use opportunistic screening programs compared with the individuals who were illiterate. The individuals who resided in urban areas and who had religious beliefs were more likely to receive opportunistic screening programs compared with their counterparts. Those who were in the first quartile for the total household assets were 2.6 times more likely to use opportunistic screening programs than those who were in the fourth quartile for the total household assets. Privately insured people were 1.6 times more likely to use opportunistic screening programs than those who were not insured. Finally, the individuals who self-assessed their health status as worst were 2.1 times more likely to use opportunistic screening programs compared individuals who self-assessed their health status as best. CONCLUSIONS: This study suggests that opportunistic screening programs can be an indicator for whether or not an individual is among the advantaged group in terms of their socioeconomic characteristics and type of health insurance.
Aged ; Female ; Health Promotion ; Humans ; Korea ; Logistic Models ; Longitudinal Studies ; Male ; Mass Screening/*utilization ; Middle Aged ; Social Class

BACKGROUND: There are many rating scales for assessment of geriatrics. But each of these scales were not sufficient to evaluate comprehensive geriatric assessment, physical and psychologic efforts for care. METHODS: We developed new scales to comprehensive geriatric assessment for care of geriatric patients. The Geriatrics Physical Support Scale(GPSS) evaluates physical effort consists of 10 areas and the Geriatrics Global Support Scale(GGSS) evaluates general condition of patients consist of 6 areas. Eighty probable and possible AD patients received the Clinical Dementia Rating Rating Scale(CDR), Korearn version of Mini-Mental State Examination(K-MMSE), Barthel Activity of Daily Living Index(B-ADL) GPSS, GGSS. We tested internal consistency, correlation among dementia rating scales. RESULTS: The GPSS correlated to CDR -0.63(p<0.01), B-ADL -0.90(p<0.01) and the GGSS correlated to CDR -0.60(p<0.01), B-ADL -0.75(p<0.01). The internal consistency were 0.69(GGSS), 0.92(GPSS). CONCLUSION: The Geriatrics Global Support Scale evaluate general condition of patients and the Geriatrics Physical Support Scale evaluate physical efforts needed for care of geriatric patients. These scales an also brief and easy rating scales to grade degree of caregiver`s burden.
Dementia ; Geriatric Assessment ; Geriatrics* ; Humans ; Physical Exertion ; Reproducibility of Results* ; Weights and Measures

In order to observe the development of ventricular arrhythmia during regional myocardial ischemia and reperfusion, especially under the presence or absence of ST-T electrical alternans on epicardial EKG. The proximal left descending coronary artery(LAD) was ligated for 20 minutes and then reperfused suddenly in twenty-three cats. Standard lead EKG(Lead??, chest lead EKG and epicardial lead EKG were recorded simultaneously during the occlusion and reperfusion respectively. During the ligation of LAD, STEA was observed in thirteen cats(56.5%). In occlusion period, the incidence of ventricular tachycardia in STEA positive group was significantly higher than in the negative group(p<0.01) and arrhythmic score was significantly higher(p<0.005) also In the reperfusion period the incidence of vefntricular fibrillation in STEA positive group was significantly higher than in the negative group(p<0.025). But there was the tendency to be higher in arrhythmic score of STEA positive group. There were no differences in heart rate, systolic left ventricular pressure, ST elevation and ST width in both groups. Most forms of ST-T of sinus rhythm before and after development of ventricular premature beat was low form(L). It was concluded that at the presence of STEA on EKG, the incidence of ventricular arrhythmia was more prevalent. So, STEA can be available as a marker of ventricular arrhythmia and prognostic factor.
Animals ; Arrhythmias, Cardiac* ; Cardiac Complexes, Premature ; Cats ; Electrocardiography* ; Heart Rate ; Incidence ; Ligation ; Myocardial Ischemia ; Reperfusion ; Tachycardia, Ventricular ; Thorax ; Ventricular Pressure

We report a case of coronary arteriovenous fistula in a female adult confirmed by aortography. The fistulous communication was between right coronary artery and right ventricle. This is the first case report of adult patient with coronary arteriovenous fistula in Korea.
Adult ; Aortography ; Arteriovenous Fistula* ; Coronary Vessels ; Female ; Heart Ventricles ; Humans ; Korea

This study analyzes determinants of patients' choice of healthcare providers in outpatient services and identifies their effects. Data were collected from two waves of the Korean Health Panel. The unit of analysis was an outpatient visit (n=189,739). Various types of medical institutions were grouped into general hospitals (including tertiary hospitals), hospitals, and clinics. A multinomial logit model was used to examine the determinants of medical institution selection. Clinics were the most frequent (82.2%) medical institution selected, followed by general hospitals (10.9%) and hospitals (6.9%). Males and beneficiaries of Medical Aid were more likely to choose the upper-level institutions. The upper-level institution selection was also positively associated with the level of education, household income, and severe diseases, while negatively associated with the level of health status. The medical institution selection was significantly different by region. Not only enabling factors for healthcare utilization, such as family and community resources, but also the users' characteristics were strong determinants of the type of medical institution selected. We, therefore, recommend that patients' characteristics and needs, in addition to the sharing of roles and functions among medical institutions, should be considered in making healthcare policies for efficient medical utilization and an effective medical delivery system.
Consumer Satisfaction ; Delivery of Health Care ; Family Characteristics ; Health Personnel ; Health Status ; Hospitals, General ; Humans ; Logistic Models ; Male ; Outpatients

No abstract available.
Epidermolysis Bullosa Acquisita* ; Epidermolysis Bullosa*