Pigmented Bowen's disease (PBD) is a rare variant of Bowen's disease(BD). Most of the reported cases showed pigmented patches or thin plaques. Thus its clinical manifestations may simulated other various pigmented skin lesions. We experienced 2 cases of PBD in patients with multiple BD developed after taking Korean proprietary pills (KPP, "Hwan-Yak"), which were suspected to contain certain amount of arsenics. Both patients also showed arsenical keratosis on their palms and soles. The darker pigmentation of the PBL led us to differentiated them from melanoma.
Bowen's Disease* ; Humans ; Keratosis ; Melanoma ; Pigmentation ; Skin

The purpose of this study is to investigate the effect of job stress and social support on the organizational effectiveness of hospital employees and to examine the role of social support in the experience of job stress among the employees. Previous studies have yielded mixed results regarding the role of social support. Some studies provide supporting evidence for the buffering effect of social support, while others do not. Still others report findings about reverse buffering effects. These inconsistent findings are, in part, accounted for by methodological problems such as poor measurement, small sample size, and the existence of high multicollinearity. To examine more rigorously the role of social support in relation to the negative effects of job stress, this study was carefully designed to overcome methodolgical shortcomings found in the past research. In addition, unlike the previous studies, which were concerned mostly with health-related variables as consequences of job stress, in this study, three work-related variables (job satisfaction, organizational commitment, and intent to stay) which had close relationships with organizational effectiveness were examined as output variables. The sample used in this study consisted of 353 employees from a university hospital in the suburbs of seoul. Data were collected with self-administered questionnaires and analyzed using canonical analysis and hierarchical regression analysis. The results of this study indicate that; (l) job stress has negative main effects on job satisfaction, organizational commitment, and intent to stay; (2) social support has positive main effects on the same three output variables, (3) social support does not moderate the harmful effects of job stress on the three outcome variables, and (4) the three-way interaction effects of (social support * job stress * gender) and of (social support * job stress * education) are not supported The implications of these findings for the management of human resources are discussed.
Humans ; Job Satisfaction ; Surveys and Questionnaires ; Sample Size ; Seoul

No Abstract Available.
Alopecia* ; Telemedicine*

We report a case of primary cutaneous cryptococcosis on Rt. forehead and perioral area of 57 year old woman with non-insulin dependent diabetes mellitus and Lt. cerebral infarction. She had large ulcers with yellowish purulent exudates on Rt. forehead and perioral area for 2months. A histopathological examination from the lesion showed numerous encapsulated, round spores and the organisms were identified as Cryptococcus neoformans in a series of fun-gal studies. The patient received a 5-week course of IV and oral fluconazole with resolution of her skin lesion. The patient is free of any lesion several months after completing therapy. This experience supports the use of fluconazole as initial and single therapy in primary cutaneous cryptococcosis.
Cerebral Infarction ; Cryptococcosis* ; Cryptococcus neoformans ; Diabetes Mellitus ; Exudates and Transudates ; Female ; Fluconazole* ; Forehead ; Humans ; Skin ; Spores ; Ulcer

No abstract available.
Humans ; Lower Urinary Tract Symptoms* ; Prostate* ; Urethral Obstruction*

Solitary circumscribed neuroma is a benign nerve sheath tumor of unknown etiology. Clinically, it appears as a long-standing, solitary, asymptomatic, skin-colored papule or papulonodule. It has been found predominantly on the face in both sexes, mostly in middle age. A 53-year-old female patient visited our department because of a nodule on the side of the distal interphalangeal joint of the left second finger. A biopsy specimen showed a well-circumscribed, partially encapsulated tumor composed of interlacing fascicles of spindle cells. Neither pleomorphism nor mitosis was found. Immunohistochemical stainings for vimentin, neuron specific enolase (NSE) and epithelial membrane antigen (EMA) were positive, but negative for S-100 protein and smooth muscle actin (SMA). We herein report an uncommon case of solitary circumscribed neuroma.
Actins ; Biopsy ; Female ; Fingers ; Humans ; Joints ; Middle Aged ; Mitosis ; Mucin-1 ; Muscle, Smooth ; Neuroma* ; Phosphopyruvate Hydratase ; S100 Proteins ; Vimentin

Superior mesenteric artery (SMA) injuries remain a challenge to most trauma surgeons and continue to result in significant mortality despite aggressive management. We report successful management of a proximal SMA injury through endovascular treatment in a 56-year-old man. The patient presented with hypotension due to a stab wound after the epigastrium. He underwent emergency laparotomy and repair of the penetrated wall of the stomach. Right retroperitoneal hematoma at the initial laparotomy expanded and ruptured, requiring a massive transfusion. At the second laparotomy, we performed lateral arteriorrhaphy of the proximal SMA. Follow-up abdominal computed tomography angiography on post-injury day 7 showed a pseudoaneurysm on the left side of the SMA trunk. The patient was treated successfully with an endovascular stent graft.
Aneurysm, False* ; Angiography ; Blood Vessel Prosthesis ; Emergencies ; Endovascular Procedures ; Follow-Up Studies ; Hematoma ; Humans ; Hypotension ; Laparotomy ; Mesenteric Artery, Superior* ; Middle Aged ; Mortality ; Stomach ; Wounds, Stab

The provision of adequate soft tissue cover for a complex hand and forearm wound-dirty, infected and exposed bone can be a challenging problem. Conventionally, a distant flap or free flap have been used, but these have been associated with several problems such as joint stiffness, risk of microsurgical procedures, negligible donor site morbidity, prolonged operation time and economic restriction. As well, fasciocutaneous flap has been the limitation of infection control. In these situations, the ipsilateral muscle flap provides the ideal cover with its rich blood supply and single operative field. Previously described by Lendrum(1980), by Lae et al.(1981), and later by McGeorge(1991), the brachioradilis muscle is the most superficial muscle on the radial side of the forearm. Its flap is based on the radial artery and venae comitantes. From August 1996 to October 1997, we performed branchioradialis muscle flap in seven patients. Despite the sacrifice of the major hand artery, brachioradialis muscle flap has many advantages including the reliability of flap survival, easy dissection, early mobilization and absence of functional and aesthetic problems at the donor site. It is a relatively simple and rapid method for resurfacing soft tissue defect in the hand and forearm. We obtained satisfactory and reliable results.
Arteries ; Early Ambulation ; Forearm* ; Free Tissue Flaps ; Hand* ; Humans ; Infection Control ; Joints ; Radial Artery ; Tissue Donors

Bilateral jumped facets dislocation in upper thoracic spine is rare injury because the thoracic spine is relatively immobile structure. We experienced a case of T2-3 dislocation without fracture and successfully reduced the dislocation after partial resection of the superior articular process of the third thoracic spine and performed fixation and fusion from T1 to T4 with pedicle screw system.
Dislocations* ; Spine

BACKGROUND: It is traditiqnally considered that the non-bullous fonn of impetigo is primarily of streptococcal origin and the bullous form is of staphylococcal origin. However, recent reports have shown that Staphylococcus aureus (SA) has become the predominant cauative pathogen of non-bullous impetigo as well as of bullous impetigo. Objective. Our purpose was to evaluate the predominant causativi. pathogen, and to establish a therapeutic guideline for impetigo. METHOD: We described the characteristics of lesions and gerformed bacterial culture and susceptibility tests in patients with impetigo. Patients were treatecl by one of three frequently used antibiotics(erythromycin, cefuroxime, fusidic acid). RESULTS: Of 77 patients, there were 47 cases of crusted type(61.9%), 18 cases of mixed type with crusted and bullous lesiona(23.3%), 7 cases of mixed type with crusted and pustular lesions(9.1%) and 5 cases of bullous type(6.6%). SA was grown from 90.1% af the cases, in 83.1% of cases it was the only organism to be foind and no gowth of streptococcus was faund even in mixed infections. An antimicrobial susceptibility test of 63 strains of SA demonstrated high susceptibility to vancomycin(98.4%), cefuroxime(97.1%), oxacillin(96.4%), cephalothin(95.2%), fusidic acid(91.7%) etc, and high resistance to penicillin(93.7%), gentamicin(90.5%), tobramycin(88.9%) and erythromicin(80.9%). Of 19 patients treated with erythrornycin, 12(63.1% ) showed treatment failure at a weeks, while no treatment failure occured in groups treated with cefuroxime and usidic acid. There were statistically significant differences iri therapeutic effect between cefuroxirne and erythromycin(P=0.005 by two tailedy test), and betweer fusidic acid and erythromycin(P=0.0040. But there was no significant difference between cefuroxime and fusidic acid. CONCLUSION: The predominant pathogen of non-bullous impetigo a well as bullous impetigo was SA which were highly resistant to erythromycin and highly sensitive to efuroxime and fusidic acid. In the clinical response, cefuroxinie and fusidic acid treatment were most effective and erythromycin was inadequate for treatment of impetigo.
Cefuroxime ; Coinfection ; Erythromycin ; Furosemide ; Fusidic Acid ; Humans ; Impetigo* ; Staphylococcus aureus ; Streptococcus ; Treatment Failure