ABSTRACT
OBJECTIVE: Critically ill patients sometimes require transport to another location. Longer intra-hospital transport time increases the risk of hemodynamic instability and associated complications. Therefore, reducing intra-hospital transport time is critical. Our objective was to evaluate whether or not a new device the easy tube arrange device (ETAD) has the potential to reduce intra-hospital transport time of critically ill patients. METHODS: We enrolled volunteers for this prospective randomized controlled study. Each participant arranged four, five, and six fluid tubings, monitoring lines, and therapeutic equipment on a cardiopulmonary resuscitation training mannequin (Resusci Anne). The time required to arrange the fluid tubings for intra-hospital transport using two different methods was evaluated. RESULTS: The median time to arrange four, five, and six fluid tubings was 86.00 (76.50 to 98.50), 96.00 (86.00 to 113.00), and 115.50 (93.00 to 130.75) seconds, respectively, using the conventional method and 60.50 (52.50 to 72.75), 69.00 (57.75 to 80.80), and 72.50 (64.75 to 90.50) seconds using the ETAD (all P<0.001). The total duration (for preparing the basic setting and organizing before and after the transport) was 280.00 (268.75 to 293.00), 315.50 (304.75 to 330.75), and 338.00 (319.50 to 360.25) seconds for four, five, and six fluid tubings, respectively, using the conventional method and 274.50 (261.75 to 289.25), 288.00 (271.75 to 298.25), and 301.00 (284.50 to 310.75) seconds, respectively, using the new method (P=0.024, P<0.001, and P<0.001, respectively). CONCLUSION: The ETAD was convenient to use, reduced the time to arrange medical tubings, and is expected to assist medical staff during intra-hospital transport.
Subject(s)
Humans , Cardiopulmonary Resuscitation , Critical Illness , Equipment and Supplies , Hemodynamics , Manikins , Medical Staff , Methods , Prospective Studies , Transportation of Patients , VolunteersABSTRACT
A rare case of perforating pilomatricoma is reported. A rice grain-sized lesion occurred on the 23-year-old man's left upper arm about 3 years ago. It has developed into a 0.5X0.8cm sized well-defined scaly hard tumor during recent 1 year. Excised tumor showed small islands of shadow cells in the mid-dermis and calcified materials, extruded from the dermis into the deeply invaginated epidermis, by transepidermal elimination.
Subject(s)
Humans , Young Adult , Arm , Dermis , Epidermis , Islands , PilomatrixomaABSTRACT
A rare case of perforating pilomatricoma is reported. A rice grain-sized lesion occurred on the 23-year-old man's left upper arm about 3 years ago. It has developed into a 0.5X0.8cm sized well-defined scaly hard tumor during recent 1 year. Excised tumor showed small islands of shadow cells in the mid-dermis and calcified materials, extruded from the dermis into the deeply invaginated epidermis, by transepidermal elimination.
Subject(s)
Humans , Young Adult , Arm , Dermis , Epidermis , Islands , PilomatrixomaABSTRACT
Hypoglycemic hemiplegia is an under-recognized manifestation of hypoglycemia and mimics cerebrovascular dis-ease, especially in elderly patients. We report a 70-year-old diabetic woman with hypoglycemic hemiplegia, whose dif-fusion- and perfusion- weighted images showed large cortical high signal intensities and hypoperfusion of the right hemisphere during the period of hypoglycemia. We suggest that the regional cerebral blood redistribution and selective vulnerability in hypoglycemia are responsible for the laterality of neurological deficits observed during hypoglycemic episodes.
Subject(s)
Aged , Female , Humans , Hemiplegia , Hypoglycemia , Magnetic Resonance ImagingABSTRACT
Peripheral nerve damage in leprosy would be related to the local cell-mediated immune response to mycobacterial antigens and, presumedly, metabolic and biochemical changes of Schwann cell or circulating demyelinating factors and otherwise, autoimmune process would be involved. The neuralipid composing of cholesterol, ethanolamine glycerophosphatide, sphingomyelin, galactocerebroside(GalC), ethanolamine plasmalogen, serine and choline glycerophophatide, sulfatide are abundant in the myelin and have immunogenicity. Especially, GalC and sulfatide are known to play an important role in myelin function and its stability. The study was undertaken to detect the titers of anti-GalC and anti-sulfatide antibodies for the neural destruction mechanism of leprosy. Subjects tested were 53 leprosy patients with polar type consisting of 25 in tuberculoid leprosy(TT) and 28 in lepromatous leprosy(LL). The titeration of the antibody was done in the sera of patients and controls by enzyme-linked immunosorbent assay(ELISA). The results obtained were as follows ; 1. The detection rate of anti-GalC antibody was in 13(24.5%) of the 53 leprosy patients compared with 3(13.0%) of the 23 normal controls. Among the leprosy patients, there was 8(32.0%) in TT and 5(17.9%) in LL. 2. The detection rate of anti-sulfatide antibody was in 24(45.3%) of leprosy patients compared with 7(26.1%) of normal controls. Both types showed almost same rate of 46.4% and 44.0%, respectively. 3. Mean titer of anti-GalC antibody was 18.9+/-17.0EU/ml in leprosy patients and 12.8+/-8.8EU/ml in normal controls, with statistically insignificant level(p>0.05, one-way ANOVA). Among the leprosy patients, mean titer was 24.7+/-20.9EU/ml in TT and 13.8+/-10.5EU/ml in LL, with significance in TT(p0.05). Among the leprosy patients, mean titer was 26.0+/-15.4EU/ml in TT and 24.7+/-14.0EU/ml in LL, which was nearly same quantities in both types. 5. Examinations using Pearson correlation analysis revealed that the association between anti-GalC and anti-sulfatide antibodies was non-specific in LL(r=0.09) and TT(r=0.04). The analysis between duration of illness and anti-GalC antibody was decreasing correlation(r=-0.89, p0.05). In comparison with anti-sulfatide antibody and duration, LL was higher in 41-50 years, while being higher in 31-40 years in TT, but correlation in both types could not be found(r=0.08, -0.06) In conclusion, the anti-GalC and anti-sulfatide antibodies seemed to be related with nerve damage. Hereafter we think that more study for other neural lipid should be investigated
Subject(s)
Humans , Antibodies , Cholesterol , Choline , Ethanolamine , Leprosy , Myelin Sheath , Peripheral Nerves , SerineABSTRACT
Cutaneous metastasis from renal cell carcinoma is not unusual, occurring in 3 to 7%, although it may be overlooked. We report a case of metastatic renal cell carcinoma in a 74-year-old man who was presented with a 1.5 x 1.5 x 0.5 cm-sized nodule on the right zygoma for 3 months. A skin biopsy demonstrated the typical clear cell adenocarcinoma with PAS(+) granules in the cytoplasm and honeycombed or glandular configuration, compatible with metastatic renal cell carcinoma. Kidney ultrasonogram and abdomina1 CT scanning showed a large cystic mass on the upper pole of the left kidney. Furthermore radiologic studies revealed multiple metastatic lesions in the lung, liver and brain. He died 4 months later.
Subject(s)
Aged , Humans , Adenocarcinoma, Clear Cell , Biopsy , Brain , Carcinoma, Renal Cell , Cytoplasm , Kidney , Liver , Lung , Neoplasm Metastasis , Skin , Tomography, X-Ray Computed , Ultrasonography , ZygomaABSTRACT
We describe herein a sui generis case of poikilodermatous type of mycosis fungoides in a 33-year-old male. The lesions were peculiarly manifested by variegated changes such as hyper- and hypopigmented patches of varying size over the generalized area for about 5 years. Dry, scaly patches studded with violaceous-colored lichen planus-like plaques were on the left thigh and knee. Peripheral lymph nodes were nonpalpable. Biopsy specimens revealed epidermotrophism and Pautrier's microabscess being focal collection of large mononuclear cells with sight hyperchromatic cells in the epidermis. The infiltrating cells on the immunohistochemical staining were LCA and CD3 positive, but negative for CD20 in the epidermis and dermis.
Subject(s)
Adult , Humans , Male , Biopsy , Dermis , Epidermis , Knee , Lichens , Lymph Nodes , Mycosis Fungoides , ThighABSTRACT
BACKGROUND: E. floccosum was known to be the frequent dermatophyte of tinea cruris and fourth causative agent of dermatophytosis in Korea. However, its incidence has been decreasing. OBJECTIVE: The purpose of this study was to investigate epidemiologic aspects of E. floccosum. METHOD: We performed the epidemiologic study on 900 patients with E. floccosum infections in from January 1976 to December 1997. RESULTS AND CONCLUSION: The incidence of dermatophytosis was 16.5% out of a total of 614,139 outpatients, and that of E. floccosum was 0.9% out of a total of 101, 314 dermatophytosis. Among the age groups, the incidence rate was high in the first decade (29.4%) and second decade (41.7%). The ratio of male to female patients was 6.6:1. The prevalence of the month was high in the August, September and October. Involved sites were groin (85.8%), foot (6.2%), trunk (3.7%), hand (1.3%), leg (1.0%), toenail (0.8%), face (0.7%) and arm (0.6%) in decreasing order of frequency. We found that the incidence of E. floccosum had been markedly decreasing since 1986.
Subject(s)
Female , Humans , Male , Arm , Arthrodermataceae , Epidemiologic Studies , Epidermophyton , Foot , Groin , Hand , Incidence , Korea , Leg , Nails , Outpatients , Prevalence , TineaABSTRACT
Verrucous carcinoma of the oral cavity is a rare tumor representing 4.5-9.0% of oral squamous tumors. Involvement of the lip is less common within the oral cavity. It presents as a slowly enlarging, exophytic warty growth with extensive local invasion, though well-differentiated and rarely metastaticl. We herein repart a case of verrucous carcinoma on the lower lip in a 31-year-old man.
Subject(s)
Adult , Humans , Carcinoma, Verrucous , Lip , MouthABSTRACT
Lipoblastoma is a rare benign mesenchymal tumor that exhibits a tendency to invade locally but not to metastasize, and develops from embryonic remnants of white fat tissue. We experienced a case of lipoblastoma occurring in a 7-month-old girl. A small nodule developed on her right inguinal region at the age of 4 months. It had grown to be a 1.2x2.0cm in size, well-defined, volcano-like, ovoid erythematous nodule. Histopathologically it was composed of well-defined lobulated fat tissue with multivacuolated lipoblasts, undifferentiated mesenchymal cells such as stellate or spindle cells and minimal myxoid stroma. Electron microscopic findings demonstrated lipoblasts with eccentric nuclei and coarse chromatins. Complete local excision was done.
Subject(s)
Female , Humans , Infant , Adipose Tissue, White , Chromatin , LipoblastomaABSTRACT
Dystrophic epidermolysis bullosa is a rare, chronic non-inflammatory bullous disease, which easily forms bullae by minor mechanical trauma or spontaneously, is inherited either in an autosomal dominant or autosomal recessive fashion. We report herein two cases which presented with bullae, erosions and ulcers on extremities, buttock, chest, abdomen and face and loss of all nail since birth in two sisters. Bulla occured bencath the basal lamina histopathologically, anchoring fibrils were almost absent on electron miaoscopy in both cases. The two sisters represented dystrophic epidermolysis bullosa considering the absence of family history inheritcd in an autosomal dominant fashion and the clinical, histological and electronmicroscopic findings.