Herpes zoster in infancy occurs very rarely. And it may be the primary clinical manifestation of reactivation of latent varicella-zoster virus infection acquired transplacentally during intrauterine life. We report a case of herpes zoster in right T2 dermatome in a normal 3-month-old boy, The patient had no history of chickenpox and varicella vaccination. And his mother did not recall herself varicella infection, though she was exposured to chickenpox patient at 7 months of pregnancy. Laboratory findings demonstrated that varicella-zoster Ig-G and Ig-M antibodies were 0.94, 0.12 respectively ( EIA method, negative, <0.8; positive, >1.0) at the second day of vesicular eruption. Fourteen days after vesicular developing, the Ig-G and Ig M titers were rising to 1.92, and 0.47 respectively. His mother's varicella-zoster Ig-G and Ig-M antihodies were 2.64, 0.14 respectively. The baby received acyclovir treatment and the skin lesions healed rapidly without sequela. In this case, although the cause was unclear whether it was a mother-child infection, the patient was suspected subclinical intrauterine varicella-zoster virus infection during pregnancy.
Acyclovir ; Antibodies ; Chickenpox ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Infant* ; Male ; Mothers ; Pregnancy ; Skin ; Vaccination

A 46-year-old female patient was admitted to the intensive care unit (ICU) after liver transplantation. About an hour later after the ICU admission, she had no pupillary light reflex. Both pupils were also fixed at 5 mm. Patients who undergo liver transplantation are susceptible to neurologic disorders including hepatic encephalopathy, thromboembolism and intracranial hemorrhage. Abnormal pupillary light reflex usually indicates a serious neurologic emergency in these patients; however, benign neurologic disorders such as peripheral autonomic neuropathy or Holmes-Adie syndrome should also be considered. We experienced a case of fixed pupillary light reflex after liver transplantation diagnosed as peripheral autonomic neuropathy.
Adie Syndrome ; Emergencies ; Female ; Hepatic Encephalopathy ; Humans ; Intensive Care Units ; Intracranial Hemorrhages ; Liver Transplantation* ; Liver* ; Middle Aged ; Nervous System Diseases ; Peripheral Nervous System Diseases* ; Pupil ; Reflex* ; Reflex, Pupillary ; Thromboembolism

No abstract available.
Animals ; Clone Cells* ; Cloning, Organism* ; DNA, Complementary* ; Leptin* ; Rats* ; Receptors, Leptin*

BACKGROUND: There are prerequisites for fungal nail infection: fungal organism, susceptible host, and environments with damaged nail. OBJECTIVE: The purpose of this study was to evaluate the growth rate of the great toe nail in distal subungual onychomycosis(DSO). MATERIALS AND METHODS:: The subjects are 60 adult patients with DSO and 19 age- and sex-matched controls with tinea pedis but no DSO. The growth rate of the great toe nail was measured. Data were evaluated with Mann-Whitney U-test and regression analysis using the statistical program for PC. RESULTS: The growth rate of the patients group showed a decrease against that of the controls. The equation for expected nail growth rate of specific age and sex was as follows: the expected nail growth rate(mm/day) = 0.07382 + (0.01498 × G) - (0.00033 × Age) - (0.00669 × S): if a person has DSO, G is 1, and if he has no DSO, G is 2; if a person is male, S is 1, and, female, 2. CONCLUSION: Patients with DSO often have a decreased growth rate of the nail compared with that of the controls. The authors propose the equation of expected nail growth rate in persons with or without DSO, and think that the growth rate of the nail is one of factors in the pathogenesis of onychomycosis.
Adult ; Female ; Humans ; Male ; Onychomycosis* ; Tinea Pedis ; Toes*

Although the incidence is not high in the general surgical population, pulmonary aspiration of gastric contents can result in serious long-term morbidity and mortality. We report a case of early use of extracorporeal membrane oxygenation (ECMO) to correct severe hypoxemia refractory to conventional mechanical ventilation in a patient with massive aspiration of gastric contents immediately followed by acute lung injury during general anesthesia induction. A 64-year-old woman diagnosed with stomach cancer was scheduled for elective diagnostic laparoscopy. Although there was no sign of gastrointestinal tract obstruction and midnight Nil per Os (NPO) was performed before the operation, pulmonary aspiration occurred during the induction of anesthesia. Despite the endotracheal intubation with mechanical ventilation, severe hypoxemia with hypercapnea persisted. Medical team agreed with applying veno-venous (VV) ECMO, and her blood gas analysis results became stable. ECMO was weaned successfully 9 days after the first aspiration event had occurred. Based on this case, early application of extracorporeal life support can have survival benefits.
Acute Lung Injury ; Anesthesia* ; Anesthesia, General ; Anoxia ; Blood Gas Analysis ; Extracorporeal Membrane Oxygenation* ; Female ; Gastrointestinal Tract ; Humans ; Incidence ; Intubation, Intratracheal ; Laparoscopy ; Middle Aged ; Mortality ; Pneumonia, Aspiration ; Respiration, Artificial ; Stomach Neoplasms

PURPOSE: The purpose of this study was to identify post-operative discomfort, sense of loss, family support, and resilience in breast cancer surgery patients, and to investigate factors that affect resilience.METHOD: The sample of this study consisted of 108 patients who underwent surgery for breast cancer in two university hospitals located in B city. The collected data was analyzed with descriptive statistics, t-test, ANOVA, and Scheffé test, Pearson's correlation coefficients, and hierarchical multiple regression.RESULTS: The factors that significantly affected resilience were as follows: having a religion (β=-.20, p=.006), having an occupation (β=.14, p=.049), having a high school diploma (β=.31 p=.001), making less than 2–3 million won (β=-.19, p=.036) per month, experiencing a sense of loss (β=-.22, p=.003) and family support (β=.44, p < .001). The total explanatory power amounted to 53.8% (F=14.83, p < .001, AdjR²=.54).CONCLUSION: Educational intervention programs for breast cancer surgery patients that improve resilience by reducing the sense of loss and increasing family support must be developed.
Breast Neoplasms ; Breast ; Hospitals, University ; Humans ; Methods ; Occupations

OBJECTIVES: The differentiation of tuberculous effusion from the other causes of exudative pleural effusion remained difficult even with aids of biochemical analyses and pleural biopsy. As the pathophysiology of tuberculous pleural effusion is an enhanced cell mediated immunity, Adenosine deaminase(ADA) and various cytokines including Inteferon-γ, tumor necrosis factor alpha(TNF-α) are considered as useful diagnostic tools in differentiating exudative pleural effusion The author would like to demonstrate the diagnostic usefulness of TNF-α in the differentiation of exudative pleural effusion, and compared the discriminating ability of TNF-α with ADA. METHODS: Pleural fluids obtained from 80 patients (tuberculous : 39, malignant : 31, parapneumonic : 10) with exudate pleural effusions were processed for cell counts and biochemical analysis including ADA and TNF-α RESULTS: Tuberculous pleural fluid showed higher levee of ADA and TNF-α, 48.7α 32.7U/L and 184.1±214.2pg/mL than that of non-tuberculous effusion 26.0α41.3U/L and 44.1α114.2pg/mL, respectively (ADA, TNF-α : p<0.05, p<0.01). Receiver operating characteristics(ROC) curves were generated for ADA and TNF-α, and the best cut-off value for adenosine deaminase and TNF-α were considered as 30U/L and 15pg/ml, respectively. Comparing the area under the ROC curves, there was no significant difference between ADA and TNF-α CONCLUSION: For the differential diagnosis of tuberculous pleural effusion from the other causes of exudative pleural effusions, TNF-α as well as ADA was considered as useful diagnostic method. However adding TNF-α to ADA has no further diagnotic benefit than ADA alone.
Adenosine ; Adenosine Deaminase ; Biopsy ; Cell Count ; Cytokines ; Diagnosis, Differential ; Exudates and Transudates ; Humans ; Immunity, Cellular ; Pleural Effusion* ; ROC Curve ; Tuberculosis ; Tumor Necrosis Factor-alpha*

The testicular feminization is the most common type of male pseudohermaphroditism. Mutation of androgen receptor gene impairs normal sexual differentiation in genetic male (46, XY) and subsequently develops secondary female characteristics. We report three cases of complete testicular feminization syndrome with normal development of female external genitalia, but with blindly ended vagina and inguinal or pelvic masses. Microscopic examination of the testes and their adnexa had three components: 1) A testis composed of immature tubules, prominent Leydig cells and a spindle cell stroma resembling ovarian stroma with hamartomatous nodule or Sertoli cell adenoma, 2) a white, whorled, firm, smooth muscle body in the medial pole of the testis, and 3) a lateral adnexal cysts of varying sizes.
46, XY Disorders of Sex Development ; Adenoma ; Androgen-Insensitivity Syndrome* ; Cryptorchidism* ; Disorders of Sex Development ; Female ; Genitalia ; Humans ; Leydig Cells ; Male ; Muscle, Smooth ; Receptors, Androgen ; Sex Differentiation ; Testis ; Vagina

BACKGROUND & OBJECTIVES: The degree and the nature of performance deficit in confrontation naming tasks of patients with dementia of the Alzheimer type (DAT) are multifaceted depending on the stage of illness. Quantative analysis of patients responses may reveal the gradual deterioration of naming ability as the illness exacerbrates. In addition, based on the cognitive model proposed by Ellis and Young (1988), functional components and network involved in naming can be scrutinized for their integrity. The aim of this study is then two fold: first, it is to determine whether thee are quantitative differences in naming performance among the normal control and three DAT groups of different severities. Secondary it is to observe whether there are qualitative differences among the groups and if so, what categories of errors could differentiate one group from the others. METHOD: The DAT patients were trichotomized (CDR 0.5, CDR 1, and CDR 2) according to the severity of the illness based clinical dementia rating (CDR) scale. The Korean version of Boston Naming Test (K BNT) was administered to each DAT group and the normal. The responses were analysed according to six categories and then by detailed subcategories under each of the six categories. RESULTS & CONCLUSION: The results revealed significant mean value differences between the normal and CDR I & 2 groups. The CDR 0.5 group differentiated from the normal group since indefinite response were more evident in the former. Moreover, semantically unrelated errors and no-response errors became predominant as the illness worsens. These findings explicate that qualitative analysis of naming errors may be a valuable tool for us to understand the nature of naming deficits in DAT patients.
Dementia* ; Humans

Embryos of most mammalian species grown in vitro would undergo developmental arrest at the approximate time of genomic activation. Stage-specific cell block and the resulting rapid loss of embryo viability in conventional culture media have limited the duration for which embryos may be cultured prior to transfer. As a result, embryos are usually transferred to the uterus at the 4-to 8-cell stage to avoid the loss of viability associated with long-term in vitro culture. Early transfer has led to asynchrony of the endometrium-trophectoderm interaction at the time of implantation and a resultant reduction in the rate of implantation. To overcome these problems, a variety of co-culture systems has been devised in which embryos can develop for a longer period prior to embryo transfer. Vero cells, derived from African green monkey kidney, share a common embryologic origin with cells from the genital tract. In addition, they are potentially safe to use, since they are highly controlled for viruses and other contaminants. Therefore, co-culture using Vero cells has been widely utilized to enhance embryo viability and development, although not without controversies. We thus designed a series of experiments to demonstrate whether Vero cells do indeed enhance mouse embryo development as well as to compare the efficacy of co-culturing mouse 1-cell embryos on Vero cell monolayer in both Ham's F-10 and human tubal fluid (HTF) culture media. 1-cell stage ICR mouse embryos were cultured either in the presence of Vero cells (Group A) or in conventional culture medium alone (Group B). In Ham's F-10 significantly more 3-to-8cell embryos developed in group A than group B (59.8 versus 10.0%; F<0.01). In contrast, there was no significant difference in embryonic development both group A and group B in HTF. However, significant differences were noted only in later embryonic stage (13 and 0%; p<0.05 of group A and B respectively, hatching or hatched). In Ham's F-10, we also could observe the beneficial effect of Vero cell on hatching process (70.7 and 42.1%; p<0.05 of group A and group B respectively).
Animals ; Cercopithecus aethiops ; Coculture Techniques* ; Culture Media ; Embryo Transfer ; Embryonic Development* ; Embryonic Structures* ; Female ; Humans ; Kidney ; Mice* ; Mice, Inbred ICR ; Pregnancy ; Uterus ; Vero Cells*