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

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*

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*

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

Malignant Mixed Mullerian tumors(MMMTs) are unusual neoplasms occumng mostly in the uterus and, ralely, they arise in the ovary. The clinical features of malignant mixed mullerian tumor of the ovary are similiar to other ovarian malignancies. The clinical course is rapidly progressive and fatal. The optimal treatment modalities has remained elusive. The most reliable prognostic criterion is the initial tumor stage and the overall survival was poor. We experienced two cases of malignant mixed miillerian tumor of the ovary, so we report these cases with a brief review of the concerned literatures.
Female ; Ovary* ; Respiratory Sounds ; Uterus

We studied the ultrastructural alteration of glomerular anionic sites in 6 patients with minimal change nephrotic syndrome, 5 patients with membranous glomerulonephritis, 4 patients with focal segmental glomerulosclerosis, and 4 patients with IgA nephropathy by staining with polyethyleneimine (PEI) as a cationic probe. The control study was examined by using a nephrectomy specimen of non-glomerular disease which had no proteinuria. This method seems to selectively stain heparan sulphate in the basement membranes and has been widely used to evaluate changes in basement membrane charge in various human diseases as well as in experimental studies. The anionic sites in the lamina rara interna and lamina densa of normal glomerular basement membrane were always less numerous and less regularly distributed than those in the lamina rara externa. Characteristic common findings in these glomeruli showed a marked decrease of glomerular anionic sites in the regions with immune-complex deposits and normal distribution in the regions with focally those being absorbed and newly forming glomerular basement membrane. They were not detected in the gap of the basement membrane and on the area of the detached overlying epithelium using the PEI method. But the foot process fusion of epithelial cells seems not to influence the loss of anionic sites on the glomerular basement membrane.
Basement Membrane ; Epithelial Cells ; Epithelium ; Foot ; Glomerular Basement Membrane* ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranous ; Glomerulosclerosis, Focal Segmental ; Humans ; Nephrectomy ; Nephrosis, Lipoid ; Polyethyleneimine ; Proteinuria

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*

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