Although there has been recently noted a nation-wide spread of Trichophyton verrucosum infection in cattle associated with promoted stock raising and dairy farming, there were no case reports in Korean dermatologic literature describing the characteristic clinical features of tinea barbae caused by that particular fungus. We report 3 cases of tinea barbae due to T. verrucosum that developed in male stock farmers breeding cattle. One Patient acted 37, experienced acutely inflamed bo99y tumors on the chin and sub-mandible. The others aged 43 and 46 experienced inflammatory lesions with multiple follicular pustules, crusts and loss of hairs on their upper lips. They were successfully treated with oral griseofulvin and local antifungal ointment combined with short-term oral antibiotics or corticosteroid for about one month.
Animals ; Anti-Bacterial Agents ; Breeding ; Cattle ; Chin ; Fungi ; Griseofulvin ; Hair ; Humans ; Lip ; Male ; Tinea* ; Trichophyton*

Myiasis is most prevalent in Mexico, central and south America, tropical Africa, and the southwestern United States. Although dermal myiasis is rare in most of the United States, it is a disorder that may be seen in international travelers. In the United States, external myiasis is usually caused by the cattle botfly. We report here a case of ophthalmomyiasis involving the left upper eyelid of a child. We examined a six-year-old boy who presented to the Massachusetts Eye and Ear Infirmary (MEEI) in September 1998. He complained of persistent swelling of his left upper eyelid for the previous ten days. The edema and erythema were unresponsive to warm compresses and oral antibiotics. Ocular examination revealed a mild preseptal cellulitis of the left upper eyelid with a small draining fistula. On slit-lamp examination, we found one larva protruding intermittently from the fistula site. The larva was extracted with forceps, wrapped in a moist towel and sent in a jar to the parasitology laboratory. The specimen was identified as a Cuterebra larva by a parasitologist at the Harvard School of Public Health. One week later, the patient's eyelid edema and erythema had completely resolved.
Animal ; Case Report ; Child ; Diagnosis, Differential ; Diptera* ; Eye Infections, Parasitic*/surgery ; Eye Infections, Parasitic*/parasitology ; Eye Infections, Parasitic*/diagnosis ; Eyelid Diseases/surgery ; Eyelid Diseases/parasitology* ; Eyelid Diseases/diagnosis ; Eyelids/parasitology* ; Human ; Larva ; Male ; Myiasis*/surgery ; Myiasis*/parasitology ; Myiasis*/diagnosis

PURPOSE: The morphometric change of optic nerve axons is one of the parameters for evaluating the optic nerve function in pathologic conditions such as optic neuritis, anterior optic neuropathy, glaucomatous optic nerve damage, and etc. There are various reports about the diameter of optic nerve axon and its change with age. This study was performed to observe the distribution and aging change of axon diameter, and morphometric characteristic of normal human optic nerve axon. METHODS: Eight enucleated eyes(36~80-year-old), which had no specific lesion in the optic nerve, were enrolled in the study. Optic nerve specimens at central and peripheral portions in each anterior and posterior sides of lamina cribrosa were obtained. The optic nerve axons were observed using transmission electron microscopy and the diameters of optic nerve axons were measured. RESULTS: The mean diameter of optic nerve axon was 1.172 micrometer(0.299 micrometer~6.432 micrometer, SD : 0.326). The mean diameter of optic nerve axon in anterior side of lamina cribrosa was 1.018 micrometer, central nerve fiber was 1.015 micrometer and peripheral nerve fiber was 1.022 micrometer. The mean diameter of optic nerve axon in posterior side of lamina cribrosa was 1.306 micrometer, central nerve fiber was 1.257 micrometer and peripheral nerve fiber was 1.355 micrometer. As age increased, the diameter of optic nerve axon had a tendency to increase(1.08 micrometer in 36-year-old, 1.373 micrometer in 80-year-old). CONCLUSIONS: The optic nerve axons in anterior side of lamina cribrosa were larger than those in posterior side of lamina cribrosa and the peripheral nerve fibers were larger than the central nerve fibers. This study demonstrated the morphometric variability of optic nerve fibers according to their locations and ages.
Adult ; Aging ; Axons* ; Humans* ; Microscopy, Electron, Transmission ; Nerve Fibers ; Optic Nerve Diseases ; Optic Nerve* ; Optic Neuritis ; Peripheral Nerves

BACKGROUND: Mechanical ventilation constitutes the last therapeutic method for acute respiratory failure when oxygen therapy and medical treatment fail to improve the respiratory status of the patient. This invasive ventilation, classically administered by endotracheal intubation or by tracheostomy, is associated with significant mortality and morbidity. Consequently, any less invasive method able to avoid the use of endotracheal ventilation would appear to be useful in high risk patient. Over recent years, the efficacy of nasal mask ventilation has been demonstrated in the treatment of chronic restrictive respiratory failure, particularly in patients with neuromuscular diseases. More recently, this method has been successfully used in the treatment of acute respiratory failure due to parenchymal disease. METHOD: We assessed the efficacy of Bilevel positive airway pressure(BiPAP) in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD). This study prospectively evaluated the clinical effectiveness of a treatment schedule with positive pressure ventilation via nasal mask(Respironics BiPAP device) in 22 patients with acute exacerbations of COPD. Eleven patients with acute exacerbations of COPD were treated with nasal pressure support ventilation delivered via a nasal ventilatory support system plus standard treatment for 3 consecutive days. An additional 11 control patients were treated only with standard treatment. The standard treatment consisted of medical and oxygen therapy. The nasal BiPAP was delivered by a pressure support ventilator in spontaneous timed mode and at an inspiratory positive airway pressure 6-8cmH2O and an expiratory positive airway pressure 3-4cmH2O. Patients were evaluated with physical examination(respiratory rate), modified Borg scale and arterial blood gas before and after the acute therapeutic intervention. RESULTS: Pretreatment and after 3 days of treatment, mean PaO2 was 56.3mmHg and 79.1mmHg (p<0.05) in BiPAP group and 56.9mmHg and 70.2mmHg (p<0.05) in conventional treatment (CT) group and PaCO2 was 63.9mmHg and 56.9mmHg (p<0.05) in BiPAP group and 53mmHg and 52.8mmHg in CT group respectively. pH was 7.36 and 7.41 (p<0.05) in BiPAP group and 7.37 and 7.38 in CT group respectively. Pretreatment and after treatment, mean respiratory rate was 28 and 23 beats/min in BiPAP group and 25 and 20 beats/min in CT group respectively. Borg scale was 7.6 and 4.7 in BiPAP group and 6.4 and 3.8 in CT group respectively. There were significant differences between the two groups in changes of mean PaO2, PaCO2 and pH respectively. CONCLUSION: We conclude that short-term nasal pressure-support ventilation delivered via nasal BiPAP in the treatment of acute exacerbation of COPE), is an efficient mode of assisted ventilation for improving blood gas values and dyspnea sensation and may reduce the need for endotracheal intubation with mechanical ventilation.
Appointments and Schedules ; Dyspnea ; Humans ; Hydrogen-Ion Concentration ; Intubation, Intratracheal ; Masks ; Mortality ; Neuromuscular Diseases ; Oxygen ; Positive-Pressure Respiration ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive* ; Respiration, Artificial ; Respiratory Insufficiency ; Respiratory Rate ; Sensation ; Tracheostomy ; Ventilation* ; Ventilators, Mechanical

Lymphangioleiomyomatosis(LAM) is defined as an abnormal proliferation of smooth muscles in the lung tissue throughout lymphatics, vascular and bronchial structure. A 52-year-old postmenopausal woman was admitted to our hospital for recurrent pneumothorax. She was treated for medroxyprogesterone by LAM 1 month ago. We performed operation of pulmonary partial resection and pleurodesis. The patient is receiving continuous medroxyprogesterone and Leuplin administration, and currently, 6 months after the operation, is still showing good results.
Female ; Humans ; Lung ; Lung Neoplasms ; Lymphangioleiomyomatosis* ; Lymphangioma ; Medroxyprogesterone ; Middle Aged ; Muscle, Smooth ; Pleurodesis ; Pneumothorax*

The etiology of allergic diseases has been considered multi-factorial, comprising genetic, epigenetic, developmental, and environmental factors, as well as their complex interactions. The rising prevalence of allergic disease in recent decades could be explained by changes in environmental factors rather than genetic factors. Climate change has many significant impacts on aeroallergens such as pollen and mold. Therefore, climate changes are considered to be a key environmental factor affecting not only the prevalence but also the severity of allergic disease. In addition, these environmental factors might be more important for young children than for adults. While the concept that environmental factors including climate change would affect the characteristics of allergic disease is generally accepted, it is not enough to explain the mechanisms of the increase in the prevalence and severity of allergic diseases. Nevertheless, evidence exists that climate change has spurred changes in aeroallergens such as pollen and outdoor fungi, and that these changes are associated with the increased incidence of pediatric allergic disease.
Adult ; Child ; Climate ; Climate Change ; Epigenomics ; Fungi ; Humans ; Incidence ; Pollen ; Prevalence

OBJECTIVES: Mediastinal tumors are not uncommon but almost half of them are asymptomatic because of the potential space of the mediastinum. Recently owing to the routine screening chest roentgenography and frequent chest CT scans the incidence have increased. Mediastinal masses are both benign or malignant. Even benign masses may continue to enlarge and compromise vital organ function or rupture, bleed, and become infected. Mediastinal tumors have their own predilection site. There are different incidences of these masses in adults and children, sexes, and there may be difference in incidence between races. There are only a few reports about these tumors in Korea, and we are interested in the clinical manifestations of mediastinal tumors in Korea, METHODS: We retrospectively reviewed medical records of 286 cases of mediastinal tumors which were pathologically confirmed at Keimyung, Kyungpook, and Yeungnam University Hospital in Taegu from 1985 to 1994 but excluded metastatic lesion, tuberculosis, and tumor originated from esophagus, heart, and large vessels. RESULTS: Mediastinal tumors were more frequent in male(60.8%) than female and age distribution was relatively even. Thymoma was most common mediastinal tumor(107 cases, 37.4%). The most common tumor in anterior mediastinum was thymoma (107/212, 50.5%). In posterior mediastinum, neurogenic tumor was the most common(52/67, 77.6%) and teratodermoid tumor was common in middle mediastinum(3/7, 42.9%). The most common symptom was chest discomfort(129 cases, 45.1%) and 67 cases were asymptomatic(23.4%). Benign tumors were more common(175 cases, 61.1%) than malignant tumors. In therapies, complete or partial resections were done in 190 cases(79.8%), chemotherapy or radiotherapy in 71 cases(29.8%), in 24 cases(10.1%) only biopsy was taken without any treatment. Neurogenic tumors have been reported as the most common tumors in western countries and neurogenic and teratodermoid tumor were found to be the most common tumors in the past Korean reports. But thymoma was the most common tumor in this study. CONCLUSION: Thymoma was the most common mediactinal tumor in this study. And thymoma was the most common tumor in anterior mediastinum neurogenic tumor in posterior rnediastinum and teratodermoid tumor in middle mediastinum
Adult ; Age Distribution ; Biopsy ; Child ; Continental Population Groups ; Daegu ; Drug Therapy ; Esophagus ; Female ; Gyeongsangbuk-do ; Heart ; Humans ; Incidence ; Korea ; Mass Screening ; Mediastinum ; Medical Records ; Radiography ; Radiotherapy ; Retrospective Studies ; Rupture ; Thorax ; Thymoma ; Tomography, X-Ray Computed ; Tuberculosis

OBJECTIVE: Endometriosis is assumed to be one of the causes of infertility, although the mechanism remains unclear. The purpose of this study was to determine the prognostic factors for the fertility in women with severe endometriosis. METHODS: Clinical data of 78 consecutive infertile patients who had taken surgery for stage III and IV endometriosis were retrospectively analyzed in two groups: A- pregnant after surgery (n=43, 55.1%): B- non-pregnant after surgery (n=35, 44.9%). All patients were treated with GnRHa after surgery. Each group were compared age, BMI, duration of infertility, stage of endometriosis, size and number of endometrioma, peritoneal implant outside the pelvic cavity, peritubal adhesion, ovarian adhesion and cul-de-sac obliteration. RESULTS: Among these factors, duration of infertility (p=0.03), peritoneal implant (p=0.01), tubal adhesion (p=0.04) and ovarian adhesion (p=0.02) were significantly different. However, patients' age, BMI, size and number of endometrioma, cul-de-sac obliteration and stage of endometriosis did not showed significantly different. CONCLUSION: We concluded that the duration of infertility and tubal and ovarian adhesion are important factors for predicting pregnancy after surgery in severe endometriosis.
Endometriosis* ; Female ; Fertility ; Humans ; Infertility ; Pregnancy* ; Retrospective Studies

BACKGROUND AND PURPOSE: Estimating age- and sex-specific population attributable risks (PARs) of major risk factors for stroke may be a useful strategy to identify risk factors for targeting preventive strategies. METHODS: For this case-control matched study, consecutive patients aged 18-90 years and admitted to nine nationwide hospitals with acute ischemic stroke between December 2008 and June 2010, were enrolled as cases. Controls, individually matched by age and sex, were chosen from the 4th Korean National Health & Nutrition Examination Survey (2008-2010). Based on odds ratios and prevalence, standardized according to the age and sex structure of the Korean population, PARs of major risk factors were estimated according to age (young, < or = 45; middle-aged, 46-65; and elderly, > or = 66 years) and sex subgroups. RESULTS: In 4,743 matched case-control sets, smoking (PAR, 45.1%) was the greatest contributing risk factor in young men, followed by hypertension (28.5%). In middle-aged men, the greatest contributing factors were smoking (37.4%), hypertension (22.7%), and diabetes (14.6%), whereas in women the greatest factors were hypertension (22.7%) and stroke history (10.6%). In the elderly, hypertension was the leading factor in men (23.7%) and women (23.4%). Other noticeable factors were stroke history (men, 19.7%; women, 17.3%) and diabetes (men, 12.5%; women, 15.1%). In young women, risk factors with a PAR greater than 10% were not found. CONCLUSIONS: Smoking cessation in young people and hypertension and diabetes control in older people may be effective in reducing the burden of stroke on the population. In the elderly, secondary prevention could also be emphasized.
Aged ; Case-Control Studies ; Female ; Humans ; Hypertension ; Male ; Odds Ratio ; Prevalence ; Risk Factors* ; Secondary Prevention ; Smoke ; Smoking ; Smoking Cessation ; Stroke*

Recent changes in healthcare systems have changed the epidemiologic paradigms in many infectious fields including bloodstream infection (BSI). We compared clinical characteristics of community-acquired (CA), hospital-acquired (HA), and healthcare-associated (HCA) BSI. We performed a prospective nationwide multicenter surveillance study from 9 university hospitals in Korea. Total 1,605 blood isolates were collected from 2006 to 2007, and 1,144 isolates were considered true pathogens. HA-BSI accounted for 48.8%, CA-BSI for 33.2%, and HCA-BSI for 18.0%. HA-BSI and HCA-BSI were more likely to have severe comorbidities. Escherichia coli was the most common isolate in CA-BSI (47.1%) and HCA-BSI (27.2%). In contrast, Staphylococcus aureus (15.2%), coagulase-negative Staphylococcus (15.1%) were the common isolates in HA-BSI. The rate of appropriate empiric antimicrobial therapy was the highest in CA-BSI (89.0%) followed by HCA-BSI (76.4%), and HA-BSI (75.0%). The 30-day mortality rate was the highest in HA-BSI (23.0%) followed by HCA-BSI (18.4%), and CA-BSI (10.2%). High Pitt score and inappropriate empirical antibiotic therapy were the independent risk factors for mortality by multivariate analysis. In conclusion, the present data suggest that clinical features, outcome, and microbiologic features of causative pathogens vary by origin of BSI. Especially, HCA-BSI shows unique clinical characteristics, which should be considered a distinct category for more appropriate antibiotic treatment.
Adult ; Aged ; Anti-Bacterial Agents/therapeutic use ; Bacteremia/drug therapy/*epidemiology/microbiology/mortality ; Community-Acquired Infections/drug therapy/*epidemiology/microbiology/mortality ; Cross Infection/drug therapy/*epidemiology/microbiology/mortality ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Prospective Studies ; Risk Factors ; Treatment Outcome ; Young Adult