Herpes zoster involving noncontiguous dual dermatomes is very rare in both immunocompetent and immunocompromised persons. This unique presentation has been referred to as zoster duplex unilateralis or bilateralis, depending whether one or both halves of the body are involved. A 22-year-old woman, who had been treated for acute leukemia, congestive heart failure and chronic disseminated candidiasis, was referred to our department for painful papulovesicular eruptions on the right side of the anterior chest and upper back for 2 days, and the left buttock for 1 day. Tzanck smear revealed multinucleated giant cells with intranuclear inclusion bodies. We report a rare case of zoster duplex bilateralis.
Buttocks ; Candidiasis ; Female ; Giant Cells ; Heart Failure ; Herpes Zoster* ; Humans ; Intranuclear Inclusion Bodies ; Leukemia ; Thorax ; Young Adult

Erythropoietic protoporphyria, sometimes also called erythrohepitic protoporphyria or simple protoporphyria, is a heritable detect of heme synthesis in which the last enzyme of the heme synthetic pathway, ferrochelatase(or heme synthetase), is functioning subopt,imally. A 23-year-old male has experi nced erythema and edema on the fae and hands during or immediately after sun exposure, since 3 years of age. The skin lesions have been accompanied by severe itching, a buring sensation and pain. Severe episodes were followed hy head iche and vomiting. We have seen a case of erythropoietic protoporphyria presenting clinically and histo athologically, wit.h a skin lesion on the sun exposured area, and free erthrocyte protoporphyrin serologically.
Edema ; Erythema ; Hand ; Head ; Heme ; Humans ; Male ; Protoporphyria, Erythropoietic* ; Pruritus ; Sensation ; Skin ; Solar System ; Vomiting ; Young Adult

Fibrous dysplasia in the orbit and cranial base may involve the optic canal. Although fibrous dysplasia is benign, it may produce a mass effect along the course of the optic nerve which can then induce visual disturbance as well as contour deformities of the skull and facial bone. The treatment of fibrous dysplasia in the orbit and cranial base is to resect the lesion as much as possible and then reconstruct immediately. As well, if there is any evidence of optic canal involvement and disease progression, the treatment of fibrous dysplasia may include optic nerve decompression. It is generally understood that some patients experience improvement of visual function after optic nerve decompression. We performed radical excision and reconstruction by means of autogenous calvarial bone graft and methylmethacrylate in 7 cases. The autogenous calvarial bone was used to reconstruct the orbit. The methylmethacrylate was used to reconstruct bony defect in the temporal area. The orbit was reconstruced into one block which was made of autogenous calvarial bone with a microplate and screw. This method is superior compared to the previous multifragment wiring method with regard to stability, operation time, and appearance. The patients in our series showed satisfactory appearance. In 6 cases, we performed optic nerve decompression. Therapeutic optic nerve decompression was done in 3 cases and prophylatic optic nerve decompression was done in the others. Following therapeutic optic nerve decompression, visual acuity was improved in 2 cases while the others showed a decrease in visual acuity. There was no change of visual acuity and visual field in 1 case after prophylactic optic nerve decompression. However, the others showed decrements in visual acuity or visual field. Therefore, we believe that more attention should be paid during optic nerve decompression procedure and strict indications to that procedure should be applied.
Congenital Abnormalities ; Decompression* ; Disease Progression ; Facial Bones ; Humans ; Methylmethacrylate ; Optic Nerve ; Orbit* ; Skull ; Skull Base* ; Transplants ; Visual Acuity ; Visual Fields

PURPOSE: To investigate the clinical outcome in patient underwent surgical correction of consecutive esotropia. METHODS: The medical records of 20 patients with at least 1 year follow-up who underwent surgical correction of consecutive esotropia from 1986 to 2001 were reviewed retrospectively. The authors investigated the deviation angle, amblyopia, diplopia before and after exotropia surgery, efficacy of occlusion on the angle of consecutive esotropia, and clinical course after consecutive esotropia surgery. RESULTS: Incidence of the consecutive esotropia was 0.9% (20 out of 2260 exotropia patients who were required surgery to correct consecutive esotropia), average age at exotropia surgery was 5 year-old, and average deviation of exotropia was 33 prism diopters (PD). There were lateral incomittancy in 4 patients, convergence insufficiency in 3 patients, amblyopia in 1 patients and no had diplopia. Monocular lateral rectus recession and medial rectus recession (R and R) was performed in 13 patients and bilateral recession in 7 patients. In most patients, even though esotropic angle was reduced by occlusion therapy, they were still esotropic. Postoperative cyclic esotropia in 3 patients, diplopia in 7 patients and amblyopia in 7 patients were developed. Surgery for esotropia was performed average 13months after surgery for exotropia, angle of esodeviation at surgery was average 31PD and amblyopia improved after surgery and occlusion in 3 eyes. There were exotropia in 15 patients, esotropia in 3 patients and orthotropia in 2 patients after surgery for consecutive esotropia. The second surgery for exotropia in 2 patients and esotropia in 1 patient were performed. CONCLUSIONS: The clinical results in surgical correction of consecutive esotropia were variable. We could not anticipate the surgical result. Careful observation and treatment for development of amblyopia is needed.
Amblyopia ; Child, Preschool ; Diplopia ; Esotropia* ; Exotropia ; Follow-Up Studies ; Humans ; Incidence ; Medical Records ; Ocular Motility Disorders ; Retrospective Studies

Competition will usually develop between the opposing walls as the restorative resin shrinks during polymerization. Magnitude of this phenomenon may be depended upon cavity configuration and volume. The purpose of this sturdy was to evaluate the effect of cavity configuration and volume on microleakage of composite resin restoration that has margins on the enamel site only. The labial enamel of forty bovine teeth was ground using a model trimmer to expose a flat enamel surface. Four groups with cylindrical cavities were defined, according to volume and configuration factor (Depth x Diameter / C-factor) - Group I: 1.5 mm x 2.0 mm / 4.0, Group II: 1.5 mm x 6.0 mm / 2.0, Group III: 2.0 mm x 1.72 mm / 5.62, Group IV: 2.0 mm x 5.23 mm / 2.54. After treating with fifth-generation one-bottle adhesive - BC Plus(TM) (Vericom, AnYang, Korea), cavities were bulk filled with microhybrid composite resin - Denfill(TM) (Vericom). Teeth were stored in distilled water for one day at room temperature and were finished and polished with Sof-Lex system. Specimens were thermocycled 500 times between 5degrees C and 55degrees C for 30 second at each temperature. Teeth were isolated with two layers of nail varnish except the restoration surface and 1 mm surrounding margins. Electrical conductivity (microA) was recorded in distilled water by electrochemical method. Microleakage scores were compared and analyzed using two-way ANOVA at 95% level. The results were as follows: 1. Small cavity volume showed lower microleakage score than large one, however, there was no statistically significant difference. 2. There was no relationship between cavity configuration and microleakage. Factors of cavity configuration and volume did not affect on microleakage of resin restorations with enamel margins only.
Adhesives ; Dental Enamel* ; Electric Conductivity ; Gyeonggi-do ; Paint ; Polymerization ; Polymers ; Tooth ; Water

The case is presented a 49-year-old man had several year history with chronic renal failure with hyperlipidemia due to diabetes mellitus. Treatment of hyperlipidemia was started by oral bezafibrate intake 600 mg per day. Several days later, patient noticed muscle weakness and myalgia. The serum CK, LDH, AST levels were remarkably elevated, myoglobulinuria was also noticed The symptoms of the patient were resolved after the drug was discontinued, thus the diagnosis was established as having bezafibrate induced rhabdomyolysis. On the basis of the above description, bezafibrate may induce muscle damage if dose is excess over the renal capacity. Extreme caution is warranted when the patient is placed on bezafibrate and has renal dysfunction.Strict dose adjustment is necessary in taking account of renal function to avoid muscle damage including rhabdomyolysis.
Bezafibrate ; Diabetes Mellitus ; Diagnosis ; Humans ; Hyperlipidemias ; Kidney Failure, Chronic ; Middle Aged ; Muscle Weakness ; Myalgia ; Rhabdomyolysis

Aneurysm of the vein of Galen is a rare midline arteriovenous malformation, usually presenting with cardiac failure in infancy or with hydrocephalus and raised intracranial pressure in older children. We experienced a case of the vein of Galen aneurysm diagnosed with computed tomographic (CT) features and magnetic resonance image (MRI), a new imaging modality. Our case was a 3 day-old male neonate and had a nonspesific symptom of high fever without cardiac failure. A brief review of related literature was made.
Aneurysm* ; Arteriovenous Malformations ; Cerebral Veins* ; Child ; Fever ; Heart Failure ; Humans ; Hydrocephalus ; Infant, Newborn ; Intracranial Pressure ; Male ; Veins*

No abstract available.
Hand Deformities ; Humans ; Parkinsonian Disorders*

Necrotizing fasciitis (NF) is an uncommon, life-threatening infection of the subcutaneous tissue and superficial fascia. The clinical course of NF is rapid and progressive, and it is often fatal despite the appropriate therapy. The prognosis of NF depends on a timely diagnosis and then proper treatment. At onset it may not be possible to clearly distinguish NF from minor soft-tissue infections. Although infection are common due to the use of steroids and immunosuppressive agents in patients with systemic lupus erythematous (SLE), it is interesting that NF has rarely been reported with SLE. Here, we present two cases of NF with SLE.
Fasciitis, Necrotizing ; Humans ; Immunosuppressive Agents ; Prognosis ; Steroids ; Subcutaneous Tissue

BACKGROUND: Direct puncture by a needle is a risk factor for nerve damage. This study was designed to demonstrate nerve damage caused by a needle using the synchrotron small-angle X-ray scattering (SAXS) technique. METHODS: A 15 mm section of rat (Male Spargue-Dawley, about 250 grams) sciatic nerves were involved in this study. The nerve specimen for the experiment (N = 5) was punctured 5 times by a needle (25 G, 100 beveled) under general anesthesia with enflurane. The needle was placed perpendicular to the nerve and the needle bevel was placed parallel to the nerve. The SAXS patterns of the punctured nerves, extracted about 15 min prior to the experiment, were acquired after 1 week. The SAXS patterns of a normal sciatic nerve (N = 5), extracted about 15 min prior to the experiment, were measured in order to provide a comparison. Experiments were carried out at 4C1 beamline at Pohang Accelerator Laboratory in Korea. Incoming X-rays were monochromatized at 11 keV using a double multilayer (WB4C) monochromator; the beam size was around 0.5 (V) x 0.8 (H) mm2. The exposure time was 60 sec, and 8 to 12 images were acquired per sample with a 0.5 mm interval. RESULTS: In the punctured group, the periodic peaks of myelin sheath and collagen fiber were not changed. However, the periodic peaks of interfibrillar distance of collagen were greatly changed. CONCLUSIONS: Direct needle-nerve impalement did not cause damages in myelin sheath and collagen fibers when the needle was placed perpendicular and the needle bevel paralleled to the nerve fiber. This result can imply that the needle slipped into the interfibrillar packing of collagen fibrils.
Anesthesia, General ; Animals ; Collagen ; Enflurane ; Gyeongsangbuk-do ; Korea ; Myelin Sheath ; Needles* ; Nerve Fibers ; Peripheral Nerve Injuries* ; Punctures ; Rats* ; Risk Factors ; Sciatic Nerve* ; Synchrotrons*