It has been known that right ACA occlusions can cause callosal disconnection syndrome. A 61-year old right-handed man was admitted because of a left ACA occlusion. MRI showed infarction of the medial frontal cortex and the anterior two-thirds of the corpus callosum. He presented with weakness and gait initiation failure in the right leg with grasp reflex, suspicious alien hand sign, and tactile anomia in the right hand. He was diagnosed with transcortical motor aphasia. He was unable to successfully complete written tasks in response to dictations and writing down spontaneous answers. He wrote down incorrect words and demonstrated paragraphism with his left hand. He could copy simple items but not written words and complex items with his left hand. Finally, he had difficulties in writing answers in response to complex verbal and written commands with his left hand, but preserved the ability to simple verbal commands, somato-sensory, and visually guided tasks. We attribute these results to the anterior callosal disconnection of the right sensorimotor cortex from the left language area.
Anomia ; Anterior Cerebral Artery ; Aphasia, Broca ; Corpus Callosum ; Emigrants and Immigrants ; Gait ; Hand ; Hand Strength ; Humans ; Infarction ; Leg ; Magnetic Resonance Imaging ; Middle Aged ; Reflex ; Writing

Dermatophytes infect the human hair, skin, nail and cause the dermatophytosis. The extracellular and intracellular proteinases of the dermatophytes commonly occur in the genus Trichophyton like T. rubrum, T. mentagrophytes, and T. granulosum. These enzymes play a prominent role in growth, multiplication and infection of the host tissue. Extracellular proteinases have been purified from the species of Trichophyton and Microsporum. We purified the proteinase partially from the culture filtrate of the Trichophyton tonsurans through Mono-Q and Superose 12 column and investigated its biochemical and enzymatic characters. The molecular size of the proteinase was estimated to be 41 kDa by SDS-PAGE. And pI was 3.2. The optimal temperature and pH for an enzymatic activity were 27C and 7.5, respectively. The purified porteinase degraded the keratin, bovine serum albumin, hemoglobin. The serine proteinase inhibitor like PMSF and DFP inhibited the proteolytic activity of the purified enzyme whereas the cysteinase inhibitor did not. These results demonstrated that the purified proteinase is a serine proteinase and can contribute the tissue invasion.
Arthrodermataceae ; Electrophoresis, Polyacrylamide Gel ; Hair ; Humans ; Hydrogen-Ion Concentration ; Isoflurophate ; Microsporum ; Peptide Hydrolases ; Serine Proteases* ; Serine* ; Serum Albumin, Bovine ; Skin ; Tinea ; Trichophyton*

OBJECTIVE: To investigate the clinical manifestations of adult onset Still's disease in Korea. METHODS: 22 patients who were diagnosed at Seoul National University Hospital during 10 years from March, 1984 to June, 1994 were reviewed. RESULTS: Age of onset was evenly distributed between 16 and 45 years in most of the patients. Fever and arthralgia were present in all cases. Arthritis and skin rash were developed in 91% and 77% of the patients respectively. Laboratory tests showed accelerated ESR in 95~o, increased serum ferritin in 79%, leukocytosis in 68%, anemia in 32%, hypoalbuminemia in 32%, and abnormal liver function test in 36% of the patients. Commonly affected joints were knees, wrists, proximal interphalangeal joints, ankles, elbows and shoulders in order. Bone marrow biopsy in 7, lymph node biopy in 2 cases revealed reactive hyperplasia. Nonsteroidal anti-inflammatory drugs (NSAID) were effective in 73% of the patients, corticosteroid with or without NSAID in 50% of the patients. Toxic hepatitis was developed in 2, acute renal failure in 1 and drug rash in 1 case during NSAID treatment, which resolved after discontinuance or switching to another NSAID. CONCLUSIONS: The clinical manifestations of AOSD in Korea generally resemble those previously reported in other countries except that lymphadenopathy, splenomegaly, joint deformity, pleurisy, leukocytosis and anemia were significantly less frequent in our cases.
Acute Kidney Injury ; Adult* ; Age of Onset ; Anemia ; Ankle ; Arthralgia ; Arthritis ; Biopsy ; Bone Marrow ; Congenital Abnormalities ; Drug-Induced Liver Injury ; Elbow ; Exanthema ; Ferritins ; Fever ; Humans ; Hyperplasia ; Hypoalbuminemia ; Joints ; Knee ; Korea* ; Leukocytosis ; Liver Function Tests ; Lymph Nodes ; Lymphatic Diseases ; Pleurisy ; Seoul ; Shoulder ; Splenomegaly ; Still's Disease, Adult-Onset* ; Wrist

No Abstract available.
Cross Infection* ; Korea*

The role of chain cystourethrogram in the diagnosis of stress urinary incontinence (SUI) is still controversial. This study evaluates the diagnostic significance of beaded-chain cystourethrogram in 37 women with stress urinary incontinence and 18 continent women as control. The results were as follows: 1. In women with SUI, the degree of urinary incontinence was divided into three groups by Stamey classification: Grade I in 4 patients, grade III in 23 patients and Grade III in 10 patients. 2. The range of posterior urethrovesical angle was as follows: those of 2 cases (5.4%) of incontinent women and 2 cases (11.1%) of continent women were in the range of 90-100 degrees (normal) showed, those of 16 cases (45.2%) of incontinent women and 12 cases (66.7%) of continent women were in the range or 101-150 degrees. And those of 19 cases (51.4%) of incontinent women and 4 cases (22.2%) of continent women were in the range of 151-180 degrees (p>0.05). 3. The range of urethral inclination was as follows : those of 12 cases (32.4%) of incontinent women were abnormal (>45%). but those of all continent women were within normal range (p<0.05). Therefore. we concluded that urethral inclination was more specific rather than posterior urethrovesical angle in the diagnostic value of SUI using with beaded-chain cystourethrogram (p<0.05). but still beaded-chain cystourethrogram itself has limitations in the confirmatory diagnosis of the stress urinary incontinence (p>0.05).
Classification ; Diagnosis ; Female ; Humans ; Reference Values ; Urinary Incontinence*

No abstract available.
Spine*

Open reduction in an AO 33-A3 class distal femur transverse and comminuted fracture is often difficult due to frequent reduction loss during surgery, leading to longer operative time and increased blood loss intra-operation. In this study, the authors report a case in which the use of an offset grid plate (OsteoMed, USA) using 2.4 mm HPS (hand plating system) eased the process of fracture reduction and achieved a stable internal fixation, ultimately leading to successful osteosynthesis. The authors experienced no need for temporary fixation devices such as K-wires or screws, which are otherwise required to stabilize the reduction. The fracture reduction was stable throughout the primary fixation of the fracture using a locking plate and screws. The authors report that the advantage of the HPS plate is fitting into the cortical contour and providing stable maintenance of fracture reduction intra-operation, which would be beneficial in certain distal femoral fracture patterns.

No abstract available.
Eosinophils* ; Gyeongsangbuk-do* ; Humans ; Immunoglobulin E* ; Skin*

OBJECTIVES: Shift work is a stressful situation. It is important to know the factors associated with the ability to adapt to a shift work schedule. The aim of the present study was to investigate the association between sleep, as well as personality variables, and the resilience of shift work nurses. METHOD: Self-report questionnaires were administered to 95 nurses who worked in one national university hospital. Connor-Davidson resilience scale, hospital anxiety and depression scale, morningness-eveningness scale, Pittsburgh sleep quality index, other sleep-related questionnaires, and Korean defense style questionnaires were used. RESULTS: Age, shift work duration, off-day oversleep, depression, anxiety, adaptive defense style, and self-suppressive defense style were significantly associated with resilience (p < 0.05). Multiple regression analysis showed that age (beta = 0.34, p < 0.05), depression (beta = -0.25, p < 0.05), adaptive defense style (beta = 0.45, p < 0.001), and self-suppressive defense style (beta = -0.19, p < 0.05) significantly predicted the resilience of shift work nurses. Concerning individual defense mechanisms, resignation (beta = -0.20, p < 0.05), sublimation (beta = 0.19, p < 0.05), omnipotence (beta = 0.19, p < 0.05), and humor (beta = 0.20, p < 0.05) significantly predicted the resiliency. CONCLUSION: The findings indicate that a specific defense style and other mechanisms were associated with the resilience of shift work nurses. A future prospective study with more participants could further clarify the relationship between sleep-related variables, as well as personality factors, and resilience of shift work nurses.
Anxiety ; Appointments and Schedules ; Defense Mechanisms ; Depression ; Surveys and Questionnaires ; Sublimation

BACKGROUND: Anesthesia induction time is related to speed of injection, injected volume, and Keo. In the case of target controlled infusion, induction time can be controlled by adjusting the induction time mode. The aim of this study was to estimate the effect of induction time mode on variable parameters and vital signs during anesthesia induction with propofol using a target controlled infusion (TCI). METHODS: Sixty unpremedicated adult patients (ASA class I or II, 18 55 yrs) scheduled for elective surgery were randomly allocated to four groups according to induction mode. Group 1 was assigned a flash induction mode, and groups 2, 3 and 4 were assigned 2, 3 and 4min respectively. The end point of anesthesia induction was loss of eyelash reflex. Various parameters including induction time, infused volume, current/effect concentration at induction, and vital signs were compared. RESULTS: As the induction time mode was prolonged, induction time was delayed, but there was no difference in infused volume. Also, the current concentration decreased gradually, but the effect concentration did not show any difference. The vital signs were more stable in groups 3 and 4 compared with groups 1 and 2. CONCLUSIONS: For anesthesia induction, a rapid induction mode showed more rapid induction and low current concentration, but vital signs were relatively unstable and the effect concentration at induction showed no difference. For critically ill patients or patients with unstable hemodynamics, a more gradual induction mode for anesthesia induction in propofol TCI is recommended.
Adult ; Anesthesia* ; Critical Illness ; Hemodynamics ; Humans ; Propofol* ; Reflex ; Vital Signs*