Onychomycosis caused by the genus aspergillus is extremely rare in Korea and only one case due to A. sydowi has been reported. We experienced two casea of onychomycosis infected with A. repens, which were healthy adults. The first case was a 29 year-old male who developed thickening and dark discoloratian of 1st, and, 3rd and 5th toe-nails of left foot from about 5 months on. The second case was a 27 year-old male who developed thickening and yellow-whitish discoloration of the nail of right thumb from about 3 rnonths on. In both cases, direct examination of the affected nails showed many thick bluish hyphae and spore chains, and A. repens was isolated. Our cases were first reported through the Korean literature.
Adult ; Aspergillus* ; Foot ; Humans ; Hyphae ; Korea ; Male ; Onychomycosis* ; Spores ; Thumb

Aging process of the forehead in human reflects imbalance of the forehead muscles, forehead ptosis including eyebrow, and winkles of the forehead and glabella. Forehead lifting through bicoronal incision was adopted as an universal method to correct these problems of the aging process. In a view of the aesthetic surgery, however, there are several problems such as large scar alopecia, and numbness beyond the incision line in the scalp for the correction of the forehead aging stigma. During the part few decades, minimally invasive technology forced many surgical specialities to undergo dramatic changes. In plastic & reconstructive surgery also minimally invasive technology using endoscope gave many advantages. Therefore it has reduced morbidity rates and got greater patient acceptances for the forehead lifting. When we perform endoscopic blow-forehead lift to get a good results in oriental people, 1. it needs a extended periorbital dissection. 2. we have to concern lift in the lateral part of forehead rather than in medial forehead. 3. it needs more aggressive tissue modifications (e.g. myotomies, neurotomy) 4. it needs more strong fixation such as permanent microscrew fixation or cortical bone drill hole technique. We performed 13 cases of the eyebrow-forehead lifting by using endoscope from August 95 to September 96 followed up them from 3 to 12 months and obtained satisfactory result. We would like to report our experiences with literature review.
Aging ; Alopecia ; Cicatrix ; Endoscopes ; Eyebrows ; Forehead ; Humans ; Hypesthesia ; Lifting* ; Muscles ; Plastics ; Scalp

Bovine growth hormone (bGH) gene was expressed in an insect spodoptera frugiperda cell line using a Baculovirus, Hyphantria cunea nuclear polyhedrosis virus (HcNPV). The bGH gene in pbGH plasmid was sequenced and amplified by PCR technique with two primers containing NcoI sites. The bGH gene consisted of 654 bp (217 amino acid residues), the 5'-untranslated region of the cloned bGH cDNA contains 56 bp, and the 3'-untranslated region contains 145 bp and two pallindromic regions. The amplified bGH gene DNA fragment (654 bp) was inserted into the NcoI site of the pHcEVII vector, which was named pHcbGH. The pHcbGH transfer vector DNA and the wild type HcNPV DNA were cotransfected into s. frugiperda cells to construct a recombinant virus. Eight recombinant viruses were selected and named HcbGH. One clone, HcbGH-4-1 showed largest plaque size, therefore the recombinant virus was further studied. The multiplication patters of the recombinant HcbGH-4-1 was similar to that of the wild type HcNPV. The bGH gene DNA in the HcbGH-4-1 recombinant was confirmed by Southern lot hybridization. The amount of the bGH (217 amino acid residues, 21 kDa) produced in S. frugiperda cells infected with the HcbGH-4-1 recombinant was approximately 5.5 ng per ml (106 cells) by radioimmunoassay.
Baculoviridae* ; Cell Line ; Clone Cells ; DNA ; DNA, Complementary ; Growth Hormone* ; Insects ; Nucleopolyhedrovirus* ; Plasmids ; Polymerase Chain Reaction ; Radioimmunoassay ; Spodoptera

A number of methods have been introduced for support the orbital floor following a maxillectomy without orbital exenteration or severe facial trauma. These methods including skin graft and muscular sling provided the unsatisfactory results, like as diplopia, orbital ptosis, enophthalmos and severe facial deformity. Therefore the bone and soft tissue reconstructions using microvascular free flaps were performed recently by many surgeons, but long time operation, donor site morbidity, postoperative large scar, and ptosis of the flap were pointed out as disadvantages of free flap reconstruction. Vascularized calvarial bone flap, a modified method of free calvarial bone graft, was adequate for reconstruction of the orbital floor and the infraorbital rim as a horizontal buttress, especially in case of poor vascular bed and postradiated state. The authors introduced the vascularized calvarial bone flap for the orbital floor and the infraorbital rim reconstruction in 3 cases of maxillectomy, and could be obtained satisfactory results aesthetically and functionally.
Cicatrix ; Congenital Abnormalities ; Diplopia ; Enophthalmos ; Free Tissue Flaps ; Humans ; Orbit* ; Skin ; Tissue Donors ; Transplants

OBJECTIVES: This Study was designed to investigate the pattern of AUI(Alcohol Use Inventory) and MAST(Michigan Alcohol Screening Test) according to the awareness of drinking problem and receptiveness to treatment, and to know whether the type(type1 and type 2 according to Barbor's typology) has effects on the RECPAWAR(acknowledgement and awareness of use problem and receptive to treatment of these problem) score. METHODS: Subjects were 134 alcoholic patients from Alcoholic treatment ward. They were requested to fill up the questionnaires of Korean version of AUI and MAST(MAST for patient and MAST for caretaker). At first, based on the RECPAWAR, they divided into high RECPAWAR group(above 30 percentile) and low RECPAWAR group(below 30 percentile). According to typology, they divided into type 1 and type 2. The data was analyzed by T-test, Correlation, and Regression Analysis. RESULTS: 1) Significant negative correlation was observed between RECPAWAR score and MAST difference score(patient's MAST-caretaker's MAST). 2) High RECPAWAR group had significantly higher scores in the most scales than low RECP-AWAR group, except ENHANCED scale in AUI. 3) There was not significant difference on RECPAWAR score between type 1 and type 2. CONCLUSION: Except ENHANCED scale, the high RECPAWAR group had higher score in the second level scale. As compared with the low RECPAWAR group, the high RECPAWAR group responds more negative in drinking, and is more anxious about their drinking problems. So, they seem to have the objective view about their drinking problems. However the type was not related to receptive and awareness of drinking problem.
Alcoholics* ; Drinking* ; Humans ; Mass Screening* ; Michigan* ; Surveys and Questionnaires ; Self Report* ; Weights and Measures

Recently, several reports of extrahepatic hepatocellular carcinoma metastasis demonstrated by technetium-99mTc-IDAs scan have shown that 99mTc-IDAs can be used to detect extrahepatic metastasis in hepatocellular carcinoma. We report here a case of hepatocellular carcinoma with pulmonary nodules that were demonstrated as metastasis in nature by the use of the 99mTc-DISIDA. The findings in this case and several reports reviewed here suggest that the 99mTc-DISIDA scan may be a useful diagnostic agent that can detect the extrahepatic metastasis of hepatocellular carcinoma and stage the disease. But more clinical study in needed to establish the position of 99mTc-DISIDA in the field of diagnosis of extrahepatic hepatocellular carcinoma.
Carcinoma, Hepatocellular* ; Clinical Study ; Diagnosis ; Lung* ; Neoplasm Metastasis ; Technetium Tc 99m Disofenin

The intradermal (ID) test has been widely used in Korea and several reports about the results of the ID test are known. We examined the egg of Clonorchis sinensis (C.s.) by ID test in 443, stool's egg-counting technique in 79 and direct smear (cellophane thick smear technique) in 1204 subjects. The results are as follows: 1. The positive rate of C.s. was 3.8% out of 1304 persons. 2. The sensitivity of ID test was 82.1% out of 39 persons and the specificity was 64.6% out of 404 persons. 3. The false positive of ID test was 35.4% out of 404 persons and, the false negative was 17.9% out of 39 persons. Intradermal test is a rapid, sensitive and useful supplementary diagnostic tool for the detection of Clonorchiasis infection and must be used as screening test with direct smear of stool but cross reaction with other helminth infections and moderate false reaction are the main disadvantages in its practical application.
Clonorchiasis ; Clonorchis sinensis* ; Cross Reactions ; Helminths ; Humans ; Intradermal Tests* ; Korea ; Mass Screening ; Ovum ; Sensitivity and Specificity

Purpose: This study examined the frequency of early cessation of intravenous patient-controlled analgesia (IV-PCA) after orthopedic surgery, and the difference in frequency according to the surgical site and type to determine the factors affecting the early cessation of IVPCA. Materials and Methods: Based on the medical records of 2,915 patients using PCA after orthopedic surgery from October 2018 to February 2020, sex, age, smoking status, surgical site, operation name, anesthesia method, PCA usage time, satisfaction, side effects, early discontinuation and the reason of early discontinuation were assessed. Orthopedic surgery was classified into major surgery and minor surgery, and the surgical site was classified into the upper limb, lower limb, and spine. The reasons for discontinuation were side effects, patient rejection, and discharge. The factors affecting early discontinuation were identified by univariate analysis, and the degree of each factor affecting early discontinuation was confirmed by logistic regression analysis. Results: The early discontinuation rate of IV-PCA was 6% (upper limb: 8.3%, lower limb: 5.7%). Univariate analysis identified, age, surgical site, surgical classification, anesthesia method, PCA usage time, satisfaction, and side effects as factors affecting early discontinuation. Logistic regression analysis showed that early discontinuation of the upper limb surgery was higher than the lower extremity surgery (p=0.005, odds ratio [OR]=1.78). Moreover, that the early discontinuation of minority surgery was higher than that of major surgery (p=0.002, OR=2.029). The most common reason for early discontinuation in lower extremity surgery is the side effects (71.5%), whereas patient rejection was the major reason in upper limb surgery (41.7%). Conclusion Early cessation of IV-PCA for postoperative pain control was more frequent in upper extremity surgery than lower extremity surgery. The rate of early discontinuation due to simple rejection or discharge of patients was higher in the upper extremity surgery than lower extremity surgery. Therefore, methods such as neuroaxial anesthesia should be considered for pain control after upper limb surgery rather than IV-PCA.

BACKGROUND: Korea is, known to be an endemic area of viral hepatitis B, and 5-6% of population are carriers. Immunization can reduce the spread of hepatitis B infection. Hower, not all people respond to hepatitis B immunsation. 5-15% of primary vaccinees fail to be immunized. After revaccination, only 37.5 44% of the primary failures elicit antibody response. Recent studies have reported that it is effective to inject a double dose vaccination in immunocompromsed patients. In some country, they recommend that neonate whode mother is HBV carrier shoud receive double dose vaccination. This study documented the results of double dose vaccintion only once to nonrsponders toward the HBV immunzation. METHODS: Healthy nonresponders to Hepatitis B immunization were recuited from Sep. 1995 to Aug. 1996. Subjects with their AST/ALT level over 40, or over 65 years old were excluded. They were received 2ml of plasma-derived vaccine(Hepavax-B) intramuscularly in the deltoid muscle. Anti-HBs antibody testing were performed at 1 to 3 months after vaccintion. RESULTS: 17 healthy nanreponders to Hepatitis B immunization(male 10, female 7) were included. Their mean ages were 47(32 to64), AST/ALT level 20/19(16 to 28/11 to 35), smoking 4.3pys(1 to 7). Seroconversion occured in 13 of them(76.5%). CONCLUSIONS: Nonresponders to Hepatitis B vaccintion respond well to double dose vaccination once.
Aged ; Antibody Formation ; Deltoid Muscle ; Female ; Hepatitis B* ; Hepatitis* ; Humans ; Immunization ; Immunization, Secondary ; Infant, Newborn ; Korea ; Mothers ; Smoke ; Smoking ; Vaccination*

Bicoronal approach is adopted as an universal method for reduction and internal fixation of the fractured zygomatic arch in the treatment of complex zygomatic fracture. However bicoronal approach leaves many disadvantages, such as long incision, alopecia, prolonged edema, and paresthesia. Nowadays endoscopically assisted minimal invasive technique has been widespread not only for the aesthetic surgery, but also for the reconstructive surgical fields because of the benefits. We have been recently trying to apply endoscopic surgery to facial bone fracture surgery. Endoscopically assisted minimal invasive technique has been applied to 14 patients who admitted to Chosun university hospital from March 1996 to July 1997. We used 4 mm, 30' endoscope and two 1.5-2 cm temple incisions and a subciliary incision for approaching to the zygomatic arch. Protected drill bit and driver had access to fractured zygomatic arch though tiny(5 mm) stab incision over the zygomatic arch. We have been able to successfully reduce and make fixation of the fracture of zygomatic arch by using endoscopically assisted minimal invasive technique. Follow up for 3 months revealed good maintenance of the reduction. We think that application of the endoscopic technology to midfacial bone fracture will result in significant reduction in morbidity and improve postoperative results.
Alopecia ; Edema ; Endoscopes ; Facial Bones ; Follow-Up Studies ; Fractures, Bone ; Humans ; Paresthesia ; Zygoma* ; Zygomatic Fractures