No abstract available.
Lung* ; Pneumonia*

Vivax malaria has been endemic in Korea since the 15th century. In the 1960s a Malaria Eradication Project was introduced by the Korean government in conjunction with the World Health Organization (WHO). In 1979, WHO declared Korea a malaria-free area. Thereafter, any cases of malaria in Korea were imported cases. In 1993 a case of malaria, that was not imported, was identified. From then, malaria cases have increased exponentially and have tended to expand toward souther areas of Korea. We experienced three cases showing atypical clinical course of vivax malaria. In the first case, the patient had a spike of fever after the completion of standard chloroquine-primaquine therapy. He revealed the recrudescence of vivax malaria. The second one was asymptomatic parasitemia. The patient had no complaint for the prolonged period despite low level of parasitemia. The third patient was natural healing or vivax malaria with a relative long incubation period. Therefore we report these atypical cases with review.
Fever ; Humans ; Korea ; Malaria ; Malaria, Vivax* ; Parasitemia ; Plasmodium vivax ; Recurrence ; World Health Organization

No abstract available.
Down Syndrome*

No abstract available.
Humans ; Male ; Spinal Cord Injuries* ; Spinal Cord*

A buttonhole deformity of the finger is characterized by flexion of the pmximal interphalangeal joint and hyperextension of the terminal interphalangeal joint. When the central slip of the extensor tendon and the triangular ligament are ruptured,(or severed) on the base of the middle phalanx, buttonhole deformity will result.This article is based on clinical and follow up studies of 5 patients with buttonholedeformities. Five cases were treated by the modified Littler method and were followed from 4 months to 24 months postoperatively and good results were obtained in all cases.
Congenital Abnormalities ; Fingers ; Follow-Up Studies ; Humans ; Joints ; Ligaments ; Methods ; Tendons

Synovial chondromatosis is an uncommon benign lesion characterized by metaplastic cartilage formation within the synovial connective tissue which disintegrates into the joint and continues to grow. Of the eight cases of synovial chondromatosis seen by the authors, three cases involved the knee, two of these were bilateral, three cases involved the elbow, one the hip joint and one the proximal phalanx of the right middle finger. The diagnosis of synovial chondroamtosis was made by histopathological findings of the excised mass. Most synovial chondromatosis cases obtained favorable results by removing masses from the joint and at the same time performing a partial synovectomy, except one case in which degenerative arth ritis had developed proeoperatively.
Cartilage ; Chondromatosis, Synovial ; Connective Tissue ; Diagnosis ; Elbow ; Fingers ; Hip Joint ; Joints ; Knee

No abstract available.
Female ; Humans ; Hypertension, Pregnancy-Induced* ; Pregnancy ; Pregnancy Trimester, Second*

A 30 years old female patient was diagnosed valvular heart disease and double valve replacement was ndertaken. After operation, mediastinitis developed and we had done continuous mediastinal irrigation and had used IV antibiotics for 3 weeks. During outpatient follow-up, infection signs developed, so she readmitted and was reoperated because CT revealed mediastinal abscess. No infected material was observed at the operation. Infection signs continued for 3 weeks. Chest CT revealed giant pseudoaneurysm of ascending aorta. We resected the pseudoaneurysm and performed an aortoplasty with bovine pericardium under deep hypothermia and total circulatroy arrest. She recovered well and was discharged without any complication.
Abscess ; Adult ; Aneurysm, False ; Anti-Bacterial Agents ; Aorta* ; Female ; Follow-Up Studies ; Heart Valve Diseases ; Humans ; Hypothermia ; Mediastinitis* ; Outpatients ; Pericardium ; Thoracic Surgery* ; Tomography, X-Ray Computed

Rhino-orbito-cerebral mucormycosis is a rare opportunistic invasive fungal infection, with rapid progression and high mortality. It is characterized by an aggressive necrotizing infection spreading from the nose to the paranasal sinuses, orbit, and the brain. This disease is often associated with diabetic ketoacidosis, leukemia, malnutrition, AIDS and immunocompromis ed patients. Typical initial symptoms of a patient with rhino-orbito-cerebral mucormycosis are facial pain and swelling, headache, fever, and blood-tinged rhinorrhea. Symptoms rapidly progressed to facial or orbital cellulitis, proptosis, and visual loss, facial nerve palsy. We report a case report of a 66-year-old woman with poorly controlled diabetes mellitus who developed mucormycosis which involved unilateral paranasal sinus, orbit, and selective cranial nerves.
Aged ; Brain ; Cranial Nerves ; Diabetes Mellitus ; Diabetic Ketoacidosis ; Exophthalmos ; Facial Nerve ; Facial Pain ; Female ; Fever ; Headache ; Humans ; Leukemia ; Malnutrition ; Mortality ; Mucormycosis* ; Nose ; Orbit ; Orbital Cellulitis ; Paralysis ; Paranasal Sinuses

BACKGROUND: Chronic obstructive pulmonary disease(COPD) is one of the major contributors to morbidity and mortality amont the adult population. Cigarette smoking(CS) is undoubtedly the single most important factor in the pathogenesis of COPD. However, its mechanism is unclear. The current hyopthesis regarding the pathogenesis of COPD postulates that an imbalance between proteases and antiproteases leads to the destructive changes in the lung parenchyma. This study had two aims. First, to evaluate the effect of CS exposure on histologic changes of the lung parenchyme, and second, to evaluate the effect of CS exposure on the expression of the gelatinolytic enzymes in BAL fluid cells in guinea pigs. METHODS: Two groups of five guinea pigs were exposed to the whole smoke of 20 commerical cigarettes per day, 5 hours/day, 5 days/week, for 6 weeks, and 12 weeks, respectively, using a smoking apparatus. Five agematched guinea pigs exposed to room air were used as controls. Five or more sections were microscopically examined(×400) and the number of cellular infiltration of the alveolar wall was measured in order to evaluate the effect of CS exposure on the histologic changes of lung parenchyme. The statistical significance was analyzed by a linear regression method. To evaluate the expression of the gelatinolytic enzymes in intraalveolar cells, BAL fluid was obtained and the intraalveolar cells were separated by centrifugation (500 g for 10 min at 4℃). Two sets of culture plates were loaded with 1×106 intraalveolar cells. One plate, contained 0.1mM EDTA, a inhibitor of matrix metalloproteases(MMPs), and the other plate had no EDTA. Both plates were incubated for 48 hours at 37℃. After incubation, gelatinolytic protease expression in the supernatants was analyzed by gelatin zymography. RESULTS: At the end of CS exposure, the level of blood carboxy Hb had increased significantly(4.1g/dl in control group, 24g/dl immediately after CS exposure, 18g/dl 30 min after CS exposure). Alveolar inflammatory cells were identified in the CS exposed guinea pigs. The number of alveolar cellular cells observed in a microscopic field (400×) was 121.4±7.2, 158.0±20.2, 196.8±32.8, in the control, the 6 weeks, and the 12 weeks group, respectively. The increased extent of inflammatory cellular infiltration of the lung parenchema showed a statistically significant linear relationship with the duration of CS exposure(p=0.001, r2=0.675). Several types of gelatinolytic enzymes in the intraalveolar cells of CS exposed guinea pigs were expressed, of which some were inhibited by EDTA. However, the gelatinolytic enzymes were not expressed in the control groups. CONCLUSION: CS exposure increases inflammatory cellular infiltration of the alveolar wall and the expression of gelatinolytic preoteases in guinea pigs. EDTA inhibits some of the gelatinolytic proteases. These findings suggest a possibility that CS exposure may increase MMP expression in the lungs of gunea pigs.
Adult ; Animals ; Centrifugation ; Edetic Acid ; Gelatin ; Guinea Pigs* ; Guinea* ; Humans ; Linear Models ; Lung* ; Mortality ; Peptide Hydrolases* ; Protease Inhibitors ; Pulmonary Disease, Chronic Obstructive ; Smoke* ; Smoking* ; Swine ; Tobacco Products