BACKGROUND: This study aimed to estimate the clinical outcome and identify the characteristics of a group of patients with pulmonary tuberculosis who completed anti-tuberculosis therapy with the First-line drugs in spite of having positive smear results with negative sputum culture results over the previous six months. METHOD: A retrospective chart review of 21 patients who fulfilled the above criteria between 1995 and 1999 was performed. The laboratory data as well as the clinical data of the patient with positive smear results and negative culture results over a six months period were reviewed. RESULTS: The negative conversion of sputum culture results was achieved within 1.3±1.2 months and the negative conversion of the sputum smear results was accomplished during 9.5±3.3 months. Chest X-rays at 5 months following the institution of anti-tuberculosis therapy from all patients revealed improvements. Four out of 21 patients(19%) relapsed during the follow up, 15.2±13.4 months after administering anti-tuberculosis therapy for 13.3±3.1 months. Relapses were confirmed from between 3 months and 4 months after the treatment completion. Only one of the four relapses had no past history of anti-tuberculosis therapy and the others had prior treatment twice (p<0.01). The period of anti-tuberculosis treatment was extended to a mean of 4.6±2.6 months in 12 patients. However, prolongation of anti-tuberculosis therapy had no affect on the relapse rate (odds ratio, 95% CI 0.18, 2.15). CONCLUSION: Prolongation of therapy with the First-line drugs is not necessary for patients with persistently positive smear results over 6 months and negative culture results. A patient who has had prior anti-tuberculosis therapy more than twice should be paid the closest attention.
Follow-Up Studies ; Humans ; Recurrence ; Retrospective Studies ; Sputum* ; Thorax ; Tuberculosis, Pulmonary

A 40-year-old woman presented with a pruritic erythematous eroded patch on the right labium majus which had been for 3 years. Histopathological findings were consistent with superficial basal cell epithelioma. Basal cell epithelioma of the labium majus is a rare neoplasm and its clinical appearance is usually nodular. In contrast to the other types of basal cell epithelioma, the superficial type occurs mainly on the trunk. We report a case of superficial basal cell epithelioma arising from the labium majus.
Adult ; Carcinoma, Basal Cell* ; Cytochrome P-450 CYP1A1 ; Female ; Humans

The compartment syndrome was described by von Volkmann in 1872 and numerous reports have since been published. The anterior tibial syndrome is well known, but the peroneal compartment syndrome is very rare and have some differences in it's etiology, diagnosis and treatment. We experienced a case of the peroneal compartment syndrome developed after playing foot-ball, and treated by fasciotomy with some delay, but obtained a satisfactory functional result.
Anterior Compartment Syndrome ; Compartment Syndromes ; Diagnosis

It is generally accepted that integrity of the posterior cruciate ligament plays a major role in knee stability. The potential disability resulting from disruption of the posterior cruciate ligament is sufficient to warrant aggressive operative management when the lesion is discovered. From August 1980 to July 1982, the authors treated the 8 cases of the posterior cruciate ligament injury at the department of orthopedic surgery, Chung Ang university hospital; primary repair(2 cases), reconstruction using the medial head of the gastrocnemius muscle(6 cases). In the operative procedure of reconstruction using gastrocnemius, we experienced the following obstacle and resolved it effectively. l. In the surgical approach, we choosed the separate incision on the anteromedial and posteromedial aspect of knee and satisfactory results were obtained. 2. In adequate length of the gastrocnemius tendon was resolved by releasing of gastrocnemius as closer to it's femoral condyle origin as possible or together with attached periosteum and bone chips, by fixation of gastrocnemius with pull through wire suture method. 3. In advancement of the gastrocnemius into the knee joint, we used No. 32 chest tube and achieved the smooth enterance. 4. Adequate position of the femoral condyle drill hole was achieved by using hip screw reamer and K-wire.
Chest Tubes ; Head ; Hip ; Knee ; Knee Joint ; Methods ; Orthopedics ; Periosteum ; Posterior Cruciate Ligament ; Surgical Procedures, Operative ; Sutures ; Tendons

No abstract available in English.
Amputation

PURPOSE: The purpose of this study is to investigate clinical features and causative organisms in febrile infants younger than three months, to help identification of high risk patients for serious bacterial infection (SBI). METHODS: A total of 313 febrile infants younger than three months, who had visited Seoul National University Children's Hospital from January 2008 to December 2010 were included. Clinical features, laboratory findings, causative organisms, and risk factors of SBI were analyzed by retrospective chart review. Causative bacterial or viral pathogens were identified by gram stain and cultures, rapid antigen tests, or the polymerase chain reaction from clinically reliable sources. RESULTS: Among 313 infants, etiologic organisms were identified in 127 cases (40.6%). Among 39 cases of bacterial infections, Escherichia coli (66.7%) and Streptococcus agalactiae (12.8%) were common. Enterovirus (33.7%), respiratory syncytial virus (19.8%), and rhinovirus (18.8%) were frequently detected in 88 cases of viral infection. Patients with SBI (39 cases) showed significantly higher values of the white blood cell count (14,473+/-6,824/mm3 vs. 11,254+/-5,775/mm3, P=0.002) and the C-reactive protein (6.32+/-8.51 mg/L vs. 1.28+/-2.35 mg/L, P<0.001) than those without SBI (274 cases). The clinical risk factors for SBI were the male (OR 3.7, 95% CI 1.5-8.9), the presence of neurologic symptoms (OR 4.8, 95% CI 1.4-16.8), and the absence of family members with respiratory symptoms (OR 3.6, 95% CI 1.2-11.3). CONCLUSION: This study identified common pathogens and risk factors for SBI in febrile infants younger than three months. These findings may be useful to guide management of febrile young infants.
Bacterial Infections ; C-Reactive Protein ; Enterovirus ; Escherichia coli ; Fever ; Humans ; Infant ; Infant, Newborn ; Leukocyte Count ; Male ; Neurologic Manifestations ; Polymerase Chain Reaction ; Respiratory Syncytial Viruses ; Retrospective Studies ; Rhinovirus ; Risk Factors ; Sepsis ; Streptococcus agalactiae

Glomus tumor shows histologically characteristic three components of glomus cells, vascular structures, and spindle-shaped smooth muscle cells. It is classified into solid glomus tumor, glomangioma and glomangiomyoma according to relative proportions of components. Glomangiomyoma, the least frequent type of glomus tumor, has its overall histopathologic pattern identical to common solid glomus tumor or glomangioma. In contrast to the foregoing types, however, it has an important number of spindle-shaped smooth muscle cells, which blend with the glomus cells. A 49-year-old woman presented with 2-year history of painful bluish red nodule beneath nail plate of right 4th finger. We made a diagnosis of glomangiomyoma by virtue of routine histopathologic examinations and immunohistochemical stains such as vimentin, smooth muscle actin and desmin.
Actins ; Coloring Agents ; Desmin ; Diagnosis ; Female ; Fingers ; Glomus Tumor ; Humans ; Intervertebral Disc ; Middle Aged ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Spine ; Vimentin ; Virtues

BACKGROUND: Glycolic acid is currently reported to have beneficial effects on the photoaged skin. These effects may be through the modulatory action of glycolic acid in the production of dermal extracellular matrix proteins of fibroblast. OBJECTIVE: The aim of this study was to investigate the specific effect of glycolic acid on the collagen and elastic fiber gene expression in vitro. METHODS: Human skin fibroblasts were cultured from normal skins of excised specimens and glycolic acid (75 µg/ml) was treated. After 24 hours of treatment, six each cell lines were processed for extraction of RNA and subjected to Northern analysis. RESULTS: Type I collagen mRNA expression was significantly increased in the glycolic acid-treated fibroblasts. Elastin mRNA expression did not show any significant change. CONCLUSION: These results suggested that glycolic acid induced the increase of type I collagen mRNA expression and had the specific biologic effect on fibroblast.
Cell Line ; Collagen Type I ; Collagen* ; Elastic Tissue ; Elastin ; Extracellular Matrix Proteins ; Fibroblasts* ; Gene Expression* ; Humans* ; RNA ; RNA, Messenger ; Skin*

We present a case of generalized syringoma in a 12-year-old healthy girl. The patient has numerous skin colored or yellowish papules on the face, neck, anterior chest, axillae and abdomen. She has a family history of eyelid syringoma occuring in her mother and maternal grandmother. Diagnosis was confirmed by characteristic histopathologic findings.
Abdomen ; Axilla ; Child ; Diagnosis ; Eyelids ; Female ; Humans ; Mothers ; Neck ; Skin ; Syringoma* ; Thorax

BACKGROUND: The high concentration of plasma total homocysteine is recently considered an independent risk factor for atherosclerosis. The purpose of this study was to provide reference ranges for plasma homocysteine levels and to investigate the relationship between plasma homocysteine and cardiovascular risk factors in healthy Korean men. METHODS: Anthropometric parameters, alcohol intake, cigarette use and nutrient intake were determined in 166 healthy men within a wide age range(30-69 yr). Serum levels of lipids, glucose and insulin levels during oral glucose tolerance test(OGTT), plasma amino acid concentrations and levels of antioxidant nutrients and enzymes were also measured. Hyperhomocysteinemia was defined as plasma homocysteine levels above the 90th percentile(> or =15micromol/L) of respective plasma homocysteine distribution in study subjects. Characteristics of hyperhomocysteinemic men(n=16) were compared to normohomocys- teinemic men(n=16) matched for age and body mass index. RESULTS: Plasma total homocysteine values ranged from 2.4 to 38.1micromol/L, a skewed, right-tailed distribution. The homocysteine levels of 25th, 50th and 75th percentile were 7.02, 9.61 and 12.4micromol/L, respectively. The mean concentration of plasma total homocysteine was 10.7micromol/L. Plasma total homocysteine level was positively correlated to body mass index, serum cholesterol and triglyceride levels and alcohol intake, but negatively correlated to serum bata-carotene concentration. In multivariate analysis, serum triglyceride level was the strongest determinant of plasma total homocysteine concentration. There were no significant differences between two groups in waist to hip ratio, alcohol intake, cigarette use, blood pressure and serum levels of glucose and insulin during OGTT. Hyperhomocysteinemic men had significantly higher mean values of serum triglyceride(258mg/dl), total cholesterol(226mg/dl), and LDL-cholesterol(140mg/dl) than normohomocysteinemic men. Hyperhomocysteinemic men showed a decrease in lipid corrected values of serum bata-carotene and alpha-tocopherol and plasma concentrations of serine and taurine, when compared to normohomocysteinemic men. The mean intakes of vitamin B6, folate, vitamin B12 and bata-carotene tended to decline by 25-30% in hyper- homocysteinemic group, when compared to normohomocysteinemic group. CONCLUSION: Our results indicate that healthy Korean men with hyperhomocys- teinemia show signs of hyperlipidemia and decreased antioxidants nutrients and these factors increase risk for coronary artery disease. In addition, hyperhomocysteinemia may affect amino acid metabolism related to homocysteine.
alpha-Tocopherol ; Antioxidants ; Atherosclerosis ; Blood Pressure ; Body Mass Index ; Cholesterol ; Coronary Artery Disease ; Folic Acid ; Glucose ; Glucose Tolerance Test ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Hyperlipidemias ; Insulin ; Male ; Metabolism ; Multivariate Analysis ; Plasma* ; Reference Values ; Risk Factors* ; Serine ; Taurine ; Tobacco Products ; Triglycerides ; Vitamin B 12 ; Vitamin B 6 ; Waist-Hip Ratio