Cutaneous protothecosis sometimes poses diagnostic and therapeutic problems. Isolation of the causative organism may not be successful and spores may be mistaken for other skin diseases unless the characteristic sporangia are detected in tissue sections. Because there are few cases, the optimal therapy is still being debated. On Liebs crystal violet staining we found charateristic purplish dots in Prototheca spores; these correspond to the amyloplasts or dense bodies found under electron microscopy. The isolated organisms were inhibited in vitro by itraconazole, amphotericin B, ketoconazole, and amorolfine and we were able to successfully treat two patients with itraconazole.
Amphotericin B ; Gentian Violet* ; Humans ; In Vitro Techniques ; Itraconazole* ; Ketoconazole ; Microscopy, Electron ; Plastids ; Prototheca ; Skin Diseases ; Sporangia ; Spores

In spite of recent introduction of such highly sophisticated diagnostic modalities as computerized tomography,cardioangiography and polytomography the simple PA chest remaines as an essential and important method of chestdiagnosis especially in terms of vascular diseases of the lung and heart. Until recently, however, theinterpretation of chest x ray has been largely dependent on much subjective observation of roentgen anatomy of thechest. Several years ago Simon proposed a quantitative approach to interpretation of the chest in an attempt tomake the judgement more objective. In the present study we have carried out a clinical study on normalities of thestandard PA chest of Korean adults. The materials consisted of 216 normal chest films. Age ranged from 20 to 60years and sex distribution 103 males and 113 females, We counted the number of vessels in both lung fields,measured the diameter of the basal artery and investigated the level of hilum points as well as hilar distance.There were 9 to 11 vessels in the upper zone and 9 to 12 in the lower zone. There were no significant sexdifference. The number of vessels was not affected by aging. The average diameter of the basal artery was11.7±2.4mm in the right lower zone and 10±1.8mm in the left lower zone in female. There was significant sexdifference (p 0.01). Aging seemed not to be affected the size of the basal artery. The majority of hilum point waslocated at the level of 5-6th rib at axillary portion and the left hilar point is 0.3-2.0cm higher in locationthan the right. The hilar distance was 4.1±0.4cm on the right 5.0±1.1cm on the left in male and 4.0±0.7cm onthe right and 4.7±0.5cm on the left in female. There was significant sex difference (p 0.01). There wassignificant difference in size of the basal arteries and hilar distance between the Koreans and Englishmen but thenumbers of vessels were not significantly different.
Adult ; Aging ; Arteries ; Clinical Study ; Female ; Heart ; Humans ; Lung ; Male ; Methods ; Ribs ; Sex Characteristics ; Sex Distribution ; Thorax ; Vascular Diseases

The diaphragmatic injury is often associated with thoracic or abdominal trauma. This injury has wide spectrum of symptoms from minimal discomfort to strangulation of the herniated organ. Herein we report a case of delayed presentation of traumatic diaphragmatic hernia treated surgically. The case was discovered about five years later after fall down accident. The patient complained intermittent chest discomfort and pain at the first visit of our department. On physical examination, slightly decreased breathing sound was noted in right lower lung field. The thoracic CT and MRI findings were suggestive of right side diaphragmatic injury with herniation of liver. Under general anesthesia, we confirmed diaphragmatic hernia through thoracoscopic evaluation of right thorax. Unfortunately it was too hard to put liver back into peritoneal cavity through the thoracoscopic procedures. Then we performed abdominal laparotomy and the herniated liver was reduced. The patient was tolerated well and recovered without complications.
Anesthesia, General ; Diaphragm ; Hernia ; Hernia, Diaphragmatic ; Hernia, Diaphragmatic, Traumatic* ; Humans ; Laparotomy ; Liver ; Lung ; Magnetic Resonance Imaging ; Peritoneal Cavity ; Physical Examination ; Respiratory Sounds ; Thorax

PURPOSE: The purpose of this study was to investigate the prevalence of diaper dermatitis (DD), knowledge of DD prevention and treatment, and diaper hygiene practices among mothers with diaper-wearing children. METHODS: The participants were 176 mothers who presented to an outpatient clinic at a children's hospital with diaper-wearing children. Data were collected using a structured self-administered questionnaire. RESULTS: The percent of correct answer for knowledge about DD was 59.7%. Almost half of the participants' children had experienced at least 1 episode of DD during the last 6 months. Inappropriate diaper hygiene practices, such as using talcum powder on DD and rubbing with a dry towel after cleansing, were reported. Moreover, only 37% of mothers used the recommended skin barrier to prevent DD. Although many children suffer from DD, levels of educational experience and perceived need for education on this topic were low. Almost 70% of mothers obtained DD-related information through internet sites. CONCLUSION: Educating parents about the etiology of DD and evidence-based diaper hygiene practices is an important aspect of effective DD prevention and treatment. Internet sites or smartphone apps may be effective methods for education on DD prevention and treatment considering parents' preferences for ways to obtain health information.
Ambulatory Care Facilities ; Child ; Dermatitis ; Diaper Rash ; Education ; Humans ; Hygiene ; Infant ; Internet ; Mothers ; Parents ; Prevalence ; Skin ; Smartphone ; Talc

“Breakthrough” of psychosis despite good compliance of antipsychotics medication for a long time is a major obstacle to the treatment of schizophrenia, whether the mechanism is caused by dopamine hypersensitivity or insufficient dose of antipsychotics. Researchers advocating “Dopamine Supersensitivity Psychosis” (DSP) emphasize to avoid excessive inhibition of dopamine 2 receptors from the beginning of treatment. On the other hand, researchers advocating “Breakthrough psychosis on Antipsychotic Maintenance Medication” (BAMM) in which psychosis recurs due to insufficient medication despite continuous administration of antipsychotics without non-adherence argue that dose of antipsychotics should be increased to enhance therapeutic effect. In patients using long-acting antipsychotics injection (LAI), non-compliance can be ruled out. We believe that in treating non-affective psychosis, it is necessary to continuously maintain the lowest dose possible using the optimal dose considering the side effects of second-generation antipsychotics and the cycle and stage of psychosis, and the optimal formulation such as LAI.

BACKGROUND: The Cobas(R) Integra is a new automated chemistry analyzer with continuous and random-access features for routine chemistries, specific proteins, electrolytes, therapeutic drugs and drugs of abuse. The system maintains 68 test-specific reagent cassettes on board and have test principles of absorbance photometry, immunoturbidometry, fluorescence polarization and ISE measurements. We evaluated the usefulness of Cobas(R) Integra in the aspect of accuracy, precision, linearity, comparison study, test speed and general performance. METHODS: We evaluated the analytical performance of the Cobas(R) Integra for T. bilirubin, CRP, BUN, creatinine, sodium, potassium, chloride, valproic acid, phenytoin and carbamazepine according to NCCLS guidelines (EP5-T2, EP6-P, EP9-T and GP10-T). RESULTS: In accuracy study, error ranges(%) of most test items, except sodium and chloride, were within analytic goals. In within-run and between-run precision study, Coefficient of variation (CV, %) of most items, except sodium, were lower than limits suggested by College of American Pathologists Survey 1991. The linearities were maintained well in the range of medically significant levels and were statistically acceptable (p<0.001). The comparison study for most items, except sodium and chloride, indicated good correlation with Hitachi 747 and TDx FLx(TM) and correlation coefficients (r) were above 0.98. Throughput was about 450 tests/hr. CONCLUSIONS: Cobas(R) Integra showed satisfactory accuracy, precision, linearity, good correlation with other analyzers and high throughput. So, we concluded that Cobas(R) integra is highly suitable for not only routine use but also emergency tests in medium to large-sized hospitals because of its high productivity and reliability.
Bilirubin ; Carbamazepine ; Chemistry* ; Creatinine ; Efficiency ; Electrolytes ; Emergencies ; Fluorescence Polarization ; Phenytoin ; Photometry ; Potassium ; Sodium ; Street Drugs ; Valproic Acid

BACKGROUND: The Cobas(R) Integra is a new automated chemistry analyzer with continuous and random-access features for routine chemistries, specific proteins, electrolytes, therapeutic drugs and drugs of abuse. The system maintains 68 test-specific reagent cassettes on board and have test principles of absorbance photometry, immunoturbidometry, fluorescence polarization and ISE measurements. We evaluated the usefulness of Cobas(R) Integra in the aspect of accuracy, precision, linearity, comparison study, test speed and general performance. METHODS: We evaluated the analytical performance of the Cobas(R) Integra for T. bilirubin, CRP, BUN, creatinine, sodium, potassium, chloride, valproic acid, phenytoin and carbamazepine according to NCCLS guidelines (EP5-T2, EP6-P, EP9-T and GP10-T). RESULTS: In accuracy study, error ranges(%) of most test items, except sodium and chloride, were within analytic goals. In within-run and between-run precision study, Coefficient of variation (CV, %) of most items, except sodium, were lower than limits suggested by College of American Pathologists Survey 1991. The linearities were maintained well in the range of medically significant levels and were statistically acceptable (p<0.001). The comparison study for most items, except sodium and chloride, indicated good correlation with Hitachi 747 and TDx FLx(TM) and correlation coefficients (r) were above 0.98. Throughput was about 450 tests/hr. CONCLUSIONS: Cobas(R) Integra showed satisfactory accuracy, precision, linearity, good correlation with other analyzers and high throughput. So, we concluded that Cobas(R) integra is highly suitable for not only routine use but also emergency tests in medium to large-sized hospitals because of its high productivity and reliability.
Bilirubin ; Carbamazepine ; Chemistry* ; Creatinine ; Efficiency ; Electrolytes ; Emergencies ; Fluorescence Polarization ; Phenytoin ; Photometry ; Potassium ; Sodium ; Street Drugs ; Valproic Acid

Tinea pedis is frequently found in those people with poor hygine and in hot and humid environments. The authors investigated the clinical, epidemiologicol a id mycological characteristics of tinea pedis in 138 sewerage workers attending a sewerage plant in Seoul. Tinea pedis was found in 82, with a prevalence of 59.4%. The prevalence of tinea pedis increased with age and the period working at sewerage plant, however, there was no statistical significance. Also there was no difference in the prevalence of tinea pedis between the clerical workers and the field workers. Positive rate for KOH smear was 73.2%, and culture positive rates were 42.7%, producing 35 strains of dermatophytes. Twertyeight strains of Trichophyton Rubrum and 7 strains of Trichophyton mentagrophytes were isolated. Twentyseven yeast-form colonies were isolated, and Trichosporon beigelii was foungl in 19 samples. Most of the yeast forms were found mixed with dermatophytes and moulcis, However, 6 were isolated from direct smear positive cases and yieIded pure colonies of yeast. These included 4 cases of T. beigelii, 1 case of Candida parapsilosis, and 1 case of Candida hormicola. In view of the recent report of these fungi as pathogenic organism, these isolates, rspecially T. beigelii, were considered as a causative agent of tinea pedis in certain groups like sewerage workers.
Arthrodermataceae ; Candida ; Fungi ; Health Personnel ; Humans ; Plants ; Prevalence ; Seoul ; Tinea Pedis* ; Tinea* ; Trichophyton ; Trichosporon ; Yeasts

Quantitative medical genetics including genetic epidemiological studies, linkage studies, and association studies are the basis for molecular genetic studies to find the susceptible genes or responsible mutations for psychiatric disorders. Epidemiological studies on recurrence risk, twin studies and adoption studies have shown that genetic components are contributing for the development of psychiatric disorders. The basic concept of quantitative genetics is recombination and linkage phenomenon. Linkage is that two genetic loci located close enough to each other will not be separated after recombination in meiosis. Linkage analysis and association studies can be accomplished by appropriate genetic analysis methods with genetically well defined phenotype data and genotype data generated by PCR. Linkage analysis are focused on simultaneous transmission of genotype and phenotype in multiplex pedigrees. Linkage analysis could be divided into two categories: parametric and nonparametric methods. Association studies are designed to find linkage disequilibrium between candidate gene and disease phenotype. Family-based association study methods are recommended to exclude possible population stratification of population-based case control studies. In spite of lots of evidence supporting great genetic influence on psychiatric disorders, genetic studies on psychiatric disorders have not been easy. It is probably because psychiatric disorders are composed of complex traits which do not follow Mendelian inheritance and several genes may contribute to only a small proportion of variances in the trait. In order to solve this complexity, animal models and genetically proper endophenotypes should be developed and be applied to QTL (Quantitative Trait Loci) analysis. At the same time, statistically powerful sample size should be established through worldwide collaboration to overcome small gene effects of psychiatric disorders.
Case-Control Studies ; Cooperative Behavior ; Endophenotypes ; Genetic Loci ; Genetics* ; Genetics, Medical ; Genotype ; Linkage Disequilibrium ; Meiosis ; Models, Animal ; Molecular Biology ; Phenotype ; Polymerase Chain Reaction ; Recombination, Genetic ; Recurrence ; Sample Size ; Wills

The purpose of the study was to evaluate the effect of commonly used orthopaedic material, stainless steel (SS) screw (2.7xlOmm, Synthes) and titanium (Ti) screw (2.7x10mm, Synthes), on bacterial adherence and infection. The bacteria used for this study was Staphylococcus epidermidis for its ability of adherence. For in vitro assay, screws of each material were placed into test tube containing 107 colony forming unit (CFU) of S. epidermidis in trypticase soy broth for 18 hours. Following incubation, each screws were treated either with trypsin or with an ultrasonic cleaner. For in vivo assay, we inoculated 5x107 CFU of S. epidermidis into the proximal tibial metaphysis of the rabbits, and then inserted Ti screw on the right side and SS screw on the left side. The amount of in vitro adherence of S. epidermidis was greater for SS screw than for Ti screw. Especially following trypsin treatment, SS groups yielded significantly higher bacterial counts than Ti group, respectively (1.4x105 CFU vs 2.8x104 CFU, p<0.05). We found a significantly higher bacterial count after use of SS screw than after Ti screw in rabbits in vivo assay also. Trypsin treatment for identifying biofilm embedded bacteria from implanted metal may be useful in the diagnosis of infection. Ti screw appears to have biocompatibility to inhibit bacterial adherence compared with SS screw in the rabbit tibial model.
Bacteria ; Bacterial Load ; Biofilms ; Diagnosis ; Rabbits ; Stainless Steel ; Staphylococcus epidermidis ; Stem Cells ; Titanium ; Trypsin ; Ultrasonics