Syphilis is a communicahble disease caused by the motile microaerophilic spirochete Treponema pallidum, which is only a netural pathogen for human. Prevalence of syphilis and other sexually transmitted diseases has traditioially fluctuated with changes in sccia, conditions and sexual behavior. Although sexual contact is the main route of transmission, T. pallidum may also be infected through direct contact with syphilitic lesions, blood transfusion, ingestion of menstrual blood or vaginal secretions, or trsnsplacental transemission. Fomites as the means of transfer is only hypothetical and account for very few, if any, infection. Prosectors, blood handlers and laboratory technicians are at risk for accidental inoculation with infected materials. In extremely unusual circumstances, infection by means of contact with a skin lesion and human bite have been reported. We report two cases of eyphilis following the abnormal imposition of hands, which caused unnecessary erosive trauma with fingernails,
Bites, Human ; Blood Transfusion ; Eating ; Fomites ; Hand* ; Humans ; Laboratory Personnel ; Nails ; Prevalence ; Sexual Behavior ; Sexually Transmitted Diseases ; Skin ; Spirochaetales ; Syphilis* ; Treponema pallidum

PURPOSE: The purpose of this study was to determine the mechanisms and exact causes of injuries to children by analyzing the medical records of children who visited emergency medical centers. METHODS: We reviewed the medical records of 7,114 pediatric patients (aged below 15 years) who visited the emergency care center (ECC) of a Yeungnam university hospital in Daegu between January 2007 and December 2009. RESULTS: Among the pediatric patients who visited the ECC, 1,526 (27.2%) were admitted for injuries (boys, 979 [64.2%] and girls, 547 [35.8%]); the boy-to-girl ratio in this study population was 1.8:1. The proportion of boys was higher than that of girls over all age ranges, except for children aged less than 1 year. The highest incidence of injury due to slipping (20.5%) was noted in the 1-year-old group, and nearly half the total number of cases (49.3%) involved children who were under 4 years of age. Of the sites of injury, 999 involved the head and face (73.7%) and 134 involved the hand and wrist (9.9%). Seventy-one injuries (5.7%) occurred on the bed, 70 (5.6%) at the door, and 67 (5.3%) on the stairs. Of the approximately 250 types of injuries classified by cause, 17 accounted for 50.4% of all the injuries. CONCLUSION: The cause of injury could be attributed to approximately 20 causes in more than half the cases of pediatric injuries. A classification of the types of injuries and the development of appropriate preventive strategies can help avoid such injuries.
Aged ; Child ; Emergencies ; Emergency Medical Services ; Hand ; Head ; Humans ; Incidence ; Korea ; Medical Records ; Wrist

Unilateral localized hyperhidrosis over scalp and face is an extremely rare disease that usually has undetermined origin. We report a case of idiopathic unilateral localized hyperhidrosis over left scalp and face. A 55-year-old female patient with unilateral hyperhidrosis that is localized in the left side of scalp and face visited our dermatology clinic. She had increased sweating in left face and scalp, recurring in summer for 3 years. She complained of the exacerbation by thermal and gustatory stimuli and exercise. The starch iodine test and digital infrared thermal imaging test revealed a marked increase in sweat gland activity on the affected areas as compared to the contralateral normal sites.
Dermatology ; Female ; Humans ; Hyperhidrosis* ; Iodine ; Middle Aged ; Rare Diseases ; Scalp* ; Starch ; Sweat ; Sweat Glands ; Sweating

There are few reports about generalized hypertrichosis after treatment with topical minoxidil , even though there are numerous reports about generalized hypertrichosis after treatment with oral minoxidil. We experienced a rare case of generalized hypertrichosis after treatment with 3% topical minoxidil in a 5-year-old boy. He visited our hospital for generalized hypertrichosis on face, trunk, arm after treatment with 3% topical minoxidil for 2 months due to alopecia areata. The laboratory examination including CBC, SMA and the level of corticotropin releasing hormone, luteinizing hormone, follicular stimulating hormone, cortisol, estradiol, testosterone were within normal limits. Two months after discontinuation of treatment with 3% topical minoxidil, the hair started to shed and six months after discontinuation of topical minoxidil, he showed almost complete resolution.
Alopecia Areata ; Arm ; Child, Preschool ; Corticotropin-Releasing Hormone ; Estradiol ; Hair ; Humans ; Hydrocortisone ; Hypertrichosis* ; Luteinizing Hormone ; Male ; Minoxidil* ; Testosterone

OBJECTIVE: In the pathogenesis of pre-eclampsia, endothelial cell activation or dysfunction is the central theme and marked dyslipidemia may contribute to endothelial cell dysfunction. The objective of this study was to evaluate the association between pre-eclampsia and the Asp9Asn mutation and the -93G promotor mutation. STUDY DESIGN: DNA was extracted from whole blood or cheek swabs of 224 pre-eclamptic patients, 265 controls, and 106 babies from pre-eclamptic patients. Controls consisted of women who had undergone at least two term pregnancies unaffected by pre-eclampsia. All samples were genotyped for all the polymorphisms using Polymerase Chain Reaction (PCR) of known allelic variants. Sequences were confirmed on an Applied Biosystems 373 DNA Sequencer. Results were analyzed with a x2 contingency table. RESULTS: The prevalences of the LPL Asp9Asn mutation and the LPL -93G promotor mutation were not significantly different between the patients with pre-eclamptic patients, severe pre-eclamptic patients, and HELLP syndrome patients and controls and also not significantly different between the babies born from pre-eclamptic mothers and controls. CONCLUSION: In this caucasian population, the LPL Asp9Asn mutation and the LPL -93G promotor mutation are not associated with an increased risk for pre-eclampsia and HELLP syndrome.
Cheek ; DNA ; Dyslipidemias ; Endothelial Cells ; Female ; HELLP Syndrome ; Humans ; Hypertension, Pregnancy-Induced* ; Lipoprotein Lipase* ; Lipoproteins* ; Mothers ; Polymerase Chain Reaction ; Pre-Eclampsia ; Pregnancy ; Prevalence

PURPOSE: Pancreatic body/tail cancer often involves the celiac axis (CA) and it is regarded as an unresectable disease. To treat the disease, we employed distal pancreatectomy with en bloc celiac axis resection (DP-CAR) and reviewed our experiences. METHODS: We performed DP-CAR for seven patients with pancreatic body/tail cancer involving the CA. The indications of DP-CAR initially included tumors with definite invasion of CA and were later expanded to include borderline resectable disease. To determine the efficacy of DP-CAR, the clinico-pathological data of patients who underwent DP-CAR were compared to both distal pancreatectomy (DP) group and no resection (NR) group. RESULTS: The R0 resection rate was 71.4% and was not statistically different compared to DP group. The operative time (P = 0.018) and length of hospital stay (P = 0.022) were significantly longer in DP-CAR group but no significant difference was found in incidence of the postoperative pancreatic fistula compared to DP group. In DP-CAR group, focal hepatic infarction and transient hepatopathy occurred in 1 patient and 3 patients, respectively. No mortality occurred in DP-CAR group. The median survival time (MST) was not statistically different compared to DP group. However, the MST of DP-CAR group was significantly longer than that of NR group (P < 0.001). CONCLUSION: In our experience, DP-CAR was safe and offered high R0 resection rate for patients with pancreatic body/tail cancer with involvement of CA. The effect on survival of DP-CAR is comparable to DP and better than that of NR. However, the benefits need to be verified by further studies in the future.
Axis, Cervical Vertebra* ; Celiac Artery ; Humans ; Incidence ; Infarction ; Length of Stay ; Mortality ; Operative Time ; Pancreatectomy* ; Pancreatic Fistula ; Pancreatic Neoplasms ; Tail*

PURPOSE: Various pancreaticojejunostomy (PJ) techniques have been devised to minimize the rate of postoperative pancreatic fistula (POPF) after pancreatoduodenectomy (PD). This study describes a modification of the mattress suture PJ technique, which we call "inverted mattress PJ (IM)". The results of an IM group and a historical consecutive control group were compared to determine how the IM technique affected POPF. METHODS: From 2003 to 2010, 186 consecutive patients underwent PD. A former group of 52 consecutive patients who underwent conventional duct-to-mucosa PJ (DM) was used as a historical control group. The IM technique was utilized for the IM group (134 patients). The clinicopathological features and surgical outcomes of the 2 groups were compared, with a particular focus on postoperative POPFs. RESULTS: The average surgery duration was shorter in the IM group (580.3 minutes vs. 471 minutes, P < 0.001). Grades B and C POPFs occurred less frequently in the IM group, but the difference was not statistically significant (17.3% vs. 9.7%, P = 0.200). However, no grade C POPF occurred in the IM group compared with 5.8% of grade C POPFs (3/52) in the DM group (P = 0.020). Three patients died (1 in the DM group and 2 in the IM group). The causes of death were arrhythmia in 2 cases and Candida sepsis in 1 case. POPF was not causally related to the 3 deaths. CONCLUSION: IM end-to-side PJ shortened operation time and increased safety with no incidence of grade C POPF.
Arrhythmias, Cardiac ; Candida ; Cause of Death ; Humans ; Incidence ; Pancreatic Fistula* ; Pancreaticoduodenectomy ; Pancreaticojejunostomy* ; Sepsis ; Sutures

PURPOSE: Taurolidine is an antimicrobial agent that was originally used in the local treatment of peritonitis. The aim of this study was to evaluate the efficacy of taurolidine irrigation in primary total knee arthroplasty (TKA). MATERIALS AND METHODS: All patients who underwent TKA at our institute from January 2015 to March 2017 were eligible. There were 300 patients in the taurolidine irrigation group and 300 patients in the control group. The patients in the taurolidine irrigation group were irrigated after implantation with a mix of 250 mL of taurolidine and 750 mL of normal saline. The patients in the control group were not irrigated after implantation. We compared postoperative C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and infection rate between groups. RESULTS: The taurolidine irrigation group had a significantly lower CRP (5.39 mg/dL vs. 7.55 mg/dL; p<0.001) and ESR (53.21 mm/hr vs. 58.74 mm/hr; p=0.003) on postoperative day 3 after TKA, as compared with the control group. However, there was no difference between the two groups on postoperative days 6, 13, and 20. Periprosthetic joint infection occurred in one patient in the taurolidine irrigation group. CONCLUSIONS: We believe that it is not necessary to use taurolidine for patients who undergo primary TKA.
Arthroplasty ; Arthroplasty, Replacement, Knee ; Blood Sedimentation ; C-Reactive Protein ; Humans ; Joints ; Knee ; Peritonitis

BACKGROUND: Soluble epoxide hydrolase (sEH) is an enzyme that converts epoxyeicosatrienoic acid (EET) into the anti-inflammatory dihydroxyeicosatrienoic acids (DHET). Inhibition of sEH by the potent soluble epoxide hydrolase inhibitor (sEHI) decreases inflammation by increasing EET. The K/BxN serum transfer mouse model of arthritis displays an initial inflammation and an associated tactile allodynia that continues on following the resolution of inflammation. METHODS: We undertook the following studies: i) Using the K/BxN mouse model, we examined effects on allodynia during the early inflammatory phase of administration of sEHI 3 mg/kg and/or diclofenac (DFC) 10 mg/kg. ii) In the late inflammatory phase, we administered sEHI (3, 10, or 30 mg/kg); DFC 10 mg/kg; gabapentin 100 mg/kg. iii) Using the conditioned place preference (CPP) we examined the synergism between sEHI and DFC in the K/BxN mouse using the CPP paradigm. The drug was administered intraperitoneally and the allodynia was measured with the von Frey test. RESULTS: In the early phase, both sEHI and DFC displayed an antiallodynic action. In the late phase, sEHI, and gabapentin but not DFC were effective in reversing the allodynia. Comparable results were observed with the CPP. CONCLUSIONS: This study demonstrates that sEHI reduces mechanical allodynia in both the early and the late inflammatory K/BxN mouse model of arthritis. The sEHI target thus addresses the hyperalgesia arising from inflammation as well as the post-inflammatory phase that has been said to reflect neuropathic-like states, thus presenting alternatives to the limited efficacy of arthritis drugs in use.
Animals ; Arthritis* ; Diclofenac ; Hyperalgesia ; Inflammation ; Mice*