A 19-year-old man noticed a very slowly spreading erythematous macular lesion on his cheek when he was 5 years old. This asymptomatic and well circumscribed patch was covered with fine scales. He sought first medical attention at the age of 12 years and diagnosis was cutaneous tuberculosis was made by skin biopsy. Seven years after the second biopsy was made and it revealed a few spores within giant cells in the upper dermis. By mycologic study, it was identified as Paecilomyces lilacinus. The patient was put on the treatment of topical and oral antifungal agents. The skin lesion showed signs of improvement after 12 weeks of treatment.
Antifungal Agents ; Biopsy ; Cheek ; Child, Preschool ; Dermis ; Diagnosis ; Giant Cells ; Humans ; Paecilomyces* ; Skin ; Spores ; Tuberculosis, Cutaneous ; Weights and Measures ; Young Adult

Argon laser trabeculoplasty(ALT) is commonly used in the treatment of uncontrolled open angle glaucoma. The authors retrospectively reviewed the efficacy of ALT in 52 patients(57 eyes) with primary open angle glaucoma. The mean follow-up was 28 months(range 2-48 months). The decrease in intraocular pressure 10P) was 10.1 +/- 3.5 mmHg at 1 month, 8.2 +/- 2.8 mmHg at 1 year, 6.2 +/- 5.1 mmHg at 2 years and 51% at 3 years. Failure was most common in the first 6 months after treatment(29%) and thereafter failure occurred at a rate of 5% to 15% per year. The sex and age of patients had no significant effect on success rate. The success rate was high in the patients with baseline IOP of 26 to 30 mmHg. A mild iritis in all cases, transient rise in IOP, peripheral anterior synechia and microscopic hyphema were noted as early complications of ALT.
Argon* ; Follow-Up Studies ; Glaucoma, Open-Angle* ; Humans ; Hyphema ; Intraocular Pressure ; Iritis ; Retrospective Studies ; Trabeculectomy*

The Flash Light Emitted Diode Flash Visual Evoked Potential(Flash VEP) is useful when patients are unable to cooperate sufficiently for a Pattern Reversal Visual Evoked Potential(RP-VEP). In order to evaluate the clinical utility of Flash VEP, we performed the PR-VEP and Flash VEP in 208 eyes of 104 normal persons. The average P100 latency(LaP100) was analyzed according to check size, age, sex, and the laterality of the eye. The LaP100 of PR-VEP stimulated with 8 X 8(120' X 96'), 16 X 16(60' X 48'), 32 X 32 (30' X 24') and 64 X 64(15' X 12') check size were 98.88 +/- 7.57msec(mean S.D msec) , 97.68 +/- 7.44msec, 96.31 +/- 7.21msec, 101.20 +/- 7.81msec, respectively. The LaP100 of PR-VEP stimulated with 32 X 32 check size at 3rd, 4th, 5th, 6th and 7th decades were 93.95 +/- 5.61msec, 94.70 +/- 7.71msec, 92.92 +/- 6.28msec, 97.78 +/- 6.24 msec, 102.79 +/- 5.27msec, respectively. The LaP100 of PR-VEP remained relatively stable until over 6th decade when it increased significantly (p<0.05). The LaP100 of FlashVEP in age of 3rd, 4th, 5th, 6th and 7th decade were 87.08 +/- 7.82msec, 91.07 +/- 8.46msec, 99.37 +/- 6.36msec, 105.30 +/- 7.82msec, and 111.62 +/- 5.54msec, respectively. The LaP100 of Flash YEP increased progressively with aging changes(p<0.05). There were no statistically significant differences between the left and right eyes(p>0.05), and between male and female(p>0.05) in the LaP100 of both VEP. These results showed that LaP100 of PR-VEP changes according to the check size and patient's age. We should interprete the LaP100 of PR-VEP or Flash VEP after the processing of averaging its P100 according to the patient's.
Aging ; Humans ; Male

It is recognized that rebleeding of traumatic hyphema may predispose patients to several complications including decreased visual acuity. We reviewed the medical records of 92 patients(92 eyes) with the diagnosis of nonperforating traumatic hyphema. The relative efficiencies of Aminocaproic acid and systemic Predisolone for reducing rate of rebleeding and their side effects were evaluated under the statistical analysis. Fourty-seven patients received an oral dosage of 50 mg/kg of Aminocaproic acid every 4 hours for 5 days(up to a maximum 30 gm/day), and fourty-five patients took an oral dosage of 0.6 mg/kg of Prednisolone daily in two devided doses. The frequency of rebleeding was not statistically significantly different between the aminocaproic acid treated group(4.3%, 2/47 patients) and the prednisolone treated group(6.7%, 3/45 patients). The developing rates of their acute adverse reaction were statistically different between the aminocaproic acid treated group(44.7%, 21/47 patients) and the prednisolone treated group(20%, 9/45 patients).
Aminocaproic Acid* ; Diagnosis ; Humans ; Hyphema* ; Medical Records ; Prednisolone* ; Visual Acuity

BACKGROUND: We developed a new disposable anaerobic culture system, namely, the Quick anaero-system, for easy culturing of obligate anaerobes. METHODS: Our system consists of 3 components: 1) new disposable anaerobic gas pack, 2) disposable culture-envelope and sealer, and 3) reusable stainless plate rack with mesh containing 10 g of palladium catalyst pellets. To evaluate the efficiency of our system, we used 12 anaerobic bacteria. We prepared 2 sets of ten-fold serial dilutions of the 12 anaerobes, and inoculated these samples on Luria-Bertani (LB) broth and LB blood agar plate (LB-BAP) (BD Diagnostic Systems, USA). Each set was incubated in the Quick anaero-system (DAS Tech, Korea) and BBL GasPak jar with BD GasPak EZ Anaerobe Container System (BD Diagnostic Systems) at 35-37degrees C for 48 hr. The minimal inoculum size showing visible growth of 12 anaerobes when incubated in both the systems was compared. RESULTS: The minimal inoculum size showing visible growth for 2 out of the 12 anaerobes in the LB broth and 9 out of the 12 anaerobes on LB-BAP was lower for the Quick anaero-system than in the BD GasPak EZ Anaerobe Container System. The mean time (+/-SD) required to achieve absolute anaerobic conditions of the Quick anaero-system was 17 min and 56 sec (+/-3 min and 25 sec). CONCLUSIONS: The Quick anaero-system is a simple and effective method of culturing obligate anaerobes, and its performance is superior to that of the BD GasPak EZ Anaerobe Container System.
Bacteria, Anaerobic/*growth &development ; Bacteriological Techniques/instrumentation/methods ; Culture Media/chemistry ; Gases/chemistry ; Palladium/chemistry ; Reagent Kits, Diagnostic

PURPOSE: We analyzed the preoperative and postoperative clinical findings of orbital wall fracture patients between the group operated within 2 weeks (early group) and the group operated 3 weeks or later (delayed group). METHODS: Eighty three patients who had been operated from January 1997 to December 2001 were included, 68 patients were early group and 15 patients were delayed group. We analyzed retrospectively the degree of diplopia, limitation of extraocular motility and enophthalmos for more than 6 months following surgery. RESULTS: Orbital wall fracture predominantly occurred in male than in female (p>0.05), and mostly between 21 and 40 years old. The main cause was from violence and traffic accidents. The major coexisting diseases were head trauma and fractures of low extremities, especially in the group of delayed operation. The common locations of fracture were either inferior wall or combined inferior and medial walls. The early group showed less severe preoperative clinical states and better outcomes of postoperative improvement than the delayed group. However, there was no statistically significant difference between two groups in the degree of postoperative limitation of extraocular motility and enophthalmos. CONCLUSIONS: The early group tended to be less severe preoperatively and showed better postoperative outcome than the delayed group. However, the repair of orbital wall fracture was be indicated to improve clinical states even after 3 weeks following injury.
Accidents, Traffic ; Adult ; Craniocerebral Trauma ; Diplopia ; Enophthalmos ; Extremities ; Female ; Humans ; Male ; Orbit* ; Retrospective Studies ; Violence

PURPOSE: We undertook this study to evaluate the significance of p53 immunoreactivity in squamous cell carcinoma of the cervix, treated with radiotherapy alone. MATERIALS AND METHODS: Immunohistochemical staining of p53 proteins were performed in eighty patients with squamous cell carcinoma of the cervix, and who completed curative radiotherapy between Jan. 1996 and Apr. 1998 at the Department of Therapeutic Radiology, Chonnam National University Hospital. External- beam radiotherapy was combined with intracavitary brachytherapy. Results were analyzed for the end points of pelvic tumor control and distant failure rates. The follow-up time ranged from 7 to 58 months with a median of 40 months. RESULTS: p53 positive and negative groups involved 45 and 35 patients, respectively, and the positive p53 immunoreactivity rate was 56% (45/80). p53 immunoreactivity showed no significant correlation with age, tumor size, serum tumor marker (SCC), or HPV18 expression, while there was a statistically marginally significant correlation with HPV16 expression. The pelvic tumor control rate of the p53 positive group was 87% and that of p53 negative group was 83% (0.05). The other parameters influencing negatively to the pelvic tumor control and with statistical significance were tumor ulceration and barrel type. Multivariate analysis also showed that p53 immunoreactivity had no prognostic value for pelvic tumor control of the disease, and that the statistically significant factor was tumor ulceration. The treatment failure rate of the p53 positive group was 23% and that of the negative group was 26% (p>0.05). CONCLUSION: p53 immunoreactivity in the cervix cancer stage IB, II patients seems to have no value as a predictor of tumor behavior after curative radiotherapy.
Brachytherapy ; Carcinoma, Squamous Cell* ; Cervix Uteri* ; Female ; Follow-Up Studies ; Humans ; Jeollanam-do ; Multivariate Analysis ; Radiation Oncology ; Radiotherapy* ; Treatment Failure ; Ulcer ; Uterine Cervical Neoplasms

Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is the most common form of primary extranodal lymphomas. In most cases, it is developed as multifocal and mucosal lesions, and its initial diagnosis is made by biopsy of suspicious lesions on endoscopy. However, when gastric MALT lymphoma afflict submucosal site without typical mucosal lesion, further procedures are necessary for diagnosis, such as endoscopic mucosal resection and endoscopic ultrasonography. We recently experienced two cases of submucosal tumor-like gastric MALT lymphoma. Both cases were without any mucosal lesion. One case was confirmed by endoscopic mucosal resection, and the latter was by wedge resection. Treatment modalities included endoscopic mucosal resection, surgery, H. pylori eradication, and/or chemotherapy. Both cases achieved complete remission until our 18 months' and 16 months' follow up.
Anti-Bacterial Agents/therapeutic use ; Endosonography ; Female ; Gastric Mucosa/*pathology ; Gastroscopy ; Helicobacter Infections/drug therapy ; Helicobacter pylori ; Humans ; Lymphoma, B-Cell, Marginal Zone/*diagnosis/pathology/surgery ; Male ; Middle Aged ; Stomach Neoplasms/diagnosis

PURPOSE: In response to a growing threat of violence in hospitals, we examined a specific educational effort to reduce emergency department (ED) violence in the shortterm. METHODS: Cross-sectional prospective surveys were conducted at Chosun University Hospital Emergency Center during a baseline period from May 26 to Jul. 9. 2003, and during a post-education period from Aug. 7 to Sep. 20. 2003. Questions addressed the degree of violence, the reason for the violence, demographic information about the perpetrator of the violence, the outbreak time of the violence and the response of emergency personnel. RESULTS: After an education program on violence, the rate of violent events in the ED was decreased by 23.5%. A notable change was that ED workers handled the violence more positively during the post-education period by isolating or restraining the aggressor. Almost all of the violence was caused by males, particularly those in their third or fourth decade. The violence occurred mostly on the night shift. Of the violence, 52.4% was caused by the patient while 34.8% was caused by the patient's guardian. The leading causes of violence were drunkenness and delays in laboratory tests and treatment. Verbal abuse and threats were the most concern forms of violence. CONCLUSION: Violent events are frequent in the ED. Education programs may reduce the number of events at least temporarily.
Alcoholic Intoxication ; Education* ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Male ; Prospective Studies ; Violence*

Neuromyelitis optica(Devie's disease) is a demyelinating disorder of unknown etiology that is characterized by bilateral acute optic neuritis, associated with transverse myelitis. The authors experienced a case of Neuromyelitis optica in a 28 year old female who developed acute visual disturbance, sensory loss under the thoracic dermatome 8, and paraplegia, shortly after upper respiratory infection. Bilateral acute optic neuritis was noted with abnormal visually evoked potential. We confirmed this case by neurologic features, magnetic resonance imaging, and cerebrospinal fluid finding, and treated with Corticosteroid "pulse therapy".
Adult ; Cerebrospinal Fluid ; Demyelinating Diseases ; Evoked Potentials ; Female ; Humans ; Magnetic Resonance Imaging ; Myelitis, Transverse ; Neuromyelitis Optica* ; Optic Neuritis ; Paraplegia