Herpes simplex esophagitis has been recognized with increased frequency as an opportunistic infection in immunosuppressed or debilitated patients. However, it is also documented as self-limited esophagitis in apparently healthy patients. We report two cases of herpetic esophagitis diagnosed by biopsies. One case was noted in an immunocompetent patient having gastric peptic ulcer who had clinical improvement with symptomatic treatment. And the other was noted in an immunosuppressed patient having chemotherapy for gastric carcinoma who had resolution of symptoms with acyclovir therapy. Histologically, esophageal mucosa exhibited erosion and inflammatory cellular exudate with intranuclear eosinophilic inclusions in the epithelial cells. These were confirmed by the PCR and immunohistochemical stain for herpes simplex virus using a biopsy material.
Acyclovir ; Biopsy ; Drug Therapy ; Eosinophils ; Epithelial Cells ; Esophagitis* ; Exudates and Transudates ; Herpes Simplex* ; Humans ; Mucous Membrane ; Opportunistic Infections ; Peptic Ulcer ; Polymerase Chain Reaction ; Simplexvirus

PURPOSE: We investigated the relationship between thyroid hormone and serum tumor necrosis factor (TNF-alpha), interleukin (IL-6) and N-terminal fragment of pro-brain natriuretic peptide (NT-proBNP) in patients with Kawasaki disease (KD). METHODS: Serum levels of thyroid hormone, TNF-alpha, IL-6, and NT-proBNP were measured in 52 KD patients in the acute and subacute phase and 10 patients with acute febrile illness (control group). TNF-alpha and IL-6 were determined by sandwich enzyme-linked immunosorbent assay (ELISA). Echocardiography was performed to detect coronary artery lesions (CAL) in KD patients. RESULTS: Low T3 syndrome occurred in 63.5% of KD patients. T3 in the acute phase of KD was lower than that in the control. In KD patients, T3 was lowered in the acute phase and elevated in the subacute phase, whereas TNF-alpha, IL-6 and NT-proBNP were elevated in the acute phase and decreased in the subacute phase. NT-proBNP, and IL-6 were higher in patients with low T3 than in those with normal T3. In addition, T3 inversely correlated with IL-6 and NT-proBNP. Of the 4 patients with CAL, 3 had very low T3. Compared with intravenous immunoglobulin (IVIG)-responsive patients, IVIG-resistant patients had lower T3 and higher IL-6 and NT-proBNP. CONCLUSION: T3 decreases in the acute phase of KD and normalizes in the subacute phase without thyroid hormone replacement. Low T3 may be partially induced by IL-6 rather than TNF-alpha, and is strongly associated with high NT-proBNP. T3 in KD may be used for the differential diagnosis, monitoring the activity of the disease, and predicting the severity of inflammation.
Coronary Vessels ; Diagnosis, Differential ; Echocardiography ; Enzyme-Linked Immunosorbent Assay ; Euthyroid Sick Syndromes ; Humans ; Immunoglobulins ; Inflammation ; Interleukin-6 ; Interleukins ; Mucocutaneous Lymph Node Syndrome ; Natriuretic Peptide, Brain ; Peptide Fragments ; Thyroid Gland ; Tumor Necrosis Factor-alpha

A Clinical observation on 272 cases of epidemic encephalitis admitted to the Department of Pediatrics, Chonnam University Hospital with 5 year duration from 1971 to 1975 was carried out and the serum protein fractions were studied paperelectrophoretically on 28 cases in 1975 The following results are obtained. : 1) The peak age group was from 6 to 10 years old, and the male to female ratio was 1.7:1 2) The complaints on admission were fever(100%), neck stiffness(78.3%), Kernig's sign(71.7%), vomiting(64.0%), unconsciousness(59.6%), and headache(57.4%), in order of frequency. 3) Laboratory findings were as follows ; In the most cases(79.4%), peripheral leukocytosis with increased polymorphocyte was noted. And the findings of C.S.F. showed; Pleocytosis (98.5%), increased protein content(90.1%), normal or slightly increased sugar content(97.8%) and within normal limits of chloride level. 4) Mortality rate was 20.2% 5) The total protein and beta-globulin level showed no change and decreased albumin and A/G ratio. The gamma-globulin level showed increased initially and thereafter decreased to normlal limits gradually.
Beta-Globulins ; Child ; Encephalitis, Arbovirus* ; Female ; gamma-Globulins ; Humans ; Jeollanam-do ; Leukocytosis ; Male ; Mortality ; Neck ; Pediatrics

PURPOSE: To determine the result of early surgery for intermittent exotropia for children under 4 year old and the factors which affect it. METHODS: The study subjects consisted of 25 children younger than 4 years who had received surgery for intermittent Exotropia. They were followed up for more than 1 year after surgery by the Department of Ophthalmology of the Gachon Medical School, between July 1998 and December 2003. The interval from onset to initial surgery, preoperative deviation angle, dissociated vertical deviation, stereopsis, preoperative patching, type of surgery, and initial postoperative deviation angle were compared and analyzed in a retrospective manner. RESULTS: The average age of the subjects and the preoperative deviation angle were 3.2 years and 28.67+/-8.08PD respectively. The average deviation angle at postoperative year 1 was 5.60+/-8.69PD. Out of the 25 patients, 19 (76%) showed a deviation angle less than 10PD were and 4 (16%) had recurrence of exotropia. Consecutive esotropia occurred in 2 (8%). The clinical factor statistically related to results was the initial postoperative deviation angle. The group who had esophoria of more than 10 PD (18.27+/-6.18 PD) showed 93% orthophoria at postoperative year 1, which was statistically significant. CONCLUSIONS: Though a patient be under 4 years old, if their deviation angle is in progress or if non-surgical treatment is ineffective in the case when surgery is delayed, it is presumed that performing surgery at postoperative day 1 with an overcorrection of about 10 PD is preferred.
Child* ; Child, Preschool ; Depth Perception ; Esotropia ; Exotropia* ; Humans ; Ophthalmology ; Recurrence ; Retrospective Studies ; Schools, Medical

PURPOSE: To examine the difference of clinical features according to age of onset of refractive accommodative esotropia. METHODS: We retrospectively analyzed the medical record of 52 cases of refractive accommodative esotropia for more than 12 months of follow-up from March, 2000 to December, 2003. The factors we compared were gender, age of first ocular examination, interval from age of onset to first glasses, preoperative refractive error, amount of deviation corrected with hyperopic glasses, stereopsis and associated ocular conditions. RESULTS: Cases were grouped according to age of onset. Fourteen (27%) patients were less than 2 years old., 32 (62%) were between 2 to 4 years old, and 6 (11%) were between 4 to 6 years old 6. the group less than 2 years old showed lower levels of preoperative refractive error than the group more than 2 years old. The younger the age of onset, the lager the deviation angle without hyperopic glasses. There were no differences according to age of onset in gender, interval from age of onset to first glasses, stereopsis, anisometropia or amblyopia. CONCLUSIONS: In refractive accommodative esotropia, the younger the age of onset is, the lager the deviation angle without hyperopic glasses and the greater the deviation can be corrected with hyperopic glasses.
Age of Onset* ; Amblyopia ; Anisometropia ; Child ; Child, Preschool ; Depth Perception ; Esotropia* ; Eyeglasses ; Follow-Up Studies ; Glass ; Humans ; Medical Records ; Refractive Errors ; Retrospective Studies

OBJECTIVES: To compare the self-rated health in chronic disease patients with depression, chronic disease patients, and depression patients, and to observe the related factors to the self-rated health of people age 65 and older. METHODS: The subjects were 2,549 elderly people, over 65 years old in Busan Metropolitan City who participated in 2009 community health survey. Association between self-rated health and general characteristics, life style and disease status were observed. Depressive symptoms were measured using the Centre for Epidemiologic Studies Depression Scale (CES-D). Analysis of complex sample was done with SAS (ver. 9.2), using chi2-test and multiple logistic regression. RESULTS: Among total 2,549, there were 740 normal people (29.8%), 50 people with depression (1.8%), 1,495 people with other chronic diseases (58.2%), and 264 people with the comobidity of depression and other chronic diseases (10.1%). Good self-related health accounted for 20.3% for the whole, 33.4% for normal, 16.7% for chronic disease, 16.1% for depression, and 3.2% for chronic diseases with depression. Disease, gender, education, income, alcohol drinking, regular exercise and regular walking were independent factors associated with the good self-related health. CONCLUSIONS: It is suggested that when the chronic disease control program for the elderly is developed, depression care should be considered along with the program. This program should be given priority to the women and the vulnerable classes and should also be related to the regular walking.
Aged ; Alcohol Drinking ; Chronic Disease ; Depression ; Epidemiologic Studies ; Female ; Health Surveys ; Humans ; Life Style ; Phenothiazines ; Walking

Sustained abnormal liver function is closely associated with chronic hepatitis in Korea with high prevalence of hepatitis B infection. Follow up about AST and ALT on 839 adults(male 727, female 112) was executed with interval of at least 6 months for 2 years to evaluate the factors contribute to the progression of chronic hepatitis. HBsAg, HBsAb, anti-HCV, body mass index(BMI), total cholesterol, fasting blood sugar(FBS), Clonorchis sinensis in stool(Cs), fatty liver on abdominal sonogram and alcohol habit were also checked. We defined abnormal liver function as both of AST 35 U/L and ALT 50 U/L. As the result of first time liver function test(LFT), the frequency of abnormal liver function was 13.6%(114/839). The positive rate of HBsAg and HBsAb was 7.0% and 73.9%, respectively, and the positive rate of anti-HCV and Cs was 0.7% and 1.3%. As the result of the follow up, 6.2%(52/839) in total has a tendency of chronic hepatitis with sustained abnormal LFT. Among abnormal LFT, 45.6%(52/114) was sustained LFT abnormality, and 12.8%(93/725) was aggravated LFT abnormality from normal LFT at the first check. From these results, male and hepatitis B infection were evaluated as important factors for the progression of chronic hepatitis. HBsAb considered that has a protective effect to the progression of chronic hepatitis. Therefore, even though no symptoms or sign, periodic examination for hepatitis B marker and LFT is important to control the chronic hepatitis, especially for male. Furthermore, because only 25%(13/52) of sustained abnormal LFT was HBsAg positive, it suggests that further study for evaluating the factors except hepatitis B infection would be needed for the control of chronic hepatitis.
Cholesterol ; Clonorchis sinensis ; Fasting ; Fatty Liver ; Female ; Follow-Up Studies ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis, Chronic* ; Humans ; Korea ; Liver ; Male ; Prevalence ; Transaminases*

OBJECTIVES: To determine the prevalence and related factors of work related musculoskeletal symptoms in hairdressers. METHODS: Informations on general characteristics, job strain, and musculoskeletal symptoms were obtained by a self-administered questionnaire, through adopting NIOSH instrument and JCQ(Job content questionnaire), from 267 hairdressers, between March and May, 2000. RESULTS: The symptom prevalence by NIOSH surveillance criteria in total was high as 94.4%; shoulder (61.0%), neck (59.9%), low back (53.2%), hand and wrist (41.6%), etc. In multiple logistic regression, significant factors affecting the symptoms by body region; job insecurity on neck' gender, alcohol, decision latitude on low back; alcohol on hand and wrist; smoking on thigh and knee,' smoking, decision latitude on ankle and foot; job insecurity on upper back. CONCLUSIONS: Musculoskeletal symptoms of hairdresser were highly prevalent, and associated with job strain and their health habits. This is a basic data of work related musculoskeletal disorders among hairdressers who are not the subjects of occupational health service at the present time in Korea.
Ankle ; Body Regions ; Foot ; Hand ; Korea ; Logistic Models ; National Institute for Occupational Safety and Health (U.S.) ; Neck ; Occupational Health Services ; Prevalence ; Questionnaires ; Shoulder ; Smoke ; Smoking ; Thigh ; Wrist

The diagnostic accuracy of echocardiography alone and the safety of cardiac surgery using this diagnostic approach were retrospectively assessed in 111 children operated for congenital heart defects (CHD) during a 3.5-yr period ending in October 2001. Preoperative diagnosis was compared with the intraoperative findings obtained by surgical inspection. Perioperative death was defined as death within 30 days postoperatively. Of the patients, 70% were operated on in infancy. Seventy-six percent (84 of 111) underwent surgery after echocardiographic diagnosis alone. A high percentage of patients with patent ductus arteriosus (100%), partial atrioventricular canal (100%), coarctation of the aorta (89%), ventricular septal defect (86%), atrial septal defect (85%), and total anomalous pulmonary venous connection (75%) was operated without prior catheterization. Diagnostic errors occurred in 2.4% (2 of 84) of patients with echocardiography only and in 7.4% of patients with catheterization. No error in either group was related to surgical morbidity or mortality. There were five (6.0%) perioperative deaths in the echocardiography group and two (7.4%) in the catheterization group, with no difference in the mortality between the groups. In conclusion, many patients with CHD can be accurately diagnosed by echocardiography alone, and can safely undergo surgery without catheterization, not increasing the overall risk.
Adolescent ; *Cardiac Surgical Procedures ; Child ; Child, Preschool ; Diagnostic Errors ; *Echocardiography ; Heart Catheterization ; Heart Defects, Congenital/*surgery/*ultrasonography ; Humans ; Infant ; Infant, Newborn ; Perioperative Care ; Predictive Value of Tests ; Retrospective Studies

BACKGROUND: Bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) is known as an effective neurosurgical procedure for the treatment of advanced Parkinson disease (PD). Although short- and long-term effects of STN stimulation in PD are relatively well known, an interim analysis of its efficacy is essential for us to continue with this procedure in the future. We present the clinical outcome of 6 month follow-up in patients who were assessed in our hospital after bilateral STN stimulation. METHODS: Twenty-nine patients with PD treated with bilateral STN DBS were included in this study. The effect of STN DBS was assessed at 6 months after surgery, which included the followings; motor disability in 'DBS- off/on, medication-off/on' states, activity of daily living (ADL) in 'medication-off/on' states, levodopa-induced motor complication, daily levodopa and levodopa-equivalent dosage, neuropsychological assessment and quality of life. RESULTS: Nineteen patients completed the follow-up assessment. STN stimulation produced significant improvements in the motor disability score both during 'medication-off' and 'medication-on' states. The ADL score was improved only in 'medication-off' states. The amount of levodopa-induced dyskinesia and response fluctuation also significantly decreased. Scores of Korean version of Mini-mental status examination (K-MMSE), Korean version of Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) and Beck Depression Inventory (BDI) did not change. Daily levodopa and levodopa-equivalent dosages were significantly reduced. No serious side effect was encountered. CONCLUSIONS: Bilateral STN DBS is a relatively safe and beneficial treatment for PD patients with levodopa- induced motor complications. In order to obtain a better prognosis in the future, we should assess the long-term outcome and the clinical predictive factors of STN DBS.
Activities of Daily Living ; Alzheimer Disease ; Deep Brain Stimulation ; Depression ; Dyskinesias ; Follow-Up Studies ; Humans ; Levodopa ; Neurosurgical Procedures ; Parkinson Disease ; Prognosis ; Subthalamic Nucleus