Rhinoscleroma is a chronic, granulomatous infectious lesion most frequently affecting the respiratory tract mucosa. This disease is endemic to Africa, Central and South America, South Central and Eastern Europe, the Middle East, and China. We report an extremely rare disease of nasal rhinoscleroma in Korea. The patient was a 63-yr-old man, who suffered from chronic nasal obstruction and septal deviation. Characteristic histology from a nasal biopsy was proven and special stains for bacteria were employed: periodic acid-Schiff, Warthin-Starry silver, Giemsa, and Gram stains. Isolation of Klebsiella rhinoscleromatis from a culture of nasal discharge was failed, but ultrastructural examination of numerous phagocyzed bacilli in the Mikulicz cells confirmed the diagnosis. The histiocytic nature of the Mikulicz cells was confirmed, using CD 68 and alpha-1 antitrypsin, and by the ultrastructural features of Mikulicz cells. Here, we emphasize the recognition of this rare entity in nonendemic regions, frequently leading to delayed diagnosis.
Endemic Diseases ; Fibrosis ; Human ; Klebsiella pneumoniae/*isolation & purification ; Korea ; Male ; Microscopy, Electron ; Middle Aged ; Nasal Mucosa/*microbiology/pathology/ultrastructure ; Rhinoscleroma/*pathology

No abstract available.
Alcoholics* ; Erythrocyte Indices* ; Humans

Tetrodotoxin (TTX) cause neurologic dysfunction by blocking the voltage-gated sodium channels located in all of the peripheral nerves and muscles. We experienced two patients presenting with generalized motor weakness after ingestion of pufferfish. The nerve conduction study showed diffuse slowing of motor and sensory nerve conduction velocity, prolonged motor terminal latency and decreased sensory nerve action potentials without temporal dispersion or conduction block. Abnormal findings of nerve conduction study improved rapidly without any deterioration. Clinical symptoms and signs ameliorated in accordance with findings of nerve conduction study without any neurologic sequelae. These imply that tetrodotoxication is reversible and functional neurologic disorder. We suggest that nerve conduction studies can be available in serial monitoring of tetrodotoxication as an objective means.
Action Potentials ; Eating ; Humans ; Muscles ; Nervous System Diseases ; Neural Conduction ; Neurologic Manifestations ; Peripheral Nerves* ; Tetraodontiformes ; Tetrodotoxin ; Voltage-Gated Sodium Channels

PURPOSE: This study was designed to examine the effects of a weight control program on body weight and the sense of efficacy for control of dietary behavior in psychiatric inpatients. METHODS: A quasi-experimental design was used. Data were collected from March 1 to September 30, 2007. Female mentally ill patients in closing psychiatry ward of H University Hospital participated in the study (16 persons in the experimental group and 13 in the control group). RESULTS: The weight control program including diet therapy, exercise, education and behavior modification therapy decreased the rate of weight gain in female mentally ill patients taking atypical antipsychotics, and effectively increased a sense of efficacy for control of dietary behavior. CONCLUSION: Weight control program had a positive effect as a nursing intervention to decrease obesity and to increase the sense of efficacy for control of dietary behavior of psychiatric inpatients in psychiatric inpatients.
Adult ; Cognitive Therapy ; Diet Therapy ; Exercise ; Female ; Health Behavior ; Hospitals, Psychiatric ; Humans ; Inpatients/psychology ; Mentally Ill Persons/*psychology ; Middle Aged ; Patient Education as Topic ; Psychiatric Nursing ; *Weight Loss

PURPOSE: Many investigators suggested that changes in hormonal environment in the postmenopausal women functionally or histologically effect the clitoris and vagina. We investigated the mechanism of female se xual dysfunction occurring in the decreased hormonal status, and aimed to establish and experimental base for the hormone replacement in postmenopausal women to correct sexual dysfunction. MATERIALS AND METHODS: Twenty mature female New Zealand white rabbits were randomly divided into three groups; control group, oophorectomy group, estrogen replacement group after oophorectomy. Nitric oxide synthase (NOS) activity and the degree of expression of neuronal NOS (nNOS) and endothelial NOS (eNOS), collagen content in clitoral tissues were analysed. RESULTS: nNOS and eNOS were significantly increased in the oohporectomized group while decreased in the estrogen replacement group (p<0.01). NOS activity showed the similar pattern of change (p<0.05). Oophorectomy induced a significant increase in collagen content, while the ratio of smooth muscle content was increased significantly after the estrogen replacement (p<0.01). CONCLUSIONS: Estrogen deficiency induces collagen synthesis and decreases the content of smooth muscle in clitoris, resulting in a structural relaxation difficulty. We believe that NOS becomes more active to improve the relaxation difficulty and that hormone replacement helps to restore the normal state of smooth muscle relaxation. Considering these findings, we suggest that estrogen down-regulates NOS and its activity.
Clitoris* ; Collagen ; Estrogen Replacement Therapy ; Estrogens* ; Female ; Humans ; Muscle, Smooth ; Neurons ; Nitric Oxide Synthase ; Ovariectomy ; Rabbits ; Relaxation ; Research Personnel ; Vagina

Behcet's disease is a multisystem autoimmune disease with vasculitic features, and major vascular involvement occurs in 7.7-60% of patients. Venous lesions are more common than arterial lesions and arterial thrombotic events are relatively rare. We report a patient with Behcet's disease who developed a splenic infarct associated with splenic thrombotic arteritis. A 44-year-old man who had been diagnosed with Behcet's disease 5 years earlier presented with left flank pain lasting for 5 days. Laboratory tests revealed an elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Computed tomography (CT) and three-dimensional CT showed a wedge-shaped splenic infarct and thrombus in the splenic artery. We treated him with low-molecular-weight heparin and prednisolone. The symptoms improved within 6 days of hospitalization, after which we stopped the heparin and added methotrexate and azathioprine. Splenic infarct should be ruled out if patients with Behcet's disease complain of new left-sided abdominal pain.
Abdominal Pain ; Adult ; Arteritis ; Autoimmune Diseases ; Azathioprine ; Blood Sedimentation ; C-Reactive Protein ; Flank Pain ; Heparin ; Heparin, Low-Molecular-Weight ; Hospitalization ; Humans ; Methotrexate ; Prednisolone ; Splenic Artery ; Splenic Infarction ; Thrombosis

Behcet's disease is a multisystem autoimmune disease with vasculitic features, and major vascular involvement occurs in 7.7-60% of patients. Venous lesions are more common than arterial lesions and arterial thrombotic events are relatively rare. We report a patient with Behcet's disease who developed a splenic infarct associated with splenic thrombotic arteritis. A 44-year-old man who had been diagnosed with Behcet's disease 5 years earlier presented with left flank pain lasting for 5 days. Laboratory tests revealed an elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Computed tomography (CT) and three-dimensional CT showed a wedge-shaped splenic infarct and thrombus in the splenic artery. We treated him with low-molecular-weight heparin and prednisolone. The symptoms improved within 6 days of hospitalization, after which we stopped the heparin and added methotrexate and azathioprine. Splenic infarct should be ruled out if patients with Behcet's disease complain of new left-sided abdominal pain.
Abdominal Pain ; Adult ; Arteritis ; Autoimmune Diseases ; Azathioprine ; Blood Sedimentation ; C-Reactive Protein ; Flank Pain ; Heparin ; Heparin, Low-Molecular-Weight ; Hospitalization ; Humans ; Methotrexate ; Prednisolone ; Splenic Artery ; Splenic Infarction ; Thrombosis

Recently, the incidence of pertussis has been increasing; however, reports on mixed infection of pertussis with other respiratory pathogens are rare in highly immunized populations. We report the case of a 10-year-old girl who presented with cough, post-tussive emesis, and fever. She was subsequently diagnosed with bronchopneumonia. Although she had received five doses of diphtheria-tetanus-acellular pertussis vaccine, polymerase chain reaction of her nasopharyngeal aspirate confirmed Bordetella pertussis infection. In addition, serologic testing for Mycoplasma pneumoniae was also positive. The patient was treated with roxithromycin without any complications. This is the first report of mixed B. pertussis and M. pneumoniae infection in Korea. To avoid under-diagnosis, pertussis should be considered in patients with chronic cough even when other respiratory pathogens have been documented.
Bordetella pertussis ; Bronchopneumonia ; Child* ; Coinfection ; Cough ; Female* ; Fever ; Humans ; Incidence ; Korea ; Mycoplasma Infections* ; Mycoplasma pneumoniae ; Mycoplasma* ; Pertussis Vaccine ; Pneumonia ; Pneumonia, Mycoplasma ; Polymerase Chain Reaction ; Roxithromycin ; Serologic Tests ; Vomiting ; Whooping Cough*

Background/Aims: Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) is integral to the diagnosis of gastrointestinal (GI) subepithelial tumors (SETs). The impact of different EUS-FNB tissue sampling techniques on specimen adequacy and diagnostic accuracy in SETs has not been fully evaluated. This study aimed to compare the diagnostic outcomes of slow-pull (SP) and standard suction (SS) in patients with GI SETs. Methods: In this retrospective comparative study, 54 patients were enrolled. Medical records were reviewed for location and size of the target lesion, FNB needle type/size, technical order, specimen adequacy, diagnostic yield, and adverse events. The acquisition rate of adequate specimens and diagnostic accuracy were compared according to EUS-FNB techniques. Results: The mean lesion size was 42.6±36.4 mm, and most patients were diagnosed with GI stromal tumor (75.9%). The overall diagnostic accuracies of the SP and SS techniques were 83.3% and 81.5%, respectively (p=0.800). The rates of obtaining adequate core tissue were 79.6% and 75.9%, respectively (p=0.799). No significant clinical factors affected the rate of obtaining adequate core tissue, including lesion location and size, FNB needle size, and final diagnosis. Conclusions SP and SS had comparable diagnostic accuracies and adequate core tissue acquisition for GI SETs via EUS-FNB.

BACKGROUND/AIMS: Spontaneous bacterial peritonitis (SBP) is one of critical complications in liver cirrhosis patients with ascites. We aimed to review clinical course of SBP patients in a 10-year period from single center. METHODS: This study enrolled SBP patients between 2005 and 2015. Their medical records were reviewed. The laboratory findings of serum and ascites were examined, and characteristics of isolated microorganisms in ascites were analyzed. RESULTS: Total 51 patients were enrolled. Male patients were predominant (64.7%), and mean age was 59.20 years. The most common etiology of cirrhosis was alcohol (41.2%), followed by hepatitis B (39.2%). Microorganism was isolated from the ascites in 31 patients (60.78%). The proportions of Gram negative and Gram positive were 80.64% and 19.36%. The proportions of Escherichia coli, Klebsiella, and Streptococcus species were 29.41%, 19.61% and 11.76%. Among Escherichia colis, 4 cases were ESBL positive (7.84%). The most commonly used first-line antibiotic was cefotaxime (80.40%). Prophylactic antibiotics treatment was performed only in 8 patients, and SBP was recurred in 7 patients (13.72%). When comparing the SBP recurrence group and the non-recurrence group, there were no significant differences in laboratory findings of serum and ascitic fluid. CONCLUSIONS: SBP is still a critical complication in cirrhosis patients with ascites, and the clinical features of SBP have not been altered much compared with those in 1990's. The effective treatment of SBP is still very important for a better prognosis of cirrhosis patients.
Anti-Bacterial Agents ; Ascites ; Ascitic Fluid ; Bacteria ; Cefotaxime ; Escherichia coli ; Fibrosis ; Hepatitis B ; Humans ; Klebsiella ; Liver Cirrhosis ; Male ; Medical Records ; Peritonitis* ; Prognosis ; Recurrence ; Streptococcus