Erythema multiforme is an episodic, self-limited, mucocutaneous, inflammatory disorder and the disease manifests as severe form is called Stevens-Johnson syndrome. It is most commonly precipitated by herpes simplex infection or drugs and the pathogenesis of the mucocutaneous lesion is thought to be related to immune complexes, cell-mediated immunity, or both. We experienced a case of Stevens-Johnson syndrome in 23-year-old female who had systemic bullous kin lesion and diffue mucopurulent conjunctivitis after use of oral acetazolamide for control of steroid-induced increased intraocular pressure after excimer laser photorefractive keratectomy, which has not been reported in Korea. So, we report this case with a review of the literature.
Acetazolamide* ; Antigen-Antibody Complex ; Conjunctivitis, Bacterial ; Erythema Multiforme ; Female ; Herpes Simplex ; Humans ; Immunity, Cellular ; Intraocular Pressure ; Korea ; Lasers, Excimer ; Photorefractive Keratectomy ; Stevens-Johnson Syndrome* ; Young Adult

No abstract available.
Staphylococcus aureus* ; Staphylococcus*

To elucidate iron utilization patterns of Staphylococcus aureus according to the growth, we checked the residual iron concentration and the production of siderophores at the indicated times while culturing S. aureus ATCC 6538 and 25923 strains in brain heart infusion broth. By using streptonigrin susceptibility test and investigating growth curves in three culture media of which iron concentration is 0.2, 20, 45 uM, respectively, we found out that iron metabolism of 6538 strain was more active than that of 25923 strain. In point of tendency of iron consumption, 6538 strain steeply consumed iron just before the onset of stationary phase, but 25923 strain did gradually iron throughout the growth phase. Nevertheless, total amount of iron consumed by each strain during the growth was almost no difference between the strains. CAS diffusion assay in detecting siderophores showed that siderophore production followed iron consumption. These results suggest that the siderophores play significant role in iron utilization in vitro.
Brain ; Culture Media ; Diffusion ; Heart ; Iron* ; Metabolism ; Siderophores ; Staphylococcus aureus* ; Staphylococcus* ; Streptonigrin

Patients undergoing monocular excimer laser photorefractive keratectomy (PRK) for myopic correction can develop strabismus secondary to decompensated heterophorias. We experienced a case of ocular esodeviation and diplopia that developed 8 nionths after monocular excimer laser phtorefractive keratectomy. So, we report this case with 8 review of the literature.
Diplopia ; Esotropia ; Humans ; Lasers, Excimer ; Photorefractive Keratectomy* ; Strabismus

No abstract available.
Child* ; Fistula* ; Humans

OBJECTIVES: This study investigated the health information such as the general health information, the health product information, and the hospital information, and we wanted to identify the association between internet health information and the health related behavior by analyzing the process after people search the Internet. METHODS: A telephone survey with structured questionnaire was performed by trained surveyors. The respondents were sampled proportionate to the Korean demographic distribution with considering the city size and the populations' ages and gender. The survey was conducted from October 2006 to November 2006. RESULTS: Out of 3,758 successfully connected persons of age 20 or more, 871(23.2%) respondents had used Internet health information during the last year. The purposes of searching the Internet for health was, 1) to get general health information (717 cases, 81.0%), 2) shopping for health product (109 cases, 12.3%) and 3) seeking information about hospital selection (59 cases, 6.7%). Our research showed that the process after searching the Internet for health information depends on the purpose of the search. 68.8% of the searchers for general health information, 67% of the searchers for health product shopping and 64.4% of the searchers seeking information to guide hospital selection were satisfied with their Internet search. However one third of the respondents reported not being satisfied with the result of the search. CONCLUSIONS: Unsatisfied consumers with internet health information tended to ask lay referrals from others or they gave up seeking health information. The health information system should be improved to increase the accessibility and to provide reliable and effective information. Also, a more user-centric community is needed in order to strengthen the effective role of lay referrals among the internet users.
Adult ; Consumer Health Information/*methods ; *Consumer Satisfaction ; Educational Status ; Female ; *Health Behavior ; Health Status ; Humans ; *Internet ; Male ; Middle Aged ; Residence Characteristics

BACKGROUND: As the rupture of chordae and/or papillary muscle became the main cause of mitral valve regurgitation, mitral reconstructive surgery has a very important role. In this regard, we analyzed the clinical result and postoperative early result of operative treatment performed in our hospital. MATERIAL ANDMETHOD: For this analysis, forty nine patients (male 26, female 23, mean age 49.0+/-16.5) who underwent mitral valve operation caused by the rupture of chordae and/or papillary muscle from August 1991 to April 2002 were reviewed. Among forty nine patients, twenty two (44.9%) received mital valve reconstruction and twenty seven (59.2%) received mitral valve replacement. RESULT: As to the pathological etiology of rupture of mitral and papillary muscle, twenty five cases (51.0%) were nonspecific degeneration, eleven cases (22.4%) were myxomatous degeneration, seven cases (14.3%) were subacute bacterial endocarditis. Three patients suffered mortality after operation (6.1%) and valve replacement was performed again on one patient because of remnant mitral insufficiency after valve reconstruction. The 5-year survival rate after operation for the entire mitral valve regurgitation patients was 81.4%. We have also compared and analyzed the operation results of a group of patients who underwent valve reconstruction and the other group of patients who underwent valve replacement from thirty six patients who had suffered from mitral valve regurgitation caused by degenerative disease. The mortalities were 0% and 14.3%, respectively and the 5-year survival rates were 90.2% and 64.3%, respectively, but there were no statistical significance. CONCLUSION: The most common pathological etiology of mitral valve regurgitation caused by rupture of chordae and/or papillary muscle was nonspecific degeneration. In case of degenerative disease is the cause of mitral valve regurgitation, valve reconstruction showed better long-term effects in many respects and better operation results compared to valve replacement.
Endocarditis, Subacute Bacterial ; Female ; Humans ; Mitral Valve Insufficiency* ; Mitral Valve* ; Mortality ; Papillary Muscles* ; Rupture* ; Survival Rate

PURPOSE: The purpose of the study was to investigate five cases with chronic Achilles tendon rupture that occurred after steroid injections. MATERIALS AND METHODS: In our hospital, we experienced five cases of chronic Achilles tendon rupture from September 2010 to March 2012. All patients had got steroid injection for Achilles tendinitis at the other hospitals, and their heel pain was aggravated when they visited our outpatient department. After treatment, signs and symptoms of Achilles tendon rupture were developed and the diagnosis was confirmed by ultrasonography or magnetic resonance imaging (MRI). Surgical treatment was done for Achilles tendon rupture. RESULTS: There was difference between intra-operative findings of Achilles tendon rupture and usual chronic Achilles tendon rupture. Unlike usual findings of chronic Achilles tendon rupture whose scar tissue or tissue attenuation are found around the defect area of Achilles tendon, there were partial necrosis of tendon severe adhesion with surrounding tissue, extensive defect and longitudinal rupture on ruptured area. Also, severe inflammation of paratenon, granulation and fibrinoid deposit were found on biopsy findings in four cases. CONCLUSION: Based on review of data about relative risk and benefit of local corticosteroid injection to inflammatory lesion in Achilles tendon, it requires more attention to Achilles tendon rupture following local corticosteroid injection.
Achilles Tendon* ; Biopsy ; Cicatrix ; Diagnosis ; Heel ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Necrosis ; Outpatients ; Rupture* ; Tendinopathy* ; Tendons ; Ultrasonography

BACKGROUND/AIMS: The transmission routes of HCV infection were not determined in the half of the HCV infected patients. So intrafamilial personal contact, sexual contact, vertical transmission and some vectors are supposed as a route of HCV infection. We investigated the prevalence of anti-HCV positivity in healthy Korean children and compared with the data from the healthy adults whether the vertical transmission is feasible. METHODS: Serum samples from 2,080 children in 8 elementary schools were tested for serum aminotransferases, hepatitis B viral markers by radioimmu- noassay, and anti-HCV by the third generation EIA. Sera from anti-HCV positive children were tested for HCV-RNA by RT-PCR. Six months later, same tests were repeated. RESULTS: Anti-HCV was positive in 17 children among 2,080(0.82%). Among 17 anti-HCV positive children, HCV-RNA was detected only in one case and the HCV genotype was type II by Okamotos classification. Anti-HCV was tested again in 7 of 17 anti-HCV positive children after 6 months later and all of these children were anti-HCV positive and additional 3 of 19 family members were anti-HCV positive. But HCV-RAN was not detected in alL CONCLUSION: Anti-HCV positive rate in children was 0.81%.
Adult ; Biomarkers ; Child* ; Classification ; Genotype ; Hepatitis B ; Humans ; Prevalence* ; Transaminases

BACKGROUND: The purpose of this study was to report findings of exploratory arthroscopic assessment performed in conjunction with removal of internal fixation device placed in the initial surgery for rotational ankle fracture. METHODS: A total of 53 patients (33 male, 20 female) who underwent surgery for rotational ankle fracture between November 2002 and February 2008 were retrospectively reviewed. All patients gave consent to the exploratory arthroscopic surgery for the removal of internal fixation devices placed in the initial surgery. Lauge-Hansen classification system of ankle fractures was assessed for all patients. Intra-articular lesions (osteochondral lesion, loose body, and fibrosis) were evaluated via ankle arthroscopy. Comparative analysis was then performed between radiological classification of ankle fracture/patient's symptoms and arthroscopic findings. RESULTS: Lauge-Hansen classification system of ankle fractures included supination-external rotation type (n = 35), pronation-external rotation type (n = 9), and pronation-abduction type (n = 9). A total of 33 patients exhibited symptoms of pain or discomfort while walking whereas 20 exhibited no symptoms. Arthroscopic findings included abnormal findings around the syndesmosis area (n = 35), intra-articular fibrosis (n = 51), osteochondral lesions of the talus (n = 33), loose bodies (n = 6), synovitis (n = 13), and anterior bony impingement syndrome (n = 3). Intra-articular fibrosis was seen in 31 of symptomatic patients (93.9%). Pain or discomfort with activity caused by soft tissue impingement with meniscus-like intra-articular fibrosis were found in 19 patients. There was statistical significance (p = 0.02) between symptoms (pain and discomfort) and the findings of meniscus-like fibrosis compared to the group without any symptom. CONCLUSIONS: Arthroscopic examination combined with treatment of intra-articular fibrosis arising from ankle fracture surgery may help improve surgical outcomes.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Ankle/*pathology/radiography/*surgery ; Ankle Fractures/*pathology/radiography/*surgery ; Arthralgia ; Arthroscopy/*methods ; Female ; Fibrosis ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult