Vibrio damsela is a halophilic bacterium that has been reported to cause skin ulcers and death in damselfish (Chromis punctipinnis) as well as wound and soft-tissue infections in human. Most of the previously reported cases in humans haute involved wound infections associated with exposure to seawater or handling fish. We experienced a case of primary septicemia due to V. damsela after eating raw fists in a healthy 66-year-old woman who had neither wounds nor history of exposure to sea- water. She presented fever and diarrhea followed by rapidly pregressive bullae and painful edema on left band and forearm. The patient was Improved by intensive surgical debrldement of necrotic tissue and antibiotic therapy.
Aged ; Diarrhea ; Eating ; Edema ; Female ; Fever ; Forearm ; Humans ; Seawater ; Sepsis* ; Skin Ulcer ; Vibrio* ; Wound Infection ; Wounds and Injuries

The surgical correct1on of blepharoptosis is accomplished by utilizing certain materials, the levator, the frontalis or the superior rectus muscle. The perfect postoperative results are complete cover of the eye on lid closure, adequate mobility when blinking, normal lid fold and no diplopia. The authors obtained good results in two children of congenital ptosis by attaching medial one third of superior rectus muscle to lid margin which was reported by Motais in 1897. The operation which use the superior rectus muscle is not favored recently because of complicationals such as partial corneal exposure, vertical diplopia, difficulty in blinking, and partial obliteration of the upper conjunctival fornix. But, the results of these simple physiologic proceures for binocular paralytic ptosis were remarkable without any complications as the aboves for 3 months of follow up check.
Blepharoptosis ; Blinking ; Child ; Diplopia ; Follow-Up Studies ; Humans ; Telescopes

PURPOSE: To report a case of valsalva hemorrhagic retinopathy. METHODS: A 14 year-old healthy man who presented with subhyaloidal and subretinal hemorrhages after blowing his nose over 30 times. RESULTS: Initial visual acuity was 20/20 and right fundal examination revealed peripapillary subhyaloidal and subretinal hemorrhages as well as vitreous hemorrhage. Fluorescein angiography demonstrated blocked fluorescences due to the hemorrhage and no leakage from the retinal vessels. At 4 week follow up, corrected visual acuity remained as 20/20 and subhyaloidal and vitreous hemorrhages were completely absorbed. Subretinal hemorrhage decreased significantly.
Adolescent ; Fluorescein Angiography ; Follow-Up Studies ; Hemorrhage* ; Humans ; Nose ; Retinal Vessels ; Visual Acuity ; Vitreous Hemorrhage

PURPOSE: Despite a high frequency of acquired nail disease, congenital absence of the nail, also called as anonychia, is a rare anomaly. It may be seen as an isolated of phalangeal bone(ectrodactyly), nail-patella syndrome, birth trauma, impaired peripheral circulation, alopecia areata, and pemphigus, idiopathic atrophy of the nail, bullous drug eruptions, periodic shedding, lichen planus, Stenvens-Johnson syndrome and so forth. METHODS: We have experienced a rare case of 40-day-old neonate, suffering from intrauterine growth retardation, but without familial history, chromosomal anomalies or any other diseases. RESULTS: There was no nail on left 5th finger and distal phalangeal bone of same finger. So, We diagnosed as Congenital Anonychia with ectrodactyly of 5th Finger. CONCLUSION: We report this case as congenital anonychia of 5th finger which have developed from underlying distal phalangeal ectrodactyly. We also review other reported cased in the literatures.
Alopecia Areata ; Atrophy ; Drug Eruptions ; Fetal Growth Retardation ; Fingers* ; Humans ; Infant, Newborn ; Lichen Planus ; Nail Diseases ; Nail-Patella Syndrome ; Parturition ; Pemphigus

PURPOSE: To determine the correlation between obstructive coronary artery disease and electron beamtomography coronary artery calcium(EBT CAC) scan and to measure the difference in calcium score according tosymptoms. MATERIALS AND METHODS: Fifty-six patients underwent EBT CAC scanning and either coronary angiography orstress thallium 201 scanning or the treadmill test. When the results were positive, coronary artery obstructivedisease(CAOD) was assumed to be present. The patients were divided into three groups : symptomatic CAOD,asymptomatic CAOD, and asymptomatic non- CAOD; those with a previous history of myocardial ischemia or who showedpositive results in any of the three tests relating to typical symptoms of angina were assigned to the symptomaticgroup. RESULTS: The number of cases assigned to group to group 1,2 and 3 was 19, 16 and 21, respectively; totalCAC scores were 571+/-751, 600+/-726 293+/-401, respectively. The difference in CAC score between asymptomatic CAODand asymptomatic non- CAOD was not statistically significant(p=0.079) but in asymptomatic CAOD, the score tendedto be higher. The CAC score was not different between symptomatic and asymptomatic CAOD(p>0.1). When the CACthreshold was 1, sensitivity was 89% and specificity was 14%;when the threshold was 200, sensitivity was 60% andspecificity was 67%. CONCLUSION: When the EBT CAC score is high, further evaluation provides early evidence ofcoronary artery obstructive disease.
Arteries ; Calcium ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Exercise Test ; Humans ; Myocardial Ischemia ; Sensitivity and Specificity ; Thallium ; Tomography, X-Ray Computed*

Goldenhar's syndrome is a rare form of a hemifacial microsomia in which the facial and vertebral anomalies are frequently associated with cardiac, pulmonary and renal defects. Infants with Goldenhar's syndrome commonly have an airway that is difficulty to manage. A difficult tracheal intubation may be due to a combination of mandibular hypoplasia, macrognathia, palatal defects and vertebral anomalies. We report the successful anesthetic management of a 10-month-old girl with Goldenhar's syndrome for the excision of conjunctival lipodermoid. The use of remifentanil followed with an anesthetic induction dose of propofol provides adequate conditions for tracheal intubation without the use of neuromuscluar blocking agents in a patient with Goldenhar's syndrome.
Airway Management* ; Female ; Goldenhar Syndrome ; Humans ; Infant ; Intubation ; Propofol

PURPOSE: Throat culture for streptococcal pharyngitis is a gold standard to diagnose, but it may be misleading to interpret due to the carriers. The isolation rates of beta-hemolytic streptococci (BHS) and Streptococcus pyogenes in the school children in Chinju were investigated and compared with those of Kangwon, Chungnam and Seoul previously reported. METHODS: Throat cultures were taken from the healthy 476 elementary school children who had no symptoms or signs of upper respiratory tract infection in April 1995, and the beta-hemolytic streptococci were identified with bacitracin disk (0.04 U) and latex agglutination. RESULTS: One-hundred fifty-four (32.4%) yielded BHS and 88 (18.5%) had S. pyogenes. The serogrouping revealed 30 (6.7%) group G, 24 (5.0%) group C, 4 (0.8%) group B, and 8 (1.7%) non-group A,B,C,G respectively. CONCLUSIONS: The isolation rate of BHS in Chinju was significantly higher (p<0.001) than the results of Kangwon, Chungnam and Seoul. The identification of BHS was also different from the other areas. In addition to these bacteriologic investigation, the study should be followed whether these carriers were simple contact ones or suffered from asymptomatic infections, and the epidemiologic study using serotyping, such as M or T typing, is necessary.
Agglutination ; Asymptomatic Infections ; Bacitracin ; Child* ; Chungcheongnam-do* ; Epidemiologic Studies ; Gangwon-do* ; Gyeongsangnam-do* ; Humans ; Latex ; Pharyngitis ; Pharynx* ; Respiratory Tract Infections ; Seoul* ; Serotyping ; Streptococcus pyogenes

Although throat culture is a gold standard to diagnose group A streptococcal (GAS) pharyngitis or its sequelae, antistreptolysin O (ASO) is useful to confirm the diagnosis. In case there is no elevation of ASO, it is necessary to add one or more serologic tests, such as antideoxyribonuclease (ADNase) B test. ADNase B levels were analyzed in the carriers of beta-hemolytic streptococci (BHS) in this study. ADNase B concentrations were determined quantitatively by nephelometry (Behring Nephelometer 100 Analyzer, Germany) on 157 sera of healthy elementary school children in Chungnam who were positive of BHS in the throat culture. ASO levels were measured previously by autoanalyzer (Hitachi 747, Japan). Mean ADNase B and ASO levels were compared according to serological group of BHS and number of colonies. The carriers of GAS had significantly higher ADNase B levels (mean 453 IU/ml) than those of non-A beta-hemolytic streptococci (NGAS, 278 IU/ml), while the difference of ASO levels between GAS (482 IU/ml) and NGAS (350 IU/ml) carriers was not so high. The carriers who had more than 10 CFU of BHS had significantly higher ADNase B or ASO levels than those who had less than 10 CFU. The correlation between ADNase B (Y) and ASO (X) was Y=0.4X+229 (r2=0.13). ADNase B test could discriminate GAS from NGAS more effectively than ASO test. The carriers who have more than 10 CFU might undergo asymptomatic infection, as their ADNase B or ASO levels were significantly high. Because distribution of ADNase B showed little correlation to that of ASO, ADNase B test could be used as a supplementary test to diagnose GAS infection.
Antistreptolysin ; Asymptomatic Infections ; Child ; Chungcheongnam-do ; Diagnosis ; Humans ; Nephelometry and Turbidimetry ; Pharyngitis ; Pharynx ; Serologic Tests

An anatomical anomaly, in which myocardial fibers make a bridge over the epicardial coronary artery, is known as the myocardial bridge. The clinical significance of this anomaly has been emphasized because serious cardiac diseases, such as myocardial infarctions or sudden death, can occur. We experienced the anesthetic management of a 72-year-old female patient with a myocardial bridge under general anesthesia for cholecystitis.
Aged ; Anesthesia, General ; Angina, Unstable* ; Cholecystitis ; Coronary Vessels ; Death, Sudden ; Female ; Heart Diseases ; Humans ; Myocardial Infarction

Cerebral infarction is caused by decreased perfusion to the brain. In the evaluation of the infarction, CT has been widely used but MRI ans SPECT recently tend to increase in use. The purpose of this study is to compare the efficacy of MR imaging with that of 99mTc-hexamethylpropylene amine(HMPAO) single photon emission computed tomography(SPECT) in the patients with cerebral infarction in the points of (1) number of detected lesion, (2) size of the lesion, and (3) correlation with clinical neurologic deficits. Sixty-one patients with cerebral infarctions(acute: 23, subacute:30, chronic:8) were reviewed. In all patients, MRI and corresponding 99mTc-HMPAO SPECT examinations were performed within a reasonable time span. We analyzed the fiadings of (1) clinical neurologic examination, (2) MR and, (3) Tc-99m-HMPAO SPECT independently they were compared later on. The lesion of SPECT was larger than the seen on MRI in 9 of 23 acute cases, 13 of 30 subacute cases, and 3 of 8 chronic cases. The lesion on MRI was larger than that on SPECT in seven acute cases, six subacute, and only one case in chronic stage. In the remaining cases, the size of the lesion was similar to that on both SPECT and MRI. For the detection of lesion, MRI was superior to SPECT in 15 acute cases, 13 subacute cases, and four chronic cases, while SPECT was super or to MRI in four of 30 cases at subacute stage, and one of 8 cases at chronic stage. In conclusion, there was a tendency that the detection rate of the lesion was higher on MRI but the lesion was larger on SPECT. The lesions detected on both MRI and SPECT correlated well with clinical symptoms.
Brain ; Cerebral Infarction* ; Humans ; Infarction ; Magnetic Resonance Imaging* ; Neurologic Examination ; Neurologic Manifestations ; Perfusion ; Technetium Tc 99m Exametazime ; Tomography, Emission-Computed, Single-Photon*