BACKGROUND: The diabetic patients have a tendency to develop onychomycosis more frequently than non-diabetic populations have. The overall risk ratio of individuals with diabetes having onychomycosis is 2.77 compared with age- and sex- matched non-diabetic controls. OBJECTIVE: This study was performed to find out whether the nail growth rates of diabetic patients are more slower than those of non-diabetic persons with or without onychomycosis and to observe the differences of the toenail growth rates according to the affected area of onychomycosis (less than 50% and more than 50%) within the diabetic and non-diabetic groups respectively. METHOD: The growth rates of the great toenails of 74 diabetic patients and 121 non-diabetic controls with or without onychomycosis were measured. To compare the toenail growth rates between the two groups, we classified the patients in each group into 3 subgroups according to the presence and degree of onychomycosis. Thus the two groups were divided into 6 groups. RESULTS: The growth rates of diabetic toenails without onychomycosis were slower than those of non-diabetic controls with statistical significance (p< 0.05). And the growth rates of the great toenails in non-diabetic patients were more slower according to their affected area, so to say, the more, the slower (p< 0.05). But, in diabetic patients, the growth rates of the great toenails were not different according to the affected area of onychomycosis (p> 0.05). CONCLUSION: Slow nail growth may play a role in the development of onychomycosis because the nail growth rate was slower in diabetic patients than non-diabetics. But the treatment of onychomycosis in diabetic patients should be encouraged because the toenail growth rates are not different statistically between diabetic and non-diabetic patients when the great toenails are affected.
Diabetes Mellitus ; Humans ; Nails* ; Odds Ratio ; Onychomycosis*

Background: Older adults are given high priority for coronavirus disease 2019 (COVID-19) vaccination; however, little is known about the safety of vaccines. This study was conducted to examine the safety of the COVID-19 vaccine for people who were ≥ 75 years of age, specifically those who first took two doses of the vaccine at the COVID-19 central vaccination center in South Korea. Methods: Safety monitoring after the BNT162b2 vaccine was conducted in three ways for older adults who received the first dose of the vaccine at our center between April 5 and April 23, 2021. For immediate adverse reactions, every person who was vaccinated was observed for 15–30 minutes after injection at the center. For active surveillance, a telephone interview was conducted for stratified randomly sampled people after 7 days of each vaccination to enquire regarding types of adverse reactions they experienced, and its severity and duration. For passive surveillance, reported adverse event data were collected from the COVID-19 vaccine adverse event following immunization (AEFI) surveillance system—run by the Korea Disease Control and Prevention Agency (KDCA). The data were then reviewed. Results: In total, 2,123 older adults received at least one vaccine dose during the study period. The frequency of acute adverse reactions that developed during the observed 15–30 minutes after injection was 8.5 cases per 1,000 doses. None of the reactions was assessed as acute allergic reactions to the vaccine and no cases required special treatment or drug administration. Overall, 638 people were followed up at least once by telephone interview 7 days post vaccination. The overall response rate was 82.3%. The rates of local reactions were 50.3% after the first dose and 45.2% after the second dose, and the rates of systemic reactions were 15.2% and 26.0%, respectively. During the study period, 23 medically attended adverse events (5.4 cases per 1,000 administered doses) were reported to the KDCA AEFI surveillance system. The most common symptoms of medically attended cases were nonspecific general weakness (26%) and dizziness (26%), followed by muscle pain (22%), headache (13%), fever (13%), and skin rash or urticaria (13%). Among them, there were five serious adverse events reported, which required hospitalization, including one death. However, most of them were not related to the vaccines. Conclusion BNT162b2 vaccination was tolerable among adults who were ≥ 75 years of age.

Myotubular or centronuclear myopathy(MTM) is a rare congenital myopathy, which is characterized by predominance and atrophy of type 1 fibers and centrally located nuclei in muscle pathology. The clinical features and severity are quite variable. MTM is classified as three forms according to the inheritance pattern : autosomal dominant, autosomal recessive and X-linked recessive. The authors present familial myotubular myopathy, suggestive of X linked, occurred in a sibling with intrafamilial clinical variability.
Atrophy ; Humans ; Inheritance Patterns ; Muscular Diseases ; Myopathies, Structural, Congenital* ; Pathology ; Siblings*

BACKGROUND: Currently, the incidence of hepatitis A is on the increase in Korea. Although there is emphasis on contact precautions, the nosocomial outbreak of hepatitis A virus (HAV) in healthcare personnel has increased within endemic areas because these workers inevitably come in close contact with patients and work under suboptimal hygiene conditions. In this study, we evaluated the necessity of immunization against HAV for healthcare personnel. METHODS: We investigated the seropositivity of serum immunoglobulin G (IgG) anti-HAV antibody (Ab) in 672 healthcare personnel on the basis of their age-group, sex, and occupation in Soon Chun Hyang University Hospital and Soon Chun Hyang University Bucheon Hospital. RESULTS: The subjects were divided into 6 groups on the basis of their ages to identify differences among the various age groups in the number of cases with HAV Ab seropositivity. Significant intergroup differences were noted in this respect: 21-25 years, 2/152 (1.3%); 26-30 years, 33/245 (13.5%); 31-35 years, 70/148 (47.3%); 36-40 years, 52/79 (65.8%); >40 years, 44/48 (91.7%). CONCLUSION: The number of seropositive cases was low among young healthy personnel: low seropositivity is an emerging risk for vulnerable population. With the increase in the incidence of hepatitis A, healthcare personnel have become a risk population for hepatitis A, as are community residents. Therefore, for healthcare personnel working in hospitals, immunization against HAV should be recommended for personnel younger than 30 years, and serological testing for older personnel.
Delivery of Health Care ; Hepatitis ; Hepatitis A ; Hepatitis A Antibodies ; Hepatitis A Vaccines ; Hepatitis A virus ; Humans ; Hygiene ; Immunization ; Immunoglobulin G ; Incidence ; Korea ; Occupations ; Serologic Tests ; Vulnerable Populations

This study was developed and validated for the determination of oxyclozanide residue concentrations in beef and commercial milk, using high-performance liquid chromatography system. Oxyclozanide was successfully separated on a reverse phase column (Xbridge-C18, 4.6x250 mm, 5 microm) with a mobile phase composed of acetonitrile and 0.1% phosphoric acid (60:40, v/v%). This analytical procedure involved a deproteinization process using acetonitrile for beef and 2% formic acid in acetonitrile for commercial milk, dehydration by adding sodium sulfate to the liquid analytical sample, and a defatting process using n-hexane; after these steps, the extract was exposed to a stream of nitrogen dryness. The final extracted sample was dissolved in the mobile phase and filtered using a 0.45 microm syringe filter. This method had good selectivity and recovery (70.70+/-7.90-110.79+/-14.95%) from the matrices. The LOQs ranged from 9.7 to 9.8 microg/kg for beef and commercial milk. The recoveries met the standards set by the CODEX guideline.
Acetonitriles ; Chromatography, High Pressure Liquid ; Chromatography, Liquid ; Dehydration ; Formates ; Milk ; Nitrogen ; Oxyclozanide ; Phosphoric Acids ; Rivers ; Sodium ; Sulfates ; Syringes

Churg-Strauss syndrome is a clinicopathologic disorder of severe asthma, fever , and eosinophilia together with systemic vasculitis involving various organ systems. Characteristic cutaneous lesions include erythematous maculopapules resembling erythema multiforme, hemorrhagic lesions, and cutaneous and subcutaneous nodules. Histologically, extravascular granuloma and leukocytoclastic vasculitis are the most common findings. We report a case of 40-year-old woman who presented with generalized multiple hemorrhagic bullae that had developed 1 month ago. Previously, She had allergic rhinitis and asthma. Laboratory studies revealed peripheral blood eosinophilia, and positive p-ANCA. Skin biopsy revealed eosinophilic infiltrates and leukocytoclastic vasculitis.
Adult ; Antibodies, Antineutrophil Cytoplasmic ; Asthma ; Biopsy ; Churg-Strauss Syndrome* ; Eosinophilia ; Eosinophils ; Erythema Multiforme ; Female ; Fever ; Granuloma ; Humans ; Rhinitis ; Skin ; Systemic Vasculitis ; Vasculitis

Tufted angioma is a rare, acquired vascular tumor, most commonly presenting in the first year of life, which was first described by Wilson Jones in 1979. Spontaneous resolution of this tumor are known to be very rare and local recurrence often occurs unless the tumor is excised completely. We present two cases of tufted angioma developed in two 1-year-old girls. Skin biopsy in a case showed compatible findings with tufted angioma and the other was diagnosed at an other hospital. The lesions were treated with intralesional injections of triamcinolone acetonide and showed marked improvement. During follow up period, the lesions kept improving.
Biopsy ; Female ; Follow-Up Studies ; Hemangioma* ; Humans ; Injections, Intralesional* ; Recurrence ; Skin ; Triamcinolone Acetonide

PURPOSE: To evaluate the usefulness of color Doppler ultrasonography in the differential diagnosis of breast masses. MATERIALS AND METHODS: We prospectively evaluated to pathologically proven breast lesions. Forty-three were benign (39 fibroadenomas, two papillomas and two lipoma) and 27 were malignant (25 infiltrating ductal cardinomas, one mucinous carinoma and one atypical medullary caricinoma). In 32 cases, we categorized color signal from 0 to III, according to the degree of vascularity, and analysed peak systolic velocity (PSV) and resistive index (RI). RESULTS: Color signals of malignant lesions tended to be high grade (II, III), whereas those of benign lesions tended to be low (0, I), and the difference was statistically significant (P<0.005). In the analysis of spectral waveform , correlation between RI, PSV and malignancy was statistically significant (P<0.02). RI above 0.7 and PSV above 10 were the highest recorded values for sensitivity and specificity. CONCLUSION: Color Doppler ultrasound is a useful modality to distinguish benign from malignant breast masses. Malignancy is suggested when the color signal is grade II or III, the resistive index is higher than 0.7, and peak systolic velocity is higher than 10cm/sec.
Breast* ; Diagnosis, Differential ; Fibroadenoma ; Mucins ; Papilloma ; Prospective Studies ; Sensitivity and Specificity ; Ultrasonography ; Ultrasonography, Doppler, Color*

BACKGROUND/AIMS: Quantitation of hepatitis B surface antigen (HBsAg) is an increasingly popular method to determine the treatment response in chronic hepatitis B (CHB) patients. The clinical value of HBsAg level measurement during rescue therapy for lamivudine (LMV)-resistant CHB patients have not been evaluated to date. Therefore, this study investigated the correlation between HBsAg level and treatment response in LMV-resistant CHB patients treated with adefovir (ADV) add-on therapy. METHODS: LMV-resistant CHB patients treated with LMV-ADV combination therapy for over 2 years were included. HBsAg levels were measured at 6 month intervals until 1 year, and annually thereafter. Treatment response was assessed by determining the virological response (VR, undetectable HBV DNA levels) during treatment. RESULTS: Fifty patients were included, of which 40 showed a VR. HBsAg levels were not different significantly at baseline (4.0 vs. 3.6 Log10 IU/mL, P=0.072). However, the HBsAg level decreased after 6 months of treatment in patients with a VR and became different significantly between the groups thereafter (3.9 vs. 3.3 at 6 months, P=0.002; 3.8 vs. 3.2 at 1 year, P=0.004; 3.9 vs. 3.2 at 2 years, P=0.008; 3.7 vs. 3.1 at 3 years, P =0.020). CONCLUSIONS: The HBsAg level at 6 months after treatment can help predict treatment response.
Adenine/*therapeutic use ; Adult ; Antiviral Agents/*therapeutic use ; Area Under Curve ; DNA, Viral/blood ; Drug Resistance, Viral ; Female ; Hepatitis B Surface Antigens/*blood ; Hepatitis B virus/genetics ; Hepatitis B, Chronic/*drug therapy/virology ; Humans ; Lamivudine/*therapeutic use ; Male ; Middle Aged ; Organophosphates/*therapeutic use ; ROC Curve ; Treatment Outcome

PURPOSE: Paroxysmal non-epileptic event (PNE) is a common seizure-like symptom in children. With regard to therapy, a decrease in iron levels was reported in breath-holding spells, but not in other PNEs. The effects of iron supplementation were investigated on various PNEs. METHODS: Medical records of patients who visited our clinic with seizure-like symptoms were retrospectively reviewed at Chungnam National University Hospital, from March 2013 to March 2016. RESULTS: A total of 29 patients (65.9%) were boys and 15 (34.1%) were girls. The mean gestational age and birth weight were 39.3 weeks and 3,200 g, respectively. The mean age at the time of visit was 23.5 months. Of the 11 patients who underwent brain imaging, 10 (90.9%) had normal findings and 1 (9.1%) had subdural hemorrhage. An electroencephalogram was performed in 29 patients; 26 of them had normal findings (89.7%), 2 (6.9%) had slow background, and 1 (3.4%) had epileptiform discharges. A total of 31 patients (70.5%) had iron levels lower than 80 µg/dL. Iron supplementation was administered in 4 of the 13 patients with normal iron status and in 21 of the 31 patients with low iron status. A significant improvement in the frequency and severity of symptom was observed in 91.7% of patients who received iron supplementation (P<0.05). CONCLUSIONS: Symptoms improved in 80% of patients with PNE, and a higher rate of symptom improvement could be expected with iron supplementation.
Birth Weight ; Child* ; Chungcheongnam-do ; Electroencephalography ; Female ; Gestational Age ; Hematoma, Subdural ; Humans ; Infant ; Infant Behavior ; Infant, Newborn ; Iron* ; Medical Records ; Neuroimaging ; Retrospective Studies ; Seizures