Streptococcus anginosus is a member of Streptococcus milleri group, and is found in the oral mucosa, respiratory tract, and gastrointestinal tract as normal flora. It can develop into a disease in patients with deteriorating clinical condition or with clinical risk factors. A previously healthy 15-year-old boy was admitted due to fever, abdominal discomfort and vomiting which lasted for 7 days. He had a history of dental procedure 1 day before the development of fever. He was diagnosed with acute acalculous cholecystitis based on the clinical, laboratory, and imaging finding, and S. anginosus was isolated from the blood culture. The patient was successfully treated with antibiotic therapy.
Acalculous Cholecystitis ; Adolescent ; Bacteremia ; Cholecystitis ; Fever ; Gastrointestinal Tract ; Humans ; Mouth Mucosa ; Respiratory System ; Risk Factors ; Streptococcus ; Streptococcus anginosus ; Streptococcus milleri Group ; Vomiting

BACKGROUND: The skin changes of X-linked recessive ichthyosis are cnused by the deficiency of the enzyme steroid sulfatase, which usually results from deletions of this gene in Caucasian populations. OBJECTIVE AND MEHTODS: To disgnose X-linked recessive ichthyosis and detect its carrier, we have investigated distinctive gene deletion and measured gene dosage of steroid sulfatase gene by southern blot hybridization in Korean patients with X-linked recessive ichthyosis. RESULTS: Patients from 8 of 9 unrelated families exhibited deletions, if the steroid sulfatase gene. Of 6 families showing a family history compatible with X-linked recessive inheritance, One family exhibited a normal pattern of hybridization. All but one family showed deletion of steroid sulfatase gene. All three patients lacking a fami1y history of the disease exhibited gene deletions. The ratio of the steroid sulfatsse specific band density to the Factor VIII specific band density was measured in 8 obligate carriers using a laser densitometer. The average ratio exhibited by the car riers was less than half that of normal women. Conclusian: These results suggest that the X-linked recessive ichth osis patient and its carrier can also be diagnosed and detected by Southern blot hybridization of steroid sulfatase gene in Korea.
Blotting, Southern* ; Diagnosis* ; Factor VIII ; Female ; Gene Deletion ; Gene Dosage ; Humans ; Ichthyosis* ; Korea ; Skin ; Steryl-Sulfatase ; Wills

No abstract available.
Blood Platelets*

STATEMENT OF PROBLEM: Factors affecting patients' decision-making for dental prosthetic treatment should be examined in terms of understanding improving patients' oral health. PURPOSE: The main purpose of this dissertation was to investigate patients' dental prosthetic treatment and factors affecting patients' decision-making for dental prosthesis treatment in Deagu and Gyungbook areas. MATERIAL AND METHODS: This study was based on the preliminary survey of dental patients conducted from July 1 to August 31 in 2006. A total of 700 questionnaires had been distributed and 640 were collected. 629 questionnaires were used for the statistical analysis. Descriptive and inferential statistics, such as frequencies, cross tabulation analysis, correlation analysis, logistic regression analysis, and multiple regression analysis were introduced. In the multiple regression analysis and logistic regression analysis, twenty-two independent variables were employed to explore the factors which have impacts on decision-making and satisfaction. RESULTS: The results of this dissertation are as follows: Logistic regression analysis turned out that monthly income, age, degree of expectation, marital status, and employer-insured policy of national insurance statistically increased the odds of decision-making of dental prosthesis treatment. But educational attainment decreased the odds ratio of the decision-making of dental prosthesis treatment. However, the rest independent variables do not have statistically significant impacts on the decision-making of dental prosthesis treatment CONCLUSION: Among independent variables, marital status had the most significant influence on the decision making of dental prosthesis treatment. Finally, suggestions for the future study and policy implications to improve satisfaction of the patients' dental prosthetic treatment were discussed.
Decision Making ; Dental Prosthesis ; Humans ; Insurance ; Logistic Models ; Marital Status ; Odds Ratio ; Oral Health ; Surveys and Questionnaires

35 neurogenic tumors of the thorax were analyzed with plain film and CT scan. Radiological analysis emphasizedshape, location calcification, bone change, pleural change in plain film and calcification, cystic change, bonechange, pleural change, presence of contrast enhancement in CT scan. The results were as follows; 1. Age may bethe most important clinical factor for differential diagnosis. 2. Plain film findings(35 cases); 1) The mostcommon shape in the ganglion series tumor (ganglioneuroma, ganglioneuroblastoma, neuroblastoma), was elongation(80%) and these tumors generally had tapered borders(50%). In contrast with those of the genglion series, nervesheath tumors(schwannoma, neurofibroma, malignant Schwannoma) showed a definite tendency to be roudn (95%) and thesulcus effect was more frequetnly seen(67.5%). Most of the masses were smooth. The lobulated masses were commonlymalignant ganglion series tumors. 2) Though overall incidence of calcification was low(8.6%), it was observed morefrequently in ganglion series tumors(20%). 3) Associated bony abnormality were generally observed in large tumorsabove 5cm in long axis, especially in neuroblastoma and ganglioneuroblastoma. 4) Tumors showed pleural effusionwere all malignant. 3. CT findings (17 cases); 1) The overall incidence of cystic change of the mass was 23.6%. Itwas most common in Schwannoma(60%). 2) The contrast enhancement was noted in 64.7%. It's degree was variable andshowed no predilection to any specific tumors. 3) The incidence of calcification, associated bony abnormality andpleural effusion were similiar to plain film. Confident specific diagnosis can be made in most of the neurogenictumors of the thorax by shape of the mass in plain film and internal architecture in CT combined with patient'sage as clinical information.
Diagnosis ; Diagnosis, Differential ; Ganglion Cysts ; Ganglioneuroblastoma ; Incidence ; Neuroblastoma ; Neurofibroma ; Thorax ; Tomography, X-Ray Computed

PURPOSE: To present an eccrine poroma that occurred on the sweat gland of upper eyelid. METHODS: A 54-year-old female developed a non-tender palpable mass on her left upper eyelid 2 months ago. She removed the same lesion 6 months ago. We performed excisional biopsy. RESULTS: Histopathologic examination revealed an eccrine poroma. The mass was completely removed and there was no evidence of recurrence 6 months postoperatively.
Biopsy ; Eyelids* ; Female ; Humans ; Middle Aged ; Poroma* ; Recurrence ; Sweat Glands

Oral clonidine premedication appears to inhibit the outflow of sympathoadrenal activity and adrenocortical hormone release, thereby decreasing the minimum alveolar anesthetic concentration of inhaled anesthetics and stabiliring cardiovascular system. It has been reported that oral clonidine premediacation for spinal anesthesia, similar to intrathecal administration of clonidine, has prolonging effect of sensory and motor blocks. The purposes of this study are to assess the effects of oral clonidine premedication on the duration of tetracaine spinal anesthesia, and the hemodynamic changes during spinal anesthesia. Twenty patients undergoing hemorrhoidectomy, TURP, and device removal of lower extremity under spinal anesthesia (0.5% hyperbaric tetracaine), were given diazepam 10 mg orally (Group 1, n=10) or clonidine 150 ug orally (Group 2, n=10) 1 hour before tbe anestbesia. The results were the following, (1) No significant differences was noted between two groups in either the maximum level of sensory extension or time to maximum level of sensory blockade between two groups. In Group 2, the time for two-segment regression was prolonged compared with group 1, but not significant. The time for regression to L1 was significantly prolonged in Group 2 (238+/-37.74min) compared with Group 1 (167.6+/-25.85min)(P<0.05). (2) The number of patient in Bromage's scale score 3 of motor blockade between 180min and 260min after spinal anesthesia was 10 times higher in Group 2 compaired with Group 1 (P<0.05). (3) In Group 1, the lowest systolic blood pressure during spinal anesthesia was significantly low compared with that before premedication (P<0.05). In Group 2, systolic blood pressure before spinal anesthesia, mean systolic blood pressure during first 20mins of spinal anesthesia and the lowest systolic blood pressure were significantly reduced respectively comparing with those before premedication. Significant difference (P<0.05) was noted between Group 1 and 2 in mean systolic blood pressure during the first 20 mins of spinal ansthesia and in lowest systolic blood pressure during spinal anesthesia. In both groups, the lowest heart rate was significantly lower after than before premedication (P<0.01), but the difference in the amount of heart rate change between two groups was not significant. In conclusion, prolongation of sensory and motor blocks of spinal anesthesia with hyperbaric 0.5% tetracaine may be accomplished with oral premedication of 150 ug clonidine without serious clinieal complication.
Anesthesia, Spinal* ; Anesthetics ; Blood Pressure ; Cardiovascular System ; Clonidine* ; Device Removal ; Diazepam ; Heart Rate ; Hemodynamics ; Hemorrhoidectomy ; Humans ; Lower Extremity ; Premedication* ; Tetracaine ; Transurethral Resection of Prostate

PURPOSE: Although the overall incidence of hepatitis A in Korea has been decreasing recently, the adolescents born before the introduction of the hepatitis A vaccine remain to be highly vulnerable to outbreak. This study examines the unvaccinated adolescents' and their parents' knowledge and health beliefs toward hepatitis A vaccination. METHODS: Healthy adolescents aged 13-19 years old who had no previous history of hepatitis A vaccine and hepatitis A infection, and their parents or legal guardians were the subjects of the study. The survey was conducted using a structured questionnaire based on the Health Belief Model, and examined the subjects' demographics, knowledge, and health beliefs (i.e., perceived susceptibility, severity, benefits, and barriers). RESULTS: We included 157 adolescents and their parents/guardians (mean age: 16.0+/-1.6 and 45.6+/-4.7 years, respectively). The average knowledge item score for adolescents and parents was 6.4+/-3.7 and 7.3+/-3.4 (out of 18), respectively. Similarly, average Health Belief Model item scores were: susceptibility, 5.6+/-1.6 and 5.9+/-1.7 (range: 2-10); severity, 16.3+/-4.1 and 18.3+/-3.6 (range:5-25); benefits, 19.7+/-3.3 and 20.6+/-2.1 (range:5-25); and barriers, 41.3+/-8.9 and 39.0+/-9.1 (range:7-85). The major reason for not undergoing hepatitis A vaccination was lack of knowledge about its importance. CONCLUSIONS: Refresher health lectures about hepatitis A and the vaccine are needed by both the adolescents and their parents. Furthermore, the inclusion of hepatitis A vaccine in the national immunization program should be considered to reduce the risk of hepatitis A outbreak and to raise the vaccination coverage among the adolescents in Korea.
Adolescent ; Demography ; Hepatitis A Vaccines ; Hepatitis A* ; Hepatitis* ; Humans ; Immunization Programs ; Incidence ; Korea ; Lectures ; Legal Guardians ; Parents* ; Surveys and Questionnaires ; Vaccination*

BACKGROUND: The regular meal pattern with consistent day-to-day calorie and carbohydrate intake is one of the most important determinants of good glycemic control in diabetes. This study was aimed to investigate the meal pattern and their relationships with total energy intake, nutrients intake and glycemic and lipid profile in type 2 diabetes. METHODS: 1,084 subjects were divided according to glycemic status into three groups: the diabetes (DM), dysglycemia (DG) and normal (N). The meal frequency (MF), meal interval (MI) and daily intake of total energy, macronutrient and micronutrient were estimated with the 24 hours dietary recall from the Korean National Health and Nutrition Examination Survey (KNHANES) in 2001 and Eulji hospital. For analysis of meal pattern and it's relations with the nutrients intake, we regrouped into meal skipper (G1), non-meal skipper with unreasonable MI (G2), and non-meal skipper with reasonable MI (G3). RESULTS: 17.5% of DM, 21.8% of DG, 23.3% of N skipped at least one meal a day without significant difference across the groups. 55.9% of non-meal skipper had unreasonable MI. Meal was more regular in older age, lower educated person, employee, and female. G1 took higher fat, and more calories form snack and less micronutrient density, compared with G3 (P < 0.05). HbA1c, total cholesterol and triglyceride values were higher in G1 compared with other two groups (P < 0.05). CONCLUSION: Many type 2 diabetics had the irregular meal patterns, which was associated with poor glycemic control, lipid profiles and less micronutrient density. This suggested that another treatment strategy might be required for those who had irregular lifestyle.
Cholesterol ; Energy Intake ; Female ; Humans ; Life Style ; Meals ; Micronutrients ; Nutrition Surveys ; Snacks

PURPOSE: Osteoarticular infections in children and adolescents are important because it can cause functional compromise if appropriate treatment is delayed. Therefore, this study was designed to describe the clinical presentations and causative organisms of osteoarticular infections in children and adolescents in order to propose early diagnosis method and an appropriate empiric antimicrobial therapy. METHODS: Forty-two medical records were reviewed retrospectively, which were confirmed as osteomyelitis (OM) or septic arthritis (SA) at Department of Pediatrics or Orthopedic Surgery in patients under 18 years old of Ewha Womans University Mokdong Hospital from March 2008 to March 2015. RESULTS: We identified 21 cases of OM, 13 cases of SA and 8 cases of OM with SA. There were 31 males and 11 females and mean age was 7.1 years old. The most common symptoms were pain and tenderness of involved site. Major involved bones were femur (10 cases, 34.5%), tibia (7 cases, 24.1%) and major involved joints were hip (9 cases, 42.9%), and knee (5 cases, 23.8%). Increased serum C-reactive protein and erythrocyte sedimentation rate were observed in 37 cases (88.1%) respectively. Magnetic resonance imaging was performed in 40 cases among 42 cases and was used to demonstrate osteoarticular infections and other adjacent infections. Nine cases (23.7%) among 38 cases and 20 cases (50.0%) among 40 cases were positive in blood culture and infected site culture respectively. The most common causative organism was Staphylococcus aureus, which was represented in 22 cases (75.9%), of which nine cases (40.9%) were resistant to methicillin. CONCLUSIONS: S. aureus was the most common causative organism of osteoarticular infections in children and adolescents and the proportion of MRSA was high in this study. Therefore, we recommend vancomycin as the first empiric antimicrobial therapy and suggest that further study is necessary to elucidate an appropriate guideline for treatment which takes into account MRSA proportion.
Adolescent* ; Arthritis, Infectious ; Blood Sedimentation ; C-Reactive Protein ; Child* ; Early Diagnosis ; Female ; Femur ; Hip ; Humans ; Joints ; Knee ; Magnetic Resonance Imaging ; Male ; Medical Records ; Methicillin ; Methicillin-Resistant Staphylococcus aureus ; Orthopedics ; Osteomyelitis ; Pediatrics ; Retrospective Studies* ; Staphylococcus aureus ; Tibia ; Vancomycin