BACKGROUND: It has been well known that patients with diabetes mellitus are prone to cutaneous infections, but whether superficial mycoses are truly more prevalent in diabetic patients is still controversial. OBJECTIVE: The purpose of this study was to determine the true prevalence of superficial mycoses in diabetic patients as comparing with non-diabetic, non-immunocompromised individuals. METHODS: We examined for evidence of superficial fungal disease in 137 diabetic patients and compared it with 146 non-diabetic non-immunocompromised ones. Potassium hydroxide preparations and fungus cultures were performed from all suspected lesions. RESULTS: Superficial mycoses were more common in diabetic patients(50%) than controls(31%) (p=0.0004), especially in the age group of 4th and 5th decades9p=0.011). The duration of diabetes mallitus or blood sugar levels were not significantly correlated with the prevalence of superficial mycoses.The organism most commonly isolated was Trichophyton rubrum in both groups(53% vs 79%) and Candida albicans was more prevalent in diabetic patients(34% vs 7%). More than 2 kinds of superficial mycoses were mose common in diabetic patients than controls(38% vs 16%). CONCLUSION: This study shows that the prevalence rate of superficial mycoses in diabetic patients is higher than that in controls and the in controls and the duration of diabetes mellitus or blood sugar levels were not significantly correlated with it.
Blood Glucose ; Candida albicans ; Diabetes Mellitus ; Fungi ; Humans ; Mycoses* ; Potassium ; Prevalence ; Trichophyton

The purpose of this study are to delineate the temporal and spatial changes of bone mineralization at the distraction gap and adjacent parent bone, and to investigate the effect of microaxial dynamization on regenerate bone healing and on development of regional osteopenia at the adjacent parent bone, during callotasis. Sixteen Korean adult mongrel dogs underwent bilateral tibial lengthening by callotasis. To the right hindlimbs, no dynamization was applied and served as control group (group I, and axial elastic dynamization was conffered to the left hindlimbs (group II). Bone mineral density(BMD) was measured by dual X-ray absorptionmetry(DXA) at immediate post-operative day, post-operative 12 day, 22 day, 36 day, 50 day, 65 day, and 85 day. Quantitative computed tomogram(Q-CT) was also taken after sacrifice to analyze temporal changes of mineralization pattern in the distraction gap. The following results were obtained; 1. In both group I and II, the BMD was lowest at the interzone in the distraction gap and increased linearly toward the corticotomy surface. This pattern did not change with time until the consolidation of the distraction gap, but the difference of BMD between the interzone and adjacent parent bone decreased with progress of consolidation. 2. During the distraction period, BMD increased progressively at the distraction gap and adjacent parent bone in both group I and II. During consolidation period, although BMD of the distraction gap still increased progressively, that of the adjacent parent bone decreased progressively in group I; the more distant from the corticotomy surface, the more decreased the relative BMD. in group II, the decrease in BMD of the adjacent parent bone was less than that in group I which was statistically significant in mid-consolidation period. In conclusion, the new bone in the distraction gap during callotasis appeared to form in bilateral direction with linear gradient from interzone toward corticotomy surface. Dynamization during callotasis not only stimulated regenerate bone healing in the distraction gap, but also prevented the occurrence of transient regional osteopenia at the distant part of the adjacent bone during midconsolidation period.
Adult ; Animals ; Bone Density ; Bone Diseases, Metabolic ; Calcification, Physiologic ; Dogs ; Hindlimb ; Humans ; Miners ; Osteogenesis, Distraction ; Parents ; Tibia

PURPOSE: The purpose of this study was to determine whether intravenous injection of the zoledronic acid could promote osseointegration of the porous implant inserted into the rabbit medullary cavity. MATERIALS AND METHODS: A rabbit intramedullary osseointegration model was used. A specially designed porous nitinol implant (Bio-Smart, Sungnam, Gyeonggi-do, Korea) was inserted in the right distal femur of twenty six rabbits. They were randomized into the control or the experimental groups. In the control group, an intravenous injection of normal saline 2 ml/kg (Daihan Pharm, Seoul, Korea) was given at the end of the operation. In the experimental group, an intravenous injection of zoledronic acid 0.1 mg/kg (AclastaG(R) 2 ml/kg, Norvatis, Stein, Switzerland) was given at the end of the operation. Six weeks later, all animals were sacrificed and undecalcified histologic sections were prepared. Then, histomorphometric measurement of bone affinity index (%) and bone ingrowth area rate (%) was carried out. RESULTS: Six rabbits were excluded due to death and wound infection. Nine rabbits in the control group and eleven rabbits in the experimental group were included for the analysis. The bone affinity indices were 19.9+/-7.9% in the control group, and 28.4+/-7.2% in the experimental group. Although there was no statistical significance (p=0.056), the bone affinity index of the experimental group was higher than that of the control group. The bone ingrowth area rates were 8.7+/-3.7% in the control group, and 12.1+/-4.1% in the experimental group (p=0.046), indicating zoledronic acid had an positive effect on the promotion of bone ingrowth into the porous implant. CONCLUSION: In our rabbit intramedullary osseointegration model, intravenous injection of the zoledronic acid promoted early osseointegration of the porous implant. Zoledronic acid might be useful to promote the early osseointegration of the joint replacement implants.
Alloys ; Animals ; Diphosphonates ; Femur ; Imidazoles ; Injections, Intravenous ; Joints ; Osseointegration ; Rabbits ; Wound Infection

BACKGROUND: To assess the current level of development of emergency medicine (EM) systems in Asia. METHOD: Survey of EM professionals from 12 Asian countries during a 90-day period from August to November 1998. 12 EM professionals from 12 Asian countries completed the survey. All participants were physicians. 7 participants (58%) gave presentations at an international EM conference during the study period. Respondents completed a 103 question questionnaire about the status of EM specialty, academic, patient care, information and management systems and the factors influencing the future of EM in their countries. RESULTS: 92% of respondents stated that their countries have hospital-based emergency departments (ED). More than 80% of respondents reported that their countries have EMS systems and ED systems for trauma care and patient transfer. More than 70% stated that their countries have national EM organizations, EM research, national EMS activation phone numbers, ED systems for pediatric emergency care, emergency physician (EP) training in ACLS and ATLS and peer review. More than 60% reported official recognition of EM as an independent specialty status, ED triage systems and systems for customer service. More than 50% reported EM residency training programs, EM journals and EP ability to perform rapid sequence intubation (RSI). 50% reported EP ability to perform thrombolysis for acute MI and 33% reported EP ultrasonography. 92% felt that a lack of funding posed a moderate or great obstacle to the future development of EM in their countries. CONCLUSION: Many essential systems of EM now exist throughout Asia. In the systems of administration and emergency medical information in many countries, there are some parts to be developed further.
Asia ; Asian Continental Ancestry Group* ; Surveys and Questionnaires ; Education ; Emergencies* ; Emergency Medical Services ; Emergency Medicine* ; Emergency Service, Hospital ; Financial Management ; Humans ; Internship and Residency ; Intubation ; Patient Care ; Patient Transfer ; Peer Review ; Triage ; Ultrasonography

Pyogenic liver abscess (PLA) can be caused by bacteria entering the liver via the portal vein or primary bacteremia, or it can be cryptogenic. Recently, Klebsiella pneumoniae has been increasingly found as a PLA pathogen. PLA due to this bacterium often leads to formation of extrahepatic abscesses. The treatment of choice is dual therapy with insertion of percutaneous catheter drainage and antibiotic therapy. We report 2 cases of PLA due to K. pneumoniae in immunocompetent children. We successfully treated patient 1 with percutaneous catheter drainage for 18 days and 6-week course of antibiotic therapy. Patient 2 was treated with percutaneous needle aspiration and antibiotic therapy for the same period. In both patients, the PLAs showed the ultrasound-confirmed resolutions after the dual therapy.
Abscess ; Anti-Bacterial Agents ; Bacteremia ; Bacteria ; Catheters ; Child ; Drainage ; Humans ; Immunocompetence ; Klebsiella pneumoniae ; Klebsiella ; Liver ; Liver Abscess, Pyogenic ; Needles ; Pneumonia ; Portal Vein

A schwannoma is a benign soft tissue tumor arising from the nerve sheath of a Schwann cell. Clinically, a schwannoma is an asymptomatic mass rarely causing neurologic deficits. However, it can cause discomfort as well as motor and sensory disturbances by compressing the nerve of its origin. The authors encountered a huge schwannoma arising from the median nerve at the proximal forearm, which caused symptoms mainly in the ulnar nerve. The tingling sensation along the ulnar nerve disappeared completely after enucleation of the schwannoma originating from the median nerve.
Forearm* ; Median Nerve* ; Neurilemmoma* ; Neurologic Manifestations ; Sensation ; Ulnar Nerve*

PURPOSE: This study was conducted to survey the preliminary data on risk behaviors and to identify the factors that prevent risk-behaviors in late adolescence. METHODS: Freshmen(n=1,297) beginning the first semester in Korea University, Seoul, Korea completed self-administered risk behavior questionnaires, comprising 5 domains : demographics, smoking, drinking, drug abuse and sexual behavior. RESULTS: The rate of smoking experience was higher in people having friends who smoke and the predictors of transition to current smoking were male gender, urban residence, friends' smoking, and nicotine dependence. The rate of high risk drinking was higher among students who are male and who had experience of heavy episodic drinking. The study group showed a low prevalence of narcotic users, but two-thirds of students could get medicine easily without prescriptions. The prevalence of sexual experience was 6.5 percent, and the sexual education was not a predictor of contraceptive behavior. The prevalence of homosexuality was 1.6 percent, and the rate of mostly heterosexuality was higher in female students. CONCLUSION: The main targets of youth health education should be campaigns aimed at atcessation of reinforcing risk behaviors and the development of a surveillance system for the prevention of chronic disease. These results can be used to find risk factors of health-risk behaviors among late adolescents.
Adolescent ; Alcohol Drinking ; Chronic Disease ; Contraception Behavior ; Demography ; Drinking ; Education ; Female ; Friends ; Health Education ; Heterosexuality ; Homosexuality ; Humans ; Korea ; Male ; Prescriptions ; Prevalence ; Surveys and Questionnaires ; Risk Factors ; Risk-Taking* ; Seoul ; Sexual Behavior ; Smoke ; Smoking ; Substance-Related Disorders ; Tobacco Use Disorder

In vivo 31P NMR spectra were obtained in eight infant brain at 4.7T. Each phosphorus metabolite and its ratio were analyzed to evaluate the brain damage and maturity, and compared with the reported data obtained at the lower field strength. Measurement of T1 relaxation time at 4.7T was done in an infant and a cat brain in vivo. PCr/Pi and PCr/β-ATP ratio were used as a marker of brain damage. PME/PDE revealed higher values than those of the reported data obtained at the lower field strength and the difference was partly attributed to the long T1 relaxation time of PME rather than the brain immaturity. Although the resolution of the spectrum was improved at 4.7T, a long repetition time is recommended to minimize T1difference of phosphorus metabolites of brain at 4.7T.
Animals ; Brain* ; Cats ; Humans ; Infant ; Magnetic Resonance Spectroscopy* ; Phosphorus ; Relaxation

Impaction of an ingested foreign body in the colon is uncommon but surgical or endoscopic intervention is occasionally needed when serious complications such as perforation, obstruction or hemorrhage occur. Several factors may predispose a patient to ingestion and subsequent impaction of lower intestinal foreign body. It is more common in the elderly who wear dentures, in the mentally infirm, in chronic alcoholics or rapid eating. The majority of impaction occurs at narrowing and angulation such as ileocecal valve or rectosigmoid junction. The diagnosis of lower intestinal foreign body should be considered, among more common conditions, in the differential diagnosis of elderly patients who present with altered bowel habits. We report the case with a literature review that successfully endoscopically removed the fish bones impacted in the rectosigmoid colon complicated by rectal bleeding.
Aged ; Alcoholics ; Colon* ; Dentures ; Diagnosis ; Diagnosis, Differential ; Eating ; Foreign Bodies ; Hemorrhage ; Humans ; Ileocecal Valve

The prevalence of intestinal tuberculosis has been markedly decreased with the development of antituberculous chemotherapy, improved economic conditions, preventive medicine and early detection and treatment of pulmonary tuberculosis. An even more impressive resurgence of pulmonary and extrapulmonary tuberculosis has been seen in recent years among persons infected with the human immunodeficiency virus. The most common site of intestinal tuberculosis is the ileocecal region, and duodenum is a rare site. Symptoms and signs of duodenal tuberculosis are nonspecific. The gross pathologic appearance of the duodenal tuberculous lesions has to its traditional categorization into three forms: 1) ulcerative, 2) hypertrophic, and 3) ulcerohypertrophic (mixed). Hypertrophic lesions of the duodenal tuberculosis should be differentiated from duodenal adenocarcinoma and lymphoma. We herein report a case of duodenal tuberculosis presenting as intraluminal protruding mass in gastroduodenoscopy and multiple intraabdominal lymphadenopathy on abdominal CT. We have confirmed the duodenal tuberculosis by endoscopic biopsy, and review the current literatures.
Adenocarcinoma ; Biopsy ; Drug Therapy ; Duodenal Neoplasms* ; Duodenum ; HIV ; Humans ; Lymphatic Diseases ; Lymphoma ; Prevalence ; Preventive Medicine ; Tomography, X-Ray Computed ; Tuberculosis* ; Tuberculosis, Pulmonary ; Ulcer