No abstract available.

Forty eight skin biopsies obtained from 24 patients were reviewed, and clinical, histological and immunohistochemical findings were analyzed. Results obtained are as follows: 1) Skin manifestation was plaque, erythroderma, scale and hyperpigmentation in mycosis fungoides, and subcutaneous nodule, mass and ulcerated patch in cutaneous lymphoma. The skin of lymphomatoid papulosis revealed hemorrhagic ulcerated and erythematous papules which healed spontaneously. 2) Histologically, mycosis fungoides showed epidermotropism in most cases. Pautrier's micro-abscesses were present in one-fourth of the cases. Malignant lymphoma was different in histology from mycosis fungoides. As compared with mycosis fungoides, it showed less frequent epidermotropism, more compact and diffuse infiltration of atypical lymphocytes, more often association with ulcer and necrosis, and more frequent mitotic figures. Lymphomatoid papulosis showed striking hemorrhage and edema of the papillary dermis. 3) Based on the results of immunohistochemical study, mycosis fungoides and lymphomatoid papulosis were considered as a T cell proliferative disorder of the skin. According to these findings, lymphoproliferative disorders of the skin occurred predominantly in the elderly and males. Clinical and histopathologic findings overlapped and were similar each other. It was difficult to make a definite diagnosis in early lesions, and a sequential follow up biopsy was required. It is concluded that strict criteria such as marked atypia and clustering of atypical cells are necessary for a histologic diagnosis of malignant lymphoproliferative disorder of the skin.
Biopsy

Purpose: This study investigated the effects of an intervention that combined the abdominal drawing-in maneuver and frequency-specific neuromuscular electrical stimulation on changes in trunk muscle activity, muscle fatigue, and balance in stroke patients. Methods: Thirty stroke patients were randomly assigned to two groups. Fifteen subjects were assigned to group I which performed the abdominal drawing-in maneuver combined with low-frequency neuromuscular electrical stimulation and the other 15 subjects to group II where the abdominal drawing-in maneuver was combined with high-frequency neuromuscular electrical stimulation. Muscle activity and fatigue were measured using surface electromyography before the intervention. Balance was measured using the Trunk Impairment Scale and re-measured after six weeks of intervention for comparative analysis. Results: Both groups showed a significant increase in muscle activity and balance (p < 0.05), and there was no significant difference between the groups (p > 0.05). In the changes in muscle fatigue, only the experimental group II showed a significant increase in muscle fatigue (p < 0.05). The difference between the groups was statistically significant (p < 0.05). Conclusion It was confirmed that among stroke patients, the combination of the abdominal drawing-in maneuver and low-frequency neuromuscular electrical stimulation was more effective in changing the muscle activity and balance of the trunk by minimizing the occurrence of muscle fatigue compared to the combination of the abdominal drawing-in maneuver and high-frequency stimulation. These results can be used as basic data for clinical trunk stabilization training.

PURPOSE: Conventional indomethacin therapy(0.2mg/kg every 12 hours for three doses) has been used for closure of PDA. The effect of prolonged low dose of indomethacin therapy(0.1mg/kg daily for six days)had been reported in foreign country but, nothing had been reported in our country. So we attempted this study to examine effects of these two methods. METHODS: Forty one infants with PDA of prematurity from January 1992 to July 1995 who were admitted in NICU of Il Sin Christian Hospital were included. 27 of these infants received conventional dose of indomethacin therapy and 14 received prolonged low dose of indomethacin therapy, and we examined with closure rate and complication etc. RESULTS: 1) Closure of PDA was observed in 15(55.6%) and relapse was 3(11.1%) in conventional dose therapy group. In prolonged low dose therapy group, closure was 8(57.1%) and relapse was none. 2) Intraventricular hemorrhage was observed in 20(74.1%), 6(42.9%) and gastrointestinal tract bleeding was 6(22.2%), 13(92.2%) in each group. There was statistically significant between the two groups(p<0.05). 3) The rise of serum BUN, creatinine was observed in 9(33.3%), 6(46.2%), bleeding tendency was 9(33.3%), 8(57.1%), necrotizing enterocolitis was 2(7.4%), 0 and retinopathy of prematurity was 8(29.6%), 3(21.4%) in each group.But there was not statistically significant correlation between the two groups. 4) The development of sepsis and broncopulmonary dysplasia was slightly more in prolonged low dose therapy group. 5) The reduction of urine output was observed in 11(40.7%), 2(14.3%) in each group but, absolute oliguria was not observed in both groups. CONCLUSIONS: Though the closure rate of PDA was similar in both groups, prolonged low dose indomethacin therapy can be recommanded with its effectiveness on preventing the relapse of PDA and the accurrence of necrotizing enterocolitis.
Creatinine ; Enterocolitis, Necrotizing ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Indomethacin* ; Infant ; Oliguria ; Recurrence ; Retinopathy of Prematurity ; Sepsis

Henoch-Schonlein purpura is a common pediatric disease presenting most frequently with skin, gastrointestinal, joint and renal manifestations. But in cases are infrequently only severe gastrointestinal manifestations. It is hard to diagnose promptly and exactly. Clinical manifestations and laboratory findings were observed and analyzed in 20 cases with Henoch-Schonlein purpura which were considered as acute abdomen, hospitalized at Kyung Hee university Hospital during the period from December, 1982 to September, 1992. The following results were obtained; 1) The age distribution of Henoch-Schonlein purpura had a peak incidence between 7 to 9 year old. And male preponderance was observed with male to female ratio of 2.33 to 1. 2) The most prevalent season for the initial presentation of Henoch-Schonlein purpura was in fall: in 10 cases (50%). 3) The frequency of each type of clinical manifestations showed 20 (100%), 20 (100%), 18 (90%), 8(40%) cases for skin, gastrointestinal, joint and renal manifestation respectively in order of frequency. 4) The common previous illness were URI, 40 cases (50%) and allergy, 2 cases (10%). 5) The onset time of skin manifestation from admission were 1 to 4 days (75%0, 5 to 8 days (15%), 9 to 12 days (10%) explolaparotomies were done the last 2 cases. 6) In all cases, X-ray study (100%), abdominal sono (50%), Meckels scan and colon study (5%) respectively were done. 7) Hematologically leukocytosis over 10,000/mm3 was observed in 80% of cases and increase in ESR over 20 mm/hr in 65% of cases. Coagulation studies, immunologic and complement level revealed the result within normal range in most of the cases. 8) Among 8 cases with renal involvement, all cases had both hematuria and proteinuria. 9) Most cases were recovered within 4 weeks but in 4 cases, renal biopsies were done because of relapse. The results were Meadow classification grade I (1 case), II (1 case), IVa (2 cases). After renal biopsy, steroid pulse therapy was started.
Abdomen, Acute* ; Age Distribution ; Biopsy ; Child ; Classification ; Colon ; Complement System Proteins ; Female ; Hematuria ; Humans ; Hypersensitivity ; Incidence ; Joints ; Leukocytosis ; Male ; Proteinuria ; Purpura, Schoenlein-Henoch* ; Recurrence ; Reference Values ; Seasons ; Skin ; Skin Manifestations

PURPOSE: Infectious keratitis is a rare but serious vision- threatening potential complication which occurs after corneal refractive surgery. After LASIK, the risk of corneal infection is lower than that of after PRK which induces the presence of a large epithelial defect. But once the infectious keratitis after LASIK develops, treatment may be very difficult. METHODS: We experienced a case of suspected fungal keratitis which developed 6 weeks after LASIK in a 29- year old woman, who had central corneal opacity. There was no clinical improvement after antifungal therapy. The corneal flap was removed to improve antibiotic penetration and the stromal bed was irrigated. And antifungal medication continued . RESULTS: After 2 months of treatment, we could find progressive improvement of infection, but the central corneal scar and neovascularization remained. CONCLUSION: The treatment of fungal keratitis under the corneal flap which occurs after LASIK is difficult because the irreversibly damaged corneal flap forms a barrier against antibiotic penetration. So treatment after flap removal may be necessary for an effective medical therapy.
Cicatrix ; Corneal Opacity ; Female ; Humans ; Keratitis* ; Keratomileusis, Laser In Situ* ; Refractive Surgical Procedures

We report four unusual cases of upper eyelid retraction following periorbital trauma. Four previously healthy patients were evaluated for unilateral upper eyelid retraction following periorbital trauma. A 31-year-old man (Case 1) and a 24-year-old man (Case 2) presented with left upper eyelid retraction which developed after blow-out fractures, a 44-year-old woman (Case 3) presented with left upper eyelid retraction secondary to a periorbital contusion that occurred one week prior, and a 56-year-old man (Case 4) presented with left upper eyelid retraction that developed 1 month after a lower canalicular laceration was sustained during a traffic accident. The authors performed a thyroid function test and orbital computed tomography (CT) in all cases. Thyroid function was normal in all patients, CT showed an adhesion of the superior rectus muscle and superior oblique muscle in the first case and diffuse thickening of the superior rectus muscle and levator complex in the third case. CT showed no specific findings in the second or fourth cases. Upper eyelid retraction due to superior complex adhesion can be considered one of the complications of periorbital trauma.
Accidents, Traffic ; Adult ; Eye Injuries/*complications/surgery ; Eyelid Diseases/*etiology/radiography ; Female ; Humans ; Lacerations/complications/surgery ; Lacrimal Apparatus/*injuries ; Male ; Middle Aged ; Oculomotor Muscles ; Orbital Fractures/*complications/surgery ; Tomography, X-Ray Computed

BACKGROUND: The aim of the study was to determine prevalence of potential heterogeneous vancomycin-resistant Staphylococcus aureus (h-VRSA) among methicillin-resistant S. aureus (MRSA) isolated in Korea by using Mu-3 agar and to determine the effect of in vitro vancomycin exposure on the resistance. METHODS: MRSAs isolated in 1980-1999 were screened for the presence of VISA or h-VRSA using Mu-3 agar. MIC of vancomycin was tested by NCCLS agar dilution and broth microdilution tests. Suspected h-VRSA were selected by vancomycin-containing media and change of resistance was determined by population analysis. A strain with Mu50 type growth was serially exposed to 8 pg/ml of vancomycin containing media and change of the vancomycin resistance was determined. RESULTS: Among the 455 MRSA isolates, 18 (3.9 %) grew on selective brain heart infusion agar (BHIA), and 354 (77,8%) on Mu-3 agar, 66 (14.5%) with Mu3 type growth and 78 (17.1%) with Mu50 type growth. MIC of vancomycin was 11 pg/ml for some of the isolates when inocula were approximately 10' CFU, but VISA was not present when tested by NCCLS broth microdilution test. Exposure of the isolates to van-cornycin raised the MIC. Serial exposure once to 8 pg/ml of vancomycin resulted in significant decrease of cells susceptible to 8-12 pg/ml of vancomycin. CONCLUSION: VISA was not present among the test isolates, but 34.2% were suspected to be potential h-VRSAs, suggesting possible emergence of VISA if vancomycin was administered prolonged period. It is considered that suitable screening media are vancomycin containing BHIA for VISA and Mu-3 agar for h-VRSA. The isolates showing Mu50 type growth on Mu-3 agar are not always VISA, but rather h-VRSA.
Agar* ; Brain ; Heart ; Korea ; Mass Screening ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Prevalence ; Staphylococcus aureus* ; Staphylococcus* ; Vancomycin Resistance ; Vancomycin*

PURPOSE: Gastric emptying after a gastric resection has been studied in early gastric cancer. Most reports are retrospective and show that gastric emptying after gastroduodenal reconstruction is faster than normal. This study was designed to evaluate the gastric-emptying pattern after a gastroduodenal reconstruction with preservation of the truncal vagus nerve had been performed on a patient whose preoperative gastric-emptying time had been normal. METHODS: From July 1996 to February 1998, we performed a distal gastrectomy with gastroduodenal reconstruction with preservation of the truncal vagus nerve in 11 patients (9 patients with early gastric cancer, 1 patient with advanced gastric cancer, and 1 patient with high-grade dysplasia) whose preoperative gastric-emptying times was normal. To evaluate the gastric emptying after the gastrectomy and gastroduodenal reconstruction, we analyzed the lag time (when 10% of food is delivered to the duodenum), T1/2 (when 50% of food is delivered to the duodenum), and the residual food in the stomach after 100 minutes (%) by means of radionuclide scintigraphy using a single-head gamma camera after ingestion of an 99mTc-tin-colloid steamed egg. We defined the delayed gastric emptying as T1/2 longer than the mean of the preoperative value by 2 standard deviation. RESULTS: Among the 11 patients with gastroduodenal reconstruction, gastric emptying was normal in 4 patients and delayed in 7 patients; only one of the delayed cases has GI symptoms such as early satiety. There were no rapid gastric emptying cases. CONCLUSION: Rapid gastric emptying after gastroduodenal recon struction with preservation of the truncal vagus nerve was rare.
Eating ; Gamma Cameras ; Gastrectomy ; Gastric Emptying ; Humans ; Ovum ; Radionuclide Imaging ; Retrospective Studies ; Steam ; Stomach ; Stomach Neoplasms ; Vagus Nerve*

Benign focal amyotrophy (BFA) is a limited form of anterior horn cell disease with variable benign clinical appearance. Clinical symptoms of cold-sensitive BFA have been described but electrodiagnostic workup on these symptoms has not been done. A 28-year-old man suffering from cold-sensitive weakness and coordination disturbance of a hand underwent electrodiagnostic study while the subject was exposed to the cold. According to this study, the BFA with cold sensitivity may be classified as one type of BFA which can be confirmed by electrodiagnostic study.
Adult ; Hand ; Humans ; Motor Neuron Disease