No abstract available.
Humans ; Infant* ; Streptococcal Infections*

PURPOSE: To determine the extent to which magnetic resonance(MR) imaging findings can help differentiate between tuberculous arthritis (TA) and rheumatoid arthritis(RA). MATERIALS AND METHODS: This study involved sixteen patients with pathologically proven arthritis of the knee. In eight patients(mean age, 29.6 years; M:F=4:4) this was of the tuberculous variety, while eight (mean age, 47.5 years; M:F=2:6) suffered from the rheumatoid variety, which was monoarticular. For 14 patients, contrast enhancement studies were available. We retrospectively analyzed MR findings according to the demonstrated pattern of synovial thickening (regular and even, or irregular and nodular), bone erosion or abscess,bone marrow(BM) edema, the sites at which bursae were present, para-articular mass formation, and lymphadenopathy. RESULTS: In five of eight TA cases (62.5 %), irregular and nodular enhanced synovial thickening was present, while in six of eight RA cases (75%), thickening was regular and even. Bone erosions or subarticular abscesses were found in six TA cases (75%) and small erosions in three cases (37.5%) of RA. BM edema surrounding the erosion was found in four cases of TA (50%) and two of RA (25 %). In TA, edema was more extensive. In both TA and RA, all suprapatella bursae were distended while popliteal bursae were present in two cases of TA(25 %) and four of RA (50%). Para-articular masses with rim like enhancement were found in six cases of TA (75%) and in one case of RA (12.5 %). In particular, para-articular lymphadenopathy was seen in six cases of TA(75%), but not in RA. CONCLUSION: MR findings of irregular and nodular synovial thickening, extensive bone erosion, extensive BM edema, particular, para-articular abscess formation and ymphadenopathy, may help differentiate tuberculous arthritis of the knee from the rhumatoid variety.
Abscess ; Arthritis* ; Arthritis, Rheumatoid* ; Diagnosis, Differential* ; Edema ; Humans ; Knee* ; Lymphatic Diseases ; Magnetic Resonance Imaging* ; Retrospective Studies

BACKGROUND: The purpose of this study was to find additional effects of intrathecal nalbuphine 1 mg to morphine 0.1 mg for pain relief during a cesarean section. METHODS: Sixty healthy patients at full term who were scheduled for an elective cesarean delivery with spinal anesthesia were enrolled in the study. They received 0.5% bupivacaine 10 mg with either morphine 0.1 mg (group M), or nalbuphine 1 mg (group N), or morphine 0.1 mg nalbuphine 1 mg (group M + N). Analgesic effects were evaluated by a verbal rating scale on the duration of complete analgesia (time from the intrathecal injection to the first pain report), effective analgesia (time from the intrathecal injection to the first analgesic request), and cumulative doses of additional analgesics. Hemodynamic changes and adverse effects were also observed. RESULTS: The duration of complete analgesia increased significantly in group M, compared with group N and group M + N. Effective analgesia was longer in group M and group M + N, compared with group N. The incidence of pruritus was significantly lower in group N, compared with group M and M + N. The incidence of nausea and vomiting was the same among all groups. CONCLUSIONS: We concluded that intrathecal addition of nalbuphine 1mg to morphine 0.1 mg during spinal anesthesia for a cesarean delivery reinforced intraoperaitive analgesia compared with intrathecal morphine 0.1 mg. However, it reduced the duration of complete analgesia and had no effect on the incidence of pruritus.
Analgesia ; Analgesics ; Anesthesia, Spinal ; Bupivacaine ; Cesarean Section* ; Female ; Hemodynamics ; Humans ; Incidence ; Injections, Spinal ; Morphine* ; Nalbuphine* ; Nausea ; Pregnancy ; Pruritus ; Vomiting

BACKGROUND: Shipbuilding involves intensive welding activities, and welders are exposed to a variety of metal fumes, including manganese, that may be associated with neurological impairments. This study aimed to characterize total and size-fractionated manganese exposure resulting from welding operations in shipbuilding work areas. METHODS: In this study, we characterized manganese-containing particulates with an emphasis on total mass (n = 86, closed-face 37-mm cassette samplers) and particle size-selective mass concentrations (n = 86, 8-stage cascade impactor samplers), particle size distributions, and a comparison of exposure levels determined using personal cassette and impactor samplers. RESULTS: Our results suggest that 67.4% of all samples were above the current American Conference of Governmental Industrial Hygienists manganese threshold limit value of 100 μg/m3 as inhalable mass. Furthermore, most of the particles containing manganese in the welding process were of the size of respirable particulates, and 90.7% of all samples exceeded the American Conference of Governmental Industrial Hygienists threshold limit value of 20 μg/m3 for respirable manganese. CONCLUSION: The concentrations measured with the two sampler types (cassette: total mass; impactor: inhalable mass) were significantly correlated (r = 0.964, p < 0.001), but the total concentration obtained using cassette samplers was lower than the inhalable concentration of impactor samplers.
Humans ; Manganese* ; Particle Size ; Welding

PURPOSE: To evaluate the sonographic findings of fetal congenital intracranial teratoma. MATERIALS AND METHODS: From 1994 to 2002, of the 11 fetuses which had been diagnosed with fetal intracranial tumors after second level fetal ultrasonography, the six that were confirmed after autopsy as congenital intracranial teratomas were included in our study. The sonographic findings, including size, homogeneity, echogenicity compared with surrounding normal brain tissues, cystic components, and tumor related calcification, were retrospectively evaluated. RESULTS: The incidence of fetal congenital intracranial teratoma out of all fetal intracranial tumors was 54.5% (6 of 11 cases) during the 8-year period. The mean mass size was 7.4 cm (3.0-15.0 cm). Two thirds of (4/6) of the teratoma cases showed high echogenicity compared with normal brain tissues, and two thirds (4/6) showed heterogeneous echogenicity. Four teratoma cases (67%) showed cysts in the mass with a mean size of 1.9cm. One third (2/6) showed calcifications within the tumor. Out of the six cases, two had oropharyngeal teratoma with extension into the intracranial portion (so called epignathus) and showed homogenous mass without any cysts or calcifications. CONCLUSION: The typical sonographic appearance of intracranial teratoma was a heterogeneous, hyperechoic mass with cysts. In the epignathus cases, the sonographic appearances differed somewhat from the others. An understanding of the sonographic findings of fetal intracranial teratoma will help in the timely counseling of the parents and in obstetric decision making.
Autopsy ; Brain ; Counseling ; Decision Making ; Fetus ; Humans ; Incidence ; Parents ; Retrospective Studies ; Teratoma* ; Ultrasonography ; Ultrasonography, Prenatal

BACKGROUND AND OBJECTIVE: Atopic dermatitis(AD) is a chronic inflammatory skin disease with a high incidence in early childhood. Staphylococcus aureus(SA) is found at high concentrations in over 90% of AD skin lesions compared with 5-37% of age-matched controls. SA isolates from AD subjects have a high prevalence(37-57%) of superantigen-producing strains. And staphylococcal enterotoxin B(SEB) has been shown to induce inflammatory reactions following application to intact skin of normal and atopic subjects. These findings suggest that SA toxin produced by SA may be linked with initiation or aggravation of AD, but the role of satphylococcal enterotoxin to the T cell in the pathogenesis of AD has not been determined clearly. This study was conducted to determine whether staphylococcal enterotoxin might have a role as a superantigen in the pathogenesis of AD. Materials and Method: We investigated the proliferative responses of peripheral blood mononuclear cell(PBMC) from 8 patients with AD and 10 age-matched normal controls. We also assessed T cell markers and T cell receptor(TCR) Vbeta chain expression by flow cytometry with and without SEB stimulation. RESULTS: PBMC from AD patients showed increased proliferation to SEB 100 pg/ml and 1000 pg/ml compared to controls. There were no differences of CD3(+), CD4(+), and CD8(+) cells after SEB stimulation between the two groups. And there were also no differences of TCR Vbeta2(+) and TCR Vbeta8(+) cells with and without SEB stimulation, but TCR Vbeta17(+) cells were increased after SEB stimulation not only in AD patients but also in controls compared to culture without SEB. The expressions of TCR Vbeta17 chain of CD3(+) and CD4(+) cells after SEB stimulation were increased in AD patients compared to controls. Furthermore, there was positive correlation between the enhanced PBMC proliferative responses to SEB and increased expressions of SEB reactive TCR Vbeta17(+)/CD4(+) cells in AD patients and controls. CONCLUSION: These findings suggest that SEB is important in the pathogenesis of atopic dermatitis and also provide evidence that the increased use of certain TCR Vbeta families is of functional significance.
Dermatitis, Atopic* ; Enterotoxins* ; Flow Cytometry ; Humans ; Incidence ; Skin ; Skin Diseases ; Staphylococcus

Nodular hidradenoma was diagnosed in a 29-month-old girl on her axilla. Hidradenoma, sometimes designated as acrospiroma, is a benign sweat gland neoplasm, which mostly occurs in adults. Very few cases of hidradenoma have been documented in children in their first decade of life. This case demonstrates that when a child develops a skin nodule, nodular hidradenoma can be a diagnostic option.
Acrospiroma* ; Adult ; Axilla ; Child ; Child, Preschool* ; Female ; Humans ; Skin ; Sweat Gland Neoplasms

BACKGROUND: The aim of this study was to investigate annual changes in pulmonary function in workers who were exposed to inorganic dust. METHODS: The subjects were 2,922 male patients who had been diagnosed with pneumoconiosis more than twice during 6 years from 2005 to 2010. RESULTS: Of the 2,922 cases, forced vital capacity (FVC) decreased by 54 mL in 1 year. In contrast, the annual change of forced expiratory volume in one second (FEV1) decreased by 56 mL. CONCLUSION: This is the first study that has investigated the annual change in pulmonary function in workers exposed to inorganic dust. The results will help estimate the pulmonary condition of patients who are unable to perform a pulmonary function test due to age or a disorder.
Dust ; Forced Expiratory Volume ; Humans ; Lung ; Male ; Pneumoconiosis ; Respiratory Function Tests ; Vital Capacity

BACKGROUND: Polycystic ovary syndrome(PCOS) is characterized by the presence of chronic anovulation and hyperandrogenism, The prevalence of PCOS in premenopausal women of about 5~ 10%. There may be significant ethnic and racial variations in the prevalence and clinical presentation of PCOS. The current study was undertaken to determine the prevalence of PCOS and to identify the clinical characteristics of PCOS in Korea. METHODS: From March 2003 to March 2004, medical students from Ewha Womans University were investigated for the prevalence of PCOS. The evaluation included a history and physical examination, a modified Ferriman-Gallwey hirsutism score and screening for hyperandrogenemia. PCOS was diagnosed by the presence of the following: 1) oligomenorrhea, 2) hyperandrogenemia and/or hirsutism(a modified Ferriman-Gallwey score> or =6), and 3) the exclusion of related disorders. Hyperandrogenemia was defined as a free testosterone level above the 95th percentile of that for normal cycling nonhirsute women. RESULTS: Out of 492 students, 386 replied to the questionnaire and 203 students(19~31 yr of age) participated in the physical examination and blood sampling. Eumenorrhea without hirsutism was present in 133 students(65.5%), oligomenorrhea was present in 39 students(19.2%), hyperandrogenism was present in 21 students(10.3%) and hirsutism was present in 3(1.5%) of the 203 women. The prevalence of PCOS was 4.9%(10 of 203 students), and only 2 of 10 women with PCOS were hirsute. The mean body mass index of students with PCOS was 22.7+/- 4.3kg/m2, and two women was obese. The plasma insulin levels during the 75g oral glucose tolerance test in women with PCOS was significantly higher when compared to the age and body mass index of the controls. CONCLUSION: The prevalence of PCOS was 4.9% in college students from Seoul. This rate is similar to those rates reported by other investigators in Greece(6.7%) and United States(4%). Obesity and hirsutism are not common in Korean women with PCOS. We are planning to survey a more diverse age groups to determine the prevalence of PCOS
Anovulation ; Body Mass Index ; Female ; Glucose Tolerance Test ; Hirsutism ; Humans ; Hyperandrogenism ; Insulin ; Korea ; Mass Screening ; Obesity ; Oligomenorrhea ; Ovary ; Physical Examination ; Plasma ; Polycystic Ovary Syndrome* ; Prevalence* ; Surveys and Questionnaires ; Research Personnel ; Seoul* ; Students, Medical ; Testosterone

OBJECTIVE: To report an efficacy of gonadotropin releasing hormone (GnRH) antagonist administration after freezing of all embryos for treatment of early type ovarian hyperstimulation syndrome (OHSS). METHODS: In 10 women who developed fulminant early type OHSS after freezing of all embryos, GnRH antagonist (cetrorelix 0.25 mg per day) was started at the time of hospitalization and continued for 2 to 4 days. Fluid therapy and drainage of ascites was performed as usual. RESULTS: Early type OHSS was successfully treated without any complication. At hospitalization, the median (95% confidence interval [CI]) of the right and the left ovarian diameter was 10.0 cm (7.6 to 12.9 cm) and 8.5 cm (7.5 to 12.6 cm). After completion of GnRH antagonist administration, it was decreased to 7.4 cm (6.2 to 10.7 cm) (P=0.028) and 7.8 cm (5.7 to 12.2 cm) (P=0.116), respectively. The median duration of hospital stay was 6 days (3 to 11 days). Trans-abdominal drainage of ascites was performed in 2 women and drainage of ascites by percutaneous indwelling catheter was performed in 4 women. No side effect of GnRH antagonist was noted. CONCLUSION: GnRH antagonist administration appears to be safe and effective for women with fulminant early type OHSS after freezing all embryos. Optimal dose or duration of GnRH antagonist should be further determined.
Ascites ; Catheters, Indwelling ; Drainage ; Embryonic Structures ; Female ; Fluid Therapy ; Freezing ; Gonadotropin-Releasing Hormone* ; Gonadotropins* ; Hospitalization ; Humans ; Length of Stay ; Ovarian Hyperstimulation Syndrome*