BACKGROUND: Cellulitis is one of the most common infectious skin diseases in primary care units of military service in which personal hygiene could be easily neglected under special circumstances such as outdoor training. OBJECTIVE: This study was designed to elucidate the probable causes of the high incidence rate of cellulitis in military service. METHODS: We prospectively evaluated the clinical findings of 59 patients with cellulitis who were hospitalized in the medical detachment of the 1st Infantry Division of the ROK Army from May, 1995 to April, 1996. RESULTS: The mean age of patients was 21(19-25). Analysing the rank of the patients, the number of recruits was 3(5%), private 26(44%), private first class 17(29%), corporal 11(19%) and sergeant 2(3%). Seventy eight percent of them were included in ranks below corporal. The recurrence rate of cellulitis during the 2 1/2 year follow-up period was only 4%. Skin lesions noted were erythema(100%), tenderness(98%), swelling(98%), local heating(97%), lymphadenopathy(73%), pus (63%), fluctuation(32%), ulcer(27%), lymphangitis(14%), bullae(8%), etc. The most common route of infection was the previous wounds(46%) which allows a portal for invasion of microorganisms. Tinea pedis was also found to be in 39% of patients with cellulitis of the lower leg. The pus culture performed on 7 patients who had not been responsive to primary antibiotics resulted in 6 positive cases of Staphylococcus aureus. CONCLUSION: Considering the ranks of the patients and the routes of infection, we found that the incidence of cellulitis in the military service of the ROK Army could be reduced if more attention would be paid to preventive counterplans for secondary infection and tinea pedis.
Anti-Bacterial Agents ; Cellulitis* ; Coinfection ; Follow-Up Studies ; Humans ; Hygiene ; Incidence ; Leg ; Military Personnel ; Primary Health Care ; Prospective Studies ; Recurrence ; Skin ; Skin Diseases, Infectious ; Staphylococcus aureus ; Suppuration ; Tinea Pedis

A clinical analysis was performed on 326 cases of the non-penetrating rib fractures experienced in the department of thoracic and cardiovascular surgery, Chosun University Hospital and 102 cases of the non-penetrating rib fractures those has been admitted and treated in the department of thoracic and cardiovascular surgery, Jeonnam Hwasoon Jung-ang Hospital during a period from Jan. 1994 to Dec. 1995. 1. Sex ratio was 3.4:1 in urban and 3.6:1 in rural communities with male predominance. 2. Most common cause were traffic accident in both communities. 3. Hemothorax, pneumothorax and hemopneumothorax which needed thoracostomy were observed in 146 cases(44.7%) in the urban and 12 cases(11.7%) in the rural communities. 4. Left thorax was the spell site of rib fractures in both communities. 5. Rib fracture was prevalent from 3rd to 6th rib in both communities. 6. Open thoracotomy was performed in 37 cases(11.3%) in urban and 3 cases(2.9%) in rural communities. 7. Overall mortality was 4.29%(14 cases) in urban area and, 1.96%(2 cases) in rural communities, and cause of death were hypovolemic shock, brain edema, sepsis, respiratory failure, asphyxia, and cardiogenic shock.
Accidents, Traffic ; Asphyxia ; Brain Edema ; Cause of Death ; Hemopneumothorax ; Hemothorax ; Humans ; Jeollanam-do ; Male ; Mortality ; Pneumothorax ; Respiratory Insufficiency ; Rib Fractures* ; Ribs* ; Rural Population* ; Sepsis ; Sex Ratio ; Shock ; Shock, Cardiogenic ; Thoracostomy ; Thoracotomy ; Thorax

BACKGROUND: Unlike its use during stable conditions, central venous pressure (CVP) monitoring from a peripherally inserted central venous catheter (PICC) has not often been used in surgeries with significant hemodynamic alterations. The aim of this study was to evaluate the feasibility of measuring PICC pressure (PICCP) as an alternative to measuring centrally inserted central catheter pressure (CICCP) in adult liver transplantation (LT) patients. METHODS: We measured PICCP and CICCP simultaneously during each main surgical period in adult LT. Statistical analysis was performed using simple linear regression analysis to observe whether changes in PICCP paralleled by simultaneous changes in CICCP. Correlation analysis and Bland-Altman analysis were used to determine the degree of agreement between the two devices. Differences were considered statistically significant when P values were less than 0.05. RESULTS: A total of 1342 data pairs were collected from 35 patients. The PICCPs and CICCPs were highly correlated overall (r = 0.970, P < 0.001) as well as at each period measured. The differences among each period were not clinically significant (0.33 mmHg for pre-anhepatic, 0.32 mmHg for anhepatic, -0.15 mmHg for reperfusion, and -0.10 mmHg for neohepatic periods). The overall mean difference was 0.14 mmHg (95% confidence interval: 0.09-0.19) and PICCP tended to give a higher reading by between 0.09 and 0.19 mmHg overall. The limit of agreement was -1.74 to 2.02 overall. CONCLUSIONS: These findings suggest that PICCP can be a reasonable alternative to CICCP in situations of dynamic systemic compliance and preload, as well as under stable hemodynamic conditions.
Adult ; Catheters ; Central Venous Catheters ; Central Venous Pressure ; Compliance ; Hemodynamics ; Humans ; Jugular Veins ; Linear Models ; Liver ; Liver Transplantation ; Reperfusion

PURPOSE: To detect differentially expressed genes in the patients with uterine cervical cancer during the radiation therapy. MATERIALS AND METHODS: In patients with biopsy proven uterine cervical cancer, we took a tumor tissue just before radiation therapy and at 40 minutes after external irradiation of 1.8 Gy. Total RNAs isolated from non-irradiated and irradiated tumor tissue samples were analyzed using the differential-display reverse transcription-polymerase chain reaction (DDRT-PCR). Complementary DNA (cDNA) fragments corresponding to differentially expressed messenger RNAs(mRNAs) were eluted, and cloned. The differential expression of the corresponding mRNAs was confirmed by reverse northern blot. Differentially expressed cDNA bands were sequenced. Nucleotide sequence data were analyzed in the Gene Bank and EMBL databases via the BLAST network server to identify homologies to known genes or cDNA fragments. Expression pattern of down-regulated clone was examined using RT-PCR in 5 patients undergoing radiotherapy. RESULTS: We identified 18 differentially expressed bands by DDRT-PCR, which were eluted and cloned. There were 10 up-regulated clones and 1 down-regulated clone in reverse northern blot. One cDNA fragment had homology to chemokine receptor CXCR4, four were identified as Human ESTs in the EMBL database in EST clones. Down-regulated CxCa-11 was also down regulated in all patients. CONCLUSION: Using the DDRT-PCR, we have identified 10 up-regulated and 1 down-regulated clone(s) in the patients with uterine cervix cancer during the radiation therapy. The clinical relevance and the functions of these genes will be further investigated.
Base Sequence ; Biopsy ; Blotting, Northern ; Cervix Uteri* ; Clone Cells ; DNA, Complementary ; Expressed Sequence Tags ; Female ; Humans ; Radiotherapy* ; RNA ; RNA, Messenger ; Uterine Cervical Neoplasms

There remains controversy regarding the appropriate surgical treatment for coarctation of the aorta because of relatively high rate of recoartation and high mortality in the cases associated with complex anomalies. We evaluated 31 consecutive patients who underwent surgical repair of coarctation of the aorta from May 1992 through June 1996. Nineteen patients(61.3%) were neonates and 26(83.9%) were under three months. Nine patients did not have major associated anomalies(Group I), 15 patients had ventricular septal defect(Group II), and 7 patients had major complex anomalies(Group III). 35.5% of the patients had arch hypoplasia. Surgical procedures performed were as follows: extended end-to-end anastomosis in 17 patients, combined resection-flap procedure in 7 patients, and subclavian flap aortoplasty in 7 patients. Residual coarctation occurred in 7(25%) of 28 patients; 2 after subclavian flap aortoplasty(2/6, 33.3%), none after combined resection-flap procedure(0/7, 0%)), and 5 after extended end-to-end anastomosis(5/15, 33.3%). Higher incidence of residual coarctation was noticed in the group with arch hypoplasia. The incidence of postoperative coarctation at a mean follow-up of 20.5 months in survivals was 12.0%(3/25); 2 cases after subclavian flap aortoplasty(2/6, 33.3%), none after combined resection-flap procedure(0/7, 0%), and one after end-to-end anastomosis(1/12, 8.3%). The mortality rate related to coarctation repair was 9.7%(3 patients, all in Group III). This study revealed that isolated coarctation of aorta and coarctation with ventricular septal defect(groups I and II) can be repaired with low mortality, but repair of coarctation with complex anomaly had a high operative mortality. Also the patients with arch hypoplasia had higher incidence of post-operative residual coarctation.
Aortic Coarctation* ; Follow-Up Studies ; Humans ; Incidence ; Infant, Newborn ; Mortality

PURPOSE: A number of genes and their products are induced early or late following exposure of cells to ionizing radiation. These radiation-induced genes have various effects on irradiated cells and tissues. Suppression subtractive hybridization (SSH) based on PCR was used to identify the differentially expressed genes by radiation in cervix carcinoma cells. MATERIASL AND METHODS: Total RNA and poly (A)+ mRNA were isolated from irradiated and non-irradiated HeLa cells. Forward- and reverse-subtracted cDNA libraries were constructed using SSH. Eighty-eight clones of each were used to randomly select differentially expressed genes using reverse Northern blotting (dot blot analysis). Northern blotting was used to verify the screened genes. RESULTS: Of the 176 clones, 10 genes in the forward-subtracted library and 9 genes in the reverse-subtracted library were identified as differentially expressed radiation-induced genes by PCR-select differential screening. Three clones from the forward-subtracted library were confirmed by Northern blotting, and showed increased expression in a dose-dependent manner, including a telomerase catalytic subunit and sodium channel-like protein gene, and an ESTs (expressed sequence tags) gene. CONCLUSION: We identified differentially expressed radiation-induced genes with low-abundance genes with SSH, but further characterization of theses genes are necessary to clarify the biological functions of them.
Blotting, Northern ; Cervix Uteri* ; Clone Cells ; Expressed Sequence Tags ; Female ; Gene Library ; HeLa Cells ; Humans ; Mass Screening ; Polymerase Chain Reaction ; Radiation, Ionizing ; RNA ; RNA, Messenger ; Sodium ; Telomerase

Agenesis of the right lobe of the liver is a rare anomaly which may be associated with stone diseases, portal hypertension, and other congenital anomalies. The radiological differential diagnosis includes lobar atrophy due to cirrhosis or hilar cholangiocarcinoma. We present a case of agenesis of the right lobe of the liver with characteristic clinical and radiological findings.
Atrophy ; Diagnosis, Differential ; Fibrosis ; Hypertension, Portal ; Klatskin Tumor ; Liver*

Agenesis of the right lobe of the liver is a rare anomaly which may be associated with stone diseases, portal hypertension, and other congenital anomalies. The radiological differential diagnosis includes lobar atrophy due to cirrhosis or hilar cholangiocarcinoma. We present a case of agenesis of the right lobe of the liver with characteristic clinical and radiological findings.
Atrophy ; Diagnosis, Differential ; Fibrosis ; Hypertension, Portal ; Klatskin Tumor ; Liver*

PURPOSE: We investigated whether Tc-99m MIBI imaging is useful to predict the response of drug treatment in patients with rheumatoid arthritis. MATERIALS AND METHODS: 24 patients (15 women and 9 men, age 49 +/- 12 year) rheumatoid arthritis and treated with disease modifying antirheumatic drugs (DMARDs) were included in this study. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured, and Tc-99m MIBI scan was obtained before drug treatment. Quantitative analysis of uptake in diseased joints was performed and expressed as joint-to background ratio (J/B) and percent retention (%R) of Tc-99m MIBI. Clinical symptoms were evaluated and graded from 0 (no) to 3 (severe) regarding to presence of tenderness and swelling. RESULTS: J/B of the diseased joints were significantly correlated with ESR and CRP (p< 0.05). A highly significant correlation was found between the improvement of clinical symptoms and %R of Tc-99m MIBI (p< 0.05). CONCLUSION: The results demonstrate that Tc-99m MIBI scan may be used to predict the therapeutic response in patients with rheumatoid arthritis.
Antirheumatic Agents ; Arthritis, Rheumatoid* ; Blood Sedimentation ; C-Reactive Protein ; Female ; Humans ; Joints ; Male

The carcinoid tumor of the ampulla of Vater is extremely rare. We report a case of 57-year old male with carcinoid tumor of ampulla of Vater. This patient had been presented with bronchial asthma for one year. Abdominal CT finding revealed diffuse dilatation of common bile duct and pancreatic duct, and also ampullary soft mass protruded into duodenal lumen. The correct diagnosis was made preoperatively by endoscopic retrograde cholangiography with biopsy. Pancreatico- duodenectomy with lymph nodes dissection was performed. Malignant carcinoid tumor originating from ampulla of Vater was diagnosed with pericholedochal lymphatic metastasis. Surgical removal led to complete resolution of asthmatic symptoms.
Ampulla of Vater* ; Asthma ; Biopsy ; Carcinoid Tumor* ; Cholangiography ; Common Bile Duct ; Diabetes Mellitus ; Diagnosis ; Dilatation ; Humans ; Insulin Resistance ; Lymph Nodes ; Lymphatic Metastasis ; Male ; Middle Aged ; Obesity ; Pancreatic Ducts ; Polymerase Chain Reaction ; PPAR gamma ; Tomography, X-Ray Computed