BACKGROUND: This study aimed to estimate the clinical outcome and identify the characteristics of a group of patients with pulmonary tuberculosis who completed anti-tuberculosis therapy with the First-line drugs in spite of having positive smear results with negative sputum culture results over the previous six months. METHOD: A retrospective chart review of 21 patients who fulfilled the above criteria between 1995 and 1999 was performed. The laboratory data as well as the clinical data of the patient with positive smear results and negative culture results over a six months period were reviewed. RESULTS: The negative conversion of sputum culture results was achieved within 1.3±1.2 months and the negative conversion of the sputum smear results was accomplished during 9.5±3.3 months. Chest X-rays at 5 months following the institution of anti-tuberculosis therapy from all patients revealed improvements. Four out of 21 patients(19%) relapsed during the follow up, 15.2±13.4 months after administering anti-tuberculosis therapy for 13.3±3.1 months. Relapses were confirmed from between 3 months and 4 months after the treatment completion. Only one of the four relapses had no past history of anti-tuberculosis therapy and the others had prior treatment twice (p<0.01). The period of anti-tuberculosis treatment was extended to a mean of 4.6±2.6 months in 12 patients. However, prolongation of anti-tuberculosis therapy had no affect on the relapse rate (odds ratio, 95% CI 0.18, 2.15). CONCLUSION: Prolongation of therapy with the First-line drugs is not necessary for patients with persistently positive smear results over 6 months and negative culture results. A patient who has had prior anti-tuberculosis therapy more than twice should be paid the closest attention.
Follow-Up Studies ; Humans ; Recurrence ; Retrospective Studies ; Sputum* ; Thorax ; Tuberculosis, Pulmonary

A 40-year-old woman presented with a pruritic erythematous eroded patch on the right labium majus which had been for 3 years. Histopathological findings were consistent with superficial basal cell epithelioma. Basal cell epithelioma of the labium majus is a rare neoplasm and its clinical appearance is usually nodular. In contrast to the other types of basal cell epithelioma, the superficial type occurs mainly on the trunk. We report a case of superficial basal cell epithelioma arising from the labium majus.
Adult ; Carcinoma, Basal Cell* ; Cytochrome P-450 CYP1A1 ; Female ; Humans

The compartment syndrome was described by von Volkmann in 1872 and numerous reports have since been published. The anterior tibial syndrome is well known, but the peroneal compartment syndrome is very rare and have some differences in it's etiology, diagnosis and treatment. We experienced a case of the peroneal compartment syndrome developed after playing foot-ball, and treated by fasciotomy with some delay, but obtained a satisfactory functional result.
Anterior Compartment Syndrome ; Compartment Syndromes ; Diagnosis

It is generally accepted that integrity of the posterior cruciate ligament plays a major role in knee stability. The potential disability resulting from disruption of the posterior cruciate ligament is sufficient to warrant aggressive operative management when the lesion is discovered. From August 1980 to July 1982, the authors treated the 8 cases of the posterior cruciate ligament injury at the department of orthopedic surgery, Chung Ang university hospital; primary repair(2 cases), reconstruction using the medial head of the gastrocnemius muscle(6 cases). In the operative procedure of reconstruction using gastrocnemius, we experienced the following obstacle and resolved it effectively. l. In the surgical approach, we choosed the separate incision on the anteromedial and posteromedial aspect of knee and satisfactory results were obtained. 2. In adequate length of the gastrocnemius tendon was resolved by releasing of gastrocnemius as closer to it's femoral condyle origin as possible or together with attached periosteum and bone chips, by fixation of gastrocnemius with pull through wire suture method. 3. In advancement of the gastrocnemius into the knee joint, we used No. 32 chest tube and achieved the smooth enterance. 4. Adequate position of the femoral condyle drill hole was achieved by using hip screw reamer and K-wire.
Chest Tubes ; Head ; Hip ; Knee ; Knee Joint ; Methods ; Orthopedics ; Periosteum ; Posterior Cruciate Ligament ; Surgical Procedures, Operative ; Sutures ; Tendons

No abstract available in English.
Amputation

PURPOSE: The purpose of this study is to investigate clinical features and causative organisms in febrile infants younger than three months, to help identification of high risk patients for serious bacterial infection (SBI). METHODS: A total of 313 febrile infants younger than three months, who had visited Seoul National University Children's Hospital from January 2008 to December 2010 were included. Clinical features, laboratory findings, causative organisms, and risk factors of SBI were analyzed by retrospective chart review. Causative bacterial or viral pathogens were identified by gram stain and cultures, rapid antigen tests, or the polymerase chain reaction from clinically reliable sources. RESULTS: Among 313 infants, etiologic organisms were identified in 127 cases (40.6%). Among 39 cases of bacterial infections, Escherichia coli (66.7%) and Streptococcus agalactiae (12.8%) were common. Enterovirus (33.7%), respiratory syncytial virus (19.8%), and rhinovirus (18.8%) were frequently detected in 88 cases of viral infection. Patients with SBI (39 cases) showed significantly higher values of the white blood cell count (14,473+/-6,824/mm3 vs. 11,254+/-5,775/mm3, P=0.002) and the C-reactive protein (6.32+/-8.51 mg/L vs. 1.28+/-2.35 mg/L, P<0.001) than those without SBI (274 cases). The clinical risk factors for SBI were the male (OR 3.7, 95% CI 1.5-8.9), the presence of neurologic symptoms (OR 4.8, 95% CI 1.4-16.8), and the absence of family members with respiratory symptoms (OR 3.6, 95% CI 1.2-11.3). CONCLUSION: This study identified common pathogens and risk factors for SBI in febrile infants younger than three months. These findings may be useful to guide management of febrile young infants.
Bacterial Infections ; C-Reactive Protein ; Enterovirus ; Escherichia coli ; Fever ; Humans ; Infant ; Infant, Newborn ; Leukocyte Count ; Male ; Neurologic Manifestations ; Polymerase Chain Reaction ; Respiratory Syncytial Viruses ; Retrospective Studies ; Rhinovirus ; Risk Factors ; Sepsis ; Streptococcus agalactiae

Nuclear morphology and size are important in the diagnosis and classification of non-Hodgkin's lymphoma. The recognition of morphologic features of the lymphoma cells and their interpretation are somewhat subjective and often difficult. We apply the morphometric study in touch imprints from 22 cases of non-Hodgkin's lymphoma classified by Working formulation. Determination of the exact size of the tumor cells and substantial diagnostic value of this method compared with histology are proposed. Morphometric parameters, including nuclear area, perimeter, maximal diameter (D-max), diameter of an equivalent circle for a measured area (D-circle), circularity factor (From PE) and regularity factor (Form AR) are measured, using Kontron, user-controlled image analyser (IBAS-1). The correlation between morphometric and histologic diagnosis is relatively good, except for 2 cases of Burkitt's lymphoma, measured as large cell and 2 cases of large cell lymphoma measured as medium cell. The most reliable parameter of the nuclear size is D-circle. The parameters for the nuclear shape, Form PE and Form AR, also reflect the nuclear cleavage and polymorphous pattern. The large cell group shows more wide standard deviation than small and medium cell groups, reflecting heterogeneity and variability in unclear size of large cell group. We suggests the morphometric analysis using touch imprints is complementary diagnostic tool for more accurate and reproducible diagnosis.

Generalized distinct hyperpigrnented macules developed at 2. 7 years after starting photochemotherapy(psoralen and UVA) in a 66-year-old psoriatic male patient. The histopathologic feature of this macule was characterized as a lentiginous p roliferation. The significance and long term course of PUVA lentigo are still unknown. So, we will further monitor this patient continually for melanocytic dysplasias, including melanoma.
Aged ; Humans ; Lentigo* ; Lichen Planus ; Male ; Melanoma ; Mouth Mucosa

We present a case of familial benign chronic pemphigus in 50-year-old male patient who had had recurrent oozing, macerated and eroded skin lesions on the groin and scrotum for 20 years. At first, we diagnosed his case as scrotal eczema and/or intertrigo, but after repeated recurrance, it was confirmed as above disease by characteristic histopathologic findings.
Cytochrome P-450 CYP1A1 ; Eczema ; Groin ; Humans ; Intertrigo ; Male ; Middle Aged ; Pemphigus, Benign Familial* ; Scrotum ; Skin

We present a case of generalized syringoma in a 12-year-old healthy girl. The patient has numerous skin colored or yellowish papules on the face, neck, anterior chest, axillae and abdomen. She has a family history of eyelid syringoma occuring in her mother and maternal grandmother. Diagnosis was confirmed by characteristic histopathologic findings.
Abdomen ; Axilla ; Child ; Diagnosis ; Eyelids ; Female ; Humans ; Mothers ; Neck ; Skin ; Syringoma* ; Thorax