1.A Case of Endometrial Adenocarcinoma Associated with Polycystic Ovarian Disease.
Ok Ryoung LIM ; Ho In YOO ; Jung Hee ANN ; Hae Joong KIM ; Kyu Wan LEE
Korean Journal of Gynecologic Oncology and Colposcopy 1993;4(4):123-129
A 36 year old infertile was diagnosed endometrial adenocarcinoma by endometrial biopy due to vaginal bleeding. She was characterized by obesity, hirsutism and infertility. Diagnosis was confirmed endometrial adenocarcinoma(Geade I) associated with polycystic ovarian disease postoperatively. We experienced this case and so report this case with a brief review of literatures.
Adenocarcinoma*
;
Adult
;
Diagnosis
;
Female
;
Hirsutism
;
Humans
;
Infertility
;
Obesity
;
Ovarian Diseases*
;
Uterine Hemorrhage
2.Idiopathic pulmonary fibrosis vs. pulmonary involvement of collagen vascular disease:HRCT findings.
Myung Kwan LIM ; Jung Gi IM ; Joong Mo AHN ; Ji Hye KIM ; Seon Kyu LEE
Journal of the Korean Radiological Society 1993;29(6):1208-1213
Both idiopathic pulmonary fibrosis (IPF) and pulmonary involvement of collagen vascular disease(CVD) are well known cause of diffuse interstitial lung disease which lead to fibrosis and honeycombing. We analyzed HRCT findings of 33 patients with IPF and 14 patients with CVD in terms of predominant pattern, site of involvement, mediastinal lymph node enlargement, pleural change and pulmonary volume loss. Criteria of mediastinal lymph node enlargement and pleural thickening were 15mm in long diameter and 3mm, respectively. Volume loss of the lung was measured by using hilar height ratio (apex to hilum/hilum to diaphragmatic dome). Mean age was 61 years for IPF and 46 years for CVD and male: female ratio was 27:6, 4:10, respectively. Predominant HRCT pattern was honeycombing for IPF (63%), and ground-glass opacity for CVD (66%) (p=0.001). Predominantly, subpleural involvement was seen in 90% for IPF and 74% for CVD. Mediastinal lymph node enlargement was seen in 47% of the patient with IPF and 14% with CVD (p=0.004). pleural thickening was seen in 97% of the patients with IPF and 42% with CVD (P=0.002), Pleural effusion was seen in 10% of the patients with IPF and 36% with CVD (P=0.009). Hilar height ratio of more than 1.5 was seen in 84% of the patients with IPF and 29% with CVD. In conclusion, our study shows that patients with IPF are prone to have more progressed stage of pulmonary fibrosis than the patients with CVD on HRCT.
Collagen*
;
Female
;
Fibrosis
;
Humans
;
Idiopathic Pulmonary Fibrosis*
;
Lung
;
Lung Diseases, Interstitial
;
Lymph Nodes
;
Male
;
Pleural Effusion
;
Pulmonary Fibrosis
3.Risk Prediction Factors in Febrile Neutropenic Patients.
Joong Sik JUNG ; Kyu Yong KWON ; Kwon Seok KIM ; Yong Su LIM ; Joong Eui RHEE ; Gil Joon SUH ; Yeo Kyu YOUN
Journal of the Korean Society of Emergency Medicine 2000;11(3):305-315
BACKGROUND: Most febrile neutropenic patients are treated in an aggressive manner. However, identification of low-risk patients may enable clinicians to administer risk-based treatment. The object of this study is to certify the factors associated with increased risk at the time of visiting the emergency department. METHODS: This is a retrospective study. We reviewed the medical records of 101 febrile neutropenic patients who had visited the emergency department of Seoul National University Hospital from January 1998 to August 1999. We assumed 22 risk prediction factors that could be assessed at admission to the emergency department and 5 factors that could be assessed during treatment course. To find independent risk-prediction factors, we analyzed these factors respectively by using multiple regression analysis. RESULTS: Tachycardia(aOR=136.5), altered mentality(aOR=28.8), decreased renal function(aOR=20.1), and significant comorbidity(aOR=17.2) are the independent factors associated with higher mortality. Altered mentality(aOR=31.6) and decreased renal function(CCr<75ml/min, aOR=5.4) are those associated with a higher incidence of septic shock. Independent factors associated with persistent(more than 3 days) fever are the early(within 10 days) onset of fever after last chemotherapy(aOR=8.8) and the existence of new pulmonary infiltrates on a simple chest X-ray(aOR=4.3). CONCLUSION: The stability of vital signs, the change of mentality, the renal function, the existence of significant comorbidity, the existence of new pulmonary infiltrates, and the rate of neutropenia are clinically useful risk-predication factors in febrile neutropenia at the time of visiting the emergency department.
Comorbidity
;
Emergency Service, Hospital
;
Febrile Neutropenia
;
Fever
;
Humans
;
Incidence
;
Medical Records
;
Mortality
;
Neutropenia
;
Retrospective Studies
;
Seoul
;
Shock, Septic
;
Thorax
;
Vital Signs
4.The Application of 26S rDNA PCR-RFLP in the Identification and Classification of Malassezia Yeast.
Yang Won LEE ; Sang Hee LIM ; Kyu Joong AHN
Korean Journal of Medical Mycology 2006;11(3):141-153
BACKGROUND: Malassezia yeast are lipophilic fungi that are found in 75~80% of healthy adults. The yeast are known to be associated with pityriasis versicolor, seborrheic dermatitis, Malassezia folliculitis, and recently its pathogenicity is being expanded to other various skin disorders, such as atopic dermatitis and acne vulgaris. Up to present, mycological studies on Malassezia yeast have been carried out mostly through morphological analysis and biochemical analysis. Recently however, various molecular biological techniques are being preferred over morphological analysis, which is not a suitable method for establishing taxonomic relationship between species, and more or less time-consuming. OBJECTIVE: We sought to implement novel molecular biology technique, namely 26S rDNA PCRRFLP method in identifying and classifying Malassezia yeast, and assess its clinical applicability. METHODS: Eleven standard strains and eight clinical isolates were thoroughly examined with special attention to the shape of the colonies, size and change in media. Subsequently, the colonies were classified according to Gueho classification. For molecular analysis, RFLP analysis was carried out after DNA was isolated from each organism and 26S rDNA was amplified through PCR. The results of identification were confirmed by 26S rDNA sequencing. RESULTS: In PCR analysis to amplify the 26S rDNA, a 580bp PCR band was seen in all of eleven standard colonies. On analysis of PCR-RFLP of 26S rDNA using restriction enzymes Hha1 and BstF51, all of the database in the restriction pattern of each species was attained. On analyzing eight clinical isolates, a restriction pattern which was interspecifically distinguishable, was identified, and the result was in accord with the pattern obtained from 26S rDNA PCR-RFLP of standard colonies. Out of eight, seven clinical isolates colonies was in accord with the result of 26S rDNA PCR-RFLP. In order to assess the precision of 26S rDNA PCR-RFLP, 26S rDNA sequencing was performed, whose result was in accord with 26S rDNA PCR-RFLP analysis. CONCLUSION: As evidenced above, 26S rDNA PCR-RFLP analysis could provide a sensitive and rapid identification system for Malassezia species, which may be applied to epidemiological surveys and clinical practice
Acne Vulgaris
;
Adult
;
Classification*
;
Dermatitis, Atopic
;
Dermatitis, Seborrheic
;
DNA
;
DNA, Ribosomal*
;
Folliculitis
;
Fungi
;
Humans
;
Malassezia*
;
Molecular Biology
;
Polymerase Chain Reaction
;
Polymorphism, Restriction Fragment Length
;
Skin
;
Tinea Versicolor
;
Virulence
;
Yeasts*
5.A Case of Hypomelanosis of Ito.
Geun Soo LEE ; Hong Zoon JANG ; Yeon Lim SUH ; Kyu Joong AHN ; Jong Min KIM ; Chong Ju LEE
Korean Journal of Dermatology 1990;28(5):627-632
No abstract available.
Hypopigmentation*
6.Ensulin Autoimmune Syndrome in a Patient with Methimazole-Treated Graves' Disease: A Case report.
Joong Kyu LIM ; Yong An WOO ; Sung Jin KANG ; Sung Sik YOO ; Kun Young HONG ; Soon Ho KIM
Journal of Korean Society of Endocrinology 1998;13(4):612-616
Insulin autoimmune syndrome (IAS) includes fasting or reactive hypoglycemia, hyperinsulinemia and the presence of insulin-binding antibodies in patients who have never been exposed to exogenous insulin. This report concems a 29-year-old male patient with Graves disease who had history of having taken methimazole for two months, without any consequence, 6 months previously. However, when methimazole was administered again for three weeks, the patient suffered hypoglycemia during the next fourth week. He denied history of diabetes mellitus (DM), of taking any oral hypoglycemic agent or of having received insulin injection. Laboratory data showed total serum insulin level > 300 pu/mL, C-peptide reactivity (CPR) 8.0ng/mL and insulin antibody 89%. After stopping methimazole, he was treated with radioiodine (131I). There was no episode of hypoglycemic attack during 8 months of follow-up.
Adult
;
Antibodies
;
C-Peptide
;
Diabetes Mellitus
;
Fasting
;
Follow-Up Studies
;
Graves Disease*
;
Humans
;
Hyperinsulinism
;
Hypoglycemia
;
Insulin
;
Male
;
Methimazole
7.A study on changes of the Vertebral Pedicles and Mechanical Strengths after Screw Insertion
Seung Ik CHA ; Se Il SUK ; Choon Ki LEE ; Won Joong KIM ; Kyu Jung CHO ; Soo Taek LIM
The Journal of the Korean Orthopaedic Association 1996;31(1):42-51
Spinal fixation using pedicle screws has recently been the focus of increased attention, but the adequate size of pedicle screw and maximum percentage fill as related to the pedicle diameter and are not well known. The objects of this study were to determine the ideal ratio among pedicle, drill and screw diameter, and to determine the maximum percentage fill of the screw without significant decrease of pull-out strength. The materials used for the experiments were 376 thoracic pedicles obtained from the 38 young pigs, and the diameters of pedicles ranged from 3.0 to 8.5mm. After 40% to 100% drilling as compared to pedicle diameter, screws were inserted carefully, and measurements were taken of the outer pedicle changes and pull-out strengths, and adequate drill and screw sizes as related to the diameters of given pedicles were determined. It was found that pull-out strength was the strongest after 60% drill, and the larger the drill diameter, the smaller the holding power, and the larger the screw diameter, the greater the holding power. Maximum pull-out strength was seen at 80-90% fill with 60% drill. After sequentially drilling each pedicle with increasingly larger drill bits, larger screws could be inserted with pedicle changes such as expansion, cutout, split fracture, and comminuted fracture. after larger drilling up to 100%, pedicle screws with diameters smaller than 115% of measured pedicle diameters could be safly inserted without fracture and significant decrease of pull-out strength. It is concluded that effective percentages of drill and screw diameters to the pedicle diameter are 60% and 80-90% respectively, and pedicle screw up to 115% of measured pedicle diameter can be safely inserted into pedicle without significant decrease of pull-out strength. It is thought that fresh pedicle has elasticity and larger screw can be inserted to the pedicle with strong holding after larger drilling.
Elasticity
;
Fractures, Comminuted
;
Pedicle Screws
;
Swine
8.Problems in Completing a Death Certificate.
Kyu Seok KIM ; Yong Su LIM ; Joong Eui RHEE ; Gil Joon SUH ; Yeo Kyu YOUN ; Eun Kyung EO ; Suk Lan YOUM ; Yeon Kwon JEONG ; Yoon Seong LEE
Journal of the Korean Society of Emergency Medicine 2000;11(4):443-449
BACKGROUND: This study was conducted to analyze the current problems in completing death certificates and to identify the correct method for completing death certificates. METHODS: We reviewed 262 death certificates in three hospitals from March 1 to April 30, 2000, and 119 death certificates in one hospital from March 1 to 31, 2000. We identified major and minor errors and analyzed and compared them retrospectively. RESULTS: A total of 381 death certificates were reviewed: 59 in Seoul National University Hospital, 101 in Ewha Woman's University Hospital, and 102 in Gachon Medical College Hospital, which has no education program for completing death certificates in postgraduate training, and 119 in Samsung Medical Center which has an education program for completing death certificates. 358 certificates(94.0%) had at least one error. There were only 23 death certificates(6.0%) without an error. In 182 cases(47.8%), there was one major error. In 321 death certificates(84.3%), there were more than two errors. A comparison of Samsung Medical Center with the other hospitals showed that the number of total errors was statistically different(p=0.001). CONCLUSION: There were few death certificates without an error in this study. In a hospital which has postgraduate training in completing death certificates, there are fewer errors than in other hospitals which have no training course. Emergency physicians actually certify many deaths, so they must know the correct method of completing death certificates for statistics on morbidity and mortality.
Death Certificates*
;
Education
;
Emergencies
;
Mortality
;
Retrospective Studies
;
Seoul
9.Paronychia during Iressa(R) Treatment in a Lung Cancer Patient.
Sang Hee LIM ; Young Chan SONG ; Yang Won LEE ; Yong Beom CHOE ; Kyu Joong AHN ; Kye Yong SONG
Korean Journal of Dermatology 2008;46(4):541-543
Iressa(R) (ZD 1839, gefitinib) is a new anti-cancer agent which selectively inhibits the epidermal growth factor receptor (EGFR) tyrosine kinase in the pathway of the signal transduction. This agent can induce adverse effects in the cutaneous which are related to the interruption of normal epidermal cell kinetics. We report a case of paronychia in a 65-year-old man, developed in both sides of his finger and toe nails during treatment of non-small cell lung cancer (Stage IV) with Iressa(R) for 7 days. The patient came to our clinic with painful periungal inflammation with granulation tissue formation. The lesion was improved after treatment with topical or systemic antibiotics, Burrow's solution (0.3% aluminum acetate) soaking and electrodessication.
Aged
;
Aluminum
;
Anti-Bacterial Agents
;
Carcinoma, Non-Small-Cell Lung
;
Fingers
;
Granulation Tissue
;
Humans
;
Inflammation
;
Kinetics
;
Lung
;
Lung Neoplasms
;
Nails
;
Paronychia
;
Porphyrins
;
Protein-Tyrosine Kinases
;
Receptor, Epidermal Growth Factor
;
Signal Transduction
;
Toes
10.A Clinical and Mycological Study of Dermatophytosis Associated with Animal Contact.
Yang Won LEE ; Sang Hee LIM ; Seon Mi YIM ; Yong Beam CHOE ; Kyu Joong AHN
Korean Journal of Medical Mycology 2005;10(4):151-159
BACKGROUND: Dematophytes are classified into geophilic, zoophilic and anthrophilic fungi, based on their ecological traits. Zoophilic dermatophytosis primarily is responsible for infection in animals, and the inflammatory reaction often tends to be more severe than skin lesions inflicted by anthrophilic species. For the clinical manifestation of superficial dermatophytosis caused by these zoophilic dermatophyte are highly variable, a through review of history about the contact with these animals is often solicited. OBJECTIVE: The purpose of this study is to evaluate clinical and epidemiological zoophilic dermatophytosis associated with animal contact, in an effort to elucidate the link between the causative organism and the route of infection. METHOD: We performed clinical and mycological study on 63 cases of dermatophytosis associated with prior animal contact at the department of dermatology, Konkuk University Hospital from September 2004 to August 2005. RESULT: The ratio of male to female patient was 1: 1.17 and showed more prevalence in female. The age distribution of patients was highest in the age group of 10 years (22.2%). The exposed area (71.4%) was more frequently affected than unexposed area (28.6%) and the most common site was face and forearm. Single lesions were 41 cases (65.1%). Dogs, cats, and rabbits were the most common culprits in animal contact-associated dermatophytosis, each comprising 19, 15, and 10 respectively, of total cases. Hamsters, Guinea pigs, miniature pigs, and miscellaneous (cattles and birds) were among other causative animals. Twenty nine patients with dermatophytosis had accompanying diseases. In the age group of under 10 years old, 6 patients were being treated with atopic dermatitis; in the age group of under 40 yrs, 15 were being treated with diabetes, and 3 with pulmonary tuberculosis, and 1 with rheumatoid arthritis. These evidences support the fact that underlying conditions renders patients susceptible to opportunistic infections. In all age groups, M. canis and T. mentagraphytes var. mentagraphytes were the most predominant species, with most of them in the age groups of teens and twenties. In patients who had contact with dogs, M. canis was recovered in 8 cases, T. mentagraphytes var. mentagraphytes in 7 and M. gypseum in 3. In those patients who had contact with cats, M. canis was found in 6, and T. mentagraphytes var. mentagraphytes in 3, M. gypseum in 2, and T. verrucosum in 1 case. In those who had contact with hamsters, 2 cases each of M. canis, T. mentagraphytes var. mentagraphytes, and M. gypseum were recovered. CONCLUSION: As evidenced above, contact with specific animals play an important role in the pathogenesis of dermatomycosis. As the leisure and recreational activities of people become more diverse and more extensive, and as the influx of exotic domestic animals increases, and frequent contact with people from abroad makes the manifestation of this disease more complex, it would be wise for us to strive to come up with an effective strategy for prevention and epidemiological studies.
Adolescent
;
Age Distribution
;
Animals*
;
Animals, Domestic
;
Arthritis, Rheumatoid
;
Arthrodermataceae
;
Cats
;
Child
;
Cricetinae
;
Dermatitis, Atopic
;
Dermatology
;
Dermatomycoses
;
Dogs
;
Epidemiologic Studies
;
Female
;
Forearm
;
Fungi
;
Guinea Pigs
;
Humans
;
Leisure Activities
;
Male
;
Opportunistic Infections
;
Prevalence
;
Rabbits
;
Skin
;
Swine
;
Tinea*
;
Tuberculosis, Pulmonary