Health care workers are exposed to a small risk of being infected with HIV as a result of occupational exposures. The risks for occupational transmission of HIV vary with the type and severity of exposures. The average risk for HIV transmission after a percutaneous exposure to HIV-infected blood has been estimated to be approximately 0.3%. Health care workers can minimize their risk of occupational HIV infection by following universal precautions, ensuring timely postexposure management, and considering the administration of postexposure prophylaxis.
Collodion ; Delivery of Health Care ; HIV ; HIV Infections ; Occupational Exposure ; Universal Precautions

With a view to investigating the distribution of keratinophilic fungi in soil according to latitudes in south Korea, soil samples were collected at 81 sites in 17 areas in different latitudes across the country and keratinophilic fungi were isolated by means of Vanbreusegherns technique. The results are summarized as follows : 105 strains of keratinophilic fungi were recovered from 56(69.2%) out of 81 samples. Isolated fungi were composed of 41 strains of Trichophyton ajelloi, 24 stains of Chrysosporium species, 20 strains of Microsporum gypseum, and 20 strains of M. cookei. Frequency of isolation of keratinophilic fungi tended to decrease from higher latitudes down to lower latitudes. In areas of higher latutudes, T. ajelloi and M. cookei were isolated more frequently than in lower latitudes. M. gypseem was most frequent in Cheju City, and Chrysosporium species showed an even distribution, Among three areas under different conditions of moisture and shadedness(i.e., shaded wet, shaded dry, and sunny dry areas), frequency of isolation was highest in shaded dry areas(72.2%). T. ajelloi was the most frequent species in all the three areas, especially in shaded wet areas(53.1%). No M. gypsetcm was found in shaded dry areas. As regards distribution at various sites, roadsides and streamsides exhibited the highest frequency of isolation, and hills the lowest. Except for roadsides, T. ajelloi was the most frequent species at all sites, especially in forests. M. gypseum was frequent at sites beside streams M. cookei at streamsides, fields, and hills and Chrysosporim species in gardens, forests, and streets.
Chrysosporium ; Coloring Agents ; Fungi* ; Jeju-do ; Korea* ; Microsporum ; Rivers ; Soil* ; Trichophyton

OBJECTIVES: Physical exercise has become popular in recent years. It has been known that exercise is related to the development of heartburn, belching, regurgitation and chest pain. However there are few data concerning the effect of exercise on esophageal motor function and gastroesophageal reflux. We evaluated the effect of exercise intensity on esophageal motor activity and gastroesophageal reflux. METHODS: We studied healthy volunteers (15 males, age: 28+/-5 years, BW: 68+/-10kg) using a 24 hours ambulatory esophageal pressure, pH catheter and portable digital data recorder (Microdigitrapper 4Mb, Synetics Medical, Sweden). Subjects exercised on a treadmill (Marquette Case 15 Electronic INC) at 50% and 70% maximal heart rate for 30 min. Subjects rested 2 hours before exercise (base line) and for 30 min between exercise sessions. RESULTS: 1) Exercise of 50% maximal heart rate reduced total contraction, contraction duration, percentage of simultaneous contraction and repetitive contraction, (P<0.05) but increased percentage of contractions above 20mmHg amplitude (P<0.05). 2) Exercise of 70% maximal heart rate decreased total contraction, esophageal amplitude, contraction duration and percentage of peristaltic contraction, (P<0.05) but increased percentage of simultaneous contraction (P<0.05). 3) Gastroesophageal reflux was not change on both 50% maximal heart rate and 70% maximal heart rate exercise. CONCLUSION: More propulsive esophageal motility are induced following exercise of 50% maximal heart rate, but not 70% maximal heart rate.
Catheters ; Chest Pain ; Eructation ; Exercise ; Gastroesophageal Reflux* ; Healthy Volunteers ; Heart Rate ; Heartburn ; Humans ; Hydrogen-Ion Concentration ; Male ; Motor Activity ; Running*

Soft tissue perineurioma is a very rare tumor composed of entirely of neoplastic perineurial cells. A 54-year-old woman presented with a palpable mass in the right lower leg. The mass was excised. Grossly, the tumor measured 2.0x2.0x1.5 cm. The cut surface was well circumscribed, pale pinkish gray, and rubbery soft. Histological examination showed that the tumor was composed of spindle cells within collagenous and myxoid stroma. The tumor cells had elongated, tapering nuclei with long and thin cytoplasmic processes, and were arranged in fascicular, whorled, and storiform pattern. The tumor cells were positive for epithelial membrane antigen and collagen type IV and negative for S-100 protein. Ultrastructurally, tumor cells showed long and thin cytoplasmic processes, pinocytic vesicles, and incomplete external lamina. The diagnosis of soft tissue perineurioma was confirmed by immunohistochemical stain and ultrastructural study.
Collagen ; Collagen Type IV ; Cytoplasm ; Female ; Humans ; Immunohistochemistry ; Leg ; Middle Aged ; Mucin-1 ; Nerve Sheath Neoplasms ; S100 Proteins

Clinical observations were made on 63 cases on nevus sebaceus of Jadasshon. 52 of 63 cases were diagnosed on the basis of clinical and histopathologic findings during a period of 19 years from January 1969 to July 1987 at the Department of Dermatology, Kyungpook National University Hospital, with the remaining 11 cases diagnosed at other skin clinics in Taegu. Histopathologic examinations were made on 51 selected cases of the 63. The results were as follows : Clinical observations 1) The percentage of patients with nevus sebaceus of Jadasshon of total new outpatients was 0.12%. Of the 63 cases, males numbered 38 and females, 25, with a sex r atio of 1.5: 1. 2) Patients when first seen were most commonly in the age group of 10~19. 3) The most favorate sites were the scalp(83.3%) and face(13.3%). 4) The average size of the lesions was 2.23cm * 3.24cm with no difference among the age groups. Histopathological observations 1) The apparent proliferation of sebaceous glands was observed in 32 of 51 cases(62.7%). The degree of proliferation markedly increased in the age group of l0~19 and slightly decreased beyond this age group. Apocrine glands were present. in 17(33.3%), with a higher number of glands seen in the age group of 10~19. Immature hair follicles were found in 38(74.5%), with no changes according to aging. 2) The epidermal changes such as acanthosis(86.3%), papillomatosis(70.6%), hyperkeratosis(78.2%) and hypergranulosis(78.2%) predominated in the age group of 10-19, and severe but more gradual changes were noted 20 years of age on. 3) Inflammatory cell infiltration of moderate to marked degree was noticeable in 27(53%). The older the patients were, the more pronounced dermal infiltration was. 4) Six of 51 cases were complicated with basal cell carcinoma(3) and syringocystadenoma papilliferum(4). The tumors, which occurred beyond 30 years of age, showed a marked inflammatory cell infiltration.
Aging ; Apocrine Glands ; Daegu ; Dermatology ; Female ; Gyeongsangbuk-do ; Hair Follicle ; Humans ; Male ; Nevus* ; Outpatients ; Sebaceous Glands ; Skin

Purpose: The purpose of this study was to evaluate the mortality of patients over eighty years old with femoral neck fractures that have been treated with bipolar endoprostheses. Materials and Methods: We retrospectively studied 37 patients out of a total of 83, who suffered from hip fractures and were treated with surgery from 2000 through December 2004. We attempted to distinguish the differences between the 8 patients who died (Group A) and the 29 patients who lived (Group B). The variables that we analyzed, were: age, sex, operative time, the time period from admission to surgery, the time period from admission to discharge, the ASA score, and any medical comorbidities. Results: In Group A, 2 patients died within 1 month, 2 died between 1 and 6 months, 1 died between 6 and 12 months, and 3 died after 1 year. There were statistical differences between Group A and Group B with respect to two variables: the time period from admission to, and medical comorbidities. Conclusion: There were significant correlations with an increase in the mortality rate among patients with lung disease, female patients in general, and delays in surgery. Therefore, particular care should be paid to patients with these variables.
Comorbidity ; Female ; Femoral Neck Fractures ; Hip Fractures ; Hip* ; Humans ; Lung Diseases ; Mortality* ; Operative Time ; Retrospective Studies

Purpose: This study examined the changes in the body mass index (BMI) and the effects of BMI on the knee function and risk factors for an increase in BMI after total knee arthroplasty (TKA) in Asians. Materials and Methods: A prospective observational study was conducted on 100 cases of TKA performed by one surgeon. Obesity was defined as BMI ≥25 kg/m 2 . The BMI and Knee Society Score, consisting of the Knee Score and Function Score, were measured on the day before surgery and one year after surgery. Results: The BMI decreased or was maintained in 34 cases (34%) and increased in 66 cases (66%) one year after surgery. An increase in BMI of 5% or more was considered a clinically significant increase in BMI and occurred in 28 cases (28%). The patients with an increased BMI by more than 5% showed a significantly lower knee function score. The age and preoperative function score were significantly associated with an increased BMI by more than 5%. As the age increased by one year, the odds ratio at which the BMI would increase by more than 5% one year after surgery was 0.905. Moreover, as the preoperative function score increased by one point, the odds ratio that the BMI would increase by 5% one year after surgery was 0.902. In other words, a younger preoperative age and a lower preoperative function score mean a higher risk of a more than 5% postoperative increase in BMI. Conclusion The BMI increased by more than 5% one year after surgery in 28% of the TKA patients examined. They had a lower functional score. The risk factors for a more than 5% increase in BMI after TKA were young age and a low preoperative function score. Therefore, surgeons should educate patients, particularly those who are young or have a low preoperative function score, so that the patient’s BMI would not increase after surgery.

Methicillin-resistant Staphylococcus aureus colony variants (SCVs) are frequently auxotrophic for hemin, menadione, thiamine, and CO2 involved in biosynthesis of the electron transport chain element. This phenotype grows slowly, and forms very small, nonhemolytic colonies in routine culture, so it may be led to the misidentification of this organism. We isolated an organism with catalase-positive, gram-positive cocci in cluster from the urine of a 55-years-old woman with persistent and relapsing bladder stone, who had undergone the antibiotic treatment with cefotaxime, ceftizoxime, amikacin, and/or micronomicin, intermittently for three years. The possibility of SCVs should have been ruled out because this organism didn't grow on Mueller-Hinton agar (MHA) for the susceptibility test. It formed small colonies on blood agar plate overnight, and grew only on MHA with supplement of hemin, or with 5% CO2. This organism was coagulase-positive, DNase-positive, manitol-salt positive, and identified as S. aureus with VITEK GPI card. The susceptibility test could be performed after adding hemin(1mg/mL) into bacterial suspension and showed susceptibility against vancomycin, teicoplanin, and rifampin. Because these phenotypes can be misidentifide as other non-pathogenic organisms due to their atypical characteristics, we should consider SCVs in case of small, nonhemolytic colonies with catalase-positive, gram-positive cocci in cluster, showing no growth on MHA. In addition, infections caused by SCVs are recently recognized in relation to persistent and relapsing infection, so they could be isolated from the patients with long-term antibiotic therapy.
Agar ; Amikacin ; Cefotaxime ; Ceftizoxime ; Electron Transport ; Female ; Gram-Positive Cocci ; Hemin ; Humans ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Phenotype ; Rifampin ; Teicoplanin ; Thiamine ; Urinary Bladder Calculi* ; Urinary Bladder* ; Vancomycin ; Vitamin K 3

We observed 17 cases of cafe au lait spots histopathplogi ally. Out of 17 cases, 9 cases were neurofibromatosis with neurofibromas, 6 cases were neurofibromatosis without neurofibroma, and 2 cases were normal healthy persons. The results were as follows. l. In all 17 cases, melanin pigment was increased in melanocytes and keratinocytes. 2. Griant pigment granules were identified only in 3 cases of neurofibromatosis with neurofibromas.
Cafe-au-Lait Spots* ; Humans ; Keratinocytes ; Melanins ; Melanocytes ; Neurofibroma ; Neurofibromatoses

The development of tophi in th absence of prior episodes of gauty arthritis is unusual. We report a case of extensive tophi in a 31 year-old man, whose initial skin lesion had started without arthritis.
Adult ; Arthritis ; Gout* ; Humans ; Skin