We report a case of congenital candidiasis confined to the rail plates in a 57-day-old girl whose infected nails exhibited the rough, yellow-white, thickened, opaque distal ends and pink-colored, normal healthy plates at their proximal bases. Numerous pseudohyphae and spores were demonstrated by KOH microscopic examination. Candida albicans was identified by culture on Sabourauds glucose agar and API 20C Aux system. Histopathologic findings of nail crippings also showed mutiple hyphae beneath the hyperkeratot,ic nail plate on PAS stain. Shedding of the infected distal portion of the ungual plates ws caused by growing out of the healthy nails, resulting in spontaneous healing of the disease rithin 2 months.
Agar ; Candida albicans ; Candidiasis* ; Female ; Glucose ; Humans ; Hyphae ; Spores

We report a case of infantile acute hemorrhagic edema in a 15-month-old boy. The patient showed multiple, bean to walnut-sized, red to purple-colored, indurated purpura with a cockade pattern on the face, earlobes, and extremities. Edema of the hands, feet, and earlobes was also observed. Laboratory examinations showed thrombocytosis, decreased serum CH50, and ketone in the urine. A skin biopsy taken from indurated purpura on the lower leg exhibited findings of acute leukocytoclastic vasculitis. Direct immunofluorescence examination showed deposition of IgM along the dermo-epidermal junction and C3 in the dermal vessel walls. With-out specific management except for fluid therapy to correct dehydration, the skin lesions cleared completely in 2 weeks, and recurrence has not observed.
Biopsy ; Dehydration ; Edema* ; Extremities ; Fluid Therapy ; Fluorescent Antibody Technique, Direct ; Foot ; Hand ; Humans ; Immunoglobulin M ; Infant ; Leg ; Male ; Purpura ; Recurrence ; Skin ; Thrombocytosis ; Vasculitis

Blue rubber bleb nevus syndrome is a rare disease of cutaneous hemangioma of a variant of the carvenous type which is clinically characterized by multiple, protuberant, dark blue, generally soft, rubbery, and compressible cutaneous masses usually associated with similar lesions of the gastrointestinal tract. Most cases are sporadic, although autosomal dominant inheritance has been described. We report herein a cases of blue rubber bleb nevus syndrome in a 49-year-old, who had multiple, dark blue, slightly tender, easily compressible vascular tumors on the face, right postauricular area, tongue, neck, and right had and foot, measuring from 0.5 to 1.0 cm in diameter. Endoscopic examination also revealed several similar lesions on the upper third of the esophagus. Biopsy specimen from the lesion of the neck showed irregularly dilated vessels containing red blood cells and fibrinous material. The vascular space was lined by a single layer of flattened endothelial cells.
Biopsy ; Blister* ; Endothelial Cells ; Erythrocytes ; Esophagus ; Fibrin ; Foot ; Gastrointestinal Tract ; Hemangioma ; Humans ; Middle Aged ; Neck ; Nevus* ; Rare Diseases ; Rubber* ; Tongue ; Wills

PURPOSE: To compare the anterior segment parameters including precorneal tear film thickness (PTFT) using Pentacam(R) (Oculus, Wetzlar, Germany) between normal control and dry eye groups and to examine the relationships between the PTFT and other parameters for dry eye. METHODS: The present study included 23 normal controls (31 eyes) and 25 patients with dry eyes (31 eyes). We compared measurements including PTFT, corneal thickness and astigmatism using Pentacam(R) and analyzed the correlations among the PTFT and fluorescein tear break-up time (FBUT), Schirmer I test (without anesthesia), and ocular surface disease index (OSDI). RESULTS: The mean PTFT in dry eyes (21.1 +/- 2.0 microm) was significantly thinner than in normal eyes (37.6 +/- 2.0 microm; p < 0.01). In the dry eye group, the corneal thickness was thicker than in the normal eye group but there were no clinically significant differences. The dry eye group experienced more frequent and severe corneal astigmatism compared with the normal group. OSDI scores showed a weak negative correlation with objective clinical measures of dry eye (FBUT, Schirmer I test) but was not statistically significant. However, OSDI was statistically significantly negatively correlated with PTFT (r = -0.46, p < 0.01). The PTFT showed a weak positive correlation with FBUT and Schirmer I test without statistical significance. CONCLUSIONS: The mean PTFT using Pentacam(R) in the dry eye group was thinner than in the normal group. Additionally, the PTFT was correlated with subjective symptoms. Therefore, the PTFT measurement using Pentacam(R) could be considered a useful method for diagnosis and treatment of dry eye.
Astigmatism ; Diagnosis ; Fluorescein ; Humans ; Tears*

Malignant germ cell tumore occur in children and young women in reproductive age, of all the germ cell maligaanci orily pure dysgerminiomas had a high cure rate prior to 1970. This was due to the exquisite wdioseneitivity of these tumors. Multiple agent chemotherapy has dramatieally improved the pr nosis af patients with malignant ovarian germ cell tumors. The purpose of this study is to report the experience at Aaan Medical Center, department of Obstetrics and Gynecology, in 16 patients withmalignant ovarian germ cell tumors treated between July, l989 and June, l994. We analyzed the effect of age, histolagic subtype, FIGO stage, surgical pmcedurse and regimens of chemotherapy, on the prognosis of thwe tumors. The results obtained were as follows: 1. In histologic subtypes, dysgenninoma(38.0%), endodermal sinus tumor(25.0%), squamous cell carcinoma arising in mature cystic teratoma(19.0%), mixed cell tumor(6.0%), immature teratoma(6.0%), malignant ectodermal tumor in mature cystic teratoma(6.0%), were counted in order. 2. No site predilection was identifed. 3. Main initial symptoms were abdominal distension(31.0%), abdominal pain(31.0%), abdominal mass palpation(25.0%), amenorrhea(6.0%) in order. 4. Multiple tumor markers were considered to be useful in diagnosis and follow up of malignant germ cell tumors of ovary. 5. The mean age of malignant ovarian germ cell tumors was 29.5 years, and 11 cases(69.3%) of tumors under the age of 30.0 years. 6. The survival rate seemed to be decreased with advancing FIGO stage.
Carcinoma, Squamous Cell ; Child ; Diagnosis ; Drug Therapy ; Ectoderm ; Endoderm ; Female ; Follow-Up Studies ; Germ Cells* ; Gynecology ; Humans ; Neoplasms, Germ Cell and Embryonal* ; Obstetrics ; Ovary* ; Prognosis ; Survival Rate ; Biomarkers, Tumor

Objective The aim of this study was to evaluate the clinicopathologic findings of eight patients with primary cancer of fallopian tube diagnosed and treated in the department of Obstetrics and Gynecology, University of Ulsan, Asan Medical Center for nine years. Methods Demographic characteristics, symptoms, signs, stage, tumor grade, mode of therapy and survival of patients were reviewed retrospectively. Results The patients with primary cancer of fallopian tube constituted 0.4% of all gynecologic malignancies encountered during this period. The age of patients ranged 42 to 70 years(mean+/- S.D.; 53.9+/-9.9) and half of patients were postmenopausal and two patients were nulliparous. Patients were treated by simple or radical hysterectomy and bilateral salpingoophorectomy with or without omentectomy and five patients received postoperative chemotherapy. The FIGO surgical stages of the patients were I(4 cases), II(2 cases), III(1 case) and IV(1 case). There were 3 cases of adenocarcinoma, 3 cases of malignant mixed Mullerian tumor, 1 case of undifferentiated carcinoma and 1 case of serous cystic tumor of low malignancy potential. Serum CA 125 values were followed during treatment and decreased during clinical remission and increased at the time of tumor progression. The mean follow-up duration was 24.3(+28.3) months and 7 patients were alive free of disease and one patients with stage Ic died of the disease. Conclusion Primary fallopian tube cancer is an extremely rare malignancy of the female genitalia and preoperative diagnosis of this disease is difficult. Cytoreductive surgery and postoperative combination chemotherapy seem to be effective treatment and CA 125 value could reflect the disease status during the treatment and follow-up of patients.
Adenocarcinoma ; Carcinoma ; Chungcheongnam-do ; Diagnosis ; Drug Therapy ; Drug Therapy, Combination ; Fallopian Tube Neoplasms ; Fallopian Tubes* ; Female ; Follow-Up Studies ; Genitalia, Female ; Gynecology ; Humans ; Hysterectomy ; Obstetrics ; Retrospective Studies ; Ulsan

This study was conducted to investigate the effect of an energy restriction program on the weight loss and changes of the biochemical nutritional status for 35 obese women. The energy restriction program took place over a 3-week period that was devided into two parts. The first part consisted of 750-800kcal diet and the second part of 800-1000kcal. Subjects were provided a low energy formula and a menu for the recommended diet. Anthropometric and biochemical measurement before and after the energy restriction program were estimated. Mean weight loss was 3.0 kg, accordingly the obestiy rate was lowered from 40.2 to 34.4, BMI from 29.2 to 28.9 and fat weight from 23.3 kg to 21.0 kg(<0.01.<0.05). Waist circumference loss was most prominent(4.4%) compared to triceps(21% loss)and hip circumference(2.2%loss). Mean RBC count, hemoglobin and hematocrit were significantly lowered(<0.01) but they were in the normal range. Systolic blood pressure was significantly decreased from 124.1 mmHg to 113.1 mmHg . Mean SGOT and SGPT were lowered from 29.3u/L to 20.0u/L and from 28.7u/L to 16.6u/L, respectively. It seems that the 3 weeks of energy restriction program used in this study was effective in improving anthropometric measurements without producing deficiency of iron or other susceptible nutrients.
Alanine Transaminase ; Aspartate Aminotransferases ; Blood Pressure ; Diet ; Female ; Hematocrit ; Hip ; Humans ; Iron ; Nutritional Status* ; Reference Values ; Waist Circumference ; Weight Loss*

PURPOSE: To report a case of a patient with cytomegalovirus (CMV) retinitis who was treated with oral valganciclovir. CASE SUMMARY: A 34-year-old man who had undergone anti-cancer chemotherapy for Non-Hodgkin lymphoma was referred to the ophthalmologic oncology clinic because of decreased vision in both eyes. Fundus examination showed white, opaque, and granular retinal lesions in both eyes, and a serologic test showed a positive response to CMV antibody IgG and a negative response to CMV antibody IgM. The patient received induction therapy with intravenous ganciclovir and maintenance therapy with oral valganciclovir 900 mg once daily. CMV retinitis reactivated 4 weeks after maintenance therapy was discontinued. At that point, the patient received induction therapy with oral valganciclovir 900 mg twice daily for 3 weeks and maintenance therapy with 900 mg once daily for 5 weeks. The retinal lesion disappeared and did not recur after oral administration of valganciclovir. The patient discontinued valganciclovir after 5 weeks of maintenance therapy, and CMV retinitis did not reactivate during 6 months of follow-up. CONCLUSIONS: Oral valganciclovir was clinically effective in the treatment of CMV retinitis in a patient who was treated with anti-cancer chemotherapy for non-Hodgkin lymphoma.
Administration, Oral ; Adult ; Cytomegalovirus ; Cytomegalovirus Retinitis ; Eye ; Follow-Up Studies ; Ganciclovir ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Lymphoma, Non-Hodgkin ; Retinaldehyde ; Retinitis ; Serologic Tests ; Vision, Ocular

PURPOSE: To compare the corneal first surface higher-order aberrations (HOAs) of normal subjects and patients with dry eye using KR-1W(R) (Topcon Corp., Tokyo, Japan) and Pentacam(R) HR (Oculus Inc., Dutenhofen, Germany). We analyzed the relationship between the aberrations and the diagnostic parameters of dry eye. METHODS: We evaluated anterior corneal HOAs in 71 normal eyes and 71 dry eyes using KR-1W(R) and Pentacam(R). Dry eye patients were examined for fluorescein staining, tear break-up time (TBUT), and Schirmer I test. Ocular Surface Disease Index (OSDI) was used for assessment of subjective symptoms in dry eye patients. RESULTS: HOAs measured by both instruments were greater in the dry eye group than in the control group, although HOAs using KR-1W(R) only achieved statistical significance. The anterior corneal HOAs measured by the 2 instruments were significantly correlated with superficial punctate keratitis. Moreover, TBUT and the Shirmer I test negatively correlated, and OSDI positively correlated, with anterior corneal HOAs. CONCLUSIONS: The HOAs in patients with dry eye were significantly different from controls and tended to increase with disease severity. KR-1W(R) might be more useful than Pentacam(R) to detect tear film instabilities.
Fluorescein ; Humans ; Keratitis ; Tears

PURPOSE: To compare the corneal higher-order aberrations (HOAs) of normal young subjects using Galilei(TM) G4 (Zeimer, Port, Switzerland) and Pentacam(R) (Oculus Inc., Wetzlar, Germany). METHODS: Corneal HOAs were measured using Galilei(TM) G4 and Pentacam(R) in 41 healthy individuals (41 eyes). Intraclass correlation coefficients (ICCs) were obtained to evaluate the repeatability of the 2 devices. Differences in HOAs between the 2 instruments were analyzed with a paired t-test and correlations evaluated. RESULTS: All ICCs measured using Galilei(TM) G4 and Pentacam(R) showed more than moderate repeatability (>0.81) except trefoil, tetrafoil, 4th and 5th HOAs. When comparing the measurements obtained with Galilei(TM) G4 and Pentacam(R), total HOAs, spherical aberration (SA), secondary astigmatism and 5th total HOAs were statistically significantly different between the 2 device (all p < or = 0.001). In addition, Galilei(TM) G4 and Pentacam(R) showed discrepancy among all corneal HOAs items. Although the total corneal HOAs and the SA were significantly correlated, other HOA measurements generally exhibited a low correlation. CONCLUSIONS: Corneal HOAs obtained by the 2 instruments cannot be used interchangeably due to their differences and discrepancy although corneal HOAs measured using Galilei(TM) G4 and Pentacam(R) showed relatively high repeatability.
Astigmatism ; Lotus