From January to December of 1990, we have evaluated VDRL reactivity among 17,142 apparently normal Korean adults which consisted of 9,151 blood donors in Seoul area, 2,682 pregnant woman delivered at Severance Hospital, Yonsei University and 5,309 physical examinees. The VDRL-positive rates were 0.3% in the blood donors, 0.1% in the pregnant women and 0.8% in the physical examinees but the rates were higher in the age group of 50 years or older. The VDRL titers were below 1:2 in 94% of the VDRL-positive pregnant women and physical examinees. From the comparison of the results obtained by the present author group since 1977, i.e., 2.5 % in 1977, 1.1 % in 1981, 0.6 % in 1986 and 0.4 % in 1990, it is evident that the prevalence of syphilis in Korea is continually decreasing.
Adult ; Blood Donors ; Female ; Humans ; Korea ; Pregnant Women ; Prevalence* ; Seoul ; Syphilis*

The purpose of the present study was to examine a number of various times of Lipo-PGE1 administration in an attempt to determine the most effective time. In addition, this study examined the possible role of vascular endothelial growth factor(VEGF) on Lipo-PGE1 stimulation of a TRAM flap in the rat. Forty Sprague-Dawley rats were divided into 4 groups and a left inferior epigastric vessel pedicled TRAM flap, sized 5.0x3.5cm was created on the upper abdomen of each rat. Experimental groups included group 1(control): the flap was dissected and replaced, group 2(pharmacologic delay): Lipo-PGE1(0.5microgram) was given intraperitoneally for 5 days before elevation of flap daily, group 3(flap enhancement): Lipo- PGE1(0.5microgram) was given intraperitoneally for 5 days after flap elevation daily, group 4(pharmacologic delay and flap enhancement): Lipo-PGE1(0.5microgram) was given intraperitoneally for 5 days before elevation of flap then for 5 days after elevation of flap daily. On postoperative 5th day, we evaluated and compared the results of flap survival area, the number of blood vessel, and the VEGF expression using the western blot method. The results were as following: First, the mean percentage of the flap survival area of group II(63.9+/-12.6%), III(54.9+/-20.5%), IV(68.1+/- 18.2%) were higher than that of group I(28.7+/-15.2%) significantly(p<0.05). Second, the number of blood vessels were of group II(3.8+/-1.4), III(3.5+/-1.8), IV(4.0+/-1.5) were higher than that of group I(1.0+/-0.6) significantly(p<0.01). Third, the western blot method demonstrated a qualitatively greater amount of VEGF expression in the experimental groups. These results suggest that Lipo-PGE1 increased VEGF production and that Lipo-PGE1 may thereby enhance flap survival through VEGF production regardless of the time of Lipo-PGE1 administration.
Abdomen ; Alprostadil* ; Animals ; Blood Vessels ; Blotting, Western ; Rats* ; Rats, Sprague-Dawley ; Vascular Endothelial Growth Factor A

The aim of surgery for vestibular schwannoma is to accomplish complete tumor removal while preserving facial function and hearing ability. The middle cranial fossa approach represents one such surgical approach for resection of vestibular schwannoma with hearing preservation. As more experience has been gained with this approach, hearing preservation rates have increased. However, even if gross tumor removal is done completely, residual tumor can show regrowth microscopically. Such residual vestibular schwannoma may be treated by different options. We present a case of residual vestibular schwannoma treated with revision middle cranial fossa approach to preserve facial function and hearing ability.
Cranial Fossa, Middle ; Facial Nerve ; Hearing ; Neoplasm, Residual ; Neuroma, Acoustic

Schwannomas rarely present as intraocular tumors and are often misdiagnosed as malignant melanoma. We describe a choroidal schwannoma confirmed by sclerouvectomy. A 30-year-old woman presented with a large nonpigmented intraocular mass of the choroid in the right eye and underwent surgical excision by sclerouvectomy. Histologically, the tumor was composed of a mixture of cellular solid components (Antoni A) and loose myxoid components (Antoni B). The tumor was eventually diagnosed as a schwannoma. Currently available ancillary studies are still of little value in definitively differentiating schwannomas from other choroidal tumors. In the case of atypical findings for a malignant melanoma, a benign neoplasm should be included in the differential diagnosis. This patient avoided enucleation by first having the mass excised. We are unaware of previous reports in which a choroidal schwannoma was diagnosed by surgical excision.
Adult ; Choroid/*pathology ; Choroid Neoplasms/*diagnosis/surgery ; Diagnosis, Differential ; Eye Enucleation/*methods ; Female ; Humans ; Magnetic Resonance Imaging ; Neurilemmoma/*diagnosis/surgery

Acute hemorrhagic leukoencephalitis (AHLE) is an acute, rapidly progressing, fulminant demyelinating disease. It is a rare disease of the central nervous system with high mortality; survivors commonly present with significant neurological deficit. We report the case of a 16-month-old girl who survived AHLE and presented with the associated neurologic deficit. The patient came into the emergency department with febrile seizure. She showed bilateral pinpoint-sized pupils and hyperactive deep tendon reflexes. Her mental status was initially drowsy and rapidly progressed to stupor. Extensive demyelination and microbleeds were found in the cerebral white matter, thalamus and left cerebellum on Magnetic resonance imaging (MRI) scans. Her mental status was improved by intravenous administration of immunoglobulin and methylprednisolone. Five months after being discharged, increased white matter connectivity was found on color-coded follow-up MR diffusion tensor imaging (DTI) as compared to previous MRI. We therefore suggest adding the DTI technique when a follow-up MRI is performed in patients with AHLE. It could be useful to visualize the status of axonal injury and to encourage patients and their parents to continue the rehabilitation program.
Administration, Intravenous ; Axons ; Central Nervous System ; Cerebellum ; Child ; Demyelinating Diseases ; Diffusion Tensor Imaging* ; Diffusion* ; Emergency Service, Hospital ; Female ; Follow-Up Studies* ; Humans ; Immunoglobulins ; Infant ; Leukoencephalitis, Acute Hemorrhagic* ; Magnetic Resonance Imaging ; Methylprednisolone ; Mortality ; Neurologic Manifestations ; Parents ; Pupil ; Rare Diseases ; Reflex, Stretch ; Rehabilitation ; Seizures ; Seizures, Febrile ; Stupor ; Survivors ; Thalamus ; White Matter

Acute hemorrhagic leukoencephalitis (AHLE) is an acute, rapidly progressing, fulminant demyelinating disease. It is a rare disease of the central nervous system with high mortality; survivors commonly present with significant neurological deficit. We report the case of a 16-month-old girl who survived AHLE and presented with the associated neurologic deficit. The patient came into the emergency department with febrile seizure. She showed bilateral pinpoint-sized pupils and hyperactive deep tendon reflexes. Her mental status was initially drowsy and rapidly progressed to stupor. Extensive demyelination and microbleeds were found in the cerebral white matter, thalamus and left cerebellum on Magnetic resonance imaging (MRI) scans. Her mental status was improved by intravenous administration of immunoglobulin and methylprednisolone. Five months after being discharged, increased white matter connectivity was found on color-coded follow-up MR diffusion tensor imaging (DTI) as compared to previous MRI. We therefore suggest adding the DTI technique when a follow-up MRI is performed in patients with AHLE. It could be useful to visualize the status of axonal injury and to encourage patients and their parents to continue the rehabilitation program.
Administration, Intravenous ; Axons ; Central Nervous System ; Cerebellum ; Child ; Demyelinating Diseases ; Diffusion Tensor Imaging* ; Diffusion* ; Emergency Service, Hospital ; Female ; Follow-Up Studies* ; Humans ; Immunoglobulins ; Infant ; Leukoencephalitis, Acute Hemorrhagic* ; Magnetic Resonance Imaging ; Methylprednisolone ; Mortality ; Neurologic Manifestations ; Parents ; Pupil ; Rare Diseases ; Reflex, Stretch ; Rehabilitation ; Seizures ; Seizures, Febrile ; Stupor ; Survivors ; Thalamus ; White Matter

Objectives: ：This study assessed the psychological impact of quarantine during the coronavirus disease 2019 (COVID-19) outbreak. Methods: ：A total of 2080 participants filled the self-report questionnaire from March 17 to April 20, 2020 in Daegu, Republic of Korea. An online link was sent to currently or previously quarantined participants. The self-report questionnaire included patient health questionnaire-9 (PHQ-9), generalized anxiety disorder-7 (GAD-7), primary care post-traumatic stress disorder screen for diagnostic and statistical manual-5 (PTSD-PC), state-trait anger expression inventory (STAXI), and P4 suicidality screener scale (P4). PHQ-9 score of 5 or more and 9 or less indicates mild to moderate depressive symptoms, and 10 or more indicates severe depressive symptoms; A GAD-7 score of 5 or more and 14 or less indicates mild to moderate anxiety symptoms, and a score of 15 or more indicates severe anxiety symptoms; A PTSD-PC-5 score of 2 indicates mild to moderate PTSD; a score of 3 or higher indicates severe PTSD; A STAXI score of 14 or higher indicates severe anger symptoms; In P4, the cut-off points for each self-report questionnaire were set as mild suicidal thoughts at 1 point or more and 2 points or less, and severe suicide thoughts at 3 or more points. Logistic regression analyses were used to explore COVID-19-related risk factors. Results: ：The prevalence of mental health symptoms among the survey respondents was at 52.5% for depression, 44.5% for anxiety, 39.4% for post-traumatic stress, 31.6% for anger, and 10.9% for suicidal ideation. Participants with confirmed or suspected COVID-19 family members showed a high risk for symptoms of anxiety, posttraumatic stress, and anger. Participants with financial loss had increased symptoms of depression, anxiety, posttraumatic stress, anger, and suicidal ideation. Participants with a history of medical/psychiatric illnesses reported more symptoms of depression, anxiety, post-traumatic stress, anger, and suicidal ideation. Having inadequate basic supplies during quarantine was associated with negative mental health outcomes. Conclusions ：Quarantine had a negative psychological impact on all five mental health factors. The risk of depression, anxiety, post-traumatic stress disorder, anger, and suicidality increased among those who suffered from financial losses due to COVID-19. The associated risk factors will help identify populations at risk for mental health problems and implement mental health intervention policies.

Background: and Purpose The association between physical activity and dementia has been shown in various observational studies. We aimed to determine the risk of dementia in the elderly with lower-body fractures. Methods: We reconstructed a population-based matched cohort from the National Health Insurance Service—Senior Cohort data set that covers 511,953 recipients of medical insurance in South Korea. Results: Overall 53,776 subjects with lower-body fractures were identified during 2006–2012, and triplicate control groups were matched randomly by sex, age, and years from the index date for each subject with a fracture. There were 3,573 subjects (6.6%) with and 7,987 subjects (4.9%) without lower-body fractures who developed dementia from 2008 up to 2015. Lowerbody fractures were independently associated with a subsequent dementia diagnosis with a higher adjusted hazard ratio (aHR) (1.55, 95% confidence interval [CI]=1.49–1.62) compared with upper-body fractures (aHR=1.19, 95% CI=1.14–1.23). Conclusions These results support the protective role of physical activity against dementia and highlight the importance of promoting fracture prevention in the elderly.

Allogeneic hematopoietic stem cell transplantation is the only option for chemotherapy-refractory chronic myeloid leukemia (CML). Extramedullary relapse after transplantation is rare and usually accompanies marrow relapse. Generally, the prognosis of extramedullary relapse is poor. Here, we report a man with extramedullary relapsed CML after stem cell transplantation that presented as an isolated cardiac mass, which has shown an indolent course for more than 2 years, without evolving to medullary relapse during that period. This case implies that the CML clone might contribute to the development of quiescent extramedullary relapse with a benign course.
Bone Marrow ; Clone Cells ; Heart Neoplasms ; Hematopoietic Stem Cell Transplantation ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Prognosis ; Recurrence ; Sarcoma, Myeloid ; Stem Cell Transplantation

There have been many reports about infections in patients with rheumatoid arthritis (RA) being more frequent than general population. Increased susceptability to infections in RA could be related to disease itself, comorbid conditions, and use of immunosuppressive drugs and steroid. Herpes zoster viral infections also have been reported to be more frequent in RA. We describe a case of 60-year-old woman with RA presented with ophthalmoplegia associated with herpes zoster ophthalmicus. Initially she complained of right orbital and periorbital pain. Six days later, she noted a cutaneous herpes zoster eruption involving the right 1st division of trigeminal nerve. Three days after developing skin eruption, she developed a right ptosis with external ophthalmoplegia and pupil dilatation resulting from the 3rd and 6th cranial nerve involvement. She was placed on intravenous acyclovir for 7days. Eight weeks after the onset of ophthalmoplegia, she recovered nearly completely.
Acyclovir ; Arthritis, Rheumatoid* ; Cranial Nerves ; Dilatation ; Female ; Herpes Zoster Ophthalmicus* ; Herpes Zoster* ; Humans ; Middle Aged ; Ophthalmoplegia* ; Orbit ; Pupil ; Skin ; Trigeminal Nerve