Syphilis is a communicahble disease caused by the motile microaerophilic spirochete Treponema pallidum, which is only a netural pathogen for human. Prevalence of syphilis and other sexually transmitted diseases has traditioially fluctuated with changes in sccia, conditions and sexual behavior. Although sexual contact is the main route of transmission, T. pallidum may also be infected through direct contact with syphilitic lesions, blood transfusion, ingestion of menstrual blood or vaginal secretions, or trsnsplacental transemission. Fomites as the means of transfer is only hypothetical and account for very few, if any, infection. Prosectors, blood handlers and laboratory technicians are at risk for accidental inoculation with infected materials. In extremely unusual circumstances, infection by means of contact with a skin lesion and human bite have been reported. We report two cases of eyphilis following the abnormal imposition of hands, which caused unnecessary erosive trauma with fingernails,
Bites, Human ; Blood Transfusion ; Eating ; Fomites ; Hand* ; Humans ; Laboratory Personnel ; Nails ; Prevalence ; Sexual Behavior ; Sexually Transmitted Diseases ; Skin ; Spirochaetales ; Syphilis* ; Treponema pallidum

To determine injection time and effective dose of ciprofloxacin in endophthalmitis and to evaluate the effectiveness of dexamethasone. In rabbits, Pseudomonas aeruginosa (2 x 10(4) CFU/0.1 ml) was inoculated intravitreally. At 6, 12, 18, 24 hours postinoculation, single intravitreal doses of ciprofloxacin (300 microgram/0.15 ml or 100 microgram/0.05 ml) alone or with dexamethasone (400 microgram) were given. Electrophysiological and histologic measures were utilized to rate drug effectiveness. 300 micrograms ciprofloxacin was effective in killing P. aeruginosa at 6 and 12 hours postinoculation, but one hundred ug ciprofloxacin was not effective. 300 ug ciprofloxacin had no significant effect in killing P. alphaeruginosa at 18 hrs and 24 hrs postinoculation. Eyes treated with dexamethasone (400 microgram) and ciprofloxacin (300 microgram) at 6 hours postinoculation did not differ from eyes treated with ciprofloxacin alone. Cultures from eyes treated with dexamethasone and ciprofloxacin at 12 hours postinoculation were positive. Cultures from eyes treated with ciprofloxacin alone were negative. The failure of treatment at 18 hrs and 24 hrs postinoculation may be due to either an increased rate of clearance of drugs from the eyes or a reduced bactericidal effect of ciprofloxacin which could be altered by acidic pH, degree of hypoxia or bacterial counts. Dexamethasone had no beneficial effect in the treatment of P. aeruginosa endophthalmitis in the early phase.
Animals ; Anti-Infective Agents/*administration & dosage ; Anti-Inflammatory Agents/*administration & dosage ; Ciprofloxacin/*administration & dosage ; Dexamethasone/*administration & dosage ; Disease Models, Animal ; Dose-Response Relationship, Drug ; Drug Therapy, Combination ; Electroretinography ; Endophthalmitis/*drug therapy/microbiology/pathology ; Eye Infections, Bacterial/*drug therapy/microbiology/pathology ; Pseudomonas Infections/*drug therapy/microbiology/pathology ; Pseudomonas aeruginosa/drug effects/isolation & purification ; Rabbits ; Time Factors ; Vitreous Body/microbiology

Acrodermatitis enteropathica is a rare autosomal recessive disorder characterized by alopecia, acral and periorificial dermatitis and diarrhea. True acrodermatits enteropathica requires lifelong zinc replacement whereas transient acrodermatitis enteropathica, an acquired disorder with identical clinical features, requires only transient zinc replacement. Although premature and milk-fed infants are particularly vulnerable to development of both conditions, there have been some reports of acrodermatitis enteropathica in full-term breast-fed infants. We report a case of transient acrodermatitis enteropathica in a 5-month-old, full-term, breast-fed male baby with identical history in his 2 elder siblings. The patient presented with a 5-month history of diarrhea, hair loss and crusted erythematous patches on periorificial areas, and fingers and toes. His serum zinc levels were within lower normal limits in 2 consecutive tests. His mother was also checked for zinc levels, which was normal in serum but was markedly reduced in breast milk. Diarrhea and skin lesions disappeared promptly with oral zinc supplementation and did not recur after 11 weeks of treatment.
Acrodermatitis* ; Alopecia ; Dermatitis ; Diarrhea ; Fingers ; Hair ; Humans ; Infant ; Male ; Milk, Human ; Mothers ; Siblings* ; Skin ; Toes ; Zinc

Renal infarction with ethanol was induced exprimentally in rabbits and selective renal angiography wasperformed to evaluate the effectiveness of ethanol as embolic material. The results were as follows; 1. Completeobstruction of renal artery was produced in all cases within 1 week after injection of absolute ethanol(0.5ml/kg). 2. Incomplete obstruction of renal artery was produced in majority after injection of absolute ethanol(0.2ml/kg) and changed to complete obstruction above half cases with time. 3. Incomplete obstruction of renalartery was produced in minority after injection of 60% ethanol (0.2ml/kg) and complete obstruction of renal arterywas not produced. It was considered that ethanol is an effective agent for complete renal infarction and 0.2 to0,5ml/kg of absolute ethanol is effective dose for complete renal infarction.
Angiography ; Ethanol ; Infarction ; Rabbits ; Renal Artery

Fracture of the vertebral end plate in the lumbar and sacral spine has been reported as a rare lesion. Especially it is very rare that fractures are found at two levels simultaneously. To our knowledge, there has been only one reported case of this type of fracture in Korea3). We report a case of fractures of the vertebral end plates at two levels in adolescent patient.
Adolescent ; Humans ; Spine

The Naka-Rushton equation, R=R(max) I(n)/(I(n)+K(n)), has been used to describe the luminance-response function of the scotopic electroretinogram. R(max) is the asymptotic value of the b-wave amplitude as a function of stimulus luminance, K is the intensity that produces a b-wave amplitude that is one-half R(max) and n is a dimensionless contant that controls the slope of the function and represents the degree of homogeneity of retinal sensitivity. These three parameters are often used in experimental laboratories, since it can show selective changes in each parameter. The present study describes and compares the parameters of Naka-Rushton equation obtained by using ganzfeld stimuli(R(max)=363+/-32 uv, n=0.86+/-0.06, log K=-2.39+/-0.19 log cd.sec/m2) and direct flash stimuli(R(max)=354+/-28 uv, n=0.80+/-0.06, log K=-2.26+/-0.15 log cd.sec/m2) in 20 eyes of the normal pigmented rabbits respectively. The n values were significantly increased by the ganzfeld light stimuli than by the direct flash stimuli(p<0.05).
Rabbits ; Retinaldehyde

The Naka-Rushton equation of the form, R = R(max) I(n)/(I(n)+K(n)), has been used to describe the b-wave luminance-response function of the scotopic electroretinogram. Rmax is the asymptotic value of the b-wave amplitude as a function of stimulus luminance I, K is the luminance that produces a b-wave amplitude that is one-half R(max), and n is a dimensionless constant that controls the slope of the function. These three parameters are often used in research laboratories, since it can show selective changes in each parameter. The present study describes these parameters (R(max) = 354 +/- 28 uV, n = 0.80 +/- 0.06, log K = -2.26 +/- 0.15 log cd. sec/m2) and the values obtained from the derivative analysis of Naka-Rushton equation (Anastasi et al) in 20 normal pigmented rabbit eyes. However, Naka-Rushton equation accurately describes the function only at low to moderate flash luminances. At high flash luminances, a second amplitude increase appears in the function.
Animals ; *Dark Adaptation ; Electroretinography ; Light ; Rabbits ; Retina/*physiology

The Naka-Rushton equation of the form, R = R(max) I(n)/(I(n)+K(n)), has been used to describe the b-wave luminance-response function of the scotopic electroretinogram. Rmax is the asymptotic value of the b-wave amplitude as a function of stimulus luminance I, K is the luminance that produces a b-wave amplitude that is one-half R(max), and n is a dimensionless constant that controls the slope of the function. These three parameters are often used in research laboratories, since it can show selective changes in each parameter. The present study describes these parameters (R(max) = 354 +/- 28 uV, n = 0.80 +/- 0.06, log K = -2.26 +/- 0.15 log cd. sec/m2) and the values obtained from the derivative analysis of Naka-Rushton equation (Anastasi et al) in 20 normal pigmented rabbit eyes. However, Naka-Rushton equation accurately describes the function only at low to moderate flash luminances. At high flash luminances, a second amplitude increase appears in the function.
Animals ; *Dark Adaptation ; Electroretinography ; Light ; Rabbits ; Retina/*physiology

Iliofemoral vein thrombosis is a serious disease causing major morbidity, such as phlegmasia alba dolens, phlegmasia cerulea dolens, fatal pulmonary embolism, and post-thrombotic syndrome. Systemic anticoagulation therapy with heparin and coumadin often shows no effect and thrombectomy often results in poor long term patency due to recurrent thrombosis. Some recent studies have reported good results by catheter-guided thrombolysis therapy (CGTT) in iliofemoral vein thrombosis. Authors have experienced a good result by CGTT in an old (aging 7 weeks) iliofemoral vein thrombosis. (Case) A 21 years-old female patient with diffuse edema of left thigh and leg was admitted in SNUH. Her parents notified her abnormal gait at the age of three, but no treatment was done. In Jan. 1998, she was diagnosed as spastic diplegia due to cerebral palsy and underwent orthopedic surgery (semitendinosus tendon transfer) at other hospital. After long leg cast for 6 weeks, swelling of her left thigh developed, which waxed and waned. Seven weeks thereafter, she was diagnosed to have left iliofemoral vein thrombosis and transferred to our hospital. After initial evaluation and systemic heparin therapy, we performed CGTT via left popliteal vein puncture. After successful passage of guidewire, serial balloon dilatation and intra-clot urokinase infusion was done. Total 3.5 million units of urokinase was infused for 28 hours with simultaneous intravenous heparin. Despite of some residual thrombi, the venous flow of iliofemoral vein was restored with no complication and her symptom has much improved. Patent venous flow was detected at 6 months follow-up doppler examination.
Cerebral Palsy ; Dilatation ; Edema ; Female ; Follow-Up Studies ; Gait ; Heparin ; Humans ; Leg ; Orthopedics ; Parents ; Popliteal Vein ; Pulmonary Embolism ; Punctures ; Tendons ; Thigh ; Thrombectomy ; Thrombolytic Therapy* ; Thrombophlebitis ; Thrombosis* ; Urokinase-Type Plasminogen Activator ; Veins* ; Warfarin ; Young Adult

Acute rejection in renal transplantation is a major risk factor threatening the longterm graft survival. Acute rejections refractory to conventional anti-rejection therapy using steroid pulse or antilymphocyte preparations occur in minority, preceding to progressive deterioration of renal function and graft loss. Recent reports showed that tacrolimus rescue therapy in this refractory rejections has converted rejection process. In order to evaluate the clinical outcome of tacrolimus rescue therapy in refractory rejections, we performed a retrospective study. Since April 1997, we performed tacrolimus rescue therapy intent-to-treat for steroid- or OKT3- resistant rejections in 5 patients. All rejections were histologically confirmed according to Banff criteria. As conventional antirejection therapy, steroid pulse therapy (solumedrol 500~1000 mg iv for 3 days) or OKT3 therapy (5 mg/day for 14 days) was performed. The outcome of the rescue therapy is classified into three categories by the change of serum creatinine level or the histologic findings; Improvement-return of serum creatinine level (sCr) to or below the prerejection baseline (nadir) level, Stabilization-arrested sCr increase, Failure-progressive deterioration of renal function, or graft loss. All were men and the mean age was 38 years. Living related- & unrelated-donor transplantation were 2 and 3 cases respectively. Immunosuppression were done with CsA Pd+ (3) or CsA+ Pd+ AZA (2). Acute rejection grades according to Banff criteria were mild (2) or moderate (3). The mean interval between transplantation and tacrolimus conversion was 54.4 days. The outcome was as follows; improvement 2 cases, stabilization 1 case and failure 2 cases. During 3~10 months followup PTLD occured in 1 case, treated with graft nephrectomy and no other complications in other 4 cases. In conclusion, we can convert ongoing refractory rejections to steroid and OKT3 therapy by tacrolimus rescue therapy in 60% (3/5) successfully. Although longterm followup result is necessary to confirm the efficacy and safety of the tacrolimus rescue therapy, the result of this early trial is so good that we may try tacrolimus in refractory rejections for rejection reversal.
Creatinine ; Follow-Up Studies ; Graft Survival ; Humans ; Immunosuppression ; Kidney Transplantation* ; Male ; Muromonab-CD3 ; Nephrectomy ; Retrospective Studies ; Risk Factors ; Tacrolimus* ; Transplants