Hemorrhagic fever with renal syndrome (HIFRS), scrub typhus, murine typhus and leptospirosis have been the principal acute febrile diseases in Korea. To evaluate the seroepidemiologic patterns of acute febrile illness, sera collected from 2,423 patients in 1996 were examined for antibodies against Hantaan virus, Orientia tsutsugamushi, Rickettsia typhi, and Borrelia burgdorferi by indirect immunofluorescent antibody technique (IFA) and macroscopic agglutination test for Leptospira interogans. Seropositive cases against O. tsutsugamushi, Rickettsia typhi, Leptispira interogans and Hantaan virus were 192 (7.9%), 193 (8.0%), 12 (0.5%) and 324 (13.4%), respectively. Male was more affected in HFRS and murine typhus contrasting to scrub typhus and leptospirosis in female. Most positive cases occurred during October and November for scrub typhus, and during November and December for HFRS. These results showed similar patterns with previous epidemical data for recent couple of years, and possibly implied no significant changes occurred in ecologic situations for acute febrile diseases in Korea.
Agglutination Tests ; Antibodies ; Borrelia burgdorferi ; Female ; Hantaan virus ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Korea* ; Leptospira ; Leptospirosis ; Male ; Orientia tsutsugamushi ; Rickettsia typhi ; Scrub Typhus ; Typhus, Endemic Flea-Borne

PURPOSE: To investigate the improvement in balance after TKA and the difference of balance between posterior cruciate ligament retaining & posterior cruciate ligament substituting prostheses. MATERIALS AND METHODS: Twenty-six patients scheduled to undergo TKA were randomly assigned to receive either PCL-retaining or PCL-substituting prosthesis. The balance of the subjects were checked prior to and at least six months after the operation by computerized dynamic posturography. We investigated whether the balance improve and the difference of change between the implants. RESULTS: Patients showed significantly the improvement of balance by the knee proprioception after TKA (p<0.05) during intercepting visual compensation and the more HSS Knee score improve, the more its balance improve (p<0.05, r=0.667). But the difference of balance between the implants was not detected significantly (p>0.05). CONCLUSION: The balance by the proprioception improves as the HSS Knee Score increases after TKA, and does not show the difference between the implants.
Compensation and Redress ; Humans ; Knee ; Posterior Cruciate Ligament ; Proprioception ; Prostheses and Implants

We experienced one case of severe pituitary dwarfism in a 10 years old female girl. Magnetic resonance image (MRI) revealed transection of the pituitary stalk stalk with the formation of high intensity ectopic posterior lobe located at the median eminence and agenesis of an anterior lobe of pituitary gland. The serum growth Hormone (GH) response to clonidine and L-dopa revealed severe GH deficiency. The patient had responses to TRH, normal TSH and partial prolactin response, respectively. There was not response LH and FSH to GnRH. The morning cortisol concentration and serum T4 concentration were decreased below the normal range. These findings and no hyperprolactinemia suggested the presence of a vascular connection between the pituitary gland and hypothalamus, which is not visible on MRI. Sofar, the primary cause of idiopathic pituitary dwarfism in many patients is injury to hypothalamus by perinatal insults. In this patient, there was no history of perinatal insults and postnatal head trauma but transection of the pituitary stalk. We report a case of severe pituitary dwarfism due to agenesis with brief review of related litereature.
Child ; Clonidine ; Craniocerebral Trauma ; Dwarfism, Pituitary* ; Female ; Gonadotropin-Releasing Hormone ; Growth Hormone ; Humans ; Hydrocortisone ; Hyperprolactinemia ; Hypothalamus ; Levodopa ; Magnetic Resonance Imaging ; Median Eminence ; Pituitary Gland* ; Pituitary Gland, Anterior* ; Prolactin ; Reference Values

It is well known that circulating antibodies are produced by plasma cells derived from B lymphocytes, and T lyphocytes are endowded with the capacity to regulate the type and intensity of virtually all immune responses. Therefore, the measurement of relative and absolute number of lymphocytes in the peripheral blood of myasthenia gravis patients could be of value. We have studied the distribution pattern of lymphocytes and helper/suppressor ratio in the peripheral blood of 28 myasthenic patients in comparison with 10 patients of other neurologic diseases as control by using immunobead method. There was no significant differences between 17 myasthenic patients who had taken only anticholinesterase and control. But in 17 patients who had taken steroid, Helper T lymphocyte was decreased significantly compared to control. Both T lymphocyte and B lymphocyte were also decreased significantly compared to 17 myasthenic patients who had taken only anticholinesterase without steroid therapy. In 3 patients who had undergone thymectomy, there was significant decreases of suppressor T lymphocyte. Plasma exhange as a treatment for myasthenia gravis is currently the subject of clinical interest and research. Clinical response and muscle power measured by using sphygmomanometer were followed in 2 patients in myasthenic crisis and in 4 patients with severe disease refractory to all other treatment modalities, received 4-6 cycles of plasma exchange with Hemonetics 30-S. 2 patients had a recurrence 1.5 and 6 months after first course of plasma exchange respectively, Therefore, they had to take a second course of plasma exchange. The satisfactory increment of muscle power was noticed in 5 out of 6 cases after fourth plasma exchange.
Antibodies ; B-Lymphocytes ; Humans ; Lymphocytes* ; Myasthenia Gravis* ; Plasma Cells ; Plasma Exchange* ; Plasma* ; Recurrence ; Sphygmomanometers ; Thymectomy

Candida infections after total knee replacement are extremely rare and show no specific symptoms and signs, thus make it difficult to diagnose. It is desirable to perform fungi culture from the beginning in case of persistent swelling and burning sensation in patients after total knee replacement with risk factors such as intraarticular steroid injection, intravenous drug abuse, immunosuppressive therapy, malignant hematologic tumor, etc. Positive culture of candida should never be considered as contaminated study, and be treated immediately. We report a case of candida infection after total knee arthroplasty, which was treated with staged reimplantation.
Risk Factors

Von Hippel-Lindau disease is a rare disorder which involves multi-organs including cerebellum and retina. Recently we have experienced 2 cases of von Hippel-Lindau disease. The case 1 was a 19-year-old female with chief complaint of severe headache accompanied by vomiting on admission. Computed tomogram of brain showed space occupying lesion in the posterior fossa. She was rapidly deteriorated and diagnosed as brain death on the basis of physical and neurological examination and electroencephalogram. Kidney specimens removed for the transplantation and cerebellum obtained by partial autopsy reveled bilateral renal cell carcinomas and hemangioblastoma, respectively, on the microscopic examination.. The case 2 was a 23-year-old male who visited to our hospital due to headache, gait disturbance, and visual loss in the right eye. The findings of brain CT, vertebral angiography, ophthalmoscope, retinal angiogram, and operation were compatable to cerebello-retinal angiomatosis. With reviewing of some literatures, we present 2 cases of von Hippel-Lindau disease.
Angiography ; Angiomatosis ; Autopsy ; Brain ; Brain Death ; Carcinoma, Renal Cell ; Cerebellum ; Electroencephalography ; Female ; Gait ; Headache ; Hemangioblastoma ; Humans ; Kidney ; Male ; Neurologic Examination ; Ophthalmoscopes ; Retina ; Retinaldehyde ; Vomiting ; von Hippel-Lindau Disease* ; Young Adult

It is well known that involvement of the cranial nerves is a relatively common manifestation of tuberculous meningitis because tuberculous exudate is most likely to be located at the base of brain and in the basal cisterns. We reviewed 73 adult patients under the diagnosis of tuberculous meningitis at Hanyang University Hospital during last three and a half years from March, 1986. Patients were classified into two groups according to the presence or absence of cranial nerve palsies. Cranial nerve palsies were noted in 22 patients (30.1%) at the time of admission or in the early period of antituberculous therapy. The oculomotor and abdcens nerves were most commonly involved, followed by the optic nerve. In 10 cases with oculomotor nerve palsy, 7 cases were noted to have involvement of both pupils and extraocular movements, 2 had involvement of one pupil only and one remaining case involved extraocular movements only (spared pupil). Cranial nerve palsies developed 7 to 89 days (median, 21.5) after initial symptoms, and in 10 cases their palsies disappeared within 15 to 65 days (median, 40.9). The incidence of SIADH and basal meningeal involvement were much higher in the cranial nerve palsy group. Increase of total protein and decrease of sugar in initial CSF examination were significant (p<0.05) in the cranial nerve palsy group.
Adult* ; Brain ; Cranial Nerve Diseases* ; Cranial Nerves* ; Diagnosis ; Exudates and Transudates ; Humans ; Inappropriate ADH Syndrome ; Incidence ; Oculomotor Nerve Diseases ; Optic Nerve ; Paralysis ; Pupil ; Tuberculosis, Meningeal*

No abstract available.
Hydrocortisone* ; Prolactin*

PURPOSE: To evaluate the surgical results and complications of silicone intubation in patients with epiphora by punctal stenosis. METHODS: We reviewed the records of 35 eyes of 23 patients who had undergone silicone intubation from 1998 to 2002 and followed more than 1 year postoperatively. RESULTS: Following 1 year postoperatively, 33 eyes (94.3%) showed no epiphora, 2 eyes (5.7%) showed intermittent epiphora. Complications after silicone intubation included prolapse of tube in 3 eyes, punctal slitting in 1 eye, itching in 6 eyes, foreign body sensation in 2 eyes, discharge from punctum in 3 eyes and intranasal discomfort in 1 eye. CONCLUSIONS: Silicone intubation seemed to be an alternative method in patient with epiphora due to punctal stenosis and also a useful method to treat upper and lower punctum.
Constriction, Pathologic* ; Foreign Bodies ; Humans ; Intubation* ; Lacrimal Apparatus Diseases ; Prolapse ; Pruritus ; Sensation ; Silicones*

PURPOSE: Metabolic bone diseases have been major problems in children with renal diseases and steroid treatment is the main precipitating factor reducing bone mineral density(BMD). This study was performed to assess the prevalence of osteoporosis and to evaluate the clinical factors associated with decreased BMD in children with renal diseases. METHODS: Forty-four children with renal diseases who were diagnosed at the pediatric nephrology division of Ajou University hospital since Oct. 1994 were included. Using a new quantitative ultrasound device, BMD and the prevalence of osteoporosis were evaluated. The clinical and serological data were analyzed in association with decreased BMD. RESULTS: A total of 44 patients were evaluated. The age at initial diagnosis was 6.7+/-4.2 years. At the time of evaluation, the chronological and bone age was 9.3+/-4.2 years and 8.2+/-4.6 years, respectively. The renal diseases included nephrotic syndrome 24(54.5%), Henoch Schonlein purpura nephritis 7(15.9%), IgA nephropathy 6(13.9%), reflux nephropathy(RN) 2 (4.5%), and other renal disease 5(%). The prevalence of osteoporosis was 11%. There was no difference in the clinical factors between the long-term and the short-term treated steroid groups. CONCLUSION: The prevalence of osteoporosis was 12% in 44 children with renal diseases. No significant factor was found in association with decreased BMD and there was no relationship between osteoporosis and steroid usage duration or cumulative dose. A new quantitative ultrasound, which is relatively easy to perform, especially in children, is expected to be in common use and will enable clinicians to evaluate metabolic bone disorders with ease.
Bone Density ; Bone Diseases, Metabolic ; Child ; Diagnosis ; Equidae* ; Glomerulonephritis, IGA ; Humans ; Nephritis ; Nephrology ; Nephrotic Syndrome ; Osteoporosis ; Precipitating Factors ; Prevalence ; Purpura, Schoenlein-Henoch ; Ultrasonography*