Molluscum contagiosum is caused by a DNA virus from the poxvirus family. With the advent of new populations of immunocompromised individuals-especially those infected with HIV-molluscum contagiosum has emerged as an important cause of morbidity and disfigurement. Molluscum contagiosum in AIDS, although not life-threatening, is often a marker of late-stage disease and may lead to atypical clinical features and a progressive course that is recalcitrant to treatment. We report two cases of AIDS-related molluscum contagiosum in a 45 year-old male and a 30 year-old male. They were diagnosed as HIV-positive 3 years ago and 1 year ago, respectively. Physical examination revealed asymptomatic numerous skin-colored papules, nodules and tumorous masses on the face and neck. The histopathological finding showed characteristic features of molluscum contagiosum. We think that this is the first report of severe AIDS-related molluscum contagiosum in Korean literature.
Adult ; DNA Viruses ; Humans ; Male ; Middle Aged ; Molluscum Contagiosum* ; Neck ; Physical Examination

Compared with iron dextran, iron chondroitin sulfate(ICS) is much cheaper and has better bioavailability. To evaluate the efficacy and safety of ICS in maintenance HD patients, i.v. ICS was given to 37 HD patients [20 M, 17 F, median age 51 years, median duration of HD 21 months] whose ferritin(Fer)< 100microgram/L or transferrin saturation(TFS) <20% [Group I , 12 M, 10 F] or Hb<9.0g/dL in spite of increased rHuEPO dose, Fer>or=100microgram/L and TFS>or=20% [Group II, 8 M, 7 F]. The patients had taken oral iron [227+/-73mg/day(mean+/-SD)] before this study. All patients received 120mg i.v. ICS weekly for 1 month. Then, ICS dosage was adjusted to 40-120mg/week depending on Hb, Fer and TFS in the following 3 months. Hb, Fer, TFS, rHuEPO dose and side effects were monitored monthly. The results were as follows : 1) I.v. iron therapy produced a significant rise in Hb(8.3+/-0.9g/dL to 9.7+/-0.9g/dL; P<0.01), a significant reduction in rHuEPO dose(95+/-50U/kg/wk to 69+/-28U/kg/wk; P<0.05), a significant increase in serum ferritin levels(162+/-149microgram/L to 472+/-255microgram/L; P<0.01) and TFS(24+/-13% to 41+/-18%; P<0.05). 2) In group 1, i.v. iron therapy produced a significant rise in Hb(8.5+/-1.1g/dL to 9.9+/-0.9g/dL; P< 0.01), a significant reduction in rHuEPO dose(87+/-45U/kg/wk to 69+/-27U/kg/wk; P<0.05), increased serum ferritin levels(90+/-48microgram/L to 379+/-186microgram/L; P<0.01) and TFS(18+/-9% to 36+/-16%; P<0.05). 3) In group 2, i.v. iron therapy produced a significant rise in Hb(8.1+/-0.6g/dL to 9.3+/-0.9g/dL; P<0.01), a significant reduction in rHuEPO dose(108+/-55U/kg/ wk to 69+/-31U/kg/wk; P<0.05) and increased serum ferritin levels(274+/-185microgram/L to 602+/-287microgram/L; P< 0.01) with a tendency of increase in TFS(35+/-13% to 41+/-18%; P=0.06). 4) No significant side effect was observed. 5) An annual cost reduction of 221 US dollars per patient was expected. In conclusion, ICS is an effective and safe intravenous iron preparation in HD patients.
Anemia ; Biological Availability ; Chondroitin ; Dextrans ; Erythropoietin ; Ferritins ; Humans* ; Iron* ; Kidney Failure, Chronic ; Transferrin

Despite a large number of automobile accidents, the aneurysm of a coronary artery from blunt chest trauma in a very rare entity. Especially aneurysm of the right coronary artery has been few previously described. A 24-yeal old man sustained blunt chest trauma from steering wheel contact during automobile accident 6 hours after admission, an electrocardiogram revealed complete heart block with ST elevation in lead II, III, and aVF. He needed temporary transvenous cardiac pacing and large amount fluid infusion for treatment of cardiogenic shock from bradycardia and right ventricluar infarction in emergency center. 2-dimensional echocardiogram showed akinetic inferior wall of the left ventricle and dilatation of the right ventricle. Coronary arteriography revealed a saccular aneurysm in the proximal right coronary artery without atherosclerotic change. Size of aneurysm in right coronary artery remained unchanged on repeat coronary arteriogrpahy. His hospital course was uneventful and discharged without any sign of residual ischemia.
Aneurysm* ; Angiography ; Automobiles ; Bradycardia ; Coronary Vessels* ; Dilatation ; Electrocardiography ; Emergencies ; Heart Block ; Heart Ventricles ; Infarction ; Ischemia ; Myocardial Infarction* ; Shock, Cardiogenic ; Thorax*

BACKGROUND: A mummy is a dead body of a human being or an animal that has been preserved artificially or naturally from decaying. Because the natural environment of Korea isn't appropriate for mummification and Korean people haven't artificially made mummies, mummies were rarely studied in Korea. METHODS: On September 6, 2002, a well-preserved female mummy was found in the grave of a family in Kyunggi-do. She was submitted to a thorough autopsy examination along with the review of genealogical documents. RESULTS: The mummy died in winter. She was pregnant and the fetal head was observed at the vaginal orifice. The uterine wall was ruptured, and the peritoneum was discolored, probably by hemorrhage. Histologically, the gastric mucosa was well preserved. On the smear cytology of gastrointestinal material and the fluid from the coffin, pollens and parasitic eggs were observed. The woman seemed to be death from hypovolemic shock due to uterine rupture during the 2nd phase of labor. CONCLUSION: From this case, we concluded the causes of the woman's mummification included the cold and dry circumstance at the time of her death, and the thick mortared wall of the grave that completely isolated the body from the outside.
Animals ; Autopsy ; Eggs ; Female ; Gastric Mucosa ; Gyeonggi-do ; Head ; Hemorrhage ; Humans ; Korea ; Mummies ; Ovum ; Paleopathology ; Peritoneum ; Pollen ; Pregnant Women* ; Shock ; Uterine Rupture

BACKGROUND/AIMS: Although endoscopic band ligation or injection sclerotherapy are the current standard therapies for bleeding esophageal varices, the best method for initial control is unclear. The aim of this prospective study was to compare the efficacy and toxicity of somatostatin and vasopressin in the management of esophageal variceal hemorrhage. METHODS: From March, 1997 to September, 1998, 28 consecutive cirrhotic patients admitted to the Yonsei Medical Center because of active variceal bleeding were included in this trial. The patients were randomized to receive either somatostatin (15 patients) or vasopressin (13 patients) for 48 hours. RESULTS: There were no significant differences between the two treatment groups in relation to Child's classification, amount of bleeding before randomization and units of blood transfused during therapy. Initial control of bleeding was achieved in 13 (86.7%) patients receiving somatostatin and in 10 (76.9%) of those treated with vasopressin. However, two patients in the somatostatin group and two in the vasopressin group bled again during treatment. Therefore complete control of bleeding during the 48 hours of therapy was achieved in 11 (73.4%) patients treated with somatostatin and in eight (61.5%) of those receiving vasopressin. Differences were observed in complications associated with each therapy. Vasopressin produced complications in four patients (chest pain in two, hypertension in one and hyponatremia-induced seizure in one) while somatostatin produced minor complication in one patient. CONCLUSIONS: This study suggests that somatostatin is efficacious in controlling acute hemorrhage from esophageal varices and has a lower risk of adverse effects than vasopressin.
Classification ; Esophageal and Gastric Varices ; Hemorrhage* ; Humans ; Hypertension ; Ligation ; Prospective Studies* ; Random Allocation ; Sclerotherapy ; Seizures ; Somatostatin* ; Vasopressins*

Meningococcal sepsis-associated purpura fulminans is a rapidly progressing condition with high morbidity and mortality. There are several reports of amputation of extremities due to gangrenous change in this condition. However, in Korean literature, we found only one case report associated with amputation of one leg due to meningococcal infection. We report a case of meningococcal infection necessitating the amputation of both legs in a previously healthy seven-year-old girl with a review of literatures.
Amputation* ; Child* ; Extremities ; Female ; Humans ; Leg* ; Meningococcal Infections* ; Mortality ; Purpura Fulminans

BACKGROUND AND OBJECTIVES: There are many clinical procedures that are related to the evaluation of kinematic events concerning vocal fold vibration. However, many of these procedures are hardly applicable for precise analyses of physiological and morphological changes in vocal folds with respect to the pitch control, and vocal fold volume changes from the phonatory aspect of larynx. The purpose of this study was to examine the clinical feasibility of a new 3 dimensional image method, the functional laryngeal CT, which can provide a clear sagittal image of the vocal fold in each of the anteroposterior directions during phonation and resting state. SUBJECTS AND METHOD: Functional laryngeal CT was performed in 4 normal control and 2 cases of unilateral vocal fold paralysis. The subjects were instructed at resting position to produce sustained vowel phonation of three different kinds of pitch. Three-dimensional endoscopic images were reconstructed through segmentation and surface-rendering algorithm on personal computer, using the DICOM (Digital Image and Communication in Medicine) file of axial images. RESULTS: The dynamic vocal fold 3D image that was reconstructed by serial section image during phonation showed that the vocal fold became thin and volume was decreased in relation to the increase in pitch. Typical subglottic shoulder formation and ventricular widening was noted in the high pitched tone. CONCLUSION: Functional 3D laryngeal CT (F3DLxCT) is an informative tool for visualizing the active changes in length, tension and mass of the vocal folds for pitch control. Furthermore, the volume defect and the level difference in the paralysed vocal fold are easily detectable with this new techinque.
Imaging, Three-Dimensional ; Larynx ; Microcomputers ; Paralysis* ; Phonation ; Shoulder ; Vibration ; Vocal Cords*

BACKGROUND AND OBJECTIVES: Surgery and postoperative radiation therapy have been the main stream management of tonsil cancer. There is a variety of surgical approach methods are used for the resection of tonsil cancer, however, there have only been a few reports of the results of surgical treatment of tonsil cancer. So, on the basis of our experience, we report the results of our surgical treatments of tonsil cancer. SUBJECT AND METHOD: 32 medical records, from 1994 April to 2003 June, of patients surgically treated for tonsil cancer were reviewed. Evaluated were disease status, surgical approach methods, types of the neck dissection, surgical margin, reconstruction methods, postoperative complications, time of oral diet and decannulation, recurrence, and survival rate. RESULTS: Mean follow up periods were 2.3 years. There was 1 patient in Stage I, 5 in Stage II, 2 in Stage III, and 24 in Stage IV. For Tumor excision, 5 patients underwent intraoral approach, 10 mandibulotomy approach, and 17 lateral pharyngotomy approach. Surgical defects were primary closed in 5 patients and reconstructed with pectoralis major myocutaneous flap in 7 patients and radial forearm fasciocutaneous free flap in 20 patients. There were 2 local recurrences, 5 regional recurrences, and one distant metastasis. The mean time of the beginning of oral diet/decannulation after operation were 19.8/11.3 days in lateral pharyngotomy and 25.3/12.9 days in mandibulotomy. The mean survival period was 41.4 months. CONCLUSION: Because most of tonsil cancers are advanced diseases, more precise tumor resection and meticulous neck management are needed. Lateral pharyngotomy approach had priority to other surgical approaches in selected cases except T4. It has advantages of full range of vision for resection, better functional status and less postoperative morbidity.
Diet ; Follow-Up Studies ; Forearm ; Free Tissue Flaps ; Humans ; Medical Records ; Myocutaneous Flap ; Neck ; Neck Dissection ; Neoplasm Metastasis ; Palatine Tonsil* ; Postoperative Complications ; Recurrence ; Rivers ; Survival Rate ; Tonsillar Neoplasms*

Meningococcal sepsis-associated purpura fulminans is a rapidly progressing condition with high morbidity and mortality. There are several reports of amputation of extremities due to gangrenous change in this condition. However, in Korean literature, we found only one case report associated with amputation of one leg due to meningococcal infection. We report a case of meningococcal infection necessitating the amputation of both legs in a previously healthy seven-year-old girl with a review of literatures.
Amputation* ; Child* ; Extremities ; Female ; Humans ; Leg* ; Meningococcal Infections* ; Mortality ; Purpura Fulminans

Mycobacterium tuberculosis is capable of growing and survival within macrophage. The purpose of this study was to identify the genes regulated by infection of mycobacteria in human monocytic THP-1 cells. We used the differential display reverse transcriptase polymerase chain reaction (DD RT-PCR) and nothern blot analysis to confirm the differentially expressed genes from THP-1 cells infected with live Mycobacterium tuberculosis H37Rv, heat-kille Mycobacterium tuberculosis H37Rv and live Mycobacterium bovis BCG. Among many up or down-regulated clones, 27 clones were sequenced and compared with known genes on GenBank. Thirteen of over-expressed clones from THP-1 cells infected with live Mycobacterium tuberculosis H37Rv were identical to human prothymosin alpha, eight were novel clones and six clones showed homology with Human ferritin H chain, Escherichia coli bgl, Mouse RNA-dependent EIF-2 alpha kinase, E. coli htrL, Hyaluronan receptor and T cell receptor. Our result suggests that Mycobacterium tuberculosis might regulate prothymosin alpha gene transcription in monocytic THP-1 cell.
Animals ; Antigens, CD44 ; Clone Cells ; Databases, Nucleic Acid ; Escherichia coli ; Eukaryotic Initiation Factor-2 ; Ferritins ; Humans ; Macrophages ; Mice ; Mycobacterium bovis ; Mycobacterium tuberculosis* ; Mycobacterium* ; Phosphotransferases ; Receptors, Antigen, T-Cell ; Reverse Transcriptase Polymerase Chain Reaction ; Up-Regulation*