Onychomycosis can be diagnosed by mycological examination, but it is not easy to detect its causative organisms because the positive rate of culture is lower and its scores are variable due to the contamination inherently introduced in the current method used in sampling the ovychomycosis organisms. It was suggested that the scores depended upon the handicraft of operates and the gainning method of nail material, so we modeled the watch mending drivers into the punching instruments, and holed deeply & widly through the nail plate, from the surface to the bottom. Afterward, the KOH mount & culture were performed to compare this new punch method used with that of standard scrapping method. Through the KOH examination more numerous hypaes were found in the punch methods sample than the scrapping methods sample. Also, the punch methods positive culture rate was found to be 2. 5 times higher than that of the scrapping methods culture rate, with a 5 to 5. 5 times lower amount of contamination. In conclusion, the punch method was found to be a more precise and effective method of obtaining onychomycosis organisms. Although this method required a slight greater time to perform than the standard scrapping method, I believe it will be a valuable aid in the detection of causative organisms of onychamycosis.
Onychomycosis*

Atrophie blanche is a rare vasculitis reported by Milian in 1929, that is characterizel by small erythematous, telangiectatic purpura which developes central hemorragic curst or painful ulceration and heals with atrophic white scar several months later. It is seen more commonly in middle-aged women and become worse in summer. It manifests primarly on the lower legs, ankles and dorsa of the feet, rarely on the elbows and dorse of the hands, where are the areas of the poor blood circulation. This case was 45 year-old woman who had suffered from periodic painful ulceration on the legs, ankles, dorsa of feet k hands and. elbows for about 18 years. Histopathologic findings showed fibrinoid degeneration R partial occlusion in the capillaries and mild perivascular chronic inflammatory cells infiltration in the upper corium. The lesion was not so improved by systemic k local corticosteroid therapy for about 3 months,
Ankle ; Blood Circulation ; Capillaries ; Cicatrix ; Dermis ; Elbow ; Female ; Foot ; Hand ; Humans ; Leg ; Middle Aged ; Purpura ; Ulcer ; Vasculitis

A case of a clinical syndrome of selective hereditary complete IgA deficiency with partial T-lymphocyte inactivation is reported. A 14 year old boy was admitted with chjef complaint of persistent wide shallow ulcerated non-vesicular patches on the skin folds of whole body, chronic upper respiatory infections and gastointestinal upsets. General appearance showed us as if the undemourished or malabsorption status had been accompanied. The duration of illness was about 10 years under the incorrect or mistaken diagnosis and skin lesions have incompletely responded to the treatment. Peripheral T-lymphocyte determination was carried out by the method of Wybran to be tumed out active T-cell 14%, total T-cell 48%. Tuberculin test showed negative with 5 TU. Immunoglobulin values were respectively as follows: IgG 325 mg%, IgM 60 mg%, and IgA trace. And we diagnosed this case as selective IgA defiency with partial T-lymphocyte inactivation. We started the immunochemotherapy with tuberculo-protein complex, Tubercin-3 and antibictics for 2 months. After 2 months with above regimen. the skin lesions were markedly improved. T-cell count also retumed to the normal limit(active 35%, total 59%) and levels of TgG and IgM raised(IgG 617.5 mg%, IgM 75mg%), but IgA still showed trace amount, Tuberculin test tumed out positive.
Adolescent ; Dermatitis* ; Diagnosis ; Humans ; IgA Deficiency* ; Immunoglobulin A* ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins ; Lymphocytes* ; Male ; Skin ; T-Lymphocytes ; Tuberculin Test ; Ulcer

No abstract available.
Child* ; Humans ; Rhinitis*

Arytenoid subluxation or recurrent laryngeal nerve paralysis may result from injury to the larynx following endotracheal intubation or blunt laryngeal trauma. Early diagnosis is important for appropriate treatment and better prognosis. A 62-years-old man was admitted for cholecystectomy. He was intubated without any difficulty and nasogastric tube was inserted with the help of laryngoscope and Magill forcep before surgery. He had a weak voice and hoarseness after atraumatic extubation and those symptoms did not improve even 2 days after. Indirect laryngoscopy, videolaryngotelescopy, electromyography(EMG) and computed tomographic findings revealed anterior, inferior subluxation of left cricoarytenoid cartilage associated with left thyroarytenoid muscle denervation and resultant unilateral vocal cord palsy. Conservative treatment for 40 days after the operation and follow-up examination was done. The voice quality was improved and indirect laryngoscopy examination showed that right vocal cord crossed midline in a attempt to meet its paralyzed counterpart on phonation.
Anesthesia, General* ; Cartilage ; Cholecystectomy ; Denervation ; Early Diagnosis ; Follow-Up Studies ; Hoarseness ; Intubation, Intratracheal ; Laryngeal Muscles ; Laryngoscopes ; Laryngoscopy ; Larynx ; Paralysis* ; Phonation ; Prognosis ; Recurrent Laryngeal Nerve* ; Surgical Instruments ; Vocal Cord Paralysis ; Vocal Cords ; Voice ; Voice Quality

Recurrent episode of meningitis in infants and children frequently constitute a frustrating and distressing, both in determination of course and treatment. The authors are reporting a infected case of congenital dermal sinus with dermoid cyst in the subarachnoid space of cauda equina and conus medullaris which was cured after complete removal of cyst and sinus tract.
Cauda Equina ; Child ; Conus Snail ; Dermoid Cyst ; Humans ; Infant ; Meningitis ; Spina Bifida Occulta* ; Subarachnoid Space

We describe the case of a 45-year-old woman who had self-regressing livedo reticularis on the lower extremities. Examination of a biopsy specimen from the mottled area revealed myxomatous emboli in the deep dermal arterioles. Echocardiography showed a myxoma in the left atrium. After the tumor was surgically excised, the patient had no further evidence of the disorders during the 3-year period of follow-up. Livedo reticularis caused by an peripheral arterial embolism, which in turn was caused by the tumor fragments in our patient with left atrial myxoma, is considered to be unusual.
Arterioles ; Biopsy ; Echocardiography ; Embolism ; Female ; Follow-Up Studies ; Heart Atria ; Humans ; Livedo Reticularis* ; Lower Extremity ; Middle Aged ; Myxoma*

We have been experienced a case of malfunction of ventriculo-peritoneal shunt(Uni-shunt) due to acute appendicitis. The peritoneal tip seemed to be obstructed by inflammatory reaction around the diseased appendix. After appendectomy and reposition of the peritoneal tip to the left side, the shunting function returned to normal. We have reported the case and discussed the various causes of the malfunction of ventriculo-peritoneal shunt.
Appendectomy ; Appendicitis* ; Appendix ; Ventriculoperitoneal Shunt*

No abstract available.
Cisapride* ; Gastric Emptying* ; Humans ; Kidney Failure, Chronic*

BACKGROUND: Recently, many countries including Korea have been trying to enforce and reform their primary care system. The Family Doctor Registration Program(FDRP) which Korean government had tried and failed in 1996 continuously has been being highlighted because of it's importance. Several private family practitioners started grass root movement for conducting FDRP voluntarily. This survey aimed to know the willingness for private family practitioners to participate in voluntary FDRP and it's major services. METHODS: By mailing, the self administered questionnaires were collected two times during May 20 to June 30 in 1998. The questionnaire contained followings:demographic and practice related factors, willingness to participate FDRP, factors related to it's major services. Subjects were 496 private family physicians who had acquired the certification since 1989. Analyses were made by the Chi square test, t test, and multiple logistic regression analysis. RESULTS: Though overall response rate was only 44.8%(222/496), but age and sex distributions of respondents were similar to those of the total study subjects. The percentage of those having a willingness to participate in voluntary FDRP('Y' group) was 58.6%. The 'Y' group showed phone counselling frequency of 3.2(+/-2.6) times per day. They had much more home visiting experience than 'N' group(62.2% vs 44.9%, P=0.019). After the conduction of FDRP, the frequency of possible night time phone duty per month was 3.5(+/-2.6) times, and the frequency of possible home visiting per week was 1.9(+/-1.4) times in 'Y' group. After multiple logistic regression analysis on the meaningful variables, male(OR=2.25, P=0.0270) rather than female, percentage of child patients<40%(OR=2.526, P=0.0149) rather than that>60%, and having home visiting experience(OR=1.8, P=0.1131) rather than no experience showed relatively higher tendency of participation in voluntary FDRP. CONCLUSION: The results of this survey should be reflected into the health care policy when retrying to implement FDRP in Korea.
Certification ; Child ; Surveys and Questionnaires ; Delivery of Health Care ; Female ; House Calls ; Humans ; Korea ; Logistic Models ; Physicians, Family ; Poaceae ; Postal Service ; Primary Health Care ; Sex Distribution