The following facts have been identified as a result of epidemiogical trend and characteristic of Japanese Encephalitis in Korea for the last 20 years. First: The Epidemiological period which was ten-year and three-year in the past has been disappeared following the start of immunization program at 1970. Second: The incidence rate was much higher in the south and West areas than northeast area of Korea. City and province with the highest incidence rate was Chungcheong Nam Province and Cholla Buk Province. Third: Regardless of scope of prevalence, the main season that 90 percent of total incidence occurs in one month from mid-September. Fourth: The number of case by age was that 80 percent of total patients is children aged 3-15. Recently there is an increase in the number of patients who are elderly people. Fifth: The study on the ecological conditions of mosquito including wintering and effectiveness of immunization for Japanese Encephalitis and duration on antibody should be done. Sixth: There has been no case of Japanese Encephalitis during last three years since 1984 mainly due to disinfecting to eradicate mosquitos, immunization for vulnerable group of people aged 3-15, individual precaution not to be bitten by mosquito, improvement sanitation. While there has been no case of Japanese Encephalitis during last three years, there is possibility that Japanese Encephalitis becomes prevalent again anytime since its virus has been isolated continuously from the natural reservoirs.
Aged ; Asian Continental Ancestry Group* ; Child ; Culicidae ; Encephalitis, Japanese* ; Humans ; Immunization ; Immunization Programs ; Incidence ; Korea* ; Prevalence ; Sanitation ; Seasons

BACKGROUND AND OBJECTIVES: The relationship of cold pressor, hyperventilation and exercise test responses to circadian patterns and types of angina in vasospastic angina have still not been known. The aim of this study was to identify subgoups of patients who have similar clinical features and provocation test response. MATERIALS AND METHODS: Twenty-one consecutive patients with pure vasospastic angina were studied. Six exercise tests were performed in the early morning, late morning, and late afternoon in consecutive days, and 2 hyperventilation tests and 2 cold pressor tests in the early morning. Circadian distribution and types of angina(at rest, on physical activity or both) were evaluated by clinical history, clinical records and ambulatory ECG recordings during admission and follow-up periods(mean 19+/-9 months). RESULTS: Three patterns of circadian distribution of anginal attacks were identified during all observation periods together(morning and night: MN n=, morning and afternoon or evening: M+/E n=, morning, night and afternoon and/or evening: MN+/E n=1). Exercise test was positive in 36%(40/111) without circadian variation, hyperventilation test in 66%(23/35) and cold pressor test in 6%(2/33). Neither hyperventilation test nor cold pressor test was related to circadian patterns, types or activity of angina, or numbers of spastic artery. But positive exercise test increased significantly in patients with angina on physical activity(43% vs 21%, p<0.05), high activity(57% vs 18%, p<0.01), multivessel spasm(50% vs 27%, p<0.05 ) and circadian patterns of M+/E and MN+/E(29%, 55% vs 4%, p<0.05, p<0.01). All patients with MN had rest angina and single vessel spasm. All 6 patients with M+/E had angina both at rest and on physical activity and 5 single vessel spasm. Eight of 11 patients with MN+/E had angina both at rest and on physical activity and 8 multivessel spasm. CONCLUSION: These findings suggest that hyperventilation test is highly sensitive in vasospastic angina without any relationship to clinical features, but exercise test response is related well to circadian patterns of angina attacks which are associated with characteristic clinical features.
Arteries ; Electrocardiography ; Exercise Test ; Follow-Up Studies ; Humans ; Hyperventilation ; Motor Activity ; Muscle Spasticity ; Spasm

No abstract available.

Chronic mucocutaneous randidiasis is a clinical syndrome characte ized by chronic and reccurent superficial candidal infection of the skin, mucous membranes, and nails. This syndrome is frequently associated with immune deficiency or endocrinopathy, especially hypopar; thyroidism. We report a case of chrcinic mucocutaneous candidiasis associated with hypoparathyroidism in a 8- year-old girl.
Candidiasis ; Candidiasis, Chronic Mucocutaneous* ; Female ; Humans ; Hypoparathyroidism* ; Mucous Membrane ; Skin ; Thyroid Gland

We report two cases of malignant lymphoma of mucosa-associated lymphoid tissue arising in the conjunctiva. Case 1, an 18-year-old girl, showed her left lower conjunctival swelling for four months and Case 2, a 29-year-old man, showed similar lesions on both his eyes for one year. Histologically, both cases revealed monomorphous dense lymphoid infiltrates invading the overlying conjunctival epithelium with diffuse patterns. The infiltrates were composed of small lymphocytes admixed with centrocyte-like cells within the conjunctival epithelium and stroma in association with B-cell lineage. No relapse was noted during the period of about 1½ years follow-up in case 1 treated by local excision only and in the follow-up period of 2 months in case 2 treated by local excision and subsequent chemotherapy.
Adolescent ; Adult ; B-Lymphocytes ; Conjunctiva* ; Drug Therapy ; Epithelium ; Female ; Follow-Up Studies ; Humans ; Lymphocytes ; Lymphoid Tissue* ; Lymphoma* ; Recurrence

Torsade de pointes (TdP) is a form of polymorphic ventricular tachycardia that is associated with prolongation of the QT interval. Although it occurs in many clinical settings, torsade de pointes is most commonly caused by drugs. The second generation antihistamines, including terfenadine and astemizole, have little sedation or other adverse effects on the CNS. They have been used widely to treat various allergic diseases, but it has been reported that overdoses or combinations with antifungal agents or macrolide antibiotics may lead to TdP. We report a case of TdP that occured during com-bination therapy of terfenadine and ketoconazole.
Anti-Bacterial Agents ; Antifungal Agents ; Astemizole ; Histamine H1 Antagonists, Non-Sedating ; Ketoconazole* ; Tachycardia, Ventricular ; Terfenadine* ; Torsades de Pointes*

No abstract available.
Asian Continental Ancestry Group* ; Humans ; Humans* ; Sarcoma, Kaposi*

BACKGROUND: The diastolic transmitral flow velocity pattern has been commonly used to assess left ventricular(LV) diastolic function. The effects of multiple factors(such as, LV preload, afterload and heart rate, etc.) make difficulties in accurate interpretation. METHODS: In order to investigate the diastolic transmitral filling patterns according to the changes of the proload or heart rate, we studied 27 normal subjects with pulsed Doppler echocardiography after the administration of nitroglycerin(0.6mg/tab.) sublingually or atropine(0.5mg/amp.) intravenously. RESULTS: 1) After nitroglycerin administration, the folowings were obtained. ; The systolic blood pressure and LV diastolic filling time(DFT) decreased by 10.1% and 15.3%, respectively(p<0.001), compared with baseline data. The ratio of peak early to late diastolic transmitral flow velocities (E/A) and time-velocity integrals(TVIE/TVIA) decreased by 10.3% and 14.8%, respectively(p<0.01). The early diastolic filling time(Time E) was unchanged. Therefore, we suggest that time E is helpful, compared with the increments of the preload or the diastolic dysfunction. 2) After atropin administration, the heart rate, peak late diastolic transmitral flow velocity(PA) and percent atrial contribution(%AC) significantly increased by 43.6%, 25.1% and 41.4%, respectively(p<0.001). The E/A, TVIE/TVIA and DFT significantly decreased by 42.9%, 38.9% and 43.0%, respectively(p<0.001) compared to the data before drug administration. 3) The heart rate correlated negatively to the E/A, TVIE/TVIA and DFT. It was correlated positively to %AC(r=+0.63; p<0.001). The normalized E/A ratio by DFT(E/A/DFT) didn't correlate. Therefore, E/A/DFT is helpful on the exclusion of the influences of heart rate by the administration of the atropine. CONCLUSION: The decrement of preload or the increment of heart rate changes the diastolic transmitral flow velocity patterns. Therefore, when the diastolic function is assessed by interpretation of the Doppler transmitral flow velocity pattern with pulsed Doppler echocardiogram, the potential influences of preload and heart rate must be taken into account.
Atropine* ; Blood Pressure ; Echocardiography ; Echocardiography, Doppler* ; Echocardiography, Doppler, Pulsed ; Heart Rate ; Humans* ; Nitroglycerin* ; Time

Purulent pericarditis is an infrequent but fulminant and frequently lethal disease. Purulent pericarditis tends to occur as direct extension of bacterial pneumonia or empyema in past. In recently, purulent pericarditis tends to occur in adult via contiguous spread from an early postoperative infection after thoracic surgery or trauma, infection related to infective endocarditis, extension from a subdiaphragmatic suppurative source, and hematogenous spread during bacteremia. Endogenous causes of purulent pericarditis are frequently characterized as esophageal perforations. Common causes of esophageal perforations related to purulent pericaditis which usually develop in association with mediastinitis, pneumonia and empyema include corrosive esophagitis, complication after esophageal and tracheal instrumentation and Boerhaave's syndrome. There is very little reference to the development of pericarditis in associated with esophageal perforation which does not directly communicate with the pericardium. while, although most uncommon, it is well documented that the esophagus can perforate directly into the pericardium and produce pericarditis. We experienced a case of acute purulent pericarditis after esophageal and pericardial perforation by a small fish bone in a previously healthy man. The patient was treated successfully with systemic antibiotics and pericardiotomy.
Adult ; Anti-Bacterial Agents ; Bacteremia ; Empyema ; Endocarditis ; Esophageal Perforation ; Esophagitis ; Esophagus ; Foreign Bodies* ; Humans ; Mediastinitis ; Pericardiectomy ; Pericarditis* ; Pericardium ; Pneumonia ; Pneumonia, Bacterial ; Thoracic Surgery

BACKGROUND: Exercise tests (ET), hyperventilation tests (HVT) and cold pressor tests (CPT) have been used to induce coronary artery spasm. However their diagnostic significance and the circadian variation of exercise test response in patients with vasospastic angina are still uncertain. METHODS: To elucidate the circadian variation of ET response and to evaluate the diagnostic significance of non-pharmacological provocation tests, 21 consecutive patients with pure vasospastic angina were studied. Six ETs were performed in the early morning, late morning, and late afternoon in consecutive days, 2 HVTs and 2 CPTs in the early morning. The circadian distribution and types of angina (at rest, on physical activity, or both) from before admission to after discharge (mean follow-up periods 19+/-9 months) were evaluated by clinical history, clinical records and Holter recordings. Circadian distribution of anginal attacks recorded through the all observation periods were classified into 3 patterns (morning and night : MN, morning and afternoon or evening : M+F/E, morning, night and afternoon and/or evening : MN+F/E). RESULTS: One hundred and eleven ETs (39 early morning, 38 late morning, 34 late afternoon tests), 35 HVTs and 33 CPTs were performed. ETs showed 14 positive responses (36%) in the early morning, 14 (37%) in the late morning and 12 (35%) in the late afternoon without any circadian variation. Among the 11 patients who underwent all 6 exercise tests, 3 patients (27%) showed at least one positive response in the early morning, 4 (36%) in the late morning and 4 (36%) in the late afternoon. Subgroups of the subjects according to the types and activity of angina and the numbers of spastic artery also failed to show any circadian variation in ET response, but M+F/E group of circadian pattern of angina showed a peak of positive response in the early morning (p<0.05). HVTs showed significantly higher positive response (23/35, 66%, p<0.05) than ETs (14/39, 36%) and CPTs showed significantly lower positive response (2/33, 6%, p<0.01) than ETs in the early morning. Double tests with more than 1 positive response couldn't increase the positive response in ETs (9/19, 47%), and CPTs (2/14, 14%) but increased significantly in HVTs(15/16, 94%, p<0.05), particularly in the group with low activity (7/8, 86%, p<0.01). ETs showed ST segment elevation in 29 (72%) and depression in 11 (28%) of the 40 positive tests, HVTs in 21 (91%) and 2 (9%) of the 23 positive tests and CPTs in 2 (100%) and 0 (0%) of the 2 positive tests. The ST segment elevation was significantly higher in HVTs than in ET (p<0.05). CONCLUSION: These findings suggest that the exercise test in the early morning do not increase positive response and is not a sensitive diagnostic test associated with occasional depression of ST segment, but hyperventilation test, especially if repeated, is a very sensitive test with predominant elevation of ST segment in patients with vasospastic angina.
Arteries ; Circadian Rhythm ; Coronary Vasospasm ; Coronary Vessels ; Depression ; Diagnostic Tests, Routine ; Exercise Test* ; Follow-Up Studies ; Humans ; Hyperventilation ; Motor Activity ; Muscle Spasticity ; Spasm