A new species of Acanthamoeba was isolated from a freshwater fish in Korea and tentatively named Acanthamoeba sp. YM-4 (Korean isolate YM-4). The trophozoites were 11.0-23.0 micrometer in length and had hyaline filamentous projections. Cysts were similar to those of A. culbertsoni and A. royreba, which were previously designated as Acanthamoeba group III. Acanthamoeba YM-4 can survive at 40 degrees C, and its generation time was 19.6 hr, which was longer than that of A. culbertsoni. In terms of the in vitro cytotoxicity of lysates, Acanthamoeba YM-4 was weaker than A. culbertsoni, but stronger than A. polyphaga. On the basis of the mortality of experimentally infected mice, Acanthamoeba YM-4 was found to be highly virulent. The isoenzymes profile of Acanthamoeba YM-4 was similar to that of A. royreba. An anti-Acanthamoeba YM-4 monoclonal antibody, McAY7, was found to react only with Acanthamoeba YM-4, and not with A. culbertsoni. Random amplified polymorphic DNA marker analysis and RFLP analysis of mitochondrial DNA and of 18S small subunit ribosomal RNA, placed Acanthamoeba YM-4 in a separate cluster on the basis of phylogenetic distances. Thus the Acanthamoeba Korean isolate YM-4 was identified as a new species, and assigned as Acanthamoeba sohi.
Acanthamoeba/*classification/genetics/isolation & purification/*pathogenicity ; Amebiasis/parasitology/*veterinary ; Animals ; DNA, Mitochondrial/analysis ; DNA, Protozoan/analysis ; Fish Diseases/*parasitology ; Gills/parasitology ; Goldfish/*parasitology ; Korea ; Mice ; Phylogeny ; Polymorphism, Restriction Fragment Length ; RNA, Ribosomal, 18S/genetics ; Random Amplified Polymorphic DNA Technique ; Virulence

Acanthamoeba and Naegleria are widely distributed in fresh water, soil and dust throughout the world, and cause meningoencephalitis or keratoconjunctivitis in humans and other mammals. Korean isolates, namely, Naegleria sp. YM-1 and Acanthamoeba sp. YM-2, YM-3, YM-4, YM-5, YM-6 and YM-7, were collected from sewage, water puddles, a storage reservoir, the gills of a fresh water fish, and by corneal washing. These isolates were categorized into three groups based on the mortalities of infected mice namely, highly virulent (YM-4), moderately virulent (YM-2, YM-5 and YM-7) and nonpathogenic (YM-3). In addition, a new species of Acanthamoeba was isolated from a freshwater fish in Korea and tentatively named Korean isolate YM-4. The morphologic characters of its cysts were similar to those of A. culbertsoni and A. royreba, which were previously designated as Acanthamoeba group III. Based on experimentally infected mouse mortality, Acanthamoeba YM-4 was highly virulent. The isoenzymes profile of Acanthamoeba YM-4 was similar to that of A. royreba. Moreover, an anti-Acanthamoeba YM-4 monoclonal antibody reacted only with Acanthamoeba YM-4, and not with A. culbertsoni. Random amplified polymorphic DNA marker analysis and RFLP analysis of mitochondrial DNA and of a 18S small subunit ribosomal RNA, placed Acanthamoeba YM-4 in a separate cluster based on phylogenic distances. Thus Acanthamoeba YM-4 was identified as a new species, and assigned Acanthamoeba sohi. Up to the year 2002 in Korea, two clinical cases were found to be infected with Acanthamoeba spp. These patients died of meningoencephalitis. In addition, one case of Acanthamoeba pneumonia with an immunodeficient status was reported and Acanthamoeba was detected in several cases of chronic relapsing corneal ulcer, chronic conjunctivitis, and keratitis.
*Acanthamoeba/classification/genetics/immunology/pathogenicity ; Amebiasis/diagnosis/epidemiology/*parasitology/therapy ; Animals ; Antigens, Protozoan/analysis/genetics/immunology ; DNA, Mitochondrial/analysis ; DNA, Protozoan/analysis ; Korea/epidemiology ; Life Cycle Stages ; *Naegleria/classification/genetics/immunology/pathogenicity ; Phylogeny ; Polymorphism, Restriction Fragment Length ; Random Amplified Polymorphic DNA Technique/veterinary ; Virulence/genetics

The use of the interlocking intramedullary nails expand the possibilities for treatment of femoral shaft fractures, as illustrated by consistent and satisfactory clinical results. However, the technique is relatively complex compared to conventional nails and frequently poses technical problems. A retrospective review was undertaken of twenty-eight patients with femoral shaft fractures which had technical problems after undergoing the closed reduction and internal fixation with interlocking intramedullary nail procedure. We studied the types of the problems. Their causes, the frequency of problems with various kinds of nails, and discussed solutions of the problems. There were 21 additional comminutions and intraop erative splinterings, 8 angular deformities, 3 malpositioned nails, 3 loosened distal locked screws, 2 brocken drill bits, and 1 femoral neck fracture. Bone-union was attained in all cases (28 patients), but the period of treatment to attain bone-union was protracted to an average of 6.8 (5-12) months. In 3 cases, the knee joint range of motion was of limited flexion, 70 to 90 degrees, but in all other cases full range of motion was realized. 7 cases required 2 or more operations. The hospitalization period was for an average of 3.6 months. In conclusion, the importance of careful preoperative planning and experienced surgical technique cannot be overemphasized because we could see no significant difference in the occurence of technical problems in several kinds of the nail.
Congenital Abnormalities ; Femoral Neck Fractures ; Fracture Fixation, Intramedullary ; Hospitalization ; Humans ; Knee Joint ; Range of Motion, Articular ; Retrospective Studies

No abstract available.
Animals ; Macrophages, Peritoneal* ; Mice* ; Mycobacterium bovis*

Cutaneous horn is a clinical term for a circumscribed concial hyperkeratotic mass amounts to at least half of its largest diameter. The number of lesion may be single or multiple. We report herein a cases of penile cutaneous horn in a 22-year-old male. He had dark brownish colored conical shaped protruded mass on the penile shaft for about 2 months. We performed excisional biopsy and curettage. Histopathologic findings showed verruca vulgaris.
Animals ; Biopsy ; Curettage ; Horns* ; Humans ; Male ; Warts ; Young Adult

No abstract available.
Granuloma* ; Microsporum* ; Tinea*

PURPOSE: This study was undertaken to evaluate the treatment outcome and side effects of accelerated radiotherapy (RT) using concomitant boost for stage III non-small cell lung cancer (NSCLC). METHODS: Between April 1991 and December 1994, 102 patients with stage III NSCLC who had the favorable prognostic factors by CALGB criteria, were treated with concomitant boost radiotherapy. Patients were treated with standard large fields to 54 Gy in 6 weeks. The boost treatment was administered concomitantly during the last 2 weeks with a dose of 13 Gy in 10 fractions. The interfraction interval was at least 6 hours. The total tumor dose was 66-70 Gy, given over 6 weeks. RESULTS: With 30 months median follow-up period for survivors, median survival was 15 months with 2 and 3-year overall survival rates of 34% and 19%, respectively. Thirty patients (29%) who had achieved complete remission after RT showed significantly better 2-year survival rates than those without complete remission (58% vs 22%, p 0.001). Local failure and distant metastases as the first or only failure occurred in 40 (44%) and 13 (14%), respectively, and ultimate local and distant failure rates were 45% and 29%, respectively. Although Grade IV esophageal complication of T-E fistula was observed in one patient, most patients with pulmonary complication showed mild, transient radiation pneumonitis. CONCLUSION: This result suggests that the treatrnent of stage III NSCLC with concomitant boost RT may improve survival rates without enhanced radiation induced toxicity compared with conventional RT. Further investigation of dose escalation by conformal radiotherapy of combining chemotherapy and accelerated RT is warranted.
Carcinoma, Non-Small-Cell Lung ; Drug Therapy ; Fistula ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Radiation Pneumonitis ; Radiotherapy* ; Radiotherapy, Conformal ; Small Cell Lung Carcinoma* ; Survival Rate ; Survivors ; Treatment Outcome

OBJECTIVES: The aim of this study was to estimate the burden of disease through an analysis of Years of Life Lost due to premature deaths, one component of the Disability-Adjusted Life Years (DALY). In addition, the cause of death statistics were adjusted to improve validity, and the results were compared with those of the Global Burden of Disease (GBD). METHODS: In closely following the approach taken in the original GBD study, most of the explicit assumptions and the value judgments were not changed. However, the statistics for some problematic concerns such as deaths of infants or those due to senility, were adjusted. Deaths, standard expected years of life lost (SEYLL), and potential years of life lost (PYLL) were computed using vital registration data compiled by the National Statistical Office. RESULTS: The burden for males is 1.8 and 2.3 times higher than that for females, according to SEYLL and PYLL, respectively. The proportions of deaths due to Group I, II, and III causes are 5.4%, 80.4%, and 14.3%, respectively, for PYLL, but in a major shift from Group II to III they are 6.3%, 66.2%, and 27.5%, respectively, for SEYLL. The proportion of Group III causes in Korea, 27.5%, is extremely high when compared to 10.1% for the world, 7.6% for developed countries, and 10.7% for developing countries. CONCLUSIONS: Estimation results showed that the total burden due to premature deaths is smaller than that for the entire world but larger than that for developed countries. The disease structure of Korea has changed to resemble that of developed countries. Also, an overly large portion of the total burden in Korea stems from injuries arising from car accidents.
Cause of Death ; Cost of Illness ; Developed Countries ; Developing Countries ; Female ; Health Transition ; Humans ; Infant ; Judgment ; Korea* ; Life Expectancy ; Male ; Mortality, Premature*

Recently, there has been an increasing interchange between South Korea and North Korea. Accordingly, there has been active research to understand the society and culture of North Korea, it has been attempted to have comparative study about nursing education to increase understanding between South and North Korea. In the current educational system, 12 years of education is required for entering a nursing college or university in South Korea, but there are only 10 years for entering nursing college in North Korea. After finishing undergraduate studies one can enter graduate school for a masters degree and or a doctoral degree, but there is a longitudinal relation to medical education in North Korea. Regarding the number of nursing educational institutions, there are 50 BSN programs & 61 Diploma programs in South Korea and 11 Diploma programs in North Korea. In regards to curriculum, South Korea has diverse subjects for general education for freshmen, then is subjects to basic specialities sophomore year, and speciality subject and clinical practices from junior year corresponding to the student's intentions. North Korea has minor subjects for general education and basic specialities in freshmen, speciality subjects sophomore year, speciality subjects and clinical practice in the junior year that may not correspond with the student's intentions. The most outstanding difference in the curriculum is North Korea has various subjects for oriental medicine with clinical application. North Korea also does not teach computer science and English is at a very low level. In clinical practice, South Korea has various settings for clinical practice including community health institutions under the nursing professor or clinical instructor. However, North Korea has limited settings for clinical practice (general hospitals) under a doctor's instruction. Also both South and North Korea have a similar licensing system. Therefore, there must be many more studies regarding North Korea, especially in nursing and nursing education in order to decrease differences and confusion between the Koreas and to prepare for a future unification.
Curriculum ; Democratic People's Republic of Korea* ; Education ; Education, Medical ; Education, Nursing* ; Humans ; Intention ; Korea ; Licensure ; Medicine, East Asian Traditional ; Nursing*

BACKGROUND: The Soonchunhyang University Hospital Bloodless Center was established in 2000, and more than 2,000 bloodless surgeries have been performed there since. In this study, the lowest postoperative Hb/preoperative Hb (Hblow/pre) ratio and mortality rates of patients who underwent bloodless surgery were analyzed for each maximum surgical blood order schedule (MSBOS) category to assess whether MSBOS can be used as a predictor of successful completion of bloodless surgery. METHODS: A total of 971 patients were included. MSBOS was defined as the average number of units of RBCs transfused during each elective surgery. We used the Hblow/pre ratio as an alternative to intraoperative blood loss. Frequency of Hblow/pre ratios < or =0.5, use of transfusion alternatives, and mortality rates were compared across MSBOS categories. RESULTS: Out of the 971 patients, 701 (72.2%) were categorized as type and screen (T&S), 184 (18.9%) as MSBOS 1, 64 (6.6%) as MSBOS 2, and 22 (2.3%) as MSBOS 4. Transfusion alternatives were used by 397 (40.9%) patients. The frequency of the use of simultaneous erythropoietin and iron, hemostatics, acute normovolemic hemodilution, and Cell Saver (Haemonetics corp., USA) was higher in patients in the higher MSBOS categories. Six (0.6%) patients died within 30 days of surgery. Hblow/pre ratios tended to be lower as the level of MSBOS category increased. CONCLUSIONS: Surgeries in the higher MSBOS categories tended to be associated with high blood loss and mortality. Active use of transfusion alternatives is recommended in patients in high MSBOS categories who are scheduled to undergo bloodless surgery.
Blood Loss, Surgical/mortality/prevention & control ; Bloodless Medical and Surgical Procedures/*methods/mortality ; Erythropoietin/therapeutic use ; Hemodilution ; Hemoglobins/analysis ; Hemostatics/therapeutic use ; Hospitals, University ; Humans ; Iron/therapeutic use ; Outcome Assessment (Health Care) ; Tertiary Care Centers