In recent years, marked increase in incidence of congenital syphilis has occured throughout the world due tochanges in social norms and development of penicillin-resistant strains. Early diagnosis plays an important rolein congenital syphilis as the clinical manifestations may simulalte many other conditions in the paediatric agegroup. The authors analized 52 cases of congenital syphilis admitted tot he department of paediatrics, ChosumUniversity Hospital, clinically and radiologically. Among them, 18 cases were born in this hospital and 34 caseswere admitted from OPD, during the period of 8 years from Jan. 1975 to Dec. 1982. The reults obtained were asfollows; 1. In 28 of 34 cases (82%), the first clinical manifestations were below the age of 3 months. 2. Amongthe 52 cases, a male predominance was observed with a male to female ratio of 2:1. 3. The serologic test (VDRL) ofthe 52 studied cases showed reactive in 49 cases (94%), and that of syphilitic mothers except 6 cases, rective inall studied cases. 4. The major manifstations of the 52 cases were bone tenderness (12%) and swelling of thejoints(7%) inskeletal system, hepatosplenomegaly (79%) and skin lesions (73%) in extraskeletal one. 5. Theradiological skeletal changes were detected in 45 of 52 cases(87%), and the commonest findings were detected in 45of 52 cases (87%), and the commonest findings were metaphsitis(83%) and periostitis(81%). The most characteristictype of metaphysitis were transverse trophic line(74%) and zone of rarefaction (65%). 6. The comonest bones to beaffected were growing metaphyses of the long bones, particulary about the wrist and the knee. The order offreqeuncy were radius (80%), ulna(80%), tibia(77%), femur(69%) and hymerus(40%).
Early Diagnosis ; Female ; Humans ; Incidence ; Knee ; Male ; Mothers ; Radius ; Serologic Tests ; Skin ; Social Norms ; Syphilis, Congenital ; Wrist

No abstract available.
Aprotinin* ; Heart* ; Hemostasis* ; Thoracic Surgery*

BACKGROUND: It was recently shown that human atherosclerotic plaque contains large numbers of T lymphocytes : this indicates that immune and inflammatory mechanism may be important factors in the pathogenesis of atherosclerosis. By measuring the soluble interleukin 2 receptor(sIL-2R) level we can evaluate the activation of T lymphocyte. The purpose of this study is to evaluate relationship between T cell activation and ischemic heart disease by measuring the soluble interleukin 2 receptor (sIL-2R) level in patient with ischemic heart disease. METHOD: Seventy-two patients(40 males and 32 female, mean age : 56.5+/-9.9 years) who were taken coronary angiography were included in this study. Among them, 49 patients showed abnormal coronary angiographic findings and 23 patients showed normal coronary angiographic findings. Ten mililiters of arterial blood was drawn at the time of coronary angiography. The blood was allowed to coagulate and then the serum was removed and tested in duplicate for soluble interleukin 2 receptor (sIL-2R) level by ELISA. RESULTS: 1) The soluble interleukin 2 receptor (sIL-2R) level was significantly different between abnormal coronary angiographic findings and normal coronary angiographic findings (P < 0.001). 2) According to clinical severity of ischemic heart disease (i.e. stable angina, unstable angina, acute myocardial infarction.), soluble interleukin 2 receptor (sIL-2R) level was not significantly different between single vessel disease group and multivessels disease groups (p > 0.05), but showed increasing tendency with clinical severity. 3) According to numbers of involved coronary vessels, soluble interleukin 2 receptor (sIL-2R) level was not significantly different between single vessel disease group and multivessels disease groups (p > 0.05). CONCLUSION: T lymphocyte activation, as reflected in elevated soluble interlekin 2 receptor (sIL-2R) level, is frequent in patient with ischemic heart disease. In the further we will investigate relationship between clinical diagnosis of ischemic heart disease of the numbers of involved coronary vessels and T cell activation.
Angina, Stable ; Angina, Unstable ; Atherosclerosis ; Coronary Angiography ; Coronary Vessels ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Interleukin-2 ; Lymphocyte Activation ; Lymphocytes ; Male ; Myocardial Ischemia* ; Plaque, Atherosclerotic ; Receptors, Interleukin-2 ; T-Lymphocytes

PURPOSE: The purpose of this study is to analyze the usefulness of breast thermography in assessing the prognosis in breast cancer and to obtain correlative evidence between thermographic prognosis and prognostic factors for breast cancer. MATERIALS AND METHODS: Thermographic examinations were performed in a room maintained at 20C. The patient was undressed to the waist, with both arms elevated for 10 minutes prior to the examination in order to cool and equilibrate the breast skin at room temperature. Digital infrared thermographic system was used (NEC, San-ei, Therm Tracer 6T67). The thermographic prognosis was classified according to Dr. Hobbins (Sl good, S2=fair and S-poor) suggested by Dr. Hobbins. The results were analyzed by Chi-Squire. One hundred three patients of breast cancer were examined by digital infrared thermographic system between Jan 1992 and December 1996. RESULTS: The mean age was 48, with a range from 20 to 85. According to the TNM classification 25 (24%) were in stage I, 47 (46%) stage II, 29 (28%) stage III, and 2 (2%) stage IV. The tumor size ranged from 0.5 to 20 cm (mean 4 cm), On histologic examination, 43 (43.%) patients had metastasis in the axillary nodes, 40 (55%) patients was estrogen-receptor positive. The nuclear grade I was 46 (35%) patients, II 24 (28%) and III 16 (19%). The classification of thermographic prognosis were Sl in 47 cases (46%), 82 in 32 (31%) and 83 in 24 (23%). The classification of the thermographic prognosis was found to be statistically correlated with tumor size (p<0.0001), axillary node status (p<0.0001) and TNM tumor stage (p<0.0001). But nuclear grade and estrogen receptor were not statistically correlated with the thermographic prognosis. The correlation between thermographic prognosis and actual survival rate was not available. CONCLUSION: These results suggest that breast thermography would be useful as a predictor in breast cancer before surgery.
Arm ; Breast Neoplasms* ; Breast* ; Classification ; Estrogens ; Humans ; Neoplasm Metastasis ; Prognosis* ; Skin ; Survival Rate ; Thermography*

PURPOSE: This study was to determine the incidence and severity of venous irriation in patients receiving vinorelbine tartrate (Navelbine ) in combination chemotherapy. MATERIAL AND METHODS: Twenty four patients histologically confirmed non-small cell lung cancer were enrolled in this study who receiving vinorelbine in combination chemotherapy through a peripheral vein from Oct. 1997 to Mar. 1999 with retrospective study design method. One group was 6~10 minutes infusion rate, the other was 10~20 minutes infusion rate with the same free-flow intravenous infusion. RESULTS: A total of 126 infusions were observed in this study. Sixty-two infusions were admi nistered at the 6~10 minutes, and 64 infusions were administered at the 10~20 minutes. The incidence of any venous irritation was 3.2% (2/62) in the group that received the infusion in 6~10 minutes and 10.9% (7/64) in 10~20 minutes (p=0.164), so we could not acquire any statistical significance. However the incidence of severe venous irritation (grade 3, 4) was 0% (0/62) in 6~10 minutes infusion group and 9.4% (6/64) in 10~20 minutes infusion group. There was a significant difference between two groups (p=0.028) CONCLUSION: Our results suggest that venous irritation associated with vinorelbine tartrate infusion can be reduced by shorter duration of administration and vinorelbine tartrate might be recom mended to administer at 6~10 minutes infusion in clinical practice.
Carcinoma, Non-Small-Cell Lung ; Drug Therapy, Combination ; Humans ; Incidence* ; Infusions, Intravenous ; Retrospective Studies ; Veins

BACKGROUND: The accurate information about the volume of pericardial effusion can assist in clinical decisions and has impartant prognostic value. In addition, accurate quantification of serial change in effusion volume is necessary in assessing pericardial disease and making a decision of immediate drainage. This study was performed to evaluate the efficacy of 2-D echocardiographic quantification of pericardial effusion. METHOD: The study populations are 22 patients with large pericardial effusion whose volume of effusion is confirmed by paracentesis or surgical drainage. Through the echocardiographic reviw, the volume of pericardial sac and heart was calculated by method of D'cruz and then, the effusion volume was derived as the difference of two volumes. Each echocardiographically calculated volume of pericardial effusion was compared with the measured volume drained percutaneously or surgically. RESULTS: The volume of pericardial effusion calculated echocardiographically was excellently correlated with the drained volume(r=0.90, p < 0.01). The echo-free space was well correlated with the volume of pericardial effusion in the anterior aspect of the heart(r=0.71, p < 0.01), but not in the posterior aspect. CONCLUSION: 2-D echocardiographic Quantification of pericardial effusion is simple and reliable method, and its clinical efficacy may be great.
Drainage ; Echocardiography ; Heart ; Humans ; Methods ; Paracentesis ; Pericardial Effusion ; Treatment Outcome

OBJECTIVE: Total laparoscopic hysterectomy (TLH) is becoming more commonly used as an alternative to traditional abdominal hysterectomy and Analyzing the turning point of a learning curve can be useful in planning training programs. This study was to define the average turning point of a learning curve of TLH by comparing three separate gynecologists in one institute. METHODS: Retrospective analysis of the first 140 consecutive cases of TLH performed by three separate gynecologists A, B, and C. Patients of each gynecologist were divided into 7 equal groups of 20 operations classed chronologically. Patient's age, uterus weight, operation time and pre-post operative hemoglobin difference of the three gynecologists were compared. Operation time and pre-post operative hemoglobin difference were evaluated to build learning curves for each gynecologist. RESULTS: Learning curve built by operation time showed turning point after 80~100 cases in all three gynecologists. Learning curve built by pre-post operative hemoglobin difference did not show a decreasing pattern. There were no statistical differences in patient's age and pre-post operative hemoglobin difference between the three gynecologists. However, mean uterine weight of gynecologist C was significantly lighter than that of gynecologist A and B. Operation time was significantly longer in cases by gynecologist C than in cases by A and B. CONCLUSION: At least 80~100 cases of experience in TLH is needed for a gynecologist to reach the turning point of the learning curve. This result can be used as a guide to the training program of TLH.
Hemoglobins ; Humans ; Hysterectomy ; Learning ; Learning Curve ; Retrospective Studies ; Uterus

PURPOSE: Enterovirus (EV) infection in children can manifest various diseases from asymptomatic infection to nonspecific febrile illness, hand-foot-mouth disease, and aseptic meningitis. This study was aimed to investigate epidemiology and clinical significance of various genotypes of EV infections in pediatric inpatient. METHODS: We collected the stool samples from the admitted pediatric patients in Inha University Hospital from March 2014 to March 2015. EV detection and genotype identification were performed by real-time RT-PCR and semi-nested RT-PCR. Phylogenetic trees were constructed by neighbor joining method. RESULTS: A total of 400 samples were collected during study period and 112 patients (28%) were diagnosed with EV infections. The mean age of EV positive patients was 2.66 years (0.1-14) and sex ratio was 1.73:1. Genetic sequences of EVs were identified; coxsackievirus B5 (17, 15.2%), coxsackievirus A16 (13, 11.6%), enterovirus 71 (10, 8.9%), and coxsackievirus A2 (9, 8.0%). Nonspecific febrile illness (96, 86%) was the most common clinical manifestation and the duration of fever was 0-11 days (mean 3.1 days). Rash (44, 39%) and meningitis (43, 38%) were followed. Patients who were attending daycare center or had siblings accounted for 82.1%. Phylogenetic relationship tree revealed 6 distinct genogroups among 56 types of EVs. CONCLUSIONS: This study is the report of epidemiology, serotype distribution and clinical manifestations of children with EV infection in Incheon. This data will be helpful for further study about the epidemiology of EV infection in Korea.
Asymptomatic Infections ; Child ; Enterovirus* ; Epidemiology* ; Exanthema ; Fever ; Genotype ; Humans ; Incheon* ; Inpatients* ; Korea ; Meningitis ; Meningitis, Aseptic ; Sex Ratio ; Siblings ; Trees

PURPOSE: Precocious puberty has significantly increased recently. While obesity is associated with puberty timing, the relationship between obesity and central precocious puberty (CPP) remains controversial. The purpose of this study was to determine whether insulin resistance is associated with bone age (BA) advancement in girls with CPP. METHODS: We retrospectively analyzed the records of 804 girls referred for puberty evaluation. Anthropometric measurements, BA, sex hormone, sex hormone binding globulin (SHBG), and insulin levels, lipid profiles, and gonadotropin releasing hormone stimulation tests were assessed. Insulin resistance parameters were calculated using the homeostasis model assessment-insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI) models. RESULTS: BA, BA advancement, free estradiol index, insulin, and HOMA-IR increased significantly in girls with high body mass index (BMI) compared with that of girls with low BMI in cases of CPP. HOMA-IR was positively correlated with BA advancement and BMI but negatively correlated with SHBG. QUICKI was negatively correlated with BA advancement and BMI and positively correlated with SHBG. When HOMA-IR increased by 1, the odds for BA advancement increased 120% after adjusting for age and BMI (P=0.033). CONCLUSION: Insulin resistance could be associated with BA advancement in girls with CPP.
Adolescent ; Body Mass Index ; Estradiol ; Female* ; Gonadotropin-Releasing Hormone ; Homeostasis ; Humans ; Insulin Resistance* ; Insulin* ; Luteinizing Hormone ; Obesity ; Puberty ; Puberty, Precocious* ; Retrospective Studies ; Sex Hormone-Binding Globulin

BACKGROUND: This paper discusses the treatment protocol for patients with frostbite. METHODS: We performed a retrospective analysis of a series of 17 patients with second- and higher-degree frostbite who had been treated at our medical institution between 2010 and 2012. RESULTS: Our clinical series of patients (n=17) included 13 men and four women, whose mean age was 42.4+/-11.6 years (range, 22-67 years). The sites of injury include the foot in six patients (35.3%), the hand in six patients (35.3%) and the facial region in five patients (29.4%). Seven patients with second-degree frostbite were completely cured with only conservative treatment during a mean period of 12.7+/-3.3 days (range, 8-16 days). Of the five patients with third-degree frostbite, two underwent skin grafting following debridement, and the remaining three achieved a complete cure with conservative treatment during a mean period of 35+/-4.3 days (range, 29-39 days). Five patients with fourth-degree frostbite were treated with surgical procedures including amputation. CONCLUSIONS: With the appropriate conservative management in the early stage of onset, surgeons should decide on surgery after waiting for a sufficient period of time until the demarcation of the wound. Continuous management of patients is also needed to achieve functional recovery after a complete cure has been achieved. This should also be accompanied by patient education for the avoidance of re-exposure to cold environments.
Clinical Protocols ; Cold Temperature ; Debridement ; Female ; Foot ; Frostbite ; Hand ; Humans ; Male ; Patient Education as Topic ; Retrospective Studies ; Skin Transplantation ; Surgical Procedures, Operative