Spondylometaphyseal dysplasia (SMD) is an extremely rare, which affects the spine and metaphy-ses of the tubular bones on terms of enchondrogenesis. Children who had Kozlowski dwarfism, type of SMD are not recognized until they reach school age since they have normal clinical feature, weight and size in early childhood. Authors experienced a typical case of Kozlowski type of SMD in a 10 years old male who had i) generalized platyspondyly with anterior tapering of vertebrae ii) generalized metaphyseal dysplasia iii) minimal changes in the carpal and tarsal bones. This case is to be reported with review of references.
Child ; Dwarfism ; Humans ; Male ; Spine ; Tarsal Bones

PURPOSE: Doppler-guided hemorrhoidal artery ligation and recto-anal repair (DG-HAL & RAR) is known for low recurrence, high patient satisfaction, and less postoperative pain. The purpose of this study is to analyze the 1-year follow-up results in patients who underwent a DG-HAL & RAR and to establish the benefits of the procedure. METHODS: Among the hemorrhoid patients who were admitted to our hospital from March 2008 to May 2010 and who underwent a DG-HAL & RAR, 97 patients who were followed up for a year were investigated. Recurrence, complications, admission period, difference in preoperative and postoperative pain, operation time, and time to return to daily activities were investigated. RESULTS: The average admission period was 1.6 +/- 1.1 days. Pain at postoperative day 7 showed no significant difference from preoperative pain (P > 0.05). The operation time was 34.0 +/- 7.3 minutes on average, and return to daily activities was timed at 2.3 +/- 2.0 days postoperatively. At the one year follow-up, no serious complications were noted, and preoperative symptoms recurred only in 14 patients (14.4%). CONCLUSION: In most patients with hemorrhoids, excluding those with severe prolapsed hemorrhoids, less pain, no serious complications, and good long-term outcome can be expected from a DG-HAL & RAR.
Arteries ; Follow-Up Studies ; Hemorrhoids ; Humans ; Ligation ; Pain, Postoperative ; Patient Satisfaction ; Recurrence

It is well established that health care workers (HCWs) have a considerably higher risk of occupationally acquired tuberculosis (TB). To reduce the transmission of TB to HCWs and patients, TB infection control programs should be implemented in health care settings. The first and most important level of all protection and control programs is administrative control. Its goals are to prevent HCWs, other staff, and patients from being exposed to TB, and to reduce the transmission of infection by ensuring rapid diagnosis and treatment of affected individuals. Administrative control measures recommended by the United States Centers for Disease Control and Prevention and the World Health Organization include prompt identification of people with TB symptoms, isolation of infectious patients, control of the spread of the pathogen, and minimization of time spent in health care facilities. Another key component of measures undertaken is the baseline and serial screening for latent TB infection in HCWs who are at risk of exposure to TB. Although the interferon-gamma release assay has some advantages over the tuberculin skin test, the former has serious limitations, mostly due to its high conversion rate.
Centers for Disease Control and Prevention (U.S.) ; Delivery of Health Care* ; Diagnosis ; Health Personnel ; Humans ; Infection Control ; Interferon-gamma Release Tests ; Mass Screening ; Occupations ; Skin Tests ; Tuberculin ; Tuberculin Test ; Tuberculosis* ; World Health Organization

No abstract available.

In South Korea, bacteria in the Mycobacterium abscessus complex (MABC), a group of rapidly growing mycobacteria, are second to those in the Mycobacterium avium complex as a cause of non-tuberculous mycobacterial pulmonary disease. The MABC includes several subspecies, including M. abscessus subsp. abscessus (M. abscessus) and M. abscessus subsp. massiliense (M. massiliense), the former of which is difficult to treat owing to its antibiotic resistance.Current Concepts: M. abscessus encodes a functional erythromycin ribosomal methylase gene, erm(41), that causes inducible macrolide resistance. Contrastingly, M. massiliense lacks a functional erm(41) gene owing to a partial deletion. Accordingly, culture conversion rates using currently recommended macrolide-based antibiotic treatments are considerably higher among patients with M. massiliense infection than in those infected with M. abscessus. Phase therapy (intensive and continuous) is recommended for MABC pulmonary disease and, depending on the subspecies and antimicrobial susceptibility test results, should include an initial treatment of ≥3 to 4 injectable and oral antibiotics, followed by inhaled or intravenous amikacin and ≥1 to 2 oral antibiotics. Recommended injectable antibiotics include amikacin, imipenem or cefoxitin, and tigecycline, and oral antibiotics include macrolides (azithromycin or clarithromycin), clofazimine, linezolid, and rifabutin. For some patients, surgery should be considered as an adjunctive treatment option.Discussion and Conclusion: Given that M. abscessus expresses the inducible resistance gene erm(41) associated with macrolide resistance, the identification of MABC subspecies is important for disease management. However, despite the combined application of several injectable/oral antibiotics, the treatment outcomes for M. abscessus pulmonary disease remain unsatisfactory.

No abstract available.
Cryptococcosis* ; Lung Neoplasms* ; Lung*

No abstract available.
Cryptococcosis* ; Lung Neoplasms* ; Lung*

Bilateral sensorineural hearing loss (SNHL) is a relatively well-recognized complication of bacterial meningitis, but is a rare initial manifestation in acute cryptococcal meningitis. We report a case of cryptococcal meningitis initially presenting with bilateral SNHL. Cryptococcal meningitis should be included in the differential diagnosis of abrupt-onset bilateral SNHL.
Diagnosis, Differential ; Hearing Loss, Sensorineural* ; Meningitis, Bacterial ; Meningitis, Cryptococcal*

BACKGROUND: Fluoroquinolones are considered important substitutes for the treatment of tuberculosis. This study investigates the current status of fluoroquinolone for the treatment of tuberculosis. METHODS: In 2009, a retrospective analysis was performed at one tertiary referral center for 953 patients diagnosed with tuberculosis. RESULTS: A total of 226 patients (23.6%), who received fluoroquinolone at any time during treatment for tuberculosis, were enrolled in this study. The most common reasons for fluoroquinolone use were adverse events due to other anti-tuberculosis drugs (52.7%), drug resistance (23.5%), and underlying diseases (16.8%). Moxifloxacin (54.0%, 122/226) was the most commonly administered fluoroquinolone, followed by levofloxacin (36.3%, 82/226) and ofloxacin (9.7%, 22/226). The frequency of total adverse events from fluoroquinolone-containing anti-tuberculosis medication was 22.6%, whereas fluoroquinolone-related adverse events were estimated to be 2.2% (5/226). The most common fluoroquinolone-related adverse events were gastrointestinal problems (3.5%, 8/226). There were no significant differences in the treatment success rate between the fluoroquinolone and fluoroquinolone-naïve groups (78.3% vs. 78.4%, respectively). CONCLUSION: At our institution, fluoroquinolones are commonly used for the treatment of both multidrug-resistant tuberculosis and susceptible tuberculosis, especially as a substitute for adverse event-related drugs. Considering the low adverse event rates and the comparable treatment success rates, fluoroquinolones seem to be an invaluable drug for the treatment of tuberculosis.
Drug Resistance ; Fluoroquinolones ; Humans ; Korea* ; Levofloxacin ; Ofloxacin ; Retrospective Studies ; Tertiary Care Centers ; Tertiary Healthcare* ; Tuberculosis* ; Tuberculosis, Multidrug-Resistant

Paraneoplastic limbic encephalitis is commonly associated with small cell lung carcinoma. A 31-year-old female presented with amnesia and bizarre behavior for 1 month. Brain T2-weighted MRI showed high signal intensity in right medial temporal region. Abdominal CT revealed a mass in right lower abdomen, and subsequent excisional biopsy disclosed immature ovarian teratoma. Most symptoms improved after resection of the tumor. Our case demonstrates that immature ovarian teratoma also can be associated with paraneoplastic limbic encephalitis with good prognosis.
Abdomen ; Adult ; Amnesia ; Biopsy ; Brain ; Female ; Humans ; Limbic Encephalitis* ; Magnetic Resonance Imaging ; Prognosis ; Small Cell Lung Carcinoma ; Teratoma* ; Tomography, X-Ray Computed