PURPOSE: To report a case of a patient with cytomegalovirus (CMV) retinitis who was treated with oral valganciclovir. CASE SUMMARY: A 34-year-old man who had undergone anti-cancer chemotherapy for Non-Hodgkin lymphoma was referred to the ophthalmologic oncology clinic because of decreased vision in both eyes. Fundus examination showed white, opaque, and granular retinal lesions in both eyes, and a serologic test showed a positive response to CMV antibody IgG and a negative response to CMV antibody IgM. The patient received induction therapy with intravenous ganciclovir and maintenance therapy with oral valganciclovir 900 mg once daily. CMV retinitis reactivated 4 weeks after maintenance therapy was discontinued. At that point, the patient received induction therapy with oral valganciclovir 900 mg twice daily for 3 weeks and maintenance therapy with 900 mg once daily for 5 weeks. The retinal lesion disappeared and did not recur after oral administration of valganciclovir. The patient discontinued valganciclovir after 5 weeks of maintenance therapy, and CMV retinitis did not reactivate during 6 months of follow-up. CONCLUSIONS: Oral valganciclovir was clinically effective in the treatment of CMV retinitis in a patient who was treated with anti-cancer chemotherapy for non-Hodgkin lymphoma.
Administration, Oral ; Adult ; Cytomegalovirus ; Cytomegalovirus Retinitis ; Eye ; Follow-Up Studies ; Ganciclovir ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Lymphoma, Non-Hodgkin ; Retinaldehyde ; Retinitis ; Serologic Tests ; Vision, Ocular

OBJECTIVES: The purpose of this study was to make empirical evidence for a community based case management program for the first episode of psychosis. METHODS: We provided a case management program for first episode psychosis patients and assessed their symptoms, function, insight, and satisfaction using Positive and Negative Syndrome Scale (PANSS), the Health of Nation Outcomes Scales (HoNOS), Scale to assess Unawareness of Mental Disorder (SUMD), Global Assessment of Functioning Scales (GAF), and Quality of Life scales (QOL) at baseline and after the program. We also evaluated the treatment maintenance rate and the changes of their developmental task achievement. RESULTS: Significant improvement was observed in all sub-domains of PANSS and significant changes were also observed in the areas of symptoms and function of HoNOS. Significant improvement was observed in awareness of mental illness itself and its outcomes. The treatment maintenance rate was 87.5%, including three patients who stopped their medication with the doctor's order. The rate of participation in meaningful social activities, such as school or job showed an increase, from 25% at baseline to 81% after the program. CONCLUSION: Results of this study demonstrate the possibility of community programs for prevention of relapse, improvement of symptoms and function, and facilitation of return to meaningful social activities of first episode psychosis patients.
Case Management ; Humans ; Mental Disorders ; Psychotic Disorders ; Quality of Life ; Recurrence ; Weights and Measures

The periosteum provides a good cell source for bone formation because it possesses osteoprogenitors. In this study, the osteogenic activity of the rabbit periosteum and periosteal cells was investigated. The periosteum was harvested from the long bone surface of New Zealand White rabbits. The periosteal cells were isolated from the periosteum and expanded. In vitro examination, the morphological changes, mineralization, and osteogenicity of the periosteal cells were evaluated. The amount of osteocalcin released was measured to check the maximal activity of the cells. The periosteum and periosteal cells-scaffold composites were transplanted into athymic mice to observe the in vivo bone formation. Radiological and histological changes were checked every 2 weeks. The isolated periosteal cells were uniformly proliferated in a monolayer culture, and mineral deposition was confirmed after 10 weeks. The osteogenic markers such as osteopontin, osteonectin, type I collagen, and alkaline phosphatase were expressed from the periosteal cells after 2 weeks. Osteocalcin was expressed after 3 weeks and was maximally expressed at 4 weeks. In 3-dimensional culture, the periosteal cells were well adhered and proliferated on the poly L-lactic-co-glycolic acid scaffold. The periosteal cells-scaffold composite transplant produced of osteoid without calcification in vivo. Radiological examination showed minimal changes of bone formation during the experimental period. However, the periosteum transplant was converted to a cartilaginous structure at 2 weeks, bony calcification after 4 weeks, and complete bony trabecula and marrow space formation at 12 weeks. The radiological bone density also increased during the experimental period. The periosteum may be one of good cell sources for osseous tissue engineering. Engineered periosteal cells may be used for the treatment of nonunion, osteolysis, avascular necrosis and fusion of the spine.
Alkaline Phosphatase ; Animals ; Bone Density ; Bone Marrow ; Collagen Type I ; Mice ; Mice, Nude ; Necrosis ; Osteocalcin ; Osteogenesis ; Osteolysis ; Osteonectin ; Osteopontin ; Periosteum* ; Rabbits ; Spine ; Tissue Engineering

PURPOSE: Dexmedetomidine, a potent selective alpha2-adrenergic agonist, produces sedation and analgesia. This study was conducted to assess the effect of dexmedetomidine infusion on sevoflurane requirements, recovery profiles, and emergence agitation in children undergoing ambulatory surgery. MATERIALS AND METHODS: Forty children undergoing ambulatory hernioplasty or orchiopexy were randomized into two groups. The dexmedetomidine group (Group D, n=20) received dexmedetomidine 1 microg/kg, followed by 0.1 microg/kg/h until the end of surgery, whereas the saline group (Group S, n=20) received volume-matched normal saline. Sevoflurane was used for induction and maintenance of anesthesia and caudal block was performed in all children. End-tidal sevoflurane concentration (ET-sevo), the incidence of emergence agitation, pain scores, and sedation scores were recorded. Hemodynamic changes and other adverse effects were assessed in the perioperative period. RESULTS: ET-sevo of Group D was significantly reduced in 23.8-67% compared to Group S during surgery. The incidence of emergence agitation was lower in Group D than in Group S (5% vs. 55%, p=0.001). Postoperative pain was comparable, and discharge time was not different between the groups. Mean arterial pressure and heart rate were significantly lower in Group D during surgery. CONCLUSION: Intraoperative infusion of dexmedetomidine reduced sevoflurane requirements and decreased emergence agitation without delaying discharge in children undergoing ambulatory surgery. However, caution should be taken in regard to bradycardia and hypotension.
Adolescent ; Adult ; Ambulatory Surgical Procedures/*methods ; Child ; Dexmedetomidine/*therapeutic use ; Female ; Hemodynamics/drug effects ; Humans ; Male ; Methyl Ethers/*therapeutic use ; Psychomotor Agitation/drug therapy ; Young Adult

The presence of distinct bacterial species is found to be dependent on age, diet, and disease. We compared the detection rate of several oral bacterial strains in a cohort of 36 subjects including healthy volunteers, periodontal patients, and oral cancer patients. Gargling samples were obtained from these subjects from which DNA was then extracted. Specific primers for 29 bacterial species were used for PCR detection. In the oral cancer patients, Capnocytophaga ochracea, Gemella morbillorum, and Streptococcus salivarius were detected more frequently compared with the healthy volunteers and periodontitis patients. Fusobacterium nucleatum/polymorphym and Prevotella nigrescens were significantly less prevalent in oral cancer patients than the other groups. In periodontitis patients, Porphyromonas gingivalis and Treponema denticola were more frequently found compared with the healthy volunteers. In the healthy volunteer group, Peptostreptococcus anaerobius was more frequently found than the other groups. The detection rate of several oral bacterial species was thus found to differ between healthy volunteers, periodontitis patients and oral cancer patients.
Capnocytophaga ; Cohort Studies ; Diet ; DNA ; Fusobacterium ; Gemella ; Healthy Volunteers* ; Humans ; Microbiota* ; Mouth Neoplasms* ; Peptostreptococcus ; Periodontitis* ; Polymerase Chain Reaction ; Porphyromonas gingivalis ; Prevotella nigrescens ; Streptococcus ; Treponema denticola

No abstract available.
Plasma ; Protein C Deficiency* ; Protein C* ; Purpura Fulminans* ; Purpura* ; Warfarin

A 51-yr-old man presented with an enlarged right testis for two months. The radically resected testis showed a relatively well-circumscribed ovoid mass, nearly replacing the normal architecture with central cystic changes. Microscopically, the mass was composed of ovoid shaped tumor cells of a moderately differentiated squamous cell carcinoma (SCC). The central portion of the mass was filled with well-formed laminated keratinous materials and the remnant cavity lined by dysplastic squamous epithelium, indicated SCC may be derived from an epidermal cyst. SCC is among the most common types of neoplasm afflicting human beings, but it is rare in the testis. To our knowledge, this is the second report of the testicular squamous cell carcinoma occurring in a patient without other primary tumors, and the firstly reported case in Korea.
Carcinoma, Squamous Cell/diagnosis/*pathology ; Humans ; Korea ; Male ; Middle Aged ; Testicular Neoplasms/diagnosis/*pathology

PURPOSE: Chest pain is common in children and adolescents and is a reason for referral to pediatric cardiologists. Although most cases of chest pain in these age groups are benign and do not require treatment, timely diagnosis is important not to miss life-threatening diseases requiring prompt treatment. We investigated certain clinical characteristics that may be useful in the diagnosis of such critical diseases. METHODS: Patient medical records between July 2006 and September 2013 were retrospectively examined. We included 517 patients who presented with chest pain to the Department of Pediatrics at Kyung Hee University Hospital in Gangdong. RESULTS: Most cases of chest pain were idiopathic in origin (73.6%), followed by cases with respiratory (9.3%), musculoskeletal (8.8%), cardiac (3.8%), gastrointestinal (2.9%), and psychiatric (1.4%) causes. In 6 patients (1.2%) with air-leak syndrome including pneumothorax or pneumomediastinum, the pain was abrupt, continuous, and lasted for a short period of 1-2 days after onset in the older adolescents. Of the patients with cardiac pain, 13 had cardiac arrhythmias (65.0%), 6 had congenital heart diseases (30%), and 1 had coronary aneurysms caused by Kawasaki disease (5.0%). One patient with atrial flutter had only symptoms of syncope and chest pain. CONCLUSION: The abrupt, continuous chest pain of a short duration in the older children was characteristic of air-leak syndrome. In patients with pneumomediastinum, radiological diagnosis was difficult without careful examination. Combined syncope should not be neglected and further cardiac workup is essential in such patients.
Adolescent* ; Arrhythmias, Cardiac ; Atrial Flutter ; Chest Pain* ; Child* ; Coronary Aneurysm ; Diagnosis ; Heart Diseases ; Humans ; Mediastinal Emphysema ; Medical Records ; Mucocutaneous Lymph Node Syndrome ; Musculoskeletal Diseases ; Pediatrics ; Pneumothorax ; Referral and Consultation ; Retrospective Studies ; Syncope ; Thorax*

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and severe adverse drug reaction characterized by the cutaneous eruption, fever, eosinophilia, and involvement of internal organs. It is commonly caused by aromatic anticonvulsant drugs and antibiotics in children. In this study, we presented a case of a 9-year-old boy with bipolar disorder, who developed DRESS syndrome after lamotrigine intake for 10 days. Thereafter, lamotrigine was discontinued, and systemic corticosteroid treatment was pursued for 18 days. After 3 months, a patch test for lamotrigine was performed as a confirmatory test to check drug reaction. Reports of DRESS syndrome in adults have increased over the past decade due to the increasing use of lamotrigine as a new aromatic anticonvulsant. Although there are only a few lamotrigine-related DRESS syndrome reports in children, caution is needed with its potential widespread use in the future.

PURPOSE: The aim of this study was to evaluate the computed tomography (CT) imaging findings and clinical symptoms of patients who complained of neurosensory disturbances after mandibular implant surgery, and to investigate the relationships of these parameters with the prognosis for recovery. METHODS: CT scans were reviewed in 56 patients with nerve disturbance after mandibular implant surgery. Two oral radiologists classified the imaging findings into intrusion, contact, close, and separate groups according to the distance from the inferior border of the implant to the roof of the mandibular canal (MC). The symptoms of 56 patients were classified into 8 groups and the frequency of each group was investigated. Patients were categorized according to symptom improvement into no recovery and recovery groups, and the relationships of recovery with the CT classification and specific symptom groups were analyzed. RESULTS: Thirty-eight of the 56 nerve disturbance cases showed improvement. The close and separate groups in the CT classification had a strong tendency for recovery (90.9% and 81.8%, respectively) (P<0.05). Although the lowest recovery rate was found in the intrusion group, it was non-negligible, at 50%. The 6 patients with a worm crawling feeling all improved, while the 8 cases with a tightening sensation showed the lowest recovery rate, at 12.5%, and the symptom of a tightening sensation occurred only in the intrusion and contact groups. CONCLUSIONS: The closer the implant fixture was to the MC on CT images, the less likely the patient was to recover. Regarding paresthesia symptoms, while a worm crawling feeling is thought to be a predictor of recovery, a tightening sensation appeared to be associated with a lower recovery rate.
Classification ; Humans ; Mandibular Nerve ; Paresthesia ; Prognosis ; Sensation ; Tomography, X-Ray Computed