BACKGROUND: Chicken pox and herpes zoster are caused by the varicella-zoster virus(VZV). To investigate the epiderniologial relationship between clinical isolates of VZV, it is essential to distinguish different isolate. OBJECTIVE: This study was conducted to classify the VZV strains according to R5 tandem direct reiterations(TDR) copy numbers and Pst I endonuclease cleavage site mutation, and to analyze the distribution pattern of VZV strains isolated in Korea. METHODS: Strains of VZV were isolated from 61 patients with herpes zoster who had not been immunized with a live vaccine of VZV. Copy numbers of R5 TDR which was located in variable region IV were measured by PCR. The presence of a Pst I cleavage site in a middle portion of the long unique region of VZV genome was analyzed by PCR thereafter restriction enzyme digestion(PCR-RFLP). RESULTS: VZV strains isolated in Korea contained one to three copy numbers of R5 TDR. Of 61 isolates, 43(70%) comtained 2 copies of R5 TDR, while 11(18%) isolates contained only one copy and 7(12%) isolat s contained 3 copies. About 16% of the strains examined did not have a PstI cleavage site, although the majority of strains retained this site. VZV strains could be classified into 6 strains on the basis of the copy number of R5 TDR and PstI cleavage site, in which the strain with 2 copies of R5 TDR and PstI cleavage site positive was the most frequent type (36 out of 61 isolates) in Korea. Four batches of live attenuated vaccine(Biken) that is now used in Korea showed 2 copy numbers of R5 TDR and PstI site negative. CONCLUSION: The copy number of R5 TDR and the presence of PstI cleavage site seems to be a reliable marker for dicrimination of VZV strains in Korea. This discrimination can be used to study the molecular epiclemiology of VZV and as a criterion for identification of vaccine-related isolates.
Chickenpox* ; Discrimination (Psychology) ; Genome ; Herpes Zoster* ; Humans ; Korea* ; Polymerase Chain Reaction ; Repetitive Sequences, Nucleic Acid*

Spinal cord infarction as a complication of spine surgery occurs rarely. Herein, a case of spinal cord infarction, which developed in a 69 year old woman following posterior decompression and internal fixation for a T11 bursting fracture, is descirbed. The anesthetic induction and intraoperative course were uneventful, except at the end of the procedure, where her blood pressure suddenly dropped from 130/90 to 90/60 mmHg. The patient was aggressively treated with a transfusion and vasopressor, the blood pressure then returned to its usual value within 10 minutes. However, during a physical examination in the recovery room, the patient was found to have flaccid lower limbs, with impaired sensory function below the T8 level. Her cord diameter had increased, and a high signal lesion was observed within the thoracic spinal cord, from T9 to T12 level on T2-weighted MR images, which was diagnosing as a spinal cord infarction, was and showed no improvement despite the immediate and aggressive treatment.
Aged ; Blood Pressure ; Decompression ; Female ; Humans ; Infarction* ; Lower Extremity ; Physical Examination ; Recovery Room ; Sensation ; Spinal Cord* ; Spine*

Primary intimal sarcoma of the pulmonary artery is a rare disease and there has been no report of any case originating from the pulmonary valve. Recently we experienced a 62 year-old female patient who had a primary intimal sarcoma of the pulmonary valve with distal metastasis. She was brought to medical attention due to exertional dyspnea facial edema productive coughing and general weakness for 1 month. Chest CT and echocardi-ography suggest an acute pulmonary thromboembolism or tumor. Exploration showed a large polypoid mass arising from the pulmonary leaflets and multiple masses on distal pulmonary arteries. We replaced the pulmonary valve and reconstructed the pulmonary artery. She received radiotherapy 1 month postoperatively and now 4 months after surgery she has begun receiving chemotherapy.
Cough ; Drug Therapy ; Dyspnea ; Edema ; Female ; Humans ; Middle Aged ; Neoplasm Metastasis ; Pulmonary Artery ; Pulmonary Embolism ; Pulmonary Valve* ; Radiotherapy ; Rare Diseases ; Sarcoma* ; Tomography, X-Ray Computed

Renal oncocytoma has been recently defined histopathologically but many controversies have arised about its origin and differential diagnosis. Until the present time nearly all renal oncocytoma were considered to be benign nature, but rare cases have been reported to be metastasized. We reported a case of renal oncocytoma and synchronous contralateral renal cell carcinoma treated by radical nephrectomy on one side and enucleation on the other side.
Adenoma, Oxyphilic* ; Carcinoma, Renal Cell* ; Diagnosis, Differential ; Nephrectomy

Renal oncocytoma has been recently defined histopathologically but many controversies have arised about its origin and differential diagnosis. Until the present time nearly all renal oncocytoma were considered to be benign nature, but rare cases have been reported to be metastasized. We reported a case of renal oncocytoma and synchronous contralateral renal cell carcinoma treated by radical nephrectomy on one side and enucleation on the other side.
Adenoma, Oxyphilic* ; Carcinoma, Renal Cell* ; Diagnosis, Differential ; Nephrectomy

Congenital lymphedema is usually confined to the lower extremities and an isolated unilateral arm involvement is very rare. We report a 36-year-old women who had congenital lymphedema of the right forearm and hand.
Adult ; Arm* ; Female ; Forearm ; Hand ; Humans ; Lower Extremity ; Lymphedema*

The authors experienced 52 patients with myasthenia gravis who were diagnosed at the Department of Neurology, Yeungnam University Hospital from August 1985 to January 1996. The following results were obtained through diagnostic evaluation and treatment. 1. The ratio of male to female was 1:1.7 and the most prevalent age group was second decade. 2. The most common initial presentation symptom was ocular(71.2%) and the peak incidence group was stage I (69.3%) according to the modified Osserman's classification. 3. In 16 patients(30.8%), it took more than a year to diagnose due to symptoms which were relapsed and remitting. 4. Of 52 patients, 2 cases were associated with thyroid disease(3.8%) and 2 with insulin-dependent diabetes mellitus(3.8%). 5. All of those who received anticholinesterase and corticosteroid therapy were improved with the exception of 5 cases which were improved after thymectomy and/or plasmapheresis.
Classification ; Female ; Humans ; Incidence ; Male ; Myasthenia Gravis* ; Neurology ; Plasmapheresis ; Thymectomy ; Thyroid Gland

No abstract available.
Edema*

Varying types of polyps could occur in the vermiform appendix. However, it is very unusual. Collins found 57 cases (0.08%) of benign mucosal polyps in the 71,000 cases of appendectomy specimens. There has been no reported case of appendiceal polyp in the literature in Korea. The authors experienced two cases of polyp in the vermiform appendix. The first case was a 51 year-old male patient who received a left hemicolectomy due to colonic polyposis. The second case was a 71 year-old male patient who was treated by appendectomy under the clinical diagnosis of acute appendicitis. The microscopic type of both cases were hyperplastic polyp.
Male ; Humans

BACKGROUND: Information on the long-term fate of patients with prosthetic valve is limited. Cerebral embolism is a major cause of late morbidity and mortality in patients with prosthetic valves even though recent prostheses are less thrombogenic and anticoagulants are administered. We investigated the long-term risk of the first ischemic and hemorrhagic stroke and effect of presumed risk factors on the development of stroke in patients with prosthetic valves. METHODS: In a retrospective study, 554 patients who survived the 30-days after cardiac valve replacement between June, 1985 and May, 1995 were included. End points were attacks of ischemic and hemorrhagic stroke. Risk of stroke at end points was calculated according to Kaplan-Meier method. The influence of several clinical variables on these stroke events was analyzed by univariate and mutivariate analyses. RESULTS: Thirty seven of 554 patients had 42 stroke events(34 ischemic stroke, 8 hemorrhagic stroke) during follow-up periods(mean: 52.9months). Six of these patients died from stroke. The cumulative stroke-free probability was 92.4% at 5years and 87.7% at 10years. The cumulative ischemic stroke-free probability was 93.7% at 5years and 89.4% at 10years. No or irregular use of anticoagulants was the only significant independent predictor(RR:4.99, 95%CI:2.01-12.41, p<0.01) of ischemic stroke. The cumulative hemorrhagic stroke-free probability was 98.7% at 5years and 98.1% at 10years. CONCLUSION: Regardless of the type of prostheses, patients with prosthetic valves, notably those without anticoagulants, are at high risk for ischemic stroke.
Anticoagulants ; Follow-Up Studies ; Heart Valves ; Humans ; Intracranial Embolism ; Mortality ; Prostheses and Implants ; Retrospective Studies ; Risk Factors ; Stroke* ; Thromboembolism