Tinea pedis is frequently found in those people with poor hygine and in hot and humid environments. The authors investigated the clinical, epidemiologicol a id mycological characteristics of tinea pedis in 138 sewerage workers attending a sewerage plant in Seoul. Tinea pedis was found in 82, with a prevalence of 59.4%. The prevalence of tinea pedis increased with age and the period working at sewerage plant, however, there was no statistical significance. Also there was no difference in the prevalence of tinea pedis between the clerical workers and the field workers. Positive rate for KOH smear was 73.2%, and culture positive rates were 42.7%, producing 35 strains of dermatophytes. Twertyeight strains of Trichophyton Rubrum and 7 strains of Trichophyton mentagrophytes were isolated. Twentyseven yeast-form colonies were isolated, and Trichosporon beigelii was foungl in 19 samples. Most of the yeast forms were found mixed with dermatophytes and moulcis, However, 6 were isolated from direct smear positive cases and yieIded pure colonies of yeast. These included 4 cases of T. beigelii, 1 case of Candida parapsilosis, and 1 case of Candida hormicola. In view of the recent report of these fungi as pathogenic organism, these isolates, rspecially T. beigelii, were considered as a causative agent of tinea pedis in certain groups like sewerage workers.
Arthrodermataceae ; Candida ; Fungi ; Health Personnel ; Humans ; Plants ; Prevalence ; Seoul ; Tinea Pedis* ; Tinea* ; Trichophyton ; Trichosporon ; Yeasts

Early treatment to facilitate the muscular blood flow can avert myonephropathic metabolic syndrome (MNMS) and major amputation for patients suffering with acute limb ischemia. Delayed reperfusion or microemboli in the small vessels can aggreviate: ischemic changes and lead to irreversible muscle necrosis. Amnion is an excellent biological dressing, and we tried using it to treat anterior compartment muscle necrosis (ACMN). The amnions were aseptically collected from caesarean sections. Additional betadine (1 : 3 solution) and vaseline-soaked gauzes were applied over the amnion as a daily biologic wet dressing. The amnion was replaced every three days. Finally, split skin grafting was performed on the healthy granulation tissue. We treated two patients who happened to have shin muscle necrosis. A 65-year-old man with a femoro-femoral arterial bypass showed graft thrombosis. Thirteen days after performing balloon angioplasty with stent insertion in the right femoral artery, new emboli were found in the stent and in the left popliteal artery. There was an attack of myocardial infarction the next day after embolectomy. The severe MNMS and ACMN at the right shin occurred after cardiopulmonary resuscitation. The dry gangrene was excised 3 months later, and this was followed by a skin graft 4 months later. An 81-year-old woman with atrial fibrillation showed left common femoral arterial obstruction and ACMN on the left shin during the management of congestive heart failure. The dry gangrene was excised 2 months later, and this was followed by a skin graft 3 months later. The amnion dressing shows promises for providing healthy granulation tissue for split skin grafts when treating muscle necrosis of the leg. Biologic dressing with using amnion is an option for limb salvage in the case of muscle necrosis that is caused by acute limb ischemia, although the treatment takes a long time.
Aged ; Aged, 80 and over ; Amnion* ; Amputation ; Angioplasty, Balloon ; Atrial Fibrillation ; Bandages* ; Biological Dressings ; Cardiopulmonary Resuscitation ; Cesarean Section ; Embolectomy ; Extremities* ; Female ; Femoral Artery ; Gangrene ; Granulation Tissue ; Heart Failure ; Humans ; Ischemia* ; Leg ; Limb Salvage ; Lower Extremity* ; Myocardial Infarction ; Necrosis* ; Popliteal Artery ; Povidone-Iodine ; Pregnancy ; Reperfusion ; Skin ; Skin Transplantation ; Stents ; Thrombosis ; Transplants

No abstract available.
Cervix Uteri* ; Female ; Humans ; Mass Screening* ; Uterine Cervical Neoplasms*

Emphysematous urinary tract infection is a rare, life-threatening necrotizing infection characterized by gas generation, and usually occurs in patients with diabetes and/or urinary tract obstruction. We herein report a unique case of emphysematous renal infection occurred in. an old diabetic man with renal cell carcinoma. This case suggests that renal cell carcinoma should be also considered a rare cause of emphysematous renal infection showing mass contour.
Carcinoma, Renal Cell* ; Humans ; Urinary Tract ; Urinary Tract Infections

Vascular thrombosis and systemic hypercoagulable states are known complications of pancreatitits. The incidence of vascular obstruction associated with pancreatitis has been reported at 0.9%. They are thought to be secondary to release of proteolytic enzymes of the pancreas and direct vasculitis. Vessels near the head of the pancreas are more frequently involved, and arterial vessels are most commonly affected. Inferior vena cava (IVC) thrombosis however, is a very rare presentation of acute and chronic pancreatitis. Dignosis of IVC thrombosis may be far from easy; the presence of a leg edema, superficial thrombophlebitis or thromboembolic events may arouse clinical suspicion. Therefore, a high degree of suspicion for this complication is necessary in order to render a diagnosis. A case of a 24-year old man with chronic pancreatitis, who was found to have IVC and right iliac vein thrombosis, is herein report with a review of the relevant literature.
Diagnosis ; Edema ; Head ; Humans ; Iliac Vein* ; Incidence ; Leg ; Pancreas ; Pancreatitis ; Pancreatitis, Chronic* ; Peptide Hydrolases ; Thrombophlebitis ; Thrombosis* ; Vasculitis ; Vena Cava, Inferior* ; Young Adult

BACKGROUND AND OBJECTIVES: Many local application methods have been developed for preventing vertigo attacks while preserving hearing loss. Among them, ototoxicity of aminoglycosides has been used for the treatment of Meniere's disease. The etiology and pathophysiology of Meniere's disease remain unknown, however, intratympanic aminoglycoside infiltration has proved to be a very effective treatment method for Meniere's disease. Therefore, currently, variable modalities of intratympanic aminoglycoside inflitration have been attempted in patients with Meniere's disease. We attempted to evaluate streptomycin perfusion for the control of vertigo with the preservation of hearing in patients with Meniere's disease. MATERIALS AND METHODS: Streptomycin powder was administered by filling up the round window niches in 15 patients with menere's disease from 1993 to 1996. Transmeatal approach was used for this technique and streptomycin infiltration was conducted for three consecutive days until patients developed spontaneous nystagmus or dizziness. RESULTS: 13 (83%) patients had no episodes of vertigo, and 2 patients had decreased vertigo attack. The preservation or improvement of hearing was reported in 87% of the patients. We observed that tinnitus disappeared in 33.3% of patients, and ear fullness in 40% of patient. After the operation, all of the patients reported to have no problems in daily activity. CONCLUSION: The streptomycin perfusion is a safe and simple procedure that is effective in controlling the vertigo, tinnitus and earfullness; however, futher further studies must be done on the preservation of hearing.
Aminoglycosides ; Dizziness ; Ear ; Hearing ; Hearing Loss ; Humans ; Meniere Disease* ; Perfusion* ; Streptomycin* ; Tinnitus ; Vertigo

PURPOSE: To report the clinical findings and the treatments of patients with dacryocystocele, presenting as an uncommon mass in the medial canthal area of adults. CASE SUMMARY: Five patients, diagnosed with dacryocystocele, complained of epiphora and mucopurulent discharge and were found to have a medial canthal mass. Four of these patients presented with symptoms of acute dacryocystitis. One patient underwent repeated endonasal dacryocystorhinostomy (endonasal DCR) with silicone implantation, but the epiphora returned a few months after the treatment. The patient then received external dacryocystorhinostomy (external DCR) with silicone implantation. Two patients experienced recurrence after the first endonasal DCR and, therefore, received repeat endonasal DCR with silicone implantation via a maximum excision of the enlarged lacrimal sac. One patient underwent external DCR with silicone implantation due to acute inflammation with chronic dacryocystitis, and one attempted conservative treatment after refusing any surgical procedure but suffered a relapse. In the surgical cases, no patients experienced recurrence after the final procedure, and they all had a favorable course during the 6 to 14 months of follow-up. CONCLUSIONS: Dacryocystocele in adults always requires a surgical procedure. Additional maximum excision of the lateral wall of an enlarged lacrimal sac could be performed to reduce the possibility of recurrence.
Adult ; Dacryocystitis ; Dacryocystorhinostomy ; Follow-Up Studies ; Humans ; Inflammation ; Lacrimal Apparatus Diseases ; Recurrence ; Silicones

Renovascular hypertension is the leading cause of surgically curable arterial hypertension. With the marked advancement in the technique of vascular surgery, renal revascularization is preferred to nephrectomy. It is used for the recovery of impaired function or the prevention of renal failure and the control of hypertension. We report a case of renovascular hypertension with the nonfunction of the left kidney due to complete renal artery obstruction, treated successfully with an aortorenal bypass graft.
Hypertension ; Hypertension, Renovascular* ; Kidney ; Nephrectomy ; Renal Artery Obstruction ; Renal Insufficiency ; Saphenous Vein* ; Transplants*

PURPOSE: To compare the various imaging techniques including application of magnetization transfer(MT), administration of IV contrast materials, and imaging time after injection of contrast materials in 3D time-of-flight(TOF) cerebral magnetic resonance angiography(MRA) in normal volunteers. MATERIALS AND METHODS: Each of 11 healthy volunteers was prospectively studied with 3D TOF cerebral MRA using various imaging parameters. Various parameters of 3D TOF MRA were 1) pre-enhanced magnetization transfer(MT), 2) postenhanced MT, immediate phase, 3) postenhanced MT, 10-minutes delayed phase, 4) postenhanced MT, 20-minutes delayed phase, 5) pre-enhanced non-MT, 6) postenhanced non-MT, immediate phase, 7) postenhanced non-MT, 10-minutes delayed phase, 8) postenhanced non-MT, 20-minutes delayed phase. Image qualities of various parameters were compared with regard to depiction of cerebral arteries and veins by visual assessment For statistical analysis paired t-test was used. RESULTS: In pre-enhanced MRA, images with MT mode were better in arterial visualization than those with :n0n-MT mode(p<0.01). Postenhanced MT and non-MT images were better in arterial and venous visualization !than pre-enhanced MT and non-MT images(p<0.01), respectively. Images obtained immediately after injection of contrast material were better in both arterial and venous visualization than delayed images(p<0.01). CONCLUSION: Postenhanced cerebral 3D TOF MRA with MT obtained immediately after injection of contrast materal is the best to increase visualization of both cerebral arteries and veins, and may be indicated in some cranial vascular diseases.
Angiography* ; Brain* ; Cerebral Arteries ; Contrast Media ; Healthy Volunteers* ; Prospective Studies ; Vascular Diseases ; Veins

Adult onset Still's disease (AOSD) is a rare systemic inflammatory disorder of an unknown etiology, and its major clinical manifestations include high spiking fever, polyarthralgia, salmon-colored evanescent rash and neutrophilic leukocytosis. We describe here a 41 year old woman with AOSD who presented with non-remitting high fever, polyarthralgia, sore throat, skin rash, splenomegaly, thrombocytopenia, neutrophilic leukocytosis, hyperferritinemia and coagulopathy with disseminated intravascular coagulation (DIC). The patient had a history of laparoscopic cholecystectomy due to acalculous cholecystitis prior to admission. We suspected sepsis due to bile peritonitis after the previous laparoscopic cholecystectomy. Yet we could not detect infectious organisms on the cultures or serologic studies. Finally, we suspected AOSD-associated hemophagocytic syndrome (HS). So, intravenous immunoglobulin and pulse methylprednisolone treatment brought about transient improvement of the fever and the neutrophilic leukocytosis, but the disease progressed and the patient expired due to acute renal failure. HS is a fatal cause of AOSD. If a patient has DIC and sepsis and these fail to respond to conservative treatment, then AOSD should be added to the differential diagnosis of sepsis and DIC.
Acalculous Cholecystitis ; Acute Kidney Injury ; Adult* ; Arthralgia ; Bile* ; Cholecystectomy, Laparoscopic ; Dacarbazine ; Diagnosis, Differential ; Disseminated Intravascular Coagulation ; Exanthema ; Female ; Fever ; Humans ; Immunoglobulins ; Leukocytosis ; Lymphohistiocytosis, Hemophagocytic ; Methylprednisolone ; Neutrophils ; Peritonitis* ; Pharyngitis ; Sepsis* ; Splenomegaly ; Still's Disease, Adult-Onset* ; Thrombocytopenia