BACKGROUND: Famciclovir and valacyclovir are antiviral agents commonly used to treat herpes zoster. These medications not only reduce the time to complete cessation of zoster-associated pain, but also aid in the healing of the herpes zoster skin lesions. However, only few studies have compared these antiviral agents. OBJECTIVE: We conducted a randomized clinical trial to evaluate the extent of pain relief and wound healing, and the rate of postherpetic neuralgia associated with these drugs during 4 weeks of treatment. METHODS: The study included 69 immunocompetent adult inpatients diagnosed with herpes zoster randomly divided into 2 groups based on the antiviral agent administered. Patient age, date of visit from rash onset, and rash severity at baseline were recorded. Famciclovir or valacyclovir were administered orally for 7 days. Patients reported pain levels through a visual analog scale (VAS) score, and pain durations were assessed on days 1, 3, and 7, and at weeks 2, 3, and 4. Crust formation and reepithelialization times of skin lesions were also recorded. RESULTS: VAS scores, pain durations, ratios of patients undergoing postherpetic neuralgia, and skin lesion healing rates did not differ significantly between the 2 groups. However, rash severity independently correlated with the extent of pain experienced. CONCLUSION: Famciclovir and valacyclovir are comparable to each other in resolving zoster-associated pain, postherpetic neuralgia, and zoster wound healing. Early antiviral treatment before expansion of the skin lesion would be helpful for rapid relief of herpes zoster pain.
Adult* ; Antiviral Agents ; Exanthema ; Herpes Zoster* ; Humans ; Inpatients ; Neuralgia, Postherpetic ; Skin ; Visual Analog Scale ; Wound Healing

Submucosal infiltration and the topical application of epinephrine as a vasoconstrictor produce excellent hemostasis during surgery. The hemodynamic effects of epinephrine have been documented in numerous studies. However, its metabolic effects (especially during surgery) have been seldom recognized clinically. We report two cases of significant metabolic effects (including lactic acidosis and hyperglycemia) as well as hemodynamic effects in healthy patients undergoing orthognathic surgery with general anesthesia. Epinephrine can induce glycolysis and pyruvate generation, which result in lactic acidosis, via β2-adrenergic receptors. Therefore, careful perioperative observation for changes in plasma lactate and glucose levels along with intensive monitoring of vital signs should be carried out when epinephrine is excessively used as a vasoconstrictor during surgery.
Acidosis, Lactic* ; Administration, Topical ; Anesthesia, General ; Anesthesia, Local ; Epinephrine ; Glucose ; Glycolysis ; Hemodynamics ; Hemostasis ; Humans ; Lactic Acid ; Orthognathic Surgery* ; Plasma ; Pyruvic Acid ; Vital Signs

To delineate the coronary anatomy and left ventricular function during early myocardial infarction, coronary arteriography and left ventriculogrphy were performed, prospectively in 23(22%) of 105 patients who were admitted to the coronary care unit at Masan Koryo Hospital from June 1986 to June 1988 within 4 weeks after the onset of symptoms(medium:21 days, range:18 days to 25 days). 1) Among 23 patients, male is 20 patients and female is 3 patients. The ratio of male to female was 6.6:1. The mean age was 55.4+/-10.3 years(range:34-77 years). 2) Coronary artery narrowing state which related to myocardial infarction was as follows; 2 patients(7%) had normal, 1 patients(4%) had insignificant narrowing(below 50%) 5 patients(22%) had moderate narrowing(50-75%), 10 patients(43%) had severe narrowing(75-99%), 5 patients(22%) had complete occlusion(100%). 3) The range of coronary artery disease was as follows; 9 patients had one vessel disease, 10 patients had two vessel disease, 1 patients had three vessel disease, and ejection fraction had no significant difference among 3 groups but lowest in three vessel disease. Among 23 patients, 13 patients had anterior infarction, 10 patients had inferior infarction. 4) Left ventricular ejection fraction and multiple vessel disease had no significant difference between i) the young(under 45 years old) and the old(over 45 years old) age groups, ii) presence or non presence of previous angina, iii) Killip classification I, II and III, IV) anterior infarction and inferior infarction. 5) In left ventriculography, akinesis and dyskinesis were shown at similar ratio in anterior infarction and inferior infaraction. Dyskinesis was shown in 27% of patients who have 0-1 vessel disease, 50% of patients who have 2-3 vessel disease, 62% of patients who have collateral circulation, 26% of patients who dose not have collateral circulation. 6) Collateral circulation was found in 8 patients(35%). Age and left ventricular ejection fraction were high in patients without collateral circulation than with collateral circulation, but there is no significant difference and collateral circulation exists regardless of infarction site and range of coronary artery disease. 7) As for the complication of angiocardiography in this study, there was ventricular tachycardia in 3 patients(13%) without mortality. It is concluded that coronary arteriography can be safely performed in early stage after acute myocardial infarction. Also good prognosis is anticipated since three vessel disease and complete occlusion were low in acute myocardiaol infarction of Korean People. Since these are not much case performed study, however more study on this area is required.
Angiocardiography ; Angiography* ; Classification ; Collateral Circulation ; Coronary Angiography ; Coronary Artery Disease ; Coronary Care Units ; Coronary Vessels ; Female ; Humans ; Infarction ; Male ; Mortality ; Myocardial Infarction* ; Prognosis ; Prospective Studies ; Stroke Volume ; Tachycardia, Ventricular ; Ventricular Function, Left

Squamous cell carcinoma commonly originates from recalcitrant wound sites, including burn scars, pressure sores, stasis ulcers, osteomyelitis, and sites of frostbite. A 62-year-old male was referred to the dermatology department for skin necrosis of his right great toe and walking difficulty. He had a history of smoking, drinking alcohol, and frostbite of his right great toe 9 years prior, which deteriorated into osteomyelitis due to poor care. Although a skin biopsy was recommended before amputation, the two procedures were performed simultaneously due to a lack of toe function due to severe osteolysis. Biopsy of the amputated toe tip showed many lobules consisting of atypical keratinocytes with hyperchromatic nuclei, and severe dermal pleomorphism. After evaluation for distant metastasis, including a (99m) Tc-MDP bone scan, 18F-FDG positron emission tomography scan, computed tomography, and ultrasound, no metastasis was detected.
Amputation ; Biopsy ; Burns ; Carcinoma, Squamous Cell* ; Cicatrix ; Dermatology ; Drinking ; Fluorodeoxyglucose F18 ; Frostbite ; Humans ; Keratinocytes ; Male ; Middle Aged ; Necrosis ; Neoplasm Metastasis ; Osteolysis ; Osteomyelitis* ; Positron-Emission Tomography ; Pressure Ulcer ; Skin ; Smoke ; Smoking ; Toes ; Ultrasonography ; Varicose Ulcer ; Walking ; Wounds and Injuries

Multiple trichoepithelioma is a benign adnexal neoplasm characterized by the presence of many small papules that appear predominantly on the face. Clinical improvement have been demonstrated after several treatments such as carbon dioxide laser, cryotherapy, dermabrasion, and argon laser. However, these destructive methods have various disadvantages. We report a case of multiple trichoepithelioma treated with an intralesional bleomycin injection. Fewer lesions without scars and cosmetic improvements were observed. Bleomycin is a cytotoxic antitumor antibiotic that can be injected intralesionally by transcutaneous administration and displays excellent results for treating malignancies including skin tumors. We believe that intralesional bleomycin injection is an effective treatment option for this condition, and an easy method to conduct at the outpatient clinic.
Administration, Cutaneous ; Ambulatory Care Facilities ; Argon ; Bleomycin ; Cicatrix ; Cosmetics ; Cryotherapy ; Dermabrasion ; Lasers, Gas ; Skin

BACKGROUND: Incontinence and muscle loss are important senior health issues. Nevertheless, there are no available domestic or international studies on the association between urinary incontinence and muscle loss. The aim of this study was to investigate the association between muscle loss and urinary incontinence in elderly Korean woman. METHODS: Korean women (1,313) > or =65 years of age whose complete body composition data were collected using dual X-ray absorptiometry were analyzed from the Fourth Korean National Health and Nutritional Examination Surveys. Class I and II losses of the appendicular, truncal, and total muscle mass were defined using adjustments for weight and height. Each participant's incontinence status was collected using constructed questionnaires. Multiple logistic regression was performed to examine the association between muscle loss and incontinence. RESULTS: On the basis of physician-diagnosed incontinence, weight- and height-adjusted muscle loss showed no association with urinary incontinence (weight-adjusted muscle loss: class I adjusted odds ratio [aOR], 0.77; 95% confidence interval [CI], 0.34 to 1.73; class II aOR, 1.37; 95% CI, 0.59 to 3.18; height-adjusted muscle loss: class I aOR, 0.51; 95% CI, 0.18 to 1.51; class II aOR, 1.86; 95% CI, 0.22 to 15.79). Similar results were observed for truncal muscle and total muscle mass as well as self-reported urinary incontinence. CONCLUSION: Our study found no association between urinary incontinence and appendicular, truncal, and total muscle loss in elderly Korean women.
Absorptiometry, Photon ; Aged* ; Body Composition ; Female ; Humans ; Logistic Models ; Muscle, Skeletal ; Muscular Atrophy ; Odds Ratio ; Surveys and Questionnaires ; Urinary Incontinence*

Dermatomyositis is a systemic inflammatory disease affecting the skin, skeletal muscle, and occasionally, other organs, such as the lung. Interstitial lung disease (ILD) is a serious lung complication, which can occur in patients with dermatomyositis. It affects the prognosis of the disease and requires a more aggressive therapeutic approach. Interstitial lung disease (ILD) may be associated with systemic inflammatory disorders and autoantibody production. In particular, anti Jo-1 antibody has long been recognized as an important predictive factor in systemic manifestations of ILD in dermatomyositis. We report here a case of a 42 year old woman with cutaneous lesions typical of dermatomyositis, showing clinical features of antisynthetase syndrome, which showed rapid progression to acute respiratory distress syndrome.
Antibodies, Antinuclear ; Dermatomyositis ; Female ; Humans ; Lung ; Lung Diseases, Interstitial ; Muscle, Skeletal ; Myositis ; Prognosis ; Respiratory Distress Syndrome, Adult ; Skin

PURPOSE: This study was aimed to evaluate the clinical features of hypoxic ischemic encephalopathy(HIE) in children with and without seizures. METHODS: Fifty five children who had been diagnosed as HIE at Inha University Hospital from June 1999 to December 2011 were enrolled in this study. Subjects were divided into two groups by the presence of seizures and their medical records were retrospectively analyzed. RESULTS: Among the 55 cases, 34 patients (61.8%) had seizures, while 17 patients (32.2%) did not have them. Male to female ratio was 1:1 for the 'seizure' group and 2.5:1 for the 'no seizure' group. The onset age was 9.7 months (range: 0-158 months) for the 'seizure' group and 10 months (range : 0-108 months) for the 'no seizure' group. The most common risk factor was birth asphyxia (17.7%) for the 'seizure' group, and prematurity (23.8%) for the 'no seizure' group. The most common symptom other than seizure was respiratory arrest for both groups. On radiologic imaging studies of the brain, main causative lesion was most commonly observed in the cerebral cortex in both groups. The neurologic deficits or death were detected in 67.7% of the 'seizure' group, and 76.3% of the 'no seizure' group. There were no statistically significant differences in risk factors between the two groups. CONCLUSION: Although the characteristics between patients with and without seizures from HIE revealed no significant differences, HIE still can result in death or permanent disability in children. Therefore, permanent brain damage may be minimized by early suspicion and treatment in these patients.
Age of Onset ; Asphyxia ; Brain ; Cerebral Cortex ; Child* ; Female ; Humans ; Hypoxia-Ischemia, Brain* ; Male ; Medical Records ; Neurologic Manifestations ; Parturition ; Retrospective Studies ; Risk Factors ; Seizures*

PURPOSE: The early detection of breast cancer by screening mammography is important to reduce breast cancer mortality rate. The purpose of this study was to investigate the characteristics of breast cancer patients detected by screening mammography. MATERIALS AND METHODS: Surgically treated 1,265 patients at Asan Medical Center from Jul. 1989 to Dec. 1997 were evaluated. Among them, 119 patients (9.4%) were detected by screening mammography. These patients were compared with clinically detected symptomatic breast cancer group. RESULTS: The characteristics of breast cancer patients detected by screening mammography were as follows: The most common finding of mammography was microcalcifications (62.2%); The less invasive or more conservative minimal and non-destructive surgical treatments such as breast conserving surgery (21.0%), simple mastectomy (8.4%), breast reconstruction (8.4%) were performed more frequently; The median tumor size of invasive cancers was 16 mm; Node-negative cancers (83.2%) were more frequent; The early breast cancer of stage 0 and I was 70.6%; DCIS (29.4%) was highly proportionated; and The 5-year overall (95.8%) and 5-year disease-free survival rate (92.0%) were significantly higher than in clinically detected symptomatic breast cancer patients. CONCLUSION: The screening mammography was significant for detecting non-palpable, early stage breast cancer. Ultrasonography was needed as an adjunct for the accurate detection in dense breast or young women. According to early detection, the 5-year survival rate was high.
Breast Neoplasms* ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Chungcheongnam-do ; Disease-Free Survival ; Female ; Humans ; Mammaplasty ; Mammography* ; Mass Screening* ; Mastectomy, Segmental ; Mastectomy, Simple ; Mortality ; Survival Rate ; Ultrasonography

OBJECTIVES: The usage of fluoride varnish for a moderate to low caries-risk group has not been well validated. This study aimed to evaluate the preventive and therapeutic efficacies of fluoride varnish on the initiated root caries. MATERIALS AND METHODS: Ten premolars were sectioned into quarters, further divided into two windows, one of which was painted with Fluor Protector (1,000 ppm fluoride, Ivoclar Vivadent). An initial lesion with a well-preserved surface layer was produced by pH cycling. Scanned line analysis using energy dispersive spectrometry determined the weight percentages of Ca and P in the demineralized layer. Scanning Electron microscopy and confocal laser scanning microscopy (CLSM) evaluated the varnish-applied root surfaces. RESULTS: The mean lesion depth (SD) was 12.3 (2.6) microm (single cycling) and 19.6 (3.8) microm (double cycling). Double cycling extended the lesion depth, but induced no more mineral loss than single cycling (p < 0.05). The mean weight percentages of Ca and P between groups with and without varnish were not significantly different (p < 0.05). A CLSM showed varnish remained within 15 microm of the surface layer. CONCLUSIONS: When a mild acid challenge initiated root tissue demineralization, the application of low-concentration fluoride varnish did not influence the lesion depth or the mineral composition of the subsurface lesion.
Bicuspid ; Drug Combinations ; Fluorides ; Fluorides, Topical ; Hydrogen-Ion Concentration ; Microscopy, Confocal ; Microscopy, Electron, Scanning ; Paint ; Polyurethanes ; Root Caries ; Silanes ; Spectrum Analysis ; Waxes