No Abstract Available.
Sezary Syndrome*

We observed a 25-year-old male patient who had developed juvenile rheumatoid arthritis(RA) associated with alopecia areata at 14 years of age. When he received treatment for RA, his symptoms of RA and hair loss improved at approximately the same time. One year later, as the symptoms of RA aggravated, the hair loss had progressed eventually to alopecia universalis(AU). Thus we suggest that RA and AU may be associated with a common immunologic factor in etiology of the two diseases.
Adult ; Alopecia Areata ; Alopecia* ; Arthritis, Juvenile* ; Hair ; Humans ; Male

BACKGROUND: Intrathecal (IT) neostigmine produces analgesia in animal and human. This study was designed to evaluate the efficacy and safety of IT neostigmine for post-cesarean section analgesia. METHODS: Forty-five women undergoing cesarean section under spinal anesthesia were randomly assigned into 3 groups to receive; normal saline 0.2 ml, or neostigmine 12.5 microgram, or neostigmine 25 microgram intrathecally with 0.5% hyperbaric bupivacaine 12 mg. Degrees of sensory and motor blocks, maternal hemodynamic changes, and side effects were recorded. Apgar scores and umbilical vein blood gas analysis (UVBGA) were checked for evaluation of fetal status. Postoperative analgesia was provided by intravenous patient-controlled analgesia (PCA) using fentanyl 500 microgram and ketorolac 150 mg in 100 ml. Pain scores with 10-cm visual analogue scale (VAS), time to first PCA use, cumulative PCA consumptions, and side effects were assessed at 1, 2, 4, 8, 12, 24, and 48 hr after IT injection. RESULTS: There were no significant differences among the three groups in characteristics of spinal anesthesia, maternal blood pressure and heart rate, Apgar scores, and UVBGA data. Compared to saline group, IT neostigmine significantly prolonged time to first PCA use and decreased 24 hr- and 48 hr-PCA consumptions (P<0.05). Pain scores in neostigmine groups were significantly lower than those in saline group for first 4 hr after which there were no differences among the three groups. There were significantly higher incidences of nausea and vomiting in neostigmine groups than in saline group. CONCLUSIONS: These data indicate that IT neostigmine can be an alternative postoperative analgesic without adverse fetal effects for cesarean section. However, high incidence of nausea and vomiting seem to limit its clinical usefulness. Further studies are necessary to enhance its analgesic effects and to decrease its adverse effects.
Analgesia* ; Analgesia, Patient-Controlled ; Anesthesia, Spinal ; Animals ; Blood Gas Analysis ; Blood Pressure ; Bupivacaine ; Cesarean Section ; Female ; Fentanyl ; Heart Rate ; Hemodynamics ; Humans ; Incidence ; Ketorolac ; Nausea ; Neostigmine* ; Passive Cutaneous Anaphylaxis ; Pregnancy ; Umbilical Veins ; Vomiting

BACKGROUND: The control of multidrug-resistant microorganisms (MDROs) is important in preventing healthcare-associated infections. We performed a survey to evaluate the current system for control of MDROs in general hospitals in Korea. METHODS: A questionnaire consisted of queries about infection control systems, personnel, antibiotic use monitoring systems, isolation and barrier precautions, and obstacles to and opinions about MDROs. The questionnaire was mailed to 145 hospitals with more than 300 beds in November 2005. RESULTS: One hundred and two of the 145 (70.3%) hospitals responded; 65.3% of the responded hospitals had antibiotics control programs and 96.0% of those had control programs for MDROs. Surveillance cultures for vancomycin-resistant enterococcus (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) were taken in 21.6% and 16.7% of the hospitals, respectively. Over 90% of the hospitals had guidelines with respect to wearing gloves, collecting infectious wastes, and cleaning the environment for MRSA and VRE, but less than a half of the hospitals had the same standard for extended-spectrum beta-lactamase-producing gram-negative bacteria and carbapenem-resistant gram-negative bacteria. Most hospitals recommended gowning when contamination or invasive procedures were anticipated, but for VRE patients, gowns were used more strictly whenever there was contact with MDROs. Major obstacles related to isolation of patients infected or colonized with MDROs were the cost for isolation rooms (37.3%), and proposed solutions were reimbursement from the medical insurance company (86.3%), construction of a nationwide management system (61.8%), and effort by individual hospitals (58.8%) for MDROs infection control. CONCLUSION: Most of the hospitals have adopted control programs, but more needs to be done. Further efforts, including periodic reporting of antibiotic resistance, sufficient cost reimbursement, and providing education and increased awareness are urgently needed.
Anti-Bacterial Agents ; Colon ; Drug Resistance, Microbial ; Education ; Enterococcus ; Gram-Negative Bacteria ; Hospitals, General* ; Humans ; Infection Control* ; Insurance ; Korea* ; Methicillin-Resistant Staphylococcus aureus ; Postal Service ; Surveys and Questionnaires

PURPOSE: Recently, there has been several studies to clarify the pathogenesis of Kawasaki disease (KD) and the relations of VEGF and endostatin that act on vascular endothelial cells to the coronary artery complications. In this report, we measured serum levels of VEGF and endostatin in acute and subacute phases of KD to assess the change of these levels and the relations to the development of coronary artery lesions (CAL). METHODS: Twenty six patients were diagnosed and treated for KD between January, 2001 and July, 2005 at Kangnam St. Mary's Hospital, the Catholic University of Korea. They were divided into those with and without CAL. Serum levels of VEGF and endostatin were measured during acute and subacute phases and compared to those measured in healthy and disease control groups. RESULTS: Serum levels of VEGF were increased in KD but no differences were noted in KD with and without CAL. Serum levels of endostatin were decreased in the acute phase of KD, however they were recovered in the subacute phase of KD, regardless of CAL. The VEGF/endostatin ratio was increased in KD. KD without CAL showed a relative decrease in this ratio during the subacute phase. Significant positive correlations were found between serum VEGF and WBC count, VEGF and ESR, VEGF/endostatin ratio and ESR in the acute phase of KD. CONCLUSION: Analysis of factors influencing the vascular endothelium such as VEGF and endostatin will help to clarify the etiology of KD and the pathogenesis of CAL.
Coronary Vessels* ; Endostatins* ; Endothelial Cells ; Endothelium, Vascular ; Humans ; Korea ; Mucocutaneous Lymph Node Syndrome* ; Vascular Endothelial Growth Factor A*

OBJECTIVE: The aim of this study was to compare the success rates of the manual and motor-driven mini-screw insertion methods according to age, gender, length of mini-screws, and insertion sites. METHODS: We retrospectively reviewed 429 orthodontic mini-screw placements in 286 patients (102 in men and 327 in women) between 2005 and 2010 at private practice. Age, gender, mini-screw length, and insertion site were cross-tabulated against the insertion methods. The Cochran-Mantel-Haenszel test was performed to compare the success rates of the 2 insertion methods. RESULTS: The motor-driven method was used for 228 mini-screws and the manual method for the remaining 201 mini-screws. The success rates were similar in both men and women irrespective of the insertion method used. With respect to mini-screw length, no difference in success rates was found between motor and hand drivers for the 6-mm-long mini-screws (68.1% and 69.5% with the engine driver and hand driver, respectively). However, the 8-mm-long mini-screws exhibited significantly higher success rates (90.4%, p < 0.01) than did the 6-mm-long mini-screws when placed with the engine driver. The overall success rate was also significantly higher in the maxilla (p < 0.05) when the engine driver was used. Success rates were similar among all age groups regardless of the insertion method used. CONCLUSIONS: Taken together, the motor-driven insertion method can be helpful to get a higher success rate of orthodontic mini-screw placement.
Female ; Hand ; Humans ; Male ; Maxilla ; Private Practice ; Retrospective Studies

The authors analyzed a total of 49 cases of general anesthesia for the removal of tracheo bronchial foreign bodies, from Jan. 1970 to Aug. 1980. The results were as follows; 1) Sex distribution was 36 males(73.5%) and 13 females(26.5%). 2) Age distribution was 14 cases under 1 year and also 14 of 1-3 year olds(total 57. 2%). 3) Anesthetic agents were halothane, 32 cases(65.3%), diethyl ether, 9 cases(18.4%) and others. 4) The kinds of foreign bodies were peanuts in 24 cases(49.0%) and the others were various. 5) The sites of foreign bodies were Rt. main bronchus 29 cases(59. 2%), Lt. main bronchus in 12 cases of(24.5%), trachea 7 cases(14.3%) and vocal-cord 1 case(2.0%). 6) Anesthetic duration was within 1 hour, 41 cases(83. 7%). 7) Complications during operation were tachycardia in 36 cases. 8) Postoperative pulmonary complications were pneumonia, 4 cases and 1 case each of pyothorax, atelectasis and death.
Age Distribution ; Anesthesia, General ; Anesthetics ; Arachis ; Bronchi ; Empyema, Pleural ; Ether ; Foreign Bodies* ; Halothane ; Pneumonia ; Pulmonary Atelectasis ; Sex Distribution ; Tachycardia ; Trachea

Klippel-Feil syndrome (KFS) displays congenital fusion of the cervical vertebrae; it is a relatively common condition and has many associated malformations such as Sprengel's deformity, scoliosis, rib anomalies, congenital defects of the brain or spinal cord, renal anomalies, congenital heart disease, deafness, cleft palate, cranial and facial asymmetry, and enteric cysts. There are various types of cervical fusion observed in KFS. However, fusion of the odontoid process with the atlas is a very rare finding. We report here on a 4-year-old boy with unilateral fusion of a separated odontoid process with the lateral mass of the atlas, and this was associated with a spontaneously closed ventricular septal defect, a small patent ductus arteriosus and a horseshoe kidney.
Brain ; Cervical Vertebrae ; Child, Preschool ; Cleft Palate ; Congenital Abnormalities ; Deafness ; Ductus Arteriosus, Patent ; Facial Asymmetry ; Female ; Heart Defects, Congenital ; Heart Septal Defects, Ventricular ; Humans ; Kidney ; Klippel-Feil Syndrome* ; Male ; Odontoid Process* ; Ribs ; Scoliosis ; Spinal Cord

Dermatomyositis is a inflammatory myopathy associated with interstitial lung disease in 5~10% of cases. The occurrence of diffuse alveolar hemorrhage (DAH) is considered exceptional in the course of dermatomyositis. We experienced a case of DAH in a 58-year-old female with dermatomyositis. DAH was diagnosed by anemia, infiltration on chest X-ray and computed tomography, and a bloody aspirate on bronchoscopy. Combined Pneumocystis jiroveci (PJP) pneumonia was suspected, as the polymerase chain reaction for PJP was positive. After intravenous the administration of immunoglobulin and treatment for the PJP, she markedly improved but subsequently developed nosocomial pneumonia and died.
Anemia ; Bronchoscopy ; Dermatomyositis ; Female ; Hemorrhage ; Humans ; Immunoglobulins ; Lung Diseases, Interstitial ; Middle Aged ; Myositis ; Pneumocystis jirovecii ; Pneumonia ; Polymerase Chain Reaction ; Thorax

PURPOSE: This study was designed to examine the effect of aroma massage therapy on lower extremity edema of terminal cancer patients. METHODS: A total of thirty-six terminal cancer patients with lower extremity edema were divided into two groups: the aroma massage group received massage with blending oil which was applied from toes to 10 cm above the knee of the subject for 15 to 20 minutes in each turn, while the control group received sham aroma massage (applied with carrier oil only). The circumferences of the fore-foot, ankle and calf were measured before massage and 30 minutes, 2 hours, and 12 hours after massage. The blood pressure, pulse and body temperature were also measured to find the change of subject's physiologic conditions. RESULTS: There were no significant differences in blood pressure, heart rate, body temperature and lower extremity circumferences between two groups. However, edema at each site was slightly improved in the treatment group after the aroma massage therapy, compared to baseline data (P<0.05). In addition, the reduction of lower extremity circumference was maximal at 2 hours in foot, 30 min in right ankle and 12 hours in right calf after aroma massage therapy (P<0.05). CONCLUSION: Our results suggest that aroma massage therapy is not effective on the lower extremity edema of terminal cancer patients.
Animals ; Ankle ; Aromatherapy ; Blood Pressure ; Body Temperature ; Edema ; Foot ; Heart Rate ; Hospices ; Humans ; Knee ; Lower Extremity ; Massage ; Salicylamides ; Toes